Speech Perception In Patients Research Articles

Speech perception in patients submitted to cochlear reimplantation

Speech perception in patients submitted to cochlear reimplantation

Speech perception and parameters of speech audiometry after hearing aid: Systematic review and meta-analysis

<b>Background: </b>One of the greatest difficulties of the hearing impaired is understanding speech, especially in the presence of competitive noise. Speech perception issues are a common difficulty for those who have hearing loss. Poor speech perception is the most frequent cause of seeking hearing treatment. The most extensively used treatment to enhance speech perception is hearing aids or other assistive devices.<br /> <b>Aim: </b>To evaluate the effect of hearing aid methods on the speech perception of patients with hearing loss.<br /> <b>Methods: </b>We conducted our study based on PRISMA recommendations and guidelines. We searched Cochrane, PubMed, Scopus, and Web of Science for relevant clinical trials and prospective observational studies. Clinical trials were assessed according to Cochrane’s risk of bias tool, while observational studies were evaluated according to the National Heart, Lung, and Blood Institute. We involved the following outcomes: speech recognition thresholds, word recognition score (WRS) in noise, and WRS in quiet.<br /> <b>Results: </b>Six studies met the eligibility criteria for our meta-analysis. We found that hearing aids can cause an increase in WRS in noise (mean difference [MD]=18.32 [3.08, 33.55], p=0.02) and WRS in quiet (MD=45.13 [7.79, 82.46], p=0.02). In addition, hearing aids lead to a decrease in speech recognition thresholds (MD=45.13 [7.79, 82.46], p=0.02).<br /> <b>Conclusions: </b>Hearing aids are an effective treatment for patients with hearing loss. They can significantly improve speech perception (WRS) in quiet and noisy environments and provide other benefits, such as improved communication, increased safety, and better cognitive function. If you or someone you know has hearing loss, it is essential to speak with a healthcare professional about the benefits of using hearing aids.

Speech perception in patients submitted to cochlear reimplantation.

To analyze the performance of auditory speech perception (PF) after cochlear implant (CI) replacement surgery and associations with age, times of use of the first CI, deprivation, recovery and use of the second device. The retrospective study analyzed the medical records of 68 participants reimplanted from 1990 to 2016, and evaluated with PF performance tests, considering as a reference, the greater auditory capacity identified during the use of the first CI. Also analyzed were: Etiology of hearing loss; the reasons for the reimplantation; device brands; age range; sex; affected ear; age at first implant; time of use of the first CI, deprivation, recovery and use of the second device. The analyzes followed with the Chi-Square and Spearman, Mann-Whitney and Kruskal-Wallis tests (CI=95%; p≤0.05; Software SPSS®.v22). Most were children with hearing loss due to idiopathic causes and meningitis. Abrupt stoppage of operation was the most common cause for device replacement. Most cases recovered and maintained or continued to progress in PF after reimplantation. Adults have the worst recovery capacity when compared to children and adolescents. The PF capacity showed a significant association (p≤0.05) with: age at first implant; time of use of the first and second CI. Periodic programming and replacement of the device when indicated are fundamental for the maintenance of auditory functions. Being young and having longer use of implants represent advantages for the development of speech perception skills.

Evolution of speech perception in patients with ossified cochlea and short array cochlear implant

Background: Short array cochlear implant is indicated as rehabilitation in patients with severe to profound deafness, especially when there is cochlear ossification. In these cases, with reduced intracochlear patency, total insertion becomes more difficult, requiring the use of this type of electrode (15 mm). Few studies have been published to evaluate auditory performance, presenting controversial audiological results.Aims/Objectives: To report the speech perception of users of cochlear implants (CI) with short array. Material and Methods: A retrospective analysis of medical records of patients who underwent surgery for cochlear implantation with a short array, between 2009 and 2020, at the Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo (HRAC-USP) was carried out. Results: There was performance evolution in the speech perception tests in the data analysis. Meningitis and congenital hearing loss were the main indications for CI in the sample. Conclusion. CI with a short array is an alternative in the management of patients with a history of cochlear ossification and severe or profound sensorineural hearing loss. Significance: To demonstrate the evolution of speech perception tests with short array cochlear implant in patients with or without ossified cochlea and its characteristics for application in clinical practice.

