Outcomes of the Baha Attract System combined with auricle reconstruction in mandarin speaking patients with bilateral microtia-atresia

Background: A transcutaneous bone-conduction hearing device (tBCHD), the Baha Attract System has been recently introduced to China, and very few studies have assessed the efficacy of this system in speakers of mandarin.

Objectives: This study aims to analyze the functional and cosmetic outcomes of this system.

Materials and Methods: This prospective study included 11 patients (nine males, two females), of mean age 16 years (range 9–32 years). Seven patients were conducted the implantation simultaneously with auricle reconstruction, and the other four were before it. Auditory results were compared between unaided patients and implanted patients. Subjective satisfaction was analyzed using three questionnaires.

Results: The mean sound field thresholds were 65.9?±?5.1?dB SPL unaided and 30.9?±?4.7?dB SPL with an implanted Baha Attract System, resulting in a mean hearing gain of 35.0?±?6.7?dB. The mean WRS scores were 47.8?±?8.7% unaided and 92.1?±?2.0% with the Baha Attract System, resulting in a mean improvement of 47.8?±?8.7%. No adverse events were reported and questionnaires showed good patients satisfaction.

Conclusions: The transcutaneous Baha Attract System is effective in mandarin speaking patients, and the combination of hearing rehabilitation and auricle reconstruction surgery is promising for patients with bilateral microtia-atresia.     

Comparative outcomes of active and passive hearing devices by transcutaneous bone conduction

Conclusion Bonebridge (BB) and Sophono (SP) devices improved hearing; with the BB implant showing a better performance at medium and high frequencies. Furthermore, the BB, as an active implant, showed higher functional gain and increased time of use, when compared to the SP, a passive system. Objectives This study aims to compare surgical and audiological outcomes of SP and BB devices in order to assess and further differentiate the indication criteria. Methods Fourteen patients with conductive and mixed hearing loss were evaluated pre- and post-operatively (BB or SP) (period 2013–2014). Age, gender, surgical history, cause and type of hearing loss, implant use per day, levels of bone and air conduction, and functional gain were recorded. Data was analysed by Wilcoxon singed-rank and Wilcoxon rank-sum tests. Results Fourteen patients (BB; n?=?10 and SP; n?=?4) with an average age?=?25.42 years (CI95?=?12.41–38.43) were evaluated. The gender relation was equal (1:1), with pre-implantation osseous thresholds of 20.42?dB (CI95?=?11.15–29.69), and pre-implantation aerial thresholds of 70.83?dB (CI95?=?62.52–79.14). The SP wearing time was significantly lower than that of the BB (SP?=?7–10?h/day, BB?=?8–12?h/day; p?=?0.0323). The functional gain did not differ significantly between the two devices (BB?=?40.00?±?13.19?dB, SP?=?34.06?±?15.63?dB; p?=?0.3434), but a significant improvement from pre- to post-implantation was observed (p?p?=?0.0140) and 4?kHz (p?相似文献   

Do you hear the noise? The German matrix sentence test with a fixed noise level in subjects with normal hearing and hearing impairment

Objective: The aim of this study was to determine the relationship between hearing loss and speech reception threshold (SRT) in a fixed noise condition using the German Oldenburg sentence test (OLSA). Design: After training with two easily-audible lists of the OLSA, SRTs were determined monaurally with headphones at a fixed noise level of 65 dB SPL using a standard adaptive procedure, converging to 50% speech intelligibility. Study sample: Data was obtained from 315 ears of 177 subjects with hearing losses ranging from ? 5 to 90 dB HL pure-tone average (PTA, 0.5, 1, 2, 3 kHz). Results: Two domains were identified with a linear dependence of SRT on PTA. The SRT increased with a slope of 0.094 ± 0.006 dB SNR/dB HL (standard deviation (SD) of residuals = 1.17 dB) for PTAs < 47 dB HL and with a slope of 0.811 ± 0.049 dB SNR/dB HL (SD of residuals = 5.54 dB) for higher PTAs. Conclusion: The OLSA can be applied to subjects with a wide range of hearing losses. With 65 dB SPL fixed noise presentation level the SRT is determined by listening in noise for PTAs < ～47 dB HL, and above it is determined by listening in quiet.     

