Hearing Quality Research Articles

Studying subjective hearing loss in older adults measured by speech, spatial, and quality of hearing scale within the framework of the ICF core set for hearing loss

Objective This study aimed to assess categories underlying subjective hearing loss (SHL) in older adults using the International Classification of Functioning, Disability (ICF) and Health-Brief Core Set for Hearing Loss (ICF-BCS-HL). Design A cross-sectional study. One-hundred and thirty-one independent-living older adults (Mage = 72.32, SD = 6.83), who completed the speech, spatial, and quality of hearing (SSQ) scale and a set of clinically accepted outcome measurements linked with selected categories listed in the ICF-BCS-HL. Results A linear regression analysis model was fitted with the outcome measurements after controlling for age, sex, education, multimorbidity, and hearing aid use. The model showed 5 significant predictors underlying the SSQ-total score: HL (ß = −.38, p ≤ .001), dizziness handicap (ß = −.35, p ≤ .001), cognitive decline (ß = .17, p < .05), multimorbidity (ß = .12, p < .005), and poor ability to accept the noise level (ß = −.16, p = p < .05). Predictors varied across the SSQ-subscales scores, however. Conclusion A link of SHL with HL, cognitive deficits, poor ability to accept background noise level, and multimorbidity, collectively or individually, were well-established. So far, little attention has been paid to the impact of dizziness handicap of elderly patients when evaluating their SHL.

Mastoid cavity obliteration with allogenic and autologous material

Surgical obliteration is the treatment of choice for symptomatic mastoid cavities. Various methods and materials are available. Allogeneic material is easily available but can lead to wound infections due to rejection, granulation and inflammatory reactions. Consequently, autologous material is often preferred due to its good biocompatibility. The aim of this study was to compare the long-term outcomes of patients after mastoid cavity obliteration with allogeneic and autologous material with regard to the occurrence of recurrent cholesteatoma, the number of revision surgeries and the impact of surgery on the health-related quality of life. Patients who underwent mastoid cavity obliteration with an allogeneic material (hydroxyapatite matrix [HMM]) were retrospectively included in the study. In a prospective part, patients who underwent mastoid cavity obliteration with autologous reconstruction material (AutoM) were included. In addition to a detailed chart review, all patients underwent pure tone audiometry and completed the Zurich Chronic Middle Ear Inventory (ZCMEI-21) at the postoperative examination to assess health-related disease-specific quality of life. A total of 22 patients with a mean age of 56.9 (SD 18.7 years) receiving HMM (mean follow-up interval: 88.3 months [SD 21.9 months]) and 25 patients with a mean age of 52.4 years (SD 13.7 years) receiving AutoM (mean follow-up interval: 13.5 months [SD 9.5 months]) were included in the study. The revision-free rate for audiological indication after one year was 100% for HMM and 85% for AutoM. The recurrence-free rate at one year was 95% for HMM and 100% for AutoM. 55% of the patients with alloplastic material and 8% of the patients with autologous material required revision surgery due to ear discharge or recurrent cholesteatoma. The groups did not differ in terms of postoperative hearing outcome or postoperative quality of life. Obliteration of mastoid cavities is a surgical challenge. There was no relevant difference between the materials used in terms of recurrence rate, hearing and health-related quality of life within the 13.5-month observation period of both groups. The lack of subjective symptoms together with the high rate of recurrent cholesteatoma and revision indications emphasises the need for regular clinical follow-up including ear microscopy in chronic middle ear disease and strongly suggests regular follow-up examinations.

Longitudinal Changes of Quality of Life and Hearing Following Radiosurgery for Vestibular Schwannoma.

