Development of auditory skills after cochlear implantation in children with inner ear malformations

Conclusions: CI improves hearing thresholds and auditory skills in children with most types of inner ear malformations. However, the development of sound detection skills is not as good as it is in children without inner ear malformations. Objectives: To investigate the influence of inner ear malformations on development of auditory skills after cochlear implantation (CI). Methods: Records of 20 children with inner ear malformations who underwent cochlear implantation before 4 years of age and followed up for more than 2 years were retrospectively reviewed. Hearing thresholds, the Meaningful Auditory Integration Scale (MAIS), and Meaningful Use of Speech Scale (MUSS) scores before and after CI were analyzed and compared with 20 age-matched deaf children who underwent CI. Results: The children with inner ear malformations showed significant improvements in hearing thresholds and the MAIS and MUSS scores 1 year after CI (p?p?p?相似文献   

Comparative effects of unilateral and bilateral bone conduction hearing devices on functional hearing and sound localization abilities in patients with bilateral microtia-atresia

Abstract

Background: Various amplification options are available for patients with congenital bilateral conductive hearing loss. Unilateral bone conduction hearing device (BCHD) is widely used for these patients, whereas benefits of bilateral BCHDs in certain subgroups of patients require further exploration.

Objectives: To evaluate functional and directional hearing in patients with unilateral Bonebridge (MEDEL) and contralateral ADHEAR (MEDEL) devices.

Materials and methods: This study included 32 patients (20 males, 12 females), of mean age 11.8?years (range 7–27?years). Hearing thresholds, speech perception and sound localization were tested three months after activation of the Bonebridge under three conditions: unaided, unilateral BHCD (Bonebridge) and bilateral BHCDs (Bonebridge plus contralateral ADHEAR). Patient acceptance of these devices in daily life was evaluated by questionnaire.

Results: Compared with unaided, the mean hearing thresholds (0.5, 1, 2, and 4?kHz) and speech perception with unilateral BCHD and bilateral BCHDs were improved significantly (p?<?.05 each). Markers of directional hearing ability, including percentages of accurate responses, bias angles and RMS errors, were significantly better with bilateral BCHDs than unilateral BHCD (p?<?.05 each). Questionnaire revealed high patient satisfaction with both unilateral and bilateral devices.

Conclusions: Functional hearing and sound localization abilities were better with bilateral BCHDs than unilateral BCHD.     

Age-related altering temporal processing and binaural interaction functions in normal hearing individuals: Observational and cross-sectional study

ObjectiveThis study aimed to investigate the temporal processing and binaural interaction functions of central auditory processing tests according to the anatomical localizations of young and elderly individuals. It also sought to evaluate the relationships between the same individuals’ central auditory processing tests.MethodsThis observational and cross-sectional study included individuals with normal hearing between 18 and 30 and 60–75 years of age, who were referred to as the young group and the elderly group, respectively. The evaluation of the central auditory processing tests was completed using the frequency pattern test, duration pattern test, masking level difference test, and random gap detection test. Furthermore, speech discrimination and speech in noise scores were analyzed for both groups.ResultsStatistically significant differences were identified between the groups’ scores for the speech in noise test, masking level difference test, random gap detection test, frequency pattern test, and duration pattern test (p < 0.05). A statistically significant relationship was observed between the age and the results of the central auditory processing tests (p < 0.05).ConclusionWhen compared to younger individuals, elderly individuals presented with declined temporal sequences, temporal resolutions, and binaural interaction skills.     

