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PubMedDate not supplied

[Hearing aids: objective and subjective evaluations of linear and nonlinear amplification users].

BACKGROUND: Sensorineural hearing impaired individuals benefit themselves with the use of nonlinear amplification, once the compression tries to reestablish the sensation of normal loudness. However, the literature is still controversial in relation to the benefits for speech recognition in users of linear and nonlinear hearing aids. AIM: For this reason, the purpose of this study was to compare the performance of linear and nonlinear hearing aid users through objective and subjective evaluations, verifying the best circuit for hearing adaptation and speech recognition in silence and in noise. METHOD: 21 bilateral hearing aid users, who had been using the hearing aid for at least 3 months, with 12 to 64 years of age and with mild to moderate-severe hearing losses were studied according to the type of amplification used, forming two groups: linear group composed by 10 linear hearing aid users; and nonlinear group, composed by 11 nonlinear hearing aid users. Speech recognition tests were applied in silence and in noise, as well as the International Outcome Inventory of Hearing Aids questionnaire. RESULTS: Statistically significant differences were not observed between the groups for the speech recognition tests, in silence and in noise, and for the questionnaire. CONCLUSION: It can be concluded that no difference exists in the performance of linear and nonlinear hearing aids users, regarding the objective evaluations (speech tests) and the subjective evaluations (questionnaire), that indicate a better adaptation or a better speech recognition in silence or in noise.

Adolescent↗
PubMedDate not supplied

[Speech perception in cochlear implant users: two programming situations].

BACKGROUND: In order to shorten the programming process of cochlear implanted (CI) children it is possible to establish the T level (threshold level) as being 10% of the C level (most comfortable level). AIM: To compare the results of speech perception tests using the map of the real thresholds levels and the map corresponding to 10% of the C level. MRTHODS: A list of monosyllables and sentences were used with 30 CI individuals in two programming situations. RESULTS: no difference was found between the results in the speech tests in the two programming situations. CONCLUSION: The use of the map with the T level corresponding to 10% of the C level can be an option to program young children, especially for those who do not respond to the investigation of the real T levels.

Adolescent↗
PubMed2004

Recognition of speech presented at soft to loud levels by adult cochlear implant recipients of three cochlear implant systems.

OBJECTIVE: The purpose of this study was to conduct a large-scale investigation with adult recipients of the Clarion, Med-El, and Nucleus cochlear implant systems to (1) determine average scores and ranges of performance for word and sentence stimuli presented at three intensity levels (70, 60, and 50 dB SPL); (2) provide information on the variability of scores for each subject by obtaining test-retest measures for all test conditions; and (3) further evaluate the potential use of lower speech presentation levels (i.e., 60 and/or 50 dB SPL) in cochlear implant candidacy assessment. DESIGN: Seventy-eight adult cochlear implant recipients, 26 with each of the three cochlear implant systems, participated in the study. To ensure that the data collected reflect the range of performance of adult recipients using recent technology for the three implant systems (Clarion HiFocus I or II, Med-El Combi 40+, Nucleus 24M or 24R), a composite range and distribution of consonant-nucleus-consonant (CNC) monosyllabic word scores was determined. Subjects using each device were selected to closely represent this range and distribution of CNC performance. During test sessions, subjects were administered the Hearing in Noise Test (HINT) sentence test and the CNC word test at three presentation levels (70, 60, and 50 dB SPL). HINT sentences also were administered at 60 dB SPL with a signal-to-noise ratio (SNR) of +8 dB. Warble tones were used to determine sound-field threshold levels from 250 to 4000 Hz. Test-retest measures were obtained for each of the speech recognition tests as well as for warble-tone sound-field thresholds. RESULTS: Cochlear implant recipients using the Clarion, Med-El, or Nucleus devices performed on average equally as well at 60 compared with 70 dB SPL when listening for words and sentences. Additionally, subjects had substantial open-set speech perception performance at the softer level of 50 dB SPL for the same stimuli; however, subjects' ability to understand speech was poorer when listening in noise to signals of greater intensity (60 dB SPL + 8 SNR) than when listening to signals presented at a soft presentation level (50 dB SPL) in quiet. A significant correlation was found between sound-field thresholds and speech recognition scores for presentation levels below 70 dB SPL. The results demonstrated a high test-retest reliability with cochlear implant users for these presentation levels and stimuli. Average sound-field thresholds were between 24 and 29 dB HL for frequencies of 250 to 4000 Hz, and results across sessions were essentially the same. CONCLUSIONS: Speech perception measures used with cochlear implant candidates and recipients should reflect the listening challenges that individuals encounter in natural communication situations. These data provide the basis for recommending new candidacy criteria based on speech recognition tests presented at 60 and/or 50 dB SPL, intensity levels that reflect real-life listening, rather than 70 dB SPL.