Simple SummarySince vestibular schwannomas are slow-growing tumors that can be controlled with different treatment modalities such as neurosurgery or radiotherapy, preserving quality of life is an important consideration. In this study, we analyzed how quality of life (QoL) changes for patients who receive stereotactic radiation in the months and years after treatment and if there is a correlation between changes in QoL and changes in hearing function. The results suggest that proper hearing of the unaffected ear might compensate for a hearing loss of the other ear due to the tumor or the treatment and in turn preserve QoL. However, this association should be confirmed in additional studies.Background: Most existing publications on quality of life (QoL) following stereotactic radiosurgery (SRS) for vestibular schwannomas (VS) gather information retrospectively by conducting surveys several years after treatment. The purpose of this study is therefore to provide longitudinal QoL data and assess how changes in hearing impact QoL. Methods: Patients completed the 12-item short-form (SF-12) health survey prior to treatment and at every follow-up visit. One hundred and seventy-five patients who had complete forms prior to treatment as well as at an early and at a late follow-up were included in the analysis. For 51 of these patients, longitudinal audiometry data were available. Results: Median follow-up was 7.2 years. Patients experienced a significant reduction in the physical composite score (PCS, p = 0.011) compared to before treatment. The mental composite score (MCS) increased significantly (p = 0.032). A decrease in PCS was not significantly correlated with an increased hearing threshold on the affected but rather on the unaffected ear (r(49) = −0.32, p = 0.023). Conclusions: It is unclear whether the decline in the PCS is due to treatment-related toxicity or the normal decline of PCS with age. Ensuring proper hearing on the untreated ear might be crucial to ensure good QoL for patients treated with SRS for VS, though this association should be confirmed in additional studies.

Improved Jitter Buffer Management for WebRTC

This work studies the jitter buffer management algorithm for Voice over IP in WebRTC. In particular, it details the core concepts of WebRTC’s jitter buffer management. Furthermore, it investigates how jitter buffer management algorithm behaves under network conditions with packet bursts. It also proposes an approach, different from the default WebRTC algorithm, to avoid distortions that occur under such network conditions. Under packet bursts, when the packet buffer becomes full, the WebRTC jitter buffer algorithm may discard all the packets in the buffer to make room for incoming packets. The proposed approach offers a novel strategy to minimize the number of packets discarded in the presence of packet bursts. Therefore, voice quality as perceived by the user is improved. ITU-T Rec. P.863, which also confirms the improvement, is employed to objectively evaluate the listening quality.

Preoperative Sudden Hearing Loss May Predict Hearing Preservation After Retrosigmoid Resection of Vestibular Schwannoma.

Describe the effect of preoperative sudden hearing loss (SHL) on likelihood of hearing preservation (HP) after surgical resection of vestibular schwannoma (VS). Retrospective chart review. Tertiary referral center. Adult patients (≥18 years) who underwent retrosigmoid VS resection for HP between February 2008 and December 2018 were reviewed. All patients had preoperative word recognition score (WRS) of at least 50%. Similarly, HP was defined as postoperative WRS of more than or equal to 50%. Regression analysis was used to describe the effect of SHL on HP, accounting for tumor size, and preoperative hearing quality. All patients underwent retrosigmoid VS resection for HP. WRS of at least 50%. Of 160 patients who underwent retrosigmoid VS resection during the study period, 153 met inclusion criteria. Mean tumor size was 14.0 (±6) mm. Hearing was preserved in 41.8% (n = 64). Forty patients (26.1%) had a history of preoperative SHL. Among 138 patients (90.2%) in whom the cochlear nerve was anatomically preserved during surgery, HP was achieved in 61.8% of those with SHL (21 of 34) and 41.3% of those without SHL (43 of 104) (p = 0.0480). On univariate and multivariate analysis (accounting for tumor size and preoperative hearing quality), SHL was a significant positive predictor of HP (odds ratio 2.292, p = 0.0407 and odds ratio 2.778, p = 0.0032, respectively). In patients with VS and retained serviceable hearing, SHL is an independent predictor of HP after retrosigmoid microsurgical resection when the cochlear nerve is preserved.

WOMEN LISTENING TO WOMEN AT ZERO-ACQUAINTANCE: INTERPERSONAL BEFRIENDING AT THE INDIVIDUAL AND DYADIC LEVELS

ABSTRACT Tend and Befriend theory specifies interpersonal stress responses women utilize; we studied them at the individual and dyadic levels using the Social Relations Model (SRM). Speaking about stressful life events with another woman perceived as listening attentively and with interest was predicted to engender interpersonal closeness and stress reduction. In 265 dyads, women discussed stressful events with at least three other women. Then, they judged their own and their partners’ listening quality. Each predicted their partner’s judgment of their listening. Women also rated interpersonal closeness to their partners, their partners’ closeness to them, and stress. SRM revealed individual and dyadic effects on listening, interpersonal closeness, and stress. We used the SRM effect estimates in individual and dyadic phenomenological listening models. Modeling supported the prediction that perceived listening quality impacts interpersonal closeness and stress reduction. The result extended Tend and Befriend theory by demonstrating individual and dyadic support mechanisms at zero-acquaintance. The results also extended Relational Regulation Theory by showing that even conversations about stress can reduce it.

