Characteristics and determinants of music appreciation in adult CI users

The main objective of this study was to assess the associations between self-reported listening habits and perception of music and speech perception outcomes in quiet and noise for both unilateral cochlear implant (CI) users and bimodal (CI in one ear, hearing aid in contra-lateral ear) users. Information concerning music appreciation was gathered by means of a newly developed questionnaire. Moreover, audiological data (pure-tone audiometry, speech tests in noise and quiet) were gathered and the relationship between speech perception and music appreciation is studied. Bimodal users enjoy listening to music more in comparison with unilateral CI users. Also, music training within rehabilitation is still uncommon, while CI recipients believe that music training might be helpful to maximize their potential with current CI technology. Music training should not be exclusively reserved for the good speech performers. Therefore, a music training program (MTP) that consists of different difficulty levels should be developed. Hopefully, early implementation of MTP in rehabilitation programs can enable adult CI users to enjoy and appreciate music and to maximize their potential with commercially available technology. Furthermore, because bimodal users consider the bimodal stimulation to be the most enjoyable way to listen to music, CI users with residual hearing in the contra-lateral ear should be encouraged to continue wearing their hearing aid in that ear.

Test-retest reliability of the assessment of postural stability in typically developing children and in hearing impaired children

The purpose of this study was to establish test-retest reliability of centre of pressure (COP) measurements obtained by an AccuGait portable forceplate (ACG), mean COG sway velocity measured by a Basic Balance Master (BBM) and clinical balance tests in children with and without balance difficulties. 49 typically developing children and 23 hearing impaired children, with a higher risk for stability problems, between 6 and 12 years of age participated. Each child performed the modified Clinical Test of Sensory Interaction on Balance (mCTSIB), Unilateral Stance (US) and Tandem Stance on ACG, mCTSIB and US on BBM and clinical balance tests: one-leg standing, balance beam walking and one-leg hopping. All subjects completed 2 test sessions on 2 different days in the same week assessed by the same examiner. Among COP measurements obtained by the ACG, mean sway velocity was the most reliable parameter with all ICCs higher than 0.72. The standard deviation (SD) of sway velocity, sway area, SD of anterior-posterior and SD of medio-lateral COP data showed moderate to excellent reliability with ICCs between 0.55 and 0.96 but some caution must be taken into account in some conditions. BBM is less reliable but clinical balance tests are as reliable as ACG. Hearing impaired children exhibited better relative reliability (ICC) and comparable absolute reliability (SEM) for most balance parameters compared to typically developing children. Reliable information regarding postural stability of typically developing children and hearing impaired children may be obtained utilizing COP measurements generated by an AccuGait system and clinical balance tests.

Tinnitus severity and the relation to depressive symptoms: A critical study

Introduction

Research indicates that subjective tinnitus severity varies among tinnitus patients. One of the variables held responsible for these differences is depression. However the relationship between depression and tinnitus severity was never investigated more in depth.

Objectives

If depression is responsible for differences in subjective tinnitus severity two conditions need to be fulfilled. First, there should be evidence for the presence of moderate to severe depressive symptomatology in a substantial group, and second, there should be evidence for a substantial relationship between depressive symptoms and tinnitus severity which can not be explained due to method and content overlap.

Aims

In this study we investigated whether tinnitus severity is a depression related problem.

Methods

136 consecutive help-seeking tinnitus patients were seen by a psychologist and an audiologist. All patients filled in the Beck Depression Inventory (BDI-II), the Tinnitus Handicap Inventory (THI), and underwent psychoacoustic measurement (pitch and loudness).

Results

Mean scores indicate the presence of no or minimal depressive symptoms. There was only a positive correlation (p < .01) between the BDI-II and the THI. No correlations were found between psychoacoustic measures and the self-report questionnaires. Linear regression analysis revealed that only the somatic depression subscale significantly predicted tinnitus severity.

Conclusions

Tinnitus does not seem to be a depression-like problem. There is no substantial group of tinnitus patients with moderate to severe depressive symptoms. The relation between depressive symptoms and tinnitus severity seems to be an artefact due to content overlap between de THI and the somatic subscale of the BDI-II.

