Interaural Differences Research Articles

Novel Approaches to Measure Spatial Release From Masking in Children With Bilateral Cochlear Implants.

To investigate the role of auditory cues for spatial release from masking (SRM) in children with bilateral cochlear implants (BiCIs) and compare their performance with children with normal hearing (NH). To quantify the contribution to speech intelligibility benefits from individual auditory cues: head shadow, binaural redundancy, and interaural differences; as well as from multiple cues: SRM and binaural squelch. To assess SRM using a novel approach of adaptive target-masker angular separation, which provides a more functionally relevant assessment in realistic complex auditory environments. Children fitted with BiCIs (N = 11) and with NH (N = 18) were tested in virtual acoustic space that was simulated using head-related transfer functions measured from individual children with BiCIs behind the ear and from a standard head and torso simulator for all NH children. In experiment I, by comparing speech reception thresholds across 4 test conditions that varied in target-masker spatial separation (colocated versus separated at 180°) and listening conditions (monaural versus binaural/bilateral listening), intelligibility benefits were derived for individual auditory cues for SRM. In experiment II, SRM was quantified using a novel measure to find the minimum angular separation (MAS) between the target and masker to achieve a fixed 20% intelligibility improvement. Target speech was fixed at either +90 or -90° azimuth on the side closer to the better ear (+90° for all NH children) and masker locations were adaptively varied. In experiment I, children with BiCIs as a group had smaller intelligibility benefits from head shadow than NH children. No group difference was observed in benefits from binaural redundancy or interaural difference cues. In both groups of children, individuals who gained a larger benefit from interaural differences relied less on monaural head shadow, and vice versa. In experiment II, all children with BiCIs demonstrated measurable MAS thresholds <180° and on average larger than that from NH children. Eight of 11 children with BiCIs and all NH children had a MAS threshold <90°, requiring interaural differences only to gain the target intelligibility benefit; whereas the other 3 children with BiCIs had a MAS between 120° and 137°, requiring monaural head shadow for SRM. When target and maskers were separated at 180° on opposing hemifields, children with BiCIs demonstrated greater intelligibility benefits from head shadow and interaural differences than previous literature showed with a smaller separation. Children with BiCIs demonstrated individual differences in using auditory cues for SRM. From the MAS thresholds, more than half of the children with BiCIs demonstrated robust access to interaural differences without needing additional monaural head shadow for SRM. Both experiments led to the conclusion that individualized fitting strategies in the bilateral devices may be warranted to maximize spatial hearing for children with BiCIs in complex auditory environments.

Effects of Bilateral Automatic Gain Control Synchronization in Cochlear Implants With and Without Head Movements: Sound Source Localization in the Frontal Hemifield.

Purpose For bilaterally implanted patients, the automatic gain control (AGC) in both left and right cochlear implant (CI) processors is usually neither linked nor synchronized. At high AGC compression ratios, this lack of coordination between the two processors can distort interaural level differences, the only useful interaural difference cue available to CI patients. This study assessed the improvement, if any, in the utility of interaural level differences for sound source localization in the frontal hemifield when AGCs were synchronized versus independent and when listeners were stationary versus allowed to move their heads. Method Sound source identification of broadband noise stimuli was tested for seven bilateral CI patients using 13 loudspeakers in the frontal hemifield, under conditions where AGCs were linked and unlinked. For half the conditions, patients remained stationary; in the other half, they were encouraged to rotate or reorient their heads within a range of approximately ± 30° during sound presentation. Results In general, those listeners who already localized reasonably well with independent AGCs gained the least from AGC synchronization, perhaps because there was less room for improvement. Those listeners who performed worst with independent AGCs gained the most from synchronization. All listeners performed as well or better with synchronization than without; however, intersubject variability was high. Head movements had little impact on the effectiveness of synchronization of AGCs. Conclusion Synchronization of AGCs offers one promising strategy for improving localization performance in the frontal hemifield for bilaterally implanted CI patients. Supplemental Material https://doi.org/10.23641/asha.14681412.

