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Madhukesh S, Palaniswamy HP, Ganapathy K, Rajashekhar B, Nisha KV. The impact of tinnitus on speech perception in noise: a systematic review and meta-analysis. Eur Arch Otorhinolaryngol 2024:10.1007/s00405-024-08844-1. [PMID: 39060407 DOI: 10.1007/s00405-024-08844-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2024] [Accepted: 07/10/2024] [Indexed: 07/28/2024]
Abstract
PURPOSE Tinnitus is a condition that causes people to hear sounds without an external source. One significant issue arising from this condition is the difficulty in communicating, especially in the presence of noisy backgrounds. The process of understanding speech in challenging situations requires both cognitive and auditory abilities. Since tinnitus presents unique challenges, it is important to investigate how it affects speech perception in noise. METHOD In this review, 32 articles were investigated to determine the effect of tinnitus on the effect of speech in noise perception performance. Based on the meta-analysis performed using a random-effects model, meta-regression was used to explore the moderating effects of age and hearing acuity. RESULTS A total of 32 studies were reviewed, and the results of the meta-analysis revealed that tinnitus significantly impacts speech in terms of noise perception performance. Additionally, the regression analysis revealed that age and hearing acuity are not significant predictors of speech in noise perception. CONCLUSION Our findings suggest that tinnitus affects speech perception in noisy environments due to cognitive impairments and central auditory processing deficits. Hearing loss and aging also contribute to reduced speech in noise performance. Interventions and further research are necessary to address individual challenges associated with continuous subjective tinnitus.
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Affiliation(s)
- Sanjana Madhukesh
- Department of Speech and Hearing, Manipal College of Health Professions (MCHP), Manipal Academy of Higher Education (MAHE), Manipal, Karnataka, India
| | - Hari Prakash Palaniswamy
- Department of Speech and Hearing, Manipal College of Health Professions (MCHP), Manipal Academy of Higher Education (MAHE), Manipal, Karnataka, India.
| | - Kanaka Ganapathy
- Department of Speech and Hearing, Manipal College of Health Professions (MCHP), Manipal Academy of Higher Education (MAHE), Manipal, Karnataka, India
| | - Bellur Rajashekhar
- Department of Speech and Hearing, Manipal College of Health Professions (MCHP), Manipal Academy of Higher Education (MAHE), Manipal, Karnataka, India
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Wang H, Chen Y, Lv J, Cheng X, Cao Q, Wang D, Zhang L, Zhu B, Shen M, Xu C, Xun M, Wang Z, Tang H, Hu S, Cui C, Jiang L, Yin Y, Guo L, Zhou Y, Han L, Gao Z, Zhang J, Yu S, Gao K, Wang J, Chen B, Wang W, Chen ZY, Li H, Shu Y. Bilateral gene therapy in children with autosomal recessive deafness 9: single-arm trial results. Nat Med 2024; 30:1898-1904. [PMID: 38839897 PMCID: PMC11271389 DOI: 10.1038/s41591-024-03023-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 04/29/2024] [Indexed: 06/07/2024]
Abstract
Gene therapy is a promising approach for hereditary deafness. We recently showed that unilateral AAV1-hOTOF gene therapy with dual adeno-associated virus (AAV) serotype 1 carrying human OTOF transgene is safe and associated with functional improvements in patients with autosomal recessive deafness 9 (DFNB9). The protocol was subsequently amended and approved to allow bilateral gene therapy administration. Here we report an interim analysis of the single-arm trial investigating the safety and efficacy of binaural therapy in five pediatric patients with DFNB9. The primary endpoint was dose-limiting toxicity at 6 weeks, and the secondary endpoint included safety (adverse events) and efficacy (auditory function and speech perception). No dose-limiting toxicity or serious adverse event occurred. A total of 36 adverse events occurred. The most common adverse events were increased lymphocyte counts (6 out of 36) and increased cholesterol levels (6 out of 36). All patients had bilateral hearing restoration. The average auditory brainstem response threshold in the right (left) ear was >95 dB (>95 dB) in all patients at baseline, and the average auditory brainstem response threshold in the right (left) ear was restored to 58 dB (58 dB) in patient 1, 75 dB (85 dB) in patient 2, 55 dB (50 dB) in patient 3 at 26 weeks, and 75 dB (78 dB) in patient 4 and 63 dB (63 dB) in patient 5 at 13 weeks. The speech perception and the capability of sound source localization were restored in all five patients. These results provide preliminary insights on the safety and efficacy of binaural AAV gene therapy for hereditary deafness. The trial is ongoing with longer follow-up to confirm the safety and efficacy findings. Chinese Clinical Trial Registry registration: ChiCTR2200063181 .