Significance of endolymphatic sac surgery with and/or without simultaneous cochlea implant surgery in respect of vertigo control and speech perception in patients with Menière’s disease

PurposeThe focus on treating patients with Menière’s Disease (MD) lies on the reduction of vertigo attacks and the preservation of sensory function. Endolympathic hydrops is considered as an epiphenomenon in MD, which can potentially be altered by endolymphatic sac surgery (ESS). Purpose of the study was to investigate the influences on vertigo control through manipulation of the perilymphatic system with or without ESS.MethodsRetrospective data analysis of 86 consecutive patients with MD according to current diagnostic criteria after endolymphatic sac surgery alone (ESSalone; n = 45), cochlear implantation (CI) alone (CIalone; n = 12), and ESS with CI (ESS + CI; n = 29), treated at a tertiary referral center. Main Outcome Measures: vertigo control, speech perception pre- and postoperatively.ResultsGender, side, and preoperative treatment were similar in all groups. Age was younger in the ESSalone-group with 56.2 ± 13.0 years (CIalone = 64.2 ± 11.4 years; ESS + CI = 63.1 ± 9.7 years). Definitive MD was present in all the CIalone, in 79.3% of the ESS + CI and in 59.6% of the ESSalone-patients. Likewise, vertigo control rate was 100% in the CIalone, 89.7% in the ESS + CI and 66.0% in the ESSalone-group.ConclusionsVertigo control was improved in all three groups, however, superior in groups treated with CI, potentially contributed by the manipulation of both the endo- and perilymphatic systems. A more systematic characterization of the patients with larger case numbers and documentation of follow up data would be needed to evaluate a clinical effect more properly.

A 15-year Review of 260 Children With Auditory Neuropathy Spectrum Disorder: II. Management and Outcomes.

Following a review of the demographic and clinical characteristics of all pediatric patients diagnosed with auditory neuropathy spectrum disorder (ANSD) by a pediatric health care system from 2005 to 2020, the present report highlights the type and timing of intervention and outcomes in the same 260 patients with ANSD. This was a retrospective study reviewing the demographic data, medical history, imaging studies, audiological and speech language data, type of audiological intervention (hearing aids or cochlear implants), and mode of communication in 260 pediatric patients diagnosed with ANSD over a 15-year period. A significant decrease over time in the age at hearing aid fitting was observed. While a similar reduction in the age at implantation occurred over time, cochlear implantation is still rarely performed by 12 months of age in most ANSD patients. Among bilateral ANSD patients fitted with hearing aids, the majority (89.2%) did not benefit from conventional amplification and most received cochlear implants. Some hearing aid benefit for speech and language development was observed in 5.8%, though communication difficulties were persistent and most used a combination of oral and sign language for communication. Only six patients (5%) received significant benefit from their hearing aids for speech and language development. This review of ANSD management over a 15-year period reveals that hearing aids are not a viable option to develop speech and language for most infants and children with ANSD. This finding confirms previous reports and suggest that while hearing aid trials are warranted, children must be tracked closely so as to avoid delays in decision making. Cochlear implantation constitutes the major (if not only) rehabilitative intervention that allows for speech perception in patients who do not benefit from conventional amplification.

Benefits of amplification for unaided speech discrimination in age-related hearing loss with flat type audiogram

ObjectiveThe present study aimed to investigate whether hearing aid use can induce improvement as acclimatization effect in unaided speech perception in patients with age-related hearing loss. MethodsFifty ears in 41 patients (age range: 65-91 years) diagnosed as age-related hearing loss were enrolled in this study. They used hearing aids for more than 8 hours per day. Unaided speech audiometry using 67-S Japanese monosyllabic word list was performed one or two years after the commencement of hearing aid use. The changes in the unaided speech discrimination score before and after the commencement of hearing aid use were analyzed. To investigate factors for improvement, the patients’ backgrounds in terms of age, sex, pure tone average, unaided maximum speech discrimination score, fitting period (one year/two years), fitting ear (bilateral/unilateral), audiogram type (flat-type/other-type), and the level of amplification were also analyzed. ResultsSignificant improvement in the unaided speech discrimination score after hearing aid use was seen only in the flat-type audiogram group. More than half of older patients in the flat-type audiogram group improved their unaided maximum speech discrimination score 10 % or more. The analysis of aided hearing thresholds revealed that the flat-type audiogram group had significantly lower thresholds of 3kHz and 4kHz than the other-type audiogram group. The age, sex, pure tone average, fitting period, fitting ear, functional gain were not influential factors for improvement. On the other hand, unaided maximum speech discrimination score before using hearing aid and aided hearing threshold at 4kHz had a negative correlation with improvement. ConclusionThe findings suggested that older patients with age-related hearing loss whose audiogram is a flat type can benefit from amplification as means of improving their unaided speech perception since flat-type audiogram can be more easily adjusted to sufficiently amplify speech sound at high frequencies. It should be considered that the potential for experience-dependent plasticity is retained even in older adults.

