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Öz O, D'Alessandro HD, Batuk MÖ, Sennaroğlu G, Govaerts PJ. Assessment of Binaural Benefits in Hearing and Hearing-Impaired Listeners. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2023; 66:3633-3648. [PMID: 37494143 DOI: 10.1044/2023_jslhr-23-00077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/28/2023]
Abstract
PURPOSE The purpose of this study was to (a) investigate which speech material is most appropriate as stimulus in head shadow effect (HSE) and binaural squelch (SQ) tests, (b) obtain normative values of both tests using the material decided to be optimal, and (c) explore the results in bilateral cochlear implant (CI) users. METHOD Study participants consisted of 30 normal-hearing (NH) persons and 34 bilateral CI users. This study consisted of three phases. In the first phase, three different speech materials (1) monosyllabic words, (2) spondee words, and (3) sentences were compared in terms of (a) effect size, (b) test-retest reliability, and (c) interindividual variability. In the second phase, the speech material selected in the first phase was used to test a further 24 NHs to obtain normative values for both tests. In the third phase, tests were administered to a further 23 bilateral CI users, together with localization test and the Speech, Spatial, and Qualities of Hearing scale. RESULTS The results of the first phase indicated that spondees and sentences were more robust materials compared with monosyllables. Although the effect size and interindividual variability were comparable for spondees and sentences, sentences had higher test-retest reliability in this sample of CI users. With sentences, the mean (± standard deviation) HSE and SQ in the NH group were 58 ± 14% and 22 ± 11%, respectively. In the CI group, the mean HSE and SQ were 49 ± 13% and 13 ± 14%, respectively. There were no statistically significant correlations between the test results and the interval between the implantations, the length of binaural listening experience, or the asymmetry between the ears. CONCLUSIONS Sentences are preferred as stimulus material in the binaural HSE and SQ tests. Normative data are given for HSE and SQ with the LiCoS (linguistically controlled sentences) test. HSE is present for all bilateral CI users, whereas SQ is present in approximately seven out of 10 cases.
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Affiliation(s)
- Okan Öz
- The Eargroup, Antwerp, Belgium
- Department of Audiology, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey
| | | | - Merve Özbal Batuk
- Department of Audiology, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey
| | - Gonca Sennaroğlu
- Department of Audiology, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey
| | - Paul J Govaerts
- The Eargroup, Antwerp, Belgium
- Faculty of Medicine and Health Sciences, Translational Neurosciences, Otorhinolaryngology & Head and Neck Surgery, University of Antwerp, Belgium
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Takeyama T, Shimada A, Sakamoto Y, Aoki T, Kondo E, Nakano S, Fukuda J, Azuma T, Sato G, Okamoto H, Kitamura Y, Udaka J, Takeda N. Development of receptive vocabulary and verbal intelligence in Japanese children with unilateral hearing loss. Auris Nasus Larynx 2021; 49:335-341. [PMID: 34511300 DOI: 10.1016/j.anl.2021.08.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Revised: 07/31/2021] [Accepted: 08/11/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE In the past, it was believed that unilateral hearing loss has a minimal impact on the speech and language development in children. However, several studies have suggested that some school-age children with unilateral hearing loss have learning impairments in language. In the present study, we first examined whether preschool-age children with unilateral severe-to-profound hearing loss (UHL) have delays in the development of receptive vocabulary and verbal intelligence. In the follow-up study, we tested the children again after school admission. The objective of the present study was to reveal the development of receptive vocabulary and verbal intelligence from preschool to school years in children with UHL. METHODS Fifteen Japanese preschool-age children with UHL and a control group of 20 age-matched Japanese children with bilateral normal hearing (NH), who were examined because articulation disorder was suspected, were enrolled in this study. The development of receptive vocabulary and verbal intelligence was evaluated using the Picture Vocabulary Test-Revised (PVT-R) and the Wechsler Intelligence Scale, respectively. The present retrospective study was approved by the Committee for Medical Ethics of Tokushima University Hospital (#3801). RESULTS The scaled score (SS) of the PVT-R and verbal intelligence quotient (VIQ)/verbal comprehension index (VCI), but not performance intelligence quotient/perceptual reasoning index in children with UHL were significantly lower than those in the control children with NH at preschool-age. The SS of the PVT-R and VIQ/VCI in children with UHL significantly improved after school admission. In the subgroup analysis, the SS of the PVT-R in the lower receptive vocabulary group of children with UHL at preschool-age was significantly increased after school admission, but the SS in the normal and higher receptive vocabulary group of children with UHL at preschool-age were still around the standardized mean of SS after school admission. CONCLUSION These findings suggest that the development of receptive vocabulary and verbal intelligence was delayed in preschool-age children with UHL and that most of them caught up to exhibit normal language ability after school admission.
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Affiliation(s)
- Takaaki Takeyama
- Department of Otolaryngology, Tokushima University Graduate School of Biomedical Sciences, 3-18-15 Kuramoto, Tokushima 770-8503, Japan; Udaka ENT Clinic, Tokushima, Japan
| | - Aki Shimada
- Department of Otolaryngology, Tokushima University Graduate School of Biomedical Sciences, 3-18-15 Kuramoto, Tokushima 770-8503, Japan
| | - Yuki Sakamoto
- Department of Otolaryngology, Tokushima University Graduate School of Biomedical Sciences, 3-18-15 Kuramoto, Tokushima 770-8503, Japan
| | - Toshihito Aoki
- Department of Otolaryngology, Tokushima University Graduate School of Biomedical Sciences, 3-18-15 Kuramoto, Tokushima 770-8503, Japan; Udaka ENT Clinic, Tokushima, Japan
| | - Eiji Kondo
- Department of Otolaryngology, Tokushima University Graduate School of Biomedical Sciences, 3-18-15 Kuramoto, Tokushima 770-8503, Japan
| | - Seiichi Nakano
- Department of Otolaryngology, Tokushima University Graduate School of Biomedical Sciences, 3-18-15 Kuramoto, Tokushima 770-8503, Japan
| | - Junya Fukuda
- Department of Otolaryngology, Tokushima University Graduate School of Biomedical Sciences, 3-18-15 Kuramoto, Tokushima 770-8503, Japan
| | - Takahiro Azuma
- Department of Otolaryngology, Tokushima University Graduate School of Biomedical Sciences, 3-18-15 Kuramoto, Tokushima 770-8503, Japan
| | - Go Sato
- Department of Otolaryngology, Tokushima University Graduate School of Biomedical Sciences, 3-18-15 Kuramoto, Tokushima 770-8503, Japan
| | - Hidehiko Okamoto
- Department of Physiology, International University of Health and Welfare School of Medicine, Narita, Japan
| | - Yoshiaki Kitamura
- Department of Otolaryngology, Tokushima University Graduate School of Biomedical Sciences, 3-18-15 Kuramoto, Tokushima 770-8503, Japan
| | - Jiro Udaka
- Department of Otolaryngology, Tokushima University Graduate School of Biomedical Sciences, 3-18-15 Kuramoto, Tokushima 770-8503, Japan; Udaka ENT Clinic, Tokushima, Japan
| | - Noriaki Takeda
- Department of Otolaryngology, Tokushima University Graduate School of Biomedical Sciences, 3-18-15 Kuramoto, Tokushima 770-8503, Japan.