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Affiliation(s)
- Hui Wang
- ENT Institute and Otorhinolaryngology Department of Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, China
| | - Yuxin Chen
- ENT Institute and Otorhinolaryngology Department of Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, China
| | - Jun Lv
- ENT Institute and Otorhinolaryngology Department of Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, China
- Institutes of Biomedical Sciences, Fudan University, Shanghai, China
- State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Fudan University, Shanghai, China
| | - Xiaoting Cheng
- ENT Institute and Otorhinolaryngology Department of Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, China
| | - Qi Cao
- ENT Institute and Otorhinolaryngology Department of Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, China
- Department of Otorhinolaryngology, the Second Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, Hunan, China
| | - Daqi Wang
- ENT Institute and Otorhinolaryngology Department of Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, China
| | - Longlong Zhang
- ENT Institute and Otorhinolaryngology Department of Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, China
| | - Biyun Zhu
- ENT Institute and Otorhinolaryngology Department of Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, China
| | - Min Shen
- Shanghai Rehabilitation Institute for the Exceptional Children, Shanghai, China
| | - Chunxin Xu
- Shanghai Rehabilitation Institute for the Exceptional Children, Shanghai, China
| | - Mengzhao Xun
- ENT Institute and Otorhinolaryngology Department of Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, China
| | - Zijing Wang
- ENT Institute and Otorhinolaryngology Department of Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, China
| | - Honghai Tang
- ENT Institute and Otorhinolaryngology Department of Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, China
| | - Shaowei Hu
- ENT Institute and Otorhinolaryngology Department of Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, China
| | - Chong Cui
- ENT Institute and Otorhinolaryngology Department of Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, China
- Institutes of Biomedical Sciences, Fudan University, Shanghai, China
- State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Fudan University, Shanghai, China
| | - Luoying Jiang
- ENT Institute and Otorhinolaryngology Department of Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, China
- Institutes of Biomedical Sciences, Fudan University, Shanghai, China
- State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Fudan University, Shanghai, China
| | - Yanbo Yin
- ENT Institute and Otorhinolaryngology Department of Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, China
| | - Luo Guo
- ENT Institute and Otorhinolaryngology Department of Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, China
| | - Yi Zhou
- ENT Institute and Otorhinolaryngology Department of Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, China
| | - Lei Han
- ENT Institute and Otorhinolaryngology Department of Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, China
- Institutes of Biomedical Sciences, Fudan University, Shanghai, China
- State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Fudan University, Shanghai, China
| | - Ziwen Gao
- ENT Institute and Otorhinolaryngology Department of Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, China
| | - Jiajia Zhang
- ENT Institute and Otorhinolaryngology Department of Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, China
- Institutes of Biomedical Sciences, Fudan University, Shanghai, China
- State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Fudan University, Shanghai, China
| | - Sha Yu
- ENT Institute and Otorhinolaryngology Department of Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, China
| | - Kaiyu Gao
- Shanghai Refreshgene Therapeutics Co. Ltd., Shanghai, China
| | - Jinghan Wang
- ENT Institute and Otorhinolaryngology Department of Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, China
| | - Bing Chen
- ENT Institute and Otorhinolaryngology Department of Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, China
| | - Wuqing Wang
- ENT Institute and Otorhinolaryngology Department of Eye & ENT Hospital, Fudan University, Shanghai, China.
- NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, China.
| | - Zheng-Yi Chen
- Department of Otolaryngology-Head and Neck Surgery, Graduate Program in Speech and Hearing Bioscience and Technology and Program in Neuroscience, Harvard Medical School, Boston, MA, USA.