Hearing and Speech Perception for People With Hearing Loss Using Personal Sound Amplification Products.

BackgroundHearing loss (HL) is the most common chronic disease and has been linked to negative health outcomes. Hearing aids (HAs) are regarded as the gold standard for HL management, however, the adoption rate of HAs is relatively low for various reasons. With this background, hearing devices, such as personal sound amplification products (PSAPs) received significant attention as an alternative to conventional HAs. This study aimed to evaluate the clinical efficacy of PSAPs in patients with mild to moderately severe HL.MethodsNineteen patients with mild hearing loss (MHL), 23 with moderate hearing loss (MDHL), and 15 with moderately severe hearing loss (MSHL) participated in the study. Electroacoustic analysis, simulated real-ear measurements (REMs), and three clinical evaluations were implemented.ResultsAll devices satisfied the electroacoustic tolerances. All devices provided sufficient gain for MHL and MDHL audiograms. However, in MSHL audiogram, the gains of PSAPs were insufficient, especially for high frequencies. In terms of clinical evaluations, sound-field audiometry showed significant improvements between aided and unaided thresholds in all groups for all devices (P < 0.001). Significant improvements of word recognition scores were only shown for HAs between aided and unaided conditions. The Korean version of the Hearing In Noise Test did not show any consistent findings for all devices and groups.ConclusionCertain PSAPs are beneficial for improving hearing and speech perception in patients with HL. Well-chosen PSAPs could be an alternative hearing rehabilitation option for these patients.

Cochlear Synaptopathy due to Mutations in OTOF Gene May Result in Stable Mild Hearing Loss and Severe Impairment of Speech Perception.

Congenital profound hearing loss with preserved cochlear outer hair cell activity (otoacoustic emissions and cochlear microphonic) is the most common phenotype associated with mutations in the OTOF gene. The aim of this study was to investigate the pathophysiological mechanisms behind the auditory dysfunction in five patients (2 adults and 3 children) carrying biallelic mutations in OTOF, who showed an uncommon phenotype of mild hearing impairment associated with severe difficulties in speech perception and delay of language development. Patients underwent audiometric assessment with pure-tone and speech perception evaluation, and otoacoustic emissions and auditory brainstem response recording. Cochlear potentials were recorded in all subjects through transtympanic electrocochleography in response to clicks delivered in the free field from 120 to 60 dB peak equivalent SPL and were compared to recordings obtained from 20 normally hearing controls and from eight children with profound deafness due to mutations in the OTOF gene. Three patients out of five underwent unilateral cochlear implantation. Speech perception measures and electrically evoked auditory nerve potentials were obtained within 1 year of cochlear implant use. Pathogenic mutations in the two alleles of OTOF were found in all five patients, and five novel mutations were identified. Hearing thresholds indicated mild hearing loss in four patients and moderate hearing loss in one. Distortion product otoacoustic emissions were recorded in all subjects, whereas auditory brainstem responses were absent in all but two patients, who showed a delayed wave V in one ear. In electrocochleography recordings, cochlear microphonics and summating potentials showed normal latency and peak amplitude, consistently with preservation of both outer and inner hair cell activity. In contrast, the neural compound action potential recorded in normally hearing controls was replaced by a prolonged, low-amplitude negative response. No differences in cochlear potentials were found between OTOF subjects showing mild or profound hearing loss. Electrical stimulation through the cochlear implant improved speech perception and restored synchronized auditory nerve responses in all cochlear implant recipients. These findings indicate that disordered synchrony in auditory fiber activity underlies the impairment of speech perception in patients carrying biallelic mutations in OTOF gene who show a stable phenotype of mild hearing loss. Abnormal nerve synchrony with preservation of hearing sensitivity is consistent with selective impairment of vesicle replenishment at the ribbon synapses with relative preservation of synaptic exocytosis. Cochlear implants are effective in restoring speech perception and synchronous activation of the auditory pathway by directly stimulating auditory fibers.

