Hearing loss, coupled with the configurations of hearing devices, adds to the complexity of understanding the subjective and personal implications of losing musical fidelity. Hearing music through assistive listening devices significantly impacts music perception and enjoyment, yet research examining music-related quality of life for late-deafened adults is limited. This study aimed to capture late-deafened adults' experiences related to music and quality of life. The study administered a cross-sectional survey designed around three established questionnaires: Cochlear Implant Quality of Life, Goldsmiths Musical Sophistication Index, and Music Related Quality of Life. It was completed by 116 late-deafened adults (mean age 65.4 years, with an average of 23.1 years of hearing loss). It was hypothesised that the use of different hearing devices would impact music importance, engagement, enjoyment, and related quality of life in disparate ways. To determine if and how quality of life differed between hearing device users, statistical analyses were stratified across a subgroup of 75 participants with bilateral hearing aids (n = 33; musicians n = 18, and non-musicians n = 15), bilateral cochlear implants (n = 21; musicians n = 5, and non-musicians n = 16), and bimodal configurations (n = 21) musicians n = 8, and non-musicians n = 13). Music remained important for most participants (n = 55, 73%) despite hearing loss. However, regardless of music being valued, only 36 (48%) participants enjoyed music "Always" or "Most of the Time", while 17 (23%) "Rarely" or "Never" enjoyed it. Bilateral hearing aid users reported the highest, and bilateral cochlear implant users the lowest quality-of-life scores. These effects extended to participation in real-world musical activities: hearing aid users attended more live music events, while bilateral cochlear implant users experienced the greatest reduction in musical activities compared to other hearing device users. Musical quality of life is fundamentally about music enjoyment and engagement and how late-deafened adults integrate music into their everyday life. Hearing loss and hearing devices create a profound disconnect between the capacity to enjoy and engage with music. Musicianship did not guarantee better musical enjoyment or engagement. However, musicians demonstrated greater perseverance when enjoyment was limited, in the hope of improvement. Understanding this allows clinicians to develop effective rehabilitation strategies tailored to different hearing devices and musicianship abilities and set realistic expectations.

Purpose: Hearing loss (HL) is a prevalent condition significantly impairing quality of life, with genetic mutations accounting for a substantial proportion of congenital cases, notably those involving the GJB2 gene encoding connexin 26. This study aims to analyze the current knowledge, feasibility, and challenges of gene therapy targeting GJB2-related HL, emphasizing both embryonic and postnatal interventions. Methods: A comprehensive scoping review was conducted across electronic databases up to October 2025, including studies focusing on GJB2-associated HL, gene therapy approaches, and the timing of interventions. Data extraction encompassed mutation types, animal models, delivery strategies, outcomes, and ethical considerations. Results: The results indicated over 467 GJB2 variants which could impair cochlear ion homeostasis and development. Animal models, mainly murine, demonstrated early-onset degeneration with limited recovery following delayed gene therapy, while early postnatal intervention showed greater efficacy. Viral vectors like AAV have been employed for targeted gene delivery via cochlear injections, achieving partial restoration of connexin expression and cochlear function, yet they have faced limitations including transduction efficiency, immune responses, and long-term stability. Challenges in translating these findings to humans have been compounded by anatomical, immunological, ethical, and safety issues, particularly regarding embryonic gene therapy and germline modifications. Ethical frameworks can vary internationally, highlighting the necessity for careful regulation. Conclusions: While promising advances in gene therapy for GJB2-related HL have been achieved in preclinical studies, significant scientific, technical, and ethical barriers must be addressed before clinical application, especially during embryogenesis. A multidisciplinary, cautious approach is essential to realize the potential of gene therapy in restoring natural hearing while safeguarding individual and societal interests.