Intelligibility of hearing impaired children as judged by their parents: A comparison between children using cochlear implants and children using hearing aids

OBJECTIVES

The aim of this study was to determine the intelligibility of prelingually deaf children with cochlear implants (CI) as judged by their own parents, and to compare these results with prelingually hearing impaired children using hearing aids (HA) and normally hearing (NH) children. The authors hypothesised that subjects using conventional hearing aids would have poorer intelligibility judgements compared to NH and CI children.

METHODOLOGY

This is a comparative study of 24 prelingually deaf CI children (m.a. 8.3 years), 24 prelingually hearing impaired HA children (m.a. 9.0 years) and 25 NH children. Recorded speech samples at word-, sentence- and story-level were perceptually judged by two speech pathologists and the child's main caregiver (the mother in most cases) using a five-point hierarchical scale. In addition, the sample of each child was transcribed by the child's main caregiver. The investigators counted and determined a percentage of words correctly understood.

RESULTS

The judgements of the speech pathologists and the transcriptions of the mothers were not different between the CI and NH children, although the mothers tended to judge their CI child to be less intelligible. The HA children on the other hand, showed a mean intelligibility inferior to NH and CI children, as demonstrated by the judgements of the mothers and speech pathologists as well as by the percentages of correctly identified words by the mothers.

CONCLUSION

The intelligibility of the prelingually deaf CI children is very close to the intelligibility of NH children, while the HA children still show a decreased mean intelligibility.

A comparison of vowel productions in prelingually deaf children using cochlear implants, severe hearing-impaired children using conventional hearing aids and normal-hearing children

OBJECTIVE

The purpose of this study was to compare vowel productions by deaf cochlear implant (CI) children, hearing-impaired hearing aid (HA) children and normal-hearing (NH) children.

PATIENTS AND METHODS

73 children [mean age: 9;14 years (years;months)] participated: 40 deaf CI children, 34 moderately to profoundly hearing-impaired HA children and 42 NH children. For the 3 corner vowels [a], [i] and [u], F(1), F(2) and the intrasubject SD were measured using the Praat software. Spectral separation between these vowel formants and vowel space were calculated.

RESULTS

The significant effects in the CI group all pertain to a higher intrasubject variability in formant values, whereas the significant effects in the HA group all pertain to lower formant values. Both hearing-impaired subgroups showed a tendency toward greater intervowel distances and vowel space.

CONCLUSION

Several subtle deviations in the vowel production of deaf CI children and hearing-impaired HA children could be established, using a well-defined acoustic analysis. CI children as well as HA children in this study tended to overarticulate, which hypothetically can be explained by a lack of auditory feedback and an attempt to compensate it by proprioceptive feedback during articulatory maneuvers.

Sequential changes in motor speech across a levodopa cycle in advanced Parkinson's disease

Previous research has indicated that in Parkinson's disease (PD) some motor speech characteristics are changed by levodopa administration, while others are not. In advanced PD, the time course of these changes and the correlations with motor performance have not been sufficiently investigated. The purpose was to investigate the sequential changes of respiratory, articulatory, and phonatory speech characteristics across a levodopa drug cycle, using spirometry, acoustic, and motor speech analysis. Seven patients with advanced PD were included. All patients were evaluated sequentually at 15 minute intervals before and following levodopa intake. Data were analysed using repeated measures ANOVA and non-parametric analysis. Significant changes were found in motor function, vital capacity, and standard deviation of the diadochokinetic period. A trend was present for shimmer and frequency of the first formant. Significant inter-individual differences in the sequential changes were demonstrated for nearly all evaluated parameters. The conclusion is that, in advanced PD, the evaluation of speech characteristics at one moment after levodopa administration is not representative of an entire drug cycle and that an individualized evaluation of an entire drug cycle is warranted before initiation of a speech-language pathology program.

Short-term auditory effects of listening to an MP3 player

OBJECTIVES

To determine the output levels of a commercially available MPEG layer-3 (MP3) player and to evaluate changes in hearing after 1 hour of listening to the MP3 player.

