A Hearing Screening Protocol for Stroke Patients: An Exploratory Study

Nehzat Koohi

Deborah Vickers

Nattawan Utoomprurkporn

David Werring

Doris Bamiou

Click here for additional data file.^{(25K, docx)}

^{Department of Neuro-audiology, The Ear Institute, University College London, London, United Kingdom}

^{Neuro-otology Department, University College London Hospitals, London, United Kingdom}

^{Speech Hearing and Phonetic Sciences, University College London, London, United Kingdom}

^{Department of Otolaryngology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand}

^{Department of Brain Repair and Rehabilitation, Stroke Research Centre, Institute of Neurology, University College London Hospitals, London, United Kingdom}

^{Biomedical Research Centre, National Institute for Health Research, London, United Kingdom}

Edited by: Paola Marangolo, University of Naples Federico II, Italy

Reviewed by: Bin Jiang, Capital Medical University, China; Vinaya Manchaiah, Lamar University, United States

*Correspondence: Nehzat Koohi ku.ca.lcu@ihook.n

Doris-Eva Bamiou ku.ca.lcu@uoimab.d

This article was submitted to Stroke, a section of the journal Frontiers in Neurology

Edited by: Paola Marangolo, University of Naples Federico II, Italy

Reviewed by: Bin Jiang, Capital Medical University, China; Vinaya Manchaiah, Lamar University, United States

Received 2019 Feb 10; Accepted 2019 Jul 19.

This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

Abstract

Background: Auditory impairment post stroke is common and may be due to both peripheral hearing loss and or central auditory processing disorder (CAPD). When auditory impairment remains untreated, it may impact on patient communication and rehabilitation after stroke. Offering a comprehensive audiological assessment to all stroke patients would be both costly and time-consuming. A brief hearing screening is thus required.

Objective: The aim of this study was to determine whether a two-tiered hearing screening approach, with use of a handheld hearing screener and two validated hearing questionnaires could be used as a hearing screening for peripheral hearing loss and CAPD in stroke survivors. The sensitivity and specificity of the screening method was analyzed.

Methods: This was a prospective study conducted in a tertiary neurology hospital. Forty-two consecutive stroke patients were recruited and tested within 3–12 months post-onset of their stroke. Three screening tools for the identification of hearing impairment were evaluated in this study: A handheld hearing screener for determination of peripheral audiometric hearing loss and two validated questionnaires (The Amsterdam Inventory Auditory for Disability (AIAD) and the Hearing Handicap Inventory for Elderly (HHIE) questionnaires) for determination of peripheral hearing loss and/or CAPD.

Results: The hearing screener had a sensitivity of 92. 59% detecting a hearing loss and specificity of 100%. The greatest test accuracy in identifying a central auditory processing type hearing impairment in stroke patients was found when the handheld hearing screener and the AIAD questionnaire were combined.

Conclusion: This study is a first step toward addressing the complex auditory needs of stroke survivors in a systematic manner, with the ultimate aim to support their communication needs and long-term recovery and wellbeing.

Registration: Project Identification number 11/0469 and REC ref 11/LO/1675.

Keywords: stroke, hearing loss, hearing screening, central auditory processing disorder, hearing questionnaires

Abstract

Acknowledgments

We would like to thank the study participants, and our colleagues at the Neuro-otology Department, University College London Hospitals.

Acknowledgments

Footnotes

Funding. This study was funded by the British Medical Association Helen Lawson grant.

Footnotes

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