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Biomedical subjects

S Arlinger

Publications and source records attributed to S Arlinger.

At least 19 recordsLinked to original sources
PubMed2001

Cognitive effects in dichotic speech testing in elderly persons.

OBJECTIVE: To study the effect of chronologic age on central auditory functions using dichotic speech tests and to study whether and how the age effect in dichotic listening is related to cognitive ability. DESIGN: Dichotic speech tests and cognitive tests were performed on 30 bilaterally hearing-impaired subjects, with a pure-tone average better than 50 dB HL. They were between 42 and 84 yr of age and were divided into an older and a younger group comprising 15 subjects each. The dichotic test material were digits, low-redundancy sentences and consonant-vowel syllables. The subjects reported stimuli heard in both ears (free report) or in one ear (directed report to left or right ear). The cognitive test battery comprised tests focusing on short-term memory, verbal information-processing speed and phonologic processing. RESULTS: A decreased overall performance in all dichotic speech tests was observed in the older group. In the syllable test the older subjects showed poorer results when focusing on the stimuli heard in the left ear, as compared with when focusing on stimuli heard in the right ear, whereas the younger group showed almost equal results for left- and right ear-focusing conditions. An age effect was also seen in reaction times recorded in the cognitive tests and in the scores of the reading span test. These cognitive parameters correlate with the results of the dichotic test when focusing to the left, but not when focusing to the right in the directed report condition. In the free report condition the overall performance showed a high correlation with cognitive test parameters. CONCLUSIONS: Effects of chronologic age in dichotic speech tests in the elderly have been verified. The degree of effect is dependent on test material, way of reporting and focusing condition. The different listening tasks in dichotic tests put different demands on cognitive ability shown by a varying degree of correlations between cognitive function and dichotic test parameters. Also, the results indicate a strong connection between age-related cognitive decline in the elderly and problems to perceive stimuli presented to the left ear.

Adult↗
PubMed2001

Speech recognition in background noise: monaural versus binaural listening conditions in normal-hearing patients.

HYPOTHESIS: Patients with unilateral conductive hearing impairment often experience a great advantage in improved hearing thresholds after reconstructive ear surgery because the binaural hearing leads to increased speech recognition in competing noise. The aim of this study was to develop a clinical audiometric test to quantify the ability of speech recognition in background noise preoperatively and postoperatively. METHODS: A model consisting of phonetically balanced (PB) monosyllabic words and/or a just-follow-conversation test (JFC) was used in 16 normal-hearing listeners. In 8 of the participants, JFC at two levels of background noise (60 and 40 dB sound pressure level) was used as the only method. The tasks were performed in an anechoic chamber with varying spatial separations of speech and noise sources under free field conditions. The tests were made binaurally and monaurally; the latter condition was achieved by occluding one ear with a hearing protector. In PB word tests, the percent of correctly repeated words was scored. In the JFC task, the speech signal was adjusted by the listener to a level where he or she could just understand what was being said. This was expressed as a signal-to-noise (S/N) ratio. RESULTS: In both types of tests, the subjects achieved significantly better speech recognition scores in the binaural situations. In summary, compared with monaural conditions, the subjects achieved 17% to 18% better speech recognition in PB tests, and in JFC tests a 2-to 3-dB lower S/N ratio in binaural conditions. CONCLUSION: These free field tests can be developed further as a clinical tool preoperatively and postoperatively to evaluate the effect of binaural hearing after ear surgery.

Audiometry, Pure-Tone↗
PubMed2000

Evaluation of OAE-recording as a complementary test method for adults with moderate to profound mental retardation.

The recording of otoacoustic emissions (OAE) was evaluated as a complementary test method for adults with moderate to profound mental retardation (MR). A portable apparatus, ILO 288 Echoport linked to a Compaq LTE 5100 notebook with software ILO 88 V 4.2, was used. Otoscopy and tympanometry were also performed. Criteria for emissions were S/N 3 dB or more and reproducibility 60% or more for at least three frequency-bands. The criteria for partial emissions were the same, but for only one or two frequencies. Two examiners were needed: one to keep the tested person calm and quiet and the other to handle the keyboard. Thirty-eight people with different degrees of MR in connection with other disabilities were included. They had all exhibited incomplete results in a previous hearing screening of more than 1,000 adults with MR. Reproducible transiently evoked OAEs (TEOAE) were recorded from 11 ears (7 people), partial TEOAEs from 6 ears (4 people) and no emissions from 15 ears (10 people). Registration from 24 ears (13 people) could not be evaluated because of too much external and internal noise. Eight people rejected the examination. Only four people showed emissions in both ears. Accordingly, 34 people (89.5%) had to be re-tested or referred for further investigation, 21 of them (55%) because of noisy recordings or no co-operation. It is concluded that the TEOAE-test in its present form cannot fulfil the demands for a functioning test method for this population. In single cases, however, TEOAE-recording can complement other audiological tests.

