Speech In Noise Test Research Articles

The role of hidden hearing loss in tinnitus: Insights from early markers of peripheral hearing damage

Since the presence of tinnitus is not always associated with audiometric hearing loss, it has been hypothesized that hidden hearing loss may act as a potential trigger for increased central gain along the neural pathway leading to tinnitus perception. In recent years, the study of hidden hearing loss has improved with the discovery of cochlear synaptopathy and several objective diagnostic markers. This study investigated three potential markers of peripheral hidden hearing loss in subjects with tinnitus: extended high-frequency audiometric thresholds, the auditory brainstem response, and the envelope following response. In addition, speech intelligibility was measured as a functional outcome measurement of hidden hearing loss. To account for age-related hidden hearing loss, participants were grouped according to age, presence of tinnitus, and audiometric thresholds. Group comparisons were conducted to differentiate between age- and tinnitus-related effects of hidden hearing loss. All three markers revealed age-related differences, whereas no differences were observed between the tinnitus and non-tinnitus groups. However, the older tinnitus group showed improved performance on low-pass filtered speech in noise tests compared to the older non-tinnitus group. These low-pass speech in noise scores were significantly correlated with tinnitus distress, as indicated using questionnaires, and could be related to the presence of hyperacusis. Based on our observations, cochlear synaptopathy does not appear to be the underlying cause of tinnitus. The improvement in low-pass speech-in-noise could be explained by enhanced temporal fine structure encoding or hyperacusis. Therefore, we recommend that future tinnitus research takes into account age-related factors, explores low-frequency encoding, and thoroughly assesses hyperacusis.

Adverse Effects of Extended high frequency Hearing Impairment on Digit in Noise Perception

Purpose: The present study aims at comparing the adverse effects of EHF hearing loss with Digit In Noise perception, between two age groups-Young adults and Early adulthood.Methods: A total of 30 participants aged between 18 to 25 years as Young adults group and 26 to 35 years as early adulthood group were included in the study. All the participants were having EHF hearing loss with normal conventional audiogram. Digit in Noise test was carried out for these subjects. Digit in Noise recognition threshold was considered here.Results: When compared to young adults group, the early adulthood population exhibited poorer thresholds at EHFs as well as 95% of the participants in this group showed poor scores in DIN test. Among the young adults group, 46.6% showed poor DIN scores.Conclusions: Poor DIN recognition thresholds along with EHF loss despite normal conventional audiogram results necessitate the inclusion of EHF audiometry and Speech in noise test as part of the routine audiological evaluations. This helps in early detection, monitoring and prevention of hearing loss even during the third decade of human life.

The contributions of acoustic and non-acoustic factors to spatial release from masking

The ability to identify speech at worse signal-to-noise ratios when the maskers are spatially separated compared to when they are colocated is called spatial release from masking (SRM) and is thought to be a combination of monaural and binaural advantages arising from spatially separating the target from the maskers. Also, a host of other cognitive skills including attention, working memory, and executive function that support listeners’ ability to segregate, track and attend to a “target” signal while tuning out other unwanted signals contributes to understanding speech better in complex environments. Previous research with young normal hearing listeners from our lab indicated that SRM was predicted by an individual’s ability to use binaural cues (ITD thresholds), switch attention between two streams of information (trail making test) and ability to suppress irrelevant information (flanker task). Here, we present data from older listeners with varying hearing abilities on acoustic (envITD sensitivity) and non-acoustic tasks measuring attention (auditory and visual single and dual task), processing (trail making task), executive control (flanker task) and speech in noise tests (spatial release from masking using coordinate Response Measure sentences). The relationship between these acoustic and non-acoustic factors to speech understanding in complex listening environments will be discussed.

Validation of the acoustic change complex (ACC) prediction model to predict speech perception in noise in adult patients with hearing loss: a study protocol

