Pure-tone Thresholds Research Articles

Expanding Understanding of Electrocochleography in Cochlear Implantation: Auditory Neuropathy Spectrum Disorder With Normal Pure Tone Average.

Describe the preoperative decision-making, intraoperative electrocochleographic (ECoG) findings, and outcome of cochlear implantation (CI) in a patient with auditory neuropathy spectrum disorder (ANSD) and normal pure-tone thresholds. A 19-year-old with a history of hypoxic ischemic encephalopathy and seizures was referred for hearing rehabilitation in the setting of typical hearing by pure tone audiometry but poor speech understanding. A diagnosis of ANSD was made based on acoustic brainstem response (ABR), distortion product otoacoustic emission, and acoustic reflex testing. Imaging revealed no central cause of hearing impairment. Right-sided CI. Preoperative and postoperative audiometric data. Intraoperative ECoG. Preoperatively the patient underwent comprehensive audiologic testing with behavioral audiometry, ABR testing, and CI candidacy evaluation. In the right ear, the pure tone average (PTA) was 15 dB and word recognition score was 36%. ABR confirmed ANSD. Preoperative CNC and AzBio in quiet were 8% and 0%, respectively. Intraoperative ECoG amplitudes and audiometry showed responses in the 100 uV range and estimated PTA of 42 dB HL. Postoperative testing at 1-month post-initial activation revealed PTA of 45 dB HL and unchanged word and sentence scores. However, the patient cites an improved ability to communicate and increased confidence and averages over 14 hours of device use daily. To our knowledge, this is the first reported case of CI in an ear with normal PTA. Given that nearly all presently available ECoG data comes from patients with greater degrees of hearing loss, this unique case adds to our understanding of hearing preservation in CI.

Analysis of Causative Disorders and Hearing Improvement in 100 Consecutive Stapes Surgeries

Background and Objectives Stapes surgery has been widely used to improve the conductive hearing loss caused by stapedial fixation. The purpose of this study is to evaluate the causes of stapedial fixation using audiological results of 100 stapes surgeries.Subjects and Method We reviewed the medical records of 100 consecutive stapes surgeries between June 2011 and December 2022. A total of 100 ears from 86 patients were included and the patient age ranged from 6 to 80 years. Hearing improvements of pure-tone thresholds were defined as successful when air-bone gap (ABG) was reduced to 20 dB or less, and as excellent when ABG was reduced to within 10 dB.Results The causative diseases of stapedial fixation were otosclerosis (n=74, 74%), ossicular anomaly (n=19, 19%) and chronic otitis media (n=7, 7%). Overall, the pre-operative bone-conduction thresholds/air-conduction thresholds (BC/AC) thresholds were 32±14/58±18 dB HL and ABG were 26±11 dB while the postoperative BC/AC thresholds were 29±15/36±18 dB HL and ABG were 7±8 dB. The postoperative ABG was excellent in 77% and successful in 93%. The postoperative ABG was excellent in 82.4% and successful in 97.3% of otosclerosis, excellent in 78.9% and successful in 89.5% of ossicular anomaly, and excellent in 14.3% and successful in 57.2% for chronic otitis media. ABG significantly improved less in revision cases than in primary otosclerosis cases (<i>p</i>=0.006).Conclusion Stapes surgery is an effective method to improve hearing for various types of stapedial fixation. There was a difference in the degree of hearing improvement according to causative disorders.

Association of Psoriasis With Hearing Loss: A Systematic Review and Meta-Analysis.

The relation between psoriasis and hearing loss has been unclear. To investigate the association of psoriasis with hearing loss. We searched MEDLINE and Embase on 12th November 2022 for studies on the association between psoriasis and hearing loss. We conducted a random-effects model meta-analysis to calculate pooled mean difference (MD) in the pure tone thresholds, pooled odds ratio for sensorineural hearing loss, and pooled hazard ratio for sudden sensorineural hearing loss related to psoriasis. We included 12 case-control/cross-sectional and 3 cohort studies with 202,683 subjects. Psoriasis was associated with hearing loss at 500 Hz (pooled MD 2.21, 95% CI (CI) 0.13 to 4.29), 1000 Hz (pooled MD 2.97, 95% CI 1.01 to 4.93), 2000 Hz (pooled MD 5.13, 95% CI 2.45 to 7.82), 4000 Hz (pooled MD 9.3, 95% CI 5.1 to 13.51), and 6000 Hz (pooled MD 11.04, 95% CI 5.05 to 17.03). Patients with psoriasis had increased odds for sensorineural hearing loss (pooled odds ratio 3.85, 95% CI 1.07-13.9) and risk for sudden sensorineural hearing loss (pooled hazard ratio 1.45; 95% CI 1.22-1.71). Psoriasis is associated with hearing loss, especially at high frequencies.

