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The occlusion effect in unilateral versus bilateral hearing aids.

The benefit of bilateral hearing aids is well documented, but many hearing-aid users still wear only one aid. It is plausible that the occlusion effect is part of the reason for some hearing-aid users not wearing both hearing aids. In this study we quantified the subjective occlusion effect by asking ten experienced users of bilateral hearing aids and a reference group of ten normal-hearing individuals to rate the naturalness of their own voice while reading a text sample aloud. The subjective occlusion effect was evaluated in the unilateral versus bilateral condition for a variety of vent designs in earmolds and in a custom hearing aid. The subjective occlusion effect was significantly higher for bilateral hearing aids with all vent designs with the exception of a non-occluding eartip option. The subjective occlusion effect was reduced with the more open vent designs in both the unilateral and bilateral conditions. Assuming that the occlusion effect is a barrier to bilateral hearing aid use, these results indicate that open-hearing-aid fittings can help promote the use of two aids.

Acoustic Stimulation↗
PubMed1999

[Multivariate analyses by quantitative method II of subjective pitch and tonality of tinnitus].

Factors affecting subjective tinnitus pitch and tinnitus tonality were analyzed with the use of the quantitative method II. Ninety-one patients with unilateral tinnitus of a single kind were studied. Major factors affecting subjective tinnitus pitch were pitch matched frequency, age, puerility and impurity of tinnitus tonality, and loudness of tinnitus. In addition, major factors affecting puerility and impurity of tinnitus tonality were pitch matched frequency, loudness of tinnitus, and nature of the test tone. Furthermore, subjective puerility of tinnitus was associated with middle-pitched frequency and high-pitched frequency, and a loudness level of tinnitus between 25 and 49 dB HL. Whereas impurity of tinnitus was related to low-pitched frequency and noise of the test tone. These results may contribute to the clinical evaluation of tinnitus.

Adolescent↗
PubMed2001

[Multivariate analysis using quantitative methods to evaluate the subjective loudness of tinnitus].

Factors affecting the subjective loudness of tinnitus were analyzed using quantitative methods. One hundred and eighty-four patients with unilateral tinnitus were studied. Major factors affecting the subjective loudness of tinnitus were found to be subjective tinnitus pitch, annoyance, diagnosis, pitch-matched frequency, insomnia, age, tinnitus loudness level in dB HL, the duration of tinnitus and the tinnitus loudness level in dB SL at the first axis. Tinnitus pitch and pitch-matched frequency strongly affected the loudness of the tinnitus; high-pitch tinnitus and middle and low frequencies were associated with the subjective loudness of the tinnitus. In contrast, low-pitch tinnitus and a high frequency were associated with the subjective softness of the tinnitus. Thus, tinnitus pitch and pitch-matched frequency are inversely related. Sudden deafness and dizziness were associated with subjective softness of tinnitus, while hearing loss in elderly patients was associated with subjective loudness of tinnitus. Our results suggest that the level of annoyance from tinnitus and the subjective loudness of tinnitus are closely related. The relation between these factors should be considered when evaluating patients with tinnitus.

Female↗
PubMed1992

[Factors influencing the pitch and loudness of tinnitus].

Pitch match and loudness balance tests were given to 397 cases with tinnitus. The factors which influenced tinnitus pitch and loudness were analyzed statistically from the clinical point of view. The results obtained were as follows: 1) Onomatopoeia of tinnitus, either [Keeeen] or [Jeeeen], were observed in a majority of cases. 2) Significantly sharp sounding onomatopoeia such as [Keeeen] or [Meeeen] had high pitches, over 4kHz, and dull sounds like [Gooooh] or [Buuuun] had low pitches, below 500Hz. 3) Acute stage tinnitus, within one month of onset, had a significantly depressed pitch and walked loudness, above 6dB. 4) The pitches observed in cases with Meniere's disease and chronic otitis media were distributed evenly from low frequencies to high. In other cases, especially presbyacusis and noise deafness, high pitch tinnitus (above 4kHz) was frequently noted. The loudness of tinnitus without hearing loss was significantly greater than in other diseases. 5) As a rule the more deteriorated the hearing level was, the lower the frequency of the pitch, and the smaller the loudness in tinnitus. 6) A high pitch of tinnitus nearly corresponded with hearing type, that is, the pitch of tinnitus was also in accordance with the disturbed frequency in the hearing threshold.