European multi-centre study of the Nucleus Hybrid L24 cochlear implant

Abstract

Objectives: To investigate the preservation of residual hearing in subjects who received the Nucleus Hybrid L24 cochlear implant. To investigate the performance benefits up to one year post-implantation in terms of speech recognition, sound quality, and quality of life. Design: Prospective, with sequential enrolment and within-subject comparisons. Post-operative performance using a Freedom Hybrid sound processor was compared with that of pre-operative hearing aids. Study sample: Sixty-six adult hearing-impaired subjects with bilateral severe-to-profound high frequency hearing loss. Results: Group median increase in air-conduction thresholds in the implanted ear for test frequencies 125–1000 Hz was < 15 dB across the population; both immediately and one year post-operatively. Eighty-eight percent of subjects used the Hybrid processor at one year post-op. Sixty-five percent of subjects had significant gain in speech recognition in quiet, and 73% in noise (≥ 20 percentage points/2 dB SNR). Mean SSQ subscale scores were significantly improved (+ 1.2, + 1.3, + 1.8 points, p < 0.001), as was mean HUI3 score (+ 0.117, p < 0.01). Combining residual hearing with CI gave 22?26 %age points mean benefit in speech recognition scores over CI alone (p < 0.01). Conclusions: Useful residual hearing was conserved in 88% of subjects. Speech perception was significantly improved over preoperative hearing aids, as was sound quality and quality of life.     

Comparison of speech perception between monaural and binaural hearing in cochlear implant patients

Objective To assess the advantages of binaural hearing for cochlear implant (CI) users using a hearing aid (HA) for the contralateral ear.

Material and Methods The subjects comprised 3 males and 3 females (age range 48–84 years). All of them had been using a CI and HA for >6 months. Their speech perception was examined in quiet using monosyllables and Japanese Hearing in Noise Test (J-HINT) sentences. Speech perception in noise was examined using J-HINT sentences. Late cortical waves were measured while subjects listened to 1 kHz frequent and 2 kHz target tone stimuli. The latency of the event-related potential (P300) wave was compared for monaural and binaural hearing conditions.

Results Three subjects showed significantly better results for binaural than monaural (CI alone) hearing for monosyllables and HINT sentences (p<0.05; paired t-test). Subjects with better speech perception had been using an HA for longer than those with poor performance (18.3 vs 4.0 years). The overall average score was better for binaural than monaural hearing in the speech perception test under quiet and noisy conditions. Comparison of the latency of the P300 wave under monaural and binaural hearing conditions showed a significantly shorter latency for the latter (p=0.02; paired t-test).

Conclusion Although the use of an HA alone showed marginal benefit for CI users, binaural hearing (CI + HA) resulted in a significant improvement in speech perception under various circumstances.     

Cochlear implantation outcome in straightforward cases: can we do more for adults who cannot understand speech using hearing aids alone?

Abstract

Background: Many adults with moderate–profound hearing loss whose speech recognition has deteriorated and are no longer benefitting from hearing aids (HAs) could benefit from cochlear implantation (CI). Of these, only <5% are implanted. In order to inform eligible patients about expected results and ease the route to implantation, better guidelines for candidate selection are needed.

Objectives: To provide reliable guidelines by determining, in a well-characterized group of implantees, the minimal expected post-CI scores for monosyllabic (MS) word recognition.

Patients and methods: In total, 20 adults unilateral implantees considered (prior to implantation) straightforward CI candidates were assessed ≥20 months post-CI. Their post-CI CI-aided thresholds and MS word recognition were compared to their pre-CI scores. In addition, SSQ12 scores were evaluated post-CI.

Results: Post-CI, thresholds were 40?dB or better in all participants, and 35?dB or better in 95% of them. 90% scored 60% or better on MS words in quiet. In speech noise all scored 15–60% and 50% scored 45–60%. Poorer unaided pre-CI thresholds yielded greater patient satisfaction.

Conclusions: Adults with moderate–profound hearing loss, whose speech recognition has deteriorated, are no longer benefitting from HAs and fulfil defined criteria for straightforward CI, should be referred for formal CI candidacy evaluation.     

An underestimated issue: unsuspected decrease of sound processor microphone sensitivity,technical, and clinical evaluation

Abstract

Objective

To describe the rate of occurrence of unsuspected decrease in sensitivity of the sound processor microphone and to evaluate its effect on the patient's audiological performance in terms of reduction in speech recognition scores.

Design

Speech processor microphones were tested by connecting the speech processor acoustic monitor circuit to a hearing aid analyzer. The response curves were compared with those obtained from fully working microphones.

During a 6-month investigation period, microphone response curves were measured from a group of cochlear implant recipients who had not reported any problems. Despite the absence of any subjective problem, some microphones were found to show a loss of sensitivity. Their users, aged between 4 and 67 years, were tested both with the defective and a working microphone in order to calculate the correlation between the degree of microphone failure and the decline in audiological performance.

