Speech Audiometry Research Articles

Development of SC-10: A psychometrically equivalent Singapore Mandarin disyllabic word list for clinical speech audiometry use.

ObjectiveThe aim of this study is to develop and evaluate a set of psychometrically equivalent disyllabic wordlist (SC-10) in Singapore Mandarin for clinical use.Study designA preliminary set of 1000 words were obtained from a dictionary of frequently used words by Singapore students. Ten native judges rate the familiarity level of each word. This is followed by a face-to-face public survey to rank the shortlisted word set from most to least familiar. The final 108 disyllabic words were recorded by a native female talker. 20 normal hearing subjects were used to obtain the percentage of correct word recognition at 24 intensity levels (−10 dB HL to 26 dB HL in 2 dB increment). Psychometric function slopes were calculated for each word. 100 words were eventually chosen and assigned into ten 10-word lists based on a psychometric balancing protocol. Minor digital adjustments were made to the intensity of each wordlist to improve their auditory homogeneity.The developed SC-10 wordlists were validated by a separate group of 25 normal hearing subjects. Test-retest reliability was carried out on 20 out of 25 participants at the selected intensity levels (SRT-5, SRT, SRT+5).ResultsThe calculated regression slopes in the psychometric functions for the ten lists are between 8.0 and 9.8%/dB. Single factor ANOVA analysis showed no significant difference in both the mean intensity required to obtain 50% recognition score (f = 0.109, df = 9, p = 0.999) and the slopes of the psychometric functions (f = 0.078, df = 9, p = 0.999) between the ten word lists. List validation on 25 normal hearing participants (PTA = 11.0 dB HL, SD = 4.3) showed a mean speech recognition threshold (SRT) of 9.3 dB HL (SD = 3.5)and regression slope of 8.395%/dB. Quadratic regression analysis showed a positive correlation (r2 = 0.923) between presentation level and word recognition score (WRS). The difference between PTA and SRT of each subject all fall within the clinically acceptable difference of 10 dB HL. Test-retest reliability, carried out on 20 subjects at three levels (SRT-5, SRT, and SRT+5 dB), showed no significance difference between word recognition score when the same participant is tested again at the same intensity level using a different wordlist.ConclusionAll in all, it shows that the SC-10 speech materials are valid for clinical use for Mandarin speech audiometry in Singapore.

Speech audiometry in noise: SNR Loss per age-group in normal hearing subjects

ObjectivesThe present study aimed to determine normal SNR values per age group for the 50% speech reception threshold in noise (SNR Loss) on the VRB (Vocale Rapide dans le Bruit: rapid speech in noise) test. Material and MethodsTwo hundred patients underwent pure-tone threshold and VRB speech-in-noise audiometry. Six ages groups were distinguished: 20–30, 30–40, 40–50, 50–60, 60–70 and>70 years. All subjects had normal hearing for age according to ISO 7029. SNR Loss was measured according to age group. ResultsMean SNR Loss ranged from −0.37dB in the youngest age group (20–30 years) to +6.84dB in the oldest (>70 years). Range and interquartile range increased with age: 3.66 and 1.49dB respectively for 20–30 year-olds; 6 and 3.5dB for>70 year-olds. Linear regression between SNR Loss and age showed a coefficient R2 of 0.83. ConclusionThe present study reports SNR Loss values per age group in normal-hearing subjects (ISO 7029), confirming that SNR Loss increases with age. Scatter also increased with age, suggesting that other age-related factors combine with inner-ear aging to impair hearing in noise.