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Lopez-Poveda EA, Eustaquio-Martín A, Fumero MJ, Gorospe JM, Polo López R, Gutiérrez Revilla MA, Schatzer R, Nopp P, Stohl JS. Speech-in-Noise Recognition With More Realistic Implementations of a Binaural Cochlear-Implant Sound Coding Strategy Inspired by the Medial Olivocochlear Reflex. Ear Hear 2021; 41:1492-1510. [PMID: 33136626 PMCID: PMC7722463 DOI: 10.1097/aud.0000000000000880] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Accepted: 03/24/2020] [Indexed: 12/15/2022]
Abstract
OBJECTIVES Cochlear implant (CI) users continue to struggle understanding speech in noisy environments with current clinical devices. We have previously shown that this outcome can be improved by using binaural sound processors inspired by the medial olivocochlear (MOC) reflex, which involve dynamic (contralaterally controlled) rather than fixed compressive acoustic-to-electric maps. The present study aimed at investigating the potential additional benefits of using more realistic implementations of MOC processing. DESIGN Eight users of bilateral CIs and two users of unilateral CIs participated in the study. Speech reception thresholds (SRTs) for sentences in competition with steady state noise were measured in unilateral and bilateral listening modes. Stimuli were processed through two independently functioning sound processors (one per ear) with fixed compression, the current clinical standard (STD); the originally proposed MOC strategy with fast contralateral control of compression (MOC1); a MOC strategy with slower control of compression (MOC2); and a slower MOC strategy with comparatively greater contralateral inhibition in the lower-frequency than in the higher-frequency channels (MOC3). Performance with the four strategies was compared for multiple simulated spatial configurations of the speech and noise sources. Based on a previously published technical evaluation of these strategies, we hypothesized that SRTs would be overall better (lower) with the MOC3 strategy than with any of the other tested strategies. In addition, we hypothesized that the MOC3 strategy would be advantageous over the STD strategy in listening conditions and spatial configurations where the MOC1 strategy was not. RESULTS In unilateral listening and when the implant ear had the worse acoustic signal-to-noise ratio, the mean SRT was 4 dB worse for the MOC1 than for the STD strategy (as expected), but it became equal or better for the MOC2 or MOC3 strategies than for the STD strategy. In bilateral listening, mean SRTs were 1.6 dB better for the MOC3 strategy than for the STD strategy across all spatial configurations tested, including a condition with speech and noise sources colocated at front where the MOC1 strategy was slightly disadvantageous relative to the STD strategy. All strategies produced significantly better SRTs for spatially separated than for colocated speech and noise sources. A statistically significant binaural advantage (i.e., better mean SRTs across spatial configurations and participants in bilateral than in unilateral listening) was found for the MOC2 and MOC3 strategies but not for the STD or MOC1 strategies. CONCLUSIONS Overall, performance was best with the MOC3 strategy, which maintained the benefits of the originally proposed MOC1 strategy over the STD strategy for spatially separated speech and noise sources and extended those benefits to additional spatial configurations. In addition, the MOC3 strategy provided a significant binaural advantage, which did not occur with the STD or the original MOC1 strategies.
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Affiliation(s)
- Enrique A. Lopez-Poveda
- Laboratorio de Audición Computacional y Psicoacústica, Instituto de Neurociencias de Castilla y León, Universidad de Salamanca, Salamanca, Spain
- Grupo de Audiología, Instituto de Investigación Biomédica de Salamanca, Universidad de Salamanca, Salamanca, Spain
- Departamento de Cirugía, Facultad de Medicina, Universidad de Salamanca, Salamanca, Spain
| | - Almudena Eustaquio-Martín
- Laboratorio de Audición Computacional y Psicoacústica, Instituto de Neurociencias de Castilla y León, Universidad de Salamanca, Salamanca, Spain
- Grupo de Audiología, Instituto de Investigación Biomédica de Salamanca, Universidad de Salamanca, Salamanca, Spain
| | - Milagros J. Fumero
- Laboratorio de Audición Computacional y Psicoacústica, Instituto de Neurociencias de Castilla y León, Universidad de Salamanca, Salamanca, Spain
- Grupo de Audiología, Instituto de Investigación Biomédica de Salamanca, Universidad de Salamanca, Salamanca, Spain
| | - José M. Gorospe
- Laboratorio de Audición Computacional y Psicoacústica, Instituto de Neurociencias de Castilla y León, Universidad de Salamanca, Salamanca, Spain
- Grupo de Audiología, Instituto de Investigación Biomédica de Salamanca, Universidad de Salamanca, Salamanca, Spain
- Departamento de Cirugía, Facultad de Medicina, Universidad de Salamanca, Salamanca, Spain
- Unidad de Foniatría, Logopedia y Audiología, Servicio de Otorrinolaringología, Hospital Universitario de Salamanca, Salamanca, Spain
| | - Rubén Polo López
- Servicio de Otorrinolaringología, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | | | | | | | - Joshua S. Stohl
- North American Research Laboratory, MED-EL Corporation, Durham, North Carolina, USA
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Sakamoto Y, Shimada A, Nakano S, Kondo E, Takeyama T, Fukuda J, Udaka J, Okamoto H, Takeda N. Effects of FM system fitted into the normal hearing ear orcartilage conduction hearing aid fitted into the affected ear on speech-in-noise recognition in Japanese children with unilateral congenital aural atresia. THE JOURNAL OF MEDICAL INVESTIGATION 2021; 67:131-138. [PMID: 32378596 DOI: 10.2152/jmi.67.131] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
The effects of FM system fitted into the normal hearing ear (NHE) or a cartilage conduction hearing aid (CCHA) fitted into the affected ear (AE) on the speech recognition ability in noise were examined in children with unilateral congenital aural atresia (UCAA). In children with bilateral normal hearing (BNH), speech recognition score (SRS) was significantly decreased in the noisy environment of -5 dB signal-to-noise ratio (SNR), compared with those in quiet. In children with UCAA, SRS was significantly decreased in noisy environments of 0 and -5 dB SNR, compared with those in quiet. In noisy environments of 0 and -5 dB SNR, SRS in children with UCAA was significantly decreased, compared those in children with BNH. In the noisy environment of -5 dB SNR, SRS in UCAA children aided by FM system fitted into NHE was significantly better than those in unaided children in the same group. In the noisy environment of 0 dB SNR, SRS in UCAA children aided by CCHA into AE tended to be higher than those in unaided children in the same group. FM system and CCHA can be recommended as an audiological management for the improvement of speech recognition in children with UCHL in classrooms. J. Med. Invest. 67 : 134-138, February, 2020.
