Pure tone tests and beyond in audiological evaluations of middle ear pathologies-Points to consider in audiological evaluations for middle ear pathologies

Background: Unilateral Hearing loss in children has been widely underestimated in the past, but is currently matter of attention as its diagnosis is made earlier due to universal newborn hearing screening and to stricter follow-up of children at risk. A significant challenge in this area is the reduction in auditory attention, which contributes not only to difficulties in cognitive and linguistic development but also to a diminished quality of life. Children with unilateral hearing loss (UHL) often face challenges in selective auditory attention, especially in environments with multiple speakers, compared to their peers with normal hearing.

Management options for UHL in children include traditional hearing aids (HA), bone-conduction devices, contralateral routing of signal (CROS) systems, and Remote Microphone Hearing Assistance Technology (RMHAT) systems. However, there is currently no consensus regarding which levels of UHL necessitate amplification. Additionally, studies provide conflicting evidence on the benefits of restoring normal signal perception through hearing aids in children with UHL.

This prospective study aims to evaluate auditory attention and hearing quality in children with UHL by comparing outcomes between a group using hearing aids and those not using any amplification devices.

Description: Twenty-four children, including 12 hearing aids users and 12 without any hearing rehabilitation, underwent audiological evaluation including speech audiometry in both quiet and noise, auditory attention tests, and the parent-reported version of the Speech, Spatial, and Quality of Hearing Questionnaire.

Conclusions: We assessed that children with unilateral hearing impairment exhibit significant challenges in auditory attention, which may result in substantial difficulties in real-world communication, especially in comprehending speech. In contrast, peers who have used hearing aids for at least one year demonstrate notable improvements, as the restoration of binaural hearing enhances their performance in auditory attention tests and parent-reported outcomes on the SSQ questionnaire.

Tinnitus is a common issue, especially among older adults, and affects many people in Japan. In 2019, Japan released its first guidelines to support better care, focusing on counseling, sound therapy, medication, and psychological support. Most treatment is provided by ENT doctors, with care tailored to each person. This proposal will introduce how tinnitus is managed in Japan and how a combination of medical and supportive approaches helps improve quality of life.