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Results for “Speech Reception Threshold Test”

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PubMed2006

Good speech recognition and quality-of-life scores after cochlear implantation in patients with DFNA9.

OBJECTIVE: To compare audiometric and quality-of-life results in DFNA 9 patients who received a cochlear implant with cochlear implant patients with adult-onset progressive sensorineural hearing loss. STUDY DESIGN: Prospective comparative design; results were collected cross-sectionally. SETTING: Tertiary referral center. PATIENTS: Eleven DFNA 9 patients were included in the study as well as a comparative group of 39 post-lingually deafened cochlear implant subjects with adult-onset progressive sensorineural hearing loss. INTERVENTIONS: All patients received a cochlear implant. Subjects were implanted with either the Nucleus 24 M/RCS or Med-el Combi 40+ cochlear implant systems implementing the SPEAK, ACE, or CIS+ coding strategies. MEAN OUTCOME MEASURES: Speech recognition was determined by means of phonetically balanced monosyllabic word lists. The Hearing Handicap Inventory for Adults, the Glasgow Benefit Inventory, and the Scale for the Prediction of Hearing Disability in Sensorineural Hearing Loss were used to quantify the quality of life. RESULTS: The results show that the speech perception and the quality of life of the DFNA 9 patients do not differ significantly from the control group (p=0.179; p=0.56). CONCLUSION: In spite of the fact that DFNA 9 is a disease that is known to involve cochlear dendrites, cochlear implantation is a good option for treatment of deafness in DFNA 9.

Adult↗
PubMed2007

Congenital aural atresia: review of short- and long-term surgical results.

OBJECTIVES/HYPOTHESIS: To review the short- (<1 yr) and long-term (>1 yr) surgical and hearing outcomes for congenital aural atresia and to analyze the stability of surgical results over time. STUDY DESIGN: Retrospective chart review of 45 patients (54 ears) who underwent surgery for congenital aural atresia during a 5-year period at a tertiary care institution. METHODS: Preoperative and postoperative speech reception thresholds, air-bone gaps (ABGs), and pure-tone averages were compared and further analyzed for outcome stability over time. The complication rate was reviewed and compared with results from similar studies. RESULTS: Approximately 50% of patients achieved a speech reception threshold of 30 dB or better both in the short and long term. The average improvement in ABG was 22 dB, resulting in a postoperative ABG of 30 dB or less in three of four patients. Short- and long-term outcomes were not significantly different. Patients with an intact ossicular chain did not seem to have a significant advantage in hearing when compared with patients with a prosthetic reconstruction prosthesis. We report a low incidence of meatal stenosis compared with other similar reviews and describe surgical modifications that may attribute to this outcome. CONCLUSION: Overall, the mean hearing outcome for this group collectively did not significantly degrade over time and compared favorably with other series. However, there was significant variability among individual patients. The safety of this procedure and the demonstrated hearing improvement makes it a reasonable option in patients with congenital aural atresia with favorable anatomy.

Adolescent↗
PubMed2005

Unilateral acoustic neuromas: long-term hearing results in patients managed with fractionated stereotactic radiotherapy, hearing preservation surgery, and expectantly.

INTRODUCTION: Hearing preservation is invariably a consideration when exploring treatment options for acoustic neuromas. We reviewed the long-term hearing results of patients who were treated using 1) hyperfractionated stereotactic radiotherapy (HSR), 2) hearing preservation tumor excision surgery (HPTES), and 3) expectantly (no treatment). METHODS AND MATERIALS: Single institution retrospective chart review of 42 patients managed with HSR (1993-2003), 113 patients in whom HPTES was carried out, and 86 patients who were untreated (1974-2003). Hearing levels were graded according to the Gardner-Robertson classification. RESULTS: The percent of patients managed with HSR initially who had serviceable hearing (class 1-2) was 68.8%. This fell to 6.7% in the follow-up interval. Of the group treated with HPTES, 100% had preoperative serviceable hearing. This dropped to 15.9% in the follow-up interval. The percent of patients managed expectantly who initially had serviceable hearing was 77.3%. This dropped to 33.3% during the follow-up interval. Mean follow-up periods were 4.0, 9.5, and 6.8 years in the HSR, HPTES, and expectant groups, respectively. CONCLUSIONS: Hearing acuity statistically worsened over the long term (P < .01) in all three groups. There was a significant proportion of patients in whom hearing deteriorated from serviceable to nonserviceable hearing (P < .01) during the follow-up interval. The decline was most significant in the groups treated with HPTES and HSR compared with the group treated expectantly (P < .05). Hearing outcomes, in our experience, continue to be poor, but this is especially so in patients treated with HPTES or HSR.

