Speech Discrimination Research Articles

Cochlear Implantation or Stapes Surgery in Far Advanced Otosclerosis

Abstract Background Otosclerosis is a process of bone resorption of the labyrinthine capsule followed by reparative deposition of new, immature sclerotic bone. It usually occurs during the postlingual period between the second and fifth decade of life. The most commonly affected location is around the oval window (fenestral otosclerosis), which results in conductive hearing loss due to stapes footplate fixation. As it undergoes a maturation process, the sclerotic bone increases in size and depth. Objective To compare the hearing outcomes and complications of stapes surgery vs cochlear implantation in patients with far advanced otosclerosis. Data Sources Medline databases (PubMed, Medscape, Scopus, Google Scholar, Cochrane, ScienceDirect. EMF-Portal) and all materials available in the Internet till 2021. Data Extraction If the studies did not fulfill the inclusion criteria, they were excluded. Study quality assessment included whether ethical approval was gained, eligibility criteria specified, appropriate controls, and adequate information and defined assessment measures. Patients and Methods The current review followed the guidelines of preferred reporting items for systematic reviews and meta-analysis statement 2009 (PRISMA). The detailed steps of methods were described elsewhere as well as PRISMA checklist. Results The results of this meta-analysis show that comparing the outcomes and complications of cochlear implantation and stapes surgery in far advanced otosclerosis patients have different results, in some of them there was a highly favorable and recommended procedure than the other, other results declared no significant difference in postoperative outcomes. Conclusion Both Stapes surgery and CI are reliable treatment options for FAO with very close success rates. Statistics of CI are greater than Stapes surgery and CI has a consistent improvement in speech discrimination scores in comparison to Stapes surgery. Patients must receive adequate counseling regarding all the factors mentioned above and the decision must be made by surgeons and the informed patients.

Evaluation of Central Auditory Processing in Individuals with Occupational Noise exposure

Abstract Background Prolonged exposure to high levels of occupational noise can cause damage to hair cells in the cochlea and result in permanent noise-induced cochlear hearing loss. Consequences of cochlear hearing loss on speech perception and psychophysical central auditory abilities have been well documented. Objectives the aim of this research was to explore central auditory processing in individuals with history of occupational noise exposure. Subjects and method sixty subjects aged between 20 and 50 years divided into 2 groups; control group (thirty normal healthy subjects), study group (thirty subject with history of occupational noise exposure). They were subjected to Basic audiological evaluation :Pure tone audiometry for frequencies 250-8000 Hz for air conduction and 500-4000 Hz for bone conduction, Speech reception threshold (SRT) using Arabic spondee words list (Soliman et al., 1985) and speech discrimination scores using Arabic phonetically balanced words (Soliman, 1976). And Tympanometry, central auditory processing questionnaire and Psychophysical central auditory tests that will be discussed later. Results Statistically significant difference was found between the study group and control group regarding left Dichotic digits test versionII (p = 0.020), The mean of SPIN either at Right or Left ear for study group was depressed in comparison to normal individuals, those differences were statistically highly significant (p < 0.001). Furthermore, there was a Highly statically significant difference in TCST (30%,60%), GIN test and DPT between study and control groups (p < 0.001) either at Right or Left ear. Conclusions Patients with occupational noise exposure had poor performance in all central auditory tests when compared with control. This means that occupational noise exposure can lead to impaired central auditory processing with subsequent in adults

Extended preoperative speech audiometric diagnostics for cochlear implant treatment

