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PubMed1996

A comparison of the results of KTP and CO2 laser stapedotomy.

Over the last 10 years, lasers have evolved to become an integral part of stapes surgery. Argon, KTP, and CO2 lasers have all been tested for their improved accuracy and safety in the middle ear. Because of the difference in optical properties between visible light (argon, KTP) and infrared (CO2) lasers, discussions have evolved around which laser is better and safer. In an effort to clarify the issues, a prospective comparison was made of 100 consecutive primary stapedotomies by using either the CO2 or KTP laser.

Adult↗
PubMed1998

Long-term results with the titanium bone-anchored hearing aid: the U.S. experience.

OBJECTIVE: The purpose of this study is to evaluate the long-term safety and efficacy of the titanium bone-anchored hearing aid (BAHA). STUDY DESIGN: A retrospective review of 24 patients implanted with the BAHA between 1984 and 1987 in a multiinstitutional study designed to evaluate the device in the United States was performed, including detailed clinical and audiologic evaluations of the 10 patients implanted at the Columbia-Presbyterian Medical Center in New York. The data were collected from patients' charts, questionnaires, and the Nobel Biocare patient contact and repair records. PATIENTS: Candidates for the BAHA are unable to use a conventional air conduction hearing aid because of congenital aural atresia, draining mastoid cavities, or recurrent otitis externa. The audiologic indications are a conductive or a mixed hearing loss with a bone conduction average of 45 db or better and a speech discrimination score of 60% or better. INTERVENTION: A BAHA was implanted in a two-stage procedure under local anesthesia on an outpatient basis. MAIN OUTCOME MEASURES: Patients' satisfaction with the device, hearing improvement, and complication rates were reviewed. RESULTS: The majority of the patients analyzed (78%) are still using the device an average of 15.6 hours/day 10 to 13 years after implantation. The overall satisfaction score was 4.5 (1, worst; 5, best). In sound field testing, the mean speech reception threshold improved from 52 db to 27 db (p < 0.05). There were no major complications. CONCLUSION: The BAHA is a safe and effective bone conduction hearing aid with wide applications for patients with bone conduction hearing levels of 45 db and discrimination scores of 60% or better.

Bone Conduction↗
PubMed2005

Developing a speech intelligibility test based on measuring speech reception thresholds in noise for English and Finnish.

A subjective test was developed suitable for evaluating the effect of mobile communications devices on sentence intelligibility in background noise. Originally a total of 25 lists, each list including 16 sentences, were developed in British English and Finnish to serve as the test stimuli representative of adult language today. The sentences, produced by two male and two female speakers, were normalized for naturalness, length, and intelligibility in each language. The sentence sets were balanced with regard to the expected lexical and phonetic distributions in the given language. The sentence lists are intended for adaptive measurement of speech reception thresholds (SRTs) in noise. In the verification of the test stimuli, SRTs were measured for ten subjects in Finnish and nine subjects in English. Mean SRTs were -2.47 dB in Finnish and -1.12 dB in English, with standard deviations of 1.61 and 2.36 dB, respectively. The mean thresholds did not vary significantly between the lists or the talkers after two lists were removed from the Finnish set and one from the English set. Thus the numbers of lists were reduced from 25 to 23 and 24, respectively. The statistical power of the test increased when thresholds were averaged over several sentence lists. With three lists per condition, the test is able to detect a 1.5-dB difference in SRTs with the probability of about 90%.

Acoustic Stimulation↗
PubMed2005

Results from the Dutch speech-in-noise screening test by telephone.

