Discrimination vocale en présence de bruit dans les différents types de surdité

Speech Discrimination in Presence of Noise in Different Kinds of Hearing Loss

When the threshold of hearing was poorer than 70 dB HL, the speech audiometric curve was always made worse by the presence of noise. By contrast, if the threshold was better than 70 dB HL, the speech audiometric curve was improved by noise in 35% of cases. This effect was particularly noticeable in the case of cupul-shaped or ‘plateau’-shaped speech curves

In conductive hearing losses, the effect of noise was always to produce a deterioration in the speech audiogram, This is in contrast to what one would expect in view of a paracousis willisii     

Necrotizing otitis externa caused by Staphylococcus epidermidis

We present a case of malignant necrotizing otitis externa (MNOE) caused by Staphylococcus epidermidis, which is usually a non-pathogenic microorganism. The patient is an otherwise healthy, nondiabetic 58-year-old white man. Contributory history began in 1994 after surgery for bilateral exostoses of the external auditory canals. Between April 1994 and May 1998 persistent otalgia occurred, with progressive mixed hearing losses, purulent discharge from both ears, spontaneous perforations of the tympanic membranes and ulceration of canal wall skin. From the beginning, Staph. epidermidis was isolated in all but one culture, but was not recognized as the pathological agent because of the presence of other more frequently involved bacteria and fungi. After multiple intravenous and oral antibiotics and antifungal treatments failed, further management involved frequent debridement of both external auditory canals and tympanic membranes, right tympanoplasty, bilateral mastoidectomy, revision tympanomastoidectomies and left modified radical mastoidectomy. Antistaphylococcal therapy including ceftazidime, vancomycin, teicoplanin, clindamycin and rifampicin was tried. Following the modified radical radical mastoidectomy, normalization of the status of his ears took approximately 2 months and has since remained stable to date. His left ear is deaf because of vancomycin administration, while magnetic resonance imaging and gallium scintigraphy have shown persistent inflammation of the skull base. Received: 12 November 1998 / Accepted: 14 January 1999     

Estrogenic modulation of auditory processing: A vertebrate comparison

Sex-steroid hormones are well-known regulators of vocal motor behavior in several organisms. A large body of evidence now indicates that these same hormones modulate processing at multiple levels of the ascending auditory pathway. The goal of this review is to provide a comparative analysis of the role of estrogens in vertebrate auditory function. Four major conclusions can be drawn from the literature: First, estrogens may influence the development of the mammalian auditory system. Second, estrogenic signaling protects the mammalian auditory system from noise- and age-related damage. Third, estrogens optimize auditory processing during periods of reproductive readiness in multiple vertebrate lineages. Finally, brain-derived estrogens can act locally to enhance auditory response properties in at least one avian species. This comparative examination may lead to a better appreciation of the role of estrogens in the processing of natural vocalizations and mayprovide useful insights toward alleviating auditory dysfunctions emanating from hormonal imbalances.     

Audiology in Greenland: An Audiological Program in a Remote Area

For 10 years the Greenlandic population of about 50 000 has been treated audiologically by the State Hearing Centre of Odende. Greenland is a Danish island which is geographically located in the Arctic. The most populated areas are situated on the west coast at a distance of 4 000-5 000 km from Denmark. The distances in Greenland itself are tremendous, the small communities being scattered along several thousand kilometers of coastline. More than 1 000 patients are audiologically controlled and 600-700 treated by hearing aids. Deposits of hearing aids, spare parts and batteries are at the disposal of 17 hospitals. Every summer a team of professional people, including an audiologically trained otologist from Odense, goes to Greenland to visit distant places by air or boat, and to examine patients. Instructions and courses are given to the medical staffs and teachers. Help is given all the year round telegraphically or by letter. Two specially trained teaches live in Greenland and are in contact with the hearing centre. Our system is well suited for any remote areas which have to be served by hearing clinics at a great distance, for instance in small communities, colonies and the like     

