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Results for “Speech Reception Threshold Test”

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PubMed1991

Hearing aid benefit in everyday environments.

Hearing aid benefit was measured for three matched groups of eleven hearing-impaired subjects, each serving in one typical listening environment. Benefit was quantified in terms of improvement in intelligibility score for the Connected Speech Test. Each subject was individually fitted with three hearing aids, differing in nominal frequency response slope by a total of 8 dB/octave. Research questions centered on the amount of benefit typically realized in everyday environments and the interactions of this benefit with frequency response and/or visual cues. Results revealed: (1) mean benefit in a living-room type setting was about 24% and significantly greater than in a reverberant setting (7%) and a noisy setting (-1%); (2) despite the relatively large mean difference in benefit between the reverberant and noisy environments, the difference was not statistically significant (p greater than 0.05); (3) the addition of visual cues did not change hearing aid benefit in any tested environment; (4) there was no significant overall trend for any of the three different frequency-response slopes to give superior benefit in any environment; (5) 76% of the subjects achieved significantly different benefit (p less than 0.05) in at least one hearing aid condition when data were considered on an individual basis; and (6) articulation indices in the aided conditions did not successfully predict the observed within-subject benefit differences. Benefit was significantly related to speech reception threshold in the living-room environment. However, in the less favorable environments, benefit and hearing loss were not related despite the fact that benefit varied considerably across subjects.

Acoustics↗

PubMed1989

Perilymphatic fistulas in children: rationale for therapy.

We report 26 consecutive patients (32 ears) who were identified in a 2 year period (July 1, 1985-June 30, 1987) with unexplained sudden, fluctuating, or progressive sensorineural hearing loss (SNHL). All patients underwent an exploratory tympanotomy and a perilymphatic fistula was identified in 13 patients (14 ears). The mean change of 14 +/- 27 dB in speech reception threshold before and after surgery was significant at p = 0.08 among children with fistula and ranged from -30 to 80 dB. In children with sudden, progressive or fluctuating SNHL and multiple sensory deficits, including blindness or contralateral SNHL, or prior head trauma, prompt surgical exploration is mandatory. Additionally, the aggressive management of otitis media with effusion is essential in such patients to minimize fluctuations in hearing caused by superimposed conductive hearing loss. Caution must be exercised to separate fluctuating hearing loss from fluctuations in audiologic testing.

Adolescent↗

PubMed2000

[Surgical treatment of otosclerosis with argon laser].

OBJECTIVES: Argon laser stapedotomy is a new modality for the treatment of otosclerosis. The first results obtained in Denmark are reported. MATERIALS AND METHODS: A retrospective follow-up study was undertaken to evaluate the results of argon laser stapedotomy which was introduced in 1991 at the department of Otolaryngology, Rigshospitalet, Copenhagen. The results are based on 85 consecutive primary stapedotomy operations with argon laser in 76 patients during the period January 1, 1991 to June 30, 1996. Mean follow-up was 16.6 months (6-60). RESULTS: The postoperative air-bone gap was closed within 10 dB or less in 83% of the operations and in 20 dB or less in 98%. The mean speech reception threshold (SRT) was 48 dB preoperatively. All patients had an improved SRT after the operation, with a mean value of 23 dB. At 4000 Hz and 8000 Hz, 89% and 65% of the patients had maintained or improved their hearing. No patient developed profound sensorineural hearing loss or anacusis after the operation. Only one patient developed symptoms of a temporary perilymphatic fistula. CONCLUSION: Argon laser stapedotomy is a safe technique. Its complications are fewer and not as serious as conventional methods. In addition, the achieved hearing results are better, and thus it is a good example of "minimal invasive high success surgery".

Adolescent↗

PubMed2006

Speech reception thresholds in noise and self-reported hearing disability in a general adult population.