DESIGN

First, A-weighted sound pressure levels (measured in decibels [dBA]) for 1 hour of pop-rock music on an MP3 player were measured on a head and torso simulator. Second, after participants listened to 1 hour of pop-rock music using an MP3 player, changes in hearing were evaluated with pure-tone audiometry, transient-evoked otoacoustic emissions, and distortion product otoacoustic emissions.

PARTICIPANTS

Twenty-one participants were exposed to pop-rock music in 6 different sessions using 2 types of headphones at multiple preset gain settings of the MP3 player.

MAIN OUTCOME MEASURES

Output levels of an MP3 player and temporary threshold and emission shifts after 1 hour of listening.

RESULTS

The output levels at the full gain setting were 97.36 dBA and 102.56 dBA for the supra-aural headphones and stock earbuds, respectively. In the noise exposure group, significant changes in hearing thresholds and transient-evoked otoacoustic emission amplitudes were found between preexposure and postexposure measurements. However, this pattern was not seen for distortion product otoacoustic emission amplitudes. Significant differences in the incidence of significant threshold or emission shifts were observed between almost every session of the noise exposure group compared with the control group.

CONCLUSIONS

Temporary changes in hearing sensitivity measured by audiometry and otoacoustic emissions indicate the potential harmful effects of listening to an MP3 player. Further research is needed to evaluate the long-term risk of cumulative noise exposure on the auditory system of adolescents and adults.

Forward-masking patterns produced by symmetric and asymmetric pulse shapes in electric hearing

Two forward-masking experiments were conducted with six cochlear implant listeners to test whether asymmetric pulse shapes would improve the place-specificity of stimulation compared to symmetric ones. The maskers were either cathodic-first symmetric biphasic, pseudomonophasic (i.e., with a second anodic phase longer and lower in amplitude than the first phase), or "delayed pseudomonophasic" (identical to pseudomonophasic but with an inter-phase gap) stimuli. In experiment 1, forward-masking patterns for monopolar maskers were obtained by keeping each masker fixed on a middle electrode of the array and measuring the masked thresholds of a monopolar signal presented on several other electrodes. The results were very variable, and no difference between pulse shapes was found. In experiment 2, six maskers were used in a wide bipolar (bipolar+9) configuration: the same three pulse shapes as in experiment 1, either cathodic-first relative to the most apical or relative to the most basal electrode of the bipolar channel. The pseudomonophasic masker showed a stronger excitation proximal to the electrode of the bipolar pair for which the short, high-amplitude phase was anodic. However, no difference was obtained with the symmetric and, more surprisingly, with the delayed pseudomonophasic maskers. Implications for cochlear implant design are discussed.

The prevalence of middle ear pathogens in the outer ear canal and the nasopharyngeal cavity of healthy young adults

Culturing middle ear fluid samples from children with chronic otitis media with effusion (OME) using standard techniques results in the isolation of bacterial species in approximately 30-50% of the cases. Haemophilus influenzae, Streptococcus pneumoniae and Moraxella catarrhalis, the classic middle ear pathogens of acute otitis media, are involved but, recently, several studies suggested Alloiococcus otitidis as an additional pathogen. In the present study, we used species-specific PCRs to establish the prevalence, in both the nasopharyngeal cavity and the outer ear, of H. influenzae, M. catarrhalis, S. pneumoniae and A. otitidis. The study group consisted of 70 healthy volunteers (aged 19-22 years). The results indicate a high prevalence (>80%) of A. otitidis in the outer ear in contrast to its absence in the nasopharynx. H. influenzae was found in both the outer ear and the nasopharynx (6% and 14%, respectively), whereas S. pneumoniae and M. catarrhalis were found only in the nasopharynx (9% and 34%, respectively).A. otitidis, described as a fastidious organism, were able to be cultured using an optimized culture protocol, with prolonged incubation, which allowed the isolation of A. otitidis in five of the nine PCR-positive samples out of the total of ten samples tested. Given the absence of the outer ear inhabitant A. otitidis from the nasopharynx, its role in the aetiology of OME remains ambiguous because middle ear infecting organisms are considered to invade the middle ear from the nasopharynx through the Eustachian tube.