The significance of extended high-frequency audiometry in tinnitus patients with normal hearing as evaluated via conventional pure tone audiometry.

This study was designed to determine whether extended high-frequency audiometry was capable of better differentiating between participants with normal hearing who did or did not have subjective tinnitus. A total of 96 study participants were enrolled: 36 patients with unilateral tinnitus, 28 patients with bilateral tinnitus and 32 volunteers as controls. All 96 participants exhibited normal audiometry findings and hearing thresholds. Extended high-frequency audiometry was used to evaluate these patients. There were differences between the extended high-frequency hearing thresholds of affected and unaffected ears in those with unilateral tinnitus, and in the 20-29-year-old bilateral tinnitus group, at 11.2, 12.5 and 14 kHz. Unilateral tinnitus subgroups had higher extended high-frequency hearing thresholds than those in control subjects, at all extended high frequencies. Extended high-frequency audiometry can offer additional information regarding the hearing status of patients with tinnitus who exhibit normal pure tone thresholds when analysed via conventional hearing thresholds.

Examination of Factors Affecting the Likelihood of Whether Individuals Would Purchase Cartilage Conduction Hearing Aids.

Cartilage conduction hearing aids (CC-HAs) are a novel type of hearing aid relying on cartilage conduction, the so-called third auditory conduction pathway. However, CC-HAs have only recently entered routine clinical use, and therefore data on their usefulness are lacking. The purpose of this study was to examine the possibility of assessing whether individual patients would show good adaptation to CC-HAs. Thirty-three subjects (41 ears in total) underwent a free trial of CC-HAs. Age, disease category, and the pure-tone threshold of air and bone conduction, unaided field sound threshold, aided field sound threshold, and functional gain (FG) at 0.25, 0.5, 1, 2, and 4 kHz were compared between patients who subsequently purchased and did not purchase the CC-HAs. Overall, 65.9% of the subjects purchased CC-HAs after the trial. In comparison to non-purchasers, those who decided to purchase CC-HAs showed better pure tone hearing thresholds at high frequencies for both air conduction (2 and 4 kHz) and bone conduction (1, 2, and 4 kHz), as well as for aided thresholds in the sound field (1, 2, and 4 kHz) when using CC-HAs. Therefore, the high-frequency hearing thresholds of subjects trialing CC-HAs might be helpful for identifying those who are likely to benefit from them.

Sensorineural Hearing Loss in Unilateral Mucosal Type of Chronic Otitis Media.

Sensorineural hearing loss is relatively well established in the squamosal chronic otitis media. However, its association with mucosal COM is still debated. The present study aimed at evaluating the prevalence of sensorineural hearing loss in unilateral mucosal COM. The study was conducted at a tertiary care hospital in New Delhi, and 60 patients with unilateral mucosal chronic otitis media were recruited. Pure tone thresholds were ascertained for air and bone conduction in an acoustically treated room and matched against certain patient and disease characteristics. In this study, the combined prevalence of SNHL/Mixed Hearing loss in mucosal COM was found to be 8.3%. A statistically significant association between SNHL/Mixed HL was seen in the 40-50-year age group (p-0.004). Prevalence with a disease duration of more than 10years was 33% (p-0.019). All the patients who presented with SNHL/Mixed HL had an actively discharging ear. 80% of the patients who presented with SNHL/Mixed HL had large perforations. SNHL/Mixed HL prevalence of 28.6% was found in smokers, compared to 5.7% in non-smokers (p-0.039). The risk of developing SNHL/Mixed HL increased with increasing patients' age, disease duration, and size of the perforation and smokers.