To quantify the effect of microphone failure, patients’ speech recognition skills were measured by live voice connected discourse tracking series administered in different conditions and by recorded sentences lists.

Results

A total of 120 apparently fully functioning sound processors were tested in the investigation: 33 (27.5%) were affected by a subjectively unreported sensitivity decrease. Speech-tracking scores correlated significantly with the loss of microphone sensitivity in all test conditions (r = 0.69–0.77, P < 0.05). A high degree of correlation was also found for speech audiometry tests (r = 0.70–0.73, P < 0.05). Microphone sensitivity loss affected speech recognition skills, especially without lip reading and in the presence of background noise.

Conclusion

The results indicate that any reduction in sound processor microphone sensitivity causes a degree of hearing decline that negatively affects the cochlear recipient's clinical performance. Microphone faults are often unreported events, and their occurrence rate is underestimated. To establish that the microphone is providing correct input to the speech processor a standard control procedure, including technical and clinical checks, is needed in clinical practice.     

Development of Telscreen: a telephone-based speech-in-noise hearing screening test with a novel masking noise and scoring procedure

Objective: In 2006 the National Acoustic Laboratories was commissioned to create a telephone-based hearing screening test. Design: NAL developed ‘Telscreen’, a speech-in-noise test modelled on the Dutch and UK telephone tests. The first version, Telscreen I, had several novel features: individual scoring of digits; individual equalization of digit intelligibility; and accuracy-determined test termination. Evaluation of Telscreen I revealed that it did not discriminate satisfactorily between those with and without hearing impairment. Subsequently Telscreen II, which included a novel sensitized masking noise, was developed. Study sample: Telscreen I was evaluated by 105 participants (22–86 years), 37% with normal hearing (all thresholds?<20?dB HL in the test ear), 63% with hearing impairment (all thresholds?>20?dB HL in the test ear). Telscreen II was evaluated by 75 participants (25–86 years), 33% with normal hearing, 67% with hearing impairment. Results: Correlations between Telscreen I results and hearing thresholds, r?=?0.57, and hearing disability scores, r?=?0.51 were highly significant, but lower than expected. Correlations for Telscreen II were higher: r?=?0.77 and 0.65, respectively. Telscreen II was found to have high sensitivity: 90%; and specificity: 90.2%. Conclusions: Telscreen II is an efficient, reliable, and innovative hearing screening test that provides a solid foundation for future tests delivered via mobile and internet technologies.     

Outcomes of consonant-vowel monosyllable perception and word recognition after cochlear implantation in elderly Japanese patients

Conclusion: Performance in consonant-vowel (CV) monosyllable speech perception after cochlear implantation (CI) in the elderly (≥ 65 years) is equivalent to that of young adults (18–64 years). Present data in the Japanese language supported the indication for CI in the elderly. Word recognition after CI was significantly lower in the elderly than young adults. Objective: This study compared outcomes of monosyllable perception and word recognition after CI between elderly patients and young adults with post-lingual deafness. Age-related differences in CV monosyllable speech perception in Japanese were examined. Methods: A retrospective chart review of 137 patients with post-lingual deafness who underwent CI at Okayama University Hospital during 1992–2014 [young adults aged 18–64 years (n = 96) and elderly aged ≥ 65 years (n = 41) at implantation] was conducted. CV monosyllable speech perception post-CI was compared among age groups (18–29, 30–39, 40–49, 50–59, 60–69, 70–79, 80–89). CV monosyllable perception and word recognition scores post-CI were compared between the elderly and young adults. Results: There was no significant difference in CV monosyllable speech perception among age groups. CV monosyllable speech perception in the elderly (61.4 ± 25.5%) did not differ from that of young adults (65.9 ± 24.8%). Word recognition scores were significantly lower in the elderly (64.3 ± 28.1%) than young adults (80.4 ± 25.9%) (p < 0.05).     