Systemic antibiotics for chronic suppurative otitis media.

Systemic antibiotics for chronic suppurative otitis media.

The effectiveness of auditory training using virtual reality technologies in persons with chronic sensorineural hearing loss

To study the effectiveness of auditory training using virtual reality technologies in people with chronic sensorineural hearing loss in dynamics. The study included 68 patients aged from 24 to 97 years (mean age 57.63±15.87 years) with latent hearing loss (hearing loss at high frequencies), I degree of hearing loss and its variations. Auditory training was carried out on the basis of the Diagnostic and Rehabilitation System for spatial and speech hearing based on virtual reality using various audiovisual scenarios ReviAudio and control of speech perception, spatial hearing and hearing quality using the SSQRus questionnaire. A comparative analysis of the training results using the ReviAudio software revealed positive trends in the patient's response time and the patient's accuracy in determining the direction of the target signal, regardless of the symmetry and asymmetry of hearing loss. Patients with asymmetric hearing impairment observe an improvement in spatial hearing parameters, patients with symmetric hearing loss - speech perception and hearing quality, patients with latent hearing loss report an improvement in the quality of hearing. The auditory training is effective in individuals with mild chronic sensorineural hearing loss and in individuals with latent hearing loss as an adjunctive treatment.

The Impact of Hearing Aids on Quality of Life of Hearing Impaired Individuals

The regular use of hearing aids (more than 8 hours a day) benefits people in hearing for bettercommunication than those who are less-likely to use hearing aids Objective: The objective of thestudy was to assess the impact of hearing aids on the quality of life of hearing impaired individualsMethods: In this cross-sectional study total 50 participants were recruited by convenient samplingtechnique from Lahore, Pakistan. 50 patients who were diagnosed with hearing loss and wererecommended with hearing aids of both genders were included in the study. The International OutcomeInventory for Hearing Aids (IOI-HA), questionnaire was used for data collection. Data were analyzedthrough Statistical Package for Social Sciences (SPSS) version 23.0 Results: In this research 50hearing impaired individuals who were hearing aid users, participated. The mean age of participants was64.10+15.88 years. Among which 25 (50%) were males and 25(50%) were females. The average time ofhearing aid use was 3.88 hours, majority of patients responded that hearing aid helped quite a lot in thedaily routine (mean score of IOI-HA, 3.62), have moderate difficulty in residual activity (mean score of IOIHA,3.26), moderately satisfied with their hearing aid (mean score of IOI-HA, 3.28), moderately affect theparticipation restriction (mean score of IOI-HA, 3.20), impact of their hearing loss bothered moderately(mean score of IOI-HA, 3.14) and quality of life (QOL) was very much better (3.90). There was insignificantassociation between the QOL of males and females (p-value&gt;0.05) Conclusions: It was concluded fromthe study that the hearing aids have a greater impact on the quality of life and socio-economic aspectsof hearing impaired individuals. Hearing loss is such a problem, which separates certain community ofhearing impaired individuals from the normal population. Individuals with hearing impairment not onlyhave to face personal communication problems but also it affects their health, independency and qualityof life in their daily routine.

The experience in surgical treatment of hearing loss in Van der Hoeve patients

Despite the rare incidence of Van der Hoeve syndrome in the population, the problem of treating patients with this type of disease is important for modern science and practical medicine. One of the most difficult tasks in treatment is to improve the quality of hearing. The world scientific community lacks a unified coordinated approach to the methods of auditory rehabilitation of patients with Van der Hoeve syndrome. In recent years, there have been tendencies in the scientific literature to increase the frequency of non-surgical approach due to the low incidence of satisfactory results of surgical treatment. In this regard, we present our experience of complex treatment of patients with Van der Hove syndrome, based on the use of modern surgical technologies and conservative pathogenetically substantiated treatment.

