Speech Recognition Scores In Noise Research Articles

Genetic Hearing Loss Affects Cochlear Processing.

The relationship between speech recognition and hereditary hearing loss is not straightforward. Underlying genetic defects might determine an impaired cochlear processing of sound. We obtained data from nine groups of patients with a specific type of genetic hearing loss. For each group, the affected cochlear site-of-lesion was determined based on previously published animal studies. Retrospectively obtained speech recognition scores in noise were related to several aspects of supra-threshold cochlear processing as assessed by psychophysical measurements. The differences in speech perception in noise between these patient groups could be explained by these factors and partially by the hypothesized affected structure of the cochlea, suggesting that speech recognition in noise was associated with a genetics-related malfunctioning of the cochlea. In particular, regression models indicate that loudness growth and spectral resolution best describe the cochlear distortions and are thus a good biomarker for speech understanding in noise.

Three-Year Follow-Up with the Bone Conduction Implant

Background: The bone conduction implant (BCI) is an active transcutaneous bone conduction device where the transducer has direct contact to the bone, and the skin is intact. Sixteen patients have been implanted with the BCI with a planned follow-up of 5 years. This study reports on hearing, quality of life, and objective measures up to 36 months of follow-up in 10 patients. Method: Repeated measures were performed at fitting and after 1, 3, 6, 12, and 36 months including sound field warble tone thresholds, speech recognition thresholds in quiet, speech recognition score in noise, and speech-to-noise thresholds for 50% correct words with adaptive noise. Three quality of life questionnaires were used to capture the benefit from the intervention, appreciation from different listening situations, and the ability to interact with other people when using the BCI. The results were compared to the unaided situation and a Ponto Pro Power on a soft band. The implant functionality was measured by nasal sound pressure, and the retention force from the audio processor against the skin was measured using a specially designed audio processor and a force gauge. Results: Audiometry and quality of life questionnaires using the BCI or the Ponto Pro Power on a soft band were significantly improved compared to the unaided situation and the results were statistically supported. There was generally no significant difference between the two devices. The nasal sound pressure remained stable over the study period and the force on the skin from the audio processor was 0.71 ± 0.22 N (mean ± 1 SD). Conclusion: The BCI improves the hearing ability for tones and speech perception in quiet and in noise for the indicated patients. The results are stable over a 3-year period, and the patients subjectively report a beneficial experience from using the BCI. The transducer performance and contact to the bone is unchanged over time, and the skin area under the audio processor remains without complications during the 3-year follow-up.

Audiologic, surgical and subjective outcomes of active transcutaneous bone conduction implant system (Bonebridge)

Objective: Our objective was to evaluate the surgical restrictions, audiologic benefits and satisfaction from using an active transcutaneous bone conduction device (BCD), Bonebridge® (BB) in patients with mixed/conductive hearing loss (MCHL) or single-sided deafness (SSD).Design: A retrospective review from all patients who underwent BB surgery at the Pusan National University Hospital from 2015 to 2017 for SSD or MCHL was performed.Study sample: Twenty-two patients with SSD and five with MCHL had a BB implanted and analysed.Results: Complete transmastoid implantation of the device was possible for all patients with an intact canal wall (ICW), using lifts if necessary. The overall functional hearing gain (FHG) in SSD and MCHL was 31.4 and 37.6 dB, respectively. The mean percentage of speech recognition in a quiet was 81% (vs. 11% unaided) for MCHL group and 82% (vs. 29% unaided) for SSD group. Mean speech recognition scores in noise improved significantly under various signal-to-noise ratio (SNR) for both groups. Questionnaires showed overall improvement, and there was no significant difference between the two groups.Conclusions: The BB provides improved functional gain, and there were no limitations during surgery despite the large device. Both MCHL and SSD group had benefit and improved quality of life with BB.

Effects of Age and Working Memory Capacity on Speech Recognition Performance in Noise Among Listeners With Normal Hearing.

