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PubMed1992

Relationship of pure-tone averages to speech reception threshold for male and female speakers.

The availability of a compact disc with a female speaker for clinical use has raised the issue of the equivalence between the female speaker and the previous standard male speaker for assessing the speech reception threshold (SRT). This study evaluated the relationship of two- and three-frequency averages to the SRT for a male speaker on an audio tape and a female speaker on a compact disc in two similar groups of clinic patients, each consisting of 215 ears. There were no significant differences between the SRTs for the two groups, suggesting that the two speakers/recordings are equivalent for clinical purposes. The SRTs from both speakers/recordings were within 6 dB of both the two- and three-frequency averages. There were no significant differences between the SRTs and the three-frequency average.

Acoustic Stimulation↗
PubMed1992

Grading system for the selection of patients with congenital aural atresia.

It is generally recognized that surgery for congenital aural atresia is difficult. In an effort to select those patients who have the greatest chance of success, we have developed a grading scheme based on the preoperative temporal bone CT scan and the appearance of the external ear. Patients are graded on a possible best score of 10. The stapes is assigned the highest rating (2 points), while all other entrees on the scale are 1 point. The grade assigned preoperatively has been shown to correlate well with the patient's chance of success, herein defined as a postoperative speech reception threshold of 15 to 25 dB. A patient with a preoperative grade of 8/10 would, therefore, have a 80 percent chance of achieving this threshold. Patients with scores of 5/10, or less, are not considered surgical candidates, because the risk of the operation would outweigh the potential benefits. We have found that the grading system allows us to avoid impossible surgical cases while allowing for a reasonable prediction of the hearing outcome.

Abnormalities, Multiple↗
PubMed2005

Rehabilitation of high-frequency hearing loss with the RetroX auditory implant.

The RetroX is a new semi-implantable hearing aid which does not occlude the external ear canal. It consists of an electronic unit that plugs into a titanium tube which is implanted under the pinna so as to connect the retroauricular sulcus with the inside lumen of the external ear canal. Implantation requires minor surgery which can be performed under local anesthesia. Moreover, a pre-implant simulator exists and allows patients to try the device before deciding on definite implantation. The RetroX auditory implant is indicated in case of high-frequency sensorineural hearing loss with a steep slope (ski-slope audiogram). We implanted 25 adults suffering from such a hearing loss, and we report their hearing measured after 2.5 to 15 months of use. Four patients developed a persistent granulomatous reaction which disappeared after explantation. Two patients complained of acoustic feedback and needed supplementary fitting. Twenty three of our 25 subjects are satisfied or even extremely satisfied with the hearing improvement provided by the RetroX; they wear the implant daily, from morning until evening. Audiometrically, we observed a statistically significant improvement of the pure-tone thresholds at 1, 2, 4 and 8 kHz. In quiet, the speech reception thresholds decreased by 10 dB SPL and in noise, speech intelligibility increased by 15% for signal-to-noise ratios between -5 dB and +5 dB. Up till now, our patients were implanted monaurally because of financial considerations and our initial inexperience with this new implant. The overall results, however, are promising and nowadays, we advise bilateral implantation for patients who tolerate the first implant. By doing so, we hope to improve hearing in noise and spatial sound perception.

Audiometry, Speech↗
PubMed1991

[Clinical study of speech understanding in noise].

