[Acoustic interference during speech audiometry and its diagnostic value].
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Adolescent↗
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Results for “Speech Reception Threshold Test”
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The effect of noise-induced hearing loss on the intelligibility of speech in noise.
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Audiometry↗
The influence of syllabic stress on children's speech reception thresholds.
One tape exemplar of each words cowboy, baseball, airplane, cupcake, popcorn, and hotdog spoken with natural (trochaic) and again with unnatural (spondaic) stress were selected from a pool to collect monaural SRTs by earphone in children. There were no significant differences due to type of stress, nor between boys and girls. Older children (N: 16, aged 5.0--6.0 yrs; SRT = --0.2 db HL) exhibited lower SRTs than younger (N: 16, aged 3.0--4.0 yrs; SRT = 3.2 db HL). It was informally observed that response, especially in younger Ss, tended (even when correct) to be at a slower rate, a condition to which the clinician should be alert.
Age Factors↗
Surgery for otosclerosis in children.
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Adolescent↗
Tactile perception of stress and intonation.
Tactile perception of alteration in sentence meaning due to modification of intonation and stress patterns was determined for 10 normal hearing young adults. Stimuli consisted of sentences varying with respect to syllable length (4--7 syllables), place of stress (initial, medial or final), or intonation type (rising, steady or falling). All stimulus items were presented to the fingers by a bc oscillator at 15 db re vibrotactile threshold. Analysis of data using Chi Square yielded significant results for tactile perception of stress but scores for perception of intonation were no better than chance. These results show that taction is a viable modality to supplement a deficient auditory mode.
Adult↗
Relative intelligibility of CID spondees for normal and hearing-impaired listeners.
The relative intelligibility of the 36 CID spondees presented via tape recording was found on Ss with normal hearing, and on Ss with flat and with sloping sensorineural losses (N: 15 in each group). The spondees as a group were found not to be homogeneous in intelligibility for each group and across groups. Ss with a sloping loss identified the spondees at a significantly (p less than 0.05) higher sensation level (SL) compared with the other groups. A list of 14 spondees was derived encompassing relative intelligibility within a 5-db range for clinical use with such Ss.
Adolescent↗
Binaural interference in multiple sclerosis: case study.
A case report of a young, adult male with multiple sclerosis who demonstrates binaural interference is presented. Binaural interference was demonstrated on behavioral and physiologic measures during the active stage. Binaural interference was present, although reduced, during the stage of remission. During remission, binaural interference occurred despite the absence of interaural asymmetry in the audiometric configuration or suprathreshold speech-recognition score. A trial period of left ear amplification was introduced. A possible explanation for the improvement in soundfield suprathreshold speech-recognition score with amplification is the reduction of the binaural-interference effect with monaural amplification of the affected ear when there is bilateral normal-hearing sensitivity.
Acoustic Stimulation↗
Averaged electrode voltages used to identify nonfunctioning electrodes in cochlear implants: case study.
We present the case of an adult male whose internal cochlear implant unit failed. Several months elapsed following initial stimulation with the implant before the problem was identified and corrected. The sequence of the failure and its detection are detailed. Following reimplantation, the patient did not initially report improved sound quality. However, within a week of the initial stimulation of the second device, he reported being able to identify environmental sounds, and speech began to sound the way he remembered it before he lost his hearing. We suggest a method of detection that might improve the early identification of a nonfunctioning device or of nonfunctioning individual electrodes. Knowledge of specific nonfunctioning electrodes is important in device adjustment, especially for young children.
Audiometry, Pure-Tone↗
[Stapedectomy in congenital stapes fixation].
Because several cases of cerebral-spinal fluid leakage (perilymph gushers) have been reported during stapedectomy for congenitally fixed stapes in children, many otologists advise against surgical intervention. The pathophysiologic mechanism of the gusher and its association with a congenitally fixed stapes is, however, poorly understood. This study was designed to examine the pre-operative presentation and hearing results of 10 children undergoing stapedectomies for congenital fixation. No perilymph gushers of significant sensorineural hearing loss was encountered. All but one case resulted in closure of the air-bone gap and speech frequencies to within 20 dB. The average air-bone gap was 11.2 dB. Minor congenital abnormalities of the stapes suprastructure were seen in 3 cases. Review of case reports in the literature indicate that gushers in association with surgical manipulation of the congenitally-fixed stapes occur almost exclusively in males and that pathophysiology involves a defect in the internal auditory canal (as opposed to a patent cochlear aqueduct). A pre-existing sensorineural hearing loss may also be a risk factor for perilymph gusher.
