Key Takeaways:

1. Biomimicry breakthrough: The new aerogel mimics owl feathers and skin to create a dual-layer structure that absorbs a broad range of sound frequencies.
2. Superior performance: It absorbs 58% of incoming soundwaves and reduces engine noise by nearly 9 decibels—outperforming top existing noise control materials.
3. Durability and potential use: The material is lightweight, resilient through repeated use, and shows promise for real-world applications in automotive and industrial soundproofing.

If you’ve seen an owl fly, you probably didn’t hear a thing. That’s because their skin and feathers dampen sound by absorbing high- and low-frequency flight noise. Inspired by this natural soundproofing, researchers publishing in ACS Applied Materials & Interfaces from the American Chemical Society (ACS) developed a two-layer aerogel that mimics the structures inside owl feathers and skin to mitigate sound pollution. This new material could be used in cars and manufacturing facilities to reduce traffic and industrial noise.

Noise pollution is more than a nuisance; excessive noise can cause hearing loss and can worsen health conditions such as cardiovascular disease and type 2 diabetes. When eliminating the source of noise pollution isn’t feasible, soundproofing materials help dampen it. However, traditional materials absorb either high-frequency sounds, like squealing breaks, or low-frequency sounds, like the deep rumbling from a car engine. This means engineers often layer multiple types of soundproofing materials to achieve full-spectrum noise control, which adds weight and bulk. 

To overcome this, Dingding Zong and colleagues turned to an unlikely acoustic expert: the owl. The owl uses its soft feathers and porous skin to remain whisper-quiet during flight. The researchers’ goal was to engineer a similarly versatile broadband sound absorber.

The researchers froze droplets of hexane into a layer of soft material, using a technique called emulsion-templated freeze-reconstruction. Removing the frozen hexane revealed a honeycomb-like pattern in the material. They added a second layer with silicon nanofibers instead of hexane droplets to create a fibrous pattern. The resulting light, porous two-layer aerogel mimics the structures in owl skin and feathers: The bottom porous layer resembles the bird’s skin with microscopic cavities that cancel out low-frequency noise; and the top feather-inspired layer, made of fluffy nanofibers, dampens high-frequency sounds.

Notably, the researchers found that their owl-inspired aerogels can:

• Absorb 58% of soundwaves that strike it, surpassing the threshold for effective noise control materials.
• Reduce 87.5 decibels of automobile engine noise to a safe level of 78.6 decibels, which is a better reduction than existing high-end noise absorbers.
• Maintain structural integrity through 100 compression cycles, with only 5% deformation.

The researchers believe this study paves the way for high-performance, lightweight and durable sound-absorbing materials that can significantly alleviate noise pollution from industrial equipment and traffic.

The authors acknowledge funding from the Natural Science Foundation of Tianjin and the Open Project Program of the Ministry of Education Key Laboratory for Advanced Textile Composite Materials, Tiangong University.

Note: ACS does not conduct research but publishes and publicizes peer-reviewed scientific studies.

Featured image: A new soundproofing material (fluffy white disk, right image) that mimics the structure of owl skin and feathers reduced the rumble of a car engine more than a traditional felt fiber soundproofing material (fluffy white disk, left image). Credit: Adapted from ACS Applied Materials & Interfaces 2025, DOI: 10.1021/acsami.5c04691

Starkey participated in the 2025 Twin Cities Hearing Loss Association of America (HLAA) Walk4Hearing, joining thousands of advocates across the country working to break down barriers and empower people with hearing loss. With more than 100 employees, friends, and family walking together, the event underscored Starkey’s role in health education and advocacy.

Starkey President and CEO Brandon Sawalich, who also serves as the national Walk4Hearing Co-chair, helped lead the charge on behalf of the company’s ongoing commitment to community engagement through Starkey Cares—an initiative focused on bringing hearing health resources to those who need them most.

“Starkey sets the standard for what it means to lead in hearing health,” says Sawalich. “We are driving change through innovation, advocacy, and education. Starkey Cares’ participation in the Walk4Hearing reflects our commitment to breaking down barriers, building community, and empowering people with hearing loss to reach their full potential.”

As a Hear4Life sponsor, Starkey’s partnership with HLAA supports programs that raise awareness, advocate for accessibility, and bring hope to millions of Americans living with hearing loss. The Walk4Hearing movement takes place in 20 cities nationwide, uniting families, HLAA Chapters, schools, professionals, and partners around a shared goal: to help people thrive.

To learn more about Starkey Cares, visit https://www.starkey.com/starkeycares.

Key Takeaways:

1. Over 70 Oticon team members joined the 5K event in person and virtually to raise funds and awareness for veterans in need.
2. Oticon hosted an educational booth at the event and emphasized its ongoing collaboration with federal agencies to support veterans with hearing loss.
3. The company continues to provide advanced hearing solutions and specialized training to enhance care within the Veterans Health Administration.

Employees from Oticon and Demant once again joined forces with the Oticon Government Services team to participate in Community Hope’s Flag Day 5K Run/Walk in Lyons, NJ, on June 12, 2025. This marks the team’s seventh year supporting the annual event, which raises funds and awareness for military veterans in need.

Team Oticon was represented by over 70 participants at this year’s Flag Day 5K event, both in person at the Lyons VA Medical Center in New Jersey and virtually from across the country.  On site, the team hosted an informational booth featuring educational materials and resources for event participants. 

“Oticon Government Services is honored to continue our partnership with Community Hope in this vital fundraising event that aids veterans and families in overcoming homelessness,” said Sarah Draplin, AuD, CCC-A, F-AAA, senior manager, Training and Education, Oticon Government Services. “Our dedicated team collaborates daily with the U.S. Department of Veterans Affairs, the Department of Defense, and other federal agencies to deliver innovative technology that significantly benefits veterans with hearing loss. The Flag Day celebration is a wonderful opportunity for us to show our gratitude and admiration for the brave men and women who have served our country.”

Oticon is a recognized provider of high-quality hearing solutions to the Veterans Health Administration. Throughout the year, Oticon Government Services offers in-depth learning opportunities and practical training designed to support VA audiologists and technicians in delivering exceptional care and outcomes for their patients.

To watch a video recap of the event, visit oticon.com/solutions/for-veterans#givesback.

By Robert M. DiSogra, AuD

It has been five years since the COVID-19 pandemic started in the United States. Each of us has dealt with the impact of COVID-19 personally and professionally. In 2019, there were many unknowns about the virus’s effect on the many parts of the auditory system: hearing, tinnitus, balance, auditory processing, and cognition. Although it was tempting to make early declarations regarding the impact of COVID-19 on these areas, the aggregated peer-reviewed literature points to a more realistic picture.

Introduction

As of June 17, 2025, the National Library of Medicine (NLM), a division of the National Center for Biotechnology Information (NCBI), part of the National Institutes of Health (NIH), PubMed website had documented 61,991 peer reviewed books, documents, clinical trials, meta-analyses, randomized controlled trials, and reviews (including systematic review) on the topic of COVID-19.

Also, as of June 17, 2025, the NIH’s website identifying ongoing clinical trials (www.clinicaltrials.gov), listed only three ongoing studies using the following parameters: COVID-19, Corona virus, Recruiting studies, Phase (Early Phase, Phases 1, 2, 3), and Interventional studies. These studies were taking place in the USA and India.

The American Academy of Audiology lists 239 articles when you Search “COVID-19.” 

This manuscript will summarize what we, as a profession, have learned about COVID-19 and its impact on the auditory system: hearing, balance, auditory processing, and cognition. Details can be found in the referenced literature.