Background: Bone vibrator (BV) stimulation applied to skin sites on the body elicits hearing by soft tissue conduction (STC). However, BV stimulation to sites far from the ear requires the delivery of higher-intensity stimulus vibrations to achieve threshold, which can then induce hearing by air conduction (AC) contamination. This problem limits the study of STC thresholds at sites more distant from the ear. Objective: To overcome this problem, we evaluated the possibility of delivering STC vibratory stimuli to body sites in a water bath, based on the different acoustic impedances between air and water, which produces a 30 dB reduction in transmission from water to air. Methods: A standard clinical BV delivered vibration stimuli (tonal and speech stimuli) applied directly to two body sites: finger and foot. BV and body sites were immersed in a water bath. One control involved both stimulation site and BV both in water, but not in contact. In an additional control, the BV was in the bath, while the stimulation site was out of the bath. Results: STC hearing of both pure tones and speech could be elicited at stimulus intensities below those induced by control stimulation (body site and BV both in water, but not in contact; BV in bath, stimulation site out of bath). STC thresholds at the finger site were lower than those at the foot. Conclusions: The current results suggest that water-immersion method enables study of STC hearing in response to higher-intensity vibrational stimuli, and at body sites more distant from the ear, without contamination by AC hearing.

Objectives: This study aimed to determine whether adults with tinnitus exhibit altered phase-specific mandibular kinematics during saliva swallowing and increased prevalence of tongue thrust and Eustachian-tube insufficiency versus tinnitus-free controls. Methods: This was a cross-sectional case–control study including adults with tinnitus and controls. Standardized computerized kinesiography recorded three spontaneous saliva swallows per participant. Primary outcomes were opening/closing time (OCT) and post-closure stabilization time (STT); total swallowing time (SWT) was secondary. Tongue thrust (TT) and tubal insufficiency (TI) were assessed clinically. Distributional assumptions were checked with Shapiro–Wilk; between-group comparisons used two-sided Mann–Whitney U tests and Fisher’s exact tests (TT, TI). Effect sizes included rank-biserial correlation (r), Hodges–Lehmann median difference (Δ), and odds ratios (ORs) with 95% confidence intervals. Co-occurrence of TT and TI and their relationships with OCT, STT, and SWT were evaluated within strata (cases vs. controls) using Fisher’s exact test, φ, Mann–Whitney U tests, and Spearman’s ρ. Given the marked imbalance in age and sex between groups, unadjusted non-parametric comparisons were complemented by multivariable models with adjustment for age and sex. An omnibus non-parametric combination test summarized case–control differences across OCT, STT, and SWT. Results: Statistical analysis was performed on 77 cases with tinnitus and 78 controls. Tinnitus cases showed longer OCT (1.75 ± 0.92 vs. 1.12 ± 0.62 s; p < 0.001; r ≈ 0.40; Δ ≈ +0.60 s) and STT (1.44 ± 0.88 vs. 0.84 ± 0.62 s; p < 0.001; r ≈ 0.42; Δ ≈ +0.60 s), while SWT differed modestly and was not significant (2.75 ± 0.69 vs. 2.57 ± 0.65 s; p = 0.115; r ≈ 0.15; Δ ≈ +0.18 s). TT was more frequent in cases (18.2%) than controls (6.4%; OR = 3.05, 95% CI 1.08–8.61; p = 0.029), whereas TI occurred in 16.9% of cases and 0% of controls (corrected OR = 32.85, 95% CI 1.92–563.49; p < 0.001). Within tinnitus cases, TT and TI did not show meaningful co-occurrence (φ ≈ −0.03; p = 1.00). TT+ tinnitus patients exhibited markedly prolonged OCT compared with TT− (median 2.22 vs. 1.45 s; Δ ≈ +0.88 s; r ≈ 0.60; p < 0.001), whereas STT and SWT were minimally affected; TI was not materially associated with any swallowing-time parameter. Spearman analyses confirmed a moderate monotonic association between TT and OCT in tinnitus cases (ρ ≈ 0.40; p < 0.001), with all other correlations small and clinically negligible. Age- and sex-adjusted analyses confirmed longer OCT and STT in tinnitus cases, whereas SWT remained non-significant; TT and TI also remained more frequent in cases after adjustment. The omnibus test indicated a clear global separation between groups across OCT, STT, and SWT (permutation p < 0.001). Conclusions: Adults with tinnitus exhibit a distinct swallowing signature characterized by prolonged OCT and STT, together with higher prevalence of TT and TI. TT in tinnitus patients is specifically linked to a pronounced prolongation of OCT, while STT and SWT remain largely unchanged, and TI shows no relevant impact on kinematic indices.