Association of Alopecia Areata with Sensorineural Hearing Loss: A Systematic Review and Meta-analysis

Background: Immune-mediated melanocyte-related pathogenesis in alopecia areata (AA) may cause sensorineural hearing loss (SNHL). However, the relation between AA and SNHL has been unclear. Therefore, we aimed to investigate this association between AA and SNHL. Methods: We performed a systematic review and searched MEDLINE and Embase on July 25, 2022, for cross-sectional, case-control, or cohort studies that examined the association of AA with SNHL. The Newcastle-Ottawa Scale was used to evaluate their risk of bias. A random-effects model meta-analysis was performed to obtain the mean differences in frequency-specific hearing thresholds between AA patients and age-matched healthy controls and the pooled odds ratio for SNHL in relation to AA. Results: We included 5 case-control studies and 1 cohort study, with none of them rated with high risk of biases. The meta-analysis showed AA patients had significantly higher mean differences in pure-tone hearing thresholds at 4,000 Hz and 12,000–12,500 Hz. The meta-analysis also found increased odds for SNHL among patients with AA (OR: 3.18; 95% CI: 2.06–4.89; I² = 0%). Conclusions: AA is associated with an increase of SNHL, especially at high frequencies. Otologic consultation may be indicated if AA patients present with hearing loss or tinnitus.

Effects of Chemoradiation Therapy on Hearing in Patients with Malignancy of Head and Neck.

To study effects of chemoradiation therapy on hearing in patients with malignancy of head and neck. Patients receiving drugs other than cisplatin as well as those with any otology-related pathology or abnormalities were excluded from the study. Patients with primary biopsy-proven malignancy of the Nasopharynx, Oropharynx, Paranasal Sinuses, Oral Cavity, and Parotid with chemoradiation by cisplatin and different radiation modalities were all eligible. Areas of interest and OARs are indicated on CT images. All patients' hearing was assessed using pure tone audiometry at the beginning of treatment, at its conclusion, and six months later. Variations in pure tone thresholds from baseline and CTCAE - Common Terminology Criteria for Adverse Events grading are related to cochlear dose. The study involves 75 patients. At cochlear dosage levels of more than 40Gy, significant SNHL (>10 dB loss) is seen. Absolute PTA threshold values do not statistically differ from baseline to completion at any frequency. For 4000 and 8000Hz, the absolute PTA threshold values differed from baseline to follow-up, but only for 8000Hz was the difference statistically significant after six months of follow-up. Following treatment, 64% of patients had grade I CTCAE scoring and 16% and 12%, respectively, had otitis media with effusion and Eustachian tube dysfunction. The inner ear may be harmed in patients receiving radiation to the head and neck. Radiation-induced SNHL typically goes unreported in routine clinical practise because of its long-term nature. In the group of head and neck tumours with high-risk locations, nearly 90% of patients with SNHL were affected. Therefore, it's critical to reduce cochlear dosage in these patient populations. More investigation is needed to distinguish between cochlear and retro-cochlear types of sensorineural hearing loss.

Bilateral Congenital Ossicular Anomalies: Are the Anomalies Symmetric for Both Ears?

To evaluate whether bilateral congenital ossicular anomalies (COAs) differ regarding ossicular anomalies and hearing loss severities between the ears of the individual. Retrospective case review. Tertiary referral academic center. Between March 2012 and December 2022, 7 consecutive patients (14 ears) with surgically confirmed bilateral COAs were included in the study. Preoperative pure-tone thresholds, COA classification according to the Teunissen and Cremers system, surgical procedures, and postoperative audiometric results were compared between the 2 ears of each patient. The median age of the patients was 11.5 (range: 6-25) years. Both ears of each patient were categorized based on the same classification. Three patients possessed class III COAs and the other 4 had class I COAs. The interaural differences in preoperative bone and air conduction thresholds were within 15 dB for all patients. Differences in postoperative air-bone gaps between ears were not statistically significant. The surgical procedures required for ossicular reconstruction were almost identical for both ears. The severity of ossicular abnormalities and hearing loss in patients with bilateral COAs were symmetrical between ears, thereby enabling prediction of the characteristics of the contralateral ear based on the findings observed in 1 ear. These symmetric clinical features can aid surgeons when operating on the contralateral ear.