Main Sources for Current COVID-19 Information (2025)

1. World Health Organization (WHO): (www.who.net)

2. Centers for Disease Control and Prevention (CDC): www.cdc.gov

3. Food and Drug Administration (FDA): www.fda.gov; Search COVID-19

4. Peer-reviewed COVID research from 2019: www.pubmed.ncbi.nlm.nih.gov

COVID-19 Vaccine Information (2025)

U.S. Department of Health and Human Services (HHS): www.hhs.gov

Centers for Disease Control and Prevention: www.vaccines.gov

To report a vaccine adverse reaction: Vaccine Adverse Event Reporting System (VAERS): https://vaers.hhs.gov

COVID-19 Dietary Supplements

There are no over-the-counter (OTC) dietary supplements for COVID-19 approved by the U.S. Food and Drug Administration (FDA). However, if an adverse reaction occurs from any dietary supplement, it should be reported to the FDA’s VAERS program (https://vaers.hhs.gov). NOTE: VAERS is a voluntary reporting program.

COVID-19 

As of 1/23/2025, there were three pharmaceuticals that were FDA approved or authorized drugs to reduce the risk of hospitalization or death for patients with mild to moderate COVID-19: Paxlovid (nirmatrelvir and ritonavir), Veklury (remdesivir), Lagevrio (molnupiravir), and Pemgarda. Lagevrioand Pemgarda have been authorized under Emergency Use Authorization (EUA). Additional information about EUA can be found on the FDA’s website (search Emergency Use Authorization).

Auditory-Related Vaccine Side Effects (2024)

Vaccine adverse effects are published monthly by the National Vaccine Information Center(www.medalerts.org). Table 1 shows the auditory-related adverse events from FDA-approved vaccines and Table 1a lists the top 10 adverse reactions as reported in December 2024.

Table 1: Auditory-Vestibular-Cognitive Related Vaccine Side Effects

n = 2,652,032 (as of 12/27/2024)

Symptom¹                                                   n           Percentage (rounded)       

Auditory Disorder (unspecified)                                   225                           0.0085

Auditory Hallucination (not specified)                         283                           0.0107

Auditory Nerve Disorder                                                 21                           0.0008

Auditory Neuropathy Spectrum Disorder                         1                           0.00004

Brain Fog                                                                    1,071                           0.0404

Central Auditory Processing Disorder                              2                           0.00008           

Cognitive Disorder                                                     2,475                           0.0933

Cognitive Linguistic Impairment                                    10                           1.0194

Sudden Sensorineural HL                                           2,077                           0.0783

Deafness² – total                                                          3,639                           0.1372

Bilateral                                                             346                           0.0130

Conductive                                                           23                           0.0009

Congenital                                                             3                           0.0001

Mixed                                                                     6                           0.0002

Neonatal                                                                2                           0.00008

Neurosensory                                                     681                           0.0258

Permanent                                                           24                           0.0009

Transitory³                                                         114                           0.0043

Traumatic                                                              7                           0.0003

Unilateral                                                       2,433                           0.0917

Dizziness – total                                                      128,201                           4.8341

     Exertional                                                                 189                           0.0071

     Postural                                                                 2,142                           0.0808

     Persistent postural perceptual                                    59                           0.0022

     Procedural                                                                  10                           0.0004

Hearing Disability                                                           39                           0.0015

Otitis Media (includes acute,                                         245                           0.0092

     allergic, bacterial, chronic

     and viral)

Tinnitus⁴                                                                    26,063                          0.9827

Vertigo – total                                                             17,424                          0.6570

     CNS Origin                                                                  15                          0.0005

     Cervicogenic                                                                  1                          0.00004

     Labyrinthine                                                                21                          0.0008

     Phobic postural                                                           17                          0.0006             

     Positional                                                                   810                          0.0305

     Vertigo                                                                  16,560                          0.6242

Vascular Cognitive Impairment                                         2                          0.00008

1. No formal language requirement exists when reporting auditory impairments (including balance, tinnitus and cognitive disorders

2. It appears that the terms “hearing disability, “deafness,” “conductive deafness” are being used interchangeably with sensorineural (neurosensory) or mixed hearing loss. These were the terms used by those reporting to the VAERS

3. Duration not specified

4. Duration, uni-/bilateral, continuous or pulsatile or description not specified

_____________________________________________________________________________

Table 1. The number of auditory-related adverse events from FDA approved vaccines that were voluntarily reported to the Vaccine Adverse Event Reporting System as of 12/27/2024.

Table 1a: Top 10 Vaccine Reactions for December 2024

Reaction                                                         Reports                                                                      

Dizziness                                         126,201

Tinnitus                                             26,063

Vertigo                                              17,424

Deafness                                             3,639

Cognitive Disorder                                2,475

Sensorineural HL                                 2,077

Brain Fog                                            1,071 

Auditory Hallucinations*                         283

Otitis Media                                            245

Auditory Disorder*                                  225

*unspecified                                     

__________________________________________________________________

Table 1a. The top 10 adverse reactions as reported in December 2024 from the National Vaccine Information Center. See Table 1 for details.

What Is Known About the Impact of COVID-19 on Hearing, Balance, and Cognition

The following is a summary of information that the PubMed website identified when the specific search term was used.

Cerumen

There has been evidence of the COVID-19 virus in cerumen (Hanege, 2021; Celik, 2021). It is recommended that there be an increase in the use of personal protective equipment (PPE); cerumen disposal does not have to be handled any differently, as long as one is following Universal Precautions per the CDC (DiSogra, 2021).

CPT Code 99072 can be used for billing for the time spent pre-screening patients before the visit; time spent checking patients for symptoms onsite; PPE for the patient, clinician, and staff; and for cleaning supplies needed for disinfecting equipment and rooms after each encounter. Unfortunately, there is no guarantee of payment depending on the insurance coverage the patient has.

Middle Ear Pathology

The coronavirus can colonize in the middle ear and mastoid region. The resulting otitis media should be referred to an ENT specialist for intervention (Frazier, 2020). 

Cochlear Hearing Loss

Because the virus is systemic, you can expect bilateral sensorineural hearing loss. Satar (2020) found that COVID-19-associated hearing loss occurs within one month of the diagnosis. 

Cochlear Hearing Loss – Subjective Testing

COVID-19-associated sensorineural hearing loss (SNHL) is usually high frequency ( >4kHz) and often above 8kHz) (Jafari, 2020). Hearing thresholds can recover to pre-COVID levels, but not in all cases (Mustafa, 2020).

Cochlear Hearing Loss – Objective Testing

1. Distortion Product Otoacoustic Emission (DPOAE) Testing

DPOAE parameters are no different for the COVID patient than for any other patient complaining of hearing loss. Loss of outer hair cells can be identified with this test procedure. Interpretation is the same. A baseline test including all available frequencies above 2000Hz should be established to monitor stability, recovery, or progression of the loss.

• Auditory Brainstem Response Test (ABR)

Early on in the COVID-19 pandemic, neuroauditory problems could not be ruled out as having been caused by the virus (Sriwijitalai and Wiwanitkit, 2020). Therefore, the ABR is an excellent procedure to support the DPOAE test with either the presence or absence of a Wave I. If subsequent waves are absent or the morphology of the response is poor, then the Middle Latency Test (MLR) becomes the test of choice for looking at other areas of the auditorypathway.

• Middle Latency Response Test (MLR)

The MLR test visualizes the electrical activity of the primary auditory cortex, the auditory thalamus-cortical pathways, and the temporal processing of linguistic information (Frizzo,2015). A latency shift and abnormal morphology raises suspicions that the virus has affected cells in the brainstem.

NOTE: an abnormal ABR (Waves II – V) and/or MLR (delayed Na wave or smaller Pa wave amplitude) could occur in the presence of a normal pure tone audiogram.

Sudden Sensorineural Hearing Loss (SSNHL)

SSNHL has been reported after a COVID vaccination, but the incidence has not been shown to be greater than pre-COVID-19 with the general population (Formeister, 2022).

Word Recognition Scores

There has been no research specifically looking at changes in word recognition scores (WRS) with COVID-19 patients (Mikhail and Perez, 2024). Therefore, WRS remains a dubious test at best, but does appear to be essential as expected based on the degree of SNHL.