Auditory steady-state responses to MM and exponential envelope AM2/FM stimuli in normal-hearing adults

The present study utilized a commercially available multiple auditory steady-state response (ASSR) system to test normal hearing adults (n=55). The primary objective was to evaluate the impact of the mixed modulation (MM) and the novel proposed exponential AM(2)/FM stimuli on the signal-to-noise ratio (SNR) and threshold estimation accuracy, through a within-subject comparison. The second aim was to establish a normative database for both stimulus types. The results demonstrated that the AM(2)/FM and MM stimulus had a similar effect on the SNR, whereas the ASSR threshold results revealed that the AM(2)/FM produced better thresholds than the MM stimulus for the 500, 1000, and 4000 Hz carrier frequency. The mean difference scores to tones of 500, 1000, 2000, and 4000 Hz were for the MM stimulus: 20+/-12, 14+/-9, 10+/-8, and 12+/-8 dB; and for the AM(2)/FM stimulus: 18+/-13, 12+/-8, 11+/-8, and 10+/-8 dB, respectively. The current research confirms that the AM(2)/FM stimulus can be used efficiently to test normal hearing adults.

Distortion product otoacoustic emissions: An objective technique for the screening of hearing loss in children treated with platin derivatives

In order to develop a sensitive audiometric protocol for identifying ototoxicity in children, a retrospective study of 16 children treated with cisplatin and/or carboplatin was performed. Audiometric testing was done by means of pure-tone threshold audiometry (PTA), high-frequency audiometry (HFA), and distortion product otoacoustic emissions (DPOAEs). Cisplatin caused a sensorineural high-frequency hearing loss in the study group compared to the controls (p < 0.01). Sixty-six percent of the cisplatin patients had a grade 2 or 3 ototoxicity. However, ototoxicity was not found in the patients treated with carboplatin. An excellent correlation was found between DPOAE levels and results obtained by audiometry (r = 0.82). Patients exposed to cisplatin are at significant risk for the development of drug-induced sensorineural hearing loss. Because of the several advantages of DPOAEs (noninvasive, objective, rapid, easy to use, sensitive) this method should be added in the audiological follow-up in infants and toddlers.

Water irrigation versus air insufflation: A comparison of two caloric test protocols

The aim of the present study was to construct and compare two caloric test protocols, one for water irrigation, and one for air insufflation. A set of reference data was constructed and tabulated as well as the intersubject variability. The effect of age, sex, ear, and temperature, as well as a possible priming effect and order effect were investigated. Forty-seven subjects (18-58 years) without otological or vestibular history participated. Four response parameters were investigated: slow component velocity (SCV), frequency, unilateral weakness (UW), and directional preponderance (DP). Statistically higher SCV values were obtained for water compared to air, with statistically higher standard deviations for SCV water values. No influences of age, sex, ear, or temperature could be demonstrated on any of the response parameters. The same applied for the presence of an order effect and a priming effect. Comparing the two protocols to one another led the present authors to favour water as the standard irrigation medium, and air only in situations where water is contra-indicated.

The clinical value of the multiple-frequency 80-Hz auditory steady-state response in adults with normal hearing and hearing loss

OBJECTIVES

To determine the ability of the air-conduction multiple-frequency auditory steady-state response (ASSR) technique to diagnose normal hearing (NH) and mild and moderate degrees of sensorineural hearing loss (SNHL), to assess patients with conductive hearing loss (CHL), to evaluate flat and sloping configurations of hearing impairment, and to provide sensitivity and specificity values for various ASSR cutoff criteria.

DESIGN

A comparative study between ASSR and criterion-standard behavioral thresholds.

SETTING

Ear, nose, and throat department at a university hospital.

PATIENTS

The study population comprised 40 adults with NH, 17 with SNHL, and 7 with CHL.

MAIN OUTCOME MEASURES

The measure of interest was the difference between ASSR and behavioral thresholds at 0.5, 1.0, 2.0, and 4.0 kHz. The sensitivity, specificity, positive predictive value, negative predictive value, and efficiency were calculated for several ASSR cutoff criteria.