Cochlear Implantation in Pediatrics: The Effect of Cochlear Coverage

The effect of insertion depth and position of cochlear implant (CI) electrode arrays on speech perception remains unclear. This study aimed to determine the relationship between cochlear coverage and speech performance in children with prelingual hearing loss with CI. Pure tone audiometry (PTA) and speech audiometry, including speech reception threshold (SRT) using spondee words and speech discrimination score (SDS) using phonetically balanced monosyllabic words, were tested. The Categories of Auditory Performance (CAP) and Speech Intelligibility Rating (SIR) scales were also used. Thirty-one ears were implanted with the FLEX 28 electrode array, and 54 with the FORM 24 were included in the current study. For the studied ear, the mean cochlear duct length was 30.82 ± 2.24 mm; the mean cochlear coverage was 82.78 ± 7.49%. Cochlear coverage was a significant negative predictor for the mean pure tone threshold across frequecnies of 0.5, 1, 2, and 4 kHz (PTA4) (p = 0.019). Cochlear coverage was a significant positive predictor of SDS (p = 0.009). In children with cochlear coverage ≥ 82.78%, SDS was significantly better than in those with coverage < 82.78% (p = 0.04). Cochlear coverage was not a significant predictor of the SRT, CAP, or SIR. In conclusion, the cochlear coverage of the CI electrode array has an impact on the users' SDS. Further long-term studies with larger sample sizes should be conducted to address the most critical factors affecting CI recipients' outcomes.

Výtěžnost sluchové zkoušky šepotem společně s vyšetřením screeningových otoakustických emisí v záchytu nedoslýchavosti

Summary Introduction: The aim of this paper is to evaluate the ability of a whisper hearing test together with an examination of transiently evoked otoacoustic emissions (TEOAE) to detect a hearing loss at the first contact with an adult patient with the indicated hearing impairment. This can be helpful in situations when a threshold pure tone audiometry cannot be performed. Methodology: We included a group of patients who were examined simultaneously with a classical whisper hearing test, TEOAE and a pure tone audiometry at the Department of Otorhinolaryngology and Head and Neck Surgery of the Pardubice Hospital. Sixty-two patients with a hearing impairment and 14 healthy subjects were tested. Results: A sensitivity of the whisper hearing test alone was 85% and that of TEOAE was 71%. The sensitivity increased to 94%, when both of them were used. At the same time, a relatively high specificity (75%) of the examination was present. Using the whisper hearing test and TEOAE, we did not detect 3.3% of patients with hearing loss detected by pure tone audiometry. Conclusion: In the situation when no pure tone audiometry is available a combination of the whisper hearing test and TEOAE may be used to detect a hearing loss. The combination of these two methods can be considered for a recently much-discussed screening for hearing impairment in the elderly. Key words whisper hearing test – transient evoked otoacoustic emissions – TEOAE – hearing loss – screening

Identifying reduced hearing in children who have developmental disabilities: Insights for inclusive research practices with electronic health records.

Recent advancements in big data analytics and the formation of large-scale clinical data repositories provide a unique opportunity to determine the current state of pediatric hearing health care for children who have developmental disabilities. Before answering unresolved questions about diagnostic practice, it is paramount to determine a standard and reliable method for identifying children who have reduced hearing because clinical management is affected by hearing status. The purpose of this study was to compare 5 different methods for identifying cases of reduced hearing from pure-tone thresholds based on developmental disability status. Using retrospective clinical data from 100,960 children (0-18 years), hearing status was determined for a total of 226,580 encounters from three clinical sites. 9% of the children had a diagnosis of intellectual disability, autism spectrum disorder, Down syndrome, or cerebral palsy. Results revealed that encounters from children who have developmental disabilities were more likely to have insufficient data to allow hearing status to be determined. Moreover, methods with higher data demands (i.e., number of thresholds and ear-specific thresholds) resulted in fewer classifiable encounters. The average child age when hearing status was classified for the first time was older for children who have developmental disabilities than for children in the comparison group. Allowing thresholds to build up over multiple test sessions did result in more children who have developmental disabilities being classified than for single-encounter methods, but a meaningful decrease in child age at the time of classification was not seen for this strategy. Compared to the comparison group, children who have developmental disabilities were more likely to have reduced hearing that was stable over time, yet their hearing status was determined at older ages. Results provide key guidance to researchers for how to determine hearing status in children for big data applications using electronic health records. Furthermore, several assessment disparities are spotlighted for children who have developmental disabilities that warrant further investigation.

