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PubMed1995

Longitudinal assessment of physiological and psychophysical measures in cochlear implant users.

OBJECTIVE: The purpose of this study was to evaluate the effects of long-term electrical stimulation on human cochlear implant users. DESIGN: Repeated measures of electrically evoked auditory brain steam response (EABR) threshold, slope of the EABR growth function, and behavioral measures of threshold and dynamic range were made for a group of 22 Ineraid cochlear implant users and 19 Nucleus cochlear implant users over a 3- to 5-yr period. RESULTS: Data from both Ineraid and Nucleus cochlear implant users suggest that EABR threshold, slope of the EABR growth function, and behavioral measures of threshold and dynamic range remain reasonably stable for periods up to 5 yr postimplant. CONCLUSIONS: The results of this study show little evidence that prolonged electrical stimulation through daily use of a cochlear implant has deleterious effects on the auditory system.

Cochlear Implants↗
PubMed1975

Reliability of the TIP and DIP speech-hearing tests for children.

The reliability of SRT and speech intelligibility tests has been studied on adults. Reliability estimates for SRT are between .60 and .90, with standard error estimates from 1.5 to over five dB. For speech intelligibility tests the reliability estimates range from .50 to 90, with standard error of estimates from 2.5% to over 10%. Little has been reported on test reliability with children. For this study the TIP and DIP tests, for threshold and discrimination, respectively, were given to 295 normal and 138 hypacusic children three through twelve years of age. Subjects were retested within one week. TIP test-retest reliability was .72 for normals, and .89 to .99 for hypacusics. DIP test-retest reliability was .46 to .51 for normals and .60 to .93 for hypacusics. Standard error of estimate was about 3 dB for TIP, and 10% for DIP. These values are about the same as the reliability values for adults.

Child↗
PubMed1990

Residual hearing capacity of severely hearing-impaired subjects.

Speech reception functions (speech reception threshold and maximum discrimination score for phonemes) and auditory functions (hearing threshold, difference limens for intensity and frequency, temporal modulation threshold function, critical ratio and temporal integration) have been investigated in a group of severely hearing-impaired subjects (64 ears, median Fletcher Index of 80 dB). The results were separated into low-, middle- and high-frequency regions. The investigations were intended to describe and quantify the residual hearing capacities and the correlations between the different functions. It was found that the speech functions, the difference limen for frequency, the critical ratio and the time constant of temporal integration deteriorate gradually with increasing hearing loss. These functions show a relatively high mutual correlation in the low-frequency region and considerable scatter in the high-frequency part. The sensitivity for modulations and the difference limen for intensity were least affected. The results revealed that the residual capacity can be described by means of two independent factors: frequency discrimination at the higher frequencies and a decrease in processing efficiency of the system. The latter is dominated by the middle- and low-frequency hearing elements.

Adolescent↗
PubMed1986

Speech-reception threshold in noise with one and two hearing aids.

The binaural free-field speech-reception threshold (SRT) in 70-dBA noise was measured with conversational sentences for 24 hearing-impaired subjects without hearing aids, with a hearing aid left, right, and left plus right, respectively. The sentences were always presented in front of the listener and the interfering noise, with a spectrum equal to the long-term average spectrum of the sentences, was presented either frontally, from the right, or from the left side. For subjects with only moderate hearing loss, PTA (average air-conduction hearing level at 500, 1000, and 2000 Hz) less than 50 dB, the SRT in 70-dBA noise in both ears is determined by the signal-to-noise ratio even if only one hearing aid is used. For larger hearing losses the SRT appears to be partly determined by the absolute threshold. In conditions with a high noise level relative to the absolute threshold, in which case for both ears the SRT is determined by the signal-to-noise ratio, a second hearing aid, just as a monaural hearing aid, generally does not improve the SRT. However, in the case of a high hearing level, or a low noise level, in which a monaural hearing aid is profitable, the use of two hearing aids is even more profitable. In a separate experiment, acoustic head shadow was measured at the entrance of the ear canal and at the microphone location of a hearing aid. It appeared that, for a lateral noise source and speech frontal, the microphone position of behind-the-ear hearing aids has a negative effect on the signal-to-noise ratio of 2-3 dB.

Adult↗
PubMed1985

Speech reception thresholds using conventional vs high-frequency spondees in normals and in subjects with marked high-frequency sensorineural loss.