For severe hearing loss and even profound deafness, cochlear implants (CIs) have become the treatment of choice. For establishment of the CI indication, the preoperative Freiburger monosyllabic word recognition (EV) at 65 dB SPL in free field with ahearing aid (EVHG65) and the maximal understanding (mEV) without ahearing aid with headphones results are important. The goal of this retrospective study was to analyse the correlation of word recognition with ahearing aid at 80 dB SPL (EVHG80) and mEV. This represents an extension to measuring EVHG65 compared to mEV and to pure-tone audiometry (4FPTA). In this study, word recognition with and without ahearing aid was retrospectively analysed for 661ears. Inclusion criterium was CI implantation at alater date. During preoperative CI diagnostics, an mEV of 0% was found in334 ears. The EVHG65 for 485ears and the EVHG80 for 335ears were also 0%. The EV with hearing aid was found to worsen with increasing 4FPTA at both sound pressure levels, although this effect was smaller at 80 dB SPL than at 65 dB SPL. Including only ears with mEV > 0 % (N = 260 ears), astronger correlation between EVHG80 and mEV with adifference of (-4.0 ± 16.4%) in comparison to EVHG65 and mEV with adifference of (-18.3 ± 16.7%) is seen. This shows asignificant difference between mEV and EVHG80 compared to mEV and EVHG65. At asound pressure level of 65 dB SPL, EV with hearing aid often does not show the accordance with mEV specified by hearing aid and CI guidelines. The EVHG80 correlates better with mEV than EVHG65. For clinical diagnosis it is rational to measure speech discrimination with hearing aid at levels higher than 65 dB SPL.

Babies, bugs and brains: How the early microbiome associates with infant brain and behavior development.

Growing evidence is demonstrating the connection between the microbiota gut-brain axis and neurodevelopment. Microbiota colonization occurs before the maturation of many neural systems and is linked to brain health. Because of this it has been hypothesized that the early microbiome interactions along the gut-brain axis evolved to promote advanced cognitive functions and behaviors. Here, we performed a pilot study with a multidisciplinary approach to test if the microbiota composition of infants is associated with measures of early cognitive development, in particular neural rhythm tracking; language (forward speech) versus non-language (backwards speech) discrimination; and social joint attention. Fecal samples were collected from 56 infants between four and six months of age and sequenced by shotgun metagenomic sequencing. Of these, 44 performed the behavioral Point and Gaze test to measure joint attention. Infants were tested on either language discrimination using functional near-infrared spectroscopy (fNIRS; 25 infants had usable data) or neural rhythm tracking using electroencephalogram (EEG; 15 had usable data). Infants who succeeded at the Point and Gaze test tended to have increased Actinobacteria and reduced Firmicutes at the phylum level; and an increase in Bifidobacterium and Eggerthella along with a reduction in Hungatella and Streptococcus at the genus level. Measurements of neural rhythm tracking associated negatively to the abundance of Bifidobacterium and positively to the abundance of Clostridium and Enterococcus for the bacterial abundances, and associated positively to metabolic pathways that can influence neurodevelopment, including branched chain amino acid biosynthesis and pentose phosphate pathways. No associations were found for the fNIRS language discrimination measurements. Although the tests were underpowered due to the small pilot sample sizes, potential associations were identified between the microbiome and measurements of early cognitive development that are worth exploring further.

Hearing Aid in Vestibular-Schwannoma-Related Hearing Loss: A Review.

(1) Background: Several types of hearing aids are available for the rehabilitation of vestibular-schwannoma (VS)-related hearing loss. There is a lack of recently published papers regarding this theme. The aim of the present work is to organize current knowledge. (2) Methods: A review of the literature regarding the topics "vestibular schwannoma", "hearing loss", and "hearing aid" was performed. Nineteen studies were thus considered. (3) Results: Conventional hearing aids, contralateral routing of signal (CROS) aids, bone anchored hearing aids (BAHA), and others are available options for hearing rehabilitation in VS patients. The speech discrimination score (SDS) is considered the best measure to assess candidacy for rehabilitation with hearing aids. The best hearing rehabilitative conditions in VS patients when using conventional hearing aid devices are a mild-moderate hearing loss degree with good word recognition (more than 50% SDS). CROS-Aid and BAHA are reported to be beneficial. CROS-Aid expands on the area of receiving hearing. BAHA aids use direct bone-conduction stimulation. Unfortunately, there are no available studies focused specifically on VS patients that compare CROS and BAHA technologies. (4) Conclusions: Hearing aids, CROS, and BAHA are viable options for rehabilitating hearing impairment in VS, but require an accurate case-by-case audiological evaluation for rehabilitating hearing impairment in VS. Further studies are needed to prove if what is currently known about similar hearing illnesses can be confirmed, particularly in the case of VS.