索菲康骨导助听器助听效果的多中心研究

目的 评估软带或头带佩戴新型经皮传导索菲康骨导助听器对传导性聋或混合性聋、单侧聋患者的助听效果.方法 以来自国内4家三级甲等医院的109例传导性或混合性聋患者及11例单侧聋(single-sided deafness,SSD)患者为研究对象,均以纯音测听(≥6岁患者)或听性脑干反应(ABR)(<6岁患者)评估裸耳听阈后予以头带或软带佩戴索菲康Alpha 2 MPO骨导助听器;并在声场下进行未助听、佩戴当日及佩戴2周后的助听听阈(0.5~4 kHz)测试;≥6岁患者进行未助听、佩戴当日及佩戴2周助听下的言语识别阈(speech recognition threshold, SRT)测试,并记录患者佩戴后的不良反应.结果 传导性或混合性聋患者中≥6岁患者助听耳裸耳骨导及气导平均听阈均值分别为18.55±8.99、71.45±10.25 dB HL,<6岁组助听耳裸耳骨导及气导ABR阈值均值分别为18.33±8.36、70.80±8.24 dB HL;SSD患者助听耳裸耳听阈不能测出;佩戴2周后,三组助听后纯音听阈均值分别为32.21±10.00、37.33±14.15、34.38±10.76 dB HL,较未助听时明显改善,差异有统计学意义(P<0.05);≥6岁传导性或混合性聋组和SSD组患者佩戴2周后助听下各方向SRT较未助听时均显著降低,差异有统计学意义(P<0.05);各组患者均无与佩戴助听器相关的不良皮肤反应等.结论 使用软带、头带佩戴索菲康骨导助听器,可有效改善传导性或混合性聋、SSD患者听阈和安静环境下言语识别阈.     

Comparison of threshold estimation in infants with hearing loss or normal hearing using auditory steady-state response evoked by narrow band CE-chirps and auditory brainstem response evoked by tone pips

Objective: The objective of this study is to compare air-conduction thresholds obtained with ASSR evoked by narrow band (NB) CE-chirps and ABR evoked by tone pips (tpABR) in infants with various degrees of hearing loss. Design: Thresholds were measured at 500, 1000, 2000 and 4000?Hz. Data on each participant were collected at the same day. Study sample: Sixty-seven infants aged 4 d to 22 months (median age?=?96 days), resulting in 57, 52, 87 and 56 ears for 500, 1000, 2000 and 4000?Hz, respectively. Results: Statistical analysis was performed for ears with hearing loss (HL) and showed a very strong correlation between tpABR and ASSR evoked by NB CE-chirps: 0.90 (n?=?28), 0.90 (n?=?28), 0.96 (n?=?42) and 0.95 (n?=?30) for 500, 1000, 2000 and 4000?Hz, respectively. At these frequencies, the mean difference between tpABR and ASSR was ?3.6?dB (±?7.0), ?5.2?dB (±?7.3), ?3.9?dB (±?5.2) and ?5.2?dB (±?4.7). Linear regression analysis indicated that the relationship was not influenced by the degree of hearing loss. Conclusion: We propose that dB nHL to dB eHL correction values for ASSR evoked by NB CE-chirps should be 5?dB lower than values used for tpABR.     

The development and evaluation of the Finnish digit triplet test

Objectives: The aim of the study was to develop a reliable and easily accessible screening test for primary detection of hearing impairment.

Methods: Digits 0–9 were used to form quasirandom digit triplets. First, digit specific intelligibility functions and speech recognition thresholds (SRTs) were determined. To homogenize the test material digits with steep intelligibility function slopes were chosen and level correction up to ±2?dB were applied to the digits as needed. Evaluation measurements were performed to check for systematic differences in intelligibility between the test lists and to obtain normative reference function for normal-hearing listeners.

