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Results for “Speech Reception Threshold Test”

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PubMed1998

Factors governing speech reception benefits of adaptive linear filtering for listeners with sensorineural hearing loss.

Adaptive linear filtering can improve effective speech-to-noise ratios by attenuating spectral regions with intense noise components to reduce the noise's spread of masking onto speech in neighboring regions. This mechanism was examined in static listening conditions for seven individuals with sensorineural hearing loss. Subjects were presented with nonsense syllables in an intense octave-band noise centered on 0.5, 1, or 2 kHz. The nonsense syllables were amplified to maximize. the articulation index; the noises were the same for all subjects. The processing consisted of applying frequency-selective attenuation to the speech-plus-noise with the goal of attenuating the frequency region containing the noise by various amounts. Consonant recognition scores and noise masking patterns were collected in all listening conditions. When compared with masking patterns obtained from normal-hearing subjects, all hearing-impaired subjects had higher masked thresholds at frequencies below, within, and above the masker band except for one subject who demonstrated additional masking above the masker only. Frequency-selective attenuation resulted in both increases and decreases in consonant recognition scores. Increases were associated with a release from upward spread of masking. Decreases were associated with applying too much attenuation such that speech energy within the masker band that was audible before processing was partially below threshold after processing. Fletcher's [Speech and Hearing in Communication (Van Nostrand, New York, 1953)] version of articulation theory (without modification) accounted for individual subject differences within the range of variability associated with the consonant recognition test in almost every instance. Hence, primary factors influencing speech reception benefits are characterized by articulation theory. Fletcher's theory appears well-suited to guide the design of control algorithms that will maximize speech recognition for individual listeners.

Adult↗

PubMed1982

Asymptomatic schwannoma of the cochlear nerve.

During systematic study of temporal bone histopathology at The Deafness Foundation, Memphis, we found an unsuspected small schwannoma arising solely from the cochlear nerve, compressing the facial nerve within the internal auditory canal. The primary temporal bone pathologic finding was bilateral otosclerosis. Compression of the facial nerve by schwannomas of the cochlear nerve is well know to occur at a late stage and produce a lower motor neuron facial paralysis but, in the present case, although the growth of th tumor compressed the facial nerve trunk, no paralysis was noted. Hearing test of the ear associated with the tumor, performed ten months before death, revealed a mixed conductive-sensorineural deafness. Surprisingly, the speech reception threshold was 75 dB, with a speech discrimination score of 70%.

Aged↗

PubMed2001

Comparison of three procedures for initial fitting of compression hearing aids. I. Experienced users, fitted bilaterally.

We compared the effectiveness of three procedures for the initial fitting of hearing aids with multi-band compression: (1) CAMEQ, which aims to amplify speech so as to give equal loudness per critical band over the frequency range important for speech intelligibility, and to give similar overall loudness to 'normal': (2) CAMREST, which aims to amplify speech so as to restore 'normal' specific loudness patterns, over a wide range of speech levels; (3) DSL I/O, which aims to map the dynamic range of normally hearing people into the reduced dynamic range of hearing-impaired people, with 'full' restoration of audibility. Ten experienced hearing aid users with moderate sensorineural loss were fitted bilaterally with Danalogic 163D digital hearing aids, using each procedure in turn; the order was counterbalanced across subjects. The fitting required specification of gains for input levels of 55 and 80 dB SPL at six centre frequencies. Real-ear measurements were made to ensure that target gains were reached (+/-3 dB). Immediately after fitting with a given procedure, and one week after fitting, the gains were adjusted when required by the minimum amount necessary to achieve acceptable fittings. The amount of adjustment required provides one measure of the adequacy of the initial fitting. On average, the adjustments were smallest for the CAMEQ procedure. The gain changes were slightly larger for the CAMREST procedure and were largest of all for DSL I/O. For the latter, the gain changes were mostly negative, especially for high frequencies and the higher input level. This indicates that the DSL I/O procedure prescribes more high-frequency gain than is preferred by adult users. After these gain adjustments, users wore the aids for at least three weeks before filling out the APHAB questionnaire and taking part in laboratory measurements of the speech reception threshold (SRT) for sentences in quiet and in steady and fluctuating background noise at levels of 60 and 75 dB SPL. Following these tests, the hearing aids were re-fitted with the next procedure. The scores on the APHAB test and the SRTs did not differ significantly for the three procedures. We conclude that the CAMEQ and CAMREST procedures provide more appropriate initial fittings than DSL I/O.

