Configuration Of Hearing Loss Research Articles

Automated hearing impairment diagnosis using machine‐learning: An open‐source software development undergraduate research project

AbstractApproximately 700 million people will have disabling hearing loss by 2050. Underdeveloped and developing countries, which encompass a considerable proportion of people with disabling hearing impairment, have a sparse number of audiologists and otolaryngologists. The lack of specialists leaves most hearing impairments undiagnosed for a long time, resulting in negative societal and economic impacts. In this article, we propose an automated hearing impairment diagnosis software—based on machine learning—to support audiologists and otolaryngologists in accurately and efficiently diagnosing and classifying hearing loss. We present the design, implementation, and performance analysis of an open‐source automated hearing impairment diagnosis software, which consists of two modules: a hearing test data‐generation module and a machine‐learning model. The data‐generation module produces a diverse and exhaustive data set for training and evaluating the machine‐learning model. By employing multiclass and ultilabel classification techniques to learn from the hearing test data, the model can swiftly predict the type, degree, and configuration of hearing loss with high reliability. Our proposed machine‐learning model demonstrates promising results with a prediction time of 634 ms, a log‐loss reduction rate of 0.9848 and accuracy, precision, recall, and f1‐score of 1.0000—showing the model's applicability to assist audiologists and otolaryngologists in rapidly and accurately classifying the type, degree, and configuration of hearing loss. In addition to the technical contributions, this article also highlights the importance of involving undergraduate students in open‐source software development projects which have a direct impact on improving the quality of human life.

Study of Speech Recognition in Noise and Working Memory in Adults and Elderly with Normal Hearing

Abstract Introduction In clinical practice, patients with the same degree and configuration of hearing loss, or even with normal audiometric thresholds, present substantially different performances in terms of speech perception. This probably happens because other factors, in addition to auditory sensitivity, interfere with speech perception. Thus, studies are needed to investigate the performance of listeners in unfavorable listening conditions to identify the processes that interfere in the speech perception of these subjects. Objective To verify the influence of age, temporal processing, and working memory on speech recognition in noise. Method Thirty-eight adult and elderly individuals with normal hearing thresholds participated in the study. Participants were divided into two groups: The adult group (G1), composed of 10 individuals aged 21 to 33 years, and the elderly group (G2), with 28 participants aged 60 to 81 years. They underwent audiological assessment with the Portuguese Sentence List Test, Gaps-in-Noise test, Digit Span Memory test, Running Span Task, Corsi Block-Tapping test, and Visual Pattern test. Results The Running Span Task score proved to be a statistically significant predictor of the listening-in-noise variable. This result showed that the difference in performance between groups G1 and G2 in relation to listening in noise is due not only to aging, but also to changes in working memory. Conclusion The study showed that working memory is a predictor of listening performance in noise in individuals with normal hearing, and that this task can provide important information for investigation in individuals who have difficulty hearing in unfavorable environments.

Determining cochlear implant candidacy in children with residual hearing: A scoping review

ObjectivesThe purpose of this review was to summarize what is known about criteria, assessments, and recommendations for evaluating cochlear implant (CI) candidacy in children with residual hearing. MethodsPeer-reviewed studies were identified through a systematic search in five electronic databases. Articles were screened and assessed for eligibility. From the eligible studies, data were extracted to summarize and present a narrative synthesis of the findings. ResultsA total of seven articles (two reviews and five primary studies) were included in the final analysis. Hearing levels better than the moderately severe to severe range (65–90 dB HL) tend to be supported as audiological candidacy criteria for pediatric CI. Recommendations for candidacy consideration based on audiologic thresholds range from 65 to 80 dB Hl pure-tone average as the lower boundary. Our review did not identify any specific assessment protocols. However, additional decision-making considerations related to borderline hearing loss configurations and assessment tools (the Speech Intelligibility Index and the Pediatric Minimum Speech Test Battery) were identified. Supplementary assessment considerations were also reported. ConclusionThere is limited information regarding specific assessment protocols for children with residual hearing. The literature is primarily focused on guidelines related to audiologic criteria, although it is widely recommended that other areas of functioning should also be considered. Most recommendations appear to be based on expert opinion, clinical expertise, and evidence from overall pediatric CI outcomes rather than empirical evidence targeting children with residual hearing. There is an ongoing need for research to further develop protocols and tools that can assist clinicians and families in making cochlear implantation decisions for children with residual hearing.