- Eaton-Peabody Laboratory, Massachusetts Eye and Ear, Boston, MA, USA.
| | - Huawei Li
- ENT Institute and Otorhinolaryngology Department of Eye & ENT Hospital, Fudan University, Shanghai, China.
- NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, China.
- Institutes of Biomedical Sciences, Fudan University, Shanghai, China.
- State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Fudan University, Shanghai, China.
| | - Yilai Shu
- ENT Institute and Otorhinolaryngology Department of Eye & ENT Hospital, Fudan University, Shanghai, China.
- NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, China.
- Institutes of Biomedical Sciences, Fudan University, Shanghai, China.
- State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Fudan University, Shanghai, China.
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Thompson NJ, Lopez EM, Dillon MT, Rooth MA, Richter ME, Pillsbury HC, Brown KD. Cochlear Implantation for Unilateral and Asymmetric Hearing Loss: Long-Term Subjective Benefit. Laryngoscope 2023; 133:2792-2797. [PMID: 36757052 DOI: 10.1002/lary.30608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 12/10/2022] [Accepted: 01/25/2023] [Indexed: 02/10/2023]
Abstract
OBJECTIVES Assess the long-term patterns of perceived tinnitus severity and subjective benefit for adult cochlear implant (CI) users with asymmetric or unilateral hearing loss (AHL or UHL). METHODS Forty adults underwent cochlear implantation as part of a prospective clinical trial assessing the outcomes of CI use in cases of AHL (n = 20) and UHL (n = 20). Subjective measures included the Tinnitus Handicap Inventory (THI), the Speech, Spatial, & Qualities of Hearing Scale (SSQ), and the Abbreviated Profile of Hearing Aid Benefit (APHAB). Responses were obtained preoperatively and at routine intervals out to 5 years post-activation. RESULTS For subjective benefit, participants with AHL and UHL reported a significant improvement as compared to preoperative abilities, which was maintained with long-term CI use. For perceived tinnitus severity, participants with AHL and UHL reported a significant reduction with CI use as compared to preoperative perceptions. The perceived tinnitus severity significantly differed for the AHL and UHL cohorts over time. This pattern of results is likely influenced by the worse perceived severity levels for the UHL cohort preoperatively and the fluctuating perceived severity levels for some participants in the AHL cohort post-activation. CONCLUSION Adults with AHL and UHL report an early, significant reduction in perceived tinnitus severity and improvement in quality of life with CI use that is generally maintained with long-term device use. Questionnaires such as the THI, SSQ, and APHAB may contribute to a more holistic assessment of the benefits of cochlear implantation in this population. LEVEL OF EVIDENCE 2 Laryngoscope, 133:2792-2797, 2023.
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Affiliation(s)
- Nicholas J Thompson
- Department of Otolaryngology/Head & Neck Surgery, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Erin M Lopez
- Department of Otolaryngology/Head & Neck Surgery, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Margaret T Dillon
- Department of Otolaryngology/Head & Neck Surgery, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Meredith A Rooth
- Department of Otolaryngology/Head & Neck Surgery, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Margaret E Richter
- Department of Otolaryngology/Head & Neck Surgery, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Harold C Pillsbury
- Department of Otolaryngology/Head & Neck Surgery, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Kevin D Brown
- Department of Otolaryngology/Head & Neck Surgery, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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Long Y, Wang W, Liu J, Liu K, Gong S. The interference of tinnitus on sound localization was related to the type of stimulus. Front Neurosci 2023; 17:1077455. [PMID: 36824213 PMCID: PMC9941629 DOI: 10.3389/fnins.2023.1077455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Accepted: 01/23/2023] [Indexed: 02/10/2023] Open
Abstract
Spatial processing is a major cognitive function of hearing. Sound source localization is an intuitive evaluation of spatial hearing. Current evidence of the effect of tinnitus on sound source localization remains limited. The present study aimed to investigate whether tinnitus affects the ability to localize sound in participants with normal hearing and whether the effect is related to the type of stimulus. Overall, 40 participants with tinnitus and another 40 control participants without tinnitus were evaluated. The sound source discrimination tasks were performed on the horizontal plane. Pure tone (PT, with single frequency) and monosyllable (MS, with spectrum information) were used as stimuli. The root-mean-square error (RMSE) score was calculated as the mean target response difference. When the stimuli were PTs, the RMSE scores of the control and tinnitus group were 11.77 ± 2.57° and 13.97 ± 4.18°, respectively. The control group performed significantly better than did the tinnitus group (t = 2.841, p = 0.006). When the stimuli were MS, the RMSE scores of the control and tinnitus groups were 7.12 ± 2.29° and 7.90 ± 2.33°, respectively. There was no significant difference between the two groups (t = 1.501, p = 0.137). Neither the effect of unilateral or bilateral tinnitus (PT: t = 0.763, p = 0.450; MS: t = 1.760, p = 0.086) nor the effect of tinnitus side (left/right, PT: t = 0.389, p = 0.703; MS: t = 1.407, p = 0.179) on sound localization ability were determined. The sound source localization ability gradually deteriorated with an increase in age (PT: r2 = 0.153, p < 0.001; MS: r2 = 0.516, p = 0.043). In conclusion, tinnitus interfered with the ability to localize PTs, but the ability to localize MS was not affected. Therefore, the interference of tinnitus in localizing sound sources is related to the type of stimulus.