Acoustic Stimulation↗

PubMed1988

Chronic labyrinthine ischemia.

The purpose of the present study was to describe the audiological and vestibular deficit in patients presumed to suffer from chronic impairment of the blood supply to the labyrinth. Thirty-nine subjects affected by various pathologies often impairing systemic blood circulation, which also presented labyrinthine damage of unclear origin, were evaluated for a possible relationship between these two conditions. At the time of this study 80 per cent of the subjects showed also a certain degree of increased blood viscosity. The most common finding in the group was slow and progressive bilateral sensorineural loss of hearing. In most of the subjects the labyrinthine damage began with high-tone loss which, in time, became a flat curve. Less common, but still found in many patients, was a fluctuation in threshold. Short periods of spontaneous subjective improvement in hearing were accompanied by a better result in the Pure Tone Audiogram and Speech Reception Threshold. The discrimination scores remained generally lower than expected. Vestibular examination revealed pathological results for all the subjects in at least some of the tests. The mild subjective complaints concerning equilibrium could be explained by a central nervous system compensation.

Aged↗

PubMed1988

Auditory function in sickle cell anemia.

Auditory acuity and central auditory processing were assessed in 22 patients with sickle cell anemia, 13 of whom were chronically transfused, and compared with a control black population. Pure tone air conduction thresholds were within normal limits for all patients, and mean Speech Reception Threshold for each ear was normal at 10 dB. All subjects exhibited type A tympanograms. Central auditory processing was assessed by the Competing Sentence Test and Binaural Fusion Test. No significant differences were found among transfused, nontransfused, and control patients. Abnormal auditory function does not appear to be a common problem in patients with sickle cell disease.

Adolescent↗

PubMed2005

Characterization of hearing loss in aged type II diabetics.

Presbycusis - age-related hearing loss - is the number one communicative disorder and a significant chronic medical condition of the aged. Little is known about how type II diabetes, another prevalent age-related medical condition, and presbycusis interact. The present investigation aimed to comprehensively characterize the nature of hearing impairment in aged type II diabetics. Hearing tests measuring both peripheral (cochlea) and central (brainstem and cortex) auditory processing were utilized. The majority of differences between the hearing abilities of the aged diabetics and their age-matched controls were found in measures of inner ear function. For example, large differences were found in pure-tone audiograms, wideband noise and speech reception thresholds, and otoacoustic emissions. The greatest deficits tended to be at low frequencies. In addition, there was a strong tendency for diabetes to affect the right ear more than the left. One possible interpretation is that as one develops presbycusis, the right ear advantage is lost, and this decline is accelerated by diabetes. In contrast, auditory processing tests that measure both peripheral and central processing showed fewer declines between the elderly diabetics and the control group. Consequences of elevated blood sugar levels as possible underlying physiological mechanisms for the hearing loss are discussed.

Aged↗

PubMedDate not supplied

Psychoacoustic and electrophysiologic effects of partial eighth nerve damage.

The authors present psychoacoustic and electrophysiologic data concerning a patient with partial damage to the auditory nerve, presumably from a dilated arterial vessel. The lesion was described and documented during neurosurgery for vestibular nerve decompression. Pure tone thresholds, psychoacoustical tuning curves, speech reception ability for spondaic words, maximum word recognition performance for monosyllabic NU-6 word lists, and performance on the synthetic sentence identification test in the ipsilateral and contralateral competing message modalities were normal. Findings consistent with eighth nerve dysfunction, absent contralateral acoustic reflexes, absent or unrecognizable early evoked potentials occurring in the first 10 msec, brainstem auditory evoked potentials (BAEPs), and slight rollover of the performance intensity function for monosyllabic words were obtained on the involved side. In spite of the grossly abnormal BAEPs, two late, presumably cortical, auditory evoked potential components, which occur in the 60 to 250-msec range--vertex potential and T complex--were present and normal. The findings indicate that the perceptual processes needed for speech reception and recognition and for the appearance of later, presumably cortical-evoked potentials can be preserved despite partial damage to the auditory nerve.

Adult↗

PubMed2004

Comparison of three procedures for initial fitting of compression hearing aids. III. Inexperienced versus experienced users.