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Affiliation(s)
- Yuki Sakamoto
- Department of Otolaryngology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Aki Shimada
- Department of Otolaryngology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Seiichi Nakano
- Department of Otolaryngology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Eiji Kondo
- Department of Otolaryngology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Takaaki Takeyama
- Department of Otolaryngology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan.,Udaka ENT Clinic, Tokushima, Japan
| | | | - Jiro Udaka
- Department of Otolaryngology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan.,Udaka ENT Clinic, Tokushima, Japan
| | - Hidehiko Okamoto
- Department of Physiology, International University of Health and Welfare School of Medicine, Narita, Japan
| | - Noriaki Takeda
- Department of Otolaryngology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
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Baguant A, Schmerber S, Baguant K, Quatre R. Binaural squelch effect in unilateral otosclerosis surgery: comparison of speech intelligibility in noise before-after surgery. Eur Arch Otorhinolaryngol 2021; 279:1301-1310. [PMID: 33846850 DOI: 10.1007/s00405-021-06797-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Accepted: 03/31/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE We aimed to evaluate the speech intelligibility benefit in noise provided by stapedotomy in the treatment of unilateral otosclerosis. METHODS We enrolled adults suffering from unilateral conductive hearing loss and followed them up until 9 months after surgery. The patients underwent a free field speech hearing evaluation using the French Matrix test before and after stapedotomy. Speech material was sent to the front of the patients (S0) and noise was presented either at the front (N0), or at the operated ear (N-90) or at the non-operated ear (N + 90). The speech intelligibility benefit in noise was assessed by comparing Squelch effect (SE), Head shadow effect (HS) and Binaural redundancy (BR) before and after surgery. SE was measured as the difference in speech reception thresholds (SRT) between S0N + 90 situations before and after surgery, HS as the difference in SRT between S0N + 90 and S0N-90 situations, and BR as the difference in SRT between S0N0 situations before and after surgery. In addition, two quality of life's questionnaires were completed by patients to evaluate their discomfort. RESULTS Among 25 patients, 19 were followed up during 9 months, 4 were excluded and 2 were lost for the following-up. Stapedotomy provided a restoration of SE of 3.7 dB SNR (p < 0.001) and a BR gain of 1.8 dB SNR (p < 0.001). HS did not show any statistical variation after surgery (p = 0.077). Finally, the questionnaires showed a residual hearing discomfort. CONCLUSION Stapedotomy provided a binaural benefit with the restoration of the SE and BR but which remained lower than in the normal-hearing population. TRIAL REGISTRATION The 07/02/2018 on Clinical.Trial.Gouv: NCT03587792.
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Affiliation(s)
- Ashley Baguant
- Department of Otolaryngology-Head and Neck Surgery, Grenoble Alpes University Hospital, 38000, Grenoble, France. .,Department of Otolaryngology-Head and Neck Surgery, Grenoble Alpes University Hospital, 38700, La Tronche, France.
| | - Sebastien Schmerber
- Department of Otolaryngology-Head and Neck Surgery, Grenoble Alpes University Hospital, 38000, Grenoble, France.,Brain Tech Lab Inserm, UMR 1205, 38000, Grenoble, France
| | | | - Raphaële Quatre
- Department of Otolaryngology-Head and Neck Surgery, Grenoble Alpes University Hospital, 38000, Grenoble, France
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Marrufo-Pérez MI, Araquistain-Serrat L, Eustaquio-Martín A, Lopez-Poveda EA. On the importance of interaural noise coherence and the medial olivocochlear reflex for binaural unmasking in free-field listening. Hear Res 2021; 405:108246. [PMID: 33872834 DOI: 10.1016/j.heares.2021.108246] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 03/25/2021] [Accepted: 03/31/2021] [Indexed: 11/15/2022]
Abstract
For speech in competition with a noise source in the free field, normal-hearing (NH) listeners recognize speech better when listening binaurally than when listening monaurally with the ear that has the better acoustic signal-to-noise ratio (SNR). This benefit from listening binaurally is known as binaural unmasking and indicates that the brain combines information from the two ears to improve intelligibility. Here, we address three questions pertaining to binaural unmasking for NH listeners. First, we investigate if binaural unmasking results from combining the speech and/or the noise from the two ears. In a simulated acoustic free field with speech and noise sources at 0° and 270°azimuth, respectively, we found comparable unmasking regardless of whether the speech was present or absent in the ear with the worse SNR. This indicates that binaural unmasking probably involves combining only the noise at the two ears. Second, we investigate if having binaurally coherent location cues for the noise signal is sufficient for binaural unmasking to occur. We found no unmasking when location cues were coherent but noise signals were generated incoherent or were processed unilaterally through a hearing aid with linear, minimal amplification. This indicates that binaural unmasking requires interaurally coherent noise signals, source location cues, and processing. Third, we investigate if the hypothesized antimasking benefits of the medial olivocochlear reflex (MOCR) contribute to binaural unmasking. We found comparable unmasking regardless of whether speech tokens (words) were sufficiently delayed from the noise onset to fully activate the MOCR or not. Moreover, unmasking was absent when the noise was binaurally incoherent whereas the physiological antimasking effects of the MOCR are similar for coherent and incoherent noises. This indicates that the MOCR is unlikely involved in binaural unmasking.
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Affiliation(s)
- Miriam I Marrufo-Pérez
- Instituto de Neurociencias de Castilla y León, Universidad de Salamanca, Calle Pintor Fernando Gallego 1, Salamanca 37007, Spain; Instituto de Investigación Biomédica de Salamanca, Universidad de Salamanca, Salamanca 37007, Spain
| | - Leire Araquistain-Serrat
- Instituto de Neurociencias de Castilla y León, Universidad de Salamanca, Calle Pintor Fernando Gallego 1, Salamanca 37007, Spain
| | - Almudena Eustaquio-Martín
- Instituto de Neurociencias de Castilla y León, Universidad de Salamanca, Calle Pintor Fernando Gallego 1, Salamanca 37007, Spain; Instituto de Investigación Biomédica de Salamanca, Universidad de Salamanca, Salamanca 37007, Spain
| | - Enrique A Lopez-Poveda
- Instituto de Neurociencias de Castilla y León, Universidad de Salamanca, Calle Pintor Fernando Gallego 1, Salamanca 37007, Spain; Instituto de Investigación Biomédica de Salamanca, Universidad de Salamanca, Salamanca 37007, Spain; Departamento de Cirugía, Facultad de Medicina, Universidad de Salamanca, Salamanca 37007, Spain.