Round window application of an active middle ear implant (AMEI) system in congenital oval window atresia

Conclusion: Application of the Vibrant Soundbridge to the round window (RW) membrane can be utilized as an efficient therapy for congenital oval window (OW) atresia. Objective: To report the surgical technique and auditory outcome of an active middle ear implant (AMEI) system used in patients with congenital OW atresia. Methods: Nine subjects with congenital OW atresia (six males and three females, ranging in age from 5.5 to 25 years, average 12.5 years) were implanted with an AMEI (Vibrant Soundbridge) at the round window (RW-Vibroplasty). Five cases were diagnosed as having isolated congenital OW atresia while four patients presented with combined external/middle ear malformation. Results: An improvement of 30 dB in average pure-tone air conduction thresholds (0.5–4 kHz) was achieved, with the high frequencies showing greater results. The subjects achieved postoperative speech recognition scores of 80–100% on the Computerized Mandarin Speech Test System (CMSTS) sentence test. Bone conduction thresholds were confirmed as stable in all subjects postoperatively. Decline in auditory benefit was noticed in two subjects, who then underwent revision surgery. One of these revision surgery patients then experienced stable hearing recovery, while the other patient’s hearing declined.     

Bone conduction hearing in the blockage of oval and/or round windows in cats

Background: Simple or non-syndromic types of oval window (OW) or round window (RW) atresia are relatively rare in clinical. Few studies have assessed bone conduction (BC) hearing in OW or RW atresia patients, with some reporting that BC hearing lies within the normal range, whereas others observing impaired BC hearing.

Aims/Objectives: This study explored the effect of blocking the OW and RW during BC in cat models.

Material and Methods: Twenty-four cats were randomly divided into three immobilization groups (OW blockage, RW blockage, and OW?+?RW blockage) and control group. Each immobilization group also had the initial control state before blockage. Medical adhesive and ear mould glue were used to immobilise the stapes footplate and RW, respectively. Comparisons were made of the auditory brainstem response (ABR) thresholds before and after immobilization for the three immobilization groups during three different stimuli [air conduction (AC) click, BC click, and BC pure tones].

Results: The AC click thresholds increased after immobilisation in three experimental groups compared to the control group (p?<?.05). The AC click thresholds increased compared to their initial control state after all three immobilization groups (p?<?.05). With an increase in frequency from 2 to 8?kHz, there was a general decrease in the difference between pre- and post-immobilization BC hearing thresholds in all three immobilization groups. The BC click threshold and BC tone thresholds at 2–4?kHz in both OW blockage and OW?+?RW blockage groups exceeded those in RW blockage group (p?<?.05).

Conclusions and Significance: The use of medical adhesive and ear mould glue for the blockages of OW and RW, respectively in cats was feasible. The effect of blocking the OW and RW in BC hearing was larger at low frequencies than high frequencies between 2 and 8?kHz. OW blockage had a greater effect than RW blockage on BC hearing at 2–4?kHz range.     

The effect of non-native and non-regional speech testing on a multi-lingual population

Objective: This study was conducted to evaluate the speech perception of Malaysian Chinese adults using the Taiwanese Mandarin HINT (MHINT-T) and the Malay HINT (MyHINT). Design: The MHINT-T and the MyHINT were presented in quiet and noise (front, right and left) conditions under headphones. Results for the two tests were compared with each other and with the norms for each test. Study sample: Malaysian Chinese native speakers of Mandarin (N?=?58), 18–31 years of age with normal hearing. Results: On average, subjects demonstrated poorer speech perception ability than the normative samples for these tests. Repeated measures ANOVA showed that speech reception thresholds (SRTs) were slightly poorer on the MHINT-T than on the MyHINT for all test conditions. However, normalized SRTs were poorer by 0.6 standard deviations for MyHINT as compared with MHINT-T. Conclusions: MyHINT and MHINT-T can be used as norm-referenced speech perception measures for Mandarin-speaking Chinese in Malaysia.     

Horizontal sound localisation accuracy in individuals with conductive hearing loss: effect of the bone conduction implant

Abstract

Objective: The objective of this study is to quantify the effect of the Bone Conduction Implant (BCI) on sound localisation accuracy in subjects with conductive hearing loss (CHL).

Design: The subjects were tested in a horizontal sound localisation task in which localisation responses were objectively obtained by eye-tracking, in a prospective, cross-sectional design. The tests were performed unaided and unilaterally aided. The stimulus used had a spectrum similar to female speech and was presented at 63 and 73?dB SPL. The main outcome measure was the error index (EI), ranging from 0 to 1 (perfect to random performance).