OBJECTIVE: The principal objective of this study was to describe speech reception thresholds in noise (SRTTn, i.e., the signal-to-noise ratio corresponding to 50% intelligibility) and self-reported hearing disability in a general adult population. A secondary objective was to investigate to what extent the functional measurements could be predicted on the basis of the self-reported data. DESIGN: The sample consisted of 1086 subjects over 60 yr of age who participated in the Longitudinal Aging Study Amsterdam and 128 younger adults, mainly between 20 and 30 yr of age. Subjects were given a diotic speech-in-noise test by telephone to estimate the SRTTn and filled in a questionnaire to allow determination of the self-reported hearing disability. The SNR loss (signal-to-noise ratio loss), defined as the amount by which the measured SRTTn exceeds that for subjects with normal hearing, was determined and classified in three hearing-status categories: good, insufficient, and poor. RESULTS: The median SNR loss for the 60- to 64-year age group was 2.2 dB for men and 1.2 dB for women. The corresponding figures for the 80- to 84-year age group were 5.0 dB and 3.6 dB, respectively. Only 42% of the subjects with poor hearing possessed hearing aids. A single question from the self-reported hearing disability questionnaire could be used to predict the hearing-status category corresponding to the results of the speech-in-noise test correctly in 62% of the cases. Use of all five of the questions from the questionnaire allowed 69% of the subjects to be classified correctly. There is a strong effect of age on the relation between reported hearing disability and SNR loss. CONCLUSIONS: SNR loss is a common disability in people aged 60 yr or more. Relatively few people with significant SNR loss have hearing aids. Screening for SNR loss with a speech-in-noise test performed by telephone is preferable to use of a short questionnaire, even when an age-specific scoring method is applied.

Adult↗

PubMed1975

A spondee list for determining speech reception threshold without prior familiarization.

The purpose of this investigation was to select a list of spondees from the CID W-1 spondee word list that eliminates the need for familiarization but produces spondee thresholds equivalent to those obtained with familiarization. Forty-eight subjects with normal hearing responded to familiarized and unfamiliarized spondee words at their familiarized spondee threshold levels. Spondee words that were correctly identified most often without prior familiarization or whose correct response rates were least altered by familiarization were selected for the final list. Seventeen words were selected from the criteria of the present study; two of these words were excluded from the final list since they did not fall within the recommended 4-dB range. The 15 remaining spondee words without familiarization produced spondee thresholds equivalent to the entire CID W-1 list with familiarization in a direct comparison of the two lists in 20 subjects with normal hearing.

Adolescent↗

PubMed2001

[Auditory training with wide-band white noise: effects on the verbal discrimination].

The auditory training with wide-band white noise is a methodology for the qualitative recovery of the hearing loss in people suffering from sensorineural hearing loss. It is based on the application of a wide-band white modified noise. In a prospective study, we have assessed the modifications of the verbal reception threshold URV), the maximum discrimination (Dmax), and the discrimination coefficient (Kd) in a sample of 48 patients, who have followed a program of 15 auditory training with wide-band white noise sessions. The average improvements of the verbal discrimination variables expressed in percentage are 4.23% for the URV, a 9.04% for the kd, a 17.87% for the Dmax, and 4.32%, 10.05%, 13.04% for the binaural URV, Kd and Dmax respectively. From our results, it can be deduced that the auditory training with wide-band white noise improves the verbal discrimination measures. Not only it allows to reach the verbal reception threshold at a lower intensity, but also it moves the discrimination line towards the left. Furthermore, it increases the maximum discrimination both in binaural measurements and in those which consider all the ears.

Acoustic Stimulation↗

PubMed1976

Hearing under stress: III. The effect of external auditory meatal pressure on speech discrimination.

It has been well established that unequal air pressure across the tympanic membrane causes an increase in puretone thresholds. Very little information is available, however, concerning concommitant effects on reception and discrimination of speech material. This study was designed to determine whether or not further detrimental effects upon the communication process might occur in the form of decreased speech discrimination ability. The findings established that a high positive pressure in the external meatus can result in a deterioration of the individual's ability to discriminate speech sounds.