Specific language impairment: speech perception in relation to noise

BackgroundChildren with specific language impairment (SLI) fail to develop age-appropriate language despite being apparently normal in other respects. Those children usually have abnormal speech perception in noise. This work is designed to investigate speech perception in background noise in those children. It included two groups of children: control group (15 children with normal typical language development) and study group (25 children diagnosed with SLI). All children were submitted to intelligence scale, language assessment, full audiological evaluation, and Arabic Pediatric Speech Intelligibility in noise test (PSI).ResultsResults showed no statically significant difference in total and verbal IQ, while non-verbal IQ was significantly lower in the study group. As regard results of speech audiometry, the control group had better SRT and higher WD% than the study group. Expressive, receptive, and total language scores were lower in the study group. Arabic Pediatric Speech Intelligibility in noise test showed significantly increased PSI scores with increasing the SNR from 0 to +8dB in both groups. The comparison between both groups showed a significant higher score in the control group at different S/N recording conditions.ConclusionsChildren with SLI have difficulty in speech perception when compared to typically developed language children. This difficulty is more apparent in the presence of background noise.

Participation of Acoustic and Electric Hearing in Perceiving Musical Sounds.

Introduction: The objective of our study was to evaluate musical perception and its relation to the quality of life in patients with bimodal binaural auditory stimulation.Materials and Methods: Nineteen adult patients with a cochlear implant (CI) for minimum 6 months, and moderate to severe contralateral hearing loss with a hearing aid (HA), and 21 normal hearing adults were included in this prospective, cross-sectional study. Pure-tone and speech audiometry, musical test evaluating sound perception characteristics and musical listening abilities, Munich questionnaire for musical habits, and the APHAB questionnaire were recoded. Performance in musical perception test with HA, CI, and HA + CI, and potential correlations between music test, audiometry and questionnaires were investigated.Results: Bimodal stimulation improved musical perception in several features (sound brightness, roughness, and clarity) in comparison to unimodal hearing, but CI did not add to HA performances in texture, polyphony or musical emotion and even appeared to interfere negatively in pitch perception with HA. Musical perception performances (sound clarity, instrument recognition) appeared to be correlated to hearing-related quality of life (APHAB RV and EC subdomains) but not with speech performances suggesting that the exploration of musical perception complements speech understanding evaluation to better describe every-day life hearing handicap.Conclusion: Testing musical sound perception provides important information on hearing performances as a complement to speech audiometry and appears to be related to hearing-related quality of life.

Phonemically Balanced Arabic Monosyllabic Word Lists for Speech Audiometry Testing in Jordan.

Many of the Arabic monosyllabic word lists that are currently available in the literature have some limitations and drawbacks. Some of these available lists include word structures that are not consonant-nucleus-consonant (CNC) such as cluster and disyllabic word structures. Other lists have poor phonetic or phonemic distribution balance and do not represent some phoneme appropriately in each list. The purpose of the present study is to create and validate eight digitally recorded lists of phonemically balanced CNC words that represent all Arabic phonemes, to be used in the evaluation of word recognition score (WRS) of Jordanian Arabic-speaking adults. These lists should be easily adapted by other Arab countries because of the simplicity of the words, and the balanced inclusion of all the Arabic phonemes. The present study is a prospective cross-sectional study. Thirty-one (23 females, 8 males) normal hearing and healthy young adults (18-29 years old) participated in the present study. All participants were native speakers of Jordanian Arabic and had no history of ear disease or surgery. The authors created all possible combinations of Arabic CNC words, and then created eight phonemically balanced lists with 26 words in each list. Each consonant was presented only once at the beginning of a word and once at the end of a word in each list. The lists were recorded using a Jordanian male voice and the intensity of each word was digitally calibrated. The pure tone average (PTA) of 0.5, 1, 2, 4 kHz was calculated for each participant, and the WRS was obtained for each intensity level in the range of -10 to 55 dB SL (ref. PTA) in 5 dB steps. No significant difference between right and left ear WRS was found at any intensity level. The WRSs from both ears were averaged and used in the repeated measure analysis of variance. Performance-intensity functions for all the lists showed some small but statistically significant differences between lists. However, none of these differences were clinically significant (<4%). All the lists showed WRS exceeding 96% at 40 dB SL, and none of the lists showed statistically significant improvement in WRS beyond 40 dB SL. The present study provides eight lists of recorded and calibrated CNC word lists. The obtained PI functions showed that these lists are suitable for Jordanian Arabic speaking adults. These lists can be easily generalized to other Arab countries after conducting the required follow-up research.

