Speech Intelligibility In Quiet Research Articles

Reference Data for a Quick Speech-in-Noise Hearing Test in the French Language

Introduction: Difficulty in understanding speech in noise is the most common complaint of people with hearing impairment. Thus, there is a need for tests of speech-in-noise ability in clinical settings, which have to be evaluated for each language. Here, a reference dataset is presented for a quick speech-in-noise test in the French language (Vocale Rapide dans le Bruit, VRB; Leclercq, Renard, & Vincent, 2018). Methods: A large cohort (N = 641) was tested in a nationwide multicentric study. The cohort comprised normal-hearing individuals and individuals with a broad range of symmetrical hearing losses. Short everyday sentences embedded in babble noise were presented over a spatial array of loudspeakers. Speech level was kept constant, while noise level was progressively increased over a range of signal-to-noise ratios. The signal-to-noise ratio for which 50% of keywords could be correctly reported (speech reception threshold, SRT) was derived from psychometric functions. Other audiometric measures were collected for the cohort, such as audiograms and speech-in-quiet performance. Results: The VRB test was both sensitive and reliable, as shown by the steep slope of the psychometric functions and by the high test-retest consistency across sentence lists. Correlation analyses showed that pure tone averages derived from the audiograms explained 74% of the SRT variance over the whole cohort, but only 29% for individuals with clinically normal audiograms. SRTs were then compared to recent guidelines from the French Society of Audiology [Eur Ann Otorhinolaryngol Head Neck Dis. 2022;139(1):21–7]. Among individuals who would not have qualified for hearing aid prescription based on their audiogram or speech intelligibility in quiet, 18.4% were now eligible as they displayed SRTs in noise impaired by 3 dB or more. For individuals with borderline audiograms, between 20 dB HL and 30 dB HL, the prevalence of impaired SRTs increased to 71.4%. Finally, even though five lists are recommended for clinical use, a minute-long screening using only one VRB list detected 98.6% of impaired SRTs. Conclusion: The reference data suggest that VRB testing can be used to identify individuals with speech-in-noise impairment.

Speech intelligibility and its relation to auditory temporal processing in Czech and Swiss German subjects with and without tinnitus.

Previous studies have shown that levels for 50% speech intelligibility in quiet and in noise differ for different languages. Here, we aimed to find out whether these differences may relate to different auditory processing of temporal sound features in different languages, and to determine the influence of tinnitus on speech comprehension in different languages. We measured speech intelligibility under various conditions (words in quiet, sentences in babble noise, interrupted sentences) along with tone detection thresholds in quiet [PTA] and in noise [PTAnoise], gap detection thresholds [GDT], and detection thresholds for frequency modulation [FMT], and compared them between Czech and Swiss subjects matched in mean age and PTA. The Swiss subjects exhibited higher speech reception thresholds in quiet, higher threshold speech-to-noise ratio, and shallower slope of performance-intensity function for the words in quiet. Importantly, the intelligibility of temporally gated speech was similar in the Czech and Swiss subjects. The PTAnoise, GDT, and FMT were similar in the two groups. The Czech subjects exhibited correlations of the speech tests with GDT and FMT, which was not the case in the Swiss group. Qualitatively, the results of comparisons between the Swiss and Czech populations were not influenced by presence of subjective tinnitus. The results support the notion of language-specific differences in speech comprehension which persists also in tinnitus subjects, and indicates different associations with the elementary measures of auditory temporal processing.