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Legris E, Galvin J, Roux S, Aoustin JM, Bakhos D. Development of cortical auditory responses to speech in noise in unilaterally deaf adults following cochlear implantation. PLoS One 2020; 15:e0239487. [PMID: 32976532 PMCID: PMC7518575 DOI: 10.1371/journal.pone.0239487] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 09/08/2020] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND For patients with single-sided deafness (SSD), restoration of binaural function via cochlear implant (CI) has been shown to improve speech understanding in noise. The objective of this study was to investigate changes in behavioral performance and cortical auditory responses following cochlear implantation. DESIGN Prospective longitudinal study. SETTING Tertiary referral center. METHODS Six adults with SSD were tested before and 12 months post-activation of the CI. Six normal hearing (NH) participants served as experimental controls. Speech understanding in noise was evaluated for various spatial conditions. Cortical auditory evoked potentials were recorded with /ba/ stimuli in quiet and in noise. Global field power and responses at Cz were analyzed. RESULTS Speech understanding in noise significantly improved with the CI when speech was presented to the CI ear and noise to the normal ear (p<0.05), but remained poorer than that of NH controls (p<0.05). N1 peak amplitude measure in noise significantly increased after CI activation (p<0.05), but remained lower than that of NH controls (p<0.05) at 12 months. After 12 months of CI experience, cortical responses in noise became more comparable between groups. CONCLUSION Binaural restoration in SSD patients via cochlear implantation improved speech performance noise and cortical responses. While behavioral performance and cortical auditory responses improved, SSD-CI outcomes remained poorer than that of NH controls in most cases, suggesting only partial restoration of binaural hearing.
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Affiliation(s)
- Elsa Legris
- UMR1253, iBrain, Université de Tours, INSERM, Tours, France
- Ear Nose and Throat Department, Tours, France
| | - John Galvin
- House Ear Institute, Los Angeles, CA, United States of America
| | - Sylvie Roux
- UMR1253, iBrain, Université de Tours, INSERM, Tours, France
| | | | - David Bakhos
- UMR1253, iBrain, Université de Tours, INSERM, Tours, France
- Ear Nose and Throat Department, Tours, France
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Kanzara T, Ford A, Fleming E, De S. Hearing Aid Uptake in Children with Unilateral Microtia and Canal Atresia: A Comparison between a Tertiary Center and Peripheral Centers. J Int Adv Otol 2020; 16:73-76. [PMID: 32401206 PMCID: PMC7224416 DOI: 10.5152/iao.2020.5509] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Revised: 11/08/2019] [Accepted: 02/26/2020] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES To review the trialing and uptake of hearing aids in children with unilateral microtia or canal atresia, known collectively as congenital unilateral conductive hearing loss (CUCHL), observed in a tertiary hospital and local peripheral services. MATERIALS AND METHODS A retrospective review of medical records for patients with CUCHL was conducted using data from a shared audiology database at a tertiary children's hospital. RESULTS We identified 45 patients with CUCHL and excluded seven of them due to missing data. Of the 38 patients, 16 (16/38, 42%) did not have any subjective hearing complaints. Furthermore, 32% (12/38) of patients attended audiology at a tertiary centre and 83% (10/12) from this group trialled a hearing aid. In comparison, 46% (12/46) whose audiology care was delivered peripherally trialled aiding. Of the patients from the tertiary center, 58% (7/12) are still using a hearing aid compared to 27% (7/26) of patients from peripheral centers. CONCLUSION Our analysis shows that patients with CUCHL are more likely to try hearing aids and continue using them if their audiology care is in a tertiary center. Allowing for a small sample size, this may indicate a health inequality. Agreeing on minimum standards for the management of patients with CUCHL or managing them in a designated center could increase consistency.
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Affiliation(s)
- Todd Kanzara
- Department of Otolaryngology, Arrowe Park Hospital, Birkenhead, United Kingdom
| | - Alasdair Ford
- Department of Otolaryngology, Alder Hey Children's Hospital, Liverpool, United Kingdom
| | - Elizabeth Fleming
- Department of Otolaryngology, Alder Hey Children's Hospital, Liverpool, United Kingdom
| | - Su De
- Department of Otolaryngology, Alder Hey Children's Hospital, Liverpool, United Kingdom
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Wedekind A, Rajan G, Van Dun B, Távora-Vieira D. Restoration of cortical symmetry and binaural function: Cortical auditory evoked responses in adult cochlear implant users with single sided deafness. PLoS One 2020; 15:e0227371. [PMID: 31935234 PMCID: PMC6959557 DOI: 10.1371/journal.pone.0227371] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Accepted: 12/17/2019] [Indexed: 11/23/2022] Open
Abstract
Background Cochlear implantation for single-sided deafness (SSD) is the only treatment option with the potential to restore binaural hearing cues. Significant binaural benefit has been measured in adults by speech in noise and localisation tests, who receive a cochlear implant for SSD, however, little is known on the cortical changes that help provide this benefit. In the present study, detection of sound in the auditory cortex, speech testing and localisation was used to investigate the ability of a cochlear implant (CI) to restore auditory cortical latencies and improve binaural benefit in the adult SSD population. Methods Twenty-nine adults with acquired single-sided deafness who received a CI in adulthood were studied. Speech perception in noise was tested using the Bamford-Kowal-Bench speech-in-noise test, localisation ability was measured using the auditory speech sounds evaluation (AδE) localisation test and cortical auditory evoked responses, comparing N1-P2 latencies recorded from the normal hearing ear and cochlear implant were used to investigate the synchrony of the cortical pathway from the CI and normal hearing ear (NHe) with binaural hearing function. Results There was a significant improvement in speech perception in noise in all spatial configurations S0/N0 (Z = -3.066, p<0.002), S0/NHE (Z = -4.031, p<0.001), SCI/NHE (Z = -3.851, p<0.001). Localization significantly improved when tested with the cochlear implant on (p<0.001) with a shorter duration of deafness correlating to a greater improvement in localisation ability F(1:18) = 6.854; p = 0.017). There was no significant difference in N1-P2 latency recorded from the normal hearing ear and the CI. Conclusion Cortical auditory evoked response latencies recorded from the CI and NHe showed no significant difference, indicating that the detection of sound in the auditory cortex occurred simultaneously, providing the cortex with auditory information for binaural hearing.