Intratympanic injection of dexamethasone for Menires disease. What relief can be expected? A case-series study

Introduction: In patients suffering from Menires disease (MD), after failure of oral medical treatment, intratympanic in-jections (IT) may be achieved, among which, IT with dexamethasone (DXM). IT DXM has been reported to be effective on vestibular symptoms but very few reports focus on auditory symptoms. &lt;br/&gt;&lt;br/&gt;Aim: Here we assessed its efficacy both in vestibular and auditory symptoms.&lt;br/&gt;&lt;br/&gt;Patients and method: Twenty-seven MD patients who suffered from auditory and vestibular symptoms despite previous sys-temic medical treatment, underwent at least one series of five daily consecutive IT DXM. Auditory and vestibular assessment were achieved before IT DXM, and four months afterwards. Patients were ranked according to the vestibular functional level scale of the American Academy of Otolaryngology Head Neck society (1995) at the same periods. A specifically designed qu-estionnaire, focused on auditory symptoms was administered after IT DXM. Comparisons used a Chi-2 test for paired series, with p 0.05 considered significant.&lt;br/&gt;&lt;br/&gt;Results: The vestibular functional level shifted significantly towards lower levels, the median shifting from level 4 to 3. There was no complication but two persistent tympanic membrane perforation. Twelve patients (44.4%) had recurrent symptoms, on average 7 months after IT DXM and required additional treatment. Tonal and speech audiometry did not improve, neither the objective auditory and vestibular assessment. Based on the questionnaire, IT DXM was effective on auditory symptoms, at least on tinnitus in 9 cases (33.3%), mainly by lowering its intensity.&lt;br/&gt;&lt;br/&gt;Conclusion: IT DXM confirmed its capacity to relieve vestibular and auditory symptoms, in particular tinnitus, even though transiently.

Reflex Decay Test Can Reveal Ear Involvement in Fabry Disease.

Fabry disease (FD) is an X-linked lysosomal storage disorder that causes multisystem involvement, including ear disease. In this study, we aimed to investigate the nature of auditory issues in FD using a wide spectrum of audiological tests. This cross-sectional study was conducted between June 2017 and December 2018. We collected the clinical and laboratory data of 40 eligible FD patients, 45 healthy subjects, and 26 diabetic controls. All patients and controls completed audiologic evaluations that included tympanometry, acoustic reflex threshold test, reflex decay test, pure-tone audiometry, speech audiometry, transient otoacoustic emissions (TEOAEs), high-frequency audiometry, and distortion product otoacoustic emission (DPOAE). In our study population, hearing was reduced at higher frequencies starting at 4 kHz in both the FD and diabetic groups. Regarding the acoustic reflex threshold test, FD and diabetic patients had similar results. In all frequencies, positive decay was significantly more frequent in FD patients when compared with the diabetic patients and healthy controls (p < 0.001 for each ear). The FD patients and healthy controls had similar results for DPOAE testing. We showed that FD patients had a higher rate of reflex decay, indicating retrocochlear involvement. Thus, further investigation of factors associated with retrocochlear involvement could be investigated, such as ABR and speech in noise tests.

Audiological benefits and performance improvements of Baha® attract implantation in patients with unilateral hearing loss