Adult↗
PubMed1986

Traumatic lesions of the middle ear: aetiology and results of treatment.

A retrospective investigation of the aetiology and results of treatment for traumatic, conductive hearing loss was performed in 122 patients treated from 1979 to 1983. The mean age at the time of the trauma was 25 years. The average treatment delay was 7 years. The patients were grouped according to the nature of the injury. The group with head injury (40 patients) was characterized by a frequent combination of young men and traffic accidents. Among direct trauma (16 patients) lesions to the tympanic membrane and/or the middle ear were caused by ear syringing or by the introduction of swabs or other instruments into the auditory canal. In the group exposed to indirect trauma (57 patients) the dominant single cause of the trauma in the present material consisted of a blow to the ear and was most often seen among young women. A subgroup exposed to blasts contained more young men. The dominant operative findings were rupture of the tympanic membrane, luxation of the incus, partial bone necrosis and fracture of the auditory ossicles. Ear surgery consisted of closure of the ruptured tympanic membranes and restoration of the sound-transmitting function of the ossicular chain. Normal hearing was restored in 78%, and hearing improved in another 10%. The hearing remained unchanged or deteriorated in 9% of the patients, a group often characterized by a long treatment delay and/or the development of chronic otitis.

Adolescent↗
PubMed1996

Suboccipital surgery for acoustic neuroma.

A retrospective study was performed on 106 consecutive patients with an acoustic neuroma who underwent suboccipital surgery for the first time between 1980 and 1992. Complete follow-up data were available for all the patients, including regular imaging up to 1 January 1994. Incomplete removal of the tumours was chosen in preference to radical surgery in a large proportion of the patients, to avoid the risk of post-operative morbidity. The recurrence rate in this series was 20%. Comparison of the results of suboccipital surgery to those obtained using other surgical approaches, while taking the tumour size into consideration, showed that better results can be obtained after total removal of the tumour without any additional risk to post-operative facial nerve function. The long-term results of subtotal removal using the suboccipital approach were disappointing. It is therefore necessary to review the indications for non-radical surgery in patients with an acoustic neuroma.

Audiometry, Pure-Tone↗
PubMed2004

Speech-in-noise perception in high-functioning individuals with autism or Asperger's syndrome.

BACKGROUND: High-functioning individuals with autism (HFA) or Asperger's syndrome (AS) commonly report difficulties understanding speech in situations where there is background speech or noise. The objective of this study was threefold: (1) to verify the validity of these reports; (2) to quantify the difficulties experienced; and (3) to propose possible mechanisms to explain the perceptual deficits described. METHOD: Speech-in-noise perception abilities were measured using speech reception thresholds (SRTs), defined as the speech-to-noise ratio (SNR) at which approximately 50% of the speech is correctly identified. SRTs were measured for 11 individuals with HFA/AS and 9 age/IQ-matched normal-hearing control subjects, using an adaptive procedure, in a non-reverberant sound-attenuating chamber. The speech materials were standardised lists of everyday sentences spoken by a British male speaker. The background sounds were: (1) a single female talker; (2) a steady speech-shaped noise; (3) a speech-shaped noise with temporal dips; (4) a steady speech-shaped noise with regularly spaced spectral dips; and (5) a speech-shaped noise with temporal and spectral dips. RESULTS: SRTs for the HFA/AS group were generally higher (worse) than those for the controls, across the five background sounds. A statistically significant difference in SRTs between the subject groups was found only for those background sounds that contained temporal or spectro-temporal dips. SRTs for the HFA/AS individuals were 2 to 3.5 dB higher than for the controls, equivalent to a substantial decrease in speech recognition. Expressed another way, the HFA/AS individuals required a higher SNR, whenever there were temporal dips in the background sound, to perform at the same level as the controls. CONCLUSIONS: The results suggest that the speech-in-noise perception difficulties experienced by individuals with autism may be due, in part, to a reduced ability to integrate information from glimpses present in the temporal dips in the noise.

Adult↗
PubMed2001

Relations between intelligibility of narrow-band speech and auditory functions, both in the 1-kHz frequency region.