Development and validation of a new Mandarin tone identification test

ObjectivesThe objectives of this study were to develop a new Mandarin tone identification test (MTIT) to assess the Mandarin tone identification ability of children with hearing impairment (HI) and at age around 7 years; and to evaluate the reliability and sensitivity of the MTIT.MethodsThe word materials to be used in the MTIT were developed in Phase I. Monosyllables were chosen to represent the daily repertoire of young children and to avoid the influence of co-articulation and intonation. Each test stimulus set contained four words, with one target, one containing contrastive tone, and two unrelated distracters. All words were depicted using simple pictures, and the test targets in quiet or in noise were presented using recorded stimuli on a custom software. Phase II evaluated the reliability and sensitivity of the MTIT. Participants were 50 normal-hearing native-Mandarin speakers around 7 years of age.ResultsIn Phase I, the MTIT was developed as described above. The final test consists of 51 words that are within the vocabulary repertoire of children aged 7 years. In Phase II, with the Mandarin tone identification scores collected from 50 children, the repeated measure ANOVA showed a significant main effect of S/N on MTIT performance (p < 0.001). Pairwise comparisons revealed a significant difference in performance across the five S/N conditions (p < 0.01) when S/N varied from −30 to −10 dB. Cronbach's alpha at −15 dB S/N was 0.66, suggesting satisfactory internal consistency reliability. A paired-samples t-test showed that there was no significant difference between the test–retest scores across the five S/N conditions (p > 0.05).ConclusionsCompared with the available Mandarin tone identification tools, MTIT systematically evaluated the tone identification performance in noisy environment for normal hearing children at age around 7 years. Results also showed satisfactory internal consistency reliability, good test–retest reliability and good sensitivity. In the near future, MTIT could be used to evaluate tone perception ability of children with hearing impairment and help to design hearing rehabilitation strategies for this population at the age critical for their language learning.     

Evaluation of the preliminary auditory profile test battery in an international multi-centre study

Abstract

Objective: This paper describes the composition and international multi-centre evaluation of a battery of tests termed the preliminary auditory profile. It includes measures of loudness perception, listening effort, speech perception, spectral and temporal resolution, spatial hearing, self-reported disability and handicap, and cognition. Clinical applicability and comparability across different centres are investigated. Design: Headphone tests were conducted in five centres divided over four countries. Effects of test-retest, ear, and centre were investigated. Results for normally-hearing (NH) and hearing-impaired (HI) listeners are presented. Study sample: Thirty NH listeners aged 19–39 years, and 72 HI listeners aged 22–91 years with a broad range of hearing losses were included. Results: Test-retest reliability was generally good and there were very few right/left ear effects. Results of all tests were comparable across centres for NH listeners after baseline correction to account for necessary differences between test materials. For HI listeners, results were comparable across centres for the language-independent tests. Conclusions: The auditory profile forms a clinical test battery that is applicable in four different languages. Even after baseline correction, differences between test materials have to be taken into account when interpreting results of language-dependent tests in HI listeners.     

Exploring hearing aid use in older women through narratives

Abstract

This study explored experiences surrounding hearing aid use and non-use in older women with hearing loss. A narrative approach was used to gain an in-depth understanding of the meaning and contextual issues that impact upon the adaptation process of older adults and their transitions in using hearing devices. Four women over the age of sixty who were identified as being consistent hearing aid users took part in three face-to-face interviews. biographic-narrative-interview guiding framework was used to gather data in this study. Data were analyzed both holistically and thematically from a phenomenological perspective to identify the meaning and essence of the participants’ experiences. The results revealed an overarching theme of meaningful participation in life situations and events that were linked to purposeful use and non-use of hearing aids. Barriers and facilitators related to participation, which in turn affect hearing aid use and acceptance, were uncovered. The results of this study have implications for audiologic research, and practice.

Sumario

Este estudio exploró las experiencias alrededor del uso o no uso de auxiliares auditivos por ancianas con pérdidas auditivas. Se usaron las narraciones como enfoque, para lograr la comprensión exhaustiva del significado y de los aspectos contextuales que impactan el proceso de adaptación de los adultos mayores y su transición en el uso de instrumentos auditivos. Tomaron parte en tres entrevistas cara-a-cara, cuatro mujeres mayores de sesenta años, identificadas como usuarias consistentes de auxiliares auditivos. Se usó el marco guía de de entrevistas biográficas-narrativas para obtener los datos de este estudio. Estos datos fueron analizados tanto holística como temáticamente, desde una perspectiva fenomenológica para identificar el significado y la esencia de las experiencias de las participantes. Los resultados revelaron un tema enarcado de participación significativa en situaciones de vida y eventos ligados al uso propositivo o al no uso de auxiliares auditivos. Las barreras y los facilitadores relacionados con la participación, que afectan en sus momentos el uso y la aceptación del auxiliar auditivo, no fueron cubiertos. Los resultados de este estudio tienen implicaciones para la investigación y la práctica audiológica.