Results: The mean SRT and the final slope of the test lists were ?10.8?±?0.1?dB signal-to-noise ratio (SNR) and 21.7?±?1.8%/dB, respectively (measurements at constant level; inter-list variability). The mean SRT and slope of the test subjects were ?10.8?±?0.5?dB SNR and 23.4?±?5.2%/dB (measurements at constant level; inter-subject variability). The mean SRT for normal-hearing young adults for a single adaptive measurement is ?9.8?±?0.9?dB SNR.

Conclusion: The Finnish digit triplet test is the first self-screening hearing test in the Finnish language. It was developed according to current standards, and it provides reliable and internationally comparable speech intelligibility measurements.     

Smartphone threshold audiometry in underserved primary health-care contexts

Objective: To validate a calibrated smartphone-based hearing test in a sound booth environment and in primary health-care clinics. Design: A repeated-measure within-subject study design was employed whereby air-conduction hearing thresholds determined by smartphone-based audiometry was compared to conventional audiometry in a sound booth and a primary health-care clinic environment. Study sample: A total of 94 subjects (mean age 41 years?±?17.6 SD and range 18–88; 64% female) were assessed of whom 64 were tested in the sound booth and 30 within primary health-care clinics without a booth. Results: In the sound booth 63.4% of conventional and smartphone thresholds indicated normal hearing (≤15?dBHL). Conventional thresholds exceeding 15 dB HL corresponded to smartphone thresholds within?≤10 dB in 80.6% of cases with an average threshold difference of??1.6 dB?±?9.9 SD. In primary health-care clinics 13.7% of conventional and smartphone thresholds indicated normal hearing (≤15 dBHL). Conventional thresholds exceeding 15 dBHL corresponded to smartphone thresholds within ≤10 dB in 92.9% of cases with an average threshold difference of ?1.0 dB?±?7.1 SD. Conclusions: Accurate air-conduction audiometry can be conducted in a sound booth and without a sound booth in an underserved community health-care clinic using a smartphone.     

Transcutaneous bone conductive implants in patients with conductive/mixed hearing loss: audiological outcomes in noise condition

Background: Recently, the use of transcutaneous bone conduction implants (BCIs) has been increased. However, scarce data about BCI hearing recovery in noise conditions have been reported.

Objectives: To investigate the audiological benefits obtained with transcutaneous BCI-Sophono Alpha System in noise conditions. To evaluate post-implantation clinical outcomes and patient satisfaction levels.

Materials and methods: Fourteen patients suffering from conductive or mixed hearing loss implanted with the Sophono Alpha System were evaluated. Patients underwent physical examination, free-field pure-tone and speech audiometry both in unaided and aided conditions. The matrix sentence test was employed with fixed noise at 65?dB, and with a fluctuating primary signal, in three different conditions of noise presentations (S0/N0, S0/Ncontra, S0/Nipsi).

Results: Hearing gain, expressed as the difference between pre-implant AC and post-implant SAS free field, was on average 26.7?dB. The unaided speech recognition score in quiet conditions had a mean value of 64.6%, and improved after SAS implantation, achieving mean values of 98.2%. SRT₅₀ with the matrix sentence test improved in all three conditions of noise presentation.

Conclusions: Sophono Alpha System devices represent a valid treatment option for hearing rehabilitation of patients with conductive or mixed hearing loss. The audiological results regarding hearing gain in noise conditions were good.     

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.     