Paediatric amplification protocol, based on individualization of the hearing aids’ fitting parameters

Background. There are no paediatric amplification clinical practice guidelines in Russia at the moment. At the same time the technological progress of hearing aids (HA), new algorithms and functions requires the objective evidence of safety and effectiveness for the hearing impaired children. For these reasons paediatric amplification algorithm was developed by the authors. Besides the standard procedures the algorithm includes an objective electroacoustic verification of the output parameters and separate HA functions. The research is devoted to the investigation of the protocols advantages. 
 Aim development and evaluation the paediatric amplification protocol, based on objective electroacoustic verification of the output and functions of hearing aid. 
 Materials and Methods. Prospective, randomized, controlled clinical trial was performed. Two protocols effectiveness were compared. Standard protocol (control group) is based on the subjective verification. Experimental protocol suggests an electroacoustic verification of the output and different HA functions: feedback cancellation, amplitude and frequency compression, microphone directionality, digital noise reduction (experimental group). Each group included 56 children (317 years old) with permanent hearing loss from moderate to moderately-severe degree. Initial amplification was performed for each child; the results were estimated in 1, 3 and 6 months using PEACH and LIFE questionnaires, speech audiometry and phoneme testing. DataLogging and first fitting appointment time were also estimated. 
 Results. In preschool-age children of the experimental group post-amplification PEACH results were 6% better than in controls. In school-age children (LIFE questionnaire) results were 11% better comparing with control group. Speech intelligibility in quiet was 3.1% (p 0.05) higher for pre-schoolers in the experimental group and 9.3% (p 0.01) higher for school-age children comparing with control group. Speech intelligibility in noise was higher in experimental group than in control: 7.8% (p 0.05) in pre-schoolers and 13% (p 0.01) for school-age children. Phoneme recognition was better in experimental group as well: 4.5% (p 0.05) in pre-schoolers and 9.8% (p 0.01) in school-agers than in control group. After HA fitting following an experimental protocol DataLogging time was 1112% longer in comparison with standard procedure. On the other hand, experimental protocol took in average 1.5 hours for the first fitting and standard protocol 53 minutes. 
 Conclusions. Protocol of paediatric amplification based on objective electroacoustic verification of HA output and functions allows to significantly increase the effectiveness of hearing rehabilitation in children.

Evaluative audiometry after cochlear implant provision.

One of the main treatment goals in cochlear implant (CI) patients is to improve speech perception. One of the target parameters is speech intelligibility in quiet. However, treatment results show ahigh variability, which has not been sufficiently explained so far. The aim of this noninterventional retrospective study was to elucidate this variability using aselected population of patients in whom etiology was not expected to have anegative impact on postoperative speech intelligibility. Audiometric findings of the CI follow-up of 28adult patients after 6months of CI experience were evaluated. These were related to the preoperative audiometric examination and evaluated with respect to arecently published predictive model for the postoperative monosyllabic score. Inclusion of postoperative categorical loudness scaling and hearing loss for Freiburg numbers in the model explained 55% of the variability in fitting outcomes with respect to monosyllabic word recognition. The results of this study suggest that much of the cause of variability in fitting outcomes can be captured by systematic postoperative audiometric checks. Immediate conclusions for CI system fitting adjustments may be drawn from these results. However, the extent to which these are accepted by individual patients and thus lead to an improvement in outcome must be subject of further studies, preferably prospective.

Prediction of postoperative speech comprehension with the transcutaneous partially implantable bone conduction hearing system Osia®.