Acoustic Stimulation↗
PubMed2000

Fitting hearing aids to first-time users.

Clinical experience indicates that first-time hearing aid users prefer less gain and lower maximum output levels than experienced users. This hypothesis was tested on 20 subjects being fitted with their first aids. The study was double blinded by using a programmable hearing aid, set to either the standard setting according to the manufacturer's software or to reduced gain and maximum output. Half of the subjects started with one hearing aid and half with the other, changing to the other hearing aid after 3 days trial with each setting. At the end of the study, subjects stated preference in specified situations and overall. No significant differences in APHAB, sound quality, estimated communication ability or perceived loudness scores were seen for the two settings. Nine subjects preferred the standard setting, seven the reduced setting and four were undecided. No correlation could be found between preference and audiological variables.

Acoustic Stimulation↗
PubMed2000

Can we establish internationally equivalent outcome measures in audiological rehabilitation?

OBJECTIVE: This paper intends to discuss issues related to cultural, ethnic, and other nonaudiological variables that may affect the response when trying to determine outcome of audiological rehabilitation in different countries. DESIGN: The ideal measure for the determination of outcome of audiological rehabilitation would be sensitive to changes in disability as well as handicap. Further, it would allow unforeseen effects to be identified and not be limited by language borders or cultural and ethnic differences. A variety of critical factors are discussed that are related to culture, social traditions, ethnic factors, etc. that may affect outcome measures and thus make international equivalence difficult. CONCLUSIONS: With careful consideration of the factors discussed, a basic set of questions could be formulated and agreed on, calibrated on suitable populations in different countries, and thereafter used as a bridge across borders to allow comparison of different procedures or meta-analyses of studies performed by different laboratories.

Audiology↗
PubMed2000

Optimal outcome measures, research priorities, and international cooperation.

The participants in the Eriksholm Workshop on "Measuring Outcomes in Audiological Rehabilitation Using Hearing Aids" debated three issues that are reported in this article. First, it was agreed that the characteristics of an optimal outcome measure vary as a function of the purpose of the measurement. Potential characteristics of outcome self-report tools for four common goals of outcome measurement are briefly presented to illustrate this point. Second, 10 important research priorities in outcome measurement were identified and ranked. They are presented with brief discussion of the top five. Third, the concept of generating a brief universally applicable outcome measure was endorsed. This brief data set is intended to supplement existing outcome measures and to promote data combination and comparison across different social, cultural, and health-care delivery systems. A set of seven core items is proposed for further study.

Correction of Hearing Impairment↗
PubMed2000

Effects of middle ear pressure changes on clinical symptoms in patients with Ménière's disease--a clinical multicentre placebo-controlled study.

Different medical and surgical methods have been tried in attempting to reduce endolymphatic pressure in Ménière's disease. Pressure treatment has a role on the treatment staircase, after pharmacological treatment and before destructive methods. Pressure chamber treatment has shown that some patients respond well to the treatment with diminishing inner ear symptoms and also some hearing improvement. Earlier studies have shown that electrocochlear measurements improve after local pressure treatment in the ear. The present study was a prospective randomized placebo controlled, multicentre clinical trial. 56 patients with active Ménière's disease, age 20-65 years, with a hearing loss of 20-65 dB PTA participated. A total of 31 patients completed 2 weeks use with an active apparatus (Meniett) and 25 patients completed the 2 weeks with the placebo gadget. Both machines were produced by Pascal Medical, Halmstad, Sweden. Two weeks before the start of treatment a grommet was placed in the tympanic membrane. A significant improvement concerning frequency and intensity of vertigo, dizziness, aural pressure and tinnitus was reported by the active group on the visual analogue scales (VAS) questionnaire. In the placebo group no change was the most common finding, followed by worsening of the symptoms and a few improvements. The function in professional and family life improved during active treatment and did not during placebo treatment. Pure-tone audiometry did not improve after placebo treatment, but improved at the frequencies 500 Hz and 1,000 Hz after active treatment. The study showed an improvement in the inner ear symptoms after Meniett treatment. The mechanism may be explained by the influence on the round window membrane pressure receptors or an endolymphatic flow out through the pressure release points, such as the endolymphatic duct and sac, thus activating the longitudinal flow. Other mechanisms are also possible.

Adult↗
PubMed2000

A system for recording of auditory evoked responses.