The goal of this study was to determine the extent to which the difficulty frequently experienced by hearing-impaired listeners in understanding noisy speech can be clinically described in terms of the auditory site of lesion. To this end, shifts of speech reception threshold in noise, using standardized franco-québécois bisyllabic word lists, were obtained from noise-exposed workers and compared to Plomp's model to ascertain content validity. Shifts resulted from monaural listening to a broad-band speech spectrum noise held constant at 0 dB signal-to-noise ratio. In this manner, increasing the presentation levels of both speech and noise was expected to progressively minimize the contribution of Plomp's class A attenuation component to speech hearing loss and eventually show an unequivocal manifestation of its distortion component (class D speech hearing loss). Listeners were 457 noise-exposed workers giving a total of 914 observations. Rejection of those ears with suspected middle-ear pathology led to a reduction to a total of 709 observations representing various degrees of permanent hearing impairment. An additional 98 observations showed normal hearing sensitivity in spite of noise exposure averaging 9.6 years. Results indicated the presence of five categories of speech threshold shifts varying independently of hearing sensitivity. 59.8% of those observations with permanent hearing impairment (424/709) simultaneously showed a problem understanding speech in noise. On 78 occasions, listening in noise was so disturbed that the 50% performance level corresponding to the speech threshold could no longer be established within reasonable limits, that is up to 65 dB above the speech threshold in a quiet environment. Conversely, 26.5% of the observations with essentially normal hearing sensitivity (26/98) showed reduced speech reception in noise. Fitting Plomp's model confirmed our expectations for two of the five categories of scores. A principal component analysis identified similar behaviour of speech threshold shifts in noise compared with Plomp's class D speech hearing loss. Hence, these speech threshold shifts in noise were interpreted as predominantly reflecting peripheral auditory disorders, that is defective frequency selectivity and temporal resolution. The remaining categories were found to be under the predominant influence of two other mechanisms: (1) band width reduction resulting from impaired hearing; (2) disorders associated with certain non-auditory cognitive factors, namely selective attention and the ability to make use of the redundancy of the message.

Adult↗
PubMed1991

Effect of UCL on aided Articulation Index calculation.

Nine hearing threshold patterns and uncomfortable loudness level combinations were used in comparing three hearing aid prescriptive procedures by means of a modified Articulation Index. In a minority of the comparisons a small dynamic range required a reduction from the gain that would have been prescribed. For these cases reducing the real-ear gain, in turn, resulted in a mean lowering of the Articulation Index by 0.03 for POGO and 0.08 for the Berger Method.

Amplifiers, Electronic↗
PubMed1990

Speech-reception threshold in noise for hearing-impaired listeners in conditions with a varying amplitude-frequency response.

In a study on the effects of a frequency-dependent automatic gain control in hearing-aids, two experiments were carried out with hearing-impaired listeners. In the first experiment, the effect of varying the amplitude-frequency response on the speech-reception threshold (SRT) of sentences presented in noise was studied. The noise had the same spectrum as the long-term average spectrum of the sentences. Results suggest that the amplitude-frequency response may vary within a range from, roughly, -3 to +10 dB/oct relative to the bisector of the dynamic range, without giving an increase in SRT larger than 2 dB. In the second experiment, the effect on masked SRT of adjusting the amplitude-frequency response to situations of seriously interfering low-frequency noise was studied. Again, the noise had a spectrum identical with the long-term average spectrum of the sentences, but this time the noise level in one octave band was increased by 20 dB. Preliminary results indicate that a selective attenuation of the signal in the band containing the extra noise may give a decrease of masked SRT up to 4.5 dB.

Audiometry, Pure-Tone↗
PubMed1979

Binaural hearing spectacles with "no mould" by acoustic trauma.

Patients with selective hearing loss in the trebles, as commonly seen in acoustic trauma, often have a considerable hearing handicap. They seldom benefit from the usual hearing aids with closed ear moulds. When Ewertsen (1970) and Cortois (1972) reported their experiences with binaural fitting of hearing spectacles, using a free plastic tube in the ear canal ("no mould"), we at the Hearing Centre in Namsos began to fit such hearing aids to 33 patients with acoustic traumas. All of them were followed-up in February--March 1978. The results have been evaluated on the basis of answers from the patients entered on questionnaires, and speech audiometry in open field, monosyllable, with 60 dB wide-band background noise. 27 patients (80%) stated that they were greatly satisfied, and 7 (20%) well satisfied. The average daily use was 4 1/2 hrs. All of the patients emphasized the great benefit obtained with the hearing aid at conferences, meetings, social occasions, etc. The average hearing gain was 13 dB. Among those who had discrimination loss there was an average gain of 30% .

