[Studies on the optimal electrode position in patients with cochlea implants].
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Acoustic Impedance Tests↗
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Results for “Speech Reception Threshold Test”
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Sentence intelligibility in noise for listeners with normal hearing and hearing impairment: influence of measurement procedure and masking parameters.
Speech intelligibility measurements strongly depend on several procedural parameters. In order to obtain comparable results from different test procedures, these parameters must be investigated as to which should be standardized and which could be set freely. This study investigates the influence of noise level, noise type, and presentation mode on speech reception thresholds (SRTs), and intelligibility function slopes in noise for normal-hearing and hearing-impaired subjects. The noise presentation level had no significant influence on either SRTs or slope values, provided that the presentation level exceeded hearing threshold. Two stationary, speech-shaped noises produced identical results. Speech-simulating fluctuating noise yielded about 14 dB lower SRTs for normal-hearing subjects and about 10 dB lower SRTs for 20% of the heating-impaired subjects. Of the hearing-impaired subjects, 30% did not benefit from the modulations and showed similar SRTs as for stationary noise. Using continuous noise yielded lower SRTs compared to gated noise. However, the difference between the results in continuous and gated noise was not significant for the hearing-impaired subjects. A presentation level of 65 dB SPL (normal-hearing subjects) or 80 dB SPL (hearing-impaired subjects) and an interfering noise with a spectrum similar to the mean long-term average speech spectrum (LTASS) is suggested for comparable adaptive measurement procedures. A fluctuating, speech-shaped noise is recommended to differentiate between subjects.
Adult↗
On application of adaptive decorrelation filtering to assistive listening.
This paper describes an application of the multichannel signal processing technique of adaptive decorrelation filtering to the design of an assistive listening system. A simulated "dinner table" scenario was studied. The speech signal of a desired talker was corrupted by three simultaneous speech jammers and by a speech-shaped diffusive noise. The technique of adaptive decorrelation filtering processing was used to extract the desired speech from the interference speech and noise. The effectiveness of the assistive listening system was evaluated by observing improvements in A-weighted signal-to-noise ratio (SNR) and in sentence intelligibility, where the latter was evaluated in a listening test with eight normal hearing subjects and three subjects with hearing impairments. Significant improvements in SNR and sentence intelligibility were achieved with the use of the assistive listening system. For subjects with normal hearing, the speech reception threshold was improved by 3 to 5 dBA, and for subjects with hearing impairments, the threshold was improved by 4 to 8 dBA.
Acoustic Stimulation↗
Significance of auditory evoked responses (EABR and P300) in cochlear implant subjects.
An electrically derived auditory brainstem response (EABR) was recorded intra-operatively, and the event-related potential (P300) postoperatively in post-lingually deaf adult cochlear implantees. EABR and P300 were recorded from two groups of 25 subjects each. All subjects had a cochlear mini-22 system implanted at our center between 1994 and 1998. Two parameters of EABR, threshold (T) and the gradient of the amplitude-growth (AG) curve, were used for correlation with postoperative speech reception scores. The consonant recognition score (CRS) measured 1 month postoperatively showed a significant correlation with the AG curve of EABR (Spearman rank order test, p = 0.004), but not at later points in time. No correlation was found between the T and CRS at any time postoperatively. As the AG curve reflects the number of remaining spiral ganglion cells in the inner ear, a large number of surviving neurons is thought to be advantageous only for initial speech learning. The latency of P300 was measured for correlation with the speech reception score. The division of the cochlear implant subjects into a fair and a good hearing group according to their CRS showed that the average latency of P300 was significantly longer for the fair hearing group than for the good hearing group. A follow-up study showed that P300 latency significantly correlated with CRS measured at 6 months, 1 year and at a later time. As the latency of P300 is thought to reflect the time for sound processing in the central auditory system, our results indicate that plasticity of the central auditory system is more important than that of the peripheral auditory system for speech learning in cochlear implant subjects.
Adult↗
New computerized Finnish speech in noise test and binaural hearing.
