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Biomedical subjects

B J Edgerton

Publications and source records attributed to B J Edgerton.

At least 19 recordsLinked to original sources

Prosodic and segmental aspects of speech perception with the House/3M single-channel implant.

Four adult users of the House/3M single-channel cochlear implant were tested for their ability to label question and statement intonation contours (by auditory means alone) and to identify a set of 12 intervocalic consonants (with and without lipreading). Nineteen of 20 scores obtained on the question/statement task were significantly better than chance. Simplifying the stimulating waveform so as to signal fundamental frequency alone sometimes led to an improvement in performance. In consonant identification, lipreading alone scores were always far inferior to those obtained by lipreading with the implant. Phonetic feature analyses showed that the major effect of using the implant was to increase the transmission of voicing information, although improvements in the appropriate labelling of manner distinctions were also found. Place of articulation was poorly identified from the auditory signal alone. These results are best explained by supposing that subjects can use the relatively gross temporal information found in the stimulating waveforms (periodicity, randomness and silence) in a linguistic fashion. Amplitude envelope cues are of significant, but secondary, importance. By providing information that is relatively invisible, the House/3M device can thus serve as an important aid to lipreading, even though it relies primarily on the temporal structure of the stimulating waveform. All implant systems, including multi-channel ones, might benefit from the appropriate exploitation of such temporal features.

Adult

Vowel perception: experiments with a single-electrode cochlear implant.

We investigated vowel perception by 15 subjects using the single-electrode cochlear implant used at the House Ear Institute in Los Angeles. Subjects were postlingually deaf adults having histories of unsuccessful hearing aid use and a minimum of 6 to 12 months experience with the implant. Eleven American English vowels spoken by a male talker were tape recorded, digitized, analyzed, and controlled for the experiments. The stimuli were audio-recordings of both natural and loudness-matched vowels. Subjects rated the dissimilarity of both the naturally spoken and the loudness-matched vowels, and performed identification of the latter. Two normal-hearing subjects served as controls for the dissimilarity tasks. Multidimensional scaling, hierarchical clustering, and percent correct identification analyses were used to help determine the perceptual features used by the subjects in their judgments. Generally, the normal-hearing subjects took advantage of second formant (F2) frequency information. The cochlear-implant users relied primarily upon fundamental (F0) and first formant (F1) frequency information and demonstrated difficulty in vowel identification. No major differences were noted for the natural versus loudness-matched vowels. F2 information, requisite for accurate vowel recognition, did not correspond to any of the perceptual dimensions discerned in the results obtained from implant subjects.

Adult

Auditory/visual speech perception by cochlear implant users and hearing aid wearers.

This study assessed the auditory/visual speech perception abilities of profoundly hearing-impaired subjects using the cochlear implant (CI) developed at the House Ear Institute with those of patients using traditional hearing aids (HA). Audio-video tape recordings of consonant-vowel-consonants (CVCs) consisting of: ten vowels in the context/mvm/, vowel-consonant-vowels (VCVs) consisting of twenty-four consonants in the context/ C /, and the CID Everyday Sentences were presented through auditory, visual, and auditory-visual modes. Subjects' verbal responses to the stimuli were transcribed by the experimenters. Statistical analyses of the data revealed significant differences for groups, stimuli, and conditions. Inspection of the subject's confusion matrices revealed that both groups used closed-bilabial, velar, dental, labial, and easy to see/hard to see features based on place of articulation in the visual mode. Salient features in the auditory mode for the CI group were duration, sonorancy, and some manner attributes, while the HA subjects used these features as well as sibilancy and voicing. Both groups integrated auditory and visual cues to improve scores in the auditory-visual condition. These findings have implications for future developments of auditory prostheses and auditory rehabilitation programs.

Adult

Use of the California Consonant Test in evaluating hearing aids.

The California Consonant Test (CCT) was used to evaluate different hearing aids for twelve listeners with mild to moderate sensorineural hearing losses. The CCT was mixed with white noise at signal-to-noise ratios (S/Ns) of +30 (quiet), +15, +5, and O dB and presented through hearing aids for each listener; the quiet condition was retested. Significant differences were found between mean test scores for the high and low S/Ns. Intralistener hearing aid differences were found most frequently in the quiet condition. Truncation errors were frequent for the low S/Ns. These findings indicate that the sensitivity of the CCT is decreased rather than increased by mixing it with noise. Critical differences of 5% or more between hearing aids were more frequent as the S/N improved; the greatest number of differences occurred for the quiet condition.

Aged

Auditory capabilities of single-channel cochlear implant patients. Etiologic considerations.

The clinical audiometric test results from 53 postlingually deafened adults using the House single-channel cochlear implant were analyzed according to cause of deafness (otosclerosis, ototoxic drugs, meningitis, and trauma). With the exception of one measure, the routine clinical tests did not show a relationship between cause of deafness and performance with the cochlear implant. These findings suggest that, clinically, the single-channel cochlear implant is a viable prosthesis for patients with a wide variety of causes of deafness.

Adolescent

Three-dimensional reconstruction of the cochlear nuclear complex in humans.

