Foundation Award for Research

Wafaa Kaf

Dr. Wafaa Kaf

Communication Sciences and Disorders
College of Health and Human Services

I. Focus of Research

Research is one of my great passions because it allows me to blend my medical and research background into translational research that positively impacts assessment and management of individuals with auditory and balance disorders. My primary research interest is in the areas of early auditory evoked potentials to study different objectives: (1) objective assessment of hearing threshold in adults and children using Auditory Steady-State Response (ASSR) and Auditory Brainstem Response (ABR), (2) investigate the integrity of the auditory efferent system in children with autism spectrum disorders using otoacoustic emissions, and (3) study inner ear and auditory nerve neural adaptation phenomenon using both electrocochleography and ABR measures for early diagnosis of Meniere’s disease and auditory nerve lesions. Also, I have a research interest to evaluate middle ear function using wideband tympanometry measures to distinguish different middle ear pathologies. 

II. Major Projects

Novel Meniere’s disease diagnosis: simultaneous electrocochleography and auditory brainstem response recording to fast click rate (2015-Present). This study is funded by the Hearing Health Foundation’s Emerging Research Grants.

Objective assessment of mild degree of hearing loss using auditory steady-state response and auditory brainstem response pre- and post-operative (myringotomy) in children with middle ear effusion (aka. ear infection) (2014-2016). This study was funded by a sabbatical and equipment support from the Vivosonic Inc., Toronto, ON, Canada.

Another study is currently being conducted to compare the pass/refer results using automated auditory brainstem response of two screening equipment from two manufacturers. Vivosonic Inc., is also providing equipment and technical support for this study.  

III. Future Directions of Research

Findings from the objective diagnosis of Meniere’s disease project will lead to a series of clinical studies to: (i) evaluate the neural adaptation phenomenon in early vs. late phases and unilateral vs. bilateral cases; (ii) improve the understanding of the pathophysiology and the fluctuation of Meniere’s disease by comparing pattern and critical point of neural adaptation during and following Meniere’s attacks; (iii) distinguish Meniere’s disease from other related pathologies such as migraine-associated vertigo, vestibular semicircular canal dehiscence, and acoustic neuroma; (iv) monitor the effect of treatment by comparing critical rate of neural adaptation before and after treatment. 

IV. Topics related to your research and of interest to the broad University Community, for which you are available for presentations and/or consultations.

Meniere’s disease is a devastating inner ear disorder that causes characteristic symptoms such as: fluctuating, yet progressive, sensorineural hearing loss, devastating vertigo, ear fullness, and tinnitus. Its diagnosis is based on patients’ report and solely clinical symptoms without any objective confirmation of the diagnosis. This research study is the first clinical trial for an objective, early diagnosis of Meniere’s disease by recording electrocochleography and auditory brainstem response measures to fast sounds to stress the inner ear and the auditory nerve. Our hypothesis is that significant reduction in action potential amplitude of the auditory nerve will occur sooner in the Meniere’s disease than the control group. Thus, identifying the critical rate of occurrence of significant neural adaptation is a marker for early diagnosis and classification of Meniere’s disease, and distinguishing it from other inner ear diseases and auditory nerve lesions. This research has significant implications for health care providers in general and the field of otolaryngology and audiology, in particular.

Several children with autism spectrum disorders demonstrate a variety of auditory manifestations, which include hypersensitivity to sounds, difficulty hearing in the presence of competing speech or background noise, and tinnitus. Our research findings showed evidence of dysfunction of certain sets of nuclei in the brainstem that may contribute to their auditory difficulties.