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Affiliation(s)
- Yue Long
- Department of Otolaryngology-Head and Neck Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing, China,Clinical Center for Hearing Loss, Capital Medical University, Beijing, China
| | - Wei Wang
- Department of Otolaryngology-Head and Neck Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Jiao Liu
- Department of Otolaryngology-Head and Neck Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Ke Liu
- Department of Otolaryngology-Head and Neck Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing, China,Ke Liu,
| | - Shusheng Gong
- Department of Otolaryngology-Head and Neck Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing, China,Clinical Center for Hearing Loss, Capital Medical University, Beijing, China,*Correspondence: Shusheng Gong,
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Qiao Y, Zhu M, Sun W, Sun Y, Guo H, Shang Y. Intrinsic brain activity reorganization contributes to long-term compensation of higher-order hearing abilities in single-sided deafness. Front Neurosci 2022; 16:935834. [PMID: 36090279 PMCID: PMC9453152 DOI: 10.3389/fnins.2022.935834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 08/01/2022] [Indexed: 11/24/2022] Open
Abstract
Single-sided deafness (SSD) is an extreme case of partial hearing deprivation and results in a significant decline in higher-order hearing abilities, including sound localization and speech-in-noise recognition. Clinical studies have reported that patients with SSD recover from these higher-order hearing abilities to some extent over time. Neuroimaging studies have observed extensive brain functional plasticity in patients with SSD. However, studies investigating the role of plasticity in functional compensation, particularly those investigating the relationship between intrinsic brain activity alterations and higher-order hearing abilities, are still limited. In this study, we used resting-state functional MRI to investigate intrinsic brain activity, measured by the amplitude of low-frequency fluctuation (ALFF), in 19 patients with left SSD, 17 patients with right SSD, and 21 normal hearing controls (NHs). All patients with SSD had durations of deafness longer than 2 years. Decreased ALFF values in the bilateral precuneus (PCUN), lingual gyrus, and left middle frontal gyrus were observed in patients with SSD compared with the values of NHs. Longer durations of deafness were correlated with better hearing abilities, as well as higher ALFF values in the left inferior parietal lobule, the angular gyrus, the middle occipital gyrus, the bilateral PCUN, and the posterior cingulate gyrus. Moreover, we observed a generally consistent trend of correlation between ALFF values and higher-order hearing abilities in specific brain areas in patients with SSD. That is, better abilities were correlated with lower ALFF values in the frontal regions and higher ALFF values in the PCUN and surrounding parietal-occipital areas. Furthermore, mediation analysis revealed that the ALFF values in the PCUN were a significant mediator of the relationship between the duration of deafness and higher-order hearing abilities. Our study reveals significant plasticity of intrinsic brain activity in patients with SSD and suggests that reorganization of intrinsic brain activity may be one of the compensatory mechanisms that facilitate improvement in higher-order hearing abilities in these patients over time.