Study sample: Eleven subjects (aged 21–75 years, five females) with BCI participated in the study. Their mixed/conductive hearing loss was either unilateral (n?=?5) or bilateral (n?=?6).

Results: Three of five subjects (60%) with unilateral CHL, and four of six subjects (67%) with bilateral CHL showed significantly improved sound localisation when using a unilateral BCI (p?<?.05). For the subjects with bilateral CHL, a distinct linear relation between aided sound localisation and hearing thresholds in the non-implant ear existed at 73?dB SPL (18% decrease in the EI per 10?dB decrease in pure-tone average, r?=?0.98, p?<?.001).

Conclusions: Individuals with mixed/conductive hearing loss may benefit from a unilateral BCI in sound localisation.     

Long-term hearing results following vestibular surgery in meniere's disease

Objectives: The purpose of this study is to evaluate the long-term hearing changes following vestibular surgery in patients with Meniere's disease. Study Design: This is a retrospective analysis of patients operated on in a tertiary referral center setting. Methods: Preoperative, postoperative, and 3- to 9-year postoperative audiograms were analyzed in two patient groups. Twenty-one patients underwent posterior fossa vestibular neurectomy (VN) and five, mastoid endolymphatic sac decompression and shunt (ELS). All frequencies, four-frequency pure-tone averages (PTAs), spondee thresholds, and speech recognition scores were compared for operated ear against nonoperated ear of VN subjects. The results were subjected to a covariance analysis. VN and ELS patients whose hearing deteriorated from “serviceable” (PTA ≤70 dB hearing level) and speech recognition ≤30%) to nonserviceable status were compared using nonparametric statistics. Results: Progressive hearing loss beyond the rate of change of the normal contralateral ear was evident in all patients. Serviceable hearing dropped from 81% to 43% of patients an average of 4 years following VN. Conclusions: VN patients have significant hearing deterioration over time in the operated ear. This finding suggests that continued postoperative medical management is necessary for patients undergoing VN. Laryngoscope, 108:1470–1473, 1998     

A hearing self-reported survey in people over 80 years of age in China by hearing handicap inventory for the elderly–complete version vs screening version

Conclusion: HHIE-S can be a useful tool in investigating hearing loss among people over 80 years old, with the same validity as HHIE. Objective: To investigate the effect of hearing loss on the quality-of-life in people over 80 years of age in China, and to compare the results of the Chinese mandarin version Hearing Handicap Inventory for the Elderly (HHIE) and its screening version (HHIE-S). Methods: Eighty-four people over 80 years participated in the study. Both HHIE and HHIE-S were completed, and the hearing handicap degrees were rated according to HHIE scores and HHIE-S scores, respectively. Results obtained by HHIE and HHIE-S were compared. Multi-factor analysis of variance was used to analyze the impact of eight factors on hearing handicap in the oldest old people over 80 years of age, including age, noise exposure, ear surgery, infection, ototoxic drugs use, cardiovascular and cerebrovascular diseases, diabetes, and tumors. Results: Both HHIE and HHIE-S revealed 48 subjects (57.1%) with no self-perceived hearing problem, and 36 subjects (42.9%) with hearing handicap. No statistical difference was found between results of the functional hearing handicap rating by HHIE and HHIE-S (Chi-square?=?1.532, p?=?0.465). The HHIE and HHIE-S were in agreement with each other (kappa?=?0.772, p?p?>?0.05), except noise exposure on S-score of HHIE-S (p?=?0.032), and the R-squares of these factors were less than 5%.     

