It is known that listeners lose the ability to discriminate the direction of motion of a revolving sound (clockwise vs counterclockwise) beyond a critical velocity ["the upper limit (UL)"], likely due to degraded front-back discrimination. Little is known about how this ability is affected by simultaneously present distractor sounds, despite the real-life importance of tracking moving sounds in the presence of distractors. We hypothesized that the presence of a static distractor sound would impair the perception of moving target sounds and reduce the UL and show that this is indeed the case. A distractor on the right was as effective as a distractor at the front in reducing the UL, despite the likely importance of resolving front-back confusions. By manipulating the spectral content of both the target and distractor, we found that the UL was significantly reduced only when the distractor spectrally overlaps with the target in the frequency range relevant for front-back discrimination. Our findings form the first steps toward a better understanding of the tracking of multiple sounds in the presence of distractors.

Calcium pyrophosphate deposition disease (CPPD) is caused by CPP crystals and rarely forms tumors in joints. The authors describe a case of tumoral CPPD in the temporomandibular joint (TMJ), extending into the external auditory canal (EAC) and the middle ear. A 71-year-old man was referred to the department with a tentative diagnosis of CPPD in the right TMJ. Computed tomography showed the mass extending into the EAC, tympanic cavity, and bony Eustachian tube, with opacification of the mastoid cells. The audiogram revealed bilateral mixed hearing loss, suggesting the coexistence of bilateral otosclerosis. Partial resection of the mass and simultaneous implantation of a Baha® on the same side were performed. Histopathological findings revealed indistinct crystals in the surgical specimens. Calcium pyrophosphate crystals were identified using thin-film X-ray diffraction (XRD) analysis. The comorbidity of CPPD and otosclerosis in the same ear is a rare condition. Considering the unpredictable nature of CPPD, the authors opted for partial resection of the lesion involving the EAC and the middle ear to avoid any complications. Due to coexisting otosclerosis, Baha® played an important role in the auditory management of bilateral mixed hearing loss in this patient.

Tinnitus is thought to be suppressed through partial reversal of auditory deafferentation via cochlear implantation (CI). By stimulating the deafferented auditory pathway, multiple studies have revealed that tinnitus is significantly suppressed in 66-92% of patients undergoing CI. This study aimed to evaluate the efficacy of CI as a treatment for tinnitus and to investigate post-CI audiologic outcomes in patients with single-sided deafness (SSD). From November 2018 to July 2020, 10 patients who were diagnosed with SSD and suffering from tinnitus were prospectively recruited at three tertiary referral hospitals. Participants in this study agreed to undergo CI as a treatment for tinnitus. Postoperative aided pure tone audiometry (PTA) and word recognition score (WRS) were measured. Questionnaires related to tinnitus, such as the tinnitus handicap inventory (THI) and visual analogue scale (VAS) scores including loudness, distress, and perception, were administered. Additionally, a tinnitogram was obtained for loudness and pitch matching. Audiological outcomes of CI were analyzed in conjunction with the results of pitch-matching from the tinnitogram. All 10 patients completed device-on evaluations, and 9 patients completed device-off evaluations. THI scores showed statistically significant improvement 3 months after CI in both the device-on and device-off conditions (preoperative: 78; device on: 38, p = 0.027; device off: 50, p = 0.049). VAS scores also demonstrated significant improvement after CI (preoperative: 8.2; device on: 3.3, p = 0.011; device off: 6.5, p = 0.012). Four patients demonstrated changes in psychoacoustic tinnitus features after CI: 2 changed to lower frequency, 1 changed to higher frequency, and 1 patient's tinnitus changed from white noise to a specific identifiable frequency. There was no significant tendency for threshold (T-level and C-level) changes in pitch-matching frequency. In line with previous literature, this exploratory multicenter study demonstrated improvement in tinnitus loudness and distress after CI in patients with single-sided deafness and tinnitus, with a tendency for greater reduction in tinnitus intensity observed when the device was activated. Additionally, approximately half of the patients showed changes in the psychoacoustic characteristics of tinnitus after CI. Given the small sample size and the absence of a non-implanted control group, these findings should be regarded as exploratory and hypothesis-generating, and warrant confirmation in adequately powered controlled trials.

This cross-sectional study aimed to evaluate the effects of occupational noise exposure on objective auditory function and self-reported hearing difficulties in young adult dental professionals. It included 56 young adults (aged 18-40), divided into the noise-exposed (n=31) and unexposed control group (n=25). Auditory assessments consisted of pure-tone audiometry (250-8000 Hz), word recognition in clinical speech-in-noise (SIN) test at 0 dB and -5 dB signal-to-noise ratios, and the self-reported Speech, Spatial and Qualities of Hearing Scale (SSQ). No significant differences were observed between the exposed and control groups in pure-tone thresholds or SIN performance, but the exposed group reported significantly poorer hearing abilities on the SSQ Speech (7.53, 8.30; p=0.043) and SSQ Qualities (8.30, 8.91; p=0.014) subscales. These findings suggest that standard clinical assessments may overlook early functional deficits associated with occupational noise and that self-reported hearing difficulties may complement conventional audiometric assessment before measurable threshold shifts occur.