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Affiliation(s)
- Yufei Qiao
- Department of Otorhinolaryngology, Peking Union Medical College Hospital, Beijing, China
| | - Min Zhu
- Department of Otorhinolaryngology, Peking Union Medical College Hospital, Beijing, China
| | - Wen Sun
- Department of Otorhinolaryngology, Peking Union Medical College Hospital, Beijing, China
| | - Yang Sun
- School of Educational Science, Shenyang Normal University, Shengyang, China
| | - Hua Guo
- Department of Biomedical Engineering, Center for Biomedical Imaging Research, School of Medicine, Tsinghua University, Beijing, China
| | - Yingying Shang
- Department of Otorhinolaryngology, Peking Union Medical College Hospital, Beijing, China
- *Correspondence: Yingying Shang
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Bassiouni M, Häußler SM, Gräbel S, Szczepek AJ, Olze H. Lateralization Pattern of the Weber Tuning Fork Test in Longstanding Unilateral Profound Hearing Loss: Implications for Cochlear Implantation. Audiol Res 2022; 12:347-356. [PMID: 35892662 PMCID: PMC9326649 DOI: 10.3390/audiolres12040036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Revised: 06/14/2022] [Accepted: 06/15/2022] [Indexed: 12/10/2022] Open
Abstract
The Weber tuning fork test is a standard otologic examination tool in patients with unilateral hearing loss. Sound should typically lateralize to the contralateral side in unilateral sensorineural hearing loss. The observation that the Weber test does not lateralize in some patients with longstanding unilateral deafness has been previously described but remains poorly understood. In the present study, we conducted a retrospective analysis of the medical records of patients with unilateral profound hearing loss (single-sided deafness or asymmetric hearing loss) for at least ten years. In this patient cohort, childhood-onset unilateral profound hearing loss was significantly associated with the lack of lateralization of the Weber tuning fork test (Fisher’s exact test, p < 0.05) and the absence of tinnitus in the affected ear (Fisher’s exact test, p < 0.001). The findings may imply a central adaptation process due to chronic unilateral auditory deprivation starting before the critical period of auditory maturation. This notion may partially explain the poor outcome of adult cochlear implantation in longstanding single-sided deafness. The findings may suggest a role for the Weber test as a simple, quick, and economical tool for screening poor cochlear implant candidates, thus potentially supporting the decision-making and counseling of patients with longstanding single-sided deafness.
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Affiliation(s)
- Mohamed Bassiouni
- Corporate Member of Freie Universität Berlin, Berlin Institute of Health, Charitéplatz 1, Humboldt-Universität zu Berlin, 10117 Berlin, Germany; (S.G.); (A.J.S.); (H.O.)
- Correspondence: ; Tel.: +49-30-450-555-072
| | - Sophia Marie Häußler
- Department of Otorhinolaryngology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg, Germany;
| | - Stefan Gräbel
- Corporate Member of Freie Universität Berlin, Berlin Institute of Health, Charitéplatz 1, Humboldt-Universität zu Berlin, 10117 Berlin, Germany; (S.G.); (A.J.S.); (H.O.)
| | - Agnieszka J. Szczepek
- Corporate Member of Freie Universität Berlin, Berlin Institute of Health, Charitéplatz 1, Humboldt-Universität zu Berlin, 10117 Berlin, Germany; (S.G.); (A.J.S.); (H.O.)
| | - Heidi Olze
- Corporate Member of Freie Universität Berlin, Berlin Institute of Health, Charitéplatz 1, Humboldt-Universität zu Berlin, 10117 Berlin, Germany; (S.G.); (A.J.S.); (H.O.)