The active transcutaneous, partially implantable osseointegrated bone conduction system Cochlear™ Osia® (Cochlear, Sydney, Australia) has been approved for use in German-speaking countries since April 2021. The Osia is indicated for patients either having conductive (CHL) or mixed hearing loss (MHL) with an average bone conduction (BC) hearing loss of 55 dB HL or less, or having single-sided deafness (SSD). The aim of this retrospective study was to investigate the prediction of postoperative speech recognition with Osia® and to evaluate the speech recognition of patients with MHL and in particular an aided dynamic range of less than 30 dB with Osia®. Between 2017 and 2022, 29adult patients were fitted with the Osia®, 10patients (11ears) with CHL and 19patients (25ears) with MHL. MHL was subdivided into two groups: MHL‑I with four-frequency pure-tone average in BC (BC-4PTA) ≥ 20 dB HL and < 40 dB HL (n = 15patients; 20ears) vs. MHL-II with BC-4PTA ≥ 40 dB HL (n = 4patients; 5ears). All patients tested abone conduction hearing device on asoftband preoperatively. Speech intelligibility in quiet was assessed preoperatively using the Freiburg monosyllabic test in unaided condition, with the trial BCHD preoperatively and with Osia® postoperatively with Osia®. The maximum word recognition score (mWRS) unaided and the word recognition score (WRS) with the test system at 65 dB SPL were correlated with the postoperative WRS with Osia® at 65 dB SPL. Preoperative prediction of postoperative outcome with Osia® was better using the mWRS than by the WRS at 65 dB SPL with the test device on the softband. Postoperative WRS was most predictive for patients with CHL and less predictable for patients with mixed hearing loss with BC-4PTA ≥ 40 dB HL. For the test device on a softband, the achievable outcome tended to a minimum, with the mWRS tending to predict the realistically achievable outcome. Osia® can be used for the treatment of CHL and MHL within the indication limits. The average preoperative bone conduction hearing threshold also provides an approximate estimate of the postoperative WRS with Osia®, for which the most accurate prediction is obtained using the preoperative mWRS. Prediction accuracy decreases from aBC-4PTA of ≥ 40 dB HL.

Prediction of speech understanding with the transcutaneous partially implantable bone conduction hearing system Osia®. German Version

The active transcutaneous, partially implantable osseointegrated bone conduction system Cochlear™ Osia® (Cochlear, Sydney, Australia) has been approved for use in German-speaking countries since April 2021. The Osia is indicated for patients with conductive (CHL) or mixed hearing loss (MHL) with an average bone conduction (BC) hearing loss of 55 dB or less, or with single-sided deafness (SSD). The aim of this retrospective study was to investigate the prediction of postoperative speech recognition with Osia and to evaluate the speech recognition of patients with MHL and an aided dynamic range of less than 30 dB with Osia. Between 2017 and 2022, 29adult patients were fitted with the Osia, 10patients (11ears) with CHL and 19patients (21ears) with MHL. MHL was subdivided into two groups: MHL‑I with four-frequency pure-tone average in BC (BC-4PTA) ≥ 20 dB HL and < 40 dB HL (n = 15patients; 20ears) vs. MHL-II with BC-4PTA ≥ 40 dB HL (n = 4patients; 5ears). All patients tested abone conduction hearing device on asoftband preoperatively. Speech intelligibility in quiet was assessed preoperatively using the Freiburg monosyllabic test unaided and with the test system and postoperatively with Osia. The maximum monosyllabic score (mEV) unaided and the monosyllabic score with the test system at 65 dB SPL were correlated with the postoperative monosyllabic score with Osia at 65 dB SPL. Preoperative prediction of postoperative outcome with Osia was better using the mEV than the EV at 65 dB SPL with the test device on the softband. Postoperative EV was most predictive for patients with CHL and least predictive for patients with mixed hearing loss with 4PTA BC ≥ 40 dB HL. For the test device at softband, results tended to show the minimum achievable outcome and the mEV tended to predict the realistically achievable outcome. Osia can be used for the treatment of CHL and MHL within the indication limits. The average preoperative bone conduction hearing threshold also provides an approximate estimate of the postoperative EV with Osia, for which the most accurate prediction is obtained using the preoperative mEV. Prediction accuracy decreases from aBC-4PTA of ≥ 40 dB.

Evaluative audiometry after cochlear implant provision. German Version

One of the main treatment goals in cochlear implant (CI) patients is to improve speech perception. One of the target parameters is speech intelligibility in quiet. However, treatment results show ahigh variability, which has not been sufficiently explained so far. The aim of this noninterventional retrospective study was to elucidate this variability using aselected population of patients in whom etiology was not expected to have anegative impact on postoperative speech intelligibility. Audiometric findings of the CI follow-up of 28adult patients after 6months of CI experience were evaluated. These were related to the preoperative audiometric examination and evaluated with respect to arecently published predictive model for the postoperative monosyllabic score. Inclusion of postoperative categorical loudness scaling and hearing loss for Freiburg numbers in the model explained 55% of the variability in fitting outcomes with respect to monosyllabic comprehension. The results of this study suggest that much of the cause of variability in fitting outcomes can be captured by systematic postoperative audiometric checks. Immediate conclusions for CI system adjustments may be drawn from these results. However, the extent to which these are accepted by individual patients and thus lead to an improvement in outcome must be subject to further study, preferably prospective.