Development and evaluation of the Turkish matrix sentence test

Objectives: The Turkish matrix sentence test, TURMatrix, was developed for precise, internationally comparable speech intelligibility testing. Design: The TURMatrix comprises a base matrix of ten well-known Turkish names, numbers, adjectives, objects, verbs, from which syntactically fixed sentences were randomly composed. Test conduction may be in an open-set (standard), or closed-set response format. Homogeneity in intelligibility of the test material was optimized by applying level adaptations (maximal ± 3 dB) based on word-specific speech reception thresholds (SRTs). Test list equivalence was verified and reference values were determined. Study sample: Thirty-eight native listeners of Turkish with normal hearing. Results: After training, mean SRT and slope of the final test lists were ? 8.3 ± 0.2 dB SNR and 14.1 ± 1.0%/dB, respectively (fixed SNR measurements; inter-list variability). For adaptive measurements, average across listeners was ? 7.2 ± 0.7 dB SNR in the open-set and ? 7.9 ± 0.7 dB SNR in the closed-set response format. Mean SRT for adaptive measurements in the open-set response format in quiet was 20.3 ± 4.1 dB. Individual SRTs in quiet correlated more closely with audiograms than with SRTs in noise. Conclusions: The TURMatrix was developed according to European standards and provides reliable speech intelligibility measurements in noise and quiet.     

Factors affecting hearing deterioration in vestibular schwannoma patients treated with gamma knife radiosurgery: the Asan Medical Center experience

Objectives: To investigate the changes in hearing and to determine factors predicting hearing deterioration in patients with vestibular schwannoma (VS) who undergo gamma knife radiosurgery (GKRS).

Design: A retrospective review of medical records in patients diagnosed with VS and initially treated with GKRS at a tertiary care medical center between 1995 and 2015 was performed. Tumor factors (location, volume), parameters related to irradiation to the tumor and cochlea, and distance between the tumor and cochlea were reviewed.

Results: Fifty-six patients were included in the final analysis with a mean observation period following GKRS as 24.4?±?27.8 months. Prior to GKRS, the average pure tone threshold at 500, 1k, 2k, and 4k?Hz (PTA₄) was 51.0?±?29.7?dB HL. After GKRS, the mean PTA₄ was 71.6?±?33.3?dB HL. Significant independent odds ratios for hearing deterioration were 8.5 for extracanalicular tumors, 18.8 for more than 10 shots in GKRS, and 12.2 for a distance between the tumor center and cochlea modiolus less than 20?mm.

Conclusions: A significant hearing deterioration was shown in 2 years after GKRS. Tumor location, number of radiation shots, and distance between the tumor and cochlea affected hearing level after GKRS.     

Hearing gain with a BAHA test-band in patients with single-sided deafness

Purpose

It is assumed that preoperative use of a bone-anchored hearing aid (BAHA) test-band will give a patient lower gain compared to real post-operative gain because of the reduction of energy through the scalp when using a test-band. Hearing gains using a BAHA test-band were analyzed in patients with unilateral hearing loss.

Materials and Methods

Nineteen patients with unilateral sensorineural hearing loss were enrolled. A test-band, which was connected to BAHA Intenso with full-on gain, was put on the mastoid. Conventional air-conduction (AC) pure-tone averages (PTAs) and sound-field PTAs and speech reception thresholds (SRTs) were obtained in conditions A (the better ear naked), B (the better ear plugged), and C (the better ear plugged with a test-band on the poorer mastoid).

Results

Air-conduction PTAs of the poorer and better ears were 91 ± 19 and 18 ± 8 dB HL. Sound-field PTAs in condition B were higher than those in condition A (54 vs. 26 dB HL), which means that earplugs can block the sound grossly up to 54 dB HL through the better ears. The aided PTAs (24 ± 6 dB HL) in condition C were similar to those of the better ears in condition A (26 ± 9 dB HL), though condition C showed higher thresholds at 500 Hz and lower thresholds at 1 and 2 kHz when compared to condition A. The hearing thresholds using a test-band were similar to the published results of BAHA users with the volume to most comfortable level (MCL).

Conclusion

Our findings showed that a BAHA test-band on the poorer ear could transmit sound to the cochlea as much as the better ears can hear. The increased functional gain at 1 and 2 kHz reflects the technical characteristics of BAHA processor. The reduction of energy through the scalp when using a test-band seems to be offset by the difference of output by setting the volume to full-on gain and using a high-powered speech processor. Preoperative hearing gains using a test-band with full-on gain seems to be similar to the post-operative gains of BAHA users with the volume to MCL.     