Tinnitus

According to the American Tinnitus Association (2020), pre-existing behavioral conditions could contribute to COVID-19-related tinnitus. These include stress, depression, social isolation, infection, and avoidance. Also, current medication side effects must be considered as possible causes (DiSogra, 2021). Therefore, tinnitus remains a case-by-case situation based on the patient’s medical history, comorbidities, and/or medication use. No changes have been suggested in the current tinnitus assessment or management protocols for patients with COVID-19.

NOTE: Additional information about a patient’s medications and known side effects can be obtained from four reliable sources: the patient’s pharmacist, the drug’s manufacturer, and two online websites: www.rxlist.com and www.drugs.com (not an endorsement by the author or publisher).

Vestibular Assessment

Vestibular complaints can be evaluated and managed using recognized balance assessment tests that would be used for a non-COVID patient. There are no changes in management strategies either. 

In an unpublished data review (n = 250 adults), the most sensitive tests were Bithermal Calorics and the High Frequency Head Shake Test (McClung, 2024). The most common diagnoses in this group were benign paroxysmal positional vertigo (BPPV), labyrinthitis, and vestibular neuronitis. Meniere’s disease has also been reported in COVID-19 patients (Jafari, 2022). Recovery from this condition is similar to that for vestibular pathologies; however, symptoms may persist for more than 70% of the population up to a month post-diagnosis (Aedo-Sanchez (2023).

Vestibular Rehabilitation

McClung (2024) reports that a “small percentage” of COVID-19 patients are referred to physical therapy for a fall-risk assessment and rehabilitation. Others are given a home-based vestibular rehabilitation therapy (VRT) program for one month. McClung reports a 90% success rate with VRT.

Long COVID 

Long COVID (the most often used term in the literature) is defined as short- and long-term health effects associated with COVID-19 with symptoms that can last for weeks or months after recovery (CDC, 2024). These symptoms include “brain fog,” cognitive issues, and memory loss (Wu, 2022). The Wu study followed 8,000 adults and found 23% still had COVID symptoms at 12 weeks post-diagnosis. 

The American Academy of Physical Medicine and Rehabilitation estimated 1 in 5 COVID-19 survivors will experience Long COVID (AAPM&R, 2024). The National Center for Health Statistics put the number at 17% (NCHS, 2024).

The average age for experiencing Long COVID (n = 27,651) for adults is between 35 and 64 years, with women more at risk than men (8.5% and 5.2%, respectively) (Adjaye-Gbewonyo, 2023). In children, the numbers were less (1.3% n = 7,463). Hispanic children were at 1.9% compared to Asian and Black children (0.2% and 0.6%, respectively)

In a study following 1,502 pregnant women, it was estimated that 10% who had COVID-19 while pregnant will develop Long COVID (Robertson, 2024).

Brain Fog

Brain fog is a non-medical term that has found its way into the professional literature when describing a patient with the following symptoms: reduced mental acuity, reduced cognition, inability to concentrate, inability to multi-task, and loss of short- and long-term memory. 

Also, when looking at these behaviors in detail, we see a very similar pattern of behavior consistent with an auditory processing disorder (APD): delays before responding, asking people to repeat what they’ve said, mishearing spoken questions, saying “Huh?” or “What?” or “What did you say?” and becoming easily fatigued while listening (DiSogra, 2022).

Brain Shrinkage, APD, and Brain Fog

In 2021, a significant observation was made by researchers at England’s Biobank Research Center. A group of patients (n = 394) who were identified as having a normal MRI study pre-pandemic were later diagnosed with COVID-19 (with hospitalization for high fever and a course of intervention that included oxygen therapy). 

Patients needing oxygen therapy had reduced gray matter volume in the frontal lobe. Patients who experienced fever also had reduced gray matter volume in the temporal lobe. (Duoaud, 2021)

A repeat MRI showed several areas of the brain that play a role in auditory processing had shrunk in some patients after being diagnosed with COVID-19. (See Table 2).

Table 2:

Anatomical Structure                            Role in Auditory Processing                  

Cingulate Cortex                                        Dichotic Listening, Attentional Focus, Working Memory

Amygdala                                                  Rhythm/Music, Startle Response

Hippocampus and Limbic/Cortical Area                     Informational Processing

__________________________________________________________________

Table 2. Neural structures that were found to be smaller post-pandemic based on two MRI studies

Other structures that are involved with auditory processing that were not looked at specifically (and are in close proximity to the structures that appear in Table 2) are listed in Table 3.

Table 3:

Anatomical Structure                            Role in Auditory Processing                  

Corpus Callosum                                        Dichotic listening, Localization

Insula                                                        Dichotic listening, Rhythm/Music, Speech in Noise

Brainstem Nuclei                                        Localization

Planum Temporale                                     Sound Decoding

Heschl’s Gyrus                                           Audition, Auditory Processing

Table 3. Other neural structures that could affect auditory processing not measured in the Duoaud study (2022).

Auditory Processing

The Duoaud study shed new light on why “brain fog” exists. A case study was published in 2023 (Alexander, 2023) that successfully demonstrated that the traditional auditory processing test battery known as the “Buffalo Battery” (Katz, 2007) is an excellent measure for a post-COVID adult patient whose symptoms align with a diagnosis of “brain fog.”

The recommended rehabilitation was followed for three months. Repeat testing (including a post-therapy Hearing Handicap Inventory for Adults – HHIA) showed scores in the normal range for all subtests and a “No handicap” rating on the HHIA.

A new screening battery has since been proposed from the University of Pittsburgh that includes the following tests: Words-In-Noise (WIN), Random Dichotic Digits Task (RDDT), and the Quick Speech in Noise (QuickSIN) tests (Cancel, 2023).

COVID-19 Additional Tests

Knowing that brain shrinkage is a concern that could be causing “brain fog,” the Middle Latency Response Test (see Cochlear Hearing Loss – Objective Testing “C”) in addition to the Time Compressed Sentences test (Dias, 2018) would be able to objectively and subjectively identify any conduction defect along the auditory pathway. Although the rehabilitation plan is individualized based on APD test results, the findings solidify the APD diagnosis (DiSogra, 2024, Alexander, 2023).

Cognitive Impairment

A cognitive impairment can be defined as having one or more deficits in global cognition, working memory, executive function, verbal fluency, verbal learning, and memory (Miskowiak, 2023).

Cognitive problems occurin 1 of 5 COVID patients with symptoms lasting more than three months (sometimes referred to as “long-haulers”). Cognitive problems may resolve over 18-24 months. COVID-19 is also capable of eliciting “persistent measurable neurocognitive alterations” especially in the areas of attention and working memory (Lauria, 2023).

COVID-19 cognitive impairment prognosis: 70% recover by 9 months; 30% may not ever recover (Gupta, 2021).

Cognitive Screening

Cognitive complaints associated with “brain fog” can be screened via cognitive screening tests by audiologists. Beck (2024) reports that when an audiologist performs a cognitive screening, the result helps determine whether the patient’s communication problem is primarily an audiologic issue, or whether a medical referral (based on a positive cognitive screening) is the more prudent recommendation.

According to the American Academy of Audiology Scope of Practice, Principle 2, Rule 2b (American Academy of Audiology, 2024), “Individuals shall use available resources, including referrals to other specialists…”

Pharmaceutical Management for Cognitive Impairments

There are no FDA-approved pharmaceuticals or dietary supplements for cognitive impairments (Mayo Clinic, 2021).

Diagnosis Codes for Billing

The following ICD-10 Codes can be used for billing. However, payment is not guaranteed by the carrier unless the testing is a covered service.

G31.84: Mild Cognitive Impairment

H93.25: (Central) Auditory Processing Disorder

R41.9: Unspecified symptoms involving cognitive functions and awareness (i.e., “Brain Fog”)

U09.9: Post-COVID-19 condition, unspecified

Summary

For patients who have contracted COVID-19, viral hearing losses (usually high frequency and bilateral) can be confined to the cochlea and auditory pathways, although sometimes middle ear pathology may be present.

Vaccine-related auditory/vestibular/cognitive impairments can occur. However, the incidence is very low. Despite this low incidence, the data serves as an excellent counseling tool for both short- and long-term management.