Imaging-based frequency mapping for cochlear implants - Evaluated using a daily randomized controlled trial.

Due to variation in electrode design, insertion depth and cochlear morphology, patients with a cochlear implant (CI) often have to adapt to a substantial mismatch between the characteristic response frequencies of cochlear neurons and the stimulus frequencies assigned to electrode contacts. We introduce an imaging-based fitting intervention, which aimed to reduce frequency-to-place mismatch by aligning frequency mapping with the tonotopic position of electrodes. Results were evaluated in a novel trial set-up where subjects crossed over between intervention and control using a daily within-patient randomized approach, immediately from the start of CI rehabilitation. Fourteen adult participants were included in this single-blinded, daily randomized clinical trial. Based on a fusion of pre-operative imaging and a post-operative cone beam CT scan (CBCT), mapping of electrical input was aligned to natural place-pitch arrangement in the individual cochlea. That is, adjustments to the CI's frequency allocation table were made so electrical stimulation of frequencies matched as closely as possible with corresponding acoustic locations in the cochlea. For a period of three months, starting at first fit, a scheme was implemented whereby the blinded subject crossed over between the experimental and standard fitting program using a daily randomized wearing schedule, and thus effectively acted as their own control. Speech outcomes (such as speech intelligibility in quiet and noise, sound quality and listening effort) were measured with both settings throughout the study period. On a group level, standard fitting obtained subject preference and showed superior results in all outcome measures. In contrast, two out of fourteen subjects preferred the imaging-based fitting and correspondingly had better speech understanding with this setting compared to standard fitting. On average, cochlear implant fitting based on individual tonotopy did not elicit higher speech intelligibility but variability in individual results strengthen the potential for individualized frequency fitting. The novel trial design proved to be a suitable method for evaluation of experimental interventions in a prospective trial setup with cochlear implants.

Hearing rehabilitation and microbial shift after middle ear surgery with Vibrant Soundbridge in patients with chronic otitis media

IntroductionPatients with otitis media (OM) encounter significant functional hearing impairment with conductive, or a combined hearing loss and long-term sequelae involving impaired speech/language development in children, reduced academic achievement and irreversible disorders of middle and inner ear requiring a long time therapy and/or multiple surgeries. In its persistent chronic form, Otitis media (COM) can often only be treated by undergoing ear surgery for hearing restoration. The persistent inflammatory reaction plays a major role, often caused by multi-resistant pathogens in the ear. Herein, we present outcomes of patients implanted with currently the only FDA approved active Middle Ear Implant Vibrant Soundbridge (VSB), suffering from persistent COM.MethodsThe study enrolled 42 patients, treated by performing middle ear (ME) surgery to different extents and implanted with the VSB to various structures in the ME. Included were 17 children and 25 adults that had recurrent and/or persisting OM and significant hearing loss. Preoperative and postoperative patients' audiometric data were evaluated and the benefit with VSB assessed using the Glasgow Benefit Inventory for adults and pediatric cohorts. The microbial spectrum of pathogens was assessed before and after surgery, exploring the colonization of the otopathogens, as well as the intestinal microbiome from individually burdened patients.ResultsThe mean functional gain is 29.7 dB HL (range from 10 to 56.2 dB HL) with a significant improvement in speech intelligibility in quiet. Following VSB implantation, no significant differences in coupling were observed at low complication rates. Postoperatively patients showed significantly increased benefit with VSB compared to the untreated situation, including less otorrhea, pain, medical visits, and medication intake, with no recurrent OM and significant bacterial shift in otopathogens. The analysis of the intestinal microbiome displayed a high abundance of bacterial strains that might be linked to chronic and persistent inflammation.ConclusionsFunctional ear surgery including rehabilitation with a VSB in patients suffering from COM present to be safe and effective. The successful acceptance accompanied by the improved audiological performance resulted in significant benefit with VSB, with a shift in the ear pathogens and altered microbiome and thus is a great opportunity to be treated.