Objectives To evaluate the overall functional and audiological benefits in unilateral hearing loss, as well as performance improvements with Cochlear™ Baha® Attract System with Baha® 5 sound processor. Methods We performed a prospective study. Fourteen consecutive adult patients with unilateral hearing loss who were audiologically eligible for Baha® Attract were included in this study. All patients were followed-up, and a series of tests were performed in the sound field before surgery, one, two, three, and 6 months after surgery. Results Patients were categorized based on their hearing impairment type and severity. Ten patients had conductive hearing loss (CHL), or mixed hearing loss (MHL), and four patients had sensorineural hearing loss (SNHL). The hearing threshold in the sound field aided with Baha® Attract was similar to the preoperative bone conduction hearing threshold of the better ear. The results of the speech audiometry improved post-operatively, but they did not match that of the better ear before surgery. The overall score of the hearing-in-noise test was gradually improved from one month to 6 months after surgery. The results of the sound localization test for SNHL patients were not as good as those for CHL or MHL. All the questionnaires demonstrated additional benefits that implied performance improvements. Conclusions The Baha® Attract provides enough auditory benefits and performance improvements for hearing impaired patients, though there are different benefits according to the type of hearing loss. Clinicians need to counsel the unilateral hearing loss patients for Baha® Attract System carefully, according to their type of hearing loss.

Detection of hearing loss in rheumatoid arthritis patients using extended high frequency audiometry: Is it related to disease activity and severity?

Aim of the workTo evaluate audiological characteristics in rheumatoid arthritis (RA) patients compared with controls using extended high frequency audiometry and analyze their correlations with RA activity and severity to identify patients at higher risk of hearing loss. Patients and methodsThe study was carried out on 95 RA patients and 100 controls. Every subject underwent pure tone audiometry (PTA) from 250 through 8000 Hz, speech audiometry and extended high frequency audiometry (EHFA) from 10,000 to 20000 Hz. Disease activity score (DAS28) and RA medical records-based index of severity (RARBIS) were assessed. ResultsPatients were 85 females and 10 males with age mean 46.5 ± 1.1 years and disease duration of 9.57 ± 0.61 years. The hearing thresholds (HT) of patients were significantly higher than those of controls at all PTA (p < 0.001) and EHFA frequencies (p < 0.001). Hearing loss (HL) was detected in 68.4% and 64.2% by using PTA, while EHFA revealed it in 100% and 97.9% of right and left ears of RA patients respectively. Hearing loss was bilateral, symmetrical and sensorineural in all cases. HT of EHFA significantly correlated with age (r = 0.63, p < 0.001), age at onset (r = 0.51, p < 0.001), disease duration (r = 0.3, p = 0.03), DAS28 (r = 0.31, p = 0.01) and RARBIS (r = 0.21, p = 0.03). ConclusionBilateral symmetrical sensorineural hearing loss (SNHL) is significantly more frequent in RA patients compared to control. EHFA is valuable test to detect HL in patients with RA. Older age, longer disease duration, higher disease activity and severity are important factors for the development of HL in RA.

Value of Vestibular Evoked Myogenic Potentials in IdentifyingDifferent Forms of Endolymphatic Hydrops: A Cross-Sectional Study