We assessed whether gain requirements differ for experienced users and new users when fitted with multi-band compression hearing aids Three procedures for initial fitting were used: the Cambridge method for loudness equalization (CAMEQ), the Cambridge method for loudness restoration (CAMREST), and the desired sensation level input/output (DSL[i/o]) method. Twenty experienced hearing aid users and 20 new users with mild-to-severe sensorineural loss were fitted with Danalogic 163D digital hearing aids, using each procedure in turn in a counter-balanced order. The new users were given a pre-fitting with slightly reduced gains prior to the 'formal' fitting. Immediately after formal fitting with a given procedure, and 1 week after fitting, the gains were adjusted by the minimum amount necessary to achieve acceptable fittings. The amount of adjustment required provided the main measure of the adequacy of the initial fitting. On average, new users required decreases in gain for all procedures, the decreases being larger for DSL[i/o] than for CAMEQ or CAMREST. For experienced users, gain adjustments were small for CAMEQ and CAMREST, but were larger and mostly negative for DSL[i/o]. After these gain adjustments, users wore the aids for at least 3 weeks before filling out the Abbreviated Profile of Hearing Aid Benefit (APHAB) questionnaire and taking part in laboratory measurements of the speech reception threshold (SRT) for sentences in quiet and in steady and fluctuating background noise at levels of 60 and 75 dBSPL. The scores on the APHAB test and the SRTs did not differ significantly for the three procedures. We conclude that the CAMEQ and CAMREST procedures provide more appropriate initial fittings than DSL[i/o]. For inexperienced users, gains typically need to be reduced by about 3dB relative to those prescribed by CAMEQ or CAMREST, although the amount of reduction may depend on hearing loss. An analysis of gain adjustments as a function of order of testing provided some evidence for increased tolerance to high-frequency amplification with increasing experience during the 4-month course of the trial, but this effect did not differ for the experienced and new users.

Acoustic Stimulation↗

PubMed2006

The Performance-Perceptual Test (PPT) and its relationship to aided reported handicap and hearing aid satisfaction.

OBJECTIVE: Results of objective clinical tests (e.g., measures of speech understanding in noise) often conflict with subjective reports of hearing aid benefit and satisfaction. The Performance-Perceptual Test (PPT) is an outcome measure in which objective and subjective evaluations are made by using the same test materials, testing format, and unit of measurement (signal-to-noise ratio, S/N), permitting a direct comparison between measured and perceived ability to hear. Two variables are measured: a Performance Speech Reception Threshold in Noise (SRTN) for 50% correct performance and a Perceptual SRTN, which is the S/N at which listeners perceive that they can understand the speech material. A third variable is computed: the Performance-Perceptual Discrepancy (PPDIS); it is the difference between the Performance and Perceptual SRTNs and measures the extent to which listeners "misjudge" their hearing ability. Saunders et al. in 2004 examined the relation between PPT scores and unaided hearing handicap. In this publication, the relations between the PPT, residual aided handicap, and hearing aid satisfaction are described. DESIGN: Ninety-four individuals between the ages of 47 and 86 yr participated. All had symmetrical sensorineural hearing loss and had worn binaural hearing aids for at least 6 wk before participating. All subjects underwent routine audiological examination and completed the PPT, the Hearing Handicap Inventory for the Elderly/Adults (HHIE/A), and the Satisfaction for Amplification in Daily Life questionnaire. Sixty-five subjects attended one research visit for participation in this study, and 29 attended a second visit to complete the PPT a second time. RESULTS: Performance and Perceptual SRTN and PPDIS scores were normally distributed and showed excellent test-retest reliability. Aided SRTNs were significantly better than unaided SRTNs; aided and unaided PPDIS values did not differ. Stepwise multiple linear regression showed that the PPDIS, the Performance SRTN, and age were significant predictors of scores on the HHIE/A such that greater reported handicap is associated with underestimating hearing ability, poorer aided ability to understand speech in noise, and being younger. Scores on the Satisfaction with Amplification in Daily Life were not well explained by the PPT, age, or audiometric thresholds. When individuals were grouped by their HHIE/A scores, it was seen that individuals who report more handicap than expected based on their audiometric thresholds, have a more negative PPDIS, i.e., underestimate their hearing ability, relative to individuals who report expected handicap, who in turn have a more negative PPDIS than individuals who report less handicap than expected. No such patterns were apparent for the Performance SRTN. CONCLUSIONS: The study showed the PPT to be a reliable outcome measure that can provide more information than a performance measure and/or a questionnaire measure alone, in that the PPDIS can provide the clinician with an explanation for discrepant objective and subjective reports of hearing difficulties. The finding that self-reported handicap is affected independently by both actual ability to hear and the (mis)perception of ability to hear underscores the difficulty clinicians encounter when trying to interpret outcomes questionnaires. We suggest that this variable should be measured and taken into account when interpreting questionnaires and counseling patients.

