Speech Discrimination In Noise Research Articles

Speech discrimination with separated signal sources and sound localization with speech stimuli : Learning effects and reproducibility

Binaural hearing enables better speech comprehension in noisy environments and is necessary for acoustic spatial orientation. This study investigates speech discrimination in noise with separated signal sources and measures sound localization. The aim was to study characteristics and reproducibility of two selected measurement techniques which seem to be suitable for description of the aforementioned aspects of binaural hearing. Speech reception thresholds (SRT) in noise and test-retest reliability were collected from 55normal-hearing adults for aspatial setup of loudspeakers with angles of ± 45° and ± 90° using the Oldenburg sentence test. The investigations of sound localization were conducted in asemicircle and fullcircle setup (7 and 12 equidistant loudspeakers). SRT (S-45N45: -14.1 dB SNR; S45N-45: -16.4 dB SNR; S0N90: -13.1 dB SNR; S0N-90: -13.4 dB SNR) and test-retest reliability (4 to 6 dB SNR) were collected for speech intelligibility in noise with separated signals. The procedural learning effect for this setup could only be mitigated with 120 training sentences. Significantly smaller SRT values, resulting in better speech discrimination, were found for the test situation of the right compared to the left ear. RMS values could be gathered for sound localization in the semicircle (1,9°) as well as in the fullcircle setup (11,1°). Better results were obtained in the retest of the fullcircle setup. When using the Oldenburg sentence test in noise with spatially separated signals, it is mandatory to perform atraining session of 120sentences in order to minimize the procedural learning effect. Ear-specific SRT values for speech discrimination in noise with separated signal sources are required, which is probably due to the right-ear advantage. Atraining is recommended for sound localization in the fullcircle setup.

Design and Development of a Spanish Hearing Test for Speech in Noise (PAHRE)

There are few hearing tests in Spanish that assess speech discrimination in noise in the adult population that take into account the Lombard effect. This study presents the design and development of a Spanish hearing test for speech in noise (Prueba Auditiva de Habla en Ruido en Español (PAHRE) in Spanish). The pattern of the Quick Speech in Noise test was followed when drafting sentences with five key words each grouped in lists of six sentences. It was necessary to take into account the differences between English and Spanish. A total of 61 people (24 men and 37 women) with an average age of 46.9 (range 18-84 years) participated in the study. The work was carried out in two phases. In the first phase, a list of Spanish sentences was drafted and subjected to a familiarity test based on the semantic and syntactic characteristics of the sentences; as a result, a list of sentences was selected for the final test. In the second phase, the selected sentences were recorded with and without the Lombard effect, the equivalence between both lists was analysed, and the test was applied to a first reference population. The results obtained allow us to affirm that it is representative of the Spanish spoken in its variety in peninsular Spain. In addition, these results point to the usefulness of the PAHRE test in assessing speech in noise by maintaining a fixed speech intensity while varying the intensity of the multi-speaker background noise. The incorporation of the Lombard effect in the test shows discrimination differences with the same signal-to-noise ratio compared to the test without the Lombard effect.

Improvement of Self-Perceived Tinnitus and Speech Discrimination in Noise by Lyophilized Powder of Enzymolyzed Honeybee (Apis melifera) Larvae in Older Adults with Age-Related Hearing Loss: A Double-Blind Placebo-Controlled, Randomized Study

Background: Tinnitus troubles many older adults accompanying an increased threshold of high-frequency hearing, and most older adults struggle to understand conversations in noise. Objectives: An exciting power of honeybee products has been reported as alternative medicine. We also previously reported that lyophilized powder of enzymolyzed honeybee (Apis melifera) larvae may have a therapeutic effect on hearing loss or tinnitus.

Subjective Sound Quality Detection (HISQUI) over Time after Vibrant Soundbridge Implantation.