There is objective, clinical evidence that the virus affects the size of several brain structures along the auditory pathway (including brainstem and cortical regions) from pre-COVID normal MRI findings and post-COVID abnormal MRI findings on the same patients. “Shrinkage” sheds light on the inaccurate use of the term “brain fog” when the behaviors associated with this subjective, non-medical term fall in direct line with the behaviors associated with an auditory processing disorder.

Objective test results (DPOAE, ABR, and MLR) in conjunction with an APD battery of tests will support the diagnosis of an auditory processing disorder/mild cognitive impairment (or as it is sometimes referred to, ‘brain fog’). 

Acknowledgements

Special thanks to the following audiologists who contributed information for this manuscript: Angela Loucks-Alexander, AuD, Auditory Processing Institute, Queensland, Australia; Samuael Atcherson, PhD, University of Arkansas Medical School; Douglas L. Beck, AuD, audiology consultant, San Antonio, TX. Bobby McClung, Valleydale Hearing and Balance Center, Birmingham, AL.

Robert M. DiSogra, AuD, is an audiology consultant in Millstone, NJ. He is a board member of The Audiology Project, a non-profit organization that promotes audiology-based diagnosis and treatment for patients with diabetes or other chronic illness (www.theaudiologyproject.com). He was the 2020 recipient of the Clinical Excellence in Audiology Award from the American Academy of Audiology. 

References

Adjaye-Gbewonyo D, et al. (2023) Long COVID in adults: United States, 2022. National Center for Health Statistics (NCHS) Data Brief, No. 480

Aedo-Sánchez C, Gutiérrez G, Aguilar-Vidal E. (2023). COVID-19 and vestibular symptoms and assessment: a review. Audiol Neurotol 1–7

Alexander, AL, DiSogra RM, Abbas F, Braund S. Spoles C. (2023). Case study: COVID-19 brain fog or auditory processing disorder. Hear J, 76(4), April

American Academy of Audiology. (2025). COVID-19. (www.audiology.org). Accessed online 1/23/2025

American Academy of Audiology (2024). Scope of practice (www.audiology .org). Search Scope of Practice and clink on Access PDF or https://www.audiology.org/wp-content/uploads/2023/04/Scope-of-Practice_2023.pdf

American Academy of Physical Medicine and Rehabilitation. (2024). Long COVID. Accessed online 1/23/2025

American Tinnitus Association (2020). Tinnitus. Winter edition

Beck, D (2024). Cognition, audition, & repeated cognitive screenings, Hearing Review, May. https://hearingreview.com/hearing-loss/patient-care/evaluation/cognition-audition-repeated-cognitive-screenings. Accessed online 1/25/2025

Cancel VE, et al. (2023). A data-driven approach to identify a rapid screener for auditory processing disorder testing referrals in adults. Sci Rep. 2023 Aug 21;13(1):13636

Cancel VE, McHaney JR, Milne V, Palmer C, Parthasarathy A. (2023). A data-driven approach to identify a rapid screener for auditory processing disorder testing referrals in adults. Sci Rep. Aug 21;13(1):13636

Celik S, Kalcioglu MT, Esen F, Hanege FM, Cag Y, Kocoglu E. (2021). SARS-CoV-2 presence in cerumen. Ear Nose Throat J. Apr;100(2_suppl):158S-159S

Centers for Disease Control and Prevention (CDC). (2024). Long COVID. (www.cdc.gov) 

Dias JW, McClaskey CM, Harris KC. (2019) Time-compressed speech identification is predicted by auditory neural processing, perceptuomotor speed, and executive functioning in younger and older listeners. J Assoc Res Otolaryngol. Feb;20(1):73-88

DiSogra RM. (2021).  COVID-19 and its impact on the auditory and vestibular systems Audiol Today;July. OnLine Feature Article (www.audiology.org)

DiSogra RM. (2021) COVID-19 survey: disposing of cerumen from patients with a positive history of COVID-19. Audiol Today. Available online www.audiology.org/practice-resources/covid-19-resources

DiSogra RM. (2022). Are COVID-19 “brain fog” symptoms and an auditory processing disorder related? Hear Rev, 29(3) March 

DiSogra RM. (2024). COVID-19’s impact on hearing, balance, auditory processing and cognition. Paper presented at the Alabama Acad Audiol annual meeting, September

Douaud G, Lee S, Alfaro-Almagro F, Arthofer C, Wang C, McCarthy P, Lange F, Andersson JLR, Griffanti L, Duff E, Jbabdi S, Taschler B, Keating P, Winkler AM, Collins R, Matthews PM, Allen N, Miller KL, Nichols TE, Smith SM. (2022). SARS-CoV-2 is associated with changes in brain structure in UK Biobank. Nature 604, pp. 697–707 (https://doi.org/10.1038/s41586-022-04569-5)

Food and Drug Administration (2025). Emergency Use Authorization. (www.fda.gov/emergency-preparedness-and-response/mcm-legal-regulatory-and-policy-framework/emergency-use-authorization). Accessed online 1/23/2025

Food and Drug Administration. (2025). Coronavirus – COVID-19. (www.fda.gov/drugs/emergency-preparedness-drugs/coronavirus-covid-19-drugs). Accessed online 1/23/2025

Formeister EJ, Wu MJ, Chari DA, Meek R 3rd, Rauch SD, Remenschneider AK, Quesnel AM, de Venecia R, Lee DJ, Chien W, Stewart CM, Galaiya D, Kozin ED, Sun DQ. (2022). Assessment of Sudden sensorineural hearing loss after COVID-19 vaccination. JAMA Otolaryngol Head Neck Surg. Apr 1;148(4):307-315

Frazier KM, Hooper JE, Mostafa HH, Stewart CM. (2020) SARS-CoV-2 virus isolated from the mastoid and middle ear: implications for COVID-19 precautions during ear surgery. JAMA Otolaryngol Head Neck Surg. 146(10):964–966

Frizzo, ACF. (2015). Auditory evoked potential: a proposal for further evaluation in children with learning disabilities. Front. Psychol., 10 June

Gupta S. (2021) Experts: up to one-third of Covid-19 cases become ‘long Covid’. CNN.  Broadcast date: August 13. www.cnn.com/2021/08/15/health/long-haulers-covid-19-year-mystery/index.html

Hanege FM, Kocoglu E, Kalcioglu MT, Celik S, Cag Y, Esen F, Bayindir E, Pence S, Alp Mese E, Agalar C. (2021). SARS-CoV-2 presence in the saliva, tears, and cerumen of COVID-19 patients. Laryngoscope. May;131(5): E1677-E1682

Jafari Z, Kolb BE, Mohajerani MH. (2022). Hearing loss, tinnitus, and dizziness in COVID-19: a systematic review and meta-analysis. Canadian J Neuro Sci, 49(2), 184-195

Katz J. (2007). APD evaluation to therapy: the Buffalo model. Audiol Online, May. (www.audiologyonline.com)

Lauria A, Carfì A, Benvenuto F, Bramato G, Ciciarello F, Rocchi S, Rota E, Salerno A, Stella L, Tritto M, Di Paola A, Pais C, Tosato M, Janiri D, Sani G, Lo Monaco R, Pagano FC, Fantoni M, Bernabei R, Landi F, Bizzarro A, Gemelli Against COVID-19 Post-acute Care Group. (2023). Neuropsychological measures of post-COVID-19 cognitive status. Front Psychol. Jul 10;14:1136667

Mayo Clinic. (2021) Mild cognitive impairment. www.mayoclinic.org/diseases-conditions/mild-cognitive-impairment/diagnosis-treatment/drc-20354583

McClung B. (2024). COVID vestibular findings in a private practice. Unpublished research. Personal communication

Mikhail J, Paez A. (2024). COVID-19’s effect on pre-existing hearing loss. Hear Rev; 31(4):20-23