Aged↗

PubMed1977

Diaphoresis and Meniere's disease.

The effect of diaphoresis on patients with Meniere's disease (labyrinthine hydrops) previously has not been reported. With the use of two distinct activities to produce diaphoresis, we were able to document substantial transient improvements in pure-tone threshold, speech-reception threshold, and speech discrimination concurrent with a decrease in tinnitus and fullness in two patients with unilateral Meniere's disease that had been diagnosed previously by the glycerin test. The two diaphoretic activities were (1) strenuous exercise, including periodic visits to the sauna, and (2) passive activity consisting of repetitive visits to the sauna. Glycerin, an osmotic diuretic, produces similar temporary beneficial effects primarily in patients in the fluctuant hearing stage of Meniere's disease. The glycerin test is being used in several clinics as an adjunct for the diagnosis of endolymphatic hydrops.

Adult↗

PubMedDate not supplied

Occlusion effect in bone conduction pure tone and speech audiometry.

Two experiments were conducted to determine the occlusion effect (OE) for pure tone and spondee stimuli. Results of experiment I using mastoid placement and unilateral occlusion yielded a mean OE for bone conduction speech reception thresholds of 4.67 dB, which was in agreement with the average OEs of 0.50, 1.0 and 2.0 kHz, or simply the same as the OE for 1.0 kHz. However, the magnitude of the observed OEs for test frequencies of 0.25 to 4.0 kHz was considerably less than the OEs reported in previous investigations. In an attempt to explain this discrepancy, experiment II used unilateral and bilateral occlusion with mastoid and forehead placement for pure tone stimuli. Significant differences (p less than 0.05) were found between OEs obtained with mastoid versus forehead placement and for unilateral versus bilateral occlusion.

Adult↗

PubMed1992

Evaluation of a dual-channel full dynamic range compression system for people with sensorineural hearing loss.

This article describes an evaluation of an in the ear hearing aid, which applies fast-acting full dynamic range compression independently in two frequency bands. This can compensate for the loudness recruitment typically associated with sensorineural hearing loss. The crossover frequency between the two bands and the gain and compression ratio in each band are programmable to suit the individual patient. Twenty subjects with moderate sensorineural hearing loss were tested in a counterbalanced order using the aid programmed as a linear amplifier (condition L) and as a two-band compressor (condition C). All subjects were fitted binaurally. Subjects were also tested without hearing aids (condition U) and using the hearing aids that they normally wore (condition Own). Speech intelligibility was measured in quiet at three sound levels (50, 65, and 80 dB SPL), and speech reception thresholds (SRTs) in 12-talker babble were measured under monaurally and binaurally aided conditions, with the speech and babble both coincident and spatially separated. In condition C, speech intelligibility in quiet was high at all sound levels. Speech intelligibility at the two lower levels decreased in condition L, and decreased still further in conditions Own and U. Condition C gave, on average, better speech intelligibility in babble (lower SRTs) than conditions L, Own, or U. The advantage of condition C over condition L varied across subjects and was correlated with the dynamic range for tones at high frequencies; small dynamic ranges were associated with greater benefit from compression. A significant advantage for binaural aiding was found both when the speech and noise were spatially separated and when they were coincident. The binaural advantage was similar for the C and L conditions, indicating that the independent compression at the two ears did not adversely affect the use of binaural cues. Questionnaires on the subjects' experiences with the aids in everyday life indicated that they generally preferred condition C over condition L.

Adult↗

PubMed1981

Monaural vs binaural speech reception threshold and word discrimination scores in the hearing impaired.

Monaural and binaural SRT and speech discrimination scores in a sensorineural hearing-imparied sample (N: 194, aged 3--91 yrs, mn=43 yrs) indicated that while a majority of clients have neither a binaural advantage or disadvantage by these tests, an important minority (5% for SRT, 20% for discrimination) have worse binaural than better-ear scores. Binaural as well as monaural tests of SRT and of speech discrimination should be a standard part of a hearing aid evaluation.

Adolescent↗

PubMedDate not supplied

Speech pure tone audiometry as a screen for exaggerated hearing loss in industrial claims.