Evaluation of the Listening Environment of Bilateral Cochlear Implant Users through Data Logging: A Comparison of Bilateral Simultaneous and Sequential Implantation.

To evaluate the listening conditions of bilateral cochlear implant (CI) users in their daily living environment. Retrospective study. University hospital. Thirty-one adult CI users 16 years or older; 18 underwent sequential surgery, and 13 underwent simultaneous surgery. Inclusion criteria included the availability of CI data logging features and a minimum duration of binaural use of 6 months. Retrospective analysis of data obtained from the automatic scene classifier data logging system. Comparison of data logging and maximum speech discrimination scores of the two surgery groups (sequential vs. simultaneous) to investigate the potential influence of these factors on the listening conditions of CI users. The maximum speech discrimination score of the second CI in the sequential group was significantly worse than that of any other CI in the sequential and simultaneous CI groups. Additionally, the longer the interval between surgeries, the more significant the difference in "time on air" between the first and the second CIs. The second CI in sequential CI surgery had a shorter "time on air" than the first or the bilateral simultaneous CIs; the second CI was also used more frequently in noisy and speech with background noise environments. A second CI may be more frequently used in challenging listening environments because of its binaural auditory effect, despite its lower speech discrimination performance. The timing of sequential implantation and the potential impact of binaural hearing should be considered when developing rehabilitation strategies for individuals with bilateral CIs.

Audiologic Consequences of Gunshot Wounds to the Temporal Bone Show No Relation to Concomitant Neurologic or Vascular Injuries.

To evaluate audiologic consequences of gunshot wounds (GSWs) to the temporal bone (TB), and to correlate hearing outcomes with neurologic and vascular injuries adjacent to the temporal bone. Retrospective case series. University-based level-one trauma center. Retrospective review of 35 patients surviving TB ballistic injury, 2012 to 2021. Main outcomes were audiologic results. Demographics, concomitant injuries, CT, and interventions were reviewed. Mean age was 30.7 years; 80% male. Seventeen patients (48.6%) underwent audiologic testing. Mean pure tone average (PTA) was 75 ± 35 dB, bone line average 41 ± 26 dB, and speech discrimination score (SDS) 60 ± 43%. Nineteen (54.3%) demonstrated facial nerve injury (FNI), who were more likely to show SNHL especially anacusis, though their mean PTA and SDS were not statistically different from those without (P = .30 and .47, respectively). Radiographic review of those with sensorineural loss (SNHL, 6/17) revealed otic capsule-disrupting fracture (n = 2), pneumolabyrinth (n = 2), intracranial hemorrhage (n = 3). Those with mixed loss (6/17) showed otic capsule-sparing fracture (n = 6), EAC injury (n = 5), ossicular discontinuity (n = 2), and intracranial hemorrhage (n = 4). Two with mastoid tip fractures alone had normal audiograms. Audiometric outcomes were not predicted by concomitant CSF leak, spinal injuries, vascular injuries, cranial neuropathies, or traumatic brain injury. All patterns of hearing loss-conductive, sensorineural, mixed and normal-may be seen following TB ballistic injuries. Trauma severe enough to disrupt the facial nerve is more likely to cause anacusis. However, all should be formally evaluated, since ballistic injuries complicated by neurologic or vascular damage do not necessarily correlate with worse audiologic outcomes, while patients with minimal fractures may demonstrate losses.