BackgroundSpeech perception tests are essential to measure the functional use of hearing and to determine the effectiveness of hearing aids and implantable auditory devices. However, these language-based tests require active participation and are influenced by linguistic and neurocognitive skills limiting their use in patients with insufficient language proficiency, cognitive impairment, or in children. We recently developed a non-attentive and objective speech perception prediction model: the Acoustic Change Complex (ACC) prediction model. The ACC prediction model uses electroencephalography to measure alterations in cortical auditory activity caused by frequency changes. The aim is to validate this model in a large-scale external validation study in adult patients with varying degrees of sensorineural hearing loss (SNHL) to confirm the high predictive value of the ACC model and to assess its test–retest reliability.MethodsA total of 80 participants, aged 18–65 years, will be enrolled in the study. The categories of severity of hearing loss will be used as a blocking factor to establish an equal distribution of patients with various degrees of sensorineural hearing loss. During the first visit, pure tone audiometry, speech in noise tests, a phoneme discrimination test, and the first ACC measurement will be performed. During the second visit (after 1–4 weeks), the same ACC measurement will be performed to assess the test–retest reliability. The acoustic change stimuli for ACC measurements consist of a reference tone with a base frequency of 1000, 2000, or 4000 Hz with a duration of 3000 ms, gliding to a 300-ms target tone with a frequency that is 12% higher than the base frequency. The primary outcome measures are (1) the level of agreement between the predicted speech reception threshold (SRT) and the behavioral SRT, and (2) the level of agreement between the SRT calculated by the first ACC measurement and the SRT of the second ACC measurement. Level of agreement will be assessed with Bland–Altman plots.DiscussionPrevious studies by our group have shown the high predictive value of the ACC model. The successful validation of this model as an effective and reliable biomarker of speech perception will directly benefit the general population, as it will increase the accuracy of hearing evaluations and improve access to adequate hearing rehabilitation.

Results of a Novel, Nonsurgical Bone-Conduction Hearing Aid for the Treatment of Conductive Hearing Loss in Australian Children.

To determine and compare the benefits a novel adhesive bone-conduction system and a conventional bone-conduction hearing aid (BCHA) on a softband for children with conductive hearing loss. Prospective, single-subject randomized, crossover trial. Tertiary referral center in Australia. Eight children aged from 4 to 17 years with conductive hearing loss. Rehabilitative with participants using the novel adhesive bone-conduction aid and a BCHA. Aided thresholds, as well as speech perception in quiet, unaided and aided with the novel adhesive bone-conduction aid and BCHA on a softband. For the six older children, speech in noise testing was also conducted. The mean unaided four frequency average hearing levels was 48 dB HL for air conduction, 10.5 dB HL for bone conduction, with a mean air-bone gap in the aided ear of 37.5 dB HL.Four-frequency average hearing level aided thresholds were 20.2 dB for the novel device and 19.8 dB for the BCHA, with no significant difference between the devices. Aided monosyllabic word scores improved from an average of 45% in the unaided condition to 81.6 and 85% for the novel adhesive and BCHA devices, respectively. Aided speech in noise performance improved, on average, by 1.6 dB SNR when wearing the BCHA and the novel adhesive device, with no significant difference in performance between the two devices. The novel device provided equivalent performance to the BCHA on all measures and can be considered as an alternative device for pediatric patients with conductive hearing loss.

Evaluation of Asymmetries in Speech-in Noise Abilities in Audiologic Screening for Vestibular Schwannoma.

Measures of speech-in-noise, such as the QuickSIN, are increasingly common tests of speech perception in audiologic practice. However, the effect of vestibular schwannoma (VS) on speech-in-noise abilities is unclear. Here, we compare the predictive ability of interaural QuickSIN asymmetry for detecting VS against other measures of audiologic asymmetry. A retrospective review of patients in our institution who received QuickSIN testing in addition to a regular audiologic battery between September 2015 and February 2019 was conducted. Records for patients with radiographically confirmed, unilateral, pretreatment VSs were identified. The remaining records excluding conductive pathologies were used as controls. The predictive abilities of various measures of audiologic asymmetry to detect VS were statistically compared. Our search yielded 73 unique VS patients and 2423 controls. Receiver operating characteristic curve analysis showed that QuickSIN asymmetry was more sensitive and specific than pure-tone average asymmetry and word-recognition-in-quiet asymmetry for detecting VS. Multiple logistic regression analysis revealed that QuickSIN asymmetry was more predictive of VS (odds ratio [OR] = 1.23, 95% confidence interval [CI] [1.10, 1.38], p < 0.001) than pure-tone average asymmetry (OR = 1.04, 95% CI [1.00, 1.07], p = 0.025) and word-recognition-in-quiet asymmetry (OR = 1.03, 95% CI [0.99, 1.06], p = 0.064). Between-ear asymmetries in the QuickSIN appear to be more efficient than traditional measures of audiologic asymmetry for identifying patients with VS. These results suggest that speech-in noise testing could be integrated into clinical practice without hindering the ability to identify retrocochlear pathology.