Background: To evaluate the long-term audiological outcomes combined with the Hearing Implant Sound Quality Index (HISQUI) after Vibrant Soundbridge (VSB) implantation. Methods: Prospective recall cohort study of patients who received a VSB in a tertiary academic medical center between 1996 and 2017. Air conduction (AC) and bone conduction (BC), sound field thresholds in aided and unaided conditions, and speech discrimination in noise (Oldenburger sentence test) were measured. Postoperative results were compared with preoperative audiograms. Furthermore, the HISQUI was evaluated. Results: Ten patients (eleven implants) were included, the mean follow up period was nine years. The mean AC threshold preoperatively was between 63 and 70 dB, and the BC was between 38 and 49 dB from 500 to 4000 Hz. In the free-field audiogram, the mean threshold was between 61 and 77 dB unaided vs. between 28 and 52 dB in the aided condition. The average signal to noise ratio (SNR) in the Oldenburger sentence test in the unaided condition was 10 dB ± 6.7 dB vs. 2 dB ± 5.4 dB in the aided condition. Three patients reported a good to very good hearing result, four patients a moderate, and three patients a poor hearing result. There was a significant association between the years of implantation and the HISQUI (p = 0.013), as well as a significant decrease by 14 HISQUI points per 10 dB SPL decline (SE 5.2, p = 0.023). There was a significant difference between the change of BC over the years and the HISQUI, as well as the number of years after implantation and the HISQUI. On average, per dB decrease in BC, the HISQUI decreases by 1.4 points, and every year after implantation the HISQUI decreases by 2.7 points. Conclusions: The aided threshold in free field and speech understanding in noise improved significantly with VSB. An increase over time of BC thresholds was observed as well as a decrease in HISQUI score. This decrease in BC thresholds over time may be due to presbycusis. Therefore, monitoring of these patients over time should be considered to discuss alternative hearing rehabilitation measures in a timely manner.

The COVID-19 pandemic and upgrades of CI speech processors for children: part II-hearing outcomes.

PurposeTo gauge the benefits to children of upgrading speech processors during the COVID-19 pandemic.MethodsThe study involved 297 children, aged from 7.3 to 18.0 years, whose processors were upgraded to either Nucleus 7 or Kanso 2, or to Sonnet 2 or Rondo 3. To document the benefits of the upgrades, a speech-in-noise discrimination test and Patient Reported Outcome Measures (PROMs) were used.ResultsThere was a significant benefit from the newer processors in terms of speech discrimination in noise. Patient Reported Outcome Measures (PROMs) indicated less hearing disability, a higher level of functioning in everyday life situations, and more satisfaction with the new speech processor in social situations.ConclusionThere is a measurable improvement in performance when the devices are upgraded to the new technology.

Frequency Fitting Optimization Using Evolutionary Algorithm in Cochlear Implant Users with Bimodal Binaural Hearing.

Optimizing hearing in patients with a unilateral cochlear implant (CI) and contralateral acoustic hearing is a challenge. Evolutionary algorithms (EA) can explore a large set of potential solutions in a stochastic manner to approach the optimum of a minimization problem. The objective of this study was to develop and evaluate an EA-based protocol to modify the default frequency settings of a MAP (fMAP) of the CI in patients with bimodal hearing. Methods: This monocentric prospective study included 27 adult CI users (with post-lingual deafness and contralateral functional hearing). A fitting program based on EA was developed to approach the best fMAP. Generated fMAPs were tested by speech recognition (word recognition score, WRS) in noise and free-field-like conditions. By combining these first fMAPs and adding some random changes, a total of 13 fMAPs over 3 generations were produced. Participants were evaluated before and 45 to 60 days after the fitting by WRS in noise and questionnaires on global sound quality and music perception in bimodal binaural conditions. Results: WRS in noise improved with the EA-based fitting in comparison to the default fMAP (41.67 ± 9.70% versus 64.63 ± 16.34%, respectively, p = 0.0001, signed-rank test). The global sound quality and music perception were also improved, as judged by ratings on questionnaires and scales. Finally, most patients chose to keep the new fitting definitively. Conclusions: By modifying the default fMAPs, the EA improved the speech discrimination in noise and the sound quality in bimodal binaural conditions.