Adult↗

PubMed2000

Interlist equivalency of the Northwestern University Auditory Test No. 6 in quiet and noise with adult hearing-impaired individuals.

The purpose of the study was to determine the influence of sensorineural hearing loss and broadband noise on the interlist equivalency of the Northwestern University Auditory Test No. 6 (NU-6). There were two groups of participants: the first group consisted of 14 adults with mild-to-moderate hearing loss (mean age = 56 years; SD = 4.83); the second group consisted of 11 age-matched, normal-hearing individuals (mean age = 55 years; SD = 4.69). Each group heard the four lists of the NU-6 in quiet and in broadband noise at four signal-to-noise ratios (-10 dB, -5 dB, 0 dB, and +5 dB). The NU-6 stimuli were presented at 35-dB sensation level relative to each listener's speech reception threshold. Results indicated that, for both groups, there was a significant main effect for NU-6 list. Post hoc single degree of freedom contrasts revealed that this main effect was due to significant differences between some of the lists when presented in background noise. There were no differences between the lists in quiet. Because of the findings of differences between some of the lists in noise, the authors suggested that clinicians or researchers use caution when comparing scores obtained from two different NU-6 lists over time. That is, if scores from two lists are different, it is important for the clinician to determine whether this disparity is due to a change in word recognition ability or simply due to a difference between the lists.

Adult↗

PubMed2001

Hyperacusis in Williams syndrome.

OBJECTIVE: To define hyperacusis in audiologic parameters and to further elucidate central and peripheral auditory pathways. DESIGN AND SETTING: Theories surrounding hyperacusis have always been highly debated. A group of children with Williams syndrome universally complain of hyperacusis. They have highly reproducible behavioural responses to noise and are thus hampered in their social interactions. Loss of inhibitory modulation to efferent sensory input to the cochlea is thought to be a possible mechanism. METHODS: Nine patients with Williams syndrome received a complete audiologic work-up, including audiogram, speech reception thresholds, acoustic reflexes, impedance, and transient evoked otoacoustic emissions (TEOAEs). MAIN OUTCOME MEASURES: Assessment of the efferent system is done by measuring changes in TEOAEs following stimulation of the contralateral ear. RESULTS: Three patients had high-frequency sensorineural hearing loss (SNHL) and thus, as expected, absent TEOAEs, indicating cochlear damage. Two had normal hearing and normal TEOAEs. However, four patients had normal hearing with absent TEOAEs. CONCLUSIONS: These findings are suggestive of cochlear disease and may, in fact, support the hypothesis of outer hair cell modulation by the ipsilateral medial olivocochlear system. Behavioural aspects of the syndrome make audiologic testing difficult. Thus, the diagnosis of SNHL may be hampered if it truly exists. The data show a preponderance of SNHL in the older age groups of our study population. This either reflects previously missed diagnoses or underlying cochlear disease, which may manifest later in life. Thus, this finding blurs the boundary between loudness recruitment and hyperacusis.

Adolescent↗

PubMedDate not supplied

Masking level differences encountered in clinical populations.

Methods for measuring masking level differences (MLDs) at 500 Hz and for spondees were used with 290 subjects: 50 persons with normal hearing and 240 patients with various diseases. Of particular interest was whether techniques currently in clinical use could be used with ease, dispatch, and profit in determining MLD size. The methods selected, which were variations of Békésy audiometry and speech reception threshold procedures, proved clinically feasible. Results revealed differences in behavior from one group of subjects to another. Although MLDs were not affected by cortical lesions, they were very often abnormally small for patients with eight-nerve tumor, Meniére's disease, or multiple sclerosis. The high incidence of abnormally small MLDs in populations with normal sensitivity to pure tones and speech but with evidence of subcortical central lesions, such as patients with multiple sclerosis, suggests that the MLD tasks can be of diagnostic value in detecting retrocochlear lesions. However, in persons with hearing loss or significant interaural differences in threshold sensitivity, or both, the MLD tests are not always reliable in differentiating cochlear from retrocochlear disease.