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7
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Ludwig AA, Meuret S, Battmer RD, Schönwiesner M, Fuchs M, Ernst A. Sound Localization in Single-Sided Deaf Participants Provided With a Cochlear Implant. Front Psychol 2021; 12:753339. [PMID: 34744930 PMCID: PMC8566543 DOI: 10.3389/fpsyg.2021.753339] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 09/28/2021] [Indexed: 11/21/2022] Open
Abstract
Spatial hearing is crucial in real life but deteriorates in participants with severe sensorineural hearing loss or single-sided deafness. This ability can potentially be improved with a unilateral cochlear implant (CI). The present study investigated measures of sound localization in participants with single-sided deafness provided with a CI. Sound localization was measured separately at eight loudspeaker positions (4°, 30°, 60°, and 90°) on the CI side and on the normal-hearing side. Low- and high-frequency noise bursts were used in the tests to investigate possible differences in the processing of interaural time and level differences. Data were compared to normal-hearing adults aged between 20 and 83. In addition, the benefit of the CI in speech understanding in noise was compared to the localization ability. Fifteen out of 18 participants were able to localize signals on the CI side and on the normal-hearing side, although performance was highly variable across participants. Three participants always pointed to the normal-hearing side, irrespective of the location of the signal. The comparison with control data showed that participants had particular difficulties localizing sounds at frontal locations and on the CI side. In contrast to most previous results, participants were able to localize low-frequency signals, although they localized high-frequency signals more accurately. Speech understanding in noise was better with the CI compared to testing without CI, but only at a position where the CI also improved sound localization. Our data suggest that a CI can, to a large extent, restore localization in participants with single-sided deafness. Difficulties may remain at frontal locations and on the CI side. However, speech understanding in noise improves when wearing the CI. The treatment with a CI in these participants might provide real-world benefits, such as improved orientation in traffic and speech understanding in difficult listening situations.
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Affiliation(s)
- Alexandra Annemarie Ludwig
- Section of Phoniatrics and Audiology, Department of Otorhinolaryngology, University Hospital of Leipzig, Leipzig, Germany.,Faculty of Life Sciences, University of Leipzig, Leipzig, Germany
| | - Sylvia Meuret
- Section of Phoniatrics and Audiology, Department of Otorhinolaryngology, University Hospital of Leipzig, Leipzig, Germany
| | - Rolf-Dieter Battmer
- Department of Otolaryngology, Unfallkrankenhaus Berlin, Berlin, Germany.,Hearing Therapy Center Potsdam, Potsdam, Germany
| | | | - Michael Fuchs
- Section of Phoniatrics and Audiology, Department of Otorhinolaryngology, University Hospital of Leipzig, Leipzig, Germany
| | - Arne Ernst
- Department of Otolaryngology, Unfallkrankenhaus Berlin, Berlin, Germany.,Hospital of the University of Berlin, Charité Medical School, Berlin, Germany
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8
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Kim JH, Shim L, Bahng J, Lee HJ. Proficiency in Using Level Cue for Sound Localization Is Related to the Auditory Cortical Structure in Patients With Single-Sided Deafness. Front Neurosci 2021; 15:749824. [PMID: 34707477 PMCID: PMC8542703 DOI: 10.3389/fnins.2021.749824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 09/20/2021] [Indexed: 11/13/2022] Open
Abstract
Spatial hearing, which largely relies on binaural time/level cues, is a challenge for patients with asymmetric hearing. The degree of the deficit is largely variable, and better sound localization performance is frequently reported. Studies on the compensatory mechanism revealed that monaural level cues and monoaural spectral cues contribute to variable behavior in those patients who lack binaural spatial cues. However, changes in the monaural level cues have not yet been separately investigated. In this study, the use of the level cue in sound localization was measured using stimuli of 1 kHz at a fixed level in patients with single-sided deafness (SSD), the most severe form of asymmetric hearing. The mean absolute error (MAE) was calculated and related to the duration/age onset of SSD. To elucidate the biological correlate of this variable behavior, sound localization ability was compared with the cortical volume of the parcellated auditory cortex. In both SSD patients (n = 26) and normal controls with one ear acutely plugged (n = 23), localization performance was best on the intact ear side; otherwise, there was wide interindividual variability. In the SSD group, the MAE on the intact ear side was worse than that of the acutely plugged controls, and it deteriorated with longer duration/younger age at SSD onset. On the impaired ear side, MAE improved with longer duration/younger age at SSD onset. Performance asymmetry across lateral hemifields decreased in the SSD group, and the maximum decrease was observed with the most extended duration/youngest age at SSD onset. The decreased functional asymmetry in patients with right SSD was related to greater cortical volumes in the right posterior superior temporal gyrus and the left planum temporale, which are typically involved in auditory spatial processing. The study results suggest that structural plasticity in the auditory cortex is related to behavioral changes in sound localization when utilizing monaural level cues in patients with SSD.