AbstractBackground: Meniere’s disease is idiopathic Endolym-phatic Hydrops. Vestibular evoked myogenic potential is aneurophysiological assessment technique that is used determinethe function of the otolith organs of the inner ear. Usingvestibular evoked myogenic potential tests may identify thedifferent forms of the Endolymphatic Hydrops.Aim of Study: The aim of this study is to explore the roleof vestibular evoked myogenic potentials (VEMP) in diagnosis of the different kinds of Meniere’s disease (MD).Patients and Methods: Three groups of patients that wereselected according to the diagnosis, definitive MD (DMD),cochlear MD (CMD) and recurrent vestibulopathy (RV) group.Basic audiological evaluation was carried out. It includedPure tone audiometry, speech audiometry, acoustic immittancetesting and electrocochleography. Otolith function assessmentwas carried out in the form of:Cervical VEMP (c-VEMP) and ocular VEMP (o-VEMP).Vestibular assessment was carried out: The test protocolincluded spontaneous nystagmus, gaze test, oculomotor tests,positioning test (Dixhallpike), positional nystagmus, andcaloric testing. The three groups were compared for all demo-graphic variables as well as clinic-pathologic variables, andtests results.Results: The overall sample was 40 cases; 13 with DMD,10 with CMD and 17 with RV. The mean age is variablebetween groups (p-value <0.001) with the highest in the DMDgroup (38.3±7.4 years) and the lowest in the CMD group (25.2±4.6 years). The male to female ratio is variable betweengroups of the study (p-value=0.03) with the highest ratio 9:4in the DMD group. There was a significant difference betweengroups (p < 0.001) regarding dizziness. Asymmetric responseof c-VEMP was seen in nine (9/13) (69.2%) of DMD cases, (14/17) (82.4%) of RV cases and only in three (3/10) (30%)of CMD cases, (p-value <0.001). Low amplitude of o-VEMPwas seen in (11/13) (84.6%) of DMD cases, (9/10) (90%) ofCMD cases, (15/17) (88.2%) of RV cases, and only in two (25%) of normal cases, (p-value=0.002). A significant differ-ence was found between definitive and cochlear Meniere's as regards o-VEMP inter-aural amplitude difference (IAD) (p-value=0.032) only. There was a significant positive strongcorrelation between age and EchoG sp/ap ratio left ear, o-VEMP IAD and o-VEMP left ear n1. In addition, there is asignificant positive weak correlation between duration andEchoG sp/ap ratio left ear and c-VEMP left ear n1.Conclusion: Asymmetric response of c-VEMP can beused as a diagnostic tool to differentiate different kinds ofMD: DMD, RV and CMD.

Realistic Environment Audiometric Booth: Development and Clinical Validation

Background: Technological developments to treat hearing loss with different types of hearing aids and auditory implants have improved the auditory perception of patients, particularly in highly complex listening conditions. These devices can be fitted and adapted to enhance speech perception. Audiological tests that assess hearing with and without auditory devices have traditionally taken place in sound-attenuated audiometric booths. Although the insights gained from these tests are extremely useful, they do not accurately reflect everyday listening situations, and accurate information about the potential benefits of the hearing device in real acoustic scenarios cannot be established. Consequently, it is difficult to optimize this technology since fitting cannot be customized. Objectives: The aim of this study was to validate an audiological testing method using a new development, the Realistic Environment Audiometric Booth (REAB), in clinical practice. Materials: We used specifically designed software to perform audiological tests in an 8 m² sound-attenuated booth. The REAB was designed to conduct audiological tests in standard testing conditions and in new hearing scenarios that simulate real-life situations since sound can be emitted simultaneously or alternately 360° around the patient, along with 3D images. Methods: Prospective study in which subjects were tested randomly in the REAB and the conventional booth (CB) in free field. Results: 150 subjects were recruited, mean age 56 ± 20.7 years. Auditory outcomes for pure-tone audiometry showed a high correlation; this was also the case for speech audiometries in quiet and in noise. The outcome of the new scenarios with real-life noise was plotted, including the mean values and their confidence intervals. A decreasing trend was observed in the results obtained by the different groups, according to their hearing levels. Conclusions: We have developed and validated a new audiological testing method that enables hearing ability to be assessed in listening conditions similar to those found in real life. The REAB complements the tests performed in CBs, thereby aiding the diagnostic process by reproducing acoustic and visual scenarios that conventional tests do not offer.

Speech perception 30 years after cisplatin-based chemotherapy in adults: limited clinical relevance of long-term ototoxicity?