Impact of Languages and Accent on Perceived Speech Quality Predicted by Perceptual Evaluation of Speech Quality (PESQ) and Perceptual Objective Listening Quality Assessment (POLQA): Case of Moore, Dioula, French and English

Impact of Languages and Accent on Perceived Speech Quality Predicted by Perceptual Evaluation of Speech Quality (PESQ) and Perceptual Objective Listening Quality Assessment (POLQA): Case of Moore, Dioula, French and English

Ruído Ocupacional, Audição e Qualidade de Vida em Dentistas

ABSTRACT Introduction Workers with excessive noise exposure can develop problems related to general health, hearing and have changes in quality of life, with Noise-Induced Hearing Loss (NIHL) being the most common change associated with hearing. Dentists, when using different types of equipment for clinical and surgical procedures, end up being exposed to noise daily. Hearing loss is associated with decreased life quality, including an increased risk of loneliness, isolation and a decline in functional fitness. Considering that hearing is fundamental in the socialization process and, consequently, for oral communication, any and all changes in auditory perception can trigger problems in social interaction with a negative impact on people’s lives. Objective To analyse the impact of noise on hearing and life quality of dentists in Paraná. Methods This is a descriptive observational, cross-sectional study carried out with forty dentists from southern Brazil. The research subjects underwent basic audiological evaluation and high frequency audiometry, in addition to answering two questionnaires, one about life quality (SF-36) and the other with data about the working conditions, knowledge and perceptions of dentists regarding the exposure to noise at work. Results Auditory changes suggestive of being induced by noise were observed in 15% of dentists. In high frequency audiometry, auditory alterations occurred in six professionals, and in four of them there was bilateral alteration. The SF-36 indicated median values of 62.57 for general health and 64 for vitality; 100 being the maximum score. It was found that 52.5% of dentists are aware of the effects of noise exposure on health, but only 5% declared using ear protectors during the exercise of their profession. Conclusion Early awareness of the effects of noise would bring more comfort and life quality to dentists, as well as less hearing problems.

Evaluation of Efferent Auditory System and Hearing Quality in Parkinson's Disease: Is the Difficulty in Speech Understanding in Complex Listening Conditions Related to Neural Degeneration or Aging?

Purpose The effects of neurological diseases on the auditory system have been a notable issue for investigators because the auditory pathway is closely associated with neural systems. The purposes of this study are to evaluate the efferent auditory system function and hearing quality in Parkinson's disease (PD) and to compare the findings with age-matched individuals without PD to present a perspective on aging. Method The study included 35 individuals with PD (mean age of 48.50 ± 8.00 years) and 35 normal-hearing peers (mean age of 49 ± 10 years). The following tests were administered for all participants: the first section of the Speech, Spatial and Qualities of Hearing Scale; pure-tone audiometry, speech audiometry, tympanometry, and acoustic reflexes; and distortion product otoacoustic emissions (DPOAEs) and contralateral suppression of DPOAEs. SPSS Version 25 was used for statistical analyses, and values of p < .05 were considered statistically significant. Results There were no statistically significant differences in the pure-tone audiometry thresholds and DPOAE responses between the individuals with PD and their normal-hearing peers (p = .732). However, statistically significant differences were found between the groups in suppression levels of DPOAEs and hearing quality (p < .05). In addition, a statistically significant and positive correlation was found between the amount of suppression at some frequencies and the Speech, Spatial and Qualities of Hearing Scale scores. Conclusions This study indicates that medial olivocochlear efferent system function and the hearing quality of individuals with PD were affected adversely due to the results of PD pathophysiology on the hearing system. For optimal intervention and follow-up, tasks related to hearing quality in daily life can also be added to therapies for PD.

Prevalence and Associates of Fear of Falling among Community-Dwelling Older Adults.