Comparison of ASSR and frequency specificity ABR induced by NB CE-Chirp for prediction of behavioral hearing thresholds in children with conductive hearing loss

BackgroundElectrophysiological tests are often used to evaluate hearing loss in infants and young children with conductive hearing loss, no matter to quantify or characterize. However, there are advantages and disadvantages associated with the various electrophysiological tests that are currently available. Therefore, there is no gold standard test. This study aimed to compare the value of narrow-band (NB) CE-Chirp-induced auditory steady-state response (ASSR) and auditory brainstem response (ABR) for assessing hearing thresholds in children with conductive hearing loss. We hope to identify an effective electrophysiological testing method to evaluate conductive hearing loss and provide a reference for clinical hearing assessment of infants with conductive hearing loss. Subjectsand Methods: We selected 27 children (41 ears) aged 3–6 years with otitis media with effusion (OME). Within 1 day, they underwent behavioral audiometry and NB CE-Chirp-induced ASSR and ABR tests in sequence. Pearson's correlation analysis was performed to compare behavioral audiometry thresholds and ASSR and ABR response thresholds at 500, 1000, 2000, and 4000 Hz. ResultsThe behavioral audiometry thresholds of all children were strongly correlated with the response thresholds of the two electrophysiological tests, with correlation coefficients of 0.659, 0.605, 0.723, and 0.857 for ASSR, and 0.587, 0.684, 0.753, and 0.802 for ABR. The proportion of children with a difference of ≤10 dB between ASSR and behavioral audiometry thresholds or between ABR and behavioral audiometry thresholds was not high, especially in the low frequencies. ABR results were superior to ASSR results in terms of predicting actual hearing levels. At 0.5, 1, 2, and 4 kHz, the average differences between the behavioral hearing thresholds and ASSR thresholds in the 41 ears were 5.6, 5.7, 2, and 5.6 dB, respectively. The average differences between behavioral hearing thresholds and ABR thresholds was −5.6, −1.4, −6.8, and 3.2 dB, respectively. The hearing loss configuration of the ASSR exhibited a peaked pattern, similar to behavioral audiometry, whereas the ABR exhibited an ascending pattern. The time to perform the single-ear ASSR test was 5.9 min, whereas the ABR test took 17.0 min. ConclusionASSR and ABR induced by the NB CE-Chirp correlated well with behavioral audiometry in children with conductive hearing loss. The NB CE-Chirp ASSR has advantages in terms of testing time and hearing configuration evaluation, whereas ABR has better reliability than ASSR. However, the stability of ASSR and ABR induced by the NB CE-Chirp is poor, and the thresholds obtained cannot replace behavioral audiometry in evaluating the true hearing of children with conductive hearing loss. However, ASSR and ABR can be used as auxiliary tests for cross-validation.

Defining Hearing Loss Severity Based on Pure Tone Audiometry and Self-Reported Perceived Hearing Difficulty, National Health and Nutrition Examination Survey.