Spondee threshold (ST) estimates were obtained on 20 normal-hearing adults and 15 adults with high-frequency sensorineural hearing losses sloping off above 500 c/s at about 15-20 db/oct. Stimuli consisted of tapes of a woman's voice speaking permuted lists of 9 conventional (broadband) spondees and of 10 high-frequency-emphasis spondees developed especially for this research using a discrete-frequency analysis. For normals, the correspondence was good between the 3-frequency (.5, 1, 2 kc/s) PTA vs either list. However, for the sensorineural Ss, the mean ST for the conventional spondees was better matched to the 2-frequency PTA (av. of 2 best of .5, 1, 2 kc/s), while the high-frequency-emphasis list STs were better matched to the 3-frequency PTA. It was suggested that high-frequency-emphasis STs be used with such sloping losses and that ST-PTA reliability checks for such Ss be comparisons using a +/- 5-db criterion comparing high-frequency-emphasis STs with 3-frequency PTA. If conventional STs are collected, they should with such Ss be compared to the individual's 2-frequency PTA.

Adult↗
PubMed1997

Comparison of long-term hearing results after vestibular neurectomy, endolymphatic mastoid shunt, and medical therapy.

OBJECTIVE: This study aimed to compare the hearing changes in the long term after vestibular neurectomy, endolymphatic mastoid shunt, and medical treatment in classic Meniere's disease. STUDY DESIGN: A retrospective case review was conducted based on audiologic follow-up between 5 and 21 years. SETTING: The study was performed at two centers in Bari University Hospital, one performing vestibular neurectomy as the first surgical procedure for Meinere's disease and the other, endolymphatic mastoid shunt. PATIENTS AND INTERVENTIONS: Of 68 patients with intractable idiopathic Meniere's disease, 29 underwent middle fossa vestibular neurectomy, and 17 had endolymphatic mastoid shunt; 22 were offered surgery but declined. MAIN OUTCOME MEASURES: Outcome measures were puretone average (PTA), speech reception threshold, and speech discrimination score before and after treatment. RESULTS: PTA declined by an average of 9.3 dB in neurectomy patients, 13.3 dB in patients undergoing endolymphatic mastoid shunt, and 18.1 dB in patients who were offered surgery but declined. Patients were subdivided into two cohorts based on their preoperative or initial PTA. In the patients who had PTA scores worse than 50 dB initially, the PTA declined an average of 4.3 dB in the vestibular neurectomy group, 11.5 dB in the endolymphatic sac group, and 4 dB in the nonsurgical group. In the patients with PTA > or = 50 dB initially, the PTA declined an average of of 25.3 dB in the vestibular neurectomy group, 16.1 in the endolymphatic sac group, and 26.2 dB in the nonsurgical group. Although shunt patients with good hearing initially deteriorated less than neurectomy patients and less than patients who declined surgery, the difference was not significant. CONCLUSIONS: These results indicate that patients with poor hearing stabilized, while patients with good hearing continued to deteriorate. The same conditions were observed in the patients who had surgery and those who were offered surgery but declined.

Adult↗
PubMed1981

Hearing in 70 and 75 year old people: results from a cross sectional and longitudinal population study.

Audiometric data are presented from a cross sectional and longitudinal population study of 70 and 75 year old people in Gothenburg, Sweden. The population studied included 1148 randomly selected 70 year old men and women. A subsample of 376 was tested with pure tone and speech audiometry. Five years later 261 of those were tested again with the same methods. The mean pure tone thresholds were only 8 to 10 dB. higher than data chosen as representative for presbycusis in selected populations. Between the ages of 70 and 75 there was no detectable change in the pure tone thresholds for men. The hearing threshold in women had deteriorated throughout the entire frequency range and most were at 4 and 8 kHz. Speech discrimination scores were unexpectedly high. Seventy-five per cent of the women and 50 per cent of the men had discrimination scores equal to or better than 92 per cent at the age of 70. At the age of 75 about 65 per cent of the women and 35 per cent of the men had the same excellent speech discrimination

Aged↗
PubMed1987

Speech recognition threshold in noise: effects of hearing loss, frequency response, and speech materials.

Speech recognition threshold (SRT) was measured in quiet and in noise for normal-hearing subjects and subjects with high-frequency sensorineural hearing loss. For the hearing-impaired subjects, SRT in quiet approximated the amount of hearing loss in the frequency region of importance for each of two sets of speech materials--spondees and monosyllables. With changes in frequency response of the stimulus delivery system, SRT shifted differentially for spondees and monosyllables. The speed, reliability, and apparent sensitivity of the SRT in quiet and noise to frequency response characteristics make it a potentially useful tool for hearing aid evaluation if speech materials appropriate to both the hearing loss configuration and the frequency response of amplification are chosen.

Adult↗
PubMed1982

Relationships among speech threshold, loudness discomfort, comfortable loudness, and PB max in the elderly hearing impaired.