Auditory Brainstem Responses Predict Behavioral Deficits in Rats with Varying Levels of Noise-Induced Hearing Loss

Intense noise exposure is a leading cause of hearing loss, which results in degraded speech sound discrimination ability, particularly in noisy environments. The development of an animal model of speech discrimination deficits due to noise induced hearing loss (NIHL) would enable testing of potential therapies to improve speech sound processing. Rats can accurately detect and discriminate human speech sounds in the presence of quiet and background noise. Further, it is known that profound hearing loss results in functional deafness in rats. In this study, we generated rats with a range of impairments which model the large range of hearing impairments observed in patients with NIHL. One month after noise exposure, we stratified rats into three distinct deficit groups based on their auditory brainstem response (ABR) thresholds. These groups exhibited markedly different behavioral outcomes across a range of tasks. Rats with moderate hearing loss (30 dB shifts in ABR threshold) were not impaired in speech sound detection or discrimination. Rats with severe hearing loss (55 dB shifts) were impaired at discriminating speech sounds in the presence of background noise. Rats with profound hearing loss (70 dB shifts) were unable to detect and discriminate speech sounds above chance level performance. Across groups, ABR threshold accurately predicted behavioral performance on all tasks. This model of long-term impaired speech discrimination in noise, demonstrated by the severe group, mimics the most common clinical presentation of NIHL and represents a useful tool for developing and improving interventions to target restoration of hearing.

Provision of interaural time difference information in chronic intracochlear electrical stimulation enhances neural sensitivity to these differences in neonatally deafened cats

Although performance with bilateral cochlear implants is superior to that with a unilateral implant, bilateral implantees have poor performance in sound localisation and in speech discrimination in noise compared to normal hearing subjects. Studies of the neural processing of interaural time differences (ITDs) in the inferior colliculus (IC) of long-term deaf animals, show substantial degradation compared to that in normal hearing animals. It is not known whether this degradation can be ameliorated by chronic cochlear electrical stimulation, but such amelioration is unlikely to be achieved using current clinical speech processors and cochlear implants, which do not provide good ITD cues. We therefore developed a custom sound processor to deliver salient ITDs for chronic bilateral intra-cochlear electrical stimulation in a cat model of neonatal deafness, to determine if long-term exposure to salient ITDs would prevent degradation of ITD processing. We compared the sensitivity to ITDs in cochlear electrical stimuli of neurons in the IC of cats chronically stimulated with our custom ITD-aware sound processor with sensitivity in acutely deafened cats with normal hearing development and in cats chronically stimulated with a clinical stimulator and sound processor. Animals that experienced stimulation with our custom ITD-aware sound processor had significantly higher neural sensitivity to ITDs than those that received stimulation from clinical sound processors. There was no significant difference between animals received no stimulation and those that received stimulation from clinical sound processors, consistent with findings from clinical cochlear implant users. This result suggests that development and use of clinical ITD-aware sound processing strategies from a young age may promote ITD sensitivity in the clinical population.

Single-sided deafness: Bone conduction devices or cochlear implantation? A systematic review with meta-analysis

ObjectivesTo perform a systematic review with meta-analysis of the studies published on the efficacy of bone conduction devices and cochlear implantation in single-sided deafness, through the evaluation of speech discrimination in noise, sound localization and tinnitus suppression. As a secondary outcome, patient satisfaction is also assessed. DesignA systematic search in PubMed, Embase and CENTRAL was conducted, including all articles written in English and published in the last 10 years. The outcomes selected were speech perception in noise, sound localization, tinnitus intensity and, secondarily, quality of life assessment. Studies that met prospectively defined criteria were subjected to random effects meta-analyses. The review protocol is registered on PROSPERO with number CRD42019121444. ResultsNineteen articles reporting a total of 210 patients (95 patients with bone conduction devices and 115 in the cochlear implantation group) were included. The meta-analysis identifies statistically significant benefits in cochlear implantation for sound localization, tinnitus suppression, in global quality of life assessment and in 2 of the 3 subscales of quality of life assessment (ease of communication and reverberation). Bone conduction devices are better regarding speech discrimination in noise and background noise quality of life assessment. ConclusionCochlear implants effectively offer better results in 2 of the 3 evaluated parameters, being a very valid option. Bone conduction devices should continue to be considered in the treatment of these patients because, in addition to allowing better discrimination in noise, patient satisfaction is greater in environments with background noise.