For accurate physical three-dimensional reconstruction of the cochlear nuclear complex (CN), we used light microscopy to analyze the CN boundaries, cell types, and myelinated nerve bundles and transferred traced contours from enlarged photographs of serial sections onto acrylic plates. We produced two models, one demonstrating the CN in relation to the brain stem and the other showing the CN completely dissected out of the brain stem. The models localized the CN boundaries on the brain-stem surface and revealed topographic characteristics of the CN and a part of the eighth nerve adjacent to the brain stem. The major parts of the CN, namely, the ventral and dorsal cochlear nuclei, are located mainly within the lateral recess. The models produced are currently used in our institution to determine the optimal surgical and electrophysiologic approach to the CN.

Auditory Pathways

Surface topography of the cochlear nuclei in humans: two- and three-dimensional analysis.

We used three-dimensional reconstruction to study the cochlear nuclear complex (CN) in postmortem adult brains. Resulting data show that the largest part of the CN surface, particularly the dorsal cochlear nucleus (DCN), is fully within the lateral recess of the fourth ventricle. The surface of another subdivision, the ventral cochlear nucleus (VCN), is also almost entirely within the recess, except for a narrow zone adjacent to the caudoventral border of the nucleus. The caudal portion of the exposed zone of the VCN is in the vicinity of the rootlets of the glossopharyngeal (IX) nerve, and the ventral portion is close to the terminal part of the vestibulocochlear (VIII) nerve. The border between the intraventricular part of the CN and the extraventricular portion and also the terminal part of the VIII nerve approximately coincides with the line of attachment of the inferior medullary velum of the fourth ventricle (tenia of the choroid plexus). In the narrow strip of this ventral most part of the tenia we did not observe big blood vessels or neurons. Accordingly this could be a reasonably safe surgical route to the intraventricular surface of the CN.

Adult

Effects of speech materials on the loudness discomfort level.

Clinicians have used speech stimuli when measuring the loudness discomfort level (LDL) to determine the upper intensity limit for test stimulus presentation, and to select the saturation sound pressure level for an individual's hearing aid. Because little research has investigated the effects of speech stimuli on the LDL, this study was undertaken to compare LDLs using six commercially available speech materials on 120 normally hearing listeners. Our comparisons showed no significant differences between the mean scores for any of the speech stimuli. These findings suggest that any differences in the mean LDLs among studies probably are not attributable to the speech stimuli. The intrasession reliability of LDL measurement was also assessed using a modified method of limits procedure with 2-dB increments and instructions stressing initial discomfort. It was concluded that examiners probably could attain a high degree of reliability by simply averaging the results of two ascending trials, because 95% of these test/retest differences did not exceed 6 dB. Our findings were integrated with previous studies in terms of: (1) test stimuli; (2) listener experience; (3) instructional set; and (4) psychophysical method. This discussion points to many unanswered questions and concludes that the LDL should be interpreted very cautiously. Moreover, it is suggested that the stimuli selected for LDL measurement should reflect the examiner's purpose.

Acoustic Stimulation

Half-list speech discrimination measures in hearing aid evaluations.

The usefulness of half-list speech discrimination tests for evaluating hearing aids was assessed. Test and retest speech discrimination scores (SDSs) were obtained from 23 adults with moderate hearing impairment using four preselected hearing aids. Reliability coefficients were generally lower for half-lists than for full-lists, and the rankings of the hearing aids on the basis of SDSs were less consistent for the half-lists than for the full-lists. Individual subject differences between half-list SDSs were 10% or greater in more than one third of the cases. It was concluded that half-lists derived from the NU-6 full-lists should not be used to differentiate among hearing aids.

Adult

The speech air-bone gap: some clinical reservations.

Air-bone gaps derived from speech and from pure-tone testing were compared for an unselected clinic sample of 67 hearing-impaired Ss (80 ears). A moderately high Pearson r was found between the air-bone gap for speech vs for a pure-tone average (of the order of .80), but while the pure-tone air-bone gap predicted all but 5% of the cases of (confirmed) conductive losses, the speech air-bone gap prediction missed over 25%. When audiograms were grouped according to type of configuration, the flat and the high-frequency sloping types exhibited the largest discrepancies between air-bone gaps by speech vs pure tones; when the audiograms were grouped by degree of impairment, those with moderate-to-severe losses exhibited the largest discrepancies. Until a larger body of data is amassed, it was recommended that the air-bone gap for speech be used in conjunction with, not in place of, other audiometric tests.

Adolescent

A comparison of the Auditec of St. Louis cassette recordings of NU-6 and CID W-22 on a normal-hearing population.

Articulation functions were generated on a normal-hearing population with the Auditec of St. Louis cassette recordings of the NU-6 and CID W-22 speech discrimination tests. Both tests were similar and yielded slopes of about 4.4%/dB. Each gave a speech discrimination score of approximately 95% at 32 dB SL. Speech reception thresholds were obtained with monitored live voice and yielded good test-retest consistency. Speech thresholds were about 9 dB better than the ANSI (1969) specifications.