The Influence of a Single Therapeutic Dose of Methadone on Selected Auditory Functions in Patients Addicted to Opioids and Undergoing Substitution Therapy – a Preliminary Study

The main purpose of this research was to determine the influence of a therapeutic dose of an opioid drug (methadone) on selected auditory functions in patients addicted to opioids (recognition ICD-10; F11) and undergoing substitution therapy. Various hearing tests were used in this research – pure tone audiometry, impedance audiometry, otoacoustic emission measurement, and a speech in noise test – in two sessions, before and after methadone intake. It was found that methadone causes an improvement in speech intelligibility when speech is presented in speech-like noise, and slightly decreases hearing thresholds [dB HL]. Methadone consumption has no significant impact on distortion product otoacoustic emissions levels (DPOAE). In summary, a prescribed methadone dose does not worsen the hearing of opioid-dependent subjects.

The effect of ventilation tube insertion in central auditory processing disorders in children with otitis media with effusion.

Otitis media with effusion is one of the most common diseases among children. The purpose of this research is to investigate whether the resolvement of conductive hearing loss from the insertion of a ventilation tube also improves central auditory processing disorders in children with otitis media with effusion. In this cross-sectional study, 20 children between 6 and 12 years old were diagnosed with otitis media with effusion and 20 normal children were included in the study. The central auditory processing status was evaluated in all patients before ventilation tube insertion and after six months by Speech Discrimination Score, Speech Reception Threshold, Words-in-Noise, Speech in Noise, Consonant Vowel in Noise tests, and the results were compared. The mean score of Speech Discrimination Score and Consonant Vowel in Noise tests in the control group were significantly higher than the patient group before ventilation tube insertion and after surgery, in the patient group, the mean scores increased significantly. The mean scores of the Speech Reception Threshold, Words-in-Noise, and Speech in Noise tests in the control group were significantly lower than the patient group before ventilation tube insertion and after the operation, in the patient group, the mean scores significantly decreased. After VT insertion, these tests were close to the control group. Restituting normal hearing by ventilation tube treatment improves central auditory abilities as shown in speech reception, speech discrimination, the ability to hear, the ability to recognize monosyllabic words, and the power of speech in the presence of noise.

Hearing outcomes in children with single sided deafness: Our experience at a tertiary paediatric otorhinolaryngology unit.

Hearing rehabilitation options for single sided deafness (SSD) include contralateral routing of sound (CROS) aids and bone conduction devices (BCDs). This study aimed to review the management of children with SSD at our tertiary paediatric otolaryngology unit over the last 15 years. A retrospective cohort study was performed. Primary hearing outcomes were measured using the Children's Home Inventory for Listening Difficulties (CHILD) questionnaire score and secondary hearing outcomes were measured using hearing thresholds for speech in noise. Outcomes were measured pre and post bone conduction device (BCD) trial. 49 patients with SSD were identified. 20 children had trial of a BCD. 16 patients had pre- and post- BCD trial CHILD scores available for analysis. There was a statistically significant improvement in CHILD scores and speech in noise testing at +5dB and +0dB following amplification with a BCD. The mean use of BCD was 1.3h per day. We have described the management of children with SSD in our unit. This study demonstrated a statistically significant benefit of BCD use on hearing outcomes. However, device compliance is low suggesting hearing advice choice in the population is complex and further research is warranted.

Case Study: COVID-19 Brain Fog or Auditory Processing Disorder?

Case Study: COVID-19 Brain Fog or Auditory Processing Disorder?

Working memory and listening fatigue in cochlear implantation

Background Hearing involves more than just the central auditory pathway’s operation and hearing threshold. Instead, the term ‘hearing’ encompasses a range of skills such as listening, comprehending, and communicating. As a result, a thorough assessment of the patient’s listening effort and working memory is critical. Methods Forty-four subjects with cochlear implantation were included in the study, 22 patients as a study group and 22 subjects as a control group. They were assessed by digit span test for working memory, speech in noise test at different SNR levels, Fatigue assessment scale and Effort assessment scale. Results There was a statistically significant difference in the Spin test between the study and control group. The study group showed a significant higher Spin scores at all SNR levels. There was a significant difference in both digit span forward and digit span backward tests between both the study and control group with a significant negative correlation between digit span and listening effort and fatigue scales. There was a significant statistical difference in the mean results of both the listening fatigue assessment scale and listening effort assessment scale between the study and control group where the study group showed a significant higher result in both scales. Conclusion Assessing the effort associated with recognising speech is very valuable. Scales for measuring listening effort and listening fatigue as well as working memory can be easily incorporated into the basic audiological evaluation providing valuable insights for further rehabilitation.