Detection of Translocation of Cochlear Implant Electrode Arrays by Intracochlear Impedance Measurements.

Objectives:Misplacement of the electrode array is associated with impaired speech perception in patients with cochlear implants (CIs). Translocation of the electrode array is the most common misplacement. When a CI is translocated, it crosses the basilar membrane from the scala tympani into the scala vestibuli. The position of the implant can be determined on a postoperative CT scan. However, such a scan is not obtained routinely after CI insertion in many hospitals, due to radiation exposure and processing time. Previous studies have shown that impedance measures might provide information on the placement of the electrode arrays. The electrode impedance was measured by dividing the plateau voltage at the end of the first phase of the pulse by the injected current. The access resistance was calculated using the so-called access voltage at the first sampled time point after the start of the pulse divided by the injected current. In our study, we obtained the electrode impedance and the access resistance to detect electrode translocations using electrical field imaging. We have investigated how reliably these two measurements can detect electrode translocation, and which method performed best.Design:We calculated the electrode impedances and access resistances using electrical field imaging recordings from 100 HiFocus Mid-Scala CI (Advanced Bionics, Sylmar, CA) recipients. We estimated the normal values of these two measurements as the baselines of the implant placed in the cochlea without translocation. Next, we calculated the maximal electrode impedance deviation and the maximal access-resistance deviation from the respective baselines as predictors of translocation. We classified these two predictors as translocations or nontranslocations based on the bootstrap sampling method and receiver operating characteristics curves analysis. The accuracy could be calculated by comparing those predictive results to a gold standard, namely the clinical CT scans. To determine which measurement more accurately detected translocation, the difference between the accuracies of the two measurements was calculated.Results:Using the bootstrap sampling method and receiver operating characteristics–based optimized threshold criteria, the 95% confidence intervals of the accuracies of translocation detections ranged from 77.8% to 82.1% and from 89.5% to 91.2% for the electrode impedance and access resistance, respectively. The accuracies of the maximal access-resistance deviations were significantly larger than that of the maximal electrode impedance deviations. The location of the translocation as predicted by the access resistance was significantly correlated with the result derived from the CT scans. In contrast, no significant correlation was observed for the electrode impedance.Conclusions:Both the electrode impedance and access resistance proved reliable metrics to detect translocations for HiFocus Mid-Scala electrode arrays. The access resistance had, however, significantly better accuracy and it also reliably detected the electrode-location of translocations. The electrode impedance did not correlate significantly with the location of translocation. Measuring the access resistance is, therefore, the recommended method to detect electrode-array translocations. These measures can provide prompt feedback for surgeons after insertion, improving their surgical skills, and ultimately reducing the number of translocations. In the future, such measurements may allow near-real-time monitoring of the electrode array during insertion, helping to avoid translocations.

The Effects of Preoperative Audiovisual Speech Perception on the Audiologic Outcomes of Cochlear Implantation in Patients with Postlingual Deafness

Introduction: Patients with postlingual deafness usually depend on visual information for communication, and their lipreading ability could influence cochlear implantation (CI) outcomes. However, it is unclear whether preoperative visual dependency in postlingual deafness positively or negatively affects auditory rehabilitation after CI. Herein, we investigated the influence of preoperative audiovisual per­ception on CI outcomes. Method: In this retrospective case-comparison study, 118 patients with postlingual deafness who underwent unilateral CI were enrolled. Evaluation of speech perception was performed under both audiovisual (AV) and audio-only (AO) conditions before and after CI. Before CI, the speech perception test was performed under hearing aid (HA)-assisted conditions. After CI, the speech perception test was performed under the CI-only condition. Only patients with a 10% or less preoperative AO speech perception score were included. Results: Multivariable regression analysis showed that age, gender, residual hearing, operation side, education level, and HA usage were not correlated with either postoperative AV (pAV) or AO (pAO) speech perception. However, duration of deafness showed a significant negative correlation with both pAO (p = 0.003) and pAV (p = 0.015) speech perceptions. Notably, the preoperative AV speech perception score was not correlated with pAO speech perception (R² = 0.00134, p = 0.693) but was positively associated with pAV speech perception (R² = 0.0731, p = 0.003). Conclusion: Preoperative dependency on audiovisual information may positively influence pAV speech perception in patients with postlingual deafness.

Cochlear implantation in postirradiated ears: A case-control comparative study.