There is a well-known metric to describe average/normal vision, 20/20, but the same agreed upon standard does not exist for hearing. The pure tone average has been advocated for such a metric. We aimed to use a data driven approach to inform a universal metric for hearing status based on pure tone audiometry and perceived hearing difficulty (PHD). Cross-sectional national representative survey of the civilian non-institutionalized population in the United States. Data from the 2011-2012 and 2015-2016 cycles of the National Health and Nutrition Examination Survey (NHANES) was used in our analysis. Of 9,444 participants aged 20-69 years old from the 2011-2012 and 2015-2016 cycles, we excluded those with missing self-reported hearing difficulty (n=8) and pure tone audiometry data (n=1,361). The main analysis sample, therefore, included 8,075 participants. We completed a sub-analysis limited to participants with "normal" hearing based on the WHO standard (pure tone average, PTA of 500, 1000, 2000, 4000 Hz < 20 dBHL). Descriptive analyses to calculate means and proportions were used to describe characteristics of the analysis sample across PHD levels relative to PTA. Four PTAs were compared, low frequency (LF-PTA, 500, 1000, 2000 Hz), four frequency PTA (PTA4, 500, 1000, 2000, 4000 Hz), high frequency (HF-PTA, 4000, 6000, 8000 Hz) and all frequency (AF-PTA, 500, 1000, 2000, 4000, 6000, 8000 Hz). Differences between groups were tested using Rao-Scott χ2 tests for categorical variables and F tests for continuous variables. Logistic regression was used to plot receiver operating characteristic (ROC) curves with PHD as a function of PTA. The sensitivity and specificity for each PTA and PHD was also calculated. We found that 19.61% of adults aged 20-69 years reported PHD, with only 1.41% reporting greater than moderate PHD. The prevalence of reported PHD increased with higher decibel hearing levels (dBHL) categories reaching statistical significance (p < 0.05 with Bonferroni correction) at 6-10 dBHL for PTAs limited to lower frequencies (LF-PTA and PTA4) and 16-20 dBHL when limited to higher frequencies (HF-PTA). The prevalence of greater than moderate PHD reached statistical significance at 21-30 dBHL when limited to lower frequencies (LF-PTA) and 41-55 dBHL when limited to higher frequencies (HF-PTA). Forty percent of the sample had high frequency loss with normal low frequency hearing, representing nearly 70% of hearing loss configurations. The diagnostic accuracy of the PTAs for reported PHD was poor to sufficient (< 0.70), however the HF-PTA had the highest sensitivity (0.81). We provide three basic recommendations for clinical application based on our analysis. 1). A PTA based metric for hearing ability should include frequencies above 4000 Hz. 2). The data driven cutoff for any PHD/normal hearing is 15 dBHL. When considering greater than moderate PHD, the data driven cutoffs were more variable but estimated at 20-30 dBHL for LF-PTA, 30-35 for PTA4, 25-50 for AF-PTA, and 40-65 for HF-PTA. 3). Clinical recommendations and legislative agendas should include consideration beyond pure tone audiometry such as functional assessment of hearing and PHD.

Effects of audible bandwidth and stimulus modality on emotional responses to sound

A wide range of emotional responses is typical and important for overall well-being. Adults with hearing loss demonstrate a reduced range of emotional responses to non-speech sounds; their ratings of valence to pleasant and unpleasant sounds are less extreme than those of their peers with normal hearing. The purpose of this project was to explore the role of two potential explanations, limited audible bandwidth and emotional processing differences. Adults with normal hearing and sensorineural hearing loss rated their emotional responses (valence and arousal) to non-speech, affective sounds and pictures (in combination and in isolation). To explore the potential contribution of audible bandwidth, adults with normal hearing rated stimuli that were full bandwidth and also bandpass limited. In addition, adults with hearing loss were specifically recruited to include heterogeneous hearing loss configurations. Differences in ratings between auditory and visual stimuli provide insight into whether reduced emotional responses for adults with hearing loss are specific to audition or generalize to visual stimuli. Results demonstrate the importance of audition and audible bandwidth as key factors in emotional responses to pleasant, non-speech stimuli. These findings have important implications for designing interventions to support the listening needs of adults with hearing loss.

Adesão e continuidade ao uso de aparelho de amplificação sonora individual: revisão de escopo

ABSTRACT Purpose To identify the reasons that lead the individual to follow or not the recommendation to use the hearing aid and its use over the years. Research strategy Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) recommendations were followed. The databases searched were: Pubmed, Pubmed Central, Scopus, Embase, Web of science and Cochrane, using the following descriptors: “Hearing Aids”, “Patient Compliance” and the Boolean indicator AND. Selection criteria primary original articles with prospective, retrospective, observational or experimental designs; that raise, report, verify or analyze the reasons for adherence or not to the use of hearing aids, regardless of being an experienced user or not; carried out with the young, adult and elderly population; with individuals with any degree, type and configuration of hearing loss; with unilateral or bilateral adaptations and in Portuguese, English and Spanish. Results 27 studies were included in the analysis. There were two distinct situations in the auditory rehabilitation process: acceptance of the indication of the use of HA and the continuity of the effective use. Thus, the aspects that positively, negatively or do not interfere in these two phases were compiled and presented. Conclusion the most relevant factors in the non-adherence to HA were: perception of low cost-benefit, lack of understanding of the real need and difficulty in accepting its use; while the ones that most impacted the continuity of use were: HA sound quality, handling difficulties and perception of little benefit.

Rethinking the Audiogram for Hearing Aid Selection

Rethinking the Audiogram for Hearing Aid Selection

Can Closed-Set Word Recognition Differentially Assess Vowel and Consonant Perception for School-Age Children With and Without Hearing Loss?