Single-sided deafness: Bone conduction devices or cochlear implantation? A systematic review with meta-analysis

ObjectivesTo perform a systematic review with meta-analysis of the studies published on the efficacy of bone conduction devices and cochlear implantation in single-sided deafness, through the evaluation of speech discrimination in noise, sound localization and tinnitus suppression. As a secondary outcome, patient satisfaction is also assessed. DesignA systematic search in PubMed, Embase and CENTRAL was conducted, including all articles written in English and published in the last 10 years. The outcomes selected were speech perception in noise, sound localization, tinnitus intensity and, secondarily, quality of life assessment. Studies that met prospectively defined criteria were subjected to random effects meta-analyses. The review protocol is registered on PROSPERO with number CRD42019121444. ResultsNineteen articles reporting a total of 210 patients (95 patients with bone conduction devices and 115 in the cochlear implantation group) were included. The meta-analysis identifies statistically significant benefits in cochlear implantation for sound localization, tinnitus suppression, in global quality of life assessment and in 2 of the 3 subscales of quality of life assessment (ease of communication and reverberation). Bone conduction devices are better regarding speech discrimination in noise and background noise quality of life assessment. ConclusionCochlear implants effectively offer better results in 2 of the 3 evaluated parameters, being a very valid option. Bone conduction devices should continue to be considered in the treatment of these patients because, in addition to allowing better discrimination in noise, patient satisfaction is greater in environments with background noise.

Speech discrimination impairments as a marker of disease severity in multiple sclerosis

BackgroundMultiple Sclerosis (MS) pathology is likely to disrupt central auditory pathways, thereby affecting an individual's ability to discriminate speech from noise. Despite the importance of speech discrimination in daily communication, it's characterization in the context of MS remains limited. This cross-sectional study evaluated speech discrimination in MS under "real world" conditions where sentences were presented in ecologically valid multi-talker speech or broadband noise at several signal-to-noise ratios (SNRs). MethodsPre-recorded Bamford-Kowal-Bench sentences were presented at five signal-to-noise ratios (SNR) in one of two background noises: speech-weighted noise and eight-talker babble. All auditory stimuli were presented via headphones to control (n = 38) and MS listeners with mild (n = 20), moderate (n = 16) and advanced (n = 10) disability. Disability was quantified by the Kurtzke Expanded Disability Status Scale (EDSS) and scored by a neurologist. All participants passed a routine audiometric examination. ResultsDespite normal hearing, MS psychometric discrimination curves which model the relationship between signal-to-noise ratio (SNR) and sentence discrimination accuracy in speech-weighted noise and babble did not change in slope (sentences/dB) but shifted to higher SNRs (dB) compared to controls. The magnitude of the shift in the curve systematically increased with greater disability. Furthermore, mixed-effects models identified EDSS score as the most significant predictor of speech discrimination in noise (odds ratio = 0.81; p < 0.001). Neither age, sex, disease phenotype or disease duration were significantly associated with speech discrimination performance in noise. Only MS listeners with advanced disability self-reported audio-attentional difficulty in a questionnaire designed to reflect auditory processing behaviours in daily life. ConclusionSpeech discrimination performance worsened systematically with greater disability, independent of age, sex, education, disease duration or disease phenotype. These results identify novel auditory processing deficits in MS and highlight that speech discrimination tasks may provide a viable non-invasive and sensitive means for disease monitoring in MS.

Assessment of Hidden Hearing Loss in Normal Hearing Individuals with and Without Tinnitus.