Relations between perception of suprathreshold speech and auditory functions were examined in 24 hearing-impaired listeners and 12 normal-hearing listeners. The speech intelligibility index (SII) was used to account for audibility. The auditory functions included detection efficiency, temporal and spectral resolution, temporal and spectral integration, and discrimination of intensity, frequency, rhythm, and spectro-temporal shape. All auditory functions were measured at 1 kHz. Speech intelligibility was assessed with the speech-reception threshold (SRT) in quiet and in noise, and with the speech-reception bandwidth threshold (SRBT), previously developed for investigating speech perception in a limited frequency region around 1 kHz. The results showed that the elevated SRT in quiet could be explained on the basis of audibility. Audibility could only partly account for the elevated SRT values in noise and the deviant SRBT values, suggesting that suprathreshold deficits affected intelligibility in these conditions. SII predictions for the SRBT improved significantly by including the individually measured upward spread of masking in the SII model. Reduced spectral resolution, reduced temporal resolution, and reduced frequency discrimination appeared to be related to speech perception deficits. Loss of peripheral compression appeared to have the smallest effect on the intelligibility of suprathreshold speech.

Adult↗
PubMed2001

The effect of intensity perturbations on speech intelligibility for normal-hearing and hearing-impaired listeners.

Hearing-impaired listeners are known to suffer from reduced speech intelligibility in noise, even if sounds are above their hearing thresholds. This study examined the possible contribution of reduced acuity of intensity coding to this problem. The "distortion-sensitivity model" was used: the effect of reduced acuity of auditory intensity coding on intelligibility was mimicked by an artificial distortion of the speech intensity coding, and the sensitivity to this distortion for hearing-impaired listeners was compared with that for normal-hearing listeners. Stimuli (speech plus noise) were wavelet coded using a Gaussian wavelet (1/4-octave bandwidth). The intensity coding was distorted by multiplying the modulus of each wavelet coefficient by a random factor. Speech-reception thresholds (SRTs) were measured for various degrees of intensity perturbation. Hearing-impaired listeners were classified as suffering from suprathreshold deficits if intelligibility of undistorted speech was worse than predicted from audibility by the speech intelligibility index model [ANSI, ANSI S3.5-1997 (1997)]. Hearing-impaired listeners without suprathreshold deficits were as sensitive to the intensity distortion as the normal-hearing listeners. Hearing-impaired listeners with suprathreshold deficits appeared to be less sensitive. Results indicate that reduced acuity of auditory intensity coding may be a factor underlying reduced speech intelligibility in noise for the hearing impaired.

Adult↗
PubMed2001

Noisy speech recognition using de-noised multiresolution analysis acoustic features.

This paper describes a novel application of multiresolution analysis (MRA) in extracting acoustic features that possess de-noising capability for robust speech recognition. The MRA algorithm is used to construct a mel-scaled wavelet packet filter-bank, from which subband powers are computed as the feature parameters for speech recognition. Wiener filtering is applied to a few selected subbands at some intermediate stages of decomposition. For high-frequency bands, Wiener filters are designed based on a reduced fraction of the estimated noise power, making the consonant features much more prominent and contrastive. The proposed method is evaluated in phone recognition experiments with the TIMIT database. In the presence of stationary white noise at 10-dB SNR, the de-noised MRA features attain a phone recognition rate of 32%. There is a noticeable improvement compared with the accuracy of 29% and 20% attained by the commonly used mel-frequency cepstral coefficients (MFCC) with and without cepstral mean normalization (CMN), respectively. The effectiveness of the MRA features is also verified by the fact that they exhibit smaller distortion from clean speech.

Attention↗
PubMed2001

Age differences for stop-consonant and vowel perception in adults.

The purpose of this study was to determine the role of static, dynamic, and integrated cues for perception in three adult age groups, and to determine whether age has an effect on both consonant and vowel perception, as predicted by the "age-related deficit hypothesis." Eight adult subjects in each of the age ranges of young (ages 20-26), middle aged (ages 52-59), and old (ages 70-76) listened to synthesized syllables composed of combinations of [b d g] and [i u a]. The synthesis parameters included manipulations of the following stimulus variables: formant transition (moving or straight), noise burst (present or absent), and voicing duration (10, 30, or 46 ms). Vowel perception was high across all conditions and there were no significant differences among age groups. Consonant identification showed a definite effect of age. Young and middle-aged adults were significantly better than older adults at identifying consonants from secondary cues only. Older adults relied on the integration of static and dynamic cues to a greater extent than younger and middle-aged listeners for identification of place of articulation of stop consonants. Duration facilitated correct stop-consonant identification in the young and middle-aged groups for the no-burst conditions, but not in the old group. These findings for the duration of stop-consonant transitions indicate reductions in processing speed with age. In general, the results did not support the age-related deficit hypothesis for adult identification of vowels and consonants from dynamic spectral cues.

Adult↗
PubMed2001

Psychophysical suppression effects for tonal and speech signals.