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Affiliation(s)
- Andre Wedekind
- Otolaryngology, Head and Neck Surgery, School of Surgery, University of Western Australia, Perth, Australia
- Fiona Stanley Hospital, Perth, Australia
- * E-mail:
| | - Gunesh Rajan
- Otolaryngology, Head and Neck Surgery, School of Surgery, University of Western Australia, Perth, Australia
- Department of Otolaryngology, Head & Neck Surgery, Luzerner Kantonsspital, Luzern, Switzerland
| | - Bram Van Dun
- The National Acoustic Laboratories, Sydney, Australia
| | - Dayse Távora-Vieira
- Otolaryngology, Head and Neck Surgery, School of Surgery, University of Western Australia, Perth, Australia
- Fiona Stanley Hospital, Perth, Australia
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Lotfi Y, Hasanalifard M, Moossavi A, Bakhshi E, Ajaloueyan M. Binaural hearing advantages for children with bimodal fitting. Int J Pediatr Otorhinolaryngol 2019; 121:58-63. [PMID: 30875620 DOI: 10.1016/j.ijporl.2019.02.043] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2018] [Revised: 02/24/2019] [Accepted: 02/25/2019] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Bimodal fitting (BF) allows children with cochlear implant to benefit from binaural hearing advantages. Three major binaural hearing advantages, which enhance hearing function of people with normal hearing, are head shadow effect (HSE), binaural squelch effect (BSQ) and binaural summation effect (BSU). This study in pediatric patients attempting to measure the auditory benefits of bimodal stimulation in children with long-standing use of a cochlear implant (CI), and residual hearing on the contralateral side. METHODS This cross-sectional study investigated binaural advantages in 24 children of 8-12 years who had undergone cochlear implantation in a cochlear implant center in Tehran and continuously used BF. Improved score of speech perception in noise (SPiN) under BF condition, as compared to the application of cochlear implant alone, was a binaural advantage found in this study. Each binaural advantage was measured by obtaining the SPiN score under different listening and noise conditions, using relevant formulas. The measured value of each advantage reflects the improved score of SPiN, caused by that certain advantage. RESULTS In this study, improved mean SPiN score caused by the HSE, BSQ and BSU was, respectively, 3.13, 1.42 and 2.04 dB, indicating greater binaural advantages and hence improved SPiN, under BF condition in comparison with cochlear implant alone. CONCLUSION Children with unilateral cochlear implant and measurable residual hearing in non-implanted ear can benefit from binaural advantages and better SPiN when hearing aid is used in the unaided ear.
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Affiliation(s)
- Younes Lotfi
- Department of Audiology, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Mahdieh Hasanalifard
- Department of Audiology, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
| | - Abdollah Moossavi
- Department of Otolaryngology and Head and Neck Surgery, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Enayatollah Bakhshi
- Department of Biostatistics, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Mohammad Ajaloueyan
- New Hearing Technologies Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
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Albalawi Y, Nidami M, Almohawas F, Hagr A, Garadat SN. Categories of Auditory Performance and Speech Intelligibility Ratings in Prelingually Deaf Children With Bilateral Implantation. Am J Audiol 2019; 28:62-68. [PMID: 30938557 DOI: 10.1044/2018_aja-17-0112] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Purpose The aim of the current study was to review all pediatric cases with congenital deafness who underwent bilateral implantation in our center. Specifically, auditory performance and speech intelligibility ratings were compared across children based on their mode of bilateral stimulation (simultaneous or sequential implantation). Method A retrospective chart review design was used in this study. A total of 46 congenitally deaf children were included. Children ranged in age between 2 and 8 years, with a mean of 3 years 7 months. Participants were divided into 2 groups: those who received their bilateral implant simultaneously and those who received them sequentially. Categories of Auditory Performance (CAP; Archbold, Lutman, & Marshall, 1995 ) scores and Speech Intelligibility Rating (SIR; M. C. Allen, Nikolopoulos, & O'Donoghue, 1998 ) scores were used to measure their performance. Results Children scored an average of 4.1 (±1.6) on the CAP Scale and 1.6 (±1) on the SIR Scale. Results showed that children who received their implants simultaneously scored relatively higher on the CAP Scale than those with sequential implants. However, there were no differences between the 2 groups in SIR scores. These 2 outcome measures were not correlated with age at implantation. Conclusion The current study demonstrated that simultaneous implantation could potentially improve audiologic outcome.
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Affiliation(s)
| | - Mohamad Nidami
- Department of Communication and Swallowing Disorder, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Fida Almohawas
- King Abdullah Ear Specialist Center, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Abdulrahman Hagr
- King Abdullah Ear Specialist Center, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Soha N. Garadat
- Medical Audiology Sciences Program, American University of Beirut, Lebanon
- Department of Hearing and Speech Sciences, The University of Jordan, Amman
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Liu YW, Tao DD, Jiang Y, GalvinIII JJ, Fu QJ, Yuan YS, Chen B. Effect of spatial separation and noise type on sentence recognition by Mandarin-speaking cochlear implant users. Acta Otolaryngol 2017; 137:829-836. [PMID: 28296522 DOI: 10.1080/00016489.2017.1292050] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVES To investigate the effects of spatial separation and noise type on sentence recognition by unilateral Mandarin-speaking cochlear implant (CI) users and normal-hearing (NH) listeners. METHOD Twenty-two unilateral Mandarin-speaking CI users and six NH listeners participated in this study. Speech reception thresholds were measured for three noise types (steady state noise, speech babble, and music). Sentences from the Mandarin Speech Perception test were presented directly in front of the listener (0°). Noise was presented from one of the five speaker locations: -90°, -45°, 0°, +45°, and +90°. RESULTS Overall, CI performance was significantly poorer than NH performance for all spatial separation and noise type conditions. NH listeners performed best with music and poorest with steady noise. CI users performed best with steady noise, and poorest with babble. Performance was significantly affected by noise location and noise type. There was no significant difference in head shadow effects among the different noise types for CI users. CONCLUSIONS Performance was much poorer in CI than in NH listeners for all noise types and spatial separations. Noise type differently affected unilateral CI users and NH listeners. The limited spectral resolution in CI users did not appear to affect head shadow.