Adult↗
PubMed1978

Telephone performance of persons with hearing handicap in relation to speech reception threshold.

This investigation shows that there are four relevant methods of telephoning in Denmark for hearing-impaired persons: 1) Standard telephone without extra equipment for persons with a Speech Reception Threshold (SRT) up to about 40 dB in the better ear. 2) Standard telephone with receiving amplifier for persons with a SRT up to about 60 dB in the better ear. 3) Standard telephone plus individual hearing aid primarily in "T" position. Can be used by hearing-impaired persons with a SRT up to 70-75 dB in the better ear. 4) Standard telephone with receiving amplifier plus individual hearing aid primarily in "T" position. This is an effective and cheap solution for hearing losses above 70-75 dB in the better ear.

Aged↗
PubMedDate not supplied

Users' satisfaction with hearing aids.

Seventy-one hearing aid users were surveyed two years after their initial fitting to determine whether they (1) wore the hearing aid(s) prescribed, (2) were satisfied with their aid(s), (3) had specific complaints about their aid(s), and (4) would recommend that a hearing-impaired friend or relative go through the same hearing aid selection process. Ninety-six percent of the respondents obtained that aid that we recommended. Eighty-eight percent were "very satisfied" or "satisfied" with the help that their aid(s) provided. Eighty-two percent would recommend that a hearing-impaired friend or relative go directly to a "hearing specialist" for assistance when selecting a hearing aid.

Consumer Behavior↗
PubMedDate not supplied

[Sudden deafness in patients undergoing cardiac surgery with extracorporeal circulation].

Between January 1974 and December 1986, 5,975 patients underwent open heart surgery at National Institute of Cardiology "Ignacio Chávez". We reviewed all open heart cases carried out at this Center. Eleven patients (1.8/1000) presented unilateral sudden hearing loss following cardiopulmonary bypass surgery. Pure tone audiograms, speech reception threshold, discrimination testing, tympanometry and stapedius reflex testing were carried out. We then studied the relationship between the auditory deficit and the type of surgical procedure, length of time on the pump, preexisting ear disease, coexistence of diabetes, use of ototoxic drugs and occurrence of hemodynamic complications. There are 3 possible causes for hearing loss in cardiopulmonary bypass: 1) Microembolism from the cardiopulmonary bypass pump to the arteries that supply only the cochlea. 2) Decreasing cerebral flow, or 3) Microhemorrhage of the internal ear. Ototoxic drugs are used frequently, but the hallmark of these drugs is bilateral toxicity, and all the cases under discussion have been unilateral. Unilateral sudden deafness after open heart surgery constitutes another complication, fortunately rare and benign in most cases. Further studies should be undertaken to clarify the pathophysiology of this entity.

Adult↗
PubMed1988

Noradrenergic cerebral stimulation of sensorineural impaired subjects: yohimbine effects on speech intelligibility and the auditory brain response.

Norepinephrine has been shown to improve signal-to-noise ratios of sensory systems, including that of the auditory system. Yohimbine has been observed to cause a selective increase of cerebral norepinephrine. It was administered in one dose to sensorineurally impaired subjects with the object of improving their speech hearing in noise. Speech intelligibility was measured by the adaptive procedure. Mild, significant improvement was noted in one of the hearing components, "attenuation," and an adverse effect was shown on "distortion," owing to noise. Auditory brainstem response was improved significantly. The objective of temporarily improving intelligibility in noise was not attained.

Aged↗
PubMed1985

Involvement of the audiovestibular system in multiple sclerosis. An otoneurologic and audiologic study.