Localization of tones in a room by moving listeners

It is difficult to localize the source of a tone in a room because standing waves lead to complicated interaural differences that become uninterpretable localization cues. This paper tests the conjecture that localization improves if the listener can move to explore the complicated sound field over space and time. Listener head and torso movements were free and uninstructed. Experiments at low and high frequencies with eight human listeners in a relatively dry room indicated some modest improvement when listeners were allowed to move, especially at high frequencies. The experiments sought to understand listener dynamic localization strategies in detail. Head position and orientation were tracked electronically, and ear-canal signals were recorded throughout the 9 s of each moving localization trial. The availability of complete physical information enabled the testing of two model strategies: (1) relative null strategy, using instantaneous zeros of the listener-related source angle; and (2) inferred source strategy, using a continuum of apparent source locations implied by the listener's instantaneous forward direction and listener-related source angle. The predicted sources were given weights determined by the listener motion. Both models were statistically successful in coping with a great variety of listener motions and temporally evolving cues.

Reweighting of Binaural Localization Cues Induced by Lateralization Training

Normal-hearing listeners adapt to alterations in sound localization cues. This adaptation can result from the establishment of a new spatial map of the altered cues or from a stronger relative weighting of unaltered compared to altered cues. Such reweighting has been shown for monaural vs. binaural cues. However, studies attempting to reweight the two binaural cues, interaural differences in time (ITD) and level (ILD), yielded inconclusive results. This study investigated whether binaural-cue reweighting can be induced by lateralization training in a virtual audio-visual environment. Twenty normal-hearing participants, divided into two groups, completed the experiment consisting of 7 days of lateralization training, preceded and followed by a test measuring the binaural-cue weights. Participants’ task was to lateralize 500-ms bandpass-filtered (2–4 kHz) noise bursts containing various combinations of spatially consistent and inconsistent binaural cues. During training, additional visual cues reinforced the azimuth corresponding to ITDs in one group and ILDs in the other group and the azimuthal ranges of the binaural cues were manipulated group-specifically. Both groups showed a significant increase of the reinforced-cue weight from pre- to posttest, suggesting that participants reweighted the binaural cues in the expected direction. This reweighting occurred within the first training session. The results are relevant as binaural-cue reweighting likely occurs when normal-hearing listeners adapt to new acoustic environments. Reweighting might also be a factor underlying the low contribution of ITDs to sound localization of cochlear-implant listeners as they typically do not experience reliable ITD cues with clinical devices.

An Examination of Asymmetry in Adult Tympanometric Measures.

During audiologic evaluations, an examination of interaural asymmetry is commonly evaluated. To date, however, interaural differences for tympanometric indices have not been reported for adults. Without documented tympanometric right-left differences, one cannot determine if asymmetries are normal or are indicative of significant clinical asymmetries. The purpose of this study was to investigate interaural asymmetries in peak compensated static acoustic admittance (Ytm), equivalent ear canal volume (Vea), tympanometric peak pressure (TPP), and tympanometric width (TW) in normal adults. Descriptive, correlational, and inferential measures designs were employed. Participants were 188 otologically normal Caucasian young adults (i.e., 77 females and 111 males; M = 23.0 years, standard deviation [SD] = 2.7, range = 18-30 years). Ytm, Vea, TPP, and TW measures were obtained bilaterally from an admittance tympanogram using a 226 Hz probe tone. Separate two-factor mixed measures analysis of variance examined the effect of ear and sex for each tympanometric index. Correlation analyses examined the association between right and left ear indices. Interaural differences in tympanometric indices were examined with independent t-tests. Critical differences, for deciding if two tympanometric indices are different between ears, were computed from the standard deviations of the right-left ear difference for statistical confidence levels of 85, 90, 95, and 99%. The effect of ear was not statistically significant (p > 0.05) on any tympanometric index. Females had significantly lower Ytm and smaller Vea measures than males (p < 0.05). Correlations between all right and left tympanometric indices were positive and statistically significant (p < 0.05). There were no statistically significant differences in interaural differences for any of the tympanometric indices as a function of sex (p > 0.05). Critical differences, for confidence levels for 85% to 99% confidence ranged from ± 0.20-0.36 mmhos for Ytm, ± 0.23-0.41 cm3 for Vea, ± 11.1-19.8 daPa for TPP, and ± 27.2-48.7 daPa for TW. A clinician can use these critical differences to determine if tympanometric index interaural differences in ears of young normal Caucasian adults are statistically significant.