A conversational speech-in-noise test administered without human supervision is desirable to reduce the need to attend the clinic. This study aimed to create and evaluate a novel question-and-answer-based speech-in-noise test called 'CHAT', where stimuli were synthesised using text-to-speech (TTS), responses captured using automatic speech recognition (ASR), and responses evaluated using a large language model (LLM). Three tests were compared: the newly developed CHAT, the Adaptive Sentence List (ASL) and the Four Alternative Auditory Feature Test (FAAF). CHAT used synthetic speech while ASL and FAAF by default used human-recorded speech. Speech reception thresholds (SRT) of 20 participants with normal hearing and 20 with mild to moderate hearing loss were measured using these three tests. Validity was evaluated using receiver operating characteristic (ROC) analysis and correlations between SRTs and average pure-tone audiometry (PTA), across the three speech tests. Reliability was evaluated by comparing limits-of-agreement between SRTs achieved by repeated runs of CHAT and ASL tests using Bland-Altman analysis. Results revealed limits-of-agreement between repeated runs of CHAT and ASL were ±3.6 dB and ±3.1 dB, respectively. The area under the ROC curve was 0.97 for CHAT, 0.95 for ASL and 0.89 for FAAF. The correlation between SRT and PTA results was 0.86 for CHAT, 0.82 for ASL and 0.79 for FAAF. These findings indicate that CHAT demonstrates reliability and validity comparable to human-recorded ASL and FAAF, supporting the use of synthetic speech for speech-in-noise testing. Overall, the results suggest that AI tools can help create and administer conversational speech-in-noise tests.

Standard hearing tests miss cochlear neural degeneration (CND), the loss of synapses between inner hair cells and auditory nerve fibers that may underlie unexplained hearing difficulty in roughly one in ten adults. Envelope following responses (EFRs) can index this neural loss noninvasively, but conventional protocols are too slow for clinical use. We tested a dynamic amplitude-modulated (dAM) EFR that sweeps the full modulation spectrum in a single brief stimulus. In Mongolian gerbils with histologically verified CND, dAM EFRs revealed selective deficits at fast modulation rates without threshold elevation. A machine-learning classifier distinguished young from middleaged animals with high accuracy; additionally, its most informative feature, power near 400-500 Hz, tracked synapse counts, indicating a readout of cochlear neural health rather than age. Applied without retraining to 56 human listeners, the gerbil-trained classifier separated age groups above chance. dAM EFRs thus offer a rapid, objective and clinically viable marker of CND.

ObjectiveLanguage difficulties are increasingly recognized in children with nonsyndromic cleft lip and palate (NSCLP), yet little is known about their language profile in Turkish-speaking populations. This study aimed to examine multidimensional language performance in Turkish-speaking children with a history of NSCLP.DesignCross-sectional study.SettingAcoustically controlled University-affiliated audiology laboratory.ParticipantsTwenty-three children aged 4-8 years with repaired NSCLP and clinically normal hearing.InterventionLanguage abilities were evaluated using the Test of Turkish School-Age Language Development (TODIL).Main Outcome MeasurePerformance on TODIL subtests and composite language scores was compared with age-based normative data using one-sample t-tests.ResultsChildren with NSCLP performed significantly below normative expectations across all TODIL subtests and composite language measures (all p < .001), with large effect sizes. The pattern of results indicated widespread deficits across receptive, expressive, lexical, syntactic, and phonological domains.ConclusionTurkish-speaking children with NSCLP may exhibit widespread language difficulties despite clinically normal peripheral hearing. These findings support the inclusion of comprehensive language assessment and long-term language monitoring as part of routine clinical follow-up in this population.

Childhood hearing loss poses significant developmental and public health challenges, impacting language acquisition, cognitive development, social participation, and educational outcomes. Universal newborn hearing screening (UNHS) has notably enhanced the early identification of congenital hearing loss, yet limitations persist. Mild, unilateral, delayed-onset, progressive, and certain neural forms of hearing loss may remain undetected during a single neonatal screening session. This review consolidates current evidence regarding the etiologies, risk indicators, and clinical features of pediatric hearing loss in the context of UNHS. Essential areas of focus encompass genetic causes and pharmacogenetic susceptibility, congenital cytomegalovirus infection, intrauterine nutritional and metabolic conditions, environmental and lifestyle exposures, alongside perinatal or neonatal intensive care unit-related risks such as prematurity, hyperbilirubinemia, hypoxia, infection, and exposure to ototoxic medications. These factors exhibit varied clinical implications: some serve as direct causes of hearing loss, while others signify heightened vulnerability to delayed-onset or progressive auditory dysfunction. The evidence highlights a developmental perspective on pediatric hearing loss, indicating that auditory risks may emerge postnatally and cannot be ruled out based solely on normal newborn screening results. Distinguishing between etiology, risk indicators, and clinical phenotype may enhance the identification of children requiring intensified post-screening monitoring. Future research should aim to refine causal evidence, genotype-phenotype correlations, and viable strategies for risk-based follow-up.