We examined 596 patients referred with possible noise-induced hearing loss, by conventional and cortical evoked response audiometry. Discrepancies between the two tests identified 121 (20.3%) as exaggerating their hearing loss. We then studied the validity of simple conventional tests, which would be available in primary diagnostic facilities, in screening for the exaggrerators we had idenfied. By selecting those whose puretone average (for 0.5 and 1 kHz) was more than 10 dB different from the speech reception threshold, or whose initial puretone threshold at 0.5 kHz was 40 dB or greater, we identified 112 (93%) of the exaggerators, at the cost of additional examination of 209 (35% of the total) false-positive. However, this screening means that 46% of the claimants could be evaluated completely in a primary diagnostic facility, and only a small fraction of the exaggerator should be overlook.

Acoustic Stimulation↗

PubMed1989

Clinical results with a percutaneous bone-anchored hearing aid.

During a 2-year period ending in July 1987, nine patients were implanted with a percutaneous bone-anchored hearing aid developed at the University of Gothenburg and Chalmers University of Technology, Sweden. Patients selection was based on the presence of conductive or mixed hearing loss in patients who are unable to wear a conventional hearing aid because of infection or ear canal problems. Patients had speech discrimination scores of at least 60% for phonetically balanced monosyllables (CID lists) at 40 dB above threshold, and a pure tone bone conduction average of 45 dB hearing loss or better. Patients were evaluated in sound field, preoperatively and postoperatively using warble tones, speech reception threshold, speech discrimination, and synthetic speech identification. The patient's unaided hearing and hearing with a bone-anchored hearing aid were compared with the patient's hearing with a standard bone conduction hearing aid. Signal to noise ratio testing with the synthetic speech identification test demonstrated that the bone-anchored hearing aid was comparable to a standard bone conduction aid. There were no complications in our series. Five patients who reported otorrhea with conventional hearing aids experienced no otorrhea after implantation. Patient satisfaction, as assessed by questionnaire, revealed that all patients preferred the bone-anchored hearing aid to previously worn hearing aids.

Adult↗

PubMed1985

Relations between psychophysical data and speech perception for hearing-impaired subjects. II.

Twenty-one sensorineurally hearing-impaired adolescents were studied with an extensive battery of tone-perception, phoneme-perception, and speech-perception tests. Tests on loudness perception, frequency selectivity, and temporal resolution at the test frequencies of 500, 1000, and 2000 Hz were included. The mean values and the gradient across frequencies were used in further analysis. Phoneme-perception data were gathered by means of similarity judgments and phonemic confusions. Speech-reception thresholds were determined in quiet and in noise for unfiltered speech material, and with additional low-pass and high-pass filtering in noise. The results show that hearing loss for speech is related to both the frequency resolving power and temporal processing by the ear. Phoneme-perception parameters proved to be more related to the filtered-speech thresholds than to the thresholds for unfiltered speech. This finding may indicate that phoneme-perception parameters play only a secondary role, and for that reason their bridging function between tone perception and speech perception is only limited.

Acoustic Stimulation↗

PubMed2000

[Meniere's disease. The clinical effect of gentamicin treatment].

In patients with Menière's disease attacks of vertigo can be invalidating. We have tested the effect of instillation of gentamycin in the middle ear to minimize or stop the attacks of vertigo. The results of a prospective investigation of 14 patients with Menière's disease treated with gentamycin in the period from 1993 to 1996 are presented. The patients were followed up to 53 months after the treatment and a telephone follow-up was performed. At the last follow-up nine out of 12 patients were free of attacks of vertigo. Two improved and one patient was unchanged. In two patients deafness developed in the treated ear, in the other patients the hearing was unchanged measured by speech reception threshold and discrimination loss. It is concluded that treatment of patients with Menière's disease by instillation of gentamycin into the middle ear does have a therapeutic effect. The treatment is simple and the effect of treatment is equal to other types of treatments. The risk of deafness in the treated ears stresses the importance of giving the patient sufficient information before treatment.

Administration, Topical↗

PubMedDate not supplied

Threshold improvement and acoustic gain with hearing aids.

Aided speech reception thresholds were obtained from 20 hearing-impaired listeners with three hearing aids adjusted to confort settings, and with the aids adjusted to deliver 40 dB of acoustic gain. The aided speech reception threshold under each condition was substracted from the unaided speech reception threshold to yield a measure of threshold improvement. Threshold improvement and acoustic gain comparisons revealed that, at comfort setting, these two measures were quite similar. However, at the 40-dB gain setting, acoustic gain exceeded threshold improvement by an average of 5.6 dB. For the high-gain condition, it appeared that the threshold improvement obtained by subjects with relatively good unaided sensitivity was limited by the ambient noise in the test chamber.

Acoustic Stimulation↗