Effect of Polypectomy on Middle Ear Function in Nasal Polyposis Patients

Background: Nasal obstruction and nasal polyps are among the most common diseases treated by ear, nose, and throat (ENT) specialists. Clinical symptoms of the disease are mostly in the form of obstruction, such as pain or pressure in the face, nasal congestion and nasal sound, purulent nasal discharge, and dysfunction of the sense of smell. Studies show that disorders of the middle ear, Eustachian tube, nose, and paranasal sinuses affect other components. In other words, nasal polyps can cause middle ear dysfunction. The change in pressure on both sides of the tympanic membrane is accompanied by changes in the structure and function of the tympanic membrane and hearing impairment. Objectives: This study aimed to evaluate the effect of polypectomy on middle ear function in patients with nasal and sinus polyposis. Methods: This quasi - experimental study investigated 50 patients with nasal polyposis referred to the specialized ENT Clinic of Vali-e-Asr and Razi hospitals in Birjand, Iran, in 2021. After examination by a specialist and confirmation of nasal polyps, the patients were referred to an audiometry center (Tanin Audiometry Center) for audiometric testing. The results of pure - tone audiometry (PTA), speech recognition threshold (SRT), speech discrimination score (SDS), and endotracheal tube parameters before and after surgery were compared to patients’ clinical symptoms. Results: Out of 50 patients, 25 and 25 subjects were female and male, respectively. Based on the results of the present study, the mean PTA scores of the right ear before and after surgery were 15.9 ± 8.8 and 15.3 ± 8, respectively, which decreased significantly (P < 0.05). The PTA mean scores of the left ear before and after surgery were 15.4 ± 8.2 and 15.3 ± 8, respectively. The SRT mean scores of the right ear before and after surgery were 18.9 ± 9.1 and 18 ± 8.6, respectively. The SRT mean scores of the left ear before and after surgery were 18.7 ± 9.5 and 18.8 ± 10.2, respectively. The SDS mean scores of the right ear before and after surgery were 100 ± 0 and 100 ± 0, respectively. The SDS mean scores of the left ear before and after surgery were 100 ± 0 and 100 ± 0, respectively, which at the end of the study were not significantly different from those at the beginning of the study (P > 0.05). Conclusions: Middle ear function before and after chronic rhinosinusitis (CRS) surgery was not significantly different in patients undergoing surgery. In addition, the clinical symptoms of patients after CRS improved compared to those at the beginning of the study.

Is Corticosteroid Treatment Beneficial in Sudden Sensorineural Hearing Loss? A Large Retrospective Study

The main treatment approaches for sudden sensorineural hearing loss (SSNHL) involve oral and intratympanic corticosteroids, but their efficacy remains controversial. The study objective was to evaluate the benefit of oral corticosteroids followed by intratympanic salvage treatment. This was conducted by comparing the hearing results of post-treatment patients arriving early and pretreatment patients arriving late over the same time points after the onset of HL. A cohort of 776 patients with SSNHL was classified into four groups by time from onset of symptoms to the initiation of treatment (weeks). The post-treatment audiometry of those patients presenting during the first and second week post-HL was compared to the pretreatment audiometry of those presenting in weeks three and four. The post-treatment audiometry of week one and pretreatment audiometry of week three was conducted 17.2 ± 4 and 19.4 ± 3 (p = 0.13) days post-HL onset, respectively. The post-treatment audiometry of week two and pretreatment audiometry of week four was conducted on days 24.6 ± 4 and 25.2 ± 3 (p = 0.32). The pure-tune average for week one and three groups was 36.7 ± 28 and 37.5 ± 19 dB (p = 0.55), and for weeks 2 and 4, it was 31.7 ± 22 and 36.6 ± 23 dB (p = 0.1). Similarly, no significant differences in speech recognition threshold and speech discrimination were found. These results question the benefit of corticosteroid treatment for SSNHL and suggest that improvements may be due to the natural healing process.

Gaussian-Filtered High-Frequency-Feature Trained Optimized BiLSTM Network for Spoofed-Speech Classification.