Occupational Noise-Induced Tinnitus: A Review of Auditory Behavioral and Electrophysiological Evaluations

Background and Aim: The increasing prevalence of Noise-Induced Tinnitus (NIT) is considered one of the major occupational health threats these days. Despite the devastating effect of tinnitus on a subject’s performance, auditory functions and life quality, there is a lack of standard protocol for its diagnosis and management. Furthermore, the mechanisms of NIT are not clear yet. So, this review summarized data on NIT mechanisms as well as questionnaires, behavioral and physiologic assessment tools in NIT studies. Recent Findings: Based on the authors’ research, 27 eligible articles were included in this review. NIT was mainly bilateral with moderate severity with an overall prevalence ranging from 4% to 73.7%. Self-report questionnaires, tinnitus handicap inventory, auditory brainstem response, otoacoustic emissions and speech in noise tests were the most frequent NIT assessment methods in the reviewed studies. Our review highlights increased latencies in brainstem evoked potentials in tinnitus workers, but the knowledge gap about changes at subcortical and cortical levels remains. Conclusion: This review suggests speech in noise test as a useful extension to routine tinnitus assessment by questionnaires among workers. Due to insufficient studies and inconsistent results in NIT subjects, more electrophysiological research is suggested in large and homogeneous samples. Keywords: Noise; tinnitus; occupational; questionnaire; physiological

Interplay between attention, working memory, and cognition to speech understanding in noise

Speech understanding in noisy environments depends not only on hearing acuity but also on a host of other cognitive skills including attention, working memory, and executive function that support listeners’ ability to segregate, track and attend to a “target” signal while tuning out other unwanted signals. Identifying the cognitive aspects that affect listening outcomes in complex listening environment is critical for interpreting individual variability and understanding the challenges listeners with different cognitive profiles might face during listening in such environments. The latter is important for characterizing the listening deficits in older adults who, in addition to impaired peripheral auditory processing, also tend to exhibit a decline in various cognitive abilities that might affect listening. Here, we present data from a large cohort of younger listeners on various working memory (Reading Span Test), attention (auditory and visual single and dual task), processing (trail making task), executive control (flanker task), inhibition (Stroop task), and speech in noise tests (spatial release from masking using coordinate Response Measure sentences). The relationship between these various attention, working memory, and cognitive components to speech understanding in complex listening environments will be discussed.

Test-Retest Reliability of the Coordinate Response Measure in Adults with Normal Hearing or Cochlear Implants

Background: Speech perception in noise is especially challenging for cochlear implant (CI) recipients; thus, speech in noise tests are used to clinically evaluate functional hearing with CIs. The coordinate response measure (CRM) corpus can be utilized in an adaptive speech perception test with competing speakers as the masker. Determining the critical difference for CRM thresholds can enable it to be used to evaluate changes in CI outcomes for clinical and research purposes. If a change in CRM exceeds the critical difference, then this would indicate significant improvement or decrement in speech perception. Additionally, this information provides figures for power calculations that could be used for planning studies and clinical trials [Bland JM: An Introduction to Medical Statistics, 2000]. Objectives: This study determined the test-retest reliability of the CRM for adults with normal hearing (NH) and adults with CIs. The replicability, variability, and repeatability of the CRM were evaluated for the two groups separately. Method: Thirty-three NH adults and thirteen adult CI recipients were recruited and tested with the CRM twice, 1 month apart. The CI group was tested with two talkers only, while the NH group was tested with seven talkers as well as two talkers. Results: CRM had better replicability, repeatability and lower variability for the CI adults compared to NH adults. The critical difference (at p < 0.05) in the two-talker CRM speech reception thresholds (SRTs) among CI users was >5.2 dB, and it was >6.2 dB for the NH if an individual were to be tested under two different conditions. The critical difference (at p < 0.05) in the seven-talker CRM SRT was >6.49. The Mann-Whitney U test showed that CI recipients’ CRM scores’ variance (Mdn = −0.94) was significantly less than the NH group’s (Mdn = 2.2) (U = 54, p < 0.0001). Although the NH had significantly better SRTs in the two-talker condition than in the seven-talker condition (t = −20.29, df = 65, p < 0.0001), the Wilcoxon signed ranks test showed no significant difference between the CRM scores’ variance in the two conditions (Z = −1, N = 33, p = 0.08). Conclusions: NH adults had significantly lower CRM SRTs than the CI recipients; t (31.16) = −23.91, p < 0.001. CRM had better replicability, stability and lower variability for the CI adults compared to NH adults.