Vowels and consonants play different roles in language acquisition and speech recognition, yet standard clinical tests do not assess vowel and consonant perception separately. As a result, opportunities for targeted intervention may be lost. This study evaluated closed-set word recognition tests designed to rely predominantly on either vowel or consonant perception and compared results with sentence recognition scores. Participants were children (5-17 years of age) and adults (18-38 years of age) with normal hearing and children with sensorineural hearing loss (7-17 years of age). Speech reception thresholds (SRTs) were measured in speech-shaped noise. Children with hearing loss were tested with their hearing aids. Word recognition was evaluated using a three-alternative forced-choice procedure, with a picture-pointing response; monosyllabic target words varied with respect to either consonant or vowel content. Sentence recognition was evaluated for low- and high-probability sentences. In a subset of conditions, stimuli were low-pass filtered to simulate a steeply sloping hearing loss in participants with normal hearing. Children's SRTs improved with increasing age for words and sentences. Low-pass filtering had a larger effect for consonant-variable words than vowel-variable words for both children and adults with normal hearing, consistent with the greater high-frequency content of consonants. Children with hearing loss tested with hearing aids tended to perform more poorly than age-matched children with normal hearing, particularly for sentence recognition, but consonant- and vowel-variable word recognition did not appear to be differentially affected by the amount of high- and low-frequency hearing loss. Closed-set recognition of consonant- and vowel-variable words appeared to differentially evaluate vowel and consonant perception but did not vary by configuration of hearing loss in this group of pediatric hearing aid users. Word scores obtained in this manner do not fully characterize the auditory abilities necessary for open-set sentence recognition, but they do provide a general estimate.

Adaptive Hearing Aid Benefit in Children With Mild/Moderate Hearing Loss: A Registered, Double-Blind, Randomized Clinical Trial.

We completed a registered double-blind randomized control trial to compare acclimatization to two hearing aid fitting algorithms by experienced pediatric hearing aid users with mild to moderate hearing loss. We hypothesized that extended use (up to 13 months) of an adaptive algorithm with integrated directionality and noise reduction, OpenSound Navigator (OSN), would result in improved performance on auditory, cognitive, academic, and caregiver- or self-report measures compared with a control, omnidirectional algorithm (OMNI). Forty children aged 6 to 13 years with mild to moderate/severe symmetric sensorineural hearing loss completed this study. They were all experienced hearing aid users and were recruited through the Cincinnati Children's Hospital Medical Center Division of Audiology. The children were divided into 20 pairs based on similarity of age (within 1 year) and hearing loss (level and configuration). Individuals from each pair were randomly assigned to either an OSN (experimental) or OMNI (control) fitting algorithm group. Each child completed an audiology evaluation, hearing aid fitting using physically identical Oticon OPN hearing aids, follow-up audiological appointment, and 2 research visits up to 13 months apart. Research visit outcome measures covered speech perception (in quiet and in noise), novel grammar and word learning, cognition, academic ability, and caregiver report of listening behaviors. Analysis of outcome differences between visits, groups, ages, conditions and their interactions used linear mixed models. Between 22 and 39 children provided useable data for each task. Children using the experimental (OSN) algorithm did not show any significant performance differences on the outcome measures compared with those using the control (OMNI) algorithm. Overall performance of all children in the study increased across the duration of the trial on word repetition in noise, sentence repetition in quiet, and caregivers' assessment of hearing ability. There was a significant negative relationship between age at first hearing aid use, final Reading and Mathematical ability, and caregiver rated speech hearing. A significant positive relationship was found between daily hearing aid use and study-long change in performance on the Flanker test of inhibitory control and attention. Logged daily use of hearing aids related to caregiver rated spatial hearing. All results controlled for age at testing/evaluation and false discovery rate. Use of the experimental (OSN) algorithm neither enhanced nor reduced performance on auditory, cognitive, academic or caregiver report measures compared with the control (OMNI) algorithm. However, prolonged hearing aid use led to benefits in hearing, academic skills, attention, and caregiver evaluation.

Functional Assessment of Hearing Aid Benefit: Incorporating Verification and Aided Speech Recognition Testing into Routine Practice.