The purposes of this study were (1) to determine the effect of the severity of hearing loss on the most comfortable loudness level (MCL) and the loudness discomfort level (LDL), and (2) to assess the efficacy of obtaining maximum intelligibility (PB max) at MCL and/or LDL. One hundred twenty-nine ears were tested from seventy-four elderly subjects having mild to moderate sensorineural hearing losses. The results showed that mean MCLs and LDLs remained fairly constant as spondaic thresholds increased from 5 to 55 dB HTL. The data also exhibited considerable intersubject variability and indicated that MCLs and LDLs could not be closely predicted from threshold. Thus, for most clinical purposes MCL and LDL must be measured directly. This study also indicated that measuring speech intelligibility at MCL approximated PB max (+/- 12 percent) only about two-third of the time. Thus, decisions concerning auditory functioning may frequently be inaccurate if intelligibility is measured only at MCL. Neither can LDL be the single intensity at which speech intelligibility is measured, at least with elderly patients, since one in ten scores did not closely approximate PB max. Consequently, we concur with previous investigators who recommend generating an entire intelligibility function. The present findings also suggest that hearing aid users may not receive optimal benefit if their hearing aid is adjusted to MCL, and that improved intelligibility may be achieved a higher volume control settings. The hearing aid evaluation process should investigate this possibility.

Aged↗
PubMed2006

[Evaluation of the Oldenburg children's rhyme test in silence and in noise].

BACKGROUND: The Oldenburg children's rhyme test (OlKi) was designed and optimized for speech intelligibility measurements for primary school pupils in silence [8, 3]. In the optimization, the intelligibility of the particular test words was equalized. METHODS: The evaluation of the test with 147 primary school pupils with normal hearing in silence and 107 pupils in noise is presented in this article. The comparability between test lists for speech intelligibility was investigated and age dependent reference functions were determined. RESULTS: The evaluation showed that intelligibility differences are larger across children within one grade than across different test lists. The reference functions of first grade pupils are shifted to slightly higher presentation levels and signal-to-noise ratios both in silence and noise. CONCLUSIONS: The 12 optimized test lists of the OlKi test are equally intelligible both in silence and noise. No list effects are expected. The degree of difficulty of the Oldenburg children's rhyme test can be compared with the Göttingen children's test II and the Mainz children's test III.

Auditory Perceptual Disorders↗
PubMed1993

Phonetic rehabilitation after laryngectomy.

This work deals with the phonetic rehabilitation of patients after laryngectomy, describing the various types of alaryngeal voice. The rehabilitation was monitored with a computer by means of a specific voice programme which permits the registration, visualization and reproduction of each sound emitted in conjunction with the classification of the principal parameters, thus allowing the patient to check his acoustic feedback.

Humans↗
PubMed1998

[Cochlear implant for non-deaf patients?].

BACKGROUND: Cochlear implants have proven to be the method of choice for postlingually deafened adults. The great success of this application requires discussion of the degree in which the indication for cochlear implantation should be expanded to include patients with residual hearing. METHOD AND PATIENTS: Following an initial discussion of the term deafness, we present the preoperative and postoperative results in five patients with residual hearing. These patients achieve a certain degree of speech recognition with their well fitted hearing aids. However, their aided speech intelligibility did not exceed 30% with the standardized Freiburg monosyllabic word test at 70 dB. In each case the worse hearing ear was treated with a cochlear implant. Speech discrimination in silence and noise are compared with the results of a group of postlingually deafened cochlear implant patients. RESULTS: The five patients are very satisfied with the cochlear implant and use the telephone to communicate with unknown partners. They score 100% in the standardized four-syllable number test above 55 dB and they document a loss of speech discrimination between 0 and 25% within the open-set monosyllabic word test. The mean increase of best monosyllable intelligibility by the cochlear implant over the hearing aids is 65%. Using the innsbruck sentence test the patients score 100% at 70 dB; with the Göttingen sentence test, the mean result is 75%. Their mean results in noise are also very good, 76% at 10 dBS/N and 57% at 5 dBS/N respectively. None of these patients use the hearing aid on the untreated, better hearing ear. CONCLUSION: A multichannel cochlear implant lead to a significant improvement of speech comprehension in these patients with residual hearing. We can successfully implant patients with minimal benefit of their well fitted hearing aids. Our group is too small to be able to define general selection criteria. For the time being we use as an audiological indication a open-set monosyllabic word intelligibility of not more than 30% at 70 dB with well fitted hearing aids.

Adolescent↗
PubMedDate not supplied

On the calibration of two commercially recorded versions of CID auditory test W-22.

Electroacoustic analysis of two commercially available versions of CID W-22 indicated significant differences in calibration. Measured differences in level between calibration tone and stimulus words were plus 5 to 8 dB for Technisonic recordings and plus one dB for Auditec recordings. As a consequence, the Technisonic Studios recordings were approximately 40% more intelligible than were Auditec recordings when presented to normal-hearing listeners in a background of competing speech spectrum noise in a condition where the level of the calibration tone of the respective recordings was used as the reference value to specify nominal speech-to-noise ratio.