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Affiliation(s)
- Yang-Wenyi Liu
- Department of Otology and Skull Base Surgery, Eye Ear Nose and Throat Hospital, Fudan University, Shanghai, China
- Key Laboratory of Hearing Medicine, Ministry of Health, Eye Ear Nose and Throat Hospital, Fudan University, Shanghai, China
| | - Duo-Duo Tao
- Department of Ear, Nose, and Throat, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Ye Jiang
- Department of Otology and Skull Base Surgery, Eye Ear Nose and Throat Hospital, Fudan University, Shanghai, China
- Key Laboratory of Hearing Medicine, Ministry of Health, Eye Ear Nose and Throat Hospital, Fudan University, Shanghai, China
| | - John J. GalvinIII
- Department of Head and Neck Surgery, David Geffen School of Medicine, UCLA, Los Angeles, CA, USA
| | - Qian-Jie Fu
- Department of Head and Neck Surgery, David Geffen School of Medicine, UCLA, Los Angeles, CA, USA
| | - Ya-sheng Yuan
- Department of Otology and Skull Base Surgery, Eye Ear Nose and Throat Hospital, Fudan University, Shanghai, China
- Key Laboratory of Hearing Medicine, Ministry of Health, Eye Ear Nose and Throat Hospital, Fudan University, Shanghai, China
| | - Bing Chen
- Department of Otology and Skull Base Surgery, Eye Ear Nose and Throat Hospital, Fudan University, Shanghai, China
- Key Laboratory of Hearing Medicine, Ministry of Health, Eye Ear Nose and Throat Hospital, Fudan University, Shanghai, China
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Abstract
OBJECTIVE The cockpit workplace of airline pilots is a noisy environment. This study examines the hearing thresholds of pilots with respect to ambient noise and communication sound. METHODS The hearing of 487 German pilots was analysed by audiometry in the frequency range of 125 Hz-16 kHz in varying age groups. Cockpit noise (free-field) data and communication sound (acoustic manikin) measurements were evaluated. RESULTS The ambient noise levels in cockpits were found to be between 74 and 80 dB(A), and the sound pressure levels under the headset were found to be between 84 and 88 dB(A).The left-right threshold differences at 3, 4 and 6 kHz show evidence of impaired hearing at the left ear, which worsens by age.In the age groups <40/≥40 years the mean differences at 3 kHz are 2/3 dB, at 4 kHz 2/4 dB and at 6 kHz 1/6 dB.In the pilot group which used mostly the left ear for communication tasks (43 of 45 are in the older age group) the mean difference at 3 kHz is 6 dB, at 4 kHz 7 dB and at 6 kHz 10 dB. The pilots who used the headset only at the right ear also show worse hearing at the left ear of 2 dB at 3 kHz, 3 dB at 4 kHz and at 6 kHz. The frequency-corrected exposure levels under the headset are 7-11 dB(A) higher than the ambient noise with an averaged signal-to-noise ratio for communication of about 10 dB(A). CONCLUSIONS The left ear seems to be more susceptible to hearing loss than the right ear. Active noise reduction systems allow for a reduced sound level for the communication signal below the upper exposure action value of 85 dB(A) and allow for a more relaxed working environment for pilots.
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Affiliation(s)
- Reinhard Müller
- IPAS Akustiklabor, Justus-Liebig-Universität Giessen, Giessen, Germany
| | - Joachim Schneider
- Institut und Poliklinik für Arbeits- und Sozialmedizin am Universitätsklinikum Giessen und Marburg, Giessen, Germany
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Távora-Vieira D, Marino R, Acharya A, Rajan GP. Cochlear implantation in adults with unilateral deafness: A review of the assessment/evaluation protocols. Cochlear Implants Int 2016; 17:184-189. [PMID: 27142479 DOI: 10.1080/14670100.2016.1176303] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
OBJECTIVES Cochlear implantation is becoming widely used outside the tertiary research centers for treatment of unilateral deafness (UD). No consensus exists, however, on the most suitable assessment/evaluation protocols for this group of adult patients. This paper aims to review the assessment and evaluation protocols used by various research groups and to propose a protocol for the use in the clinical setting. METHODS The PubMed, Embase, and Cochrane Library databases were searched with the keywords 'cochlear', 'implant', 'single-sided', 'deafness', 'adults', 'unilateral', and 'deafness'. The words were either used individually, combined in pairs, or in groups of 5. All articles reporting on prospective studies, retrospective studies, or case studies were included. RESULTS Sixteen published studies met the inclusion criteria. Measures of hearing performance, tinnitus, subjective quality of hearing, and quality of life varied greatly among studies. DISCUSSION Adaptive speech in noise testing, localization, tinnitus measurement questionnaires, and self-rated hearing improvement are widely used among the research groups. These tools in conjunction assess and evaluate the main issues associated with UD. CONCLUSION The test battery most commonly used to assess and evaluate adult cochlea implant users with UD consists of (a) a subjective self-rating of hearing performance, (b) localization testing, and
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Affiliation(s)
- Dayse Távora-Vieira
- a Otolaryngology, Head & Neck Surgery-School of Surgery , University of Western Australia , Perth, Australia, Fiona Stanley Hospital, Perth , Australia
| | - Roberta Marino
- a Otolaryngology, Head & Neck Surgery-School of Surgery , University of Western Australia , Perth, Australia, Fiona Stanley Hospital, Perth , Australia
| | - Aanand Acharya
- a Otolaryngology, Head & Neck Surgery-School of Surgery , University of Western Australia , Perth, Australia, Fiona Stanley Hospital, Perth , Australia
| | - Gunesh P Rajan
- a Otolaryngology, Head & Neck Surgery-School of Surgery , University of Western Australia , Perth, Australia, Fiona Stanley Hospital, Perth , Australia
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The impact of cochlear implantation on speech understanding, subjective hearing performance, and tinnitus perception in patients with unilateral severe to profound hearing loss. Otol Neurotol 2015; 36:430-6. [PMID: 25594387 DOI: 10.1097/mao.0000000000000707] [Citation(s) in RCA: 83] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES This study aimed to determine the impact of cochlear implantation on speech understanding in noise, subjective perception of hearing, and tinnitus perception of adult patients with unilateral severe to profound hearing loss and to investigate whether duration of deafness and age at implantation would influence the outcomes. In addition, this article describes the auditory training protocol used for unilaterally deaf patients. DESIGN This is a prospective study of subjects undergoing cochlear implantation for unilateral deafness with or without associated tinnitus. METHODS Speech perception in noise was tested using the Bamford-Kowal-Bench speech-in-noise test presented at 65 dB SPL. The Speech, Spatial, and Qualities of Hearing Scale and the Abbreviated Profile of Hearing Aid Benefit were used to evaluate the subjective perception of hearing with a cochlear implant and quality of life. Tinnitus disturbance was measured using the Tinnitus Reaction Questionnaire. Data were collected before cochlear implantation and 3, 6, 12, and 24 months after implantation. RESULTS Twenty-eight postlingual unilaterally deaf adults with or without tinnitus were implanted. There was a significant improvement in speech perception in noise across time in all spatial configurations. There was an overall significant improvement on the subjective perception of hearing and quality of life. Tinnitus disturbance reduced significantly across time. Age at implantation and duration of deafness did not influence the outcomes significantly. CONCLUSION Cochlear implantation provided significant improvement in speech understanding in challenging situations, subjective perception of hearing performance, and quality of life. Cochlear implantation also resulted in reduced tinnitus disturbance. Age at implantation and duration of deafness did not seem to influence the outcomes.