To evaluate the functions of cochlear structures and the distal part of auditory nerve as well as dead regions within the cochlea in individuals with normal hearing with or without tinnitus by using electrophysiological tests. Nine individuals (ages: 21-59 years) with normal hearing with tinnitus were included in the study group. Thirteen individuals (ages: 25-60 years) with normal hearing without tinnitus were included in the control group. Immitancemetric examination, pure-tone audiometry (125Hz-16kHz), speech audiometry in quiet and noise environments, transient evoked otoacoustic emissions (TEOAEs), distortion product otoacoustic emissions (DPOAEs), threshold equalizing noise (TEN test (500Hz-4kHz), and ECochG tests, Beck Depression Questionnaire, Tinnitus Handicap Questionnaire, and Visual Analog Scale were performed. In the study group, three patients were found to have a minimal depression and six were found to have a mild depression. In pure-tone audiometry, the threshold (6-16 kHz) in the study group was significantly higher than that of the control group at all frequencies. In the study group, lower performance scores were obtained in speech discrimination in noise in both ears. In the control group, no dead region was detected in the TEN test whereas 75% of subjects in the study group had dead regions. DPOAE and TEOAE responses between study and control group subjects were not different. In the ECochG test, subjects in the study group showed an increase in the summating potential/action potential (SP/AP) ratio in both ears. Determination of the SP/AP ratio in patients with tinnitus may be useful in diagnosing hidden hearing loss. Detection of dead regions in 75% of patients in the TEN test may indicate that inner hair cells may be responsible for tinnitus.

Long-term evolution of the electrical stimulation for cochlear implant adult patients. The role of a progressive adaptation method

Background: In clinical experience patients who do not frequently check the cochlear implant (CI) maps have poor auditory performance and poor acceptance of map variations over time.Aims: The aim of the present study was to evaluate the effect of CI map optimization on both speech perception and subjective hearing in a group of CI patients with a long-standing map.Material and methods: 14 patients (6 females and 8 males; age range 16–77, mean age 45.86 ± 23.85 years) fitted with a unilateral CI (Cochlear Ltd, Sydney, Australia) and a map unchanged for at least 12 months were evaluated. All CIs were remapped using mapping method with progressive adaptation. The speech discrimination in noise and subjective hearing perception (SSQ questionnaire) were evaluated with old and new map.Results: The differences in electrode level with old and new map were significantly different both for T and C- Levels (p < .001). Speech discrimination in noise was significantly better (22.9%; p < .0001) after map optimization. The SSQ questionnaire showed no statistically significant difference in the overall scores, except the listening effort sub-scale.Conclusions: Longstanding MAPs are associated with poor speech discrimination. Degradation of electrical stimulation is associated with increased mental effort.

Usefulness of cochlear implantation in children with single sided deafness

ObjectivesChildren with single sided deafness (SSD) show a poorer performance at school, which is attributable to reduced speech discrimination in noise, to reduced localization ability, and to a decreased power of concentration due to faster hearing exhaustion. Therefore, it is important to provide children with SSD with adequate hearing amplification to restore binaural hearing. This can only be achieved by provision with a cochlear implant (CI). But these treatment option in children with SSD is still under discussion.The aim of the present study is to evaluate audiological and clinical results in children with SSD following cochlear implantation. A special focus was placed on the duration of deafness before implantation and on the frequency of CI-use in everyday life. MethodsSeven children with SSD of different etiologies who were provided with a CI between 3 and 16 years of age were evaluated. Every child underwent multiple audiological tests before and after cochlear implantation. After cochlear implantation speech recognition tests in noise using the HSM (Hochmair, Schulz and Moser 1997) test and localization tests were performed. Furthermore, the frequency of implant use was evaluated. ResultsSpeech recognition in noise with CI compared to the unaided condition significantly improved in all children in different settings. Improvement of the localization ability measured by the root mean square error (RMSE) was shown in all children. All children are very satisfied with the decision to have undergone cochlear implantation and are all full-time users. ConclusionsCochlear implantation benefits speech recognition in noise and sound localization ability in children with SSD at different ages. All implanted children are full-time users regardless of age or duration of deafness before implantation.

Infants and Adults Use Visual Cues to Improve Detection and Discrimination of Speech in Noise.