Aided and unaided binaural versus monaural recognition of speech has been studied with more or less laborious methods when speech and noise sources are spatially separated. The efficacy of the new Finnish speech in noise test to show binaural advantage was evaluated in free field conditions. Thirteen subjects with normal hearing were tested measuring speech recognition thresholds in noise (SRTN) in anechoic chambre with different situations of spatial separation of speech and noise sources monaurally and binaurally. The noise source was fixed above the head (treating both ears similarly) and equidistant speech was delivered at different azimuths. SRTNs with mixed speech and noise without spatial separation served as normalizing reference. Differencies in SRTNs consistently followed the changing head and pinna shadow effects on the speech-to-noise ratio with a smaller binaural advantage. This new test seems to give quite economically the same results as those of previous more sophisticated investigations on speech recognition in free field situations.
Hearing↗
Development of the Connected Speech Test (CST).
This paper describes the first phase in the development of the Connected Speech Test (CST). This test of intelligibility of everyday speech has been developed primarily for use as a criterion measure in investigations of hearing aid benefit. The test consists of 48 passages of conversationally produced connected speech. Each passage contains 25 key words for scoring. All passages are of equal intelligibility for the average normal hearer. Key words vary in intelligibility within a passage but span the same intelligibility range in all passages. Several passages are administered, and the results averaged, to yield a single intelligibility score. For pairs of scores, each based on mean performance across 4 randomly-chosen passages, the 95% critical difference is estimated to be about 14 rationalized arcsine units (rau). The performance-intensity function for the CST has a slope of 12 rau/dB signal-to-babble ratio. Investigations of the test are continuing with hearing-impaired listeners.
Auditory Threshold↗
Auditory measures of selective and divided attention in young and older adults using single-talker competition.
In this study, two experiments were conducted on auditory selective and divided attention in which the listening task involved the identification of words in sentences spoken by one talker while a second talker produced a very similar competing sentence. Ten young normal-hearing (YNH) and 13 elderly hearing-impaired (EHI) listeners participated in each experiment. The type of attention cue used was the main difference between experiments. Across both experiments, several consistent trends were observed. First, in eight of the nine divided-attention tasks across both experiments, the EHI subjects performed significantly worse than the YNH subjects. By comparison, significant differences in performance between age groups were only observed on three of the nine selective-attention tasks. Finally, there were consistent individual differences in performance across both experiments. Correlational analyses performed on the data from the 13 older adults suggested that the individual differences in performance were associated with individual differences in memory (digit span). Among the elderly, differences in age or differences in hearing loss did not contribute to the individual differences observed in either experiment.
Acoustic Stimulation↗
Dynamic free-field headphone as hearing aid transducer. A preliminary report.
A comparison between a body-worn hearing aid with a conventional earphone/earmould system, and a free-field dynamic headphone demonstrated the significance of the coupling between the hearing aid earphone and the subject's ear. Measurement of the insertion gain revealed destruction of the ear-canal resonance with a conventional earmould, whereas the ear-canal resonance was preserved by the use of a dynamic headphone. The use of a body-worn hearing aid connected to a dynamic headphone showed a greater amplification at low as well as at high frequencies. Furthermore, a significantly better discrimination score and an improved sound quality were demonstrated with the dynamic headphone.
Acoustic Impedance Tests↗
Speech intelligibility and spatial release from masking in young children.
Children between the ages of 4 and 7 and adults were tested in free field on speech intelligibility using a four-alternative forced choice paradigm with spondees. Target speech was presented from front (0 degrees); speech or modulated speech-shaped-noise competitors were either in front or on the right (90 degrees). Speech reception thresholds were measured adaptively using a three-down/one-up algorithm. The primary difference between children and adults was seen in elevated thresholds in children in quiet and in all masked conditions. For both age groups, masking was greater with the speech-noise versus speech competitor and with two versus one competitor(s). Masking was also greater when the competitors were located in front compared with the right. The amount of masking did not differ across the two age groups. Spatial release from masking was similar in the two age groups, except for in the one-speech condition, when it was greater in children than adults. These findings suggest that, similar to adults, young children are able to utilize spatial and/or head shadow cues to segregate sounds in noisy environments. The potential utility of the measures used here for studying hearing-impaired children is also discussed.