We aimed to study the prevalence of fear of falling (FOF), and its association with physical performance, functionality, frailty, sarcopenia, and a variety of geriatric syndromes including cognitive impairment, depression, quality of life and hearing. Retrospective, cross-sectional study. Community-dwelling older adults applied to the geriatric outpatient clinic of a university hospital. A total of 1021community-dwelling older adults >= 60 years of age applying to the geriatric outpatient clinic of a university hospital. We screened for falls and FOF by single close-ended questions. We performed screening and assessment of probable sarcopenia by SARC-F test and handgrip strength evaluation according to EWGSOP2. We used timed up and go test (TUG), usual gait speed (UGS) for physical performance, and Katz- activities of daily living (ADL) and Lawton-Brody instrumental activities of daily living (IADL) for functional evaluation. We screened anxiety with the Generalized Anxiety Disorder-7 scale. The prevalence of FOF was 44.6% and falls, 37.7%. Prevalence of FOF in sarcopenia screening positive participants was 30.1%; in probable sarcopenic (35/20 kg) participants, 43.9%; in those with undernutrition, 45.7%; in fallers, 51.1%; in females, 80.4%; and in prefrail/frail was 74.7% Multivariate regression analyses revealed that female sex (OR=4.1, 95%CI= 2.0-8.4, p<0.001), anxiety (OR=2.7, 95%CI= 1.1-6.5, p=0.03) and ADL limitation (OR=2.5, 95%CI= 1.03-6.3, p=0.04) were independent associates of FOF. FOF accompanied by fall experience or not is prevalent in community-dwelling older adults. It is associated with anxiety and ADL limitations apart from the female sex.

Musicians' Earplugs: Do They Affect Performance or Listeners' Perceptions?

Does wearing musicians' earplugs while performing affect the quality of the performance? Can listeners perceive a difference in sound when musicians are performing with or without earplugs? The risk of hearing loss is a concern for musicians, but some are reluctant to wear hearing protection due to factors such as an inability to hear their own instrument properly and the possibility of decreased sound quality for listeners. The purpose of this study was to determine the effect of musicians' earplugs on instrumental pitch accuracy and the perception of tone quality, intonation, and dynamic contrast, as perceived by musicians and listeners. Ten university studio faculty teachers were recorded performing single pitches and lyrical and technical passages, first without earplugs and then immediately after with earplugs. A sample of 8 studio faculty teachers and 88 undergraduate music education students completed a researcher-created music perception test of tone quality, intonation, and dynamic contrast. Objective analyses of the single pitch recordings made by faculty with and without earplugs indicate that pitch accuracy did not favor either condition consistently. Results from the perception test indicate that although both faculty and student listeners perceived some differences, the most frequent perception was that the audio pair was equal, and there was no clear difference between performing with and without earplugs in terms of tone quality, intonation, or dynamic contrast. These findings suggest that musicians should feel confident that wearing musicians' earplugs while performing does not adversely affect pitch accuracy or listeners' perceptions of their timbre and dynamic control.

Pupillometry Assessment of Speech Recognition and Listening Experience in Adult Cochlear Implant Patients.

ObjectiveThe aim of the present study was to investigate the pupillary response to word identification in cochlear implant (CI) patients. Authors hypothesized that when task difficulty (i.e., addition of background noise) increased, pupil dilation markers such as the peak dilation or the latency of the peak dilation would increase in CI users, as already observed in normal-hearing and hearing-impaired subjects.MethodsPupillometric measures in 10 CI patients were combined to standard speech recognition scores used to evaluate CI outcomes, namely, speech audiometry in quiet and in noise at +10 dB signal-to-noise ratio (SNR). The main outcome measures of pupillometry were mean pupil dilation, maximal pupil dilation, dilation latency, and mean dilation during return to baseline or retention interval. Subjective hearing quality was evaluated by means of one self-reported fatigue questionnaire, and the Speech, Spatial, and Qualities (SSQ) of Hearing scale.ResultsAll pupil dilation data were transformed to percent change in event-related pupil dilation (ERPD, %). Analyses show that the peak amplitudes for both mean pupil dilation and maximal pupil dilation were higher during the speech-in-noise test. Mean peak dilation was measured at 3.47 ± 2.29% noise vs. 2.19 ± 2.46 in quiet and maximal peak value was detected at 9.17 ± 3.25% in noise vs. 8.72 ± 2.93% in quiet. Concerning the questionnaires, the mean pupil dilation during the retention interval was significantly correlated with the spatial subscale score of the SSQ Hearing scale [r(8) = −0.84, p = 0.0023], and with the global score [r(8) = −0.78, p = 0.0018].ConclusionThe analysis of pupillometric traces, obtained during speech audiometry in quiet and in noise in CI users, provided interesting information about the different processes engaged in this task. Pupillometric measures could be indicative of listening difficulty, phoneme intelligibility, and were correlated with general hearing experience as evaluated by the SSQ of Hearing scale. These preliminary results show that pupillometry constitutes a promising tool to improve objective quantification of CI performance in clinical settings.