This study aimed to determine if younger and older listeners with normal hearing who differ on working memory span perform differently on speech recognition tests in noise. Older adults typically exhibit poorer speech recognition scores in noise than younger adults, which is attributed primarily to poorer hearing sensitivity and more limited working memory capacity in older than younger adults. Previous studies typically tested older listeners with poorer hearing sensitivity and shorter working memory spans than younger listeners, making it difficult to discern the importance of working memory capacity on speech recognition. This investigation controlled for hearing sensitivity and compared speech recognition performance in noise by younger and older listeners who were subdivided into high and low working memory groups. Performance patterns were compared for different speech materials to assess whether or not the effect of working memory capacity varies with the demands of the specific speech test. The authors hypothesized that (1) normal-hearing listeners with low working memory span would exhibit poorer speech recognition performance in noise than those with high working memory span; (2) older listeners with normal hearing would show poorer speech recognition scores than younger listeners with normal hearing, when the two age groups were matched for working memory span; and (3) an interaction between age and working memory would be observed for speech materials that provide contextual cues. Twenty-eight older (61 to 75 years) and 25 younger (18 to 25 years) normal-hearing listeners were assigned to groups based on age and working memory status. Northwestern University Auditory Test No. 6 words and Institute of Electrical and Electronics Engineers sentences were presented in noise using an adaptive procedure to measure the signal-to-noise ratio corresponding to 50% correct performance. Cognitive ability was evaluated with two tests of working memory (Listening Span Test and Reading Span Test) and two tests of processing speed (Paced Auditory Serial Addition Test and The Letter Digit Substitution Test). Significant effects of age and working memory capacity were observed on the speech recognition measures in noise, but these effects were mediated somewhat by the speech signal. Specifically, main effects of age and working memory were revealed for both words and sentences, but the interaction between the two was significant for sentences only. For these materials, effects of age were observed for listeners in the low working memory groups only. Although all cognitive measures were significantly correlated with speech recognition in noise, working memory span was the most important variable accounting for speech recognition performance. The results indicate that older adults with high working memory capacity are able to capitalize on contextual cues and perform as well as young listeners with high working memory capacity for sentence recognition. The data also suggest that listeners with normal hearing and low working memory capacity are less able to adapt to distortion of speech signals caused by background noise, which requires the allocation of more processing resources to earlier processing stages. These results indicate that both younger and older adults with low working memory capacity and normal hearing are at a disadvantage for recognizing speech in noise.

Long-term functional outcome and satisfaction of patients with an active middle ear implant for sensorineural hearing loss compared to a matched population with conventional hearing aids

The objectives of the study were to review the results of an active middle ear implant for sensorineural hearing loss in patients who were unable to wear or did not benefit from conventional hearing aids in comparison to patients with a matched degree of hearing loss successfully fitted with a conventional hearing aid. A retrospective chart review of 10 patients (10 ears) after implantation of an active middle ear implant and 12 patients (13 ears) with conventional hearing aids in one tertiary referral center was performed. Intervention for sensorineural hearing loss was the implantation of an active middle ear implant in one group or fitting of conventional hearing aids in the other group. Outcome measures were pure-tone audiometry (auditory thresholds, functional gain), speech audiometry (Freiburg Monosyllabic Test in quiet and in noise) and a quality-of-life questionnaire (Glasgow Benefit Inventory). Average functional gain was 25.2 ± 8.6 and 14.6 ± 10.8 dB, speech recognition score in noise was 36.6 ± 18.4 and 31.2 ± 19.2 % and in quiet was 66.0 ± 23.2 and 61.5 ± 23.8 %, Glasgow Benefit Inventory total score was 38.3 ± 32.3 and 24.8 ± 22.2 in patients with active middle ear implants and conventional hearing aids, respectively. In two patient groups matched for degree of sensorineural hearing loss, active middle ear implants provided comparable speech recognition and superior functional gain and quality of life compared to conventional hearing aids. 4.

Hypobaric pressure exposure effects on cochlear frequency selectivity in fluctuating, low-frequency hearing loss

To study the effects of hypobaric pressure chamber exposure on the cochlear frequency selectivity of subjects with monaural, fluctuating, low-frequency hearing loss, such as occurs in Ménière's disease. We used a hypobaric pressure chamber to create relative underpressure in the ear canal, in order to impose positive pressure gradients on the inner ear. Psychophysical tuning curves, transiently evoked otoacoustic emissions and speech recognition scores in noise were measured in 10 subjects with fluctuating, low-frequency hearing loss, before and after pressure exposure. After the exposure, subjects' overall pure tone averages showed no improvement, but individual results showed improved speech recognition scores in noise (six subjects), increased transiently evoked otoacoustic emission strength (three subjects) and increased psychophysical tuning curve steepness (two subjects). Deteriorations were also seen, mainly in psychophysical tuning curves. No association could be established between the different tests, and the measured parameters could not predict subjective improvement. The results suggest variable effects of hypobaric pressure exposure on inner-ear physiology.

Estrogen and hearing from a clinical point of view; characteristics of auditory function in women with Turner syndrome

Turner syndrome is a chromosomal aberration affecting 1:2000 newborn girls, in which all or part of one X chromosome is absent. This leads to ovarial dysgenesis and little or no endogenous estrogen production. These women have, among many other syndromal features, a high occurrence of ear and hearing problems, and neurocognitive dysfunctions, including reduced visual-spatial abilities; it is assumed that estrogen deficiency is at least partially responsible for these problems. In this, study 30 Turner women aged 40–67, with mild to moderate hearing loss, performed a battery of hearing tests aimed at localizing the lesion causing the sensorineural hearing impairment and assessing central auditory function, primarily sound localization. The results of TEOAE, ABR and speech recognition scores in noise were all indicative of cochlear dysfunction as the cause of the sensorineural impairment. Phase audiometry, a test for sound localization, showed mild disturbances in the Turner women compared to the reference group, suggesting that auditory-spatial dysfunction is another facet of the recognized neurocognitive phenotype in Turner women.