Adult

Reliability of monosyllabic discrimination tests in white noise for differentiating among hearing aids.

In spite of criticism, monosyllabic discrimination tests are widely employed for hearing aid selection. The current study was designed to investigate the following questions: (1) How reliable is aided speech discrimination of monosyllables in a background of white noise? (2) Can differences among hearing aids be reliably demonstrated by measuring intelligibility of monosyllables in a background of white noise? and (3) Do hearing aids interact with hearing loss? Twenty subjects with mild-moderate sensorineural hearing losses participated in two experimental sessions. Four hearing aids were evaluated using the NU-6 monosyllables in a background of white noise (s/n = +20 dB). Since the standard deviation of the test-retest differences was 6%, differences between aids were not considered significant unless they exceeded 12%. An interaction between subjects and hearing aids was found; that is, the best aid for one person was not the best for all. Measuring monosyllabic word intelligibility in a background of white noise does not reliably identify a single best aid. However, one or more inferior aids were consistently eliminated in 80% of the subjects.

Aged

Relative intelligibility of the CID spondees as presented via monitored live voice.

Using three speakers and 75 subjects, a 7.90dB range in the relative intelligibility of the Central Institute for the Deaf (CID) spondees was found when they were presented via monitored live voice. This range is consistent with previous research and is considered unnecessarily large and detrimental to the efficiency and precision of the speech reception threshold (SRT) test. The exclusive use of 18 words that have a mean range of 1.5 dB is suggested. The slope of the 3l-item spondee articulation function is 12 percent per decibel and is slightly steeper than previous research using the CID W-1 recorded spondees. The slope for the suggested 18-item test is also about 12 percent per decibel. For the 36-item test the mean speech detection threshold (SDT) was 6.6 dB sound pressure level (SPL) and the mean SRT was 14.2 db SPL. The 7.6-dB difference between the two speech measures is consistent with previous research but the SRT is about 6 dB better than the 20 dB SPL recommended by ANSI 1969. For the suggested 18-item test, the mean SRT was 14.5 dB SPL, which was 7.9 dB above SDT. When the 18-item test is used, average normal hearing can be expected to be about 5.5 dB better than specified by ANSI 1969.

Adult

Older persons' performance on auditory, visual, and auditory-visual presentations of the Edgerton and Danhauer Nonsense Syllable Test.

The speech sound discrimination abilities of 15 normal-hearing and 15 sensorineural hearing-impaired subjects between 55 and 65 years of age were assessed using videotaped presentations of the Nonsense Syllable Test (NST). Stimuli were presented in auditory (A), visual (V), and auditory-visual (AV) modes. All subjects received the stimuli in two trials for each presentation mode; hearing-impaired subjects were unaided for the first, and wore their own hearing aids for the second. Responses were transcribed phonemically and were scored by the phoneme method. Intra- and interjudge reliability was greater than 90%. Mean phoneme discrimination scores were plotted for each group across the three presentation modes. The results revealed that: both groups' performance improved from V to A to AV modes, but differences were apparent in the amount of increase across modes within each group; the NST differentiated between groups in the A and AV modes, but not in the V mode; the NST identified "poor" speechreaders in each group under both V and AV conditions; and consonant errors in the V mode formed seven homophenous categories based on place of articulation. The NST can be a useful screening test in auditory rehabilitation to distinguish those hearing-impaired persons who naturally take advantage of visual cues from those who do not.

Acoustic Stimulation

Cochlear implant for tinnitus. Case reports.

Various forms of electrical stimulation are effective in reducing tinnitus in some patients. Our experience with cochlear implant patients who have preimplant tinnitus demonstrated that about half experienced relief after the implant. We present five patients who underwent cochlear implant exclusively for tinnitus relief. Results are mixed with only one definite success. Electrical stimulation and our current research efforts are discussed.

Aged

Occlusion effect: bone conduction speech audiometry using forehead and mastoid placement.

The occlusion effect (OE) was determined for bone conduction speech reception thresholds (SRTs) in 24 normally hearing subjects using forehead and mastoid placement. Results indicated that the OE was about 3 dB greater using forehead as opposed to mastoid placement. The intersubject variability of the OE is similar for the forehead and mastoid positions. The formula for effective masking for bone conduction speech should be equal to the minimum masking level for bone conduction speech plus the air-bone gap of the nontest ear plus 18 dB to account for the OE when using mastoid placement.

Acoustic Stimulation

An investigation of the Auditec of St. Louis recordings of the Central Institute for the Deaf spondees.

The Auditec of St. Louis recordings of the Central Institute for the Deaf spondees were investigated with normal hearing subjects and found to have an unnecessarily large range of audibility. Consequently, an 18-item test with greater homogeneity of audibility was proposed. Articulation function slopes of about 10% per decibel were obtained with both the 18- and 36-item tests. The articulation function of the 18-item test did not reflect its improved homogeneity. The mean speech reception threshold was 5 dB better than ANSI-1969 specifications, and speech detection threshold was found to be 9 dB better than speech reception threshold. A derived speech reception threshold can be obtained by adding 5 dB to the lowest threshold at which any spondee is identified.

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