Background Cisplatin-based chemotherapy (CBCT) can cause high-frequency hearing loss, but little is known about the development and clinical relevance of this hearing loss in survivors of adult-onset cancer with very long-term follow-up. This case-control study investigates hearing and speech perception both in quiet and with background noise 30-years after CBCT. Patients and methods One-hundred-and-one patients (Cases) who received CBCT for testicular cancer between 1980 and 1994 were assessed with pure-tone audiometry (.125 − 8 kHz) and speech perception tests including hearing in noise test (HINT). Self-reported hearing and tinnitus was scored by participants. Results were compared with 30 age-matched controls. Results The median age of Cases and Controls was 60 (46 − 83) and 61 years (51 − 74), respectively. The median observation time for Cases was 30 years (22 − 37). Compared with Controls, Cases had 8 and 19 dB worse age-adjusted high-frequency hearing at 6 and 8 kHz, respectively (p <.05), while thresholds at lower frequencies did not differ. All but four Cases reached 100% speech perception with basic speech audiometry. There was no difference between Cases and Controls in speech perception neither in quiet nor with both speech and background noise from the front, although the within-group variance was greater among Cases. Cases scored slightly worse with speech from front and noise from either side. Self-reported hearing loss (both hearing loss in general and specifically with background noise), and tinnitus were about three times more common among Cases compared with Controls. Conclusions Cisplatin causes high-frequency hearing loss, but speech perception tests performed both in quiet and in background noise 30 years post-treatment indicate that the clinical relevance is limited for most patients. Few patients develop severe hearing loss that requires rehabilitation but it is important to identify these patients. Self-reported hearing loss and tinnitus were more common among Cases compared with Controls.

Clinical Importance of Sound-Field Speech Recognition Test for Measurement of Hearing Aid Benefit

Background and Objectives Although sound-field speech recognition test is an essential evaluation method to verify the benefit of hearing aids, the aided sound-field speech recognition test has not been used as a standard audiometric protocol. This study investigated whether a traditional measure of unaided speech recognition measured at an individual’s most comfortable level (MCL) can predict aided speech recognition performance and the benefit of hearing aids.Subjects and Method One hundred twenty-one ears (72 adult hearing aid users) with moderate, moderately severe, and severe degrees of hearing loss were tested. The word recognition score (WRS) and sentence recognition score (SRS) were measured at MCLs using earphones (earphone WRS and earphone SRS). From the sound-field speech audiometry, both unaided and aided WRS and SRS were evaluated at an average conversational speech level (at 65 dB SPL) using a loudspeaker (located at 0° azimuth, 1 m). This study determined the differences between earphone scores (at MCL) and aided recognition scores (at 65 dB SPL), which is known as earphone to aided difference (EAD). Also, the hearing aid benefit was simply derived by differences between the unaided and aided scores, both measured at 65 dB SPL.Results The differences between the unaided and aided scores were significantly lower with a higher degree of hearing loss, yet the earphone scores measured at MCLs did not differ across varied hearing loss. More than half of the tested ears had the EAD of greater than ±10%. The ears with a higher degree of hearing loss tended to have +EAD (earphone score&gt;aided score), whereas the ears with less hearing loss showed -EAD (earphone score≤aided score). The earphone score measured at MCLs was not a predominant contributor to predict either aided performance or hearing aid benefit.Conclusion Clinicians should not assume that the unaided speech recognition score measured with earphones at MCL can accurately predict aided speech recognition or the benefit of hearing aids. Instead, it is crucial to directly assess aided sound-field speech recognition performance at a conversational speech level.

Central auditory processing and listening effort in normal-hearing children: a pilot study

Objectives The current study aims to assess the link between central auditory processes and listening effort in a group of normal-hearing children. This will provide information over and beyond the standard central auditory processes and might have practical implications for listening situations which often require speech understanding in noisy environments. Method The current study included 35 normal-hearing children from six to eleven years old. Tympanometry, tonal audiometry, and speech audiometry was performed. Different auditory processing skills were assessed using the Frequency Pattern Test, the Staggered Spondaic Word Test, and the Dichotic Digits Test. Finally, a dual-task paradigm was used to evaluate listening effort. This paradigm consisted of the simultaneous performance of a speech-recognition task in different conditions of background noise and a visuospatial memory task using a digital Corsi Block test. Results Significant correlations between listening effort and several components of the auditory processing tests were established. Specifically, listening effort correlated significantly with some components of the SSWT as well as the DDT. Additionally, the listening effort test showed a significant age effect for the listening condition with the highest Signal-To-Noise Ratio. Conclusions Based on the current results, inclusion of listening effort in the test battery for auditory processing disorders would be valuable.