Purpose This study assessed the extent to which 6- to 8.5-month-old infants and 18- to 30-year-old adults detect and discriminate auditory syllables in noise better in the presence of visual speech than in auditory-only conditions. In addition, we examined whether visual cues to the onset and offset of the auditory signal account for this benefit. Method Sixty infants and 24 adults were randomly assigned to speech detection or discrimination tasks and were tested using a modified observer-based psychoacoustic procedure. Each participant completed 1-3 conditions: auditory-only, with visual speech, and with a visual signal that only cued the onset and offset of the auditory syllable. Results Mixed linear modeling indicated that infants and adults benefited from visual speech on both tasks. Adults relied on the onset-offset cue for detection, but the same cue did not improve their discrimination. The onset-offset cue benefited infants for both detection and discrimination. Whereas the onset-offset cue improved detection similarly for infants and adults, the full visual speech signal benefited infants to a lesser extent than adults on the discrimination task. Conclusions These results suggest that infants' use of visual onset-offset cues is mature, but their ability to use more complex visual speech cues is still developing. Additional research is needed to explore differences in audiovisual enhancement (a) of speech discrimination across speech targets and (b) with increasingly complex tasks and stimuli.

Processamento Auditivo Central em Pessoas Idosas: Resultados Preliminares

INTRODUÇÃO: A presbiacúsia acarreta dificuldades na interpretação do sinal sonoro com uma influência acrescida na perceção do discurso na presença de ruído. Pretende-se estudar as habilidades do processamento auditivo central na discriminação da fala no ruído, em pessoas idosas.MATERIAL E MÉTODOS: A amostra foi constituída por 20 sujeitos, com idades compreendidas entre os 67 e os 92 anos. Todos realizaram otoscopia, timpanograma, audiograma tonal simples e teste de fala no ruído. Este estudo é do tipo descritivo-correlacional e transversal.RESULTADOS: A curva audiométrica apresenta declínio significativo (p &lt; 0,001) com o aumento das frequências testadas, a partir da frequência dos 500 Hz, apresentando o ouvido esquerdo melhores resultados do que o ouvido direito, com significância estatística (p = 0,043), apenas nos 250 Hz. No teste de fala no ruído, os resultados do ouvido esquerdo evidenciaram uma média de acertos de 21,5% na relação sinal/ruído de 10 dB, tendo um aumento significativo (p &lt; 0,001) na relação sinal/ruído de 15 dB cuja média de acertos foi 26,3%. O ouvido direito exibe uma média de acertos de 17,3% e de 27,85% na relação sinal/ruído de 10 dB e de 15 dB respetivamente, com um aumento significativo (p = 0,002) na relação sinal/ruído de 15 dB.CONCLUSÃO: Tendo em conta os resultados, em que o teste de fala no ruído apresenta uma média de acertos inferior aos 50% em ambos os ouvidos, chegámos à conclusão que quanto menor for a relação sinal/ruído maiores as dificuldades na compreensão da fala. Assim, a avaliação audiológica da pessoa idosa deve incluir a avaliação periférica e central.

The first results of a totally implanted active middle ear device.

The aim of this study was to assess the first outcomes of a fully implantable active middle ear device. Retrospective observational nonrandomized group study. Private hospital. Fifteen patients underwent device implantation between December 2014 and June 2017. The pre-operative and post-operative air conduction (AC) and bone conduction (BC) thresholds were evaluated. The functional gain, speech perception in silence and in noise, and localization abilities were also analyzed. Sixteen active middle ear implantations were performed. Post-operatively, the mean pure tone thresholds were 50.5dB ( ± 12.64) for BC and 64.9dB ( ± 15.36) for AC. No differences were found between the post-operative and pre-operative audiometric thresholds before activating the system (p > 0.05). Post-operatively, the mean thresholds in the free field after the device was activated were 46.8dB, 45.75dB, 42.6dB, and 43.38dB at 1, 3, 6, and 12months, respectively. The global results of speech understanding in silence were 50.7dB, 47.18dB, 42dB, and 42dB for 1, 3, 6, and 12months, respectively. Patients with mixed hearing loss had better results than those with sensorineural hearing loss. Speech discrimination in noise and localization was improved. Despite the small number of patients, our results confirmed that this fully implantable active middle ear device is a viable treatment for patients with moderate-to-severe sensorineural hearing loss who cannot or do not want to use traditional hearing aids for clinical or cosmetic reasons.