A system for recording of evoked potentials from auditory stimulation was developed. The system consists of a PC equipped with an audio bandwidth board with analog input and output channels. The sound stimulus signal is generated in the computer, D/A converted, and via audio amplifier fed to earphones on the test subject. Auditory evoked potentials in response to sound stimuli are recorded via electrodes, amplified and filtered in an EEG recording system and fed to an A/D converter. The signal is analysed in the PC. The modular design of the program makes it a flexible system where stimulus and recording parameters can easily be modified and new applications can be added to standard clinical measurements. Three applications that are not possible with commercially available systems were developed and evaluated. a) A diagnostic procedure to verify hydrops in patients with Meniere's disease. b) Intraoperative recordings of auditory evoked potentials during neurootological surgery. c) Recording of mismatch negativity (MMN) potentials in evaluation of central auditory functions.

Audiometry, Evoked Response↗
PubMed1999

[Modern hearing-aids at the cutting edge of microelectronics. Increased possibilities for individual customization].

The development of modern hearing aids has been so great that they now represent the cutting edge of micro-electronics. Flexibility has been enhanced by computer-aided programming of the devices, and particularly by digital signal processing, developments which enable improved customization. Increased knowledge of the pathophysiology of the auditory system, fundamental processes in central auditory pathways, and cognitive function enable technological developments to be exploited, thus enhancing our ability to cope with an increasingly broad spectrum of hearing impairment, ranging from mild high-frequency loss to severe loss across the entire frequency range.

Auditory Pathways↗
PubMed1999

System identification of feedback in hearing aids.

The feedback problems of behind the ear (BTE), in the ear (ITE), and in the ear canal (ITEC) hearing aid categories have been investigated. All possible feedback paths (acoustical via vent, via tubing wall, mechanical, etc.) were converted to a single transfer function from the ear canal to the hearing aid microphone, here called the acoustic feedback equivalent (AFE). The attenuation of the AFE represents the maximum gain that can be used without the hearing aid starting to howl. Magnitude and phase responses of the AFE were identified on ten human subjects and on a Knowles ear manikin (KEMAR). The acoustic feedback via vent and leak between earmould and ear canal dominated the AFE. The transfer function from a reference point under the ear to the position of microphone of the different hearing aid categories was identified and used together with the AFE to calculate the maximum real ear aided gain (REAG) for the hearing aid categories. A model of the AFE, consisting of a fourth-order filter together with a delay, showed good agreement with the measured data.

Ear Canal↗
PubMed1999

Variations in the feedback of hearing aids.

Variations in the loop response of hearing aids caused by jaw movements, variations in acoustics outside the ear, and variations of vent size have been identified. Behind The Ear (BTE) and In The Ear Canal (ITEC) hearing aids were considered. The largest variations among the variations of the acoustics outside the ear, except when the hearing aid was partly removed, were found with the ITEC when a telephone set was placed by the ear. The variations of the loop response caused by changes in vent size were compared with the variations of a theoretical model of the feedback path. The theoretical model was also used to compare the feedback of different designs of the vent that gives the same acoustic impedance at low frequencies. The calculated feedback was less with the short vents (12 mm) than the long vents (24 mm).

Acoustics↗
PubMed1999

One year follow-up of users of a digital hearing aid.

A follow-up study has been performed on 29 of 33 original subjects who participated in a clinical trial of the digital hearing aid Oticon DigiFocus. The follow-up was performed after one year's use. Use of hearing instruments was assessed and questionnaires on hearing aid benefit, and hearing impairment and handicap were administered. Ratings of sound quality and measurements of speech recognition in noise were also performed. The results indicated almost doubled daily use of hearing aids as compared to that stated for the subjects' previous analogue aids one year earlier. Further, we found statistically significant improvements in speech recognition in noise one year post-fitting as compared to after one month. Other test results were essentially unchanged over time: no measure showed a significantly poorer rating or performance.

Aged↗
PubMed1999

Auditory temporal and spectral resolution in normal and impaired hearing.

Temporal, spectral, and combined temporal-spectral resolution of hearing was assessed by recording masked hearing thresholds. The masker was an octave band noise. Spectral resolution was assessed by introducing a spectral gap of half an octave bandwidth in the masker. A 50-msec gap assessed temporal resolution. The spectral and temporal gaps were used separately or simultaneously. Normal-hearing and hearing-impaired subjects participated. For each masking condition, the subjects were tested at masker levels 50, 60, 70, and 80 dB SPL and at test-tone frequencies 0.5, 1, 2, and 4 kHz. Normal-hearing subjects showed reduced masking with spectral and temporal gaps. The combination of spectral and temporal gap reduced masking further. The release of masking was dependent upon the masker level. Hearing-impaired subjects showed less release of masking than normal-hearing subjects. The degree of hearing impairment was inversely related to release of masking. Reliability of the test procedure was assessed.