Modeling sound-source localization of two sinusoidally amplitude-modulated noises in a sound field

Yost and Brown [JASA 133 (2013)] investigated the ability of listeners to localize two simultaneously presented, independent noises presented over loudspeakers from different locations. These experiments demonstrated that SAM noises that were out of phase at two spatially separated loudspeakers led to better localization performance than when the SAM noises were in phase at each loudspeaker. Performance was improved at SAM rates as high as almost 500 Hz as compared to non-SAM noise. Yost and Brown hypothesized that listeners’ behavior might be explained as a temporal-spectral (T-S) analysis, and showed that such an approach could, qualitatively, account for some of their behavioral data. This presentation will explore the degree to which a quantitative, biologically inspired peripheral/brainstem auditory model can predict some of the listener performance presented in Yost and Brown 2013. Specifically, the model structure includes simulated auditory nerve response using the Zilany et al. model (JASA, 2014) with rate-count-based estimation of interaural differences of time and intensity as they occur in the presented stimuli recorded with a KEMAR manikin.

Association Between the Right Ear Advantage in Dichotic Listening and Interaural Differences in Sensory Processing at Lower Levels of the Auditory System in Older Adults.

Current evidence suggests that an enhanced right ear advantage (REA) in dichotic listening (DL) among older adults may originate from age-related structural changes in the corpus callosum and age-related decline in cognitive processes. Less is known about the effect of information processing at lower portions of the auditory system on DL performance. The present study investigates whether interaural differences (ID) in sensory processing at lower levels of the auditory system are associated with the magnitude of the REA in DL among older adults. Sixty-eight older adults participated in the study. Participants were assessed with a DL test using nonforced (NF) and forced attention paradigms. Hearing sensitivity, transient-evoked otoacoustic emission (TEOAE), contralateral suppression of TEOAE, a proxy measure of medial olivocochlear activation, and auditory brainstem response to speech stimuli (speech-ABR) were tested in both ears separately. The ID in sensory processing at lower levels of the auditory system was derived by calculating the difference between the RE and LE for each auditory measure. Bivariate and multivariate regression models were performed. One multivariate model for each DL paradigm (NF and forced attention) was independently constructed. Measures of cognitive speed of processing and cognitive flexibility were accounted for in the regression models. For both multivariate regression models, ID in pure-tone thresholds and ID in MOC suppression of TEOAE were significantly associated with the magnitude of the REA for DL among older adults. Cognitive measures of speed of processing and cognitive flexibility also contributed to the magnitude of the REA. These results suggest that ID in sensory processing at lower levels of the auditory system account, at least in part, for the increased magnitude of the REA in DL among older adults.

Parameters of Off-Vertical Axis Rotation in Unilateral and Bilateral Vestibulopathy and Their Correlation with Vestibular Evoked Myogenic Potentials.

Off-vertical axis rotation (OVAR) is a laboratory test to assess the otolith function. This study aimed to analyze the parameters of OVAR in patients with unilateral vestibular hypofunction (UVH) and bilateral vestibulopathy (BVP), and to correlate the parameters of OVAR with those of VEMPs. Ten healthy volunteers, 41 UVH, and 13 BVP patients performed OVAR. Bias component (BIC) and modulation component (MOC) of UVH and BVP patients were compared with those of healthy controls. BIC and MOC were correlated with amplitude and interaural difference (IAD) of cervical VEMP (cVEMP) and ocular VEMP (oVEMP). In UVH patients, the direction of BICs to affected side rotation were reversed and the absolute value of BICs were decreased when they were compared to healthy controls. In BVP patients, BICs were markedly attenuated. MOCs were not changed in UVH and BVP patients. There was no statistically significant correlation between VEMPs and OVAR.