This study was performed on a material of 70 patients, who fulfilled the criteria of definitive MS. All the patients were examined by an otologist, a neurologist and a neuro-ophthalmologist. A wide range of audiologic and otoneurologic tests were used to obtain a good understanding of the respective disorders in MS, to gain a better knowledge of the role of otology in MS, to correlate the results with the clinical findings in order to find the most useful tests to detect MS lesions and to describe pathophysiologic aspects of central lesions using MS as a model. The material consisted of MS cases representing mild or moderate stages of disability (Hyllested classification 1.-4); 32 belonged to Hyllested group 1., 19 to group 2., 7 to group 3. and 12 to group 4. The age and sex distribution were similar with materials described earlier, as were most of the clinical neurologic findings. The material can thus be considered representative. The neuro-ophthalmologic examination served to rule out causes other than MS for abnormalities observed in the tests. Besides the clinical neurologic and otoneurologic evaluation a number of additional tests were performed. The ENG tests consisted of registration for spontaneous and positional nystagmus, of smooth pursuit and saccadic eye movements, optokinetic nystagmus and caloric reactions. The audiologic evaluation was based on the following tests: pure tone audiograms, speech reception thresholds, discrimination scores, filtered speech test, stapedius reflex thresholds, stapedius reflex decay and auditory brainstem responses. The clinical otologic examination revealed little abnormalities, which is well in accordance with the pathophysiology of MS. In addition the clinical examination ruled out peripheral lesions as reasons for observed abnormalities. Numerous abnormalities were found during the otoneurologic examination of the cranial nerves. The amount of abnormal findings in the otoneurologic examination were surprisingly high: only one patient exhibited normal results in all the tests used. The abnormalities most often encountered were those of smooth pursuit (96%), followed by saccadic eye movements (76%), optokinetic nystagmus (53 %), and abnormalities in the caloric reactions such as dysrhythmia (40%) and defective visual suppression of the nystagmus (43%). When comparing the results obtained with ENG with those of clinical findings seen during the neuro-ophthalmologic examination, a good intercorrelation was found. Yet, in many ENG tests a number of cases with subclinical abnormalities only, were observed, which stresses the importance of exact and objective methods for the registration of eye movements.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗
PubMed1985

Clinical trials with a 22-channel cochlear prosthesis.

During 1984, six patients have been implanted with a 22-channel cochlear prosthesis. The device features a programmable wearable speech processor using a speech feature encoding strategy. A strict clinical protocol was followed, and no patients have been lost to follow-up. All patients are regular users of the device and have shown a restoration of hearing sensation in response to acoustic stimuli. Pure tone averages ranged from 20 to 47 dB HL and speech detection thresholds varied from 15 to 32.5 dB HL. All patients have shown a recognition of a large variety of environmental sounds, and an improvement in speech recognition ability when the device is used in conjunction with lipreading. Speech reception thresholds using spondee words without lipreading were obtained in three patients at levels of 27.5 to 55 dB HL and one patient had an open-set speech discrimination score (w-22 word list) of 42% without lipreading. In addition, two of the patients show an ability to have limited interactive conversation without the use of lipreading.

Adult↗
PubMed1979

Two experiments on subtle mid-frequency hearing loss and its influence on word discrimination in noise-exposed listeners.

The present study consisted of two experiments. Experiment I was directed toward the detection of subtle mid-frequency cochlear dysfunction and the determination of word discrimination in noise for persons with noise-induced hearing loss. The presence of significantly elevated aural-overload thresholds, consistent with the presence of cochlear pathology in regions of normal pure-tone sensitivity, confirmed previous findings obtained with this subject population by other investigators. In addition, a marked reduction in word discrimination was observed in the presence of a background of competing noise. For experiment II, normal hearers listened to consonant-nucleus-consonant monosyllables filtered to match the mean audiometric configuration of the noise-exposed subjects in experiment I. Results showed significantly better performance with these filtered words by the normally hearing subjects than that by the noise-exposed group for unfiltered materials. The results of the second experiment were interpreted as providing further support for the presence of subtle auditory dysfunction in the mid-frequencies despite normal threshold sensitivity in this same frequency region.

Acoustic Stimulation↗