ObjectivesThe aim of this study is to investigate the hearing outcomes of cochlear implantation (CI) in patients with hearing loss who had received radiotherapy for nasopharyngeal cancer (NPC). The study compared speech perception in patients who had prior radiotherapy with those who did not receive radiotherapy.MethodsEighty‐eight Cantonese speaking adult patients who had profound sensorineural hearing loss and received CI from 1995 to 2015 at the Chinese University of Hong Kong CI‐center were studied. Twenty‐five patients had history of NPC and radiotherapy were determined as the exposed group, while 63 patients of mixed etiologies but with no history of radiotherapy were included in the control group. The Hong Kong Speech Perception Test Manual (HKSPTM) scores preoperatively, at 6, 12, and 24 months postoperatively were used to assess hearing performance. The HKSPTM consisted categories of speech recognition, word recognition, and tone perception.ResultsNo statistical significance differences were found at the four time‐points in the three categories of HKSPTM between the two groups.ConclusionCI is a clinically effective intervention and good rehabilitative option for hearing restoration in NPC patients with hearing impairment. Further studies with greater sample size and additional pathological studies on the pathophysiology of hearing loss in this subgroup of patients may provide supplementary information for clinicians when counseling for CI.Level of evidence4.

Gray Matter Atrophy Is Associated With Cognitive Impairment in Patients With Presbycusis: A Comprehensive Morphometric Study.

Presbycusis (PC) is characterized by bilateral sensorineural hearing loss at high frequencies and speech-perception difficulties in noisy environments and has a strikingly detrimental impact on cognitive function. As the neural consequences of PC may involve the whole brain, we hypothesized that patients with PC would show structural alterations not only in the auditory cortex but also in the cortexes involved in cognitive function. The purpose of this study was to use surface-based morphometry (SBM) analysis to elucidate whole-brain structural differences between patients with PC and age-matched normal hearing controls. Three-dimensional T1-weighted MR images of 26 patients with mild PC and 26 age-, sex- and education-matched healthy controls (HCs) were acquired. All participants underwent a battery of neuropsychological tests. Our results revealed gray matter atrophy in several auditory cortical areas, nodes of the default mode network (DMN), including the bilateral precuneus and inferior parietal lobule, the right posterior cingulate cortex (PCC), and the right insula of patients with PC compared to that in the HCs. Our findings also revealed that hearing loss was associated with reduced gray matter volume in the right primary auditory cortex of patients with PC. Moreover, structural alterations in the nodes of the DMN were associated with cognitive impairments in PC patients. Additionally, this study provides evidence that a thicker right insula is associated with better speech perception in patients with PC. Based on these findings, we argue that the onset of PC seems to trigger its own cascade of conditions, including a need for increased cognitive resources during speech comprehension, which might lead to auditory and cognition-related cortical reorganization.

Clear speech perception in patients with auditory neuropathy spectrum disorder

Introduction: One of the main characteristic of auditory neuropathy spectrum disorder (ANSD) is a significantly impaired temporal processing ability with subsequent difficulty in speech understanding particularly in noise. Enhancing temporal properties in clear speech can be beneficial in enhancing speech intelligibility in ANSD patients. Clear speech was developed in English language.Objective: To develop and standardize Arabic clear speech materials and to evaluate performance of patients with ANSD and sensory neural hearing loss (SNHL) in developed Arabic clear speech.Patients and Methods: The present study was conducted in three phases. Phase one; developing and recording of clear and conversational Arabic speech materials. Phase two; establishing norms in the developed materials by evaluation of 30 adult normal subjects. Phase three; comprised evaluation of performance of 30 adult SNHL patients and 40 adult patients with ANSD. Patients were tested in quiet as well as in noisy listening conditions.Results: Clear speech advantage in ANSD patients was 16.7% over conversational speech, while it was 5% in patients with SNHL. All patients with ANSD performed more poorly in noise at all signal to noise ratios (SNRs).Conclusion: The advantage of clear speech over conversational speech was more evident in ANSD patients than SNHL group. ANSD patients derive this advantage from enhancement of temporal properties in clear speech most likely. This study suggested using clear speech in remediation of patients with ANSD in order to improve their ability to communicate.