Voice-controlled devices are in demand due to their hands-free controls. However, using voice-controlled devices in sensitive scenarios like smartphone applications and financial transactions requires protection against fraudulent attacks referred to as "speech spoofing". The algorithms used in spoof attacks are practically unknown; hence, further analysis and development of spoof-detection models for improving spoof classification are required. A study of the spoofed-speech spectrum suggests that high-frequency features are able to discriminate genuine speech from spoofed speech well. Typically, linear or triangular filter banks are used to obtain high-frequency features. However, a Gaussian filter can extract more global information than a triangular filter. In addition, MFCC features are preferable among other speech features because of their lower covariance. Therefore, in this study, the use of a Gaussian filter is proposed for the extraction of inverted MFCC (iMFCC) features, providing high-frequency features. Complementary features are integrated with iMFCC to strengthen the features that aid in the discrimination of spoof speech. Deep learning has been proven to be efficient in classification applications, but the selection of its hyper-parameters and architecture is crucial and directly affects performance. Therefore, a Bayesian algorithm is used to optimize the BiLSTM network. Thus, in this study, we build a high-frequency-based optimized BiLSTM network to classify the spoofed-speech signal, and we present an extensive investigation using the ASVSpoof 2017 dataset. The optimized BiLSTM model is successfully trained with the least epoch and achieved a 99.58% validation accuracy. The proposed algorithm achieved a 6.58% EER on the evaluation dataset, with a relative improvement of 78% on a baseline spoof-identification system.

The effect of hearing loss on balance in subjects with cognitive disorders

Background Falls among older adults are a major health issue. Cognitive impairment is known to be an independent risk factor for falls with around 60% of people with cognitive impairment falling each year. Presbycusis is also associated increased risk of falls in older adults. Objective The aim of the present study was to investigate the relationship between hearing loss and balance in subjects with cognitive disorders. Methods Pure tone air and bone conduction thresholds, speech recognition thresholds and discrimination were measured. The Sensory Organization Test (SOT) and Adaptation Test (ADT) were performed. Results Subjects with mild hearing loss has the highest scores on SOT and composite scores while subjects with severe hearing loss has worst scores. There was no statistically significant difference between groups on ADT scores. Conclusions Hearing loss and cognitive disorders are independent risk factors for impaired balance among older adults with cognitive decline. Hearing and balance assessment and rehabilitation should be considered in the routine evaluations of older adults.

Speech perception as afunction of cochlear coverage-comparison in bimodally hearing cochlear implant patients. German version

Hearing success in bimodally hearing patients with acochlear implant (CI) and ahearing aid (HA) exhibits different results: while some benefit from bimodal CI and HA, others do not. The aim of this study was to investigate hearing success in terms of speech perception in bimodally fitted patients in relation to the cochlear coverage (CC) of the CI electrodes. Using the OTOPLAN software (CAScination AG, Bern, Switzerland), CC was retrospectively measured from CT scans of the temporal bone of 39patients, who were then categorized into two groups: CC ≤ 65% (CC500) and CC > 65% (CC600). Monaural speech intelligibility for monosyllables at asound pressure level (SPL) of 65 dB in open field was assessed at various timepoints, preoperatively with HA and postoperatively with CI, and compared between the groups. In addition, speech intelligibility was correlated with CC in the entire cohort before surgery and during follow-up (FU). Overall, no significant differences in speech intelligibility were found between CC500 and CC600 patients at any of the FU timepoints. However, both CC500 and CC600 patients showed asteady improvement in speech intelligibility after implantation. While CC600 patients tended to show an earlier improvement in speech intelligibility, CC500 patients tended to show aslower improvement during the first 3months and asteeper learning curve thereafter. The two patient groups converged during FU, with no significant differences in speech intelligibility. There was no significant relationship between unimodal/unilateral free-field speech intelligibility and CC. However, patients with aCC of 70-75% achieved maximum speech intelligibility. Despite anonsignificant correlation between CC and speech discrimination, patients seem to reach their maximum in unimodal/unilateral speech understanding mainly at 70-75% coverage. However, there is room for further investigation, as CC500 was associated with ashorter cochlear duct length (CDL), and long and very long electrodes were used in both groups.