The effect of fluctuating maskers on speech understanding of high-performing cochlear implant users

Objective: The present study evaluated whether the poorer baseline performance of cochlear implant (CI) users or the technical and/or physiological properties of CI stimulation are responsible for the absence of masking release. Design: This study measured speech reception thresholds (SRTs) in continuous and modulated noise as a function of signal to noise ratio (SNR). Study sample: A total of 24 subjects participated: 12 normal-hearing (NH) listeners and 12 subjects provided with recent MED-EL CI systems. Results: The mean SRT of CI users in continuous noise was??3.0?±?1.5 dB SNR (mean?±?SEM), while the normal-hearing group reached??5.9?±?0.8 dB SNR. In modulated noise, the difference across groups increased considerably. For CI users, the mean SRT worsened to??1.4?±?2.3 dB SNR, while it improved for normal-hearing listeners to??18.9?±?3.8 dB SNR. Conclusions: The detrimental effect of fluctuating maskers on SRTs in CI users shown by prior studies was confirmed by the current study. Concluding, the absence of masking release is mainly caused by the technical and/or physiological properties of CI stimulation, not just the poorer baseline performance of many CI users compared to normal-hearing subjects. Speech understanding in modulated noise was more robust in CI users who had a relatively large electrical dynamic range.     

The relationship between hearing loss and vestibular dysfunction in patients with sudden sensorineural hearing loss

Objective: To investigate the relationship between hearing loss and vestibular dysfunction in patients with sudden sensorineural hearing loss (SSHL).

Methods: Clinical data including the symptom of vertigo of 149 SSHL patients were investigated retrospectively. Pure tone audiometry, ocular vestibular-evoked myogenic potential (oVEMP) and cervical vestibular-evoked myogenic potential (cVEMP) evoked by air-conducted sound (ACS), and caloric test were employed for cochlear and vestibular function assessment. The relationship between hearing level and vestibular dysfunction was analyzed.

Results: The pure tone averages (PTAs) (mean?±?SD) of SSHL patients with and without vertigo were 88.81?±?21.74 dB HL and 72.49?±?21.88 dB HL (Z?=??4.411, p?=?0.000), respectively. The PTAs of SSHL patients with abnormal and normal caloric test were 84.71?±?22.54 dB HL and 70.41?±?24.07 dB HL (t?=??2.665, p?=?0.009), respectively. Conversely, vertigo and abnormal caloric results also happened more frequently in patients with profound hearing loss. However, no consistent tendency could be found among vestibular evoked myogenic potentials (VEMPs) responses or hearing loss.

Conclusions: SSHL patients with vertigo or abnormal caloric test displayed worse hearing loss; and vice versa, vertigo and abnormal caloric results happened more frequently in SSHL patients with profound hearing loss.     

Comparison of hearing thresholds obtained with Baha preoperative assessment tools and those obtained with the osseointegrated implant

We conducted a study of the Baha bone-anchored hearing aid system to quantify the difference between (1) hearing thresholds obtained through preoperative testing methods with the Baha sound processor attached to three different bone-conduction testing devices and (2) thresholds obtained postoperatively with the sound processor attached to a surgically placed osseointegrated titanium implant. Twenty-three patients underwent free-field testing in four situations: with the Baha sound processor attached to (1) the Baha Testband (transcutaneous transmission), (2) the Baha Softband (transcutaneous transmission), (3) a test rod (bone conduction via the teeth), and (4) the osseointegrated implant (percutaneous transmission). The main outcome measure was the result of a comparison of the thresholds obtained with the three preoperative test methods and those obtained with the osseointegrated implant. We found that aided thresholds obtained with the osseointegrated implant were significantly better (p < 0.05) than those obtained with the three preoperative test methods. The degree of superiority increased with higher frequencies. We conclude that thresholds of 1 to 18 dB better than those obtained by preoperative test methods can be expected postoperatively with the osseointegrated implant. The damping effect of sound transmission via the teeth or transcutaneously must be accounted for in making predictions of postoperative outcome.     