Acoustic Stimulation↗

PubMed2002

The relationship between the intelligibility of time-compressed speech and speech in noise in young and elderly listeners.

A conventional measure to determine the ability to understand speech in noisy backgrounds is the so-called speech reception threshold (SRT) for sentences. It yields the signal-to-noise ratio (in dB) for which half of the sentences are correctly perceived. The SRT defines to what degree speech must be audible to a listener in order to become just intelligible. There are indications that elderly listeners have greater difficulty in understanding speech in adverse listening conditions than young listeners. This may be partly due to the differences in hearing sensitivity (presbycusis), hence audibility, but other factors, such as temporal acuity, may also play a significant role. A potential measure for the temporal acuity may be the threshold to which speech can be accelerated, or compressed in time. A new test is introduced where the speech rate is varied adaptively. In analogy to the SRT, the time-compression threshold (or TCT) then is defined as the speech rate (expressed in syllables per second) for which half of the sentences are correctly perceived. In experiment I, the TCT test is introduced and normative data are provided. In experiment II, four groups of subjects (young and elderly normal-hearing and hearing-impaired subjects) participated, and the SRT's in stationary and fluctuating speech-shaped noise were determined, as well as the TCT. The results show that the SRT in fluctuating noise and the TCT are highly correlated. All tests indicate that, even after correction for the hearing loss, elderly normal-hearing subjects perform worse than young normal-hearing subjects. The results indicate that the use of the TCT test or the SRT test in fluctuating noise is preferred over the SRT test in stationary noise.

Adult↗

PubMed1993

New developments in speech pattern element hearing aids for the profoundly deaf.

Two new developments in speech pattern processing hearing aids will be described. The first development is the use of compound speech pattern coding. Speech information which is invisible to the lipreader was encoded in terms of three acoustic speech factors; the voice fundamental frequency pattern, coded as a sinusoid, the presence of aperiodic excitation, coded as a low-frequency noise, and the wide-band amplitude envelope, coded by amplitude modulation of the sinusoid and noise signals. Each element of the compound stimulus was individually matched in frequency and intensity to the listener's receptive range. Audio-visual speech receptive assessments in five profoundly hearing-impaired listeners were performed to examine the contributions of adding voiceless and amplitude information to the voice fundamental frequency pattern, and to compare these codings to amplified speech. In both consonant recognition and connected discourse tracking (CDT), all five subjects showed an advantage from the addition of amplitude information to the fundamental frequency pattern. In consonant identification, all five subjects showed further improvements in performance when voiceless speech excitation was additionally encoded together with amplitude information, but this effect was not found in CDT. The addition of voiceless information to voice fundamental frequency information did not improve performance in the absence of amplitude information. Three of the subjects performed significantly better in at least one of the compound speech pattern conditions than with amplified speech, while the other two performed similarly with amplified speech and the best compound speech pattern condition. The three speech pattern elements encoded here may represent a near-optimal basis for an acoustic aid to lipreading for this group of listeners. The second development is the use of a trained multi-layer-perceptron (MLP) pattern classification algorithm as the basis for a robust real-time voice fundamental frequency extractor. This algorithm runs on a low-power digital signal processor which can be incorporated in a wearable hearing aid. Aided lipreading for speech in noise was assessed in the same five profoundly hearing-impaired listeners to compare the benefits of conventional hearing aids with those of an aid which provided MLP-based fundamental frequency information together with speech+noise amplitude information. The MLP-based pattern element aid gave significantly better performance in the reception of consonantal voicing contrasts from speech in pink noise than that achieved with conventional amplification and consequently, it also gave better overall performance in audio-visual consonant identification.(ABSTRACT TRUNCATED AT 400 WORDS)

Algorithms↗

PubMedDate not supplied

Advanced Meniere's disease. A study of 356 severely disabled patients.