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Wanna GB, Gifford RH, McRackan TR, Rivas A, Haynes DS. Bilateral cochlear implantation. Otolaryngol Clin North Am 2012; 45:81-9. [PMID: 22115683 DOI: 10.1016/j.otc.2011.08.018] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
Cochlear implantation (CI) is the standard of care for the treatment of children and adults with bilateral severe-to-profound sensorineural hearing loss. Because the ultimate and continuous goal of CI teams is to improve patient performance, a potential method is bilateral CI. The potential benefits of bilateral CI include binaural summation, squelch, equivalent head shadow for each ear, improved hearing in noise, sound localization ability, and spatial release from masking. The potential disadvantages include additional or prolonged surgical procedure, unproven cost/benefit profile, and the elimination of the ability to use future technologies and/or medical therapies in the implanted ear.
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Affiliation(s)
- George B Wanna
- Department of Otolaryngology-Head and Neck Surgery, Division of Otology-Neurotology and Skull Base Surgery, Vanderbilt University Medical Center, 1215 21st Avenue South, 7209 Medical Center East, South Tower, Nashville, TN 37232, USA.
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Spatial Speech Perception Benefits in Young Children With Normal Hearing and Cochlear Implants. Ear Hear 2010; 31:702-13. [DOI: 10.1097/aud.0b013e3181e40dfe] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Köbler S, Lindblad AC, Olofsson Å, Hagerman B. Successful and unsuccessful users of bilateral amplification: Differences and similarities in binaural performance. Int J Audiol 2010; 49:613-27. [DOI: 10.3109/14992027.2010.481774] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Garadat SN, Litovsky RY, Yu G, Zeng FG. Effects of simulated spectral holes on speech intelligibility and spatial release from masking under binaural and monaural listening. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2010; 127:977-89. [PMID: 20136220 PMCID: PMC2830263 DOI: 10.1121/1.3273897] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2008] [Revised: 09/20/2009] [Accepted: 11/22/2009] [Indexed: 05/25/2023]
Abstract
The possibility that "dead regions" or "spectral holes" can account for some differences in performance between bilateral cochlear implant (CI) users and normal-hearing listeners was explored. Using a 20-band noise-excited vocoder to simulate CI processing, this study examined effects of spectral holes on speech reception thresholds (SRTs) and spatial release from masking (SRM) in difficult listening conditions. Prior to processing, stimuli were convolved through head-related transfer-functions to provide listeners with free-field directional cues. Processed stimuli were presented over headphones under binaural or monaural (right ear) conditions. Using Greenwood's [(1990). J. Acoust. Soc. Am. 87, 2592-2605] frequency-position function and assuming a cochlear length of 35 mm, spectral holes were created for variable sizes (6 and 10 mm) and locations (base, middle, and apex). Results show that middle-frequency spectral holes were the most disruptive to SRTs, whereas high-frequency spectral holes were the most disruptive to SRM. Spectral holes generally reduced binaural advantages in difficult listening conditions. These results suggest the importance of measuring dead regions in CI users. It is possible that customized programming for bilateral CI processors based on knowledge about dead regions can enhance performance in adverse listening situations.
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Affiliation(s)
- Soha N Garadat
- Waisman Center, University of Wisconsin, 1500 Highland Avenue, Madison, Wisconsin 53705, USA
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Garadat SN, Litovsky RY, Yu G, Zeng FG. Role of binaural hearing in speech intelligibility and spatial release from masking using vocoded speech. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2009; 126:2522-35. [PMID: 19894832 PMCID: PMC2787072 DOI: 10.1121/1.3238242] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
A cochlear implant vocoder was used to evaluate relative contributions of spectral and binaural temporal fine-structure cues to speech intelligibility. In Study I, stimuli were vocoded, and then convolved through head related transfer functions (HRTFs) to remove speech temporal fine structure but preserve the binaural temporal fine-structure cues. In Study II, the order of processing was reversed to remove both speech and binaural temporal fine-structure cues. Speech reception thresholds (SRTs) were measured adaptively in quiet, and with interfering speech, for unprocessed and vocoded speech (16, 8, and 4 frequency bands), under binaural or monaural (right-ear) conditions. Under binaural conditions, as the number of bands decreased, SRTs increased. With decreasing number of frequency bands, greater benefit from spatial separation of target and interferer was observed, especially in the 8-band condition. The present results demonstrate a strong role of the binaural cues in spectrally degraded speech, when the target and interfering speech are more likely to be confused. The nearly normal binaural benefits under present simulation conditions and the lack of order of processing effect further suggest that preservation of binaural cues is likely to improve performance in bilaterally implanted recipients.
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Affiliation(s)
- Soha N Garadat
- Waisman Center, University of Wisconsin, Madison, WI 53705, USA
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Poon BB, Eddington DK, Noel V, Colburn HS. Sensitivity to interaural time difference with bilateral cochlear implants: Development over time and effect of interaural electrode spacing. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2009; 126:806-15. [PMID: 19640045 PMCID: PMC2730718 DOI: 10.1121/1.3158821] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Sensitivity to interaural time difference (ITD) in constant-amplitude pulse trains was measured in four sequentially implanted bilateral cochlear implant (CI) subjects. The sensitivity measurements were made as a function of time beginning directly after the second ear was implanted, continued for periods of months before subjects began wearing bilateral sound processors, and extended for months while the subjects used bilateral sound processors in day-to-day listening. Measurements were also made as a function of the relative position of the left/right electrodes. The two subjects with the shortest duration of binaural deprivation before implantation demonstrated ITD sensitivity soon after second-ear implantation (before receiving the second sound processor), while the other two did not demonstrate sensitivity until after months of daily experience using bilateral processors. The interaural mismatch in electrode position required to decrease ITD sensitivity by a factor of 2 (half-width) for CI subjects was five times greater than the half-width for interaural carrier-frequency disparity in normal-hearing subjects listening to sinusoidally amplitude-modulated high-frequency tones. This large half-width is likely to contribute to poor binaural performance in CI users, especially in environments with multiple broadband sound sources.
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Affiliation(s)
- Becky B Poon
- Cochlear Implant Research Laboratory, Massachusetts Eye and Ear Infirmary, Boston, MA 02114, USA
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Richards VM, Moore BCJ, Launer S. Potential benefits of across-aid communication for bilaterally aided people: Listening in a car. Int J Audiol 2009; 45:182-9. [PMID: 16579493 DOI: 10.1080/14992020500250054] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
We explored whether transferring signals between two hearing aids could improve speech intelligibility in noise. This was evaluated using a simulated conversation in a car; speech was presented to the right ear and car noise was presented either to the right or both ears. In three cross-aid communication conditions, the noise in the right ear was scaled and subtracted from the noise in the left ear. Speech intelligibility was determined for a group of normally hearing listeners and a group with bilateral hearing loss. The hearing-impaired group had relatively higher intelligibility scores when the car noise was diotic, whereas the normal-hearing group had relatively higher intelligibility scores in the binaural (dichotic) conditions. The cross-aid conditions led to improved intelligibility compared to the reference conditions. The results indicate that the transfer of signals between hearing aids may be of benefit when listening to speech in a car.