The effect of tinnitus specific intracochlear stimulation on speech perception in patients with unilateral or asymmetric hearing loss accompanied with tinnitus and the effect of formal auditory training

Objectives: Previous studies show that intracochlear electrical stimulation independent of environmental sounds appears to suppress tinnitus, even long-term. In order to assess the viability of this potential treatment option it is essential to study the effects of this tinnitus specific electrical stimulation on speech perception. Design: A randomised, prospective crossover design. Study sample: Ten patients with unilateral or asymmetric hearing loss and severe tinnitus complaints. Results: The audiological effects of standard clinical CI, formal auditory training and tinnitus specific electrical stimulation were investigated. Results show that standard clinical CI in unilateral or asymmetric hearing loss is shown to be beneficial for speech perception in quiet, speech perception in noise and subjective hearing ability. Formal auditory training does not appear to improve speech perception performance. However, CI-related discomfort reduces significantly more rapidly during CI rehabilitation in subjects receiving formal auditory training. Furthermore, tinnitus specific electrical stimulation has neither positive nor negative effects on speech perception. Conclusions: In combination with the findings from previous studies on tinnitus suppression using intracochlear electrical stimulation independent of environmental sounds, the results of this study contribute to the viability of cochlear implantation based on tinnitus complaints.

Extended bandwidth nonlinear frequency compression in Mandarin-speaking hearing-aid users.

The high frequency information of consonant messages is important for recognition of speech. Recently, the nonlinear frequency compression (NLFC) technique has been shown to improve the speech perception in patients with high frequency hearing loss. In Mandarin, seven consonants are located over 10-16kHz. Extended-bandwidth (EB) NLFC may provide an additional benefit for recognition of Mandarin words. The purpose of this study was to explore the effects of NLFC and EB-NLFC on Mandarin word recognition in patients with high frequency hearing loss. Fourteen native Mandarin-speaking adult patients, aged 20-65 years with bilateral, moderate to severe, sensorineural hearing loss, specifically high frequency hearing loss were included in single-blind randomized study. The assessment tools included the Mandarin Monosyllable Recognition Test (MMRT), Mandarin Hearing in Noise Test (MHINT), and International Outcome Inventory for Hearing Aids (IOI-HA) and sound quality scale of the hearing aids. The patients were tested under unaided condition, after which they were randomly assigned to wear NLFC and EB-NLFC hearing aids, alternatively, in a crossover fashion. After each 4-week block, the patients were tested again to obtain the test outcomes. Patients with hearing aids with EB-NLFC had a significantly better word and consonant recognition using the MMRT (p<0.05). The MHINT was better for the EB-NLFC group without significant differences. The EB-NLFC group had better scores in both the IOI-HA and sound quality scale but not statistically significant. Patients with high-frequency hearing loss may benefit more from using EB-NLFC for word and consonant recognition; however, the improvement was small under a noisy listening environment. The subjective questionnaires did not show significant benefit of EB-NLFC either.

Effects of Noise Level and Cognitive Function on Speech Perception in Normal Elderly and Elderly with Amnestic Mild Cognitive Impairment.

Along with auditory function, cognitive function contributes to speech perception in the presence of background noise. Older adults with cognitive impairment might, therefore, have more difficulty perceiving speech-in-noise than their peers who have normal cognitive function. We compared the effects of noise level and cognitive function on speech perception in patients with amnestic mild cognitive impairment (aMCI), cognitively normal older adults, and cognitively normal younger adults. We studied 14 patients with aMCI and 14 age-, education-, and hearing threshold-matched cognitively intact older adults as experimental groups, and 14 younger adults as a control group. We assessed speech perception with monosyllabic word and sentence recognition tests at four noise levels: quiet condition and signal-to-noise ratio +5 dB, 0 dB, and -5 dB. We also evaluated the aMCI group with a neuropsychological assessment. Controlling for hearing thresholds, we found that the aMCI group scored significantly lower than both the older adults and the younger adults only when the noise level was high (signal-to-noise ratio -5 dB). At signal-to-noise ratio -5 dB, both older groups had significantly lower scores than the younger adults on the sentence recognition test. The aMCI group's sentence recognition performance was related to their executive function scores. Our findings suggest that patients with aMCI have more problems communicating in noisy situations in daily life than do their cognitively healthy peers and that older listeners with more difficulties understanding speech in noise should be considered for testing of neuropsychological function as well as hearing.

The relationship between hearing aid frequency response and acceptable noise level in patients with sensorineural hearing loss.