A selected material of 356 patients with Meniere's disease, all severely disabled by paroxysmal vertigo, was analysed. The question under study was to what extent and in what way the severe vertigo is reflected in the caloric reaction and in the level of hearing. The caloric response, expressed as differences in right/left sensitivity, was reduced in 59% and exaggerated in 1% of the patients; in the remaining 40% it was normal. The median values for pure tone audiogram, speech reception threshold and speech discrimination score were 56 dB,60 dB and 54%, respectively. The hearing deteriorated considerably in the early stage of the disease, but the hearing level stabilised with time. A parallelism between acoustic and vestibular dysfunction was demonstrated. Reduction of the pure tone threshold was accompanied by a progressive decrease in caloric response. The frequency of bilateral cases increased with lengthening duration of illness. All patients included in this investigation have since undergone operation.

Adult↗

PubMed2001

Phonological processing, language, and literacy: a comparison of children with mild-to-moderate sensorineural hearing loss and those with specific language impairment.

Phonological skills, language ability, and literacy scores were compared for four groups: 19 children with mild-to-moderate sensorineural hearing loss (SNH), 20 children with specific language impairment (SLI), 20 controls matched on chronological age to the SNH group (CA), and 15 controls matched on receptive vocabulary level to a subset of the SLI group (CB). In common with the SLI group, mean scores of children with mild-to-moderate hearing loss were significantly poorer on tests of phonological short-term memory, phonological discrimination, and phonological awareness than CA controls. No differences between group means were observed in SNH and CA control groups on vocabulary, digit and sentence recall, sentence comprehension, and literacy scores. However, there was considerable individual variation within the SNH group. Nearly 50% of the SNH group showed phonological impairment associated with poorer expressive and receptive vocabulary and higher hearing thresholds than remaining children without phonological impairment. Nonword repetition deficits were observed in SNH subgroups with and without phonological impairment and were of a similar magnitude to those observed in children with SLI. Indeed, poorer repetition in children with SLI could only be differentiated from children with SNH on phonologically complex nonwords. Overall, findings suggested major problems in nonword repetition and phonological impairment occurred without clinically significant deficits in wider language and literacy abilities in children with mild-to-moderate sensorineural hearing loss. Implications for theories of SLI are discussed.

Auditory Threshold↗

PubMed1994

Surgical treatment and rehabilitation of prelingually and perilingually deafened children and adults with the nucleus multichannel cochlear implant.

We began our program in September 1992, using the Nucleus 22 Channel Cochlear Implant. To date, we have operated on four patients, one child with congenital hearing loss, two prelinguistically deaf adults and one perilingually deaf adult. Our results have shown a significant increase in auditory and speech reception and perception skills in the child. The perilingually deaf adult is able to understand speech in open set speech discrimination testing and, although we do not expect open set speech discrimination in the prelinguistically deaf adults, to date their results have been satisfactory. The two prelingually deaf adults are in an audiological rehabilitation program. Their response in prosodic aspects of speech and lipreading ability with sound have improved significantly. The only surgical complication was an infection of the flap in the child, but it was treated satisfactorily with i.v. penicillin.

Adult↗

PubMed2001

Effects of degradation of intensity, time, or frequency content on speech intelligibility for normal-hearing and hearing-impaired listeners.