Adult↗
PubMed2000

The influence of hearing and age on speech recognition scores in noise in audiological patients and in the general population.

OBJECTIVE: To describe the influence of pure-tone audiometry and age on the speech recognition score in noise, both in audiological patients and also in a random population sample. DESIGN: In a cross-sectional study, speech recognition scores (SRS) using monosyllabic words presented in a fixed background noise were evaluated on 1895 audiological patients of both genders with normal hearing or sensorineural hearing losses. The background noise was speech weighted and presented with a signal to noise ratio of +4 dB. In 291 participants, SRS in quiet was estimated as well. A female random population sample also was tested (N = 513). RESULTS: The major predictor for the SRS-noise was high-frequency hearing thresholds. If hearing was normal, age had no effect on speech recognition. Young persons with hearing loss had higher SRS-noise than older persons with the same degree of hearing loss. The difference between young and old persons became larger the greater the hearing loss. Predictive SRS-noise with consideration taken to hearing function and age are presented. SRS-noise correlated stronger with pure-tone audiometry and age than SRS-quiet. Controls performed better (by 10 to 20%) than their same-aged peers with similar hearing loss. CONCLUSION: It is recommended that speech recognition tests be performed in background noise. SRS-noise is a valuable tool for audiologists and audiological physicians to identify patients in need of pedagogic rehabilitation programs or further diagnostic investigations.

Adult↗
PubMed1999

[Improvement of hearing aid fitting with digital aids and new fitting strategies].

Hearing aids with digital signal processing demonstrate a large dynamic range with negligible distortion and no significant inherent noise. Furthermore, many acoustic parameters allow the compensation of even severe hearing loss, and the adjustment is extremely accurate. However, the new hearing aid generation not only requires computerized fitting, but also an experienced examination with new integrated fitting procedures. In addition to in situ measurement, the hearing aid fitting should include not only the Freiburg speech test, but also the Göttingen sentence test and the monosyllable rhyme test with different noises, for example the Fastl noise or the Döring babble noise. Loudness scaling with different methods is particularly important.

Analog-Digital Conversion↗
PubMed2000

Visual cognitive tests, central auditory function and auditory communication.

A cognitive, text-based test battery, presented as text on a computer screen (TIPS), was used to assess properties of central cognitive processing relevant for visual and audiovisual speech comprehension. TIPS was compared and contrasted with another, purely auditory, battery, ACE, aimed at assessing afferent (A), central (C) and efferent (E) auditory communicative functions. The results show that there is no overlap with the 'A' component, but some overlap between TIPS parameters and the 'C' component, especially when the auditory-language tests are used in the C estimate. However, the TIPS parameters show high correlations with the 'E' component (i.e. measuring output and phonological parameters), suggesting that the efferent component may be composed of an interesting central feature. TIPS parameters do not fare as well in the predictions of the auditory ecological test performances, but the ACE parameters do, especially when organized according to a cognitive complexity parameter. In order to optimize the conceptual and practical benefit of the TIPS and ACE concepts, TIPS needs to be adapted auditorily and ACE tests need to be audiovisual. These developments will become important for ecological audiology.

Adult↗
PubMed2001

A vestibular phenotype for Waardenburg syndrome?

OBJECTIVE: To investigate vestibular abnormalities in subjects with Waardenburg syndrome. STUDY DESIGN: Retrospective record review. SETTING: Tertiary referral neurotology clinic. SUBJECTS: Twenty-two adult white subjects with clinical diagnosis of Waardenburg syndrome (10 type I and 12 type II). INTERVENTIONS: Evaluation for Waardenburg phenotype, history of vestibular and auditory symptoms, tests of vestibular and auditory function. MAIN OUTCOME MEASURES: Results of phenotyping, results of vestibular and auditory symptom review (history), results of vestibular and auditory function testing. RESULTS: Seventeen subjects were women, and 5 were men. Their ages ranged from 21 to 58 years (mean, 38 years). Sixteen of the 22 subjects sought treatment for vertigo, dizziness, or imbalance. For subjects with vestibular symptoms, the results of vestibuloocular tests (calorics, vestibular autorotation, and/or pseudorandom rotation) were abnormal in 77%, and the results of vestibulospinal function tests (computerized dynamic posturography, EquiTest) were abnormal in 57%, but there were no specific patterns of abnormality. Six had objective sensorineural hearing loss. Thirteen had an elevated summating/action potential (>0.40) on electrocochleography. All subjects except those with severe hearing loss (n = 3) had normal auditory brainstem response results. CONCLUSION: Patients with Waardenburg syndrome may experience primarily vestibular symptoms without hearing loss. Electrocochleography and vestibular function tests appear to be the most sensitive measures of otologic abnormalities in such patients.