Potential cochlear implant (CI) candidates arrive to the clinic with a variety of hearing loss configurations, hearing aid history, and aided capabilities. CI candidacy is primarily determined based on aided speech recognition capability, which relies on benefit derived from use of hearing aids. Therefore, contemporary evaluation for CI candidacy should incorporate a battery of testing to determine abilities and limitations and must be predicated on appropriate verification of the hearing aid fitting. However, recent reports, including a retrospective chart review of patients presenting to Cleveland Clinic for CI evaluation, suggest that a significant subset of patients may be using inappropriately fit or programmed amplification. Thus, a combination of simulated real-ear measurements and aided speech recognition testing is essential for fully assessing the effect of amplification and ultimately determination of CI candidacy. Furthermore, waiting to incorporate these tools until CI candidacy is suspected may delay timely identification of problems or need to change technology. Utilization of evidence-based decision drivers ultimately leads clinicians to timely patient-specific interventions which may include surgical intervention or other amplification options. As audiology moves into a healthcare era in which payers consider the benefit of our services to overall health and well-being, demonstrating timely, optimal outcomes using thorough, multifactorial evaluation is essential.

Vestibular functions in patients with idiopathic sudden sensorineural hearing loss and its relation to prognosis

ObjectiveBecause of the anatomically close relationship between the cochlea and the vestibular organs, cochlear function disorders may be accompanied by vestibular disorders. This study aimed to evaluate vestibular functions in patients with idiopathic sudden sensorineural hearing loss using VEMP, caloric test, and VNG test battery and its relation to prognosis. Materials and MethodsFor this study, 42 patients aged 18–55 years with idiopathic sudden sensorineural hearing loss and 30 volunteers who had no hearing and balance problems were included. Audiometry, cVEMP, oVEMP, caloric tests, and VNG tests were performed. Moreover, the effects of age, sex, time of admission, degree and configuration of hearing loss, accompanying vertigo, tinnitus, and ear fullness on improvement in hearing were evaluated. ResultsOf the 42 patients in the study group, 26 (56.52%) were male, 20 (43.48%) were female, and the mean age was 41.54 ± 12.23 years. Of the 30 individuals in the control group, 19 (63.3%) were male, 11 (36.7%) were female, and the mean age was 39.53 ± 13.03 years. There was no significant difference in the incidence of sudden sensorineural hearing loss in terms of sex and age, and the prognosis was better for female patients. Early admission to treatment was a factor of good prognosis; profound hearing loss, bilateral hearing loss and vertigo were factors of poor prognosis. Prognosis was better in patients with rising type audiogram configuration, while the prognosis was worse in patients with flat, descending and total hearing loss. Tinnitus and ear fullness had no effect on the prognosis. No anomalies were observed in VNG findings. Moreover, abnormal caloric response was higher in patients with profound hearing loss and total hearing configuration. Shortening was observed in cVEMP / oVEMP P1 and N1 latency after treatment. Furthermore, there was an improvement in abnormal responses after treatment. ConclusionIn this study, vestibular function was affected in patients with idiopathic sudden sensorineural hearing loss. The present study can help the development of a clinical strategy in the evaluation of the vestibular system in idiopathic SSNHL, patient follow-up, patient information, and the implementation of vestibular rehabilitation. Note that additional studies involving larger patients series are required.

Optimizing Parameters for Using the Parallel Auditory Brainstem Response to Quickly Estimate Hearing Thresholds.

Timely assessments are critical to providing early intervention and better hearing and spoken language outcomes for children with hearing loss. To facilitate faster diagnostic hearing assessments in infants, the authors developed the parallel auditory brainstem response (pABR), which presents randomly timed trains of tone pips at five frequencies to each ear simultaneously. The pABR yields high-quality waveforms that are similar to the standard, single-frequency serial ABR but in a fraction of the recording time. While well-documented for standard ABRs, it is yet unknown how presentation rate and level interact to affect responses collected in parallel. Furthermore, the stimuli are yet to be calibrated to perceptual thresholds. Therefore, this study aimed to determine the optimal range of parameters for the pABR and to establish the normative stimulus level correction values for the ABR stimuli. Two experiments were completed, each with a group of 20 adults (18-35 years old) with normal-hearing thresholds (≤20 dB HL) from 250 to 8000 Hz. First, pABR electroencephalographic (EEG) responses were recorded for six stimulation rates and two intensities. The changes in component wave V amplitude and latency were analyzed, as well as the time required for all responses to reach a criterion signal-to-noise ratio of 0 dB. Second, behavioral thresholds were measured for pure tones and for the pABR stimuli at each rate to determine the correction factors that relate the stimulus level in dB peSPL to perceptual thresholds in dB nHL. The pABR showed some adaptation with increased stimulation rate. A wide range of rates yielded robust responses in under 15 minutes, but 40 Hz was the optimal singular presentation rate. Extending the analysis window to include later components of the response offered further time-saving advantages for the temporally broader responses to low-frequency tone pips. The perceptual thresholds to pABR stimuli changed subtly with rate, giving a relatively similar set of correction factors to convert the level of the pABR stimuli from dB peSPL to dB nHL. The optimal stimulation rate for the pABR is 40 Hz but using multiple rates may prove useful. Perceptual thresholds that subtly change across rate allow for a testing paradigm that easily transitions between rates, which may be useful for quickly estimating thresholds for different configurations of hearing loss. These optimized parameters facilitate expediency and effectiveness of the pABR to estimate hearing thresholds in a clinical setting.