Adolescent↗
The bone-anchored hearing aid. Design principles, indications, and long-term clinical results.
This article presents a summary of design principles, indications, and clinical results obtained with the bone-anchored hearing aid (BAHA). Hearing through bone conduction and mechanical stimulation of the skull with percutaneous versus transcutaneous excitation and the functional capability of the ear level BAHA sound processor is presented. Moreover, the surgical procedure is described and the success rate to establish and maintain osseointegration is presented together with the frequency of skin reactions at the implant site. The audiologic and questionnaire results achieved with the BAHA is also presented and discussed.
Adult↗
Long-term recovery and no recovery from the auditory deprivation effect with binaural amplification: six cases.
Six subjects who developed individually significant auditory deprivation effects associated with monaural amplification were tracked for 6.2 to 15.1 years from the time of their initial hearing aid fitting. Each subject received binaural hearing aids after the auditory deprivation effect became apparent and used binaural amplification for at least 4 years. The findings corroborate and expand upon existing case reports. Several general configurations of recovery and no recovery following the introduction of binaural amplification were identified: (1) cases in which auditory deprivation effects developed within about 2 years and recovered completely within about 2 years of binaural use; (2) cases with significant but incomplete recovery; and (3) cases in which the auditory deprivation effect took several years to develop and did not recover following several years of binaural amplification. Clinical implications of the results are proposed.
Adult↗
Relative intelligibility of the revised CID W-1s as presented via MLV and auditec recordings.
The relative intelligibility of the revised CID W-1 spondaic word list, as developed and recommended for clinical use by ASHA, was evaluated in two experiments. In Experiment 1, the revised W-1s were presented via monitored live voice to 25 subjects with normal hearing. Mean minimum recognition levels for each of the 36 spondees varied between 16.8 and 25.2 dB SPL, a range of 8.4 dB. In Experiment 2, the Auditec recordings of the revised W-1s were presented to a different group of 20 subjects with normal hearing. Mean minimum recognition values for the individual spondees varied between 18.1 and 30.6 dB SPL, a range of 12.5 dB. Thus, the homogeneity of audibility for the revised W-1s is no better than has been noted in the past for the original W-1s and, in the case of the Auditec recording, is considerably worse. A reduced list of spondees with improved homogeneity of audibility is recommended for clinical use.
Adult↗
Relationship between in-situ distortion and hearing aid benefit.
In-situ hearing aid distortion is defined as distortion measured in the ear canal with stimulus inputs and hearing aid settings that are similar to those the hearing aid wearer will experience in daily life. This preliminary study examined possible relationships between in-situ distortion and benefit for appropriately fitted contemporary hearing aids. Simulated in-situ distortion was determined for 97 hearing aid fittings, divided among three typical listening environments: living room, classroom lecture, and social event. Measures included intermodulation, harmonic, and transient distortion. Overall results of between- and within-subject analyses of data suggested that there was a significant relationship between distortion and benefit in both reverberant and noisy environments similar to a classroom lecture and a social event, respectively. This outcome was seen despite the fact that distortion was quite low in absolute terms. Analyses also suggested that in-situ harmonic distortion was most closely related to benefit and that the other types of distortion measured did not make additional contributions to benefit prediction. We propose that measurements of in-situ harmonic distortion might be a valuable addition to hearing aid evaluations.
Aged↗
Cortical deafness: a longitudinal study.