Examining the feasibility of integrating pupillometry measures of listening effort into clinical audiology assessments

Pure-tone thresholds are often a poor predictor of hearing difficulties experienced by patients in audiology clinics. Approximately 25 million Americans may experience hearing difficulties despite having audiometric thresholds within normal limits. Pupil diameter increases with increasing listening effort and could provide an objective measure for determining the presence of such subclinical hearing problems. However, the cost and technical requirements of research-grade eye trackers have limited their use in audiology clinics. This study aims to determine the feasibility of using a commercially-available head mounted display (HMD) with integrated eye tracking to collect pupillometry measures during audiological testing. Pupillary data were collected for N = 46 younger normal-hearing adults while they completed clinically-relevant tests including pure tone audiometry, gaps-in-noise (GIN), dichotic digits, and speech-in-noise tests. Across tasks, task-evoked pupillary responses were generally sensitive to differences in listening demands. Results suggest audiologic testing with commercial HMD eye trackers is feasible and provides additional objective information related to listening effort that may help clinicians better understand and address patient needs. [The views expressed in this abstract are those of theauthors and do not reflect the official policy of the Department of Army/Navy/Air Force, Department of Defense, or U.S. Government.]

Hearing Rehabilitation Experiences With Osia&lt;sup&gt;®&lt;/sup&gt;2 Bone Conduction Hearing Implant in Patients With Iatrogenic Unilateral Hearing Loss

Various types of bone conduction hearing aids have been widely used for hearing rehabilitation for the last 30 years. Among them, the recently launched Osia&lt;sup&gt;®&lt;/sup&gt;2 system is a new active transcutaneous bone conduction implant system using piezoelectric effect. This can be expected to deliver more efficient sound transmission, overcome sound attenuation, and improve high-frequency hearing than conventional passive transcutaneous hearing aids, and is considered to be cosmetically superior to percutaneous hearing aids. Recently, we experienced two cases of Osia&lt;sup&gt;®&lt;/sup&gt;2 implantation in patients with iatrogenic unilateral hearing loss. Both patients showed improved pure tone threshold and better Korean Hearing in Noise Test (K-HINT) score after implantation. Furthermore, all of them had no complications after Osia&lt;sup&gt;®&lt;/sup&gt;2 implantation.

Longitudinal Electrocochleography as an Objective Measure of Serial Behavioral Audiometry in Electro-Acoustic Stimulation Patients.

Minimally traumatic surgical techniques and advances in cochlear implant (CI) electrode array designs have allowed acoustic hearing present in a CI candidate prior to surgery to be preserved postoperatively. As a result, these patients benefit from combined electric-acoustic stimulation (EAS) postoperatively. However, 30% to 40% of EAS CI users experience a partial loss of hearing up to 30 dB after surgery. This additional hearing loss is generally not severe enough to preclude use of acoustic amplification; however, it can still impact EAS benefits. The use of electrocochleography (ECoG) measures of peripheral hair cell and neural auditory function have shed insight into the pathophysiology of postimplant loss of residual acoustic hearing. The present study aims to assess the long-term stability of ECoG measures and to establish ECoG as an objective method of monitoring residual hearing over the course of EAS CI use. We hypothesize that repeated measures of ECoG should remain stable over time for EAS CI users with stable postoperative hearing preservation. We also hypothesize that changes in behavioral audiometry for EAS CI users with loss of residual hearing should also be reflected in changes in ECoG measures. A pool of 40 subjects implanted under hearing preservation protocol was included in the study. Subjects were seen at postoperative visits for behavioral audiometry and ECoG recordings. Test sessions occurred 0.5, 1, 3, 6, 12 months, and annually after 12 months postoperatively. Changes in pure-tone behavioral audiometric thresholds relative to baseline were used to classify subjects into two groups: one group with stable acoustic hearing and another group with loss of acoustic hearing. At each test session, ECoG amplitude growth functions for several low-frequency stimuli were obtained. The threshold, slope, and suprathreshold amplitude at a fixed stimulation level was obtained from each growth function at each time point. Longitudinal linear mixed effects models were used to study trends in ECoG thresholds, slopes, and amplitudes for subjects with stable hearing and subjects with hearing loss. Preoperative, behavioral audiometry indicated that subjects had an average low-frequency pure-tone average (125 to 500 Hz) of 40.88 ± 13.12 dB HL. Postoperatively, results showed that ECoG thresholds and amplitudes were stable in EAS CI users with preserved residual hearing. ECoG thresholds increased (worsened) while ECoG amplitudes decreased (worsened) for those with delayed hearing loss. The slope did not distinguish between EAS CI users with stable hearing and subjects with delayed loss of hearing. These results provide a new application of postoperative ECoG as an objective tool to monitor residual hearing and understand the pathophysiology of delayed hearing loss. While our measures were conducted with custom-designed in-house equipment, CI companies are also designing and implementing hardware and software adaptations to conduct ECoG recordings. Thus, postoperative ECoG recordings can potentially be integrated into clinical practice.