Adult↗
Saudi Arabic speech audiometry for children.
Phonetically balanced mono and disyllabic Classical Arabic word lists were chosen to construct a Saudi Arabic speech test for children. These words were taken from children's stories. They were first evaluated by primary and pre-school children in the urban and rural areas of the Province and then divided in eight subgroups of 10 words each. The articulation curves obtained from the children with this test material are similar in course and value to that of the German language using similar speech-test material under the same conditions.
Audiometry, Speech↗
Test-retest variability in testing hearing of speech.
The repeatability of W-22 PB tests at levels of speech reception threshold (SRT) plus 5 to 30 dB in quiet and in white noise at S/N = 0 and 7 dB at a level of SRT plus 20 dB for 28 subjects with sensorineural hypoacusis. Standard deviations at various levels were from 9 to 13% compared to a standard deviation of less than 8% at SRT plus 40 dB. The lower variability at SRT plus 40 dB permits satisfactory confidence in the average of two measurements. However, it was found that more tests are required for the same confidence at the lower sensation levels. A protocol is suggested for carrying out this requirement.
Adolescent↗
Posterior fossa vestibular nerve section for the management of peripheral vertigo.
Patients with vertigo resistant to conservative treatment require surgical management. Between March 1991 and August 1996, vestibular nerve sections were performed in 108 patients with peripheral vertigo not responding to conservative treatment. The diagnoses were classic Ménière's disease in 96 patients and recurrent vestibulopathy in 12 patients. Combined retrosigmoid retrolabyrinthine (n = 106) and retrolabyrinthine (n = 2) approaches were used. Patients were grouped according to follow-ups of less than 2 years and more than 2 years. In the former group (n = 49), hearing preservation and vertigo control were achieved in 93.9% and 100%, respectively. In the latter group (n = 59) the rates were 89.8% and 96.6%, respectively. Overall complications were uncommon. Three patients had cerebrospinal fluid leakage and one had total hearing loss. According to our results, posterior fossa vestibular nerve section was found to be an effective treatment for the management of patients with intractable vertigo.
Adolescent↗
Vestibular findings associated with chronic noise induced hearing impairment.
Histological and functional derangements of the vestibular system have been reported in laboratory animals exposed to high levels of noise. However, clinical series describe contradictory results with regard to vestibular disturbances in industrial workers and military personnel suffering from noise induced hearing loss (NIHL). The purpose of the present study was to evaluate vestibular function in a group of subjects with documented NIHL, employing electronystagmography (ENG) and the smooth harmonic acceleration (SHA) test. Subjects were 22 men suffering from NIHL and 21 matched controls. Significantly lower vestibulo-ocular reflex gain (p = 0.05), and a tendency towards decreased caloric responses were found in the study group. No differences in the incidence of vertigo symptoms, spontaneous, positional and positioning nystagmus, directional preponderance and canal paresis in the ENG, or the SHA test phase and asymmetry parameters were observed between the groups. These results demonstrated a symmetrical centrally compensated decrease in the vestibular end organ response which is associated with the symmetrical hearing loss measured in the study group. Statistically significant correlations were found between the average hearing loss, the decrement in the average vestibulo-ocular reflex gain (p = 0.01), and ENG caloric lateralization (p = 0.02). These correlations might indicate a single mechanism for both cochlear and vestibular noise-induced injury. The results imply subclinical, well compensated malfunction of the vestibular system associated with NIHL.
Adolescent↗
Reception thresholds for sentences in bilingual (Spanish/English) and monolingual (English) listeners.
Recent evidence on the perceptual performance of bilingual listeners suggests that a nonaudibility-based cost exists in processing a second language. That is, when compared to monolingual English speakers and early bilinguals, listeners who acquired English as a second language after puberty show reduced performance when listening to the second language in background noise, despite normal auditory thresholds. However, past studies have not controlled for the homogeneity of the bilingual participants used in auditory research; therefore, it is unknown whether the deficit observed in bilingual function is due to a lack of control for language-related variables. The ability of a homogeneous group of Spanish-English bilinguals and English monolingual listeners to perceive sentences in quiet and in noise at threshold levels was evaluated using the Hearing in Noise Test (HINT). Both groups performed similarly in quiet conditions. In the noise conditions, the bilingual group's performance was significantly poorer than the monolingual group's performance. However, both groups showed a binaural advantage of 7-8 dB when the signal and noise were separated by 90 degrees.