Miskowiak KW, Pedersen JK, Gunnarsson DV, Roikjer TK, Podlekareva D, Hansen H, Dall CH, Johnsen S. (2023). Cognitive impairments among patients in a long-COVID clinic: prevalence, pattern and relation to illness severity, work function and quality of life. J Affect Disord, Mar 1;324:162-169

Mustafa MWM. (2020). Audiological profile of asymptomatic Covid-19 PCR-positive cases. Am J Otolaryngol. May-Jun;41(3)

National Center for Health Statistics. (2024) U.S. Census Bureau, Household Pulse Survey, 2022–2024. Long COVID. (www.cdc.gov/nchs/covid19/pulse/long-covid.htm)

National Institutes of Health (NIH) (2025). Clinical Trials. https://clinicaltrials.gov. Accessed online 1/23/2025

National Institutes of Health (NIH), National Library of Medicine (NLM), National Center for Biotechnology Information (NCBI), PubMed. (2025). https://pubmed.ncbi.nlm.nih.gov. Accessed online 1/23/2025

Robertson R. (2024). One in 10 people with COVID during pregnancy will develop long COVID. MedPage, Feb 13. www.medpagetoday.com

Satar B. (2020). Criteria for establishing an association between Covid-19 and hearing loss. Am J Otolaryngol. Nov-Dec;41(6)

Sriwijitalai W. & Wiwanitkit V. (2020) Hearing loss and COVID-19: A note. Amer J Otolaryngol, 41(3)

US Department of Health and Human Services. (2025), Vaccine Adverse Event Reporting System, (VAERS). https://vaers.hhs.gov

Vaccine Information Center (2024). (www.medalerts.org). Accessed online 1/23/2025

Wu Q, Ailshire JA, Crimmins EM. (2022) Long COVID and symptom trajectory in a representative sample of Americans in the first year of the pandemic. Sci Rep 12. Accessed online 1/23/2025

Key Takeaways:

1. AI is improving hearing aid performance and patient engagement, particularly with regard to speech in noise and auditory training apps, leading to better user outcomes.
2. Audiologists see potential in AI-assisted testing and office management, but insist on clinician oversight to ensure accuracy and personalized care.
3. Hearing care professionals are united in the belief that AI should enhance, not replace, their roles, emphasizing that human connection and clinical judgment are irreplaceable in effective patient care.

By Melanie Hamilton-Basich

These days, most people are of two minds when it comes to artificial intelligence (AI). “I think overall everyone’s pretty excited just about the possibility of AI improving things for our patients,” says Hunter Gerhart, AuD, director of audiology at Livingston Hearing Aid Center in Austin, TX. But like many hearing care professionals (HCPs), he is both hopeful and a bit unsure about all of the changes that AI can bring to audiology.

A large part of what gives people pause is the uncertainty about just what AI’s capabilities are and how it’s being used, partly because of terminology. It’s important to know that not everything referred to as AI is operating in the same way.

Different Kinds of AI

For instance, there’s a difference between generative AI and machine learning. Both fall under the umbrella of artificial intelligence. But machine learning is focused on identifying patterns based on data it has “learned” and making predictions based on those patterns to aid in decision making. On the other hand, generative AI such as ChatGPT is trained on enormous datasets to actually create new content, including text, images, and video.

Currently, most of the uses of AI in audiology are for machine learning. For example, audiometers can employ machine learning algorithms to automate traditional audiometric tests to improve precision and efficiency. 

And many new hearing aids feature highly advanced chips that utilize machine learning to distinguish between different types of sound and make adjustments to focus on only the sounds it’s predicted the user wants to hear in different situations.

But what are hearing care professionals comfortable using AI for in their practices?

AI in Hearing Aids

The most talked about example of AI use in audiology right now is for hearing aids. And it’s not just because they’re new. It’s also because HCPs and patients are seeing the benefits of the technology.

Gerhart has been fitting more and more patients with AI-powered hearing aids at his clinic and has been impressed with their performance. “My patients have commented on just how much better they are hearing in noise,” he says. “And I believe that that increase in speech understanding in background noise is due to the way that AI is being utilized in today’s hearing aids to classify the different sound sources.”

Julie Prutsman, AuD, CH-TM, owner and founder of Sound Relief Tinnitus & Hearing Center based in Colorado, also welcomes the use of AI technology in hearing aids. “AI is definitely helping to better isolate speech in noise, I think for sure,” she says.

But Prutsman also sees the benefit of AI in hearing aids helping patients adjust settings in noisy situations. Without such assistance, she knows many people get overwhelmed struggling to determine which settings to adjust and how much, so they give up. 

“For a technology to help them through that, to keep them in that environment and keep them confident, keep them engaged, is really the ultimate goal so they don’t self-isolate,” she says. “Because we know social isolation is what can lead to depression, which can lead to cognitive decline, which can lead to all sorts of negative side effects.

“So it’s definitely neat to see AI being incorporated into app controls and into hearing aid chips, and I think it’s going to continue to improve.”

Auditory Training

AI can also be used for aural rehabilitation. Prutsman has found success with an auditory training app called Lace AI Pro that uses AI to help patients learn how to better understand speech in noise. 

Interactive lessons increase in difficulty to continue challenging the patient if they’re doing well. But if the AI determines the patient is struggling too much to understand the words, it will make the lessons a bit easier so the patient doesn’t get frustrated and give up. Prutsman appreciates how the app uses AI to constantly adjust difficulty in response to the user’s skill level because it helps keep them stay engaged over the long term, which is important for continued improvement.

“Patients aren’t really realizing that the exercises are getting a little bit harder or easier,” Prutsman says. “I think that’s a good thing that patients aren’t really noticing the algorithms working behind the scenes, but they’re definitely benefiting from them.”

Hearing Testing

When it comes to using AI to streamline hearing testing, audiologists’ reactions are more measured. They’re open to assistance up to a point.

“I think AI could be beneficial to help with screening out normal hearing or standard age-related hearing loss,” says Jessica Stiel, AuD, CCC-A, who works at The Ohio State University Wexner Medical Center. “And then as the clinician, I would be able to identify the red flags where a referral might be needed, if there was an asymmetric loss or a conductive loss, so it could help diagnose in that regard. Then I would have more clinical time and judgment to spend on the more complex cases.”

Stiel sees this as similar to how hearing aid software incorporating AI is currently used. “You start with an initial fit based on the user’s experience and their age and their hearing loss. And then that’s kind of preset,” she says. “And then based on how they do and what their complaints are, that’s where we come in as the professionals knowing how to make adjustments to accommodate whatever issues or complications they’re having.”

Prutsman also sees the benefits of AI taking over some of the basic hearing testing—but only with direct oversight from HCPs.

“You have to make sure what’s going into the algorithm is good data, to get out the results you’re looking for. So we would have to cross-check it,” emphasizes Prutsman. “Otherwise something could get missed or inaccurately diagnosed. You would definitely need to have some clear parameters to make sure that didn’t happen. But if we could get there, which I think they are definitely working on, it could help.”

And with a projected significant shortage of audiologists in the very near future, Prutsman sees this solution becoming especially useful. “If we could use AI to help fill some of the gaps in the number of providers needed to meet the demand, that could really be great for workflow and for better patient care, really,” she says.

For his part, Gerhart is concerned about the extent of AI’s reach in audiology testing. “I would not want to see AI replacing the diagnostician and the treatment of hearing loss, because hearing loss is not something that can be self-identified,” he says. “It’s really hard to get a proper diagnosis, and degree and severity of the loss, without having a test that’s performed by a licensed hearing healthcare professional.”

Office Management

The use of AI is not confined to HCPs themselves, of course. Many tasks that staff members must complete to make sure a practice runs smoothly can also involve AI these days.

Office management software is increasingly offering AI features to streamline processes and enhance practice efficiency. These include voice-to-text dictation, the ability to create auto-replies via text and email, and language translation.

At the practice where Stiel works, staff use AI features in their office management software for scheduling appointments, which she says has been extremely useful.