Masking Level Difference: Performance of School Children Aged 7–12 Years

Background and ObjectivesIn masking level difference (MLD), the masked detection threshold for a signal is determined as a function of the relative interaural differences between the signal and the masker. Study 1 analyzed the results of school-aged children with good school performance in the MLD test, and study 2 compared their results with those of a group of children with poor academic performance.Subjects and MethodsStudy 1 was conducted with 47 school-aged children with good academic performance (GI) and study 2 was carried out with 32 school-aged children with poor academic performance (GII). The inclusion criteria adopted for both studies were hearing thresholds within normal limits in basic audiological evaluation. Study 1 also considered normal performance in the central auditory processing test battery and absence of auditory complaints and/or of attention, language or speech issues. The MLD test was administered with a pure pulsatile tone of 500 Hz, in a binaural mode and intensity of 50 dBSL, using a CD player and audiometer.ResultsIn study 1, no significant correlation was observed, considering the influence of the variables age and sex in relation to the results obtained in homophase (SoNo), antiphase (SπNo) and MLD threshold conditions. The final mean MLD threshold was 13.66 dB. In study 2, the variables did not influence the test performance either. There was a significant difference between test results in SπNo conditions of the two groups, while no differences were found both in SoNo conditions and the final result of MLD.ConclusionsIn study 1, the cut-off criterion of school-aged children in the MLD test was 9.3 dB. The variables (sex and age) did not interfere with the MLD results. In study 2, school performance did not differ in the MLD results. GII group showed inferior results than GI group, only in SπNo condition.

The Role of Interaural Differences, Head Shadow, and Binaural Redundancy in Binaural Intelligibility Benefits Among School-Aged Children.

In complex listening environments, children can benefit from auditory spatial cues to understand speech in noise. When a spatial separation is introduced between the target and masker and/or listening with two ears versus one ear, children can gain intelligibility benefits with access to one or more auditory cues for unmasking: monaural head shadow, binaural redundancy, and interaural differences. This study systematically quantified the contribution of individual auditory cues in providing binaural speech intelligibility benefits for children with normal hearing between 6 and 15 years old. In virtual auditory space, target speech was presented from + 90° azimuth (i.e., listener's right), and two-talker babble maskers were either co-located (+ 90° azimuth) or separated by 180° (–90° azimuth, listener's left). Testing was conducted over headphones in monaural (i.e., right ear) or binaural (i.e., both ears) conditions. Results showed continuous improvement of speech reception threshold (SRT) between 6 and 15 years old and immature performance at 15 years of age for both SRTs and intelligibility benefits from more than one auditory cue. With early maturation of head shadow, the prolonged maturation of unmasking was likely driven by children's poorer ability to gain full benefits from interaural difference cues. In addition, children demonstrated a trade-off between the benefits from head shadow versus interaural differences, suggesting an important aspect of individual differences in accessing auditory cues for binaural intelligibility benefits during development.

The spatial percept of tinnitus is associated with hearing asymmetry: Subgroup comparisons.

The spatial percept of tinnitus is hypothesized as an important variable for tinnitus subtyping. Hearing asymmetry often associates with tinnitus laterality, but not always. One of the methodological limitations for cross-study comparisons is how the variables for hearing asymmetry and tinnitus spatial perception are defined. In this study, data from two independent datasets were combined (n=833 adults, age ranging from 20 to 91 years, 404 males, 429 females) to investigate characteristics of subgroups with different tinnitus spatial perception focusing on hearing asymmetry. Three principle findings emerged. First, a hearing asymmetry variable emphasizing the maximum interaural difference most strongly discriminated unilateral from bilateral tinnitus. Merging lateralized bilateral tinnitus (perceived in both ears but worse in one side) with unilateral tinnitus weakened this relationship. Second, there was an association between unilateral tinnitus and ipsilateral asymmetric hearing. Third, unilateral and bilateral tinnitus were phenotypically distinct, with unilateral tinnitus being characterized by older age, asymmetric hearing, more often wearing one hearing aid, older age at tinnitus onset, shorter tinnitus duration, and higher percentage of time being annoyed by tinnitus. We recommend that careful consideration is given to the definitions of hearing asymmetry and tinnitus spatial perception in order to improve the comparability of findings across studies.

Instrumental Quality Predictions and Analysis of Auditory Cues for Algorithms in Modern Headphone Technology.