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Affiliation(s)
- Ja Hee Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Hallym University College of Medicine, Chuncheon, South Korea.,Laboratory of Brain & Cognitive Sciences for Convergence Medicine, Hallym University College of Medicine, Anyang, South Korea
| | - Leeseul Shim
- Laboratory of Brain & Cognitive Sciences for Convergence Medicine, Hallym University College of Medicine, Anyang, South Korea
| | - Junghwa Bahng
- Department of Audiology and Speech-Language Pathology, Hallym University of Graduate Studies, Seoul, South Korea
| | - Hyo-Jeong Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Hallym University College of Medicine, Chuncheon, South Korea.,Laboratory of Brain & Cognitive Sciences for Convergence Medicine, Hallym University College of Medicine, Anyang, South Korea
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Yu F, Li H, Zhou X, Tang X, Galvin III JJ, Fu QJ, Yuan W. Effects of Training on Lateralization for Simulations of Cochlear Implants and Single-Sided Deafness. Front Hum Neurosci 2018; 12:287. [PMID: 30065641 PMCID: PMC6056606 DOI: 10.3389/fnhum.2018.00287] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Accepted: 06/27/2018] [Indexed: 11/13/2022] Open
Abstract
While cochlear implantation has benefitted many patients with single-sided deafness (SSD), there is great variability in cochlear implant (CI) outcomes and binaural performance remains poorer than that of normal-hearing (NH) listeners. Differences in sound quality across ears-temporal fine structure (TFS) information with acoustic hearing vs. coarse spectro-temporal envelope information with electric hearing-may limit integration of acoustic and electric patterns. Binaural performance may also be limited by inter-aural mismatch between the acoustic input frequency and the place of stimulation in the cochlea. SSD CI patients must learn to accommodate these differences between acoustic and electric stimulation to maximize binaural performance. It is possible that training may increase and/or accelerate accommodation and further improve binaural performance. In this study, we evaluated lateralization training in NH subjects listening to broad simulations of SSD CI signal processing. A 16-channel vocoder was used to simulate the coarse spectro-temporal cues available with electric hearing; the degree of inter-aural mismatch was varied by adjusting the simulated insertion depth (SID) to be 25 mm (SID25), 22 mm (SID22) and 19 mm (SID19) from the base of the cochlea. Lateralization was measured using headphones and head-related transfer functions (HRTFs). Baseline lateralization was measured for unprocessed speech (UN) delivered to the left ear to simulate SSD and for binaural performance with the acoustic ear combined with the 16-channel vocoders (UN+SID25, UN+SID22 and UN+SID19). After completing baseline measurements, subjects completed six lateralization training exercises with the UN+SID22 condition, after which performance was re-measured for all baseline conditions. Post-training performance was significantly better than baseline for all conditions (p < 0.05 in all cases), with no significant difference in training benefits among conditions. Given that there was no significant difference between the SSD and the SSD CI conditions before or after training, the results suggest that NH listeners were unable to integrate TFS and coarse spectro-temporal cues across ears for lateralization, and that inter-aural mismatch played a secondary role at best. While lateralization training may benefit SSD CI patients, the training may largely improve spectral analysis with the acoustic ear alone, rather than improve integration of acoustic and electric hearing.
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Affiliation(s)
- Fei Yu
- Department of Otolaryngology, Southwest Hospital, Third Military Medical University, Chongqing, China
| | - Hai Li
- Department of Otolaryngology, Southwest Hospital, Third Military Medical University, Chongqing, China
| | - Xiaoqing Zhou
- Department of Otolaryngology, Southwest Hospital, Third Military Medical University, Chongqing, China
| | - XiaoLin Tang
- Department of Otolaryngology, Southwest Hospital, Third Military Medical University, Chongqing, China
| | | | - Qian-Jie Fu
- Department of Head and Neck Surgery, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
| | - Wei Yuan
- Department of Otolaryngology, Southwest Hospital, Third Military Medical University, Chongqing, China
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