Objectives: To analyze speech perception outcomes of a cohort of experienced adult cochlear implant (CI) users to explore whether there is a correlation with electrical dynamic range (EDR) parameters, and to describe speech intelligibility curve morphology according to the degree of CI performance. Methods: A bicentric retrospective observational study. Data were extracted from a cochlear implantation database from a total of 36 CI users implanted with Advanced Bionics devices. Results: Mean age at implantation was 56.61 years. In the majority of cases, hearing loss onset was more than 15 years before implantation (80.55%), and only 11.11% of cases preserved residual hearing. This resulted in a significant relationship between speech therapy and better speech recognition (p = 0.044). At the same time, no correlation was found between age, duration of deafness before implantation, and maximum speech perception achieved (p > 0.05). Mean speech audiometry curves displayed a roll-over phenomenon in poor performers and a plateau effect in average performers. In contrast, the mean curve of high performers exhibited a steeper morphology (p < 0.0001). Speech recognition threshold (SRT) and word recognition score (WRS) were predictors of speech audiogram curves (p = 0.006). No direct correlation was found between the mean T-level, M-level, dynamic range, and maximum recognition score, even after clustering electrodes by position along the cochlea (p > 0.05). Conclusions: EDR parameters did not emerge as independent predictors of speech recognition outcomes within this specific cohort. Speech therapy and rehabilitative efforts showed a significant relationship with improved performance, and speech audiogram curve morphology may offer a more specific clinical tool for assessing global CI performance. Further prospective studies with larger, more homogenous populations are required to validate these findings.

Background/Objectives: The present study examined the effect of age on sentence recognition in noise in different noise conditions among adults with normal hearing sensitivity throughout the adult lifespan. Methods: A total of 113 adults aged between 21 and 65 years participated in the study; based on age, they were categorized into five groups. The sentence recognition was assessed in five noise conditions: speech-shaped noise (SSN), amplitude-modulated speech-shaped noise (AM-SSN), two-male-talker babble (2MB), four-male-talker babble (4MB), and four-female-talker babble (4FB). The sentences were presented at a signal-to-noise ratio of -5 dB in all noise conditions. Results: The sentence recognition scores declined with increasing age in all noise conditions. In addition, age had a differential effect on the sentence recognition scores in the AM-SSN and 2MB conditions compared with the SSN, 4MB, and 4FB conditions. In the AM-SSN and 2MB conditions, the scores were significantly different in the fourth decade compared with young adults. In other noises, the scores were significantly different after 30 years compared with younger adults. Further, across noise conditions, greater scores were obtained in the AM-SSN and 2MB conditions, and the lowest scores were obtained in the 4FB condition. Partial Spearman correlations revealed a moderate-to-strong negative correlation between age and sentence recognition scores across noise conditions. Conclusions: The findings of the present study showed that sentence recognition is negatively affected by age. In addition, age has a differential effect on sentence recognition in different noises.

Background/Objectives: Speech understanding in noise relies on both temporal fine structure (TFS) and temporal envelope (ENV) cues. While TFS primarily conveys interaural time differences (ITDs) at low frequencies, ENV cues can also support ITD processing, especially when TFS is unavailable or degraded. Expanding the ENV by increasing modulation depth has been proposed to improve speech perception, but its effects on spatial release from masking (SRM) and binaural temporal processing in normal-hearing listeners remain unclear. The goal of this study was to evaluate the effect of ENV enhancement on SRM in young adults with normal hearing and its influence on ITD sensitivity and interaural coherence (IC). Method: Thirty normal-hearing native Kannada speakers (19-34 years) participated. Speech stimuli consisted of Kannada sentences embedded in four-talker babble at -5, 0, and +5 dB signal to noise ratio (SNR). Target and masker were spatialized using head-related transfer functions at 0°, 15°, and 37.5° azimuths. Stimuli were presented with and without ENV enhancement (compression-expansion algorithm). Speech recognition scores were analyzed using generalized linear mixed models, and SRM was calculated as performance differences between co-located and spatially separated conditions. Cross-correlation analyses were performed to estimate ITDs and IC across SNRs. Result: ENV enhancement yielded significantly higher SRM values across all SNRs and spatial separations. Benefits were greatest at lower SNRs and wider target-masker separations. Cross-correlation analysis showed enhanced IC and more reliable ITD estimates under the expanded condition, particularly at moderate SNRs. Conclusions: Temporal ENV enhancement strengthens spatial unmasking and binaural timing cues in normal-hearing adults, especially under adverse listening conditions. These findings highlight its potential application in auditory rehabilitation and hearing technologies where ENV cues are critical.