Background:When fitting hearing aid as a compensatory device for an impaired cochlea in a patient with sensorineural hearing loss (HL), it is needed to the effective and efficient frequency response would be selected regarding providing the patient's perfect speech perception. There is not any research about the effects of frequency modifications on speech perception in patients with HL regarding the cochlear desensitization. The effect (s) of modifications in frequency response of hearing aid amplification on the results of acceptable noise level (ANL) test is the main aim of this study.Materials and Methods:The amounts of ANL in two conditions of linear amplification (high frequency emphasis [HFE] and mid frequency emphasis [MFE]) were measured. Thirty-two male subjects who participated in this study had the moderate to severe sensorineural HL.Results:There was not any significant difference between ANL in linear amplification of hearing aid with HFE frequency response and ANL in linear amplification of hearing aid with MFE frequency response.Conclusion:The gain modification of frequency response not only does not affect the patient's performance of speech intelligibility in ANL test. This indicates that we need to note to the cochlear desensitization phenomenon when fitting hearing aid as a compensatory device for an impaired cochlea in a patient. The cochlear desensitization has not been considered properly in hearing aid fitting formula which is needed to be explored more about the bio-mechanisms of impaired cochlea.

Evaluation of speech perception in patients with ski slope hearing loss using Arabic consonant speech discrimination lists

IntroductionCochlear dead regions are regions of the basilar membrane where the inner hair cells and/or associated neurons function so poorly, such that they may be considered dead. Diagnosing patients suffering from ski slope hearing loss should put in consideration the possibility of cochlear dead regions. These patients often miss out high-frequency components of speech, which are consonant sounds (especially fricatives).ObjectivesThe current study was designed to evaluate speech perception of patients with ski slope high-frequency hearing loss on a modified Arabic consonant speech discrimination lists developed at the University of Alexandria and to evaluate the possible effect of high-frequency dead regions of the cochlear partition on such performance.Materials and methodsTwenty patients with ski slope hearing loss were subjected to the Threshold Equalizing Noise (HL) test to bracket cochlear dead regions. The performance of each on the modified Arabic consonant speech discrimination lists was assessed and correlated with the presence or absence of cochlear dead regions and also with their extent if present across a number of spectral frequencies.ResultsThe results of this study showed that the average correct score of ears with no dead regions on the modified Arabic consonant discrimination lists was 75.32%, whereas the score of ears with dead region(s) was 61.19%. According to the extent of dead regions, the average score of ears with dead region at 4000 Hz only was 62.5%, that of ears with dead regions at 2000-4000 Hz was 61.8%, and that of ears with dead regions at 1000-4000 Hz was 56.5%. The highest probability of error in all ears was for the fricatives.ConclusionSpeech tests that emphasize high-frequency speech elements are crucial in determining cochlear functional reserves in a practical manner. Psychophysical tests that investigate dead regions of the cochlea are synergistic to the high-frequency emphasis speech tests.

Evaluation of Masking Effects on Speech Perception in Patients With Unilateral Chronic Tinnitus Using the Hearing in Noise Test

To verify that tinnitus itself could disturb speech perception and to evaluate the effects of masking noise on speech perception ability in the patients with normal hearing but unilateral chronic tinnitus using the hearing in noise test. Prospective, nonrandomized study. Between June 2009 and May 2011, we enrolled 20 patients with normal hearing and subjective unilateral tinnitus that had persisted for more than 12 months, along with 20 healthy controls of the same age. All subjects were evaluated using audiologic examinations, the tinnitus handicap inventory, and the Korean version of the Hearing in Noise Test (K-HINT) to assess characteristics of tinnitus and speech perception ability in various noisy situations. Reception threshold for speech (RTS) in a quiet environment and signal-to-noise ratio (SNR) in various conditions of noise were significantly higher in the tinnitus than in the control group, regardless of whether noise came from the front, right, or left (p < 0.05). When the tinnitus group was subdivided according to the site of noise exposure, the mean SNR of the contralateral noise group was -7.9 ± 1.4 dB, which was significantly higher than the ipsilateral noise (-9.1 ± 1.8 dB) or control group (right, -10.0 ± 0.6 dB; left, -10.1 ± 0.5 dB) (p < 0.05). In addition, there was no significant difference between ipsilateral noise and control groups. From this study, we showed that tinnitus itself could adversely affect speech perception ability by increasing both RTS and SNR in the tinnitus patients in comparison with healthy controls. In addition, we suggest that proper level of noise on the site of tinnitus might be helpful to increase speech perception in the patients who experience chronic subjective tinnitus.