Cochlear Implantation in Children With Single-Sided Deafness

In 2019, the US Food and Drug Administration approved cochlear implantation for children with single-sided deafness (SSD). The absence of robust clinical data specific to pediatric patients to guide shared decision-making and to identify potential advantages is a challenge in family counseling. To evaluate the audiological and patient-reported outcomes in children who underwent cochlear implantation for SSD and to assess the association between time of implantation, subjective outcomes, and cochlear implant device use rates. MEDLINE, Embase, Scopus, Cochrane, and PubMed were searched for English-language articles that were published in a peer-reviewed journal from database inception to February 18, 2020. Inclusion criteria were designed to capture studies that evaluated pediatric patients (1) younger than 18 years, (2) with a diagnosis of SSD for which they underwent a cochlear implantation, and (3) with at least 1 outcome of interest measured numerically: speech perception, sound localization, device use, and patient-reported outcomes. Of the 526 articles reviewed, 12 (2.3%) met the selection criteria. The Meta-analyses Of Observational Studies in Epidemiology (MOOSE) reporting guidelines were followed. Data were pooled using fixed-effect and random-effect models. The following information was obtained from each article: study characteristics, patient characteristics, hearing loss and intervention characteristics, and outcomes. Outcomes were (1) postoperative changes in speech perception (in quiet was measured as a proportion of correct responses, and in noise was measured as decibel signal to noise ratio for speech reception threshold) and sound localization (measured in degree of localization error), (2) patient-reported audiological outcomes (measured by the speech, spatial, and qualities of hearing scale), and (3) device use rates among children who received cochlear implantation for SSD. Twelve observational studies that evaluated 119 children (mean [SD] age, 6.6 [4.0] years) with SSD who received a cochlear implant were included. Most children showed clinically meaningful improvement in speech perception in noise (39 of 49 children [79.6%]) and in quiet (34 of 42 children [81.0%]). Long duration of deafness (>4 years in congenital SSD and >7 years in perilingual SSD) was the most commonly proposed reason for lack of improvement. Sound localization as measured by degrees of error from true location (mean difference [MD], -24.78°; 95% CI, -34.16° to -15.40°; I2 = 10%) improved statistically significantly after cochlear implantation. Patients with acquired SSD and shorter duration of deafness compared with those with congenital SSD reported greater improvements in speech (MD, 2.27; 95% CI, 1.89-2.65 vs 1.58; 95% CI, 1.00-2.16) and spatial (MD, 2.95; 95% CI, 2.66-3.24 vs 1.68; 95% CI, 0.96-2.39) hearing qualities. The duration of deafness among device nonusers was statistically significantly longer than the duration of deafness among regular device users (median difference, 6.84; 95% CI, 4.02-9.58). This systematic review and meta-analysis found that cochlear implantation for children with SSD was associated with clinically meaningful improvements in audiological and patient-reported outcomes; shorter duration of deafness may lead to better outcomes. These findings can guide future research efforts, refine cochlear implantation candidacy criteria, and aid in family counseling and shared decision-making.