Adult↗
PubMed2007

Speech understanding in background noise with the two-microphone adaptive beamformer BEAM in the Nucleus Freedom Cochlear Implant System.

OBJECTIVE: This paper evaluates the benefit of the two-microphone adaptive beamformer BEAM in the Nucleus Freedom cochlear implant (CI) system for speech understanding in background noise by CI users. DESIGN: A double-blind evaluation of the two-microphone adaptive beamformer BEAM and a hardware directional microphone was carried out with five adult Nucleus CI users. The test procedure consisted of a pre- and post-test in the lab and a 2-wk trial period at home. In the pre- and post-test, the speech reception threshold (SRT) with sentences and the percentage correct phoneme scores for CVC words were measured in quiet and background noise at different signal-to-noise ratios. Performance was assessed for two different noise configurations (with a single noise source and with three noise sources) and two different noise materials (stationary speech-weighted noise and multitalker babble). During the 2-wk trial period at home, the CI users evaluated the noise reduction performance in different listening conditions by means of the SSQ questionnaire. In addition to the perceptual evaluation, the noise reduction performance of the beamformer was measured physically as a function of the direction of the noise source. RESULTS: Significant improvements of both the SRT in noise (average improvement of 5-16 dB) and the percentage correct phoneme scores (average improvement of 10-41%) were observed with BEAM compared to the standard hardware directional microphone. In addition, the SSQ questionnaire and subjective evaluation in controlled and real-life scenarios suggested a possible preference for the beamformer in noisy environments. CONCLUSIONS: The evaluation demonstrates that the adaptive noise reduction algorithm BEAM in the Nucleus Freedom CI-system may significantly increase the speech perception by cochlear implantees in noisy listening conditions. This is the first monolateral (adaptive) noise reduction strategy actually implemented in a mainstream commercial CI.

Adult↗
PubMed1988

Comparing two methods of preschool and kindergarten hearing screening.

Preschool and kindergarten hearing screening programs rely primarily on pure tone audiometry though its reliability with this population has been questioned. Some experts have suggested speech reception testing may be a better indicator of hearing in young children. This study compared screening results on 576 students tested with both pure tone and Verbal Auditory Screening for Children (VASC), a speech reception-based audiometer, and findings of 43 students who could not respond to pure tone testing but did complete VASC. Data indicate VASC was more effective in identifying possible hearing deficits in young children being tested in a screening environment.

Audiometry↗
PubMed1997

A psychoacoustic model for the noise masking of plosive bursts.

A model for predicting the masked thresholds of the voiceless plosive bursts /k,t,p/ in background noise is proposed. Because plosive bursts are brief, are generated by a noise source, and have different spectral characteristics, the modeling approach accounts for duration, center frequency, and signal bandwidth. Noise-in-noise masking experiments are conducted using a broadband masker and bandpass noise signals of varying bandwidth (100-5483 Hz), duration (10-300 ms), and center frequency (0.4-4 kHz). Data from these experiments are used to parametrize an auditory filter model in which the effective bandwidth and the signal-to-noise ratio at threshold for each filter are duration dependent. The duration-dependent filter model is then used to predict the thresholds of synthetic and naturally spoken plosive bursts in background noise. Finally, results from pilot notched-noise experiments are presented which support duration-dependent frequency selectivity.

Adult↗
PubMed2006

Cochleovestibular dysfunction in ankylosing spondylitis.

Ankylosing spondylitis (AS) is a rheumatic disease characterized by chronic inflammation. The aim of this study was to evaluate the functions of the cochlea and the vestibular system in patients with AS. The study group consisted of 32 patients with AS and 30 healthy volunteers as a control group. Otorhinolaryngologic examinations were performed in all patients together with pure-tone audiometry, speech tests, impedancemetry, transient evoked otoacoustic emission (TEOAE) and electronystagmography (ENG). A significant difference was found between the 2 groups with regard to pure-tone averages at high frequencies in each ear (p < 0.05). The rates of reproducibility in TEOAE testing were significantly lower in patients with AS (p = 0.03). The signal-to-noise rates of the response values were lower at all frequencies in patients with AS, but a statistically significant difference was only observed at 2, 3 and 4 Hz (p < 0.05). ENG revealed pathologies in 11 patients with AS (34%), 8 of which were central (25%) and 3 of which were peripheral (9%). No correlation was found between cochleovestibular dysfunction and age, sex, disease duration, activity and medication taken. This study demonstrated that there is an association between AS and cochleovestibular dysfunction.

Acoustic Impedance Tests↗