OBJECTIVE: The objective of the study was to implement a previously developed automatic speech-in-noise screening test by telephone (Smits, Kapteyn, & Houtgast, 2004), introduce it nationwide as a self-test, and analyze the results. DESIGN: The test was implemented on an interactive voice response system, which can handle multiple lines. The test measures the speech reception threshold in speech-shaped noise by telephone (SRTTn) in an adaptive procedure using digit triplets as speech material. The test result is given as either good, insufficient, or poor. Questions about age, sex, and subjective rating of hearing were included in the test. The test was introduced as the National Hearing test and publicity was generated. In the first 4 mo, 65,924 people took the initiative and dialed the test. The possibility to use mobile phones was disabled because of significant worse results (0.7 dB) with that telephone type. RESULTS: After applying exclusion criteria, results from 39,968 callers were analyzed. Seventy-five percent of the callers were older than 44 yr of age. Starting at about 45 yr of age, there is an increase in SRTTn with increasing age. SRTTns for men are significantly worse than SRTTns for women for age groups 50 to 54 and higher. Older people tend to rate their hearing better than might be expected from their SRTTn. However, after converting the mean SRTTn values per age group and per subjective score to percentile values, the values remain constant across age groups. Mean measurement error was within 1 dB. These errors increase with increasing SRTTn. CONCLUSIONS: This study shows the implementation and results from a functional hearing screening test by telephone. The test can be done in about 3 minutes, 30 sec, including introductory text, explanation of the test procedure, test result, and recommendation for audiological evaluation. The high number of callers implies that the test is probably fulfilling the need for a functional hearing screening test and has enhanced public awareness about hearing loss.

Auditory Threshold↗
PubMedDate not supplied

Hearing in adult-onset diabetes mellitus.

Hearing acuity and otologic symptoms were examined in 200 patients with adult-onset diabetes mellitus. Data were analyzed according to sex and age and were compared with values of other documented studies; values were within normal limits except in two instances. Speech testing revealed that median speech reception thresholds and median discrimination scores were at the lower limits of normal. Hearing loss and otologic problems did not occur with any increased frequency in patients with adult-onset diabetes mellitus.

Adult↗
PubMedDate not supplied

A comparison of procedures and materials for speech reception thresholds.

Ascending and descending procedures were used to obtain speech reception thresholds from 32 normal-hearing subjects whereas digits and spondee words were used as test materials. Comparisons of thresholds were made for the two procedures and materials. Results indicated that slightly lower (less SPL) speech thresholds resulted from the use of a descending procedure with both types of material. In addition, digit material was found to yield generally lower threshold values than spondees. Advantages to the use of the two procedures and materials are discussed.

Adult↗
PubMed1990

The effects of hearing aids on speech discrimination in noise by normal-hearing listeners.

This investigation measured the degree to which hearing aids degrade speech discrimination in noise. Ten normal-hearing subjects were tested for speech reception thresholds (SRT) in noise. The tests were repeated under two aided conditions: one used binaural behind-the-ear (BTE) aids, the other an experimental binaural high-fidelity aid fitted with in-the-ear transducers. To assess the loss of any directional cues under aided conditions, a test environment producing directional cues in both horizontal and vertical planes was employed. Results indicated a 3 dB deterioration of speech-to-noise ratio for frontal speech with the BTE aids. Despite this, mean SRTs, when averaged over several listening directions, differed by less than 1 dB from unaided levels under both aided conditions. This suggests that improvements in hearing aid fidelity and directional performance beyond that available in current BTE aids will do little to improve speech discrimination in noise, although other benefits may accrue.

Adult↗
PubMed1980

The effect of alcohol on central auditory processing (comparison with marihuana).

Twelve subjects between the ages of 23 and 62 were tested for changes in hearing acuity and dicrimination after ingestion of four ounces of vodka (80 U.S. proof = 40 per cent ethyl alcohol). As compared with their own pre-alcohol ingestion test results, these subjects revealed, 1) a decrease in discrimination of speech on CID W22 lists under difficult listening conditions, (in quite at 10 dB SL and in noise at a signal-to-noise ratio of -6); and 2) a decrease in performance on a filtered speech test low-pass, high-pass, and binaural fusion. The staggered spondaic word test was moderately affected only in one of the 12 subjects. Pure toe thresholds, speech reception thresholds, and speech discrimination, at 40 dB SL were not influenced. It was concluded that alcohol ingestion in moderate amounts alters the central auditory processing under difficult listening conditions. When compared with a previous study using marihuana, it was found that the discrimination ability was reduced by alcohol ingestion while marihuana significantly improved speech discrimination.

Adult↗
PubMed1982

Measurement of speech reception threshold. A comparison between two methods.

In an earlier work (Hagerman, 1979) several speech reception threshold (SRT) methods were simulated in a computer. New methods were found to be more effective than the common 10-word method. In a clinical investigation the new 2 X 4-word method was compared with the common method. The result showed that the new method required fewer words than the common method. New simulations also showed that the 2 X 4-word method was somewhat more reliable than the 10-word method.

Aged↗
PubMed1980

Relation between psychophysical data and speech perception for hearing-impaired subjects. I.