NAL-NL2 Prescriptive Targets for Bone Conduction Devices With an Adaptation to Device Constraints in the Low Frequencies.

Objectives:To study the effectivity of a transformed NAL non-linear version 2 (NAL-NL2) gain prescription for percutaneous bone conduction devices (BCDs) and to investigate how to take into account output constraints for the lower frequencies.Design:The NAL-NL2 prescription was converted to a bone conduction prescription rule. Adaptations were needed, as this converted rule prescribes more output at low frequencies than the device delivers. Three adaptations with different audibility and compression were compared. Setting 1 (S1, “optimal audibility”) had most audibility due to adapted frequency-dependent compression, setting 2 (S2, “moderate audibility”) had moderate output reduction below 1 kHz, and setting 3 (S3, “reduced audibility, least distortion”) had most output reduction. Eighteen experienced BCD users rated their relative sound quality in paired comparisons for different sounds (own voice, mixed voices, traffic noise, and music). In addition speech intelligibility in quiet and noise were assessed.Results:The relative sound quality rating for the adapted prescriptions varied between the stimuli: more low-frequency sound was preferred for music (S1 over S3), and less low-frequency sound was preferred for the own voice (S2 and S3 over S1). No differences in quality rating were found for mixed voices or traffic noise. Speech intelligibility in quiet scores at 45 dB SPL was significantly lower for S3 than for S1. Speech intelligibility in noise was significantly reduced in all settings and S3 yielded significantly better speech intelligibility in noise than S1.Conclusions:With a moderate gain reduction for low frequencies to comply with device constraints the transformed NAL-NL2 prescription was found suitable for fitting BCDs. Perceived sound quality depended on the gain settings, but also on the sound spectra and how the sound was appreciated. A moderate gain reduction below 1 kHz seems to be the optimal adaptation as it has a neutral or positive relative sound quality for all stimuli without negative effects on Speech intelligibility. The NAL-NL2-BC prescribed a sufficient amount of gain, as indicated by the speech tests.

Candidacy for Cochlear Implantation in Prelingual Profoundly Deaf Adult Patients.

Cochlear implantation is usually not recommended for prelingual profoundly deaf adults, although some of these patients might benefit from it. This study aims to define the candidates for cochlear implantation in this population. This retrospective study reviewed 34 prelingual profoundly deaf patients who had received a cochlear implant at 32 ± 1.7 years old (16–55), with at least 1 year of follow-up. Speech perception and quality of life were assessed before and 3, 6, and 12 months after cochlear implantation, then every year thereafter. According to the word speech intelligibility in quiet (WSI) 1 year after implantation, two groups were identified: good performer (GP) with WSI ≥ 50% (n = 15), and poor performer (PP) with WSI ≤ 40% (n = 19). At the 1 year mark, mean WSI improved by 28 ± 4.6% (−20–100) (p < 0.0001). In GP, the intelligibility for words and sentences, communication and quality of life scales improved. In PP, the communication scale improved, but not auditory performance or quality of life. GP and PP differed pre-operatively in speech production, communication abilities, and WSI in best-aided conditions. In prelingual profoundly deaf adults, a dramatic auditory performance benefit could be expected after cochlear implantation if the patients have some degree of speech intelligibility in aided conditions and have developed oral communication and speech production.

CCi-MOBILE: A Portable Real Time Speech Processing Platform for Cochlear Implant and Hearing Research.