Effects of the Configuration of Hearing Loss on Consonant Perception between Simulated Bimodal and Electric Acoustic Stimulation Hearing.

Cochlear implant technology allows for acoustic and electric stimulations to be combined across ears (bimodal) and within the same ear (electric acoustic stimulation [EAS]). Mechanisms used to integrate speech acoustics may be different between the bimodal and EAS hearing, and the configurations of hearing loss might be an important factor for the integration. Thus, differentiating the effects of different configurations of hearing loss on bimodal or EAS benefit in speech perception (differences in performance with combined acoustic and electric stimulations from a better stimulation alone) is important. Using acoustic simulation, we determined how consonant recognition was affected by different configurations of hearing loss in bimodal and EAS hearing. A mixed design was used with one between-subject variable (simulated bimodal group vs. simulated EAS group) and one within-subject variable (acoustic stimulation alone, electric stimulation alone, and combined acoustic and electric stimulations). Twenty adult subjects (10 for each group) with normal hearing were recruited. Consonant perception was unilaterally or bilaterally measured in quiet. For the acoustic stimulation, four different simulations of hearing loss were created by band-pass filtering consonants with a fixed lower cutoff frequency of 100 Hz and each of the four upper cutoff frequencies of 250, 500, 750, and 1,000 Hz. For the electric stimulation, an eight-channel noise vocoder was used to generate a typical spectral mismatch by using fixed input (200-7,000 Hz) and output (1,000-7,000 Hz) frequency ranges. The effects of simulated hearing loss on consonant recognition were compared between the two groups. Significant bimodal and EAS benefits occurred regardless of the configurations of hearing loss and hearing technology (bimodal vs. EAS). Place information was better transmitted in EAS hearing than in bimodal hearing. These results suggest that configurations of hearing loss are not a significant factor for integrating consonant information between acoustic and electric stimulations. The results also suggest that mechanisms used to integrate consonant information may be similar between bimodal and EAS hearing.

Feasibility of Personal Sound Amplification Products in Patients With Moderate Hearing Loss: A Pilot Study.

ObjectivesThis study was conducted to investigate the electroacoustic characteristics of personal sound amplification products (PSAPs), to identify whether PSAPs provide adequate gain and output for three common hearing loss (HL) configurations, and to compare the benefits of a representative PSAP (RPSAP) and a conventional hearing aid (HA) for clinical hearing outcomes as a pilot study.MethodsThe study comprised three phases: electroacoustic analysis, simulated real-ear measurements (REMs), and clinical hearing experiments. Electroacoustic analysis and simulated REMs were performed for three basic PSAPs (BeethoSOL, EarJJang, and Geniesori2) and three high-end PSAPs (Hearing Able, Olive Smart Ear, and SoriIn) using the Aurical Hearing Instrument Test box with a 2-mL coupler. Four electroacoustic characteristics (maximum output sound pressure level at 90 dB SPL, frequency range, equivalent input noise, and total harmonic distortion) were investigated. By simulated REMs, appropriate levels of the six PSAPs for three common HL configurations (mild-to-moderate high-frequency HL, moderate to moderately severe sloping HL, and moderate flat HL) were determined. Clinical experiments compared the performance of RPSAP to HA, both of which were fitted by audiologists using REMs. Clinical experiments were administered using functional gain, a word recognition test, and the Korean version of the Hearing in Noise Test in six participants with bilateral moderate sensorineural HL.ResultsThe two high-end devices met all tolerances. One basic and two high-end PSAPs showed appropriate levels for three common HL configurations. In the clinical experiments, the RPSAP showed better performance than unaided, but slightly worse than HA under all test conditions.ConclusionCertain PSAPs met all specified tolerances for electroacoustic analysis and approximated prescriptive targets in well-controlled laboratory conditions. The pilot clinical experiments explored the possibility that the RPSAP could serve as a hearing assistive device for patients with moderate HL.