Impact of phase distortion and phase-insensitive speech enhancement on speech quality perceived by hearing-impaired listeners

Phase is important for speech since it contributes to the quality and intelligibility during speech perception. Many speech enhancement algorithms lack the ability to predict phase for speech reconstruction and apply the noisy phase instead. In this study, we investigated the influence of phase distortion on the speech-quality ratings of both normal-hearing (NH) and hearing-impaired (HI) listeners by applying different degrees of random phase on speech. In one set of conditions, the speech was embedded in babble noise at 4 different signal-to-noise ratios (SNRs) from -5 to 10 dB, while in another set of conditions, the SNR was fixed at 10 dB and the speech and noise mixture was presented in simulated rooms with reverberation times ranged from 100 to 1000 ms. The speech level was kept at 65 dB SPL for NH listeners; while amplification was applied to ensure the audibility for HI listeners. Ideal ratio mask (IRM) was used for speech enhancement. Speech-quality ratings were collected following the MUSHRA procedure and compared to two objective evaluation metrics (i.e., PESQ and HASQI). Results suggest that phase distortion has negative impact on speech quality for both NH and HI listeners and this effect becomes dominant when speech enhancement was applied.

Functional hearing quality in prelingually deaf school-age children and adolescents with cochlear implants

Objective This study investigated differences in functional hearing quality between youth with cochlear implants (CIs) and normal hearing (NH) peers, as well as associations between functional hearing quality and audiological measures, speech perception, language and executive functioning (EF). Design Youth with CIs and NH peers completed measures of audiological functioning, speech perception, language and EF. Parents completed the Quality of Hearing Scale (QHS), a questionnaire measure of functional hearing quality. Study sample Participants were 43 prelingually-deaf, early-implanted, long-term CI users and 43 NH peers aged 7–17 years. Results Compared to NH peers, youth with CIs showed poorer functional hearing quality on the QHS Speech, Localization, and Sounds subscales and more hearing effort on the QHS Effort subscale. QHS scores did not correlate significantly with audiological/hearing history measures but were significantly correlated with most speech perception, language and EF scores in the CI sample. In the NH sample, QHS scores were uncorrelated with speech perception and language and were inconsistently correlated with EF. Conclusions The QHS is a valid measure of functional hearing quality that is distinct from office-based audiometric or hearing history measures. Functional hearing outcomes are associated with speech-language and EF outcomes in CI users.

Assessing the Quality of Low-Frequency Acoustic Hearing: Implications for Combined Electroacoustic Stimulation With Cochlear Implants.

There are many potential advantages to combined electric and acoustic stimulation (EAS) with a cochlear implant (CI), including benefits for hearing in noise, localization, frequency selectivity, and music enjoyment. However, performance on these outcome measures is variable, and the residual acoustic hearing may not be beneficial for all patients. As such, we propose a measure of spectral resolution that might be more predictive of the usefulness of the residual hearing than the audiogram alone. In the following experiments, we measured performance on spectral resolution and speech perception tasks in individuals with normal hearing (NH) using low-pass filters to simulate steeply sloping audiograms of typical EAS candidates and compared it with performance on these tasks for individuals with sensorineural hearing loss with similar audiometric configurations. Because listeners with NH had similar levels of audibility and bandwidth to listeners with hearing loss, differences between the groups could be attributed to distortions due to hearing loss. Listeners with NH (n = 12) and those with hearing loss (n = 23) with steeply sloping audiograms participated in this study. The group with hearing loss consisted of 7 EAS users, 14 hearing aid users, and 3 who did not use amplification in the test ear. Spectral resolution was measured with the spectral-temporal modulated ripple test (SMRT), and speech perception was measured with AzBio sentences in quiet and noise. Listeners with NH listened to stimuli through low-pass filters and at two levels (40 and 60 dBA) to simulate low and high audibility. Listeners with hearing loss listened to SMRT stimuli unaided at their most comfortable listening level and speech stimuli at 60 dBA. Results suggest that performance with SMRT is significantly worse for listeners with hearing loss than for listeners with NH and is not related to audibility. Performance on the speech perception task declined with decreasing frequency information for both listeners with NH and hearing loss. Significant correlations were observed between speech perception, SMRT scores, and mid-frequency audiometric thresholds for listeners with hearing loss. NH simulations describe a "best case scenario" for hearing loss where audibility is the only deficit. For listeners with hearing loss, the likely broadening of auditory filters, loss of cochlear nonlinearities, and possible cochlear dead regions may have contributed to distorted spectral resolution and thus deviations from the NH simulations. Measures of spectral resolution may capture an aspect of hearing loss not evident from the audiogram and be a useful tool for assessing the contributions of residual hearing post-cochlear implantation.