Acoustic Impedance Tests↗
PubMed2002

Dynamics of gamma-band activity during an audiospatial working memory task in humans.

The representation of visual objects in short-term memory has been shown to be related to increased gamma-band activity in the electroencephalogram. Using a similar paradigm, we investigated oscillatory magnetoencephalographic activity in human subjects during a delayed matching-to-sample task requiring working memory of auditory spatial information. The memory task involved same-different judgments about the lateralization angle of pairs of filtered noise stimuli (S1 and S2) separated by 800 msec delays of background noise. This was compared with a control condition requiring the detection of a possible change in the background noise volume appearing instead of S2 (volume task). Statistical probability mapping revealed increased spectral activity at 59 Hz over left parietal cortex during the delay phase of the memory condition. In addition, 59 Hz coherence was enhanced between left parietal and right frontal sensors. During the end of the delay and during the presentation of S2, enhanced gamma-band activity at 67 Hz was observed over right frontal and later over midline parietal areas. In contrast, the volume task was characterized by increased left inferior frontotemporal 59 Hz spectral amplitude after S1. Apparently representation of the spatial position of a sound source is associated both with synchronization of networks in parietal areas involved in the auditory dorsal stream and with increased coupling between networks serving representation of audiospatial information and frontal executive systems. The comparison with S2 seemed to activate frontal and parietal neuronal ensembles. Gamma-band activity during the volume task may reflect auditory pattern encoding in auditory ventral stream areas.

Adult↗
PubMed1999

Loudness scaling revisited.

The present work was undertaken in an attempt to evaluate whether it is reasonable to expect that categorical loudness scaling can provide useful information for nonlinear hearing aid fitting. Normative data from seven scaling procedures show that the individual procedures relate the perceptual categories differently to sound level and with a substantial between-subject variance. Hearing-impaired data from four studies demonstrate that the inverse slope of the loudness function varies linearly with hearing loss and with a constant variance. In relation to hearing aid fitting, the slope can, in most cases, be predicted from the hearing loss with an accuracy within the range of a normal finetuning. For the fitting of nonlinear hearing aids, the statistical properties of both normal and impaired loudness functions are equally important. The present analysis strongly suggests that categorical loudness scaling cannot, in general, provide significant information for the fitting process.

Auditory Threshold↗
PubMed1999

The assessment of lamotrigine, an antiepileptic drug, in the treatment of tinnitus.

OBJECTIVE: Tinnitus is an extremely prevalent condition that currently has no satisfactory clinical treatment. Development of therapy has been hampered by the diversity of underlying conditions that give rise to the symptom of tinnitus. A drug that has multiple actions may have an improved chance of being effective. One such drug is lamotrigine, a recently developed antiepileptic agent that has both glutamate release inhibition and sodium channel antagonist activity. STUDY DESIGN: Lamotrigine was evaluated in a double-blind, placebo-controlled, crossover clinical trial. Patients initially were tested with an intravenous infusion of lidocaine (10 mg/mL) to a maximum of 100 mg or until a reduction in tinnitus. Lamotrigine or placebo tablets were taken once daily (25 mg) for 2 weeks, 50 mg for 2 weeks, and 100 mg for 4 weeks. SETTING: Patients were chosen from among volunteers from the tinnitus clinic in the local hospital without reference to underlying pathology. PATIENTS: Those patients whose tinnitus had been present for less than 6 months or whose tinnitus was likely to vary spontaneously were excluded. INTERVENTIONS: Perceived intensity and intrusiveness of tinnitus was assessed before entry onto the trial and at 4-week intervals throughout the trial. MAIN OUTCOME MEASURES: Assessment comprised questionnaires, visual analog scales, and a battery of audiologic measurements. RESULTS: There was no correlation between the response to lidocaine and the response to lamotrigine. There was good agreement between the questionnaires and visual analog scales in the reporting of perceived changes; however, this was not reflected as changes in the audiologic tests. CONCLUSIONS: Of the 31 participants who completed the trial, questionnaires indicated that lamotrigine was effective in a very few of these persons.

