Evaluation of temporal and suprasegmental auditory processing in patients with unilateral hearing loss

The Influence of Asymmetric Hearing Loss on Peripheral and Central Auditory Processing Abilities in Patients With Vestibular Schwannoma

OBJECTIVES

Asymmetric or unilateral hearing loss (AHL) may cause irreversible changes in the processing of acoustic signals in the auditory system. We aim to provide a comprehensive view of the auditory processing abilities for subjects with acquired AHL, and to examine the influence of AHL on speech perception under difficult conditions, and on auditory temporal and intensity processing.

DESIGN

We examined peripheral and central auditory functions for 25 subjects with AHL resulting from vestibular schwannoma, and compared them to those from 24 normal-hearing controls that were matched with the AHL subjects in mean age and hearing thresholds in the healthy ear. Besides the basic hearing threshold assessment, the tests comprised the detection of tones and gaps in a continuous noise, comprehension of speech in babble noise, binaural interactions, difference limen of intensity, and detection of frequency modulation. For the AHL subjects, the selected tests were performed separately for the healthy and diseased ear.

RESULTS

We observed that binaural speech comprehension, gap detection, and frequency modulation detection abilities were dominated by the healthy ear and were comparable for both groups. The AHL subjects were less sensitive to interaural delays, however, they exhibited a higher sensitivity to sound level, as indicated by lower difference limen of intensity and a higher sensitivity to interaural intensity difference. Correlations between the individual test scores indicated that speech comprehension by the AHL subjects was associated with different auditory processing mechanisms than for the control subjects.

CONCLUSIONS

The data suggest that AHL influences both peripheral and central auditory processing abilities and that speech comprehension under difficult conditions relies on different mechanisms for the AHL subjects than for normal-hearing controls.

Perception of Prosody in Hearing-Impaired Individuals and Users of Hearing Assistive Devices: An Overview of Recent Advances

PURPOSE

Prosody perception is an essential component of speech communication and social interaction through which both linguistic and emotional information are conveyed. Considering the importance of the auditory system in processing prosody-related acoustic features, the aim of this review article is to review the effects of hearing impairment on prosody perception in children and adults. It also assesses the performance of hearing assistive devices in restoring prosodic perception.

METHOD

Following a comprehensive online database search, two lines of inquiry were targeted. The first summarizes recent attempts toward determining the effects of hearing loss and interacting factors such as age and cognitive resources on prosody perception. The second analyzes studies reporting beneficial or detrimental impacts of hearing aids, cochlear implants, and bimodal stimulation on prosodic abilities in people with hearing loss.

RESULTS

The reviewed studies indicate that hearing-impaired individuals vary widely in perceiving affective and linguistic prosody, depending on factors such as hearing loss severity, chronological age, and cognitive status. In addition, most of the emerging information points to limitations of hearing assistive devices in processing and transmitting the acoustic features of prosody.

CONCLUSIONS

The existing literature is incomplete in several respects, including the lack of a consensus on how and to what extent hearing prostheses affect prosody perception, especially the linguistic function of prosody, and a gap in assessing prosody under challenging listening situations such as noise. This review article proposes directions that future research could follow to provide a better understanding of prosody processing in those with hearing impairment, which may help health care professionals and designers of assistive technology to develop innovative diagnostic and rehabilitation tools.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.21809772.

Unilateral auditory deprivation in humans: Effects on frequency discrimination and auditory memory span in the normal ear

Hearing with one ear is associated with auditory deprivation leading to cortical neuronal reorganization. Despite evidence for substantial effects of unilateral input on cortical and sub-cortical structures, the functional consequences of such alterations on human hearing is underexplored. Unilateral hearing impairment offers a unique model to study the perceptual consequences of cortical reorganization. The present study provides evidence for larger (poorer) difference limens for frequency for sounds heard by the normal ear of listeners with unilateral hearing loss relative to bilaterally normal-hearing controls. This difference in frequency discrimination ability was observed for the low (250 Hz), but not for the high-frequency tone (4000 Hz). Besides auditory perceptual effects, we also found reduced working memory capacity as revealed by forward and backward digit span measures. Contrary to the expectation, there was no significant association between frequency discrimination and working memory capacity in listeners with unilateral hearing loss. Auditory deprivation associated with unilateral hearing impairment affects low-frequency (pitch) discrimination and working memory capacity despite normal hearing in the intact ear. Such deficits in basic auditory processes and memory span for sounds heard by the normal ear may contribute to the hearing and communication difficulties experienced by listeners with unilateral or single-sided deafness.