Adult↗
PubMed2004

Analysis of ceiling effects occurring with speech recognition tests in adult cochlear-implanted patients.

This article presents a simple method of analysing speech test scores which are biased through ceiling effects. Eighty postlingually deafened adults implanted with a MED-EL COMBI 40/40+ cochlear implant (CI) were administered a numbers test and a sentence test at initial device activation and at 1, 3, 6, 12 and 24 months thereafter. As a measure for speech recognition performance, the number of patients who scored at the 'ceiling level' (i.e. at least 95% correct answers) was counted at each test interval. Results showed a quick increase in this number soon after device activation as well as a continuous improvement over time (numbers test: 1 month: 51%; 6 months: 73%; 24 months: 88%; sentence test: 1 month: 33%; 6 months: 49%; 24 months: 64%). The new method allows for the detection of speech recognition progress in CI patient samples even at late test intervals, where improvement curves based on averaged scores are usually assuming a flat shape.

Adult↗
PubMed1997

New speech-in-noise test in different types of hearing impairment.

A new test was developed to assess speech recognition in noise. The test was designed to be run in a personal computer supplied with a sound card. One thousand disyllabic test words and noise were stored in digitized form on the hard disk of the computer. The measure given by this test is speech recognition threshold in noise (SRTN) corresponding to 50% recognition. The present series of 180 cases with various hearing impairments and 39 controls were examined with speech-in-noise test and conventional audiometry. In keeping with earlier studies, the SRTN turned out to be significantly elevated in cases with sensorineural hearing impairment; this elevation was related to the grade of hearing impairment. On the other hand, no essential difference was seen between the SRTN values of subjects with mixed hearing impairment and persons with normal hearing.

Adult↗
PubMed1995

Bone-anchored hearing aids in patients with sensorineural hearing loss and persistent otitis externa.

Recently, a new bone-conduction hearing aid has become available which can be connected percutaneously to the skull: the bone-anchored hearing aid or BAHA. Several clinical trials have shown its efficacy in patients with a conductive or mixed hearing loss. A second group of potential candidates are patients who suffer from an almost instantaneous skin reaction to any kind of earmould. Three such patients with a predominant sensorineural hearing loss were fitted with a BAHA. The aided free-field thresholds proved to be poor compared with the desired values using prescriptive rules. Speech recognition measured objectively (with tests) and subjectively (with a questionnaire) was comparable or better than with conventional bone-conduction hearing aids. Two patients were using their BAHA all day, whereas the third patient was only using it for a few hours per day. Although it did not produce optimal results, the BAHA seems to be the best solution for these patients.

Adolescent↗
PubMed1996

Adaptive fitting of hearing instruments by category loudness scaling (ScalAdapt).

The introduction of programmable as well as non-linear hearing instruments has shown that audiogram-based fitting procedures are inappropriate for meeting the individual needs of hearing aid users with sensorineural loss. Particularly the present and future development of hearing instruments with advanced analog and digital signal processing requires suitable fitting procedures. In this context, we developed an adaptive fitting strategy (ScalAdapt) using category loudness scaling. In this paper the procedure is described and tested using programmable 3-channel AGC instruments. However, it can be modified for any other hearing aid design. The underlying idea is to normalize the aided loudness perception for two input levels, one around the most comfortable level (MCL) and the other just below the uncomfortable level (UCL), as anchor points in each channel by interactive fine-tuning of the fitting parameters (channel gain, compression onset, compression ratio, etc.). The benefits of ScalAdapt have been evaluated by a field test study in 17 experienced hearing aid users. The results showed that ScalAdapt provides consistently higher objective (speech recognition in noise) and subjective benefits (self-assessment inventory) than for instance NAL-based fittings.

Hearing Aids↗
PubMedDate not supplied

Evaluation of fitting rules with a programmable hearing aid.

A study was performed with the 3M 8200 multi-programmable hearing aid in order to try to identify an optimal frequency-gain response, based on the standard calculation rules: NAL, POGO, Berger and Half gain. Furthermore, we examined to what extent multiple programs are used and appreciated. The 3M hearing aid was presented to 126 hearing-impaired patients for a trial period. The participants undertook several tests of speech intelligibility and sound quality. In comparison to the final settings after the trial period, it transpired that the NAL rule came f1p4est to the most used program and gave the best prediction of the gain at 1000 Hz. The attempt to optimize standard calculation rules according to indications made by the patients failed. The SRT-in-noise test showed improvements of the S/N ratio of 2.5 dB. The results of this study point towards separate processing of low- and high-frequency sounds as a useful concept.

Adult↗
PubMed2003

Effects of simulated cochlear-implant processing on speech reception in fluctuating maskers.