Long-term speech perception performance in prelingually deafened adult cochlear implant recipients

Objective To investigate the postoperative long-term outcomes after an average of 9.2 years following cochlear implantation (CI) in prelingually deafened adults, along with preimplantation factors predicting postoperative outcomes. Methods Twenty-six prelingually deafened adults who underwent CI at >18 years were compared with those who had undergone CI in childhood (<9 years) and were >10 years old. Outcome measures includedhearing thresholds, preoperative and postoperative aided hearing level (HL), speech discrimination score (SDS), and Categories of Auditory Performance (CAP) scores. Correlation analyses were performed on the following: SDS results, aided HL, school attendant status, implant manufacturers, and speech processor models. Results Improvement was achieved in the aided HL and SDS results, although these results were not better than those of the child group. CAP score was also statistically significantly improved after CI. Statistically significant correlation between the preoperative SDS and postoperative HL with CI results was observed. In other words, the better the preoperative SDS results, the better the postoperative SDS results. Conclusion Prelingually deafened adults achieved considerable improvement through CI. It is important to understand that patients achieving better hearing with a well-fitted hearing aid and good SDS performance before surgery may be good candidates for CI.

Objective discrimination of bimodal speech using frequency following responses

Bimodal hearing, in which a contralateral hearing aid is combined with a cochlear implant (CI), provides greater speech recognition benefits than using a CI alone. Factors predicting individual bimodal patient success are not fully understood. Previous studies have shown that bimodal benefits may be driven by a patient's ability to extract fundamental frequency (f0) and/or temporal fine structure cues (e.g., F1). Both of these features may be represented in frequency following responses (FFR) to bimodal speech. Thus, the goals of this study were to: 1) parametrically examine neural encoding of f0 and F1 in simulated bimodal speech conditions; 2) examine objective discrimination of FFRs to bimodal speech conditions using machine learning; 3) explore whether FFRs are predictive of perceptual bimodal benefit. Three vowels (/ε/, /i/, and /ʊ/) with identical f0 were manipulated by a vocoder (right ear) and low-pass filters (left ear) to create five bimodal simulations for evoking FFRs: Vocoder-only, Vocoder +125 Hz, Vocoder +250 Hz, Vocoder +500 Hz, and Vocoder +750 Hz. Perceptual performance on the BKB-SIN test was also measured using the same five configurations. Results suggested that neural representation of f0 and F1 FFR components were enhanced with increasing acoustic bandwidth in the simulated “non-implanted” ear. As spectral differences between vowels emerged in the FFRs with increased acoustic bandwidth, FFRs were more accurately classified and discriminated using a machine learning algorithm. Enhancement of f0 and F1 neural encoding with increasing bandwidth were collectively predictive of perceptual bimodal benefit on a speech-in-noise task. Given these results, FFR may be a useful tool to objectively assess individual variability in bimodal hearing.

Telepractice in speech-language pathology: Assessing remote speech discrimination

PurposeTo evaluate adult remote performance in speech discrimination on the Temple Assessment of Language and Short-term Memory in Aphasia (TALSA), and to compare to remote performance in NU-6 word repetition and participant ratings of self-perceived hearing ability obtained via remote session. MethodSixty older adults completed TALSA speech discrimination of concrete, low frequency words and of non-words via telephone. Remote repetition of words controlled for sound frequency was assessed using the Northwestern University (NU-6) word lists administered in live voice and recorded voice conditions. Forty-six of the participants completed questionnaires about their hearing via Zoom videoconference. ResultsMean performance in TALSA speech discrimination for words was similar to performance in NU-6 word repetition. Word repetition of NU-6 lists did not differ significantly for live voice versus recorded voice conditions. TALSA non-word speech discrimination was significantly worse than TALSA speech discrimination for words and was associated with age and self-reported hearing ability. ConclusionsTALSA speech discrimination can be administered remotely to evaluate potential perceptual influences on auditory comprehension. In remote assessment, participants demonstrated the expected pattern of more accurate speech discrimination for word stimuli than for non-words. The non-word TALSA condition may be particularly useful for detecting speech perception impairment, both in face-to-face and telepractice sessions. Similar performance of participants in both live voice and recorded conditions of the NU-6 word lists suggests that recordings used in SLP receptive language or memory assessment, including the TALSA, need not be abandoned in favor of live voice to support audition during telepractice.