Assessment of outcome of cochlear implant in auditory neuropathy spectrum disorder using speech in noise test

Assessment of outcome of cochlear implant in auditory neuropathy spectrum disorder using speech in noise test

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.

The Effects of Different Frequency Lowering Technologies’ Performances on Speech in Noise Test

The Effects of Different Frequency Lowering Technologies’ Performances on Speech in Noise Test

Single-Sided Deafness: Emotional and Social Handicap, Impact on Health Status and Quality of Life, Functional Hearing, and the Effects of Cochlear Implantation.

To evaluate the functional and subjective outcomes in individuals with single-sided deafness (SSD) treated with a cochlear implant (CI). Eighty-one adult CI users with SSD participated in this study. Functional assessments consisted of speech in noise testing and localization. Subjective assessments consisted of the Speech Spatial Quality of Hearing Scale, the Tinnitus Reaction Questionnaire, the Abbreviated Profile of Hearing Aid Benefit questionnaire, the Hearing Handicap Inventory for Adults questionnaire, and the Glasgow Health Status Inventory and the Glasgow Benefit Inventory questionnaires. SSD has remarkable consequences on quality of life (QoL) and imposes a substantial emotional and social handicap on the individuals. Self-reported QoL improved after CI with tinnitus intrusion significantly reduced as early as 3 months post-CI. A significant improvement was seen in all speech understanding in noise configurations. Localization ability significantly improved with CI on. Our findings demonstrate that SSD reduces social and psychological QoL and imposes a remarkable level of handicap as per general and specific self-assessments tool. CI provided a significant improvement in function including speech understanding in noise and localization ability, as well as improved QoL and reduced tinnitus significantly in both the early and long terms.

The National Institute for Occupational Safety and Health recommended exposure level for noise needs to be revised downwards

Noise-induced hearing loss (NIHL) is caused by cumulative occupational and non-occupational noise exposure. The National Institute for Occupational Safety and Health (NIOSH) developed recommendations for occupational noise exposure in 1972, revised in 1998. Fifty years after the NIOSH 85 dBA recommended exposure level (REL) was first published, it needs to be revised downwards. In its calculations, NIOSH assumed that workers have quiet (&amp;lt;60 dBA) when not at work, something no longer true. Everyday public noise exposure now exceeds the Environmental Protection Agency's safe noise level, a time-weighted average of 70 dB for 24 hours, with multiple studies reporting average exposures near 75 dBA. Also, NIOSH calculations were based on occupational studies of material hearing loss measured by limited frequency pure tone audiometry, an insensitive measure of noise-induced auditory damage. Modern audiology techniques include extended range audiometry, speech in noise testing, diffusion product otoacoustic emissions testing, and questions about tinnitus and hyperacusis. Doing the needed research to support downward REL revision, detecting auditory damage in noise-exposed workers with these newer techniques, is a daunting task, but this is necessary both to protect workers and because the NIOSH REL forms the basis for the world's recommendations for non-occupational noise exposure.

Single-Sided Deafness: Using Cortical Auditory Evoked Potential to Improve Cochlear Implant Fitting.

To investigate if acoustic cortical auditory evoked potential (aCAEP) measures can be used to verify the cochlear implant (CI) map and consequently improve auditory outcomes in adults with single-sided deafness (SSD). aCAEPs were measured in SSD-CI recipients using speech tokens /m/, /g/, /t/, and /s/. If aCAEP responses were present for all speech tokens at the outset, no map adjustments were implemented. If aCAEP responses were absent for one or more tokens, the map was adjusted until aCAEPs were observed for all four tokens. Speech in noise testing using BKB-SiN was performed before and after aCAEP recording. The results of the speech testing results at presurgery, 6, 12, and 24 months post-CI were also analyzed. Sixty-seven CI users with SSD participated in this study. All CIs had been mapped according to the conventional subjective loudness perception method. Twenty-three SSD-CI users exhibited an aCAEP response for all four speech tokens and were therefore considered optimized at outset. Forty-four participants lacked an aCAEP response from at least one speech token and had their most comfortable levels adjusted accordingly. Of these, map adjustments allowed aCAEPs to be elicited for all four speech tokens in 23 individuals. Speech in noise testing significantly improved pre- to post-aCAEP-based adjustment. aCAEP recordings were successfully used to verify CI mapping and improve resultant speech outcomes in SSD-CI users.