Subcortical deafness as a subtype of auditory agnosia after injury of bilateral auditory radiations caused by two cerebrovascular accidents – normal auditory brainstem responses with I–VII waves and abolished consciousness of hearing –

Background In central auditory disorders caused by damage of the cerebral hemispheres, there are cortical deafness and auditory agnosia. Although clinical cases of cortical deafness have been reported, little is known about the hearing problems and localized lesions associated with cortical deafness. Aims/objectives The aims of our research are to elucidate lesion sites associated with cortical deafness and to clarify why patients with cerebral lesions are not aware of any sound at all. Materials and methods Three patients diagnosed as having total loss of hearing participated in this study. We conducted pure-tone audiometry, speech audiometry, distortion product otoacoustic emission (DPOAE), auditory brainstem response (ABR), and brain magnetic resonance imaging (MRI) to diagnose cortical deafness with aphasia tests of these patients. Results Our studies showed that waves VI and VII as well as waves I to V have normal peak latencies in ABRs in all three patients. In brain MRI, we found complete damage of proximal parts of bilateral auditory radiations in the three patients. Conclusions We propose ‘subcortical deafness’ as a subtype of auditory agnosia.

Retrosigmoidal placement of an active transcutaneous bone conduction implant: surgical and audiological perspectives in a multicentre study.

SUMMARYIntroductionThe retrosigmoidal (RS) placement of the Bonebridge system (BB) has been advocated for cases of unfavourable anatomical or clinical conditions which contraindicate transmastoid-presigmoidal positioning. However, these disadvantageous conditions, combined with the considerable dimensions of the implant, may represent a challenge, especially for surgeons with no skull base experience. Moreover, the literature reports only limited experience concerning RS implantation of the BB system.MethodsA multicentre, retrospective study was conducted to analyse the surgical and functional outcomes of a wide population of patients undergoing RS placement of the BB system by means of a surgical technique specifically developed to overcome the intraoperative issues related to this surgery. Twenty patients with conductive or mixed hearing loss and single sided deafness were submitted to RS implantation of the BB system.ResultsAudiological assessment concerning the measurement of the functional and effective gain by pure-tone audiometry (28 dB HL and -12.25 dB HL, respectively) and speech audiometry (24.7 dB HL and -21 dB HL, respectively) was conducted. A high overall subjective improvement of quality of life was recorded with the Glasgow Benefit Inventory questionnaire. No major complications, such as device extrusions or other conditions requiring revision surgery, were reported during the follow-up period (median: 42 months).ConclusionsIn our study, which has one of the largest cohort of patients reported in the literature, RS placement of the BB system was safe and effective. Our functional results showed comparable hearing outcomes with presigmoidal placement. The effective gain, rarely investigated in this field, may be the object of further research to improve our understanding of bone conduction mechanisms exploited by bone conduction hearing implants.

Psychometric function characteristics of Persian consonantvowel-consonant words

Background and Aim: Evaluation of word recognition score requires multiple lists that must be similar in terms of difficulty level. There is currently no such word lists for the Persian language. The aim of this study was to construct several lists of Persian monosyllabic words with psychometric homogeneity. Methods: The most common monosyllabic words were collected from a book of Persian word frequency. The selected monosyllabic Consonant-Vowel-Consonant (CVC) words were presented randomly to 30 normal hearing participants with the age range of 18 to 25 years. The presentation level was from 0 to 40 dB in 8 dB increments. The characteristics of psychometric function were determined for all words using the logistic regression. Results: The Persian CVC monosyllabic words have different difficulty levels with threshold varying from 2.8 to 37.2 dB HL and the slope from 2.3 to 16.4 %/dB. Conclusion: The final result of the present study is three full lists of monosyllabic words with CVC syllabic structure that have the same mean threshold and slope of psychometric function. The 25-word half-lists of each full list are similar in terms of psychometric characteristics. Keywords: Psychometric function; Persian monosyllabic words; speech audiometry