Background and objectives: Stapedotomy is the surgical treatment for otosclerosis, with excellent results in terms of hearing recovery. Various laser systems have proven to be an interesting alternative to the conventional technique, allowing for a more precise footplate fenestration with apparently less trauma to the inner ear. The diode laser, more recently introduced, seems to offer more controlled tissue interaction, potentially reducing thermal damage to surrounding structures. However, the literature remains limited. The aim of the present study was to evaluate the functional outcomes and clinical safety of diode laser stapedotomy by comparing the observed results with those previously reported. Materials and methods: A retrospective analysis of 105 patients who underwent diode laser stapedotomy was conducted. The audiological data and the complications were analyzed and compared with a cohort of patients who underwent stapedotomy performed using the conventional technique. Results: In patients who underwent diode laser stapedotomy, the postoperative air-bone gap (ABG) improved significantly at all frequencies. Hearing outcomes were excellent (ABG ≤ 10 dB) in 60.9% of cases, good (ABG ≤ 20 dB) in 89.5%, and poor (ABG > 20 dB) in 10.5% of patients. Intraoperative complications occurred in seven patients (6.7%), including two cases (1.9%) of footplate damage. Postoperatively, 13 cases of vertigo (12.4%), three cases of tinnitus (2.8%), and one case of sensorineural hearing loss (0.9%) were reported. Conclusions: Diode laser stapedotomy is an effective and safe procedure, providing excellent audiological outcomes without increasing the risk of surgical complications. The possibility of thermal damage to the inner ear must be considered, and appropriate laser parameters should be used to minimize these risks.

Background: The vestibular system encodes head motion through specialized Type I and Type II hair cells, which differentially respond to acceleration and its temporal derivative, jerk. Molecular gradients of retinoic acid establish zonal distributions of these hair cells, prefiguring their functional specialization. Objectives & Methods: Here I integrate developmental, synaptic, biomechanical, and neural evidence to propose that Type I hair cells, via multimodal synaptic transmission, are particularly well suited for ultrafast detection of transient inertial deformation (jerk), whereas Type II cells play a greater role in encoding sustained acceleration through viscous-flow mechanisms. Molecular gradients of retinoic acid help establish central-peripheral zonal patterning in the otolith and canal epithelia, which in turn underlies differential mechanical and synaptic specialization rather than a simple redistribution of hair-cell types. Computational and experimental studies reveal that the vestibular organs operate in dual mechanical regimes, enabling the dynamic encoding of motion onset and continuity. In systems terms, these viscous and inertial activation modes correspond to distinct temporal filters, whose different time constants naturally give rise to distinct frequency responses. What has traditionally been described as 'low- vs. high-frequency' tuning therefore emerges as the frequency-domain signature of acceleration- versus jerk-sensitive pathways. Conclusions: This hierarchical organization elucidates the selective activation observed in clinical vestibular tests and informs novel diagnostic and rehabilitative strategies targeting specific receptor pathways. Together, these findings redefine vestibular transduction as a multimodal dynamic sensor, enhancing our understanding of balance and spatial orientation under complex motion conditions.

Adults with severe to profound hearing loss have limited access to cochlear implants (CIs). The objective of this study was to assess the evidence to establish whether the uptake rate of CIs has changed over the past decade. A PubMed search, supplemented with manual searching, identified 15 relevant papers published from 2000 to 4 February 2025 reporting the uptake rate of CIs in adults. In addition, new calculations of uptake rates were made for 2019, based on total numbers of CIs implanted and the prevalence of hearing loss from the 2019 Global Burden of Disease Study. There was a lack of published data on the uptake rates for cochlear implants, with very little consensus in the methods used across studies. The overall uptake rates for adults and children combined, calculated for 2019 using the Lancet Global Burden of Disease Study, showed that uptake is still ≤20% for those with profound to complete hearing loss in most high-income countries. When the global population is considered (including high- to low-income countries), it is merely 2.5%. Despite the cochlear implant awareness activities of recent years, the percentage of profoundly deaf individuals with cochlear implants, even in high-income countries, remains low. Uptake rates are much worse than those for hearing aid use for severe to profound deafness. Better and more accurate data must be gathered on the number of CI recipients to meet the reporting requirements of the World Health Organisation's report on hearing.