Selection of test-setup parameters to target specific signal-to-noise regions in speech-on-speech intelligibility testing

Objective: To investigate the magnitude of the change in speech-reception threshold (SRT) provided by altering four different test-setup parameters. Furthermore, to determine whether these changes in SRT are of a sufficient magnitude, such that they can be used to design a test-setup in future experiments that target a predefined signal-to-noise ratio (SNR) region. This could be particularly important if the test contrast investigated is confounded with test SNR. Design: The investigated test-setup parameters were: Spatial separation between target (0°) and maskers (±15°, ±30°, ±45°, or ±75°), number of maskers (two, four or six), scoring method (scoring percent-correct words or sentences) and masker gender (same or opposite to target). Twenty SRTs were measured per test subject. Study sample: Twenty hearing-impaired test subjects participated over two visits. Results: Alteration of masker gender, spatial separation between target and masker (±15°, ±30°, ±?45°), and scoring method was shown to offer SRT changes of a sufficient magnitude. The different test setups resulted in average SRTs ranging from ?4.0 to 3.3?dB. Conclusion: Deliberately selecting test setup parameters can change the overall difficulty of the test by up to 7.3?dB SRT. Thus, a future experiment can, to this extent, be designed to target a specific SNR region.     

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.     

Development and evaluation of an audiology app for iPhone/iPad mobile devices

Conclusion: The application described in this study appears to be accurate and valid, thus allowing calculation of a hearing handicap and assessment of the pure-tone air conduction threshold with iPhone/iPad devices. Objective: To develop and evaluate a newly developed professional, computer-based hearing handicap calculator and a manual hearing sensitivity assessment test for the iPhone and iPad (AudCal). Methods: Multi-center prospective non-randomized validation study. One hundred and ten consecutive adult participants underwent two hearing evaluations, a standard audiometry and a pure-tone air conduction test using AudCal with an iOS device. The hearing handicap calculation accuracy was evaluated comparing AudCal vs a web-based calculator. Results: Hearing loss was found in 83 and 84 out of 220 standard audiometries and AudCal hearing tests (Cohen’s Kappa = 0.89). The mean difference between AudCal and standard audiogram thresholds was ?0.21 ± 6.38 dB HL. Excellent reliability and concordance between standard audiometry and the application’s hearing loss assessment test were obtained (Cronbach’s alpha = 0.96; intra-class correlation coefficient = 0.93). AudCal vs a web-based calculator were perfectly correlated (Pearson’s r = 1).     

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.     

Knowledge and attitude of mothers regarding infant hearing loss in Changsha,Hunan province,China

Objective: The objective of this study was to explore the knowledge and attitude among mothers of newborns regarding infant hearing loss (HL) in Changsha, Hunan province, China. Design: A questionnaire including 18 items was given to mothers. Study sample: A total of 115 mothers participated in the study. Results: Seven risk factors for hearing loss were identified correctly by above 60% of respondents and the top three were prolonged noise (88.7%), high fever (82.6%) and ear discharge (82.6%). Poor knowledge was demonstrated on risk factors jaundice (20.0%), measles (22.6%), convulsion (33.0%) and traditional Chinese medicine (39.1%). Maternal knowledge scores in identification and intervention (2.68?±?0.31) was slightly higher than the score in risk factors (2.47?±?0.34). Ninety-nine per cent of the mothers expressed the willingness to test baby’s hearing soon after birth and concern about hearing. Conclusions: Mothers were concerned about baby’s hearing and the attitude was positive. However, the correct recognition rate towards some risk factors for HL was low. Action needs to be taken to raise awareness about ear and hearing care, prevent HL caused by preventable causes and prompt early identification, early diagnosis and intervention of HL.