Anticonvulsants↗
PubMed2000

Infant rats are more likely than adolescents to orient differentially to amodal (intensity-based) features of single-element and compound stimuli.

An infantile predisposition to process quantity, over quality, of stimulation has been suggested in theories of cognitive and perceptual development, as well as for understanding ontogenetic differences in learning. In the present study, responsivity to stimulus intensity was assessed in preweanling and periadolescent rats by using magnitude of cardiac orienting as an index of perceived stimulus intensity. In Experiment 1, cardiac orienting was measured to low- and high-intensity auditory and visual stimuli in 15-, 17-, and 30-day-old rats. The results demonstrated that younger rats are more predisposed to respond differentially to single-element stimuli on the basis of stimulus intensity. Experiments 2, 3, and 4 examined cardiac orienting in preweanlings to compound stimuli. In accordance with studies of ontogeny of learning, the results of these experiments indicated that preweanlings process compound stimuli on the basis of net intensity, but only if there had been no prior experience with the compound's elements.

Age Factors↗
PubMed1999

Assessment of perceived mechanical heart valve sound level in patients.

BACKGROUND AND AIM OF THE STUDY: When mechanical heart valves close, they generate an impulse that is transmitted to the patient's inner ear by two routes: (i) As acoustically transmitted sound waves; and (ii) as vibrations transmitted through bones and vessels. The aim of this study was to quantitate what patients perceive as sound from their mechanical heart valve prostheses - including both air-transmitted sound waves and bone-transmitted vibrations. METHODS: Thirty-four patients with implanted mechanical bileaflet aortic and mitral valves (St. Jude Medical and On-X) were included in the study. Measurements were performed in a specially designed sound-insulated chamber equipped with microphones, accelerometers, preamplifiers and a loud-speaker. The closing sounds measured by an accelerometer on the patient's chest were delayed 400 ms, amplified and played back to the patient through the loudspeaker. The patient adjusted the feedback sound to the same level as the 'real-time' clicks they perceived directly from their valve. In this way the feedback sound energy includes both the air- and bone-transmitted energies. Sound pressure levels (SPL) were quantitated in both dB(A) and in loudness units (sones) according to ISO 532B (Zwicker method). RESULTS: The mean air-transmitted SPL measured close to the patient's ear was 23 +/- 4 dB(A). The total air-and bone-transmitted sounds and vibrations were perceived by the patients as a SPL of 34 +/- 5 dB(A). There was no statistically significant difference in perceived sound from the two bileaflet valves investigated, and no difference between aortic and mitral valves. CONCLUSIONS: The study showed that the presented feedback method is capable of quantitating the perceived sounds and vibrations from mechanical heart valves, if the patient's hearing is not too impaired. Patients with implanted mechanical heart valve prostheses seem to perceive the sound from their valve two to four times higher than nearby persons, because of the additional bone-transmitted vibrations.

Adaptation, Psychological↗
PubMed1997

[Effects of short-term tone exposure on DPOAEs].

Test parameter combinations are known to affect DPOAE measurement. The present study was attempted to find out if different test parameter combinations affect DPOAEs' utility in reflecting the change of cochlear function. Pure tones of moderate intensity (82 dB SPL) and short duration (3 min) were introduced into rabbit's ear canal to cause temporary change of cochlear mechanics, and the change of amplitude of 2f1-f2 DPOAE representing 10 kHz over 10 minutes after the exposure was monitored using equal- and different primary level combinations. It was found that, under the same exposure condition, 2f1-f2 DPOAEs induced by primaries of different levels (L2 = L1 - 12 dB) had showed more initial reduction in amplitude and slower recovery than that induced by primaries of equal levels (L1 = L2). The difference may indicate that there are multiple physiological processes that contribute to the generation of 2f1-f2 DPOAE and that change of DPOAE test parameters may selectively reveal different DPOAE generating processes.