Self-assessed hearing handicap in the elderly: a pilot study on Iranian population

Background and Aim: Presbycusis is a prevalent chronic condition in the elderly which may have potential adverse effects on social and emotional aspects of their life. There is no one to one relationship between audiogram and the perceived handicap in elderly. A good way to measure hearing handicap are self-assessment tools. This study was aimed to translate, adapt and establish face validity of Short form of Hearing Handicap Inventory for the Elderly (HHIE-S) and the correlation with pure-tone and speech audiometry results as well as score of the other self-assessmnet tool (Self-Assessment of Communication: SAC) in the Iranian elderly. Methods: HHIE-S was translated into Persian and face validity was established. It was administered in 80 elderly participants. Correlation of their scores with their pure tone averages of 3 and 4 frequencies (PTA0.5-1-2 and PTA0.5-1-2-4), word recognition score (WRS) in quiet, and SAC scores was determined. Results: The experts mean scores to PHHIE-S was 99.63%. There were significant correlations between PHHIE-S with SAC (r = 0.89; p &lt; 0.001), PTA0.5-1-2 (r = 0.4; p &lt; 0.001), PTA0.5-1-2- 4 (r = 0.6; p &lt;0.001) and WRS (r = -0.4; p &lt; 0.001). There was no significant gender effect on any of the measures (p &gt; 0.05). Conclusion: Simply evaluation of the hearing levels is not adequate in elderly. Self-assessment tools can shed light on the specific disability induced by hearing loss. PHHIE-S appears to be an easy and fast tool that may helpful to distinguish patients who might need rehabilitative services. Keywords: Elderly; presbycusis; selfassessment; handicap

Significance of continuing audiovestibular practice during Covid-19 pandemic

BackgroundWe aimed to evaluate the significance of continuing audiovestibular practice during the Covid-19 pandemic in the audiology clinic of the university hospital.MethodsThe precautions, test procedures, and risk factors associated with the practice of audiology were evaluated. The number and diagnoses of the cases between 23 March and 23 May 2020 were also compared with the results of the same 2 months in 2019 in an attempt to evaluate the alterations in the audiology practice.ResultsThe audiology practice has continued during the pandemic, and numerous audiovestibular tests like newborn hearing screening, pure tone and speech audiometry, auditory brainstem response (ABR) test, bedside vestibular assessment, videomystagmography (VNG), caloric test, vestibular evoked myogenic potential (VEMP), computerized dynamic posturography (CDP), video head impulse test (vHIT), intraoperative cochlear implant measurement, and postop cochlear implant fittings were performed. The number of tests has decreased significantly in the course of the pandemic (p < 0.01). No evidence of Covid-19 disease was detected in the audiology staff and patients. In general, no major risk was seen during testing under protective measures except for vestibular testing which induced vomiting and taking out the mask for lip reading during cochlear implant fitting in the elderly.ConclusionIt is possible to perform audiovestibular tests during the Covid-19 pandemic by wearing necessary protective equipment and disinfecting the potential surfaces. Vomiting during vestibular tests, uncovering the nose and mouth for lip reading, and small-sized test cabins are the main risk factors of contamination in the audiology clinics.

Speech intelligibility in different types of audiograms and speech audiometry by using the simulated hearing loss on the speech material with normal hearing people

Presbycusis and noise-induced hearing loss result in characteristic audiogram curves with increasing levels of hearing loss at higher frequencies. Another specific form of audiogram curve is the cookie bite, which is often the result of inherited hearing loss and sometimes the result of illness or injury. The influence of the hearing loss on speech intelligibility was examined along with a list of words selected according to the frequency range of the phonemes present. Dependence of speech intelligibility and frequency of dominant hearing loss, at lower, middle and higher frequencies and over the whole range is shown. The method of speech audiometry with the simulated hearing loss on the speech material and the normal hearing people is presented.