While the software Prutsman’s clinic uses doesn’t currently use AI, she’s open to using a system that does. “If AI could help with that puzzle of ideal patient scheduling in a day, that would make my life a lot easier because we spend a lot of time trying to figure out the perfect schedule,” she says.

Marketing

AI can also be used for marketing. Prutsman’s husband is in charge of all of the marketing for her practice, and he says using generative AI in the form of ChatGPT to create promotional materials has been a game changer.

“He spends way less time on having to edit and create the perfect content because with the help of AI he can really customize the message to fit the format or the language that he’s looking for for a particular marketing piece,” Prutsman says. “He’ll take a concept and say, ‘Here’s what we want to say. Can you make it more informational, or more relatable?’ Or, ‘Can you find a funny tagline for this blog post?’ So it’s just pretty amazing what you can do and how the more you use it, the more it learns what your preferences are and then it starts becoming easier and easier to get the end product that you’re really looking for.”

But Prutsman also notes that you always need to check to make sure the content ChatGPT generates is actually what you want and doesn’t contain errors or fabricated information. It still requires human oversight.

A Tool, Not a Replacement

While HCPs tend to agree that AI can be useful, they also agree that they don’t want it to replace them.

“Overall, I think it’s a powerful tool, but it’s not a substitute for clinical expertise,” says Stiel. “I feel like most of us are open to AI or excited about it, so long as we get to remain a part of the process.”

Concern about overreliance on AI to the detriment of hearing care professionals and patients is not unfounded.

In Facebook groups for people with hearing loss, Gerhart regularly sees posts from people asking HCPs to interpret their test results. “While there are a lot of great qualified professionals in these forums who will often chime in and help these users understand their results, as AI technology improves and becomes more readily available, I fear that consumers may turn to those sources before they turn to a professional,” he says. “I wouldn’t want them to replace the expertise of a hearing healthcare professional with AI.”

It seems that some companies are already working on making what Gerhart fears a reality. 

Stiel was recently contacted by a company looking for audiologists to answer questions related to hearing care for a fee. “I think they’re trying to teach their AI database how to answer these questions to create a kind of medical ChatGPT,” she says. And it wouldn’t surprise her if it came to fruition, although she hopes it doesn’t.

“I think that it’s key to use AI as a tool, not a replacement,” Stiel emphasizes. “Hearing care is deeply personal, and no algorithm can replace clinical judgment or human understanding of context.”

Gerhart also strongly believes that personal interaction in healthcare will always trump artificial intelligence. “I think that there is a fundamental component of quality hearing healthcare, and I think that’s the human touch, being able to have a one-on-one interaction with a hearing care professional where we can guide patients through how to overcome the challenges that they’re experiencing, which I don’t think AI can deliver.” 

Featured image: ID 143574018 | Ai © Blackboard373 | Dreamstime.com

Key Takeaways:

1. Targeted Innovation: LGK974 inhibits the Porcupine enzyme in the Wnt signaling pathway, significantly reducing bone overgrowth in sclerosteosis mouse models.
2. Non-Invasive Promise: This treatment could replace invasive surgeries currently used to manage complications like hearing loss and increased intracranial pressure.
3. Broader Impact: The findings may pave the way for treating other high bone mass disorders, though human trials are still needed to confirm safety and efficacy.

Sclerosteosis is a rare genetic disorder that causes excessive bone growth, leading to life-altering complications, including hearing loss and facial paralysis. In a promising new breakthrough, researchers have identified a drug called LGK974, which targets the Wnt signaling pathway by inhibiting the enzyme Porcupine. This treatment has shown the potential to effectively reduce bone mass and prevent further skeletal overgrowth in mice, offering hope for those suffering from this debilitating condition. Unlike the high-risk surgeries traditionally used to manage sclerosteosis, LGK974 presents a non-invasive alternative that could dramatically improve patient quality of life.

Sclerosteosis arises from mutations in the SOST gene, causing abnormally high bone mass and skeletal overgrowth, which can lead to severe health issues such as hearing loss and increased intracranial pressure. The key culprit behind this condition is the disruption of the Wnt signaling pathway, crucial for bone development. This groundbreaking study seeks to determine whether inhibiting Porcupine, a key regulator within this pathway, can reverse the bone overgrowth seen in this rare and serious disorder.

How LGK974 Works

This study was published (DOI: 10.1038/s41413-025-00406-3) in Bone Research, by a research team from the Skeletal Biology Group at the Royal Veterinary College, London, in collaboration with UCB Pharma, Slough, UK. Led by Dr Scott J. Roberts, the team investigates the impact of LGK974, a Porcupine inhibitor, on bone mass regulation in a sclerosteosis mouse model. By targeting the Wnt signaling pathway, LGK974 offers an innovative approach to combat the excessive bone growth seen in sclerosteosis. The research uncovers the potential of LGK974 as a promising treatment for this ultra-rare condition, providing an alternative to invasive surgeries commonly required for severe cases.

Preclinical Success in Mouse Models

Through both in vitro and in vivo experiments, the research team examined how LGK974 affects bone formation and the Wnt/β-catenin signaling pathway. The results were striking: LGK974 inhibited osteoblast activity and mineralization, mimicking the effects of sclerostin, a natural bone growth regulator. The drug successfully reduced excessive bone growth in the skull, vertebrae, and tibiae of Sost-/- mice, a model of sclerosteosis. Intriguingly, the drug exhibited a potential sexual dimorphic response, with male mice showing more pronounced benefits. The study also suggests that LGK974 not only prevents bone overgrowth but also preserves bone structure, reducing ossification. The potential for LGK974 to address the dangerous symptoms of sclerosteosis—such as hearing loss and intracranial pressure—could offer a significant improvement over the current surgical options available to patients.

“The ability to effectively inhibit bone overgrowth at sites of severe/fatal sclerosteosis pathologies, without obviously disrupting other physiological functions, is a monumental step forward,” says Dr Roberts, a senior researcher in the study. “The success of LGK974 in preclinical models marks a significant breakthrough, moving us closer to a viable, non-invasive treatment that could offer real relief for patients with this devastating condition.”

Potential for Broader Applications

The findings of this study hold great promise not only for sclerosteosis but also for other Wnt-related high bone mass conditions, such as Van Buchem disease. Targeting Porcupine provides a new avenue for treatment that could reduce reliance on high-risk surgeries. However, further clinical trials are necessary to confirm the drug’s safety and efficacy in humans, with attention to possible sex-based differences in response. 

This research highlights the importance of developing alternative, targeted therapies to manage bone overgrowth and improve the lives of patients who currently face limited treatment options and a lifetime of pain, discomfort, and debilitating symptoms.

Featured image: Dreamstime

Key Takeaways:

1. Real-Time, Smartphone-Based Diagnosis: The AI system enables patients to record and upload eye movement videos via smartphone for remote diagnostic evaluation, reducing the need for in-person visits and expensive equipment.
2. Clinical Accuracy and Telehealth Integration: In pilot testing, the model produced diagnostic results comparable to gold-standard devices, supporting its use in telehealth and underserved settings.
3. Scalable, Multi-Disciplinary Innovation: Backed by a cross-campus and multi-institutional team, the project aims to enhance accessibility, streamline clinical workflows, and expand to real-time wearable applications.

Most current AI models are based on static datasets, limiting their adaptability and real-time diagnostic potential. To address this gap, researchers from Florida Atlantic University (FAU) and collaborators have developed a novel proof-of-concept deep learning model that leverages real-time data to assist in diagnosing nystagmus—a condition characterized by involuntary, rhythmic eye movements often linked to vestibular or neurological disorders.

The Challenges of Traditional Vestibular Testing

Gold-standard diagnostic tools such as videonystagmography (VNG) and electronystagmography have been used to detect nystagmus. However, these methods can come with notable drawbacks: high costs (with VNG equipment often exceeding $100,000), bulky setups, and inconvenience for patients during testing. FAU’s AI-driven system offers a cost-effective and patient-friendly alternative, for a quick and reliable screening for balance disorders and abnormal eye movements.