Effect of wireless remote microphone application on speech discrimination in noise in children with cochlear implants

ObjectivesAlthough cochlear implantation has significantly contributed to the speech perception of cochlear implant (CI) users, these individuals still have significant difficulty in understanding speech, especially in noisy environments and keeping track of the target speaker in the presence of speech sounds of others. This study was aimed to evaluate the effect of wireless Remote Microphones (RM) on speech discrimination scores in noise in child CI users. Materials and methodsTwenty children with unilateral cochlear implantation were enrolled in this study with mean ± SD age of 5.8 ± 0.83 years who have undergone CI for at least one year. Speech discrimination scores in noise were assessed using the Words-in-Noise (WIN) test at a constant signal-to-noise ratio (SNR) of 0 dB, in the presence and absence of a wireless RM. Three loudspeakers were placed at a distance of 1 m in front of the child to present the speech and babble noise. The wireless microphone was placed on a base with a height equivalent to the height of the middle speech loudspeaker at a distance of 30 cm from it. FindingsThe mean speech discrimination score in noise in the absence of wireless RM in all children was obtained 34% (6.8 words out of 20 words), with minimum and maximum of 15% and 50% words. Findings revealed the mean speech discrimination score in noise in the presence of wireless RMs is equivalent to 65% (13 words out of 20 words), with the minimum and maximum scores of 35% and 95%, respectively. The result showed that speech discrimination scores in noise improved in the presence of wireless RM. ConclusionThe significant improvement was observed in speech discrimination in noise in all cochlear implanted children when the wireless RM was used, as compared to the absence of a wireless RM, which suggests the usefulness of this hearing aid accessory in CI users.

The signal-to-noise ratio assessment in cochlear implanted patients through the Italian Matrix Sentence test (Oldenburg test)

Purpose: A lot of energy has been spent in advances in audiology to define a new strategy of diagnosis and rehabilitation in hearing-impaired patients, in particular for those rehabilitated with cochlear implants or hearing aids. The OLSA test or Matrix Sentence test is a new testing tool able to precisely define a signal-to-noise ratio in different clinical or diagnostic conditions. Spreading of this new test has a standardized level of reference which can help clinicians in comparing patients and data.Method: Implanted patients with contralateral hearing aid use were enrolled in the recent Italian Matrix Sentence test validated for the Italian language. Patients with good perceptual outcomes without post-operative complications were asked to undergo the Italian Matrix Sentence test twice in a day section with or without a cochlear implant and/or contralateral hearing aids.Results: Forty-five cochlear implanted patients with good outcomes and without major complications were enrolled in the present study to compare speech discrimination in noise with cochlear implants and/or hearing aids during bimodal or unimodal stimulation. Obviously, a significant difference was noticed in patients with cochlear implants or hearing aids when compared with patients without digital devices, as well as a statistically significant difference was found in patients with a cochlear implant only when compared with patients with hearing aids. Nevertheless, significant differences were found when comparing bimodal stimulation to unimodal stimulation with the cochlear implant: an ameliorative trend has been reported among patients with either the devices (hearing aids and cochlear implant).Conclusion: The Italian Matrix Sentence test is useful and automated speech audiometry allows a comprehensive evaluation of perceptual abilities in hearing impaired patient. Nevertheless, gives important information among implanted patients especially in the adaptive mode for central comprehension of the signal in noise.

Performance of cochlear implant patients while using bimodal stimulation and FM system

Objectives: To study the effectiveness of bimodal stimulation coupled to FM system on the speech discrimination in noise, temporal discrimination and temporal resolution in patients with unilateral cochlear implant.Method: A total number of 28 subjects were examined in this study, they were divided into group I (19 subjects) with pre-lingual hearing loss and group II (9 subjects) with post-lingual hearing loss. Both groups had a residual hearing in the non-implanted ear that permits benefit from amplification. Full history taking, Questionnaire, Aided warble tone response, Arabic monosyllabic word test in quiet and in presence of background noise, Pitch discrimination test, Pitch pattern sequence test and Auditory fusion test-subtest 3.Results: There is significant statistical difference in CI patients' performance in most of tests while using bimodal stimulation with FM system coupled to CI than with bimodal stimulation alone or CI alone condition.Conclusions: It is recommended to use hearing aid in non-implanted ear in order to improve speech discrimination in noise, temporal discrimination and temporal resolution abilities.