Improvements Needed in Hearing Screen Protocols For Stroke Patients

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Hearing Screening Stroke Protocol

According to the National Stroke Association, strokes are on the rise in younger populations with the past decade showing a 44 percent increase in hospitalizations due to stroke. This is an alarming statistic, as two-thirds of stroke survivors will leave the hospital with a disability, including hearing loss. This requires a proper screening protocol to ensure that patients who suffer from a stroke can be efficiently screened for hearing loss before hearing impairment can negatively affect a patient’s life or rehabilitation. A new 2020 study has outlined new recommendations to better serve stroke survivors who may have their hearing impaired and better screening protocols that can make identifying hearing loss a less laborious and more practical process.

How Strokes Can Affect Hearing

Strokes can affect all levels of the hearing process depending on what area of the brain is affected and may result in various types of hearing loss. Strokes that affect one or both temporal lobes can result in mild hearing loss or complete deafness. Peripheral hearing loss, disordered auditory processing such as Auditory Agnosia, and cortical deafness can all occur as well. Though this can create life-long complications for stroke victims and severely affect rehabilitation, identifying hearing impairment in stroke patients is still often neglected.

Why Hearing Screenings Are Often Overlooked

Lead by Dr. Nehzat Koohi and Dr. Doris-Eva Bamiou of the UCL Ear Institute in London, a 2020 study has shown that performing a detailed audiological assessment of all stroke patients would be a laborious process and may not be practical, concluding that “a preliminary hearing screening program is needed. By having a hearing screening protocol in place, the full audiological assessment can be reserved for those who fail the initial hearing screening.”

To do this, the team at London’s UCL Ear Institute devised three hearing screening tools for the identification of hearing impairment in stroke victims without requiring an in-depth audiological assessment that may be laborious, unnecessary, or too expensive. First, a handheld hearing screener for the determination of peripheral hearing loss. Second, a set of questionnaires on specific auditory complaints known as the Amsterdam Inventory for Auditory Disability (AIAD). And lastly, the Hearing Handicap Inventory for the Elderly (HHIE), a sensitive and specific tool for identifying hearing loss.

Dr. Koohi and Dr. Bamiou’s Reccomendations

All three methods have found to be beneficial to increasing the likelihood of hearing screenings after strokes. The “use of such questionnaires to screen for hearing impairment has been an attractive option because they don’t require any costly equipment.” explains both doctors, “Furthermore, these hearing screening tools do not require audiology expertise and can be administered with minimal time.” These questionnaires aren’t the only beneficial option the team had found. “Our study found that the handheld hearing screener demonstrated the highest sensitivity (93%) and specificity (100%), making it a reliable tool in identifying stroke patients who need detailed assessment for peripheral hearing loss.”

These three additions to hearing screen protocols for stroke patients could be implemented easily, cost-effectively, and wouldn’t require hospitals to use labor-intensive detailed audiological assessments that may seem unnecessary at first glance. Both Dr. Koohi and Bamiou concludes that “this protocol can help identify patients with high levels of perceived hearing difficulties who need additional evaluation, thereby promoting optimal outcomes from post-stroke rehabilitation.”

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