Experimental hardware-research interfaces form a crucial role during developmental stages of any medical, signal-monitoring system as it allows researchers to test and optimize output results before perfecting the design for the actual FDA approved medical device and large-scale production. These testing platforms, intake raw signals through which performance of novel algorithms can be analyzed and modified to generate the desired data points for an optimized output, allowing the advancement of the medical device. With cochlear implants (CIs) and hearing aids (HAs) becoming a more common solution for varying degrees of hearing impairment, having modern signal processing strategies tested for such speech sensitive systems is a necessity. But the rigid design requirements of commercial CI and HA processors make it difficult to explore novel algorithms for research investigations and conducting longitudinal studies. This study presents the design, development, clinical evaluation, and applications of CCi-MOBILE, a computationally powerful signal processing testing platform built for researchers in the hearing-impaired field. The custom-made, portable research platform allows researchers to design and perform complex speech processing algorithm assessment offline and in real-time. It can be operated through user-friendly, open-source software and is compatible with implants manufactured by Cochlear Corporation. The FPGA design and hardware processing pipeline for CI stimulation is discussed followed by results from an acute study with implant users' speech intelligibility in quiet and noisy conditions. The results show a consistent level of performance compared with CI users' clinical processor, thus confirming the viability of the platform in chronic CI based studies.

Benefit on daily listening with technological advancements: comparison of basic and premium category hearing aids.

PurposeThe aim of the study was to compare the user-rated benefit of two categories of hearing aids, mainly the basic and premium categories of hearing aids.MethodsA questionnaire was administered on 102 hearing aids users (47 basic and 55 premium category users) with severity of hearing loss ranging from mild to moderately severe sensorineural hearing loss. The questionnaire administered was divided into mainly seven subscales which included speech intelligibility in quiet and in noise, ease of communication, the efficiency of noise reduction, localization, quality of music perception and cost effectiveness. The effect of duration of daily usage of hearing aids on performance among these different subscales was also assessed.ResultsEase of communication was rated better by premium hearing aid users, whereas the cost effectiveness was rated to be better by basic users. There was no significant difference observed between performances of basic versus premium category of hearing aids in other listening domains assessed. There was no significant difference in any of the listening domains with daily usage duration for both categories of hearing aid users.ConclusionThe users of premium category devices revealed better ease of communication in daily environments, whereas performance of these devices on other listening domains remains questionable. Cost effectiveness was reported to be better by the users of basic hearing aids. A prospective and controlled paired series comparison of hearing aid performance needs to be performed to confirm these findings.Supplementary InformationThe online version contains supplementary material available at 10.1007/s00405-021-07240-3.

Binaural Signal Processing in Hearing Aids.

For many years, clinicians have understood the advantages of listening with two ears compared with one. In addition to improved speech intelligibility in quiet, noisy, and reverberant environments, binaural versus monaural listening improves perceived sound quality and decreases the effort listeners must expend to understand a target voice of interest or to monitor a multitude of potential target voices. For most individuals with bilateral hearing impairment, the body of evidence collected across decades of research has also found that the provision of two compared with one hearing aid yields significant benefit for the user. This article briefly summarizes the major advantages of binaural compared with monaural hearing, followed by a detailed description of the related technological advances in modern hearing aids. Aspects related to the communication and exchange of data between the left and right hearing aids are discussed together with typical algorithmic approaches implemented in modern hearing aids.

Short report on the effects of SARS-CoV-2 face protective equipment on verbal communication.

ObjectiveTo predict the impact of face personal protective equipment on verbal communication during the SARS-CoV-2 pandemic.DesignWe assessed the effect of common types and combinations of face personal protective equipment on speech intelligibility in quiet and in a simulated noisy environment.ResultsWearing face personal protective equipment impairs transmission of middle-to-high voice frequencies and affects speech intelligibility. Surgical masks are responsible for up to 23.3% loss of speech intelligibility in noisy environments. The effects are larger in the condition of advanced face personal protective equipment, accounting for up to 69.0% reduction of speech intelligibility.ConclusionThe use of face personal protective equipment causes significant verbal communication issues. Healthcare workers, school-aged children, and people affected by voice and hearing disorders may represent specific at-risk groups for impaired speech intelligibility.

