Systematic Review and Meta-Analysis of the Application of Virtual Reality in Hearing Disorders

Abstract

Background and Objectives: Trendy technologies, such as artificial intelligence, virtual reality (VR), and augmented reality (AR) are being increasingly used for hearing loss, tinnitus, and vestibular disease. Thus, we conducted this systematic review and meta-analysis to identify the possible benefits of the use of VR and AR technologies in patients with hearing loss, tinnitus, and/or vestibular dysfunction, with the aim of suggesting potential applications of these technologies for both researchers and clinicians.Materials and Methods: Published articles from 1968 to 2022 were gathered from six electronic journal databases. Applying our specified inclusion and/or exclusion criteria, 23 studies were analyzed. As only one article on hearing loss and two articles on tinnitus were found, 20 studies on vestibular dysfunction were only finally included for the meta-analysis. Standardized mean differences (SMDs) were chosen as estimates to compare the studies. A funnel plot and Egger’s regression analysis were used to identify any risk of bias.Results: High heterogeneity (I2: 83%, τ2: 0.5431, p<0.01) was identified across the studies on vestibular dysfunction. VR-based rehabilitation was significantly effective for individuals with vestibular disease (SMDs: 0.03, 95% confidence interval [CI]: -0.08 to 0.15, p<0.05). A subgroup analysis revealed that only improvement in the subjective questionnaire was meaningful and statistically significant (SMDs: -0.66, 95% CI: -1.10 to -0.22).Conclusions: VR-based vestibular rehabilitation showed potential for subjective rating measures like Dizziness Handicap Index. The negative effect of aging on vestibular disease was indirectly confirmed. More clinical trials and an evidence-based approach are needed to confirm the implementation of state-of-the-art technology for hearing loss and tinnitus, representative diseases in neurotology.

Remote Delivery of Vestibular Rehabilitation for Vestibular Dysfunction: A Systematic Review

“…Telehealth has been described to include four major components: Live communication (e.g., video call), store and forward (e.g., recorded videos for patients to view later), remote patient monitoring (e.g., electronic communications to healthcare providers), and mobile health (e.g., mobile phone applications) (13,14). In addition to traditional telehealth, the development of medical technologies and virtual reality systems has created forms of rehabilitation to perform VRT by oneself (12,(15)(16)(17). These interventions may reduce the transportation needs for patients, because transportation can be a barrier to care for people with vestibular dysfunction (18).…”