Many hearing-impaired listeners suffer from distorted auditory processing capabilities. This study examines which aspects of auditory coding (i.e., intensity, time, or frequency) are distorted and how this affects speech perception. The distortion-sensitivity model is used: The effect of distorted auditory coding of a speech signal is simulated by an artificial distortion, and the sensitivity of speech intelligibility to this artificial distortion is compared for normal-hearing and hearing-impaired listeners. Stimuli (speech plus noise) are wavelet coded using a complex sinusoidal carrier with a Gaussian envelope (1/4 octave bandwidth). Intensity information is distorted by multiplying the modulus of each wavelet coefficient by a random factor. Temporal and spectral information are distorted by randomly shifting the wavelet positions along the temporal or spectral axis, respectively. Measured were (1) detection thresholds for each type of distortion, and (2) speech-reception thresholds for various degrees of distortion. For spectral distortion, hearing-impaired listeners showed increased detection thresholds and were also less sensitive to the distortion with respect to speech perception. For intensity and temporal distortion, this was not observed. Results indicate that a distorted coding of spectral information may be an important factor underlying reduced speech intelligibility for the hearing impaired.

Adult↗

PubMed2006

Idiopathic sudden sensorineural hearing loss in the only hearing ear: patient characteristics and hearing outcome.

OBJECTIVE: To determine the otological outcome in patients with idiopathic sudden sensorineural hearing loss (ISSHL) in their only hearing ear. DESIGN: Retrospective medical chart review study. SETTING: Tertiary care hospital. PATIENTS: Forty-five consecutive patients older than 18 years with sudden sensorineural hearing loss during a 10 year period (1985-1995), 9 of whom had ISSHL in their only hearing ear. INTERVENTION: Daily audiometric tests, oral prednisolone (full available dose), and bed rest for at least a week. MAIN OUTCOME MEASURE: The audiometric result 7 to 10 days following the start of treatment was used as the treatment outcome. RESULTS: Demographic characteristics were not significantly different between patients with ISSHL whose contralateral ear is deaf and those whose contralateral ear hears well. A tendency to seek help sooner (2.8 +/- 1.4 vs 7.1 +/- 5.2 days [mean +/- SD], respectively) was noted. The mean +/- SD improvement of hearing in the 3 more affected frequencies was 13 +/- 13.4 dB for the investigated group compared with 9 +/- 8.7dB for the rest of the patients (not statistically significant). Of the 9 patients who previously had sensorineural hearing loss in the opposite ear, 5 showed end results of speech reception thresholds of 35 dB or better, as did 13 of the 36 patients in the other group. CONCLUSIONS: Patients with ISSHL in their only hearing ear may be treated the same way as other patients because their outcome appears to be the same. About 50% of the patients will have a 10 dB or more hearing improvement, and about 60% of patients in the investigated group will regain useful hearing.

Administration, Oral↗

PubMed2002

Long-term results of small fenestra stapedectomy compared with large fenestra technique.

OBJECTIVES/HYPOTHESIS: A comparison is made of the postoperative long-term hearing results of small fenestra stapedectomy versus large fenestra techniques. Several reports in the literature favor improved hearing results in small fenestra stapedectomy compared with large fenestration and/or total stapedectomy. METHODS: A retrospective review of 34 patients who had stapedectomy performed by the same surgeon between 1982 and 1992. All patients have been followed for up to 10 years postoperatively. RESULTS: In 18 ears of 17 patients, surgery was performed with small fenestra technique, and 17 ears of 17 patients had total stapedectomy or posterior-half fenestration. After small fenestra stapedectomy, initial average air-bone gap at 500, 1000, and 2000 Hz was 9 dB hearing loss. Hearing thresholds at 4000 Hz deteriorated to 4% over the study period. Speech reception thresholds declined 15%. After total or posterior-half stapedectomy the average air-bone gap at 500, 1000, and 2000 Hz was 5 dB hearing loss. Hearing thresholds at 4000 Hz deteriorated 8% and 18% for the small fenestra and large fenestra groups, respectively, over time. Statistically, there was no difference in hearing deterioration rate between these two groups. CONCLUSIONS: An experienced surgeon can obtain excellent results using either large or small fenestra technique for otosclerosis. After initial successful closure of the air-bone gaps at all measured frequencies, hearing thresholds over the study period were stable for both groups.

Adult↗