Evaluation of the cochlear implantation users rehabilitation results using psychoacoustic methods

To investigate the correlation of the speech intelligibility in quiet with frequency resolving power (FRP) of hearing using a ripple-spectrum phase reversion test (RSPRT) in CI users. The study includes 30 CI users, three of them after bilateral CI, aged from 13 to 63 years with CI usage experience from 1 year to 16 years. 19 patients used CI systems manufactured by Cochlear Ltd. (Australia), 11 patients used CI systems manufactured by Advanced Bionics (Switzerland). All subjects underwent a number of studies including pure tone audiometry (TPA), speech audiometry in quiet using a multi-syllable speech material on a two-channel clinical audiometer AC-40 (Interacoustics A/S, Denmark); PC with recorded phonetic material from which the signal was reproduced, acoustic speaker SP90 (Interacoustics A/S, Denmark), for FRP estimation - RSPRT test in a free sound field, which was installed on the PC and also reproduced through SP 90 speakers (Interacoustics A/S, Denmark) were used. According to TPA results in a free sound field, the sound perception thresholds in all subjects corresponded to the mild degree sensorineural hearing loss. The sound perception threshold in the free sound field in the range from 500 Hz to 4 kHz was within the range of 25-30 dB nHL. The percentage of speech intelligibility in quiet in the free sound field ranged from 5 to 100%. During the FRP study of patients using RSPRT test, the following results were obtained: the average value of RSPRT test results at the frequency of 1 kHz was 1.94 RPO; for 2 kHz - 2.3 RPO; for 4 kHz - 2.2. The significant correlation between the speech intelligibility in quiet and frequency resolution of hearing was obtained at 1 and 4 kHz. The highest correlation coefficient was detected at 1 kHz - r=0.57 (p=0.0005), while at 4 kHz it was lower - r=0.46 (p=0.009), and at 2 kHz - at the boundary of the significance: r=0.34 (p=0.051). As a result of the study, it was found that there is a correlation between speech intelligibility in quiet and FRP of hearing, which makes it possible to recommend the use of RSPRT in assessing the auditory rehabilitation of patients after CI.

Hearing function in children after new coronavirus infection (COVID-19)

To evaluate hearing function in children after coronavirus infection. 87 children aged from 5 months to 17 years who have had a new coronavirus infection were examined in three cities of Russia (St. Petersburg, Novosibirsk and Surgut). Audiologic examination depended on the age and included: otoscopy, TEOAE and DPOAE, ABR, impedansometry, pure tone audiometry, speech audiometry in quiet and noise. Fisher, LittlEARS and PEACH questionnaires were used as well. An evaluation of central auditory processing was performed in case of indications. In 80 children (92%) otoscopy didn't revealed any problems. All children had type A tympanogram. Acoustic reflex was registered in 49 children (56%), wasn't registered on 1-2 frequencies in 27 (31%) children, was registered on only 1 frequency or wasn't registered at all in 11 (13%) children. OAE was present in 83 (95%) children. Audiometric thresholds in all children were within a normal range. Speech intelligibility in quiet and noise in most cases was normal. 7 children with poor speech intelligibility or low Fisher questionnaire results got an extended examination. Binaural fusion speech test, dichotic test, RuMatrix test, gap detection test data showed no signs of central auditory processing disorders. There are no cases of hearing loss or central auditory processing disorders were found in children after new coronavirus infection. Due to variety of symptoms and long-term consequences of COVID-19 further hearing examination is required in this group of patients.

Audiological benefit and subjective satisfaction with the ADHEAR hearing system in children with unilateral conductive hearing loss.