RESULTS

The ASSR technique clearly distinguished moderate SNHL from NH, but the "mild SNHL and NH" and "mild SNHL and moderate SNHL" differentiation was particularly difficult at 0.5 and 2.0 kHz, respectively. Air-conduction ASSR thresholds accurately predicted behavioral thresholds in CHL. The ASSR system precisely reflected the flat and sloping configurations. Finally, the most appropriate ASSR cutoff point for normality seems to be the 30-dB-or-lower criterion.

CONCLUSIONS

In adults, the multiple-frequency 80-Hz ASSR technique can be used to determine the degree and configuration of hearing loss. Although air-conduction ASSR thresholds accurately predicted behavioral thresholds in CHL, future research with bone-conduction ASSRs is necessary to establish the type of hearing loss. Furthermore, the applicability of these findings still needs to be confirmed for infants.

Three-Year Postimplantation Auditory Outcomes in Children with Sequential Bilateral Cochlear Implantation

Objectives:

We report on the auditory abilities and speech performance in quiet and noise of 35 children with sequential bilateral cochlear implantation after 3 years of bilateral implant use.

Methods:

Testing was done in bilateral and both unilateral listening conditions. The assessments took place before the second implantation and at several time intervals after fitting. As different auditory tests were used, the children were categorized by their age at the second implantation: Younger or older than 6 years.

Results:

The pure tone averages for the bilateral condition were significantly better than those for either unilateral condition after 12 months of bilateral implant use and remained so from that test interval onward. The speech recognition outcomes in quiet and noise also improved significantly for almost all children after 36 months, although a linear regression analysis showed a beneficial effect of younger age at first implantation on the speech-in-noise results.

Conclusions:

Bilateral cochlear implantation offered advantages to all children in comparison with the first implant — Even the children who received the second implant after the age of 6 years. Compared to the younger children, the older children needed a longer adjustment period to gain bilateral benefit. However, they obtained similar results after 2 years of bilateral implant use.

Functional outcome of sequential bilateral cochlear implantation in young children: 36 months postoperative results

OBJECTIVE

To examine the effects of sequential bilateral cochlear implantation (CI) on the life of young children after 36 months of bilateral implant use.

METHOD

Thirty-five children were assessed prior to and 3 until 36 months after activation of the second CI. Main outcome measures were: the Categories of Auditory Performance (CAP), Speech Intelligibility Rating (SIR), communication mode, classroom placement, parent reports and the Würzburg questionnaire. Results were analysed separately for children younger and older than 6 years at the time of the second implantation.

RESULTS

At the 3-year test interval, 80% of the younger children attended mainstream schools and were comprehensible for all listeners. They all used oral communication and almost 70% of them could have a conversation over the telephone. After 3 years of bilateral implant use less than 50% of the older children obtained the highest score on the SIR and CAP. Approximately 70% of them was integrated in mainstream schools and used oral communication. All parents reported a more natural communication and an improved quality of life.

CONCLUSIONS

Sequential bilateral implantation seems to offer a wide range of participation benefits to all children and facilitates the social intercourse with their hearing environment.

A genome-wide analysis identifies genetic variants in the RELN gene associated with otosclerosis

Otosclerosis is a common form of progressive hearing loss, characterized by abnormal bone remodeling in the otic capsule. The etiology of the disease is largely unknown, and both environmental and genetic factors have been implicated. To identify genetic factors involved in otosclerosis, we used a case-control discovery group to complete a genome-wide association (GWA) study with 555,000 single-nucleotide polymorphisms (SNPs), utilizing pooled DNA samples. By individual genotyping of the top 250 SNPs in a stepwise strategy, we were able to identify two highly associated SNPs that replicated in two additional independent populations. We then genotyped 79 tagSNPs to fine map the two genomic regions defined by the associated SNPs. The region with the strongest association signal, p(combined) = 6.23 x 10(-10), is on chromosome 7q22.1 and spans intron 1 to intron 4 of reelin (RELN), a gene known for its role in neuronal migration. Evidence for allelic heterogeneity was found in this region. Consistent with the GWA data, expression of RELN was confirmed in the inner ear and in stapes footplate specimens. In conclusion, we provide evidence that implicates RELN in the pathogenesis of otosclerosis.