This experiment assessed the benefits of suppression and the impact of reduced or absent suppression on speech recognition in noise. Psychophysical suppression was measured in forward masking using tonal maskers and suppressors and band limited noise maskers and suppressors. Subjects were 10 younger and 10 older adults with normal hearing, and 10 older adults with cochlear hearing loss. For younger subjects with normal hearing, suppression measured with noise maskers increased with masker level and was larger at 2.0 kHz than at 0.8 kHz. Less suppression was observed for older than younger subjects with normal hearing. There was little evidence of suppression for older subjects with cochlear hearing loss. Suppression measured with noise maskers and suppressors was larger in magnitude and more prevalent than suppression measured with tonal maskers and suppressors. The benefit of suppression to speech recognition in noise was assessed by obtaining scores for filtered consonant-vowel syllables as a function of the bandwidth of a forward masker. Speech-recognition scores in forward maskers should be higher than those in simultaneous maskers given that forward maskers are less effective than simultaneous maskers. If suppression also mitigated the effects of the forward masker and resulted in an improved signal-to-noise ratio, scores should decrease less in forward masking as forward-masker bandwidth increased, and differences between scores in forward and simultaneous maskers should increase, as was observed for younger subjects with normal hearing. Less or no benefit of suppression to speech recognition in noise was observed for older subjects with normal hearing or hearing loss. In general, as suppression measured with tonal signals increased, the combined benefit of forward masking and suppression to speech recognition in noise also increased.

Adult↗
PubMed2002

Quantifying the intelligibility of speech in noise for non-native listeners.

When listening to languages learned at a later age, speech intelligibility is generally lower than when listening to one's native language. The main purpose of this study is to quantify speech intelligibility in noise for specific populations of non-native listeners, only broadly addressing the underlying perceptual and linguistic processing. An easy method is sought to extend these quantitative findings to other listener populations. Dutch subjects listening to Germans and English speech, ranging from reasonable to excellent proficiency in these languages, were found to require a 1-7 dB better speech-to-noise ratio to obtain 50% sentence intelligibility than native listeners. Also, the psychometric function for sentence recognition in noise was found to be shallower for non-native than for native listeners (worst-case slope around the 50% point of 7.5%/dB, compared to 12.6%/dB for native listeners). Differences between native and non-native speech intelligibility are largely predicted by linguistic entropy estimates as derived from a letter guessing task. Less effective use of context effects (especially semantic redundancy) explains the reduced speech intelligibility for non-native listeners. While measuring speech intelligibility for many different populations of listeners (languages, linguistic experience) may be prohibitively time consuming, obtaining predictions of non-native intelligibility from linguistic entropy may help to extend the results of this study to other listener populations.

Adolescent↗
PubMed2002

Word recognition in competing babble and the effects of age, temporal processing, and absolute sensitivity.

This study was designed to clarify whether speech understanding in a fluctuating background is related to temporal processing as measured by the detection of gaps in noise bursts. Fifty adults with normal hearing or mild high-frequency hearing loss served as subjects. Gap detection thresholds were obtained using a three-interval, forced-choice paradigm. A 150-ms noise burst was used as the gap carrier with the gap placed close to carrier onset. A high-frequency masker without a temporal gap was gated on and off with the noise bursts. A continuous white-noise floor was present in the background. Word scores for the subjects were obtained at a presentation level of 55 dB HL in competing babble levels of 50, 55, and 60 dB HL. A repeated measures analysis of covariance of the word scores examined the effects of age, absolute sensitivity, and temporal sensitivity. The results of the analysis indicated that word scores in competing babble decreased significantly with increases in babble level, age, and gap detection thresholds. The effects of absolute sensitivity on word scores in competing babble were not significant. These results suggest that age and temporal processing influence speech understanding in fluctuating backgrounds in adults with normal hearing or mild high-frequency hearing loss.

Adult↗
PubMed2003

Evaluation of array-processing algorithms for a headband hearing aid.

Several array-processing algorithms were implemented and evaluated with experienced hearing-aid users. The array consisted of four directional microphones mounted broadside on a headband worn on the top of the listener's head. The algorithms included two adaptive array-processing algorithms, one fixed array-processing algorithm, and a reference condition consisting of binaural directional microphones. The algorithms were evaluated under conditions with both one and three independent noise sources. Performance metrics included quantitative speech reception thresholds and qualitative subject preference ratings for ease-of-listening measured using a paired-comparison procedure. On average, the fixed algorithm improved speech reception thresholds by 2 dB, while the adaptive algorithms provided 7-9-dB improvement over the reference condition. Subjects judging ease-of-listening generally preferred all array-processing algorithms over the reference condition. The results suggest that these adaptive algorithms should be evaluated further in more realistic acoustic environments.

Aged↗