The ADHEAR system (MED-EL, Innsbruck, Austria) is a new adhesive bone conduction hearing aid. This study evaluates the audiological benefit and subjective satisfaction as well as the manageability in everyday life in children with unilateral conductive hearing loss. Ten children with unilateral hearing loss of different origin were included in the study. The audiological assessment included sound field audiometry and speech intelligibility in quiet and in noise, which was tested unaided and after 4weeks of wearing the hearing system. Subjective benefit and satisfaction with the system was assessed using the SSQ for parents. With a second system-specific questionnaire, suitability for everyday use and quality of life were queried. With ADHEAR, speech perception in quiet improved by 44%. The word recognition score in noise improved from 11.7% in the unaided situation to 46.7% with the ADHEAR system. The SSQ for parents demonstrates a subjective benefit and satisfaction with the system. ADHEAR is an effective treatment option for children with unilateral conductive hearing loss. Especially children who are not eligible for semi-implantable hearing systems or do not accept hearing devices on a softband can benefit from this device.

Variability of Electrolaryngeal Speech Intelligibility in Multitalker Babble.

Purpose The purpose of this study was to report the variability of electrolarynx (EL) users' speech intelligibility in quiet and in multitalker babble. Method Ten EL users (five Servox® Digital, five TruTone™) who were at least 2 years postlaryngectomy provided recordings of five sentences from the 1965 Revised List of Phonetically Balanced Sentences. Recordings were judged by two groups of naïve listeners in quiet and in the presence of multitalker babble. Fifteen listeners orthographically transcribed a total of 750 sentences containing 3,750 key words in quiet, and another 15 listeners orthographically transcribed the same sentences mixed with multitalker babble. Results Significant differences in speech intelligibility were observed between listening conditions; 17.9% more key words were correctly identified in quiet compared to multitalker babble. Significant differences in fundamental frequency (F0) standard deviation and range but not speech intelligibility were observed between EL device types. A positive correlation of moderate significance was observed between F0 standard deviation and intelligibility for TruTone users in multitalker babble. Conclusions Findings suggest that listeners are able to identify a significantly higher percentage of EL users' speech in quiet compared to multitalker babble, but a large variability in EL users' speech intelligibility exists. Continued investigation involving a larger number of EL users is necessary to confirm this study's findings. Future research should explore the relationships among F0 measures, speaker characteristics (e.g., rate of speech, articulatory precision), and speech intelligibility, in addition to improving alaryngeal rehabilitation training protocols for EL users.

Long-term Outcomes of Clip Coupler Implantation in Patients with Unilateral Congenital Aural Atresia.

To evaluate the long-term safety and efficacy of the Clip coupler attached to the stapes head in patients with unilateral congenital aural atresia (CAA). This single-center retrospective study included 16 Mandarin-speaking patients who had unilateral microtia accompanied by CAA. All patients were divided into two groups: the short-term follow-up group (n = 9) and the long-term follow-up group (n = 7). The floating mass transducer of the Vibrant Soundbridge (VSB) was positioned in the stapes head by the Clip coupler. The safety of the VSB was investigated by comparing preoperative and postoperative bone-conduction (BC) thresholds as well as by complications. The effectiveness was evaluated by functional gain (FG), word recognition score (WRS), speech reception threshold (SRT) and signal-to-noise ratio (SNR). Pre- and post-operative BC thresholds were no different in all patients. And no complications developed. VSB-aided thresholds in the free-field had improved significantly in both short- and long-term follow-up groups. The improvements of WRS were observed in two groups. The monosyllabic VSB-aided WRS in the long-term follow-up group was significantly higher than that in the short-term follow-up group. When speech was from the impaired ear and noise presented to the side of normal ear (SVSBNCL), lower SNRs were found in two groups after VSB implantation. However, there was no statistical difference in aided SNR between the two groups at SVSBNCL status. Our results show that the FMT connected to the stapes head is a secure and useful device for patients with unilateral CHL/MHL, not only in terms of improved hearing thresholds, but also improved speech intelligibility in quiet and noisy environments.