INNOVATION & LEARNING
We develop and contribute to leading edge practice, therapies and technologies to deepen knowledge and drive continuous innovation in hearing care and wellbeing.
We provide training and capacity building for professionals and future practitioners providing hearing care and support.
Research collaboration will help shape future cochlear implant care
Collaboration between The Hearing House and the University of Auckland Audiology Department has resulted in an exciting finding that will help shape future cochlear implant care in New Zealand.
Recent Master of Audiology graduate Nina Boesch didn’t anticipate her thesis topic findings would have such a meaningful impact on clinical decision making for The Hearing House team.
After completing a three-year biomedical science degree at the University of Auckland, Nina found herself drawn to a more hands-on, client-focused career. A lecture by Professor Grant Searchfield on audiology sparked her interest, and she soon embarked on the university’s two-year master’s programme.
In February 2025, she completed her thesis under the supervision of The Hearing House’s clinical director Associate Professor Holly Teagle and Dr Rachael Taylor, a senior research fellow at the University of Auckland, before returning home to her native Hawkes Bay to begin work as a provisional audiologist at Triton Hearing in Napier.
Her current clinical role includes hearing assessments, fitting and managing hearing aid technologies, and counselling and referring her local clients for vestibular physiotherapy, or medical referrals where required.
It’s a field she feels personally connected to—her grandfather lives with hearing differences, and staying connected with him is difficult, especially since he only uses a landline.
.jpg)
Audiologist Nina Boesch with a client
Nina’s thesis, titled Preoperative Vestibular Assessment Outcomes of Cochlear Implant Candidates, explored the incidence of balance issues that have an organic cause in adults preparing to receive a cochlear implant (CI). While vestibular dysfunction is significantly more common in this group than in the general population, New Zealand had no formal data or standardised approach to preoperative vestibular screening—until now.
Associate Professor Holly Teagle adds, “While vestibular testing has become a standard part of many international cochlear implant programmes, it took assessing our own New Zealand population to show the impact of this important diagnostic tool.”
“From Nina’s thesis, we learned that the vestibular assessment could easily be included in the candidacy evaluation process and that the findings could afford meaningful contributions to patient care.
Nina’s study included 28 adult CI candidates who had histories of dizziness, vertigo, imbalance, or falls. Strikingly, 75% of the participants were found to have clinical vestibular dysfunction prior to implantation. These findings highlight the critical role of preoperative vestibular testing in surgical planning, patient counselling, and rehabilitation.
Vestibular testing assesses the balance organs of the inner ear using tools like eye-movement tracking goggles and balance platforms. In New Zealand, such testing is carried out by audiologists and specially trained physiotherapists. The goal is to determine the cause of dizziness or imbalance and ensure the safest and most effective treatment plan.
To support her findings, Nina also interviewed cochlear implant surgeons. They confirmed that vestibular assessments were clinically valuable, aiding in decisions such as which ear to implant when asymmetrical vestibular function is present. The testing also allows for better patient education about potential risks and referrals to vestibular physiotherapy when needed.
The thesis offers several recommendations: that vestibular screening be extended to all adult CI candidates, not just those showing symptoms of imbalance or dizziness, and that services be developed for paediatric CI candidates, despite current challenges in testing young children. Nina also sees value in expanding vestibular rehabilitation services, potentially through University of Auckland’s growing physiotherapy programme.
Looking ahead, Nina hopes to work with children in the public health system. For now, she’s proud of the real-world impact her research is already making, and grateful for the support she’s received from her supervisors and wider team.
“I had really amazing support from my thesis supervisors Holly Teagle and Dr Rachael Taylor, and from Caroline Selvaratham and the team at The Hearing House,” she says. “They helped facilitate the data collection and getting consent from the participants. I couldn’t have done it without them.”
Dr Teagle adds, “Nina’s thesis is a great example of how combining the resources of The Hearing House’s partners results in valuable learning opportunities for students, as well as our clinical and surgical teams.”
Raising awareness of congenital Cytomegalovirus on the local and global stage.
Dr. Holly Teagle, The Hearing House’s Clinical Director, is continuing local and global efforts to raise awareness of congenital Cytomegalovirus (cCMV), the most common cause of non-genetic hearing loss in children.
She has presented to international audiences on the subject, including the Australasian Newborn Hearing Screening (ANHS) conference in Hobart and the American Cochlear Implant Alliance Conference in Dallas, Texas.
Children born with CMV often have multiple medical diagnoses, which create many challenges for families. In addition to hearing loss, CMV can also result in developmental delays, cognitive impairment, movement and balance difficulties, visual difficulties and neurocognitive disorders, such as autism and sensory integration problems.
Around 20% of referrals for cochlear implantation at The Hearing House are children who have hearing loss as a result of CMV.
Since 2019, The Hearing House has developed and delivered several informational CMV workshops and diagnostic clinics for children, their whānau and local service providers.
The goals of these forums are to provide opportunities for medical and therapy specialists to work together and create a safe and friendly environment for parents and family members of children with CMV to meet and network; to support parents and whānau so they can learn and understand a child’s special needs; to translate findings of evaluations and make recommendations for care in the local community, as well as empower parents and whānau to advocate for their child.
“We’ve been addressing the lack of awareness by increasing the amount of information, resources and support available to Kiwi families,” says Holly.
“Part of this has been the establishment of the CMV Clinic for The Hearing House whānau, which brings family members together with medical and therapy professionals.”
The Hearing House hopes to stage further workshops for children and their whānau over the course of this year.
Artwork by Hearing House client Bev Hickson-Snook
Living Guidelines set to improve standard of hearing care for adults.
A global collaborative effort is underway to address the unmet needs for adults with hearing loss.
As a member of the Cochlear Implant Global Task Force, Dr Holly Teagle has been instrumental in developing the new Living Guidelines on hearing care for adults. These guidelines provide guidance for hearing professionals to improve the standard of adult hearing healthcare, including assessment and follow-up care for a cochlear implant.
The taskforce is calling on individuals and families to provide feedback on the draft Living Guidelines document, asking them to share their lived experience and offer their insights.
“Clinical guidelines are integral to ensuring that healthcare decisions are based on the best available evidence. Before now, there were no international and patient-centred guidelines for hearing care and cochlear implants for adults,” Holly says.
“We need to hear the voices of our cochlear implant recipients,” she says. “Their input is vital in creating a more inclusive and effective healthcare environment that provides better outcomes for everyone.
“Untreated hearing loss has been linked to decreased quality of life, cognitive decline and depression and there is a growing body of evidence suggesting an association between hearing loss in older adults and neurocognitive disorders, such as dementia.
“Additionally, hearing loss can also have an impact on the individuals close to them, including family and friends.”
The new Living Guidelines make nine recommendations across hearing screening, specialist referral and evaluation, rehabilitation and patient outcomes. The two-year research project looked at more than 13,000 peer-reviewed studies and involved a panel of 52 experts representing 58 organisations, including those living with hearing loss. The guidance and guidelines will be updated as new evidence is published.