Primary versus salvage intratympanic steroid treatment for idiopathic sudden sensorineural hearing loss.

The objective of this research is to compare primary and salvage intratympanic (IT) steroid treatments in terms of hearing outcomes in patients with idiopathic sudden sensorineural hearing loss (ISSNHL). The patients were randomized into two (primary and salvage) groups. Both groups received systemic steroid treatment for 2 weeks. The primary group also received IT dexamethasone injection three times during the treatment period, whereas the salvage group received IT dexamethasone injection only if no or slight recovery was noted at the 2-week follow-up. If needed, salvage steroid injection was administered three times during the following 2 weeks. Hearing recovery was analyzed according to the modified American Academy of Otolaryngology-Head and Neck Surgery criteria. The degrees of hearing improvement at the 3-month follow-up were similar in the two groups. Compared with baseline, the pure-tone average values and speech discrimination scores improved by 38.45 ± 21.95 dB HL and 34.32% ± 30.55%, respectively, in the primary group and 36.80 ± 22.33 dB HL and 31.87% ± 27.88%, respectively, in the salvage group (p = .762 and .659, respectively). In addition, the complete or partial hearing recovery rates were also similar in the primary and salvage groups (67.7% vs. 73.3%, respectively; p = .780). In the salvage group, 18 patients required no IT steroid injection because they recovered after systemic steroid treatment. Primary and salvage IT steroid treatments for ISSNHL led to similar outcomes. In summary, salvage IT steroid injection is recommended for patients with ISSNHL patients to prevent unnecessary IT injection. 2.

Effect of Lexical Neighbourhood on Word Recognition Test: A Study in Turkish

Background and Aim: Word Recognition Test (WRT) is a widely used component of routine audiology battery. Several studies were conducted on the effect of words in word recognition lists and whether word difficulty level had an effect in word recalling process of patients. This study aims to compare the scores of patients to the designed Başkent WRT and commonly used Hacettepe WRT by focusing on the lexical neighbourhood. Methods: Study carried out in an Ear Nose and Throat Department of a private university hospital between June and August 2021. 34 persons with sensorineural hearing loss and 34 persons without hearing loss was participated in the study. Designed WRT and widely used common WRT were presented to the participants. Results: Results showed that common WRT included words with more lexical neighbours and sensorineural hearing loss group scores were significantly lower compared to designed WRT. Conclusion: Persons with sensorineural hearing loss have a tendency to misunderstand presented words in WRT as they may trigger other words and misguide the patient. Keywords: Speech audiometry; speech discrimination tests; hearing tests; psychoacoustics

Long-term Outcome of Sound Localization with Baha® Attract System.

Spatial hearing is a critical feature in daily life. However, there is quite a range in hearing loss patients regarding the effect of bone conduction device on localization performance. To analyze the localization performance in patients with bilateral conductive or mixed hearing loss fitted with one Baha® Attract system. This prospective study included 12 patients who had followed up for more than one year. The parameters analyzed included (1) audiological results: sound field threshold, speech discrimination scores (SDSs), and sound localization test, and (2) functional results: scores for the Speech, Spatial and Qualities of Hearing Scale (SSQ) and the Chinese translation of the Spatial Hearing Questionnaire (C-SHQ). The audiological assessments showed a reduction of 28.5 dB in the mean sound field thresholds and improvements of 61.7% in the SDSs for disyllabic words. The root mean square error improved slightly with the Baha® Attract system. Patients showed promising results in the functional questionnaire assessments, with significant improvements in the SSQ and C-SHQ scores. Although most patients were not able to localize sound accurately after surgery, the change in the scores of the SSQ and C-SHQ indicated that the Baha® Attract system could improve spatial hearing.