FAU’s Real-Time Solution for Nystagmus

The platform allows patients to record their eye movements using a smartphone, securely upload the video to a cloud-based system, and receive remote diagnostic analysis from vestibular and balance experts—all without leaving their home.

At the heart of this innovation is a deep learning framework that uses real-time facial landmark tracking to analyze eye movements. The AI system automatically maps 468 facial landmarks and evaluates slow-phase velocity – a key metric for identifying nystagmus intensity, duration and direction. It then generates intuitive graphs and reports that can easily be interpreted by audiologists and other clinicians during virtual consultations.

Results of the pilot study involving 20 participants, published in Cureus (part of Springer Nature), demonstrated that the AI system’s assessments closely mirrored those obtained through traditional medical devices. This early success underscores the model’s accuracy and potential for clinical reliability, even in its initial stages.

A Cost-Effective Alternative to Traditional Tools

“Our AI model offers a promising tool that can partially supplement—or, in some cases, replace—conventional diagnostic methods, especially in telehealth environments where access to specialized care is limited,” says Ali Danesh, PhD, principal investigator of the study, senior author, a professor in the Department of Communication Sciences and Disorders within FAU’s College of Education and a professor of biomedical science within FAU’s Charles E. Schmidt College of Medicine. “By integrating deep learning, cloud computing, and telemedicine, we’re making diagnosis more flexible, affordable, and accessible—particularly for low-income rural and remote communities.” 

The team trained their algorithm on more than 15,000 video frames, using a structured 70:20:10 split for training, testing and validation. This rigorous approach ensured the model’s robustness and adaptability across varied patient populations. The AI also employs intelligent filtering to eliminate artifacts such as eye blinks, ensuring accurate and consistent readings.

Physicians and audiologists can access AI-generated reports via telehealth platforms, compare them with patients’ electronic health records, and develop personalized treatment plans.

Beyond diagnostics, the system is designed to streamline clinical workflows. Physicians and audiologists can access AI-generated reports via telehealth platforms, compare them with patients’ electronic health records, and develop personalized treatment plans. Patients, in turn, benefit from reduced travel, lower costs and the convenience of conducting follow-up assessments by simply uploading new videos from home—enabling clinicians to track disorder progression over time.

In parallel, FAU researchers are also experimenting with a wearable headset equipped with deep learning capabilities to detect nystagmus in real time. Early tests in controlled environments have shown promise, though improvements are still needed to address challenges such as sensor noise and variability among individual users.

“While still in its early stages, our technology holds the potential to transform care for patients with vestibular and neurological disorders,” says Harshal Sanghvi, PhD, first author, an FAU electrical engineering and computer science graduate, and a postdoctoral fellow at FAU’s College of Medicine and College of Business. “With its ability to provide non-invasive, real-time analysis, our platform could be deployed widely—in clinics, emergency rooms, audiology centers, and even at home.”

Interdisciplinary Initiative

Sanghvi worked closely with his mentors and co-authors on this project including Abhijit S. Pandya, PhD, FAU Department of Electrical Engineering and Computer Science and FAU Department of Biomedical Engineering, and B. Sue Graves, EdD, Department of Exercise Science and Health Promotion, FAU Charles E. Schmidt College of Science.

This interdisciplinary initiative includes collaborators from FAU’s College of Business, College of Medicine, College of Engineering and Computer Science, College of Science, and partners from Advanced Research, Marcus Neuroscience Institute—part of Baptist Health—at Boca Raton Regional Hospital, Loma Linda University Medical Center, and Broward Health North. Together, they are working to enhance the model’s accuracy, expand testing across diverse patient populations, and move toward FDA approval for broader clinical adoption.

“As telemedicine becomes an increasingly integral part of health care delivery, AI-powered diagnostic tools like this one are poised to improve early detection, streamline specialist referrals, and reduce the burden on health care providers,” says Danesh. “Ultimately, this innovation promises better outcomes for patients—regardless of where they live.”

Along with Pandya and Graves, study co-authors are Jilene Moxam, Advanced Research LLC; Sandeep K. Reddy, PhD, FAU College of Engineering and Computer Science; Gurnoor S. Gill, FAU College of Medicine; Sajeel A. Chowdhary, MD, Marcus Neuroscience Institute—part of Baptist Health—at Boca Raton Regional Hospital; Kakarla Chalam, MD, PhD, Loma Linda University; and Shailesh Gupta, MD, Broward Health North.  

Featured image: FAU researchers are also experimenting with a wearable headset equipped with deep learning capabilities to detect nystagmus in real time. Photo: Florida Atlantic University

Key Takeaways:

1. Preventable Causes: Childhood infections such as rubella, mumps, and meningitis are significant yet preventable causes of hearing loss, particularly in low-resource settings.
2. Evidence Gaps: Despite identifying 26 hearing-loss-related pathogens, only nine studies met criteria for assessing vaccine impact, revealing a major gap in empirical data and geographic coverage.
3. Policy Implications: Recognizing hearing loss prevention as an added benefit of vaccination could support stronger immunization efforts and reduce vaccine hesitancy globally.

Over 1.5 billion people worldwide are affected by some degree of hearing loss. While it is often linked to aging, a lesser-known but significant cause is infections contracted during childhood and adolescence, many of which are preventable.

This is particularly true in low- and middle-income countries, where access to hearing care is often limited. According to the World Health Organization, nearly 60% of childhood hearing loss could be prevented through public health measures such as vaccination against rubella and certain forms of meningitis.

Statistics like these led a team of researchers, including several from Université de Montréal’s School of Public Health (EPSUM), to conduct an in-depth review of the scientific literature exploring the role vaccination could play in preventing hearing loss in children and adolescents. The results of the review are published in Communications Medicine. 

The team included Mira Johri, a professor in the Department of Health Management, Evaluation and Policy at ESPUM; Shoghig Téhinian, a professional doctorate candidate at ESPUM; Myriam Cielo Pérez Osorio, a public health researcher at Quebec’s Integrated Health and Social Services Centre for Montérégie-Ouest; Enis Barış, a professor at the University of Washington; and Brian Wahl, a professor at the Yale School of Public Health.

26 Pathogens

The researchers conducted an extensive review of the literature to map existing knowledge on the relationship between vaccination and hearing loss prevention.

“It was an extremely detailed review because we looked at the pathogens one by one,” explains Téhinian. “We identified the available vaccines, their mechanisms of action, and what is known about their impact on hearing.”

The research team identified 26 infectious agents that can potentially cause hearing loss, including the virus responsible for common diseases such as measles as well as rubella, which is especially dangerous if contracted during pregnancy because it can harm the developing auditory system and cause congenital deafness.

Also on the list are the virus that causes mumps, which can lead to sensorineural hearing loss by damaging the inner ear or auditory nerve, and the bacteria Haemophilus influenzae, Streptococcus pneumoniae and Neisseria meningitidis, which cause meningitis and result in permanent hearing damage.

Gaps in the Research

The researchers found a glaring lack of empirical data on the protective effects of vaccines against hearing loss. Of the thousands of scientific articles identified as relevant, only nine published over the past 40 years met the criteria for inclusion in the new analysis.

Moreover, these nine studies covered just three infectious agents—rubella, mumps and pneumococcus—and were conducted exclusively in high-income countries, such as Sweden, Finland, the Netherlands, the United States, Australia and Japan.

“If a vaccine is shown to save lives, it’s reasonable for policy decisions to be made on that basis,” says Johri. “But vaccines can also offer significant benefits in preventing other harms, such as hearing loss, and these benefits deserve greater attention.”

The design of clinical trials can obscure these additional benefits: since their primary goal is to demonstrate effectiveness against the target disease, the prevention of side effects such as hearing loss is rarely evaluated systematically.

Some Clear Evidence

The nine empirical studies that did examine linkages between vaccines and hearing loss prevention had mixed results. Some found that vaccination can provide protection while others showed no effect. Additionally, the methods used to measure hearing loss varied considerably, making direct comparisons difficult.