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Affiliation(s)
- Virginia M Richards
- Department of Experimental Psychology, University of Cambridge, Cambridge, UK
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Stenfelt S. Bilateral fitting of BAHAs and BAHA® fitted in unilateral deaf persons: Acoustical aspects Adaptación bilateral de BAHA y adaptación de BAHA en sorderas unilaterales: Aspectos acústicos. Int J Audiol 2009; 44:178-89. [PMID: 15916119 DOI: 10.1080/14992020500031561] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The benefit of a bone-anchored hearing aid (BAHA) to a patient fitted bilaterally; and the benefit of a BAHA to a unilaterally deaf person was estimated by four acoustical measurements: directional sensitivity of a BAHA placed at the skull, vibration transmission in the skull, gain, and estimated transcranial attenuation of bone conducted sound. Provided a patient has a similar bone conduction hearing ability at both cochlea, it was found that a patient should, theoretically, benefit from bilateral fitting of BAHAs in terms of better hearing thresholds from the front, and better overall hearing ability from the surround. The data indicates further, that bilateral fitting facilitates extraction of interaural cues, which should lead to greater ability to determine the direction of a sound source, as well as better hearing in noise. However, due to the cross-hearing of bone conducted sound, the binaural processing for the patient fitted bilaterally with BAHAs is less than for normal binaural air conduction hearing. Finally, the data showed that the benefit of fitting a BAHA in a unilaterally deaf person, depends on that person's transcranial attenuation.
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Affiliation(s)
- Stefan Stenfelt
- Department of Signals and Systems, Chalmers University of Technology, Göteborg, Sweden.
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Hochmair I, Nopp P, Jolly C, Schmidt M, Schösser H, Garnham C, Anderson I. MED-EL Cochlear implants: state of the art and a glimpse into the future. Trends Amplif 2006; 10:201-19. [PMID: 17172548 PMCID: PMC4111377 DOI: 10.1177/1084713806296720] [Citation(s) in RCA: 99] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Cochlear implantation is an accepted treatment method for adults and children with severe to profound hearing loss. Confidence in technology has led to changes in individuals who can receive a cochlear implant and changes in expected benefit with a cochlear implant. This article describes the research and development activities at MED-EL, which make possible the implementation of new speech-coding strategies as well as the application of acoustic and electric stimulation via a combined speech processor in MED-EL devices. Research on benefits from bilateral cochlear implantation and electric-acoustic stimulation are also reviewed. Finally, the potential of drug delivery systems is considered as a way to improve cochlear implant outcomes, and results from preliminary evaluations of a hybrid cochlear implant system with drug delivery capabilities are reported.
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Schleich P, Nopp P, D'Haese P. Head Shadow, Squelch, and Summation Effects in Bilateral Users of the MED-EL COMBI 40/40+ Cochlear Implant. Ear Hear 2004; 25:197-204. [PMID: 15179111 DOI: 10.1097/01.aud.0000130792.43315.97] [Citation(s) in RCA: 190] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The aim of the study was to investigate the impact of bilateral cochlear implant use on speech perception in noise in bilateral users of the MED-EL COMBI 40/40+ cochlear implants. DESIGN Speech reception thresholds were measured in 21 subjects using the Oldenburg sentence test. Speech was always presented from the front. Noise was either presented from the front, from the left side, or from the right side. Each condition was measured for unilateral and bilateral implant use. RESULTS For three subjects, the test was too difficult to be administered. The 18 subjects from whom a complete data set could be obtained showed a significant head shadow effect and summation effect for all test conditions, whereas the squelch effect was significant for noise from the left side only. Average effect sizes were significant for all effects and amounted to 6.8 dB for the head shadow effect, 0.9 dB for the squelch effect, and 2.1 dB for the summation effect. Effect sizes were not correlated with duration of deafness. CONCLUSIONS Bilateral cochlear implant users can at least qualitatively benefit from the effects that are known from normal-hearing subjects, that is, head shadow, summation, and squelch effect. Bilateral cochlear implantation also reduces the performance gap between cochlear implant users and normal-hearing subjects.
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Affiliation(s)
- P Schleich
- Research and Development, Medical Electronics, Innsbruck, Austria.
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Affiliation(s)
- T A Ricketts
- Dan Maddox Hearing Aid Research Laboratory, Vanderbilt Bill Wilkerson Center, Nashville, TN
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Ricketts T. The impact of head angle on monaural and binaural performance with directional and omnidirectional hearing aids. Ear Hear 2000; 21:318-28. [PMID: 10981608 DOI: 10.1097/00003446-200008000-00007] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To evaluate the impact of head turn and monaural and binaural fittings on the sentence reception thresholds of hearing-impaired listeners wearing directional and omnidirectional hearing aids. DESIGN Sentence reception thresholds were measured for 20 listeners fit monaurally and binaurally with behind-the-ear hearing aids set in both directional and omnidirectional modes. All listeners exhibited symmetrical, sloping, sensorineural hearing loss. The aided performance across these four fittings was evaluated for three different head and body angles. The three angles reflected body turns of 0 degrees, 15 degrees, and 30 degrees as measured relative to the primary sound source, with 0 degrees denoting the listener directly facing the sound source. Listeners were instructed to keep their heads in a fixed horizontal position and turn their heads and bodies to face visual targets at the three test angles. Sentences from the Hearing in Noise Test presented with a background of five, spatially separated, uncorrelated samples of cafeteria noise served as test material. All testing was performed in a moderately reverberant (Rt = 631 msec) "living room" environment. RESULTS Participants generally performed significantly better when fit with directional versus omnidirectional hearing aids, and when fit binaurally versus monaurally across test conditions. The measured "binaural advantage" was reduced with increasing head angle. Participants performed significantly better with a 30 degree head angle than when directly facing the primary speaker. This "head turn advantage" was most prominent for monaural (versus binaural) conditions. Binaural and head turn advantages were not significantly different across directional and omnidirectional modes. CONCLUSIONS These data provide additional support for the use of directional hearing aids and binaural amplification to improve speech intelligibility in noisy environments. The magnitude of these advantages was similar to that reported in previous investigations. The data also showed that hearing aid wearers achieved significantly better speech intelligibility in noise by turning their heads and bodies to a position in which they were not directly facing the sound source. This head turn advantage was in good agreement with the increase in Directivity Index with head turn and reflected the fact that hearing aids are generally most sensitive to sounds arriving from angles other than directly in front of the hearing aid wearer. Although these data suggest that many monaural hearing aid wearers may significantly improve speech intelligibility in noise through the use of head turn, the interaction between this advantage and the potential loss of visual cues with head turn is unknown.
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Affiliation(s)
- T Ricketts
- Department of Hearing and Speech Sciences, Vanderbilt Bill Wilkerson Center, Nashville, Tennessee 37212, USA
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