Smart headphones or hearables use different types of algorithms such as noise cancelation, feedback suppression, and sound pressure equalization to eliminate undesired sound sources or to achieve acoustical transparency. Such signal processing strategies might alter the spectral composition or interaural differences of the original sound, which might be perceived by listeners as monaural or binaural distortions and thus degrade audio quality. To evaluate the perceptual impact of these distortions, subjective quality ratings can be used, but these are time consuming and costly. Auditory-inspired instrumental quality measures can be applied with less effort and may also be helpful in identifying whether the distortions impair the auditory representation of monaural or binaural cues. Therefore, the goals of this study were (a) to assess the applicability of various monaural and binaural audio quality models to distortions typically occurring in hearables and (b) to examine the effect of those distortions on the auditory representation of spectral, temporal, and binaural cues. Results showed that the signal processing algorithms considered in this study mainly impaired (monaural) spectral cues. Consequently, monaural audio quality models that capture spectral distortions achieved the best prediction performance. A recent audio quality model that predicts monaural and binaural aspects of quality was revised based on parts of the current data involving binaural audio quality aspects, leading to improved overall performance indicated by a mean Pearson linear correlation of 0.89 between obtained and predicted ratings.

Comparison of two cortical measures of binaural hearing acuity

Objective Multiple studies have demonstrated binaural hearing deficits in the aging and those with hearing loss. Consequently, there is great interest in developing efficient clinical tests of binaural hearing acuity to improve diagnostic assessments and to assist clinicians when fitting binaural hearing aids and/or cochlear implants. Design Two cortical measures of interaural phase difference sensitivity, the acoustic change complex (ACC) and interaural phase modulation following response (IPM-FR), were compared on three metrics using five different stimulus interaural phase differences (IPDs; 0°, ±22.5°, ±45°, ±67.5° and ±90°). These metrics were scalp topography, time-to-detect, and input–output characteristics. Study sample Ten young, normal-hearing listeners. Results Scalp topography qualitatively differed between ACC and IPM-FR. The IPM-FR demonstrated better time-to-detect performance on smaller (±22.5° and ±45°) but not larger (67.5°, and ±90°) IPDs. Input–output characteristics of each response were similar. Conclusions The IPM-FR may be a faster and more efficient tool for assessing neural sensitivity to subtle IPD changes. However, the ACC may be useful for research or clinical questions concerned with the topographic representation of binaural cues.

Changes in electrically evoked auditory brainstem responses in children with sequential bilateral cochlear implants

ObjectivesThe primary aim of this study is to investigate whether the electrical stimulation of the second ear causes a difference in electrically evoked auditory brainstem responses (eABR) between two ears over time. MethodsThe study included thirteen subjects under the age of five who used cochlear implants for at least six months in the first ear prior to the sequential cochlear implantation. Postoperative eABRs were conducted on the 1st (first fitting of the second speech processor), 3rd, and 6th months of the second implantation in the basal, medial, and apical electrode positions. The recording was started with the second cochlear implant (CI2), and then the first cochlear implant (CI1) was tested. Sound field audiometry and receptive/expressive language assessments were also performed at 1 and 6 months after the second cochlear implantation. ResultseABR results indicate that when eV wave latencies are examined for all electrodes, CI2 is significantly longer than CI1 (p < 0.05). When eV wave amplitudes are examined for all electrodes, CI1 is significantly higher than the CI2 (p < 0.05). eV latency and amplitude changes between both implants were examined up to six months after implantation. Statistically significant changes were observed in the basal, medial, apical electrode for eV wave latencies, and only in the medial electrode for eV wave amplitudes (p < 0.05). Average sound field thresholds and receptive/expressive language scores improved statistically significantly for all subjects at the end of the study (p < 0.05). ConclusionThe postoperative eABR test is a valuable test battery that provides the clinician with important ideas about the estimated threshold, comfortable and audible sound level, CI performance, and auditory pathways up to the brainstem. Since the maturation is still ongoing, an extended period longer than six months is needed to evaluate interaural differences.

Comparative Study Between the Auditory and Vestibular Functions in Ménière's Disease.