Adolescent↗
PubMed1998

Recording techniques for transtympanic electrocochleography in clinical practice.

Enhancement of the signal-to-noise ratio is a central issue in electrically evoked response techniques. Transtympanic electrocochleography requires careful methodological considerations as responses from the cochlea may easily be affected by various sources of electromagnetic noise. The final electrophysiological waveforms are acquired by advanced signal processing which influences the content of the recordings. A standard method of transtympanic electrocohleography is presented here to increase the feasibility of the measurements in daily clinical use and to facilitate uniform interpretation of the recordings. The electrocochleographic recordings were carried out in 61 patients with a clinical diagnosis of Meniere's disease and in 15 ears of normal hearing subjects. The electrophysiological data are presented and set in relation to the results reported by other laboratories under equivalent recording conditions. Methodological factors of consequence for the quality of the recordings, such as testing environment, properties of the equipment, mode to produce and deliver stimuli and properties of the electrodes, are analysed.

Acoustic Stimulation↗
PubMed1998

A method for evaluating temporal, spectral and combined temporal-spectral resolution of hearing.

A method for evaluating the spectral, temporal and combined spectral temporal resolution of hearing is presented; it was used to obtain masked hearing thresholds using the fixed frequency Békéy technique. The masking noise was a broadband random noise with a 3 dB/octave roll off (pink noise). Spectral resolution was assessed by introducing a spectral gap in the masking noise centered at the test tone frequency. Temporal resolution was assessed by introducing temporal gaps, the centre of which coincided in time with the centre of the test tone-pulses. The spectral and temporal gaps were used either separately or simultaneously. Release of masking values were calculated from masked hearing thresholds. One test group comprised 16 normal-hearing subjects, a second group 16 elderly (age 55-75 years) subjects with normal hearing for their age. Temporal gaps were 20, 50 and 100 ms long. Spectral gaps had a bandwidth of 1/10, 1/3, and 1 octave. Each gap or combination of gaps was tested at the frequencies 0.5, 1, 2 and 4 kHz. Release of masking increased with increasing temporal or spectral gaps. If a temporal gap and a spectral gap were combined, the release of masking increased further. Maximum release of masking was obtained with the 100 ms temporal gap combined with the 1 octave notch filter. The overall difference in release of masking between the young and elderly normal-hearing group was 2 dB.

Adolescent↗
PubMed1998

Clinical trial of a digital hearing aid.

A clinical trial of Oticon DigiFocus hearing aid was performed. The test aid was evaluated on 33 subjects with several years' experience as users of modern analog hearing aids. These aids were used as reference for the 1-month-long trial. The Abbreviated Profile of Hearing Aid Benefit (APHAB) showed a mean difference in benefit with superior ratings for the test aid concerning ease of communication, speech in reverberation and speech in background noise. The subjects' own aids were rated somewhat better concerning aversiveness of sounds, but this difference was not statistically significant. The Gothenburg Profile showed a statistically significant difference between the test aid and the reference aids in favour of the test aid. The difference was not most evident with regard to speech communication and the effects of hearing loss on social interactions. Sound quality ratings concerning clearness were significantly higher for the test aid. Speech recognition thresholds in noise were on average 0.7 dB better for the test aids when tested at speech levels 60 and 75 dB. The difference was statistically significant only at 75 dB. There was significant interaction between general preference and hearing aid type, indicating that overall sound quality was an important factor affecting the general preference for either the test aid or the reference aid. Twenty-three subjects generally preferred the test aid, six preferred their own aid and four stated no difference.

Adult↗
PubMed1998

Dichotic speech tests.

When central auditory dysfunction is present, ability to understand speech in difficult listening situations can be affected. To study this phenomenon, dichotic speech tests were performed with test material in the Swedish language. Digits, spondees, sentences and consonant-vowel syllables were used as stimuli and the reporting was free or directed. The test material was recorded on CD. The study includes a normal group of 30 people in three different age categories; 11 years, 23-27 years and 67-70 years. It also includes two different groups of subjects with suspected central auditory lesions; 11 children with reading and writing difficulties and 4 adults earlier exposed to organic solvents. The results from the normal group do not show any differences in performance due to age. The children with reading and writing difficulties show a significant deviation for one test with digits and one test with syllables. Three of the four adults exposed to solvents show a significant deviation from the normal group.

Adult↗