In heterogeneous group of ten hearing-impaired adolescents, relations are studied between several psychophysical test results and speech reception thresholds in quiet and noise. To examine the results, data-reduction techniques were used to extract the most relevant parameters. High correlations were found between the intelligibility of speech in noise on the one side, and vowel-perception parameters resulting from INDSCAL analysis (frequency resolution parameters, critical bandwidth and critical ratio) and audiogram parameters on the other.

Adolescent↗
PubMedDate not supplied

[The effect of musical practice on speech recognition in quiet and noisy situations].

BACKGROUND: Auditory training improves the perception of complex acoustic signals as well as the perception of speech. AIM: To verify if auditory training, through the practice of music, has an influence on the ability to recognize speech in quiet and noisy situations. METHOD: Participants of this study were 55 individuals, with no musical experience (non-musicians) and 45 professional musicians who had been playing at military bands for at least 5 years (musicians). All of the participants were male right-handed military volunteers, with normal hearing thresholds and with ages varying between 25 and 40 years. Using the Portuguese Sentence Lists (LSP) test, sentence recognition threshold was investigated in quiet (SRTQ) and in noise (SRTN). Based on the obtained data, the signal/noise ratio (S/N) was calculated. The sentences and noise (fixed to 65 dB HL) had a monoaural presentation using headphones. RESULTS: When comparing the performances of both groups, the statistical analysis pointed no significant difference between the mean values obtained for the SRTQ. However, a statistically significant difference was verified between the mean values obtained for the S/N ratio. CONCLUSION: In a quiet situation, musicians and non-musicians had similar performances. However, in the noise situation, musicians presented better performances, indicating that musical practice is an activity that improves the ability of speech recognition when in a noisy environment.

Acoustic Stimulation↗
PubMed1989

Word recognition functions for the CID W-22 test in multitalker noise for normally hearing and hearing-impaired subjects.

Word recognition functions for Auditec recordings of the CID W-22 stimuli in multitalker noise were obtained using subjects with normal hearing and with mild-to-moderate sensorineural hearing loss. In the first experiment, word recognition functions were generated by varying the signal-to-noise ratio (S/N); whereas in the second experiment, a constant S/N was used and stimulus intensity was varied. The split-half reliability of word recognition scores for the normal-hearing and hearing-impaired groups revealed variability that agreed closely with predictions based on the simple binomial distribution. Therefore, the binomial model appears appropriate for estimating the variability of word recognition scores whether they are obtained in quiet or in a competing background noise. The reliability for threshold (50% point) revealed good stability. The slope of the recognition function was steeper for normal listeners than for the hearing-impaired subjects. Word recognition testing in noise can provide insight into the problems imposed by hearing loss, particularly when evaluating patients with mild hearing loss who exhibit no difficulties with conventional tests. Clinicians should employ a sufficient number of stimuli so that the test is adequately sensitive to differences among listening conditions.

Adult↗
PubMed1980

Predicting speech discrimination from the audiometric thresholds.

To develop a method for predicting a speech discrimination score (SDS) from audiometric thresholds (SRT and pure-tones) three prediction systems were investigated: a stepwise multiple regression procedure, smear-and-sweep analysis and a clinical classification of the audiometric configuration. Test results of 529 ears with sensorineural hearing loss were taken from copies of audiograms obtained as part of a normal audiology clinic caseload. The three prediction systems had similar predictive ability and yielded slightly higher correlations with the SDS than those in previously reported studies. Squared correlations in this study ranged from 0.58 to 0.60. Smear-and-sweep analysis yielded the best results; however, its complexity makes clinical application difficult at this time. The stepwise multiple regression models or the clinical classification system provided more clinically useful methods for predicting the SDS. An over-riding influence of increasing variability in the SDS with increased hearing loss was observed and significantly limited the accuracy of prediction for the moderate-to-severe hearing loss groups. Small changes in the slope of the audiometric configuration were noted to affect the SDS only when the degree of hearing loss was slight.

Audiometry↗
PubMed2006

Using audiometric thresholds and word recognition in a treatment study.