To evaluate the relationship between the loss of the cochleovestibular functions in Ménière's disease (MD). Forty-three patients with definite MD underwent pure-tone audiometry (PTA) and caloric test. Canal paresis (CP%), dPTA (interaural difference), and average PTA results were contrasted. IBM SPSS V24 was used for statistical analysis. According to PTA, most patients were in stage C, and caloric weakness was found in 29 patients. Linear (R2 = 0.06) and nonlinear correlation tests (rho = 0.245, P = .113) between canal paresis (CP%) and dPTA showed no correlation, as well as between CP% and PTA analysis (R2 = 0.007, rho = 0.11, P = .481). As per the categorial analysis, no correlation was detected between the groups either (κ = 0.174, 95% CI: 0.0883 - 0.431). Based on the results of the analysis, it was concluded that a more advanced stage determined by audiometry does not indicate increasing values in the CP% parameter. Audiometric changes do not directly correspond with the vestibular ones; therefore, no specific correlation exists between them. Thus, for therapy planning and diagnosis, both tests are necessary.

The role of lateralization in release from informational masking

This study tested whether target and masker must create different spatial percepts, in this case intracranial percepts created under headphones, to achieve spatial release from informational masking. Signals were sequences of 40-ms broadband noise bursts with four target bursts interspersed within a longer train of masker bursts. From a baseline sequence in which target bursts were 400 ms apart, either the second or third burst was advanced by 80 ms to create two different temporal patterns that subjects discriminated. Target bursts were intermixed among masker bursts such that pattern identification was at chance when all bursts were diotic, but near perfect when target and masker bursts were delivered with moderate interaural differences of opposite sign. Performance in these unprocessed conditions was compared to that obtained when stimuli were processed by an algorithm that swapped interaural differences in alternating frequency bands [S. Sheffield et al., J. Acoust. Soc. Am. 145, 1129–1142 (2019)], thereby degrading lateralization but preserving the magnitudes of interaural differences. Early results show substantially reduced masking release in degraded lateralization conditions, despite their preservation of interaural differences, suggesting a prominent role for perceived target-masker separation in spatial release from informational masking. [Work supported by NIDCD R01 01625.]

Assessment of cervical and ocular vestibular evoked myogenic potentials in migraine patients

BackgroundPatients suffering from vestibular migraine (VM) are known to have various vestibular test abnormalities interictally and ictally. Recently, vestibular evoked myogenic potentials (VEMPs) have become accepted as a valid method for otolith function assessment. Many studies have identified various vestibular symptoms and laboratory abnormalities in migraineurs. Since migraineurs with no accompanying vestibular symptoms might exhibit subclinical vestibular dysfunction, we investigated vestibular function using ocular and cervical VEMPs in migraine patients. The aim was to study cervical VEMP and occular VEMP in migraineurs with and without vestibular symptoms interictally.ResultsMigraine and VM patients showed significantly longer P13 latency of cVEMP compared to controls. A statistically significant cVEMP interaural P13 latency difference was found in VM compared to healthy controls. Cervical VEMP N23 latency, peak-to-peak amplitude, interaural N23 latency, and amplitude asymmetric ratio did not show any significant difference in migraine and VM patients compared to healthy controls as well as no significant difference across the three groups regarding oVEMP parameters.ConclusionsAbnormal interictal cVEMP results in migraineurs might indicate subclinical vestibulo-collic pathway dysfunction.

Functional Integrity of the Inferior Vestibular Nerve and Posterior Canal BPPV.