#3935 AUDIOLOGICAL ASSESSMENT IN PEDIATRIC CKD PATIENTS

Abstract Background and Aims Many similarities exist between the nephron &amp; ear infrastructures, making them vulnerable to same risk factors. Idiopathic sensory neural hearing loss is frequent in pediatric patients with chronic kidney disease (CKD). Our aims were to determine the prevalence, type, &amp; degree of hearing impairment in pediatric CKD patients. Method This cross-sectional study was carried out at pediatric dialysis &amp; nephrology unit at Children's hospital &amp; Audiology unit, Faculty of Medicine Ain Shams University, included 45 CKD patients’ stage 2-4, 45 CKD patients’ stage 5 on hemodialysis, &amp; 90 children as controls. Detailed history, physical, otological examinations &amp; audiological assessment by standard pure tone audiometry, speech audiometry &amp; tympanometry, IQ test, in addition to some laboratory investigations were done for all our studied patients. Results The mean IQ was significantly lower in CKD patients than the controls, however, it was significantly higher in dialysis than non-dialysis groups (p = 0.05). Pure tone audiometry showed 16.6% of out CKD patients had hearing loss, which was mainly sensory neural (SNHL); (53.3%), that was significantly higher compared to the control group (p &amp;lt; 0.001). A mild degree of high-frequency hearing loss was frequently reported. These findings weren't significantly different between dialysis &amp; non-dialysis patients, but were significant compared to control group (P&amp;lt;0.001). Regarding speech discrimination scores, controls had a higher significant change compared to CKD patients. Regarding Tympanometry test results, most of CKD patients &amp; the controls had normal middle ear pressure. The most determining factor affecting the hearing loss in our patients was the IQ. Conclusion High-frequency SNHL is not uncommon in CKD pediatric patients, in addition to low IQ. It's recommended to do a routine audiological evaluation &amp; follow up for early diagnosis &amp; intervention.

Audiogram Configuration, Molecular Etiology, and Outcome of Cochlear Implantation in Postlingual Auditory Neuropathy Spectrum Disorder.

To explore the diverse molecular etiologies of postlingual auditory neuropathy spectrum disorder (ANSD) and report on the electrically evoked compound action potential (ECAP) thresholds and the outcome of cochlear implantation (CI). Patients with late-onset, progressive hearing loss who went through molecular genetic testing were enrolled. Type of sensorineural hearing loss (SNHL) was classified as flat, reverse-slope, midfrequency, downsloping, or ski slope. We identified postlingual ANSD subjects through diagnostic tracts applied differently depending on the degree of SNHL. For CI recipients, individual ECAP thresholds, postoperative speech perception abilities, and the genetic cause were analyzed. The detection rate of ANSD among patients with postlingual SNHL was 5.1% (15/293 probands). Diverse genetic etiologies were identified in 7 (46.6%) of the 15 postlingual ANSD subjects, the genetic cause being found exclusively in subjects with reverse-slope SNHL. The pattern of intraoperative ECAP responses was also diverse and showed some correlation with the genetic etiology. Despite the diverse molecular etiology and ECAP responses, CI in postlingual ANSD patients, including those with features involving the postsynaptic component, yielded significant improvements in speech understanding. This study proposes a differentiated diagnostic approach that focuses on both poor speech discrimination and reverse-slope hearing loss for the diagnosis of ANSD. Based on the improvement of speech understanding from all cochlear implantees with ANSD as well as the correlation between the genetic etiology and ECAP thresholds, we suggest that CI can significantly benefit ANSD subjects even those with unknown etiologies unless there is overt peripheral neuropathy.