Applications of the NTID speech recognition test (NSRT®)

Objective: This study evaluated the diagnostic capabilities of an adaptive speech recognition protocol (NSRT^®) that can be self-administered in non-clinical venues by listeners using internet-based software. Design: All participants were given an audiological evaluation, including pure-tone testing, and responded to the NSRT administered in quiet and + 5 dB SNR listening conditions. The NSRT test materials are sentence-length utterances containing phonetic contrasts, primarily minimal pairs. Study sample: Subjects were 123 adults with normal hearing to moderately severe sensorineural hearing loss (mean age = 55 years, SD = 23). Results: Performance on the NSRT is strongly related to pure-tone thresholds. Linear regression analyses support the utility of the NSRT as a proxy for clinically-obtained hearing thresholds across the octave frequencies 0.5 to 8 kHz, primarily for individuals in the ? 10 to 55 dB HL range. Other NSRT results are linked to analyses of phonetic errors and components of aural rehabilitation. Conclusions: Among its numerous results, the NSRT yields quantitative predictions of frequency-specific hearing thresholds, provides insight into the phonetic errors that affect speech understanding in adults who suffer from sensorineural hearing loss, primarily in the ? 10 to 55 dB HL range, and has implications for the design of individualized auditory training programs.     

Communication disorders in subjects with normal hearing: a behavioral and electrophysiological study

Hearing thresholds are not always predictive of performance in environments with reduced extrinsic redundancy.ObjectiveTo investigate the communication disorders reported by adults with normal hearing, and to assess their underlying conditions through behavioral and electrophysiological testing.MethodThis case control study enrolled 20 adults with normal hearing thresholds and divided them into two groups: a case group with 10 adults with hearing impairment-related communication disorders and a control group with 10 adults with normal hearing. The frequency of occurrence of communication difficulties was recorded during speech recognition tests run in quiet and noisy conditions, audiometry, and auditory evoked brainstem potential testing.ResultsCase group subjects differed statistically from controls only in self-reported scores of hearing impairment. The groups did not differ in the other ratings. A positive correlation was found between hearing thresholds and scores on self-reported impairment.ConclusionThe combination of hearing complaints and unaltered audiograms was not correlated with differences in performance in speech recognition testing in noisy conditions or in the remaining evaluations. Correlation analysis showed that the higher the pure tone thresholds, the greater were the reported communication difficulties, even in thresholds between 0 and 25 dB.     

Retrospective audiological analysis of bone conduction versus round window vibratory stimulation in patients with mixed hearing loss

Objective: To compare audiological outcomes in mild-to-moderate mixed hearing loss patients treated with a bone-anchored hearing aid or an active middle-ear implant. Analysis aimed to refine criteria used in preoperative selection of implant type. Design: Retrospective comparative analysis of audiological data. Follow-up time ranged between 0.55 and 8.8 years. Study sample: For detailed comparative analysis, 12 patients (six in each group) with comparable bone conduction thresholds and similar clinical characteristics were selected. A larger cohort of 48 patient files were used to evaluate overall audiological indication criteria (24 per group). Results: In free-field tone audiometry, Baha patients showed mean aided thresholds between 40–48 dB, whereas hearing thresholds for VSB patients were 25–43 dB. Baha and VSB users had mean WRS of 56% and 82%, respectively, at 65 dB. Better speech understanding in noise was seen with the VSB. Conclusion: Analysis of the main cohort (n = 48) showed that treatment with round window vibroplasty leads to better hearing performance than treatment with a bone-anchored hearing device, if the bone conduction pure-tone average (0.5 to 4 kHz) is poorer than 35 dB HL. Audiological analysis in the smaller comparative analysis showed similar findings.     

Relationships between speech perception abilities and spoken language skills in young children with hearing loss

The goal of this study was to examine the relationships between scores obtained from measures of speech perception and language in a group of young children with hearing loss (HL). Eighteen children (mean age = 4.3 years) and their mothers participated in this study. Speech perception was measured using the online imitative test of speech pattern contrast perception (OLIMSPAC). Standardized language age equivalent scores were obtained using the Reynell developmental language scales-III. Number of word tokens, word types, and mean length of utterance (MLU) were extracted from the children's spontaneous language samples. Significant positive relationships were observed between children's OLIMSPAC scores and both standardized language scores (r ranging from 0.60 to 0.69; p <0.01) and all measures derived from children's spontaneous language samples (r ranging from 0.80 to 0.86; p<0.01). After controlling for child age, OLIMSPAC scores explained 34.1% of the variance in children's MLU. Using a new speech perception measure with reduced language demands, strong positive correlations were evident between speech perception and language skills for a young group of children with HL.