The functional integrity of the inferior vestibular nerve (IVN) may be evaluated by the cervical vestibular evoked myogenic potential (cVEMP) response, which requires signal transmission via the nerve. As functional integrity of the IVN innervating the posterior semicircular canal is required to produce the typical positioning vertigo and nystagmus characterizing posterior canal benign paroxysmal positional vertigo (PCBPPV), we hypothesized that normal cVEMPs would be found in most PCBPPV patients. Twenty-four PCBPPV patients participated in a prospective cohort study. All were treated by canal repositioning maneuver and had air-conduction cVEMP and videonystagmography (VNG). Follow-up evaluations including history and otoneurological bedside examination were carried out 1, 3, 6, and 12 months after the initial treatment. At the last follow-up, the patients filled the Dizziness Handicap Inventory (DHI) questionnaire. Normal cVEMPs were recorded in 19 (79%) and were absent in 5 (21%) of the subjects. The average DHI in the patients with normal cVEMP was 16.42 ± 17.99 vs. 0.4 ± 0.89 among those with pathological cVEMP (p < 0.04, Mann–Whitney test). Thirteen (54%) patients experienced recurrent PCBPPV (rPCBPPV). The average DHI score was significantly higher among patients having recurrence (22.15 ± 18.61) when compared to those with complete cure (2.36 ± 5.98; p < 0.003, Mann–Whitney test). Ten (77%) of the subjects with rPCBPPV had normal and 3 (23%) had pathological cVEMP as compared to 9 (82%) and 2 (18%) subjects in the non-recurrent (nrPCBPPV) group (Fisher's exact test—not significant). cVEMP p13 and n23 wave latencies and amplitudes, inter-aural differences in p13-n23 peak-to-peak amplitudes, and response thresholds did not differ between the groups. No differences were found between the rPCBBPV and nrPCBBPV groups in VNG caloric lateralization and directional preponderance values. We have found that in most cases, PCBPPV symptoms and signs are associated with normal cVEMP response supporting the role of IVN functional integrity. The absent cVEMPs in the minority of patients, although having similar clinical presentation, raise the possibility that the ipsilateral saccule is affected by the same pathology causing degeneration of the utricle macula. Alternatively, lacking inhibitory stimuli from the involved ipsilateral utricle or partial degeneration of the IVN and ganglion could explain the diminished cVEMP response.Clinical Trial Registration: The study was registered in ClinicalTrials.gov Internet site (study ID—NCT01004913; https://clinicaltrials.gov/ct2/show/NCT01004913?cond=BPPV&cntry=IL&draw=2&rank=3).

Patterns of audiometric threshold shifts from pulsatile tinnitus due to sigmoid sinus wall anomalies.

To determine the severity and nature of audiometric threshold shifts for patients with pulsatile tinnitus (PT) due to sigmoid sinus wall anomalies (SSWA). 38 patients with SSWAs and available pre-operative audiograms were examined. Low- and high-frequency pure tone averages (LF-PTA, HF-PTA) were calculated. Audiometric data were compared between affected and unaffected ears, with the interaural difference (affected-unaffected PTA) representing the change in hearing due to PT. Additionally, post-operative change was examined in 14 patients with available data. The average pre-operative air conduction (AC) LF-PTA was 17.04dB on the affected side and 11.38dB on the unaffected side (p<0.001). The mean AC HF-PTA was significantly higher on the affected side as well (16.45dB vs. 14.08dB, p=0.008). All shifts were sensorineural, with no significant air-bone gaps, and most subjects still had low-frequency thresholds in the normal range. Though the post-op change was not significant due to attrition, 5/14 patients (35.7%) had complete resolution of their pre-op interaural difference. A similar number developed a HF-PTA post-op threshold elevation in the surgical ear. PT due to SSWAs causes a mean 6dB low-frequency bone-conduction threshold elevation, and smaller high-frequency threshold shifts, due to masking. Patients with larger threshold shifts should have other potential causes of hearing loss explored. Level IV.

Visual Gender Cues Guide Crossmodal Selective Attending to a Gender-Congruent Voice During Dichotic Listening.

Visual input of a face appears to influence the ability to selectively attend to one voice over another simultaneous voice. We examined this crossmodal effect, specifically the role face gender may have on selective attention to male and female gendered simultaneous voices. Using a within-subjects design, participants were presented with a dynamic male face, female face, or fixation cross, with each condition being paired with a dichotomous audio stream of male and female voices reciting different lists of concrete nouns. In Experiment 1a, the female voice was played in the right ear and the male voice in the left ear. In Experiment 1b, both voices were played in both ears with differences in volume mimicking the interaural intensity difference between disparately localized voices in naturalistic situations. Free recall of words spoken by the two voices immediately following stimulus presentation served as a proxy measure of attention. In both sections of the experiment, crossmodal congruity of face gender enhanced same-gender word recall. This effect indicates that crossmodal interaction between voices and faces guides auditory attention. The results contribute to our understanding of how humans navigate the crossmodal relationship between voices and faces to direct attention in social interactions such as those in the cocktail party scenario.