Blood levels of nicotinic acid negatively correlate with hearing ability in healthy older men

BackgroundAge-related hearing loss (ARHL) is a common phenomenon observed during aging. On the other hand, the decrease in Nicotinamide adenine dinucleotide (NAD +) levels is reported to be closely related to the age-related declines in physiological functions such as ARHL in animal studies. Moreover, preclinical studies confirmed NAD + replenishment effectively prevents the onset of age-related diseases. However, there is a paucity of studies on the relationship between NAD+ metabolism and ARHL in humans.MethodsThis study was analyzed the baseline results of our previous clinical trial, in which nicotinamide mononucleotide or placebo was administered to 42 older men (Igarashi et al., NPJ Aging 8:5, 2022). The correlations between blood levels of NAD+-related metabolites at baseline and pure-tone hearing thresholds at different frequencies (125, 250, 500, 1000, 2000, 4000, and 8000 Hz) in 42 healthy Japanese men aged > 65 years were analyzed using Spearman’s rank correlation. Multiple linear regression analysis was performed with hearing thresholds as the dependent variable and age and NAD+-related metabolite levels as independent variables.ResultsPositive associations were observed between levels of nicotinic acid (NA, a NAD+ precursor in the Preiss-Handler pathway) and right- or left-ear hearing thresholds at frequencies of 1000 Hz (right: r = 0.480, p = 0.001; left: r = 0.422, p = 0.003), 2000 Hz (right: r = 0.507, p < 0.001, left: r = 0.629, p < 0.001), and 4000 Hz (left: r = 0.366, p = 0.029). Age-adjusted multiple linear regression analysis revealed that NA was an independent predictor of elevated hearing thresholds (1000 Hz (right): p = 0.050, regression coefficient (β) = 1610; 1000 Hz (left): p = 0.026, β = 2179; 2000 Hz (right): p = 0.022, β = 2317; 2000 Hz (left): p = 0.002, β = 3257). Weak associations of nicotinic acid riboside (NAR) and nicotinamide (NAM) with hearing ability were observed.ConclusionsWe identified negative correlations between blood concentrations of NA and hearing ability at 1000 and 2000 Hz. NAD+ metabolic pathway might be associated with ARHL onset or progression. Further studies are warranted.Trial registrationThe study was registered at UMIN-CTR (UMIN000036321) on 1st June 2019.Graphical

A new tool for the assessment of speech understanding and spatial hearing difficulties in children: the Kid-SSQ questionnaire.

To develop and validate a new questionnaire, the Kid-SSQ, for the rapid screening of hearing abilities in children with hearing impairment, aged 7-17years. The questionnaire was constructed from two existing, validated versions of the 'Speech, Spatial and Qualities of Hearing'-(SSQ) questionnaire (pediatric form and adult short-form). The 12 selected items included auditory aspects from three subscales: speech perception, spatial hearing, and qualities of hearing. This new short form was then validated in 154 children with cochlear implants (100 bilaterally, and 54 unilaterally implanted children). Construct validity was assessed by testing relationships between Kid-SSQ scores and objective clinical parameters (e.g., age at test, pure-tone audiometry-PTA threshold, speech reception threshold-SRT, duration of binaural experience). Completion time was acceptable for use with children (less than 10min) and the non-response rate was less than 1%. Good internal consistency was obtained (Cronbach's α = 0.78), with a stable internal structure corresponding to the 3 intended subscales. External validity showed the specificity of each subscale: speech subscale scores were significantly predicted (r = 0.32, p < 0.001) by both 2kHz PTA threshold (β = 0.33, p < 0.001) and SRT (β = - 0.23, p < 0.001). Children with more binaural experience showed significantly higher scores on the spatial subscale than children with less binaural experience (F(1,98) = 5.1, p < 0.03) and the qualities of hearing subscale scores significantly depended on both age and SRT (r = 0.32, p < 0.001). The Kid-SSQ questionnaire is a robust and clinically useful questionnaire for self-assessment of difficulties in various auditory domains.