Examination of Speech Signals’ Intensity Reconstruction Through Evaluation of the Frequency Responses of Behind-the-ear Hearing Aids Fitted With NAL-NL2 and DSLi/o v5 Prescription Formulas

Background &amp; Objectives: The widespread prevalence of hearing loss can leave restrictive impacts on the acoustic and psychoacoustic hearing components, language and speech development, education, and employment of those with hearing impairments. On the other hand, given that hearing aids are the most commonly used devices to help auditory rehabilitation, and speech is the most essential human interaction signal, the examination of hearing aid’s frequency responses and the capability of intensity reconstruction of speech signals according to the existing standards are of utmost importance. The present study was conducted to compare hearing aid’s performance with two prescription formulas, at three input intensity levels, and two hearing loss configurations. Methods: Using the FRYE FP35 analyzer, the present study examined two Phonak Bolero B50 hearing aids fitted with two prescription formulas (NAL-NL2 and DSLi/o v5) for two degrees of hearing loss (mild to moderately severe and moderately severe to severe) presented with intensity-filtered ISTS speech signals at three input intensities (50, 65, and 80 dB SPL). Results: The DSLi/o v5 formula prescribed higher average gain and intensity reconstruction for both hearing loss degrees and at all three input intensities compared with the NAL-NL2 formula. Conclusion: Depending on the purpose of gain prescription, whether the loudness is important or speech intelligibility, the choice of an appropriate fitting formula can be affected.

Immediate Treatment of Sudden Sensorineural Hearing Loss: A Case Study

Immediate Treatment of Sudden Sensorineural Hearing Loss: A Case Study

Presence of hearing loss is predictive of return for further stages of tinnitus therapy following initial education and counseling

Objective Identify clinical factors that predict the likelihood of patients returning for further evaluation and treatment following stage 1 education and counselling in a staged tinnitus habituation program. Design Retrospective cross-sectional study. Demographics, audiometric findings and Tinnitus Handicap Inventory (THI) scores were used for predictive modelling to determine the likelihood of patients returning for subsequent therapy. Study samples One hundred and ninety consecutive patients treated in an outpatient, staged tinnitus habituation program. Results Improvements in THI scores were observed in all subjects (n = 119, d = 0.49, p < 0.001), both for those without hearing loss (n = 13, d = 0.54, p = 0.03) and those with hearing loss (n = 106, d = 0.48, p < 0.001) following Stage 1 education and counselling. Subjects with hearing loss were 14 times more likely to return for Stage 2 evaluation (p < 0.001) following completion of Stage 1 education and counselling. Conclusion Subjects with idiopathic subjective non-pulsatile tinnitus across all degrees of tinnitus severity benefit from group education and counselling alone. Subjects with hearing loss, irrespective of most hearing loss configurations, are more likely to return for subsequent stages of the program.

Pediatric Cochlear Implantation: Who is a Candidate in 2020?

Pediatric Cochlear Implantation: Who is a Candidate in 2020?

The effect of hearing loss configuration on cochlear implantation uptake rates: an Australian experience

Objective: Recent changes to cochlear implant (CI) candidacy criteria have led to the inclusion of candidates with greater levels of hearing in the contralateral and/or implanted ear. This study assessed the impact of various hearing loss configurations on CI uptake rates (those assessed as eligible for CI, who proceed to CI).Design: Retrospective cohort study.Study sample: Post-lingually deaf adult CI candidates (n = 619) seen at a Western Australian cochlear implant clinic.Results: An overall CI uptake rate of 44% was observed. Hearing loss configuration significantly impacted uptake rates. Uptake rates of 62% for symmetrical hearing loss, 48% for asymmetrical hearing loss (four-frequency average hearing loss (4FAHL) asymmetry ≤60 dB), 25% for highly asymmetrical hearing loss (4FAHL asymmetry >60 dB), 38% for hearing losses eligible for electric-acoustic stimulation, and 22% for individuals with single-sided hearing loss were observed. Hearing loss configuration and age were both significant factors in relation to CI uptake although the impact of age was limited.Conclusion: CI clinics who apply or are considering applying expanded CI candidacy criteria within their practice should be aware that candidates with greater levels of residual hearing in at least the contralateral ear are less likely to proceed to CI.