Adult↗
Audiologic assessment of children with suspected hearing loss.
In assessing children with suspected hearing loss, audiologists are faced with the challenge of attempting to describe auditory function in a population that presents with a wide range developmental levels and abilities. Fortunately, there are a number of behavioral and physiologic tools available for the evaluation of auditory sensitivity and system integrity in children of all ages and developmental abilities. As powerful as many of these tools may be, however, it is important that the diagnosis of hearing loss be based on the outcome of independent measures of auditory function, which serve to cross-check and complement one another. Failure to do so is likely to result in inaccurate or incomplete delineation of auditory function.
Acoustic Impedance Tests↗
Cartilage palisade tympanoplasty in sinus and tensa retraction cholesteatoma.
OBJECTIVE: The aim of this study was to investigate whether reconstruction of the eardrum with palisade cartilage technique could prevent retraction of the new eardrum after surgery for sinus and tensa retraction cholesteatoma in children and to investigate the postoperative hearing. STUDY DESIGN: In 32 children aged 5 to 15 years, operated on from June 1995 to October 2000 for cholesteatoma (21 with sinus cholesteatoma and 11 with tensa retraction cholesteatoma) the eardrum was reconstructed with the palisade cartilage technique. Postoperatively, the children were seen as outpatients and were recently reevaluated with otomicroscopy, tympanometry, and audiometry. All patients (100%) were reevaluated on an average of 37 months (range 3-63 months). MAIN OUTCOME MEASURES: Postoperative retractions, perforations, cholesteatoma recurrence, and hearing. RESULTS: At the final examination, posterosuperior retraction was observed in two patients, both operated on for sinus cholesteatoma with reconstruction of the ossicular chain. In those cases, the palisades were not placed in the posterosuperior drilling defect behind the interpositioned incus. All the patients had an intact tympanic membrane at the final follow-up visit. One small perforation was surgically closed during the observation period. No patients developed cholesteatoma during the follow-up period. The postoperative hearing was good, and the hearing did not deteriorate with increasing observation time. CONCLUSIONS: The palisade technique effectively prevented postoperative retraction of the eardrum. The postoperative hearing was good.
Acoustic Impedance Tests↗
An audiometric test battery for the evaluation of occupational exposure to industrial solvents.
Subjects exposed to various industrial solvents were evaluated with a test battery comprising both peripheral and central auditory tests. After otoscopy, all subjects underwent the following audiometric procedures: air- and bone-conduction in the conventional frequency range, air-conduction in the extended high-frequency range, speech recognition score, low-pass filtered speech recognition, stapedius reflex threshold, stapedius reflex decay, auditory brainstem response, and cognitive event-related responses. Apart from mild to moderate sensorineural hearing loss found in some of the subjects, the peripheral tests were normal in most subjects. The central tests (filtered speech and cognitive responses) showed varying degrees of abnormality which may reflect different levels of disease in this group of subjects.
Adult↗
Evaluating the benefits of cochlear implants in an education setting.
The material presented here summarizes the first year of a study to determine whether cochlear implants, tactile aids, acoustic hearing aids, or some combination of these are best for developing spoken language in prelingual profoundly deaf children. The effects of each device over and above the gains normally achieved as a result of oral instruction are examined. Each group contains three matched children, one fitted with each device, who are enrolled in the Central Institute for the Deaf (CID) school for 3 years of evaluation and training. This report describes results obtained from four groups of matched subjects during their first year in the study. These subjects improved in all areas evaluated, regardless of the device used. However, the implanted subjects exhibited a greater rate of progress in acquiring auditory speech perception skills. They exhibited no advantage in acquiring speech production skills and spoken language skills during their first year with the device. The subtle advantages provided by the implant may become apparent in spoken language development when 2- and 3-year post-test results are examined.
Child↗