Extending the High-Frequency Bandwidth and Predicting Speech-in-Noise Recognition: Building on the Work of Pat Stelmachowicz.

Recent work has demonstrated that high-frequency (>6 kHz) and extended high-frequency (EHF; >8 kHz) hearing is valuable for speech-in-noise recognition. Several studies also indicate that EHF pure-tone thresholds predict speech-in-noise performance. These findings contradict the broadly accepted "speech bandwidth" that has historically been limited to below 8 kHz. This growing body of work is a tribute to the work of Pat Stelmachowicz, whose research was instrumental in revealing the limitations of the prior speech bandwidth work, particularly for female talkers and child listeners. Here, we provide a historical review that demonstrates how the work of Stelmachowicz and her colleagues paved the way for subsequent research to measure effects of extended bandwidths and EHF hearing. We also present a reanalysis of previous data collected in our lab, the results of which suggest that 16-kHz pure-tone thresholds are consistent predictors of speech-in-noise performance, regardless of whether EHF cues are present in the speech signal. Based on the work of Stelmachowicz, her colleagues, and those who have come afterward, we argue that it is time to retire the notion of a limited speech bandwidth for speech perception for both children and adults.

Audiological outcome after stapes surgery in relation to prosthesis type

PurposeDifferent techniques are used to fix crimp and CliP® Piston stapes prostheses to the long process of the incus (LPI). The CliP® Piston provides a stiff connection in contrast to the static bended loop of the crimp prosthesis, which imitates the physiological incudostapedial joint (ISJ) and thereby potentially leads to different hearing outcome.MethodsIn a retrospective single-center study of German-speaking one hundred and ninety patients who underwent stapes surgery CliP® Piston or crimp prostheses between the years of 2016 and 2019 by the same surgeon and in the same setting. Pre- and postoperative bone- (BC) and air-conduction (AC) pure-tone thresholds, pre- and postoperative air–bone gap (ABG) for 0.5, 1, 1.5, 2, 3, 4 kHz and the surgery time were examined.ResultsThe postoperative bone conduction thresholds were significantly lower in the frequencies between 0.5 and 3 kHz and the mean ABG was < 10 dB in most cases independent of the prosthesis used. Crimp prosthesis showed a significantly better closure of the ABG at 0.5 kHz.ConclusionsThe audiological outcome after stapes surgery is dependent on the type of prosthesis used, as reflected by the frequency-specific air–bone gap. The better ABG closure with the crimp prosthesis might be the result of the connection to the LPI imitating the physiological ISJ. The crimp prosthesis may be the better choice if use of hearing aids is expected postoperatively.

Reading comprehension skill in English as a second language of Japanese middle school students with cochlear implants

Objectives To assess the English reading comprehension skill of Japanese middle school students with cochlear implants (CIs). Materials and Methods The subjects were pre- or perilingually deafened CI recipients between seventh and ninth grades (age 12–15 years). English reading comprehension skill was evaluated using the Norm Referenced Test developed for Japanese students. Furthermore, factors related to English reading comprehension were assessed, focusing on a total of 11 variables: age; sex; age at CI; length of CI use; aided pure-tone thresholds with CI; Japanese listening word recognition score; performance intelligence quotient (PIQ) score; verbal intelligence quotient (VIQ); grade; school type; and Japanese reading comprehension skill. Results A total of 40 subjects completed the test. Their average word recognition score was good, at 80.2%,and the average age at CI was late, at 4.4 years. The chi-square goodness of fit test showed the English reading comprehension skill level deviated toward lower achievement in the students with CIs compared with children with normal-hearing. VIQ and Japanese reading comprehension skill were correlated with English reading skill. On the other hand, there was no relationship between English reading skill and the factors of hearing level and CI experience.