We have studied a patient with MRI-confirmed bilateral absence of considerable portions of her temporal lobes resulting in cortical deafness. Although physiologic measures demonstrate normal peripheral hearing sensitivity, this patient's speech has the inflection and prosodic characteristics associated with profound peripheral hearing loss, and she is unable to understand spoken communication. Behaviorally obtained pure-tone thresholds taken over nearly 20 years range from normal to moderate hearing loss with normal middle ear muscle reflexes and normal ABRs; however, we consistently found abnormal middle latency and cortical evoked potentials. Because of her total inability to communicate auditorily, this patient was ultimately taught American Sign Language and educated at the Louisiana School for the Deaf. This rare case highlights the importance of using multiple audiologic measures sensitive to abnormalities at various levels of the auditory system.
Adult↗
The bone-anchored hearing aid: principal design and audiometric results.
The principle of the bone-anchored hearing aid (BAHA) is simple: sound vibrations are directly transmitted to the skull bone via a skin-penetrating titanium implant, and then are further transmitted to the cochlea, bypassing the middle ear. The present paper summarized the audiometric results from 122 patients with an average follow-up time of 5.6 years. When herein-suggested indications for treatment with the bone-anchored sound processor HC 300 are followed, the success rate is very high. The improved quality of life reported by the patients is a combination of improved quality of sound (warble tone threshold, speech reception threshold, and discrimination in noise), improved comfort, and relief from middle ear and ear canal disease occasioned by conventional hearing aids.
Audiometry↗
[Presbycusis].
Hearing loss in the elderly is the most common type of hearing impairment. The term presbyacusis has been used to describe this category of hearing loss when there are no other etiological factors. However, the term is not precise, because any of several locations along the auditory pathway may be involved to produce the symptoms. The diagnosis is based more on the course of the hearing loss and the associated biological signs of aging than on specific criteria. The loss of speech-understanding ability is one of the most important indicators for a therapeutic intervention, which generally aims at amplification using a personal hearing aid. An improvement in speech-understanding ability with a hearing aid depends on several complex factors, and there is a large amount of intersubject variability in the benefit derived from amplification, even when the magnitude of the hearing loss is comparable. The aim of research on presbyacusis over the next several years--keeping in mind the demographic development in the industrialized countries--will be to further the differential analysis of the factors contributing to auditory communication disorders in the aging population.
Aged↗
[Extensive hearing loss and deafness in adults].
Hearing and understanding are two related, yet different processes. Hearing is the perception of sound. It can be of enormous value to patients with severely impaired hearing, as it facilitates acoustic orientation. An understanding of speech, however, remains virtually impossible for most of these patients. Nevertheless, early habituation to their acoustic situation makes lip-reading much easier, thus enabling conversations to be possible in good listening environments. Severely impaired patients, however, are still not in a position to follow conversation in larger groups. Even with hearing aids and the deployment of the latest technology, sufficient help is not always given. Before making a decision on the use of these technical aids, the ENT specialist should discuss the needs of the particular individual with the hearing-aid specialist. Provided that residual hearing can be used to understand speech with the help of a hearing aid, intracochlear implantation of an electronic prosthesis is not indicated. A cochlear implant is indicated when there is a complete hearing loss on both sides. Such a profound loss means that sufficient understanding of speech is no longer possible, even with the assistance of the latest hearing aids. For most adults, deafness is a postlingual phenomenon. Adults who were born deaf or who lost their hearing in childhood tend to be unsuitable for cochlear implantation. Up to the age of six years, however, children born deaf can benefit considerably from a cochlear implant. Children who are provided with a cochlear implant shortly after becoming deaf also have a good chance of being capable of learning and understanding speech.
Adult↗
[Hearing aid rehabilitation of hearing disorders in adults].
Hearing-aid provision is still partly a medical task, in spite of technological progress and a confusing variety of types and models of devices. The diagnosis of the underlying disease, the appreciation of the consequences of hearing loss and the counseling of the hearing impaired person are prerequisites of the treatment. The physician should try to determine the etiology of the hearing loss. Also, a state-of-the-art otologic examination should be performed and the physician should be sensitive to the psychological and social consequences of the patient's hearing loss. For the assessment of fitted hearing aids, basic knowledge of the technical background is required. To measure hearing-aid benefit in the ENT office, suprathreshold and speech audiometry are indispensable tools.
Adult↗