Acoustic Stimulation↗
PubMed2000

Tinnitus Retraining Therapy (TRT) as a method for treatment of tinnitus and hyperacusis patients.

The aim of this paper is to provide information about the neurophysiologic model of tinnitus and Tinnitus Retraining Therapy (TRT). With this overview of the model and therapy, professionals may discern with this basic foundation of knowledge whether they wish to pursue learning and subsequently implement TRT in their practice. This paper provides an overview only and is insufficient for the implementation of TRT.

Hair Cells, Auditory↗
PubMed2000

Assessing growth of loudness in children by cross-modality matching.

This study examined the clinical feasibility, validity, and reliability of loudness growth assessment using cross-modality matching (CMM) between line length and loudness in 16 children 4 to 12 years old with normal hearing or bilateral sensorineural hearing losses ranging from moderate to severe in degree. Eight adult listeners with normal hearing were used as a comparison group. Loudness growth functions and real-ear measures were obtained for 500-Hz and 2,000-Hz narrowband noise stimuli for each individual. No significant differences were found between the loudness slope values for the adults and children with normal hearing. Loudness growth functions of the children with sensorineural hearing loss were significantly steeper (larger) than the slopes obtained from children with normal hearing. The numeric slope value of the loudness growth function became larger and more variable as children's hearing threshold increased and differed for children with similar thresholds. The loudness functions obtained for retested participants at two different test sessions were highly correlated. Real-ear measurements revealed that for equivalent input stimulus levels, significantly higher stimulus levels were present in the ear canals of children versus adults. Although adults and children with normal hearing had similar overall rates of loudness growth, discrete points along the loudness growth function were judged to be louder by the children. This preliminary study suggests that measures of loudness growth using CMM between line length and loudness are feasible, valid, and reliable in children with normal hearing or sensorineural hearing loss. The individual variability noted in slope values for children with hearing loss attests to the importance of subjective assessments of loudness. The protocol used in this study may have potential as a clinical tool for selecting and fitting amplification technology for children with hearing loss as young as 6 years.

Adult↗
PubMed2000

Effect of stimulation rate on cochlear implant recipients' thresholds and maximum acceptable loudness levels.

Clinically, speech processor programs are created using electrical thresholds and maximum acceptable loudness levels (MALs) at several different stimulation rates to determine what rate will provide cochlear implant recipients with the best speech recognition when using fast-rate speech coding strategies. This study was designed to determine the difference in thresholds and MALs (expressed in the clinical unit, Current Level [CL]) for pairs of six rates spanning those available with the Nucleus 24 device (i.e., 250 to 2,400 pps/ch) using monopolar, 25 microsec/phase stimulation. Test-retest measures of threshold and MAL for each rate were obtained from seven adult Nucleus 24 recipients on each of 11 electrodes. The difference in threshold and in MAL between pairs of rates was dependent on the absolute CL. Below approximately 190 CL, thresholds and MALs decreased with increasing rate; above 210 CL, there was little change in threshold or MAL with increasing rate. Based on these findings, an approach to estimating threshold and MAL from one rate to another is suggested, pending further research.

Adult↗
PubMed2000

Improving audibility with nonlinear amplification for listeners with high-frequency loss.

In contrast to fitting strategies for linear amplification that have been frequently refined for listeners with different degrees of hearing loss, we know relatively little about the effects of nonlinear amplification for differing audiometric configurations. The purpose of the current study was to determine whether increases in audibility with nonlinear amplification improved speech recognition to a comparable degree for listeners with sloping sensorineural loss as for a comparison group of listeners with flat sensorineural loss. Consonant recognition was examined as a function of audibility with wide dynamic range compression amplification and with linear amplification. For linearly amplified speech, listeners with flat and sloping loss showed similar improvements in recognition given the same increases in audibility. Results for nonlinearly amplified speech indicated that the listeners with flat loss showed a greater rate of improvement as audibility increases than the listeners with sloping loss. This difference is largely due to superior performance by the listeners with sloping loss for low-audibility speech in comparison to equivalent group performance for high-audibility speech.

Adult↗