This study investigated the effects of simulated cochlear-implant processing on speech reception in a variety of complex masking situations. Speech recognition was measured as a function of target-to-masker ratio, processing condition (4, 8, 24 channels, and unprocessed) and masker type (speech-shaped noise, amplitude-modulated speech-shaped noise, single male talker, and single female talker). The results showed that simulated implant processing was more detrimental to speech reception in fluctuating interference than in steady-state noise. Performance in the 24-channel processing condition was substantially poorer than in the unprocessed condition, despite the comparable representation of the spectral envelope. The detrimental effects of simulated implant processing in fluctuating maskers, even with large numbers of channels, may be due to the reduction in the pitch cues used in sound source segregation, which are normally carried by the peripherally resolved low-frequency harmonics and the temporal fine structure. The results suggest that using steady-state noise to test speech intelligibility may underestimate the difficulties experienced by cochlear-implant users in fluctuating acoustic backgrounds.

Acoustic Stimulation↗
PubMed1994

[Functional screening evaluation of hearing aids].

A complaint about a malfunctioning hearing aid (HA) usually will require thorough testing of all aspects of hearing aid functions by the hearing aid dispenser. However, ENT physicians can also detect defects easily by following the simple screening procedure described here. Before testing the HA function, the following questions should be answered: Are the body of the hearing aid and ear mold intact? Is the ear canal free of irritation and is the acoustic isolation of the ear canal by the HA sufficient? A rough estimate of HA function can be accomplished by covering the HA with the hand. If the HA is switched on, a feedback, high-pitched sound should be produced. HA amplification can be assessed by using a stethoclip. After the examination is completed, all switches should be put back into their previous positions. Although these basic procedures are not equivalent to diligent and comprehensive acoustical testing, they are still useful for the otologist to detect major faults in the HA before referring the patient to the hearing aid dispenser.

Adolescent↗
PubMed1987

Relationships among selected measures of single-channel cochlear implant performance.

Relationships among a number of pre- and postimplant variables measured in 20 adults implanted with a single-channel cochlear implant were examined through a variety of univariate and multivariate statistical techniques. A large number of variables were analyzed to yield information on the relationships between pre- and postimplant performance, and among a variety of postimplant measures. Variables included: age; etiology and nature of deafness; type of implant worn; pre- and postimplant warble tone and speech detection thresholds; postimplant performance on the Monosyllable-Trochee-Spondee (MTS) and Environmental Sounds tests; postimplant electrical thresholds, uncomfortable loudness levels, and dynamic range; I.Q. scores; and postimplant discourse tracking performance with and without the implant. The difference score on the discourse tracking task, representing the auditory advantage over performance with lipreading alone, related substantively to a combination of variables including type of unit worn (Sigma versus Alpha), nature of deafness (progressive versus sudden), and etiology (meningitis versus nonmeningitis). Additionally, MTS and Environmental Sounds test scores were found to relate to one another and to etiology and nature of deafness.

Adolescent↗
PubMedDate not supplied

Effect of multichannel digital signal processing on loudness comfort, sentence recognition, and sound quality.

This study evaluated the effect of increasing the number of processing channels from 32- to 64-signal processing channels on subjects' loudness comfort and satisfaction, sentence recognition, and sound quality of his or her own voice. Ten experienced hearing aid users with mild-to-moderate sensorineural hearing loss wore behind-the-ear (BTE) hearing aids with Adaptive Dynamic Range Optimization (ADRO) signal processing for a period of six weeks in the 32-channel and 64-channel conditions. Results revealed no significant differences in loudness comfort or satisfaction for the majority of sound samples as measured by the Subjective Loudness Test and Environmental Sounds Questionnaire. No significant differences in sentence recognition between the two processing conditions were found as measured by the Hearing In Noise Test (HINT). Additionally, no subjective differences in sound quality of subjects' own voice were determined by the Listening Tasks Questionnaire.

Aged↗
PubMed1995

[The context effect in speech recognition of sentences].

Context plays an important role in speech recognition. The goal of the present study was to quantify context effects in speech recognition using the Basel Sentence Understanding Test. This test consists of two types of sentences according to the amount of contextual information: sentences with high predictable (HP) final words and sentences with low predictable (LP) final words. The effect of different contextual situations on speech recognition was investigated in this study using the Basel Sentence Understanding Test. The speech recognition threshold of HP sentences was found to be 6 dB lower than that of LP sentences. However, contextual effects can only be demonstrated if the context is clearly understandable. In the Basel Sentence Understanding Test, this is achieved by special masking techniques. The significance of the contextual part of the sentence with respect to the recognition of the whole sentence is different in HP and LP sentences.

Adolescent↗