Population-level studies show that rubella and mumps vaccination significantly reduces rates of deafness associated with these diseases. In Australia, for instance, the introduction of a rubella vaccination program led to a marked decline in cases of congenital deafness.

In Sweden, the implementation of an MMR (measles, mumps, and rubella) vaccination program was associated with a significant reduction in hearing problems among children. Studies on mumps in Japan and the United States also highlight the importance of vaccination in preventing hearing loss caused by this infection.

On the other hand, three clinical trials evaluating the efficacy of pneumococcal vaccines in preventing middle ear infections (serous otitis media) found no significant reduction in infection rates. The authors point out, however, that serous otitis media is not a direct indicator of permanent hearing loss.

Expanding Vaccine Access

The researchers believe that raising awareness of the hearing-related benefits of vaccination could help strengthen existing immunization programs—especially in low- and middle-income countries, where vaccination coverage is still inadequate.

“If vaccination against measles, for example, is already recommended to reduce mortality, the fact that it can also prevent hearing loss could be highlighted as an additional benefit,” explains Johri. “This could bolster the case for adopting a universal vaccination program.”

The study recommends including the effect on hearing loss in vaccine evaluations, both during development and for products already on the market. This factor could also help inform research priorities for new vaccine formulations.

“These indirect benefits of vaccination need to be better documented and communicated to the public,” says Téhinian. “It could help reduce vaccine hesitancy.”

“Our School of Public Health is located very close to the former Montreal Institute for the Deaf and Mute,” Johri points out. “Only a few decades ago, there were so many children with hearing loss that we needed a dedicated facility for them. Now, thanks to antibiotics and vaccines, fewer people in Canada are affected by hearing loss. This is a success story that could be replicated around the world.”

Featured image: Dreamstime

Three Key Takeaways:

1. Hearing aids helped older adults retain more and deeper social relationships over three years compared to those without hearing interventions.
2. Those receiving hearing care reported slightly reduced loneliness, while untreated participants experienced increased loneliness.
3. Experts advocate for Medicare coverage of hearing aids, citing their potential to combat social isolation and its related health risks among seniors.

Providing hearing aids and advice on their use may preserve social connections that often wane as we age, a new study shows. Its authors say that this approach could help ease the loneliness epidemic that older Americans face.

According to the U.S. Centers for Disease Control and Prevention, more than a quarter of seniors say they have little or no contact with others, and a third report feeling lonely. Experts have linked such isolation in part to hearing loss, which can interfere with communication and relationship building. The 2023 U.S. Surgeon General’s Advisory named improving social connection as great a priority as targeting tobacco use, obesity, and addiction.

Led by researchers at NYU Langone Health as part of the ACHIEVE clinical trial, the study revealed that those treated for hearing loss retained one additional social connection on average over a three-year period when compared with those who received no hearing therapies and were instead educated about healthy aging.

Published online May 12 in the journal JAMA Internal Medicine, the work further showed that those given hearing aids had more diverse relationships, with networks that had many different types of connections (e.g., family members, friends, and acquaintances). They also maintained deeper, higher quality bonds than those who were not treated for hearing loss.

“Our findings add to evidence that helping aging patients hear better can also enrich their social lives and boost their mental and physical well-being,” said study lead author Nicholas Reed, AuD, PhD, a member of the NYU Grossman School of Medicine’s Optimal Aging Institute.

Experts have linked both loneliness and hearing loss to depression, heart disease, and early death, among other concerns, adds Reed, also a faculty member in the Departments of Otolaryngology-Head and Neck Surgery and Population Health at NYU Grossman School of Medicine. A 2023 report on the ACHIEVE trial showed that hearing interventions may slow cognitive decline among those at highest risk for dementia.

“These results support efforts to incorporate hearing aid coverage into Medicare as a means of addressing the nation’s social isolation epidemic, which is especially risky for the elderly,” said ACHIEVE trial co-principal investigator Josef Coresh, MD, PhD. “Making sure Americans can continue engaging with their family and friends as they age is a critical part of maintaining their quality of life,” added Coresh, also the Terry and Mel Karmazin Professor in the Department of Population Health.

For the study, the research team collected data about older adults with untreated hearing loss across four sites in Maryland, North Carolina, Minnesota, and Mississippi. The study is among the largest to date to explore if hearing care can help prevent weakening of social networks, having included nearly 1,000 men and women ages 70 through 84.

Half of the participants received hearing aids, counseling sessions and personalized instruction with an audiologist, and when needed, tools such as adaptors that connect hearing aids to televisions. The other half of the participants were given instruction about exercise, strategies for communicating with healthcare providers, and further resources for healthy aging. 

To measure social isolation, the researchers assessed how regularly participants spent time with others, the size and variety of their social networks and the roles they played in them, and the depth of their connections. Loneliness was calculated using a 20-question scoring system that evaluates how often a person feels disconnected from others. After the initial data was collected, the team followed up at six months and then every year for three years.

Among the other findings, the study revealed that before treatment, participants in both groups reported feeling equally lonely. Three years after the intervention took place, loneliness scores slightly improved among those who had received hearing care, while scores slightly worsened among those who did not.

Hearing aids and their related audiology appointments cost an average of $4,700, which is usually paid out of pocket, notes Coresh, who is the founding director of the Optimal Aging Institute. 

Also a professor in the Department of Medicine, Coresh says the authors plan to continue following the participants for another three years and to repeat the study with a more diverse group of people—the patients were mostly White. He cautions that the participants received concierge-level hearing care that provided more resources and time with audiologists than is typically offered to the public. Damaged hearing aids, for example, were replaced within days instead of weeks. 

Three Key Takeaways:

1. The book deepens understanding of patients’ emotional journeys through first-hand stories, helping audiologists offer more compassionate, patient-centered care.
2. It outlines early intervention strategies, treatment options, and management of related conditions like tinnitus and balance disorders.
3. The guide highlights the importance of clear communication and emotional support during medical appointments, empowering audiologists to be both clinicians and allies.

The book “Sudden Hearing Loss: Stories of Hope, Guidance, and Support” by Carly Sygrove, Andrea Simonson, and Caroline Norman is a compassionate guide for coping with sudden hearing loss that offers support, treatment insights, and stories of hope. 

Sudden hearing loss can strike anyone, anywhere, anytime, leaving individuals and their loved ones grappling with confusion, fear, and isolation. In this comprehensive guide, Carly Sygrove, Andrea Simonson, and Caroline Norman share personal narratives and insights to help readers affected by this life-altering condition to cope with their new reality. For hearing care professionals, the book can provide insight into what patients may be experiencing and how to better help them cope.

Drawing from their own experiences with sudden hearing loss and the testimonies of more than 60 individuals from around the world, the authors describe the immediate emotional impact, the desperate search for answers, and the various paths to adaptation and recovery. 

The guide covers important concerns:

• What to expect at medical appointments

• Early treatment protocols

• Tinnitus and hyperacusis

• Balance disorders

• Emotional impacts of sudden hearing loss

• Hearing aids and cochlear implants

With heartfelt stories and practical advice, Sudden Hearing Loss offers readers not only a wealth of information but also a sense of community and understanding. This book provides the guidance and hope needed to help people personally affected or supporting a loved one or patient to navigate the challenges of sudden hearing loss.

The book “Sudden Hearing Loss: Stories of Hope, Guidance, and Support” is available for purchase through Johns Hopkins University Press.

About the Authors

Carly Sygrove is a hearing loss coach, hearing health advocate, and writer with a background in education. She documents her experiences with sudden hearing loss on her blog, My Hearing Loss Story, and is the founder of the Sudden Hearing Loss Support website. Andrea Simonson is an educational audiologist in the Public School Partnerships Program of The Learning Center for the Deaf in Massachusetts. She has worked as a clinical audiologist in private practices and medical offices and as a research audiologist and adjunct professor at several universities. Caroline Norman is a counselor and psychotherapist in private practice who has experienced sudden hearing loss. She has worked within the National Health Service and as a clinical lead in an occupational health setting.