OBJECTIVES: First, to examine a possible limit on significant results imposed by a progressive floor effect for hearing threshold improvement in a treatment study. This floor effect for hearing recovery suggests that if inclusion criteria are not set sufficiently high, the superiority of a treatment group may not be detectable. Second, to examine the outcomes when using two different types of criteria for significant change in a subject's word recognition score. METHODS: Several single-number criteria (e.g., 15 percentage points) are compared with the 95% (p=0.05) criteria from the binomial critical difference table for monosyllables. Critical differences for binomial variables change depending on whether the starting value lies in the middle (near 50% correct) or at either extreme of the range of scores (0 or 100%). Different judgments of significant word recognition improvement (or decrease) using binomial versus single-value criteria are presented. DATA SOURCE: A recent treatment study of sudden sensorineural hearing loss (n=318) is used to illustrate these effects. CONCLUSION: First, there is a progressive floor effect of presenting severity that co-varies with the outcome measure hearing threshold recovery. In some designs, this may act to constrain the ability to detect a significant difference. Second, in the example data set, the use of single-value criteria for significant within-subject change in word recognition (e.g., 15 percentage points) introduced a miscategorization error rate of approximately 9% when compared with the result of the binomial 95% critical difference table.

Audiometry, Pure-Tone↗
PubMed1981

Bone-conducted speech: intelligibility functions and threshold force levels for spondees.

Threshold force values for spondees were obtained for thirty-six subjects with normal hearing using the Radioear B-70-AA and B-71 bone vibrators, which were coupled to the head with a Radioear P-3333 headband. Measurements were made on a Bruel & Kjaer model 4930 artificial mastoid. In addition to the 1000 Hz calibration tone preceding the spondees, speech noise and white noise were dubbed on the tape at the same level as the tone. Since the results indicated similar threshold force levels for both vibrators, the data from the B-70-AA and B-71 were pooled. These values in dB re 1 micro Newton are 53.2 dB for 1000 Hz, 56.8 dB with white noise, and 62.4 dB using speech noise. Any of these three calibrating signals appear appropriate when delivering speech to the B-70-AA or B-71 bone vibrators. Another purpose of this study was to establish normal speech intelligibility functions for the CID W-22 test using the B-71 vibrator. Sixteen subjects with normal hearing were tested at sensation levels (SLs) ranging from 0 to 34 dB. The results showed that intelligibility scores ranged from about 15 percent at 0 dB SL to 95 percent at 34 dB SL, and that the slope of the intelligibility function systematically decreased with increasing intensity. These findings are typical of speech intelligibility functions obtained via air conduction.

Adult↗
PubMed2005

[Development of a new test for speech audiometry in children and results in CI children].

BACKGROUND: Speech audiometry plays an important role for hearing evaluation in children. Hearing impaired children, such as those with cochlear implant (CI) who frequently undergo testing, learn the test words by heart. Furthermore, the standard tests use words of former time. PATIENTS AND METHODS: Using the most frequently words of modern children's literature a speech assessment test was developed for children between 1 to 8 years. The material was first evaluated on normal hearing children. In a second step the phoneme and word perception scores of 35 CI children were measured using 60 - 100 dB SPL according to the most comfortable level (MCL) in free sound field. RESULTS: The performance-intensity function for the single words were highly comparable with those of the Freiburger or Göttinger speech perception test. The average speech reception threshold in CI children was 44 % (test I), 36 % (test II), 63 % (test III) and 69 % (test IV), respectively. Compared to the Mainzer and Göttinger speech perception test the new words were more difficult to understand than those of the known tests. However, a statistically significant difference could be noted only for test II. CONCLUSIONS: The new developed "Würzburger speech perception test" appears to be a useful additional tool for the evaluation of hearing impaired children in addition to the standard test procedures.

Audiometry, Speech↗
PubMed1995

[Context effects in speech recognition of sentences].

Context plays an important role in speech recognition. The goal of the present study was to quantify context effects in speech recognition using the Basle Sentence Understanding Test. This test consists of two types of sentences according to the amount of contextual information: they contain sentences with highly predictable (HP) final words and sentences with low predictable (LP) final words. The effect of different contextual situations on speech recognition was investigated in this study using the Basle Sentence Understanding Test. The speech recognition threshold of HP sentences was found to be 6 dB lower than that of LP sentences. However, contextual effects can only be demonstrated if the context is clearly understandable. In the Basle Sentence Understanding Test, this is achieved by special masking techniques. The significance of the recognition of the contextual part of the sentence with respect to the recognition of the whole sentence is different in HP and LP sentences.

Adolescent↗