Effects on cochlear frequency selectivity after hypobaric pressure exposure

The effects of hypobaric pressure chamber exposure was measured in noise in ten patients with monaural fluctuating low‐frequency hearing loss (FLFHL) such as Meniere's disease using psychophysical tuning curves (PTC), transiently evoked otoacoustic emissions (TEOAE), binaural pitch matches and speech recognition scores (SRS) in noise. In the literature, reversible hearing losses have been observed in about 50 % of the patients, but sometimes improved SRS can be observed in patients without hearing threshold improvement. This indicates possible effects of pressure treatment on cochlear frequency selectivity. The relative overpressure in the middle ear obtained after repeated exposures in hypobaric pressure chamber (total duration 18.5 to 28 minutes) was used to impose pressure gradients to the inner ear. The results indicated that the treatment effects were small, but slightly improved SRS in noise, TEOAEs emission strength and PTCs were observed after treatment. Pure tone hearing thresholds improved only for patients exposed to longer treatment durations. Subjective improvement at follow‐up could not be predicted from the results. Although the effects were small, the data suggest that hypobaric pressure treatment may improve cochlear frequency selectivity in the affected ear in patients with monaural FLFHL.

1-Year Postactivation Results for Sequentially Implanted Bilateral Cochlear Implant Users

Evaluate speech recognition in quiet and in noise for a group of 12 children, all of whom underwent sequential bilateral cochlear implantation at various ages (range, 1 yr, 8 mo to 9 yr, 6 mo at time of second implant). Retrospective. Outpatient cochlear implant clinic. Children who underwent sequential bilateral cochlear implantation. Rehabilitative. Speech recognition in quiet was evaluated for each ear separately using single-word speech recognition assessments (Multisyllabic Lexical Neighborhood Test and Early Speech Perception Test) via recorded presentation. Speech recognition in noise was assessed for each ear separately and in the bilateral condition by obtaining a spondee recognition threshold in the presence of speech-weighted noise presented at 45 dB hearing level. The primary outcome measure for speech recognition in noise assessment was the signal-to-noise ratio for 50% performance, which was calculated by determining the difference between the presentation level of the noise and the presentation level at which the speech recognition threshold was obtained. The results of these assessments were contrasted between children receiving their second cochlear implant before 4 years of age and children receiving their second cochlear implant after 4 years of age. A statistically significant difference for speech recognition scores in quiet was obtained between the early-implanted ear and the late-implanted ears for children receiving their second cochlear implant after 4 years of age. There was not a statistically significant difference in speech recognition scores in quiet between the early-implanted and late-implanted ears of children receiving their second cochlear before 4 years of age. Both groups of children possessed better speech recognition scores in noise (statistically significant at an alpha = 0.05) in the bilateral condition relative to either unilateral condition. However, there was not a statistically significant relationship between speech recognition performance in noise and the duration of deafness of the later implanted ear. Bilateral cochlear implantation allowed for better speech recognition in noise relative to unilateral performance for a group of 12 children who underwent sequential bilateral cochlear implantation at various ages. There was not a statistically significant relationship between speech recognition in noise benefit, which was defined as the difference in performance between the first implanted ear and the bilateral condition and the age at which the second implant was received. Children receiving bilateral cochlear implants younger than 4 years of age achieved better speech recognition in quiet performance for the later implanted ear as compared with children receiving their second cochlear implant after 4 year of age.

The influence of hearing and age on speech recognition scores in noise in audiological patients and in the general population.

To describe the influence of pure-tone audiometry and age on the speech recognition score in noise, both in audiological patients and also in a random population sample. In a cross-sectional study, speech recognition scores (SRS) using monosyllabic words presented in a fixed background noise were evaluated on 1895 audiological patients of both genders with normal hearing or sensorineural hearing losses. The background noise was speech weighted and presented with a signal to noise ratio of +4 dB. In 291 participants, SRS in quiet was estimated as well. A female random population sample also was tested (N = 513). The major predictor for the SRS-noise was high-frequency hearing thresholds. If hearing was normal, age had no effect on speech recognition. Young persons with hearing loss had higher SRS-noise than older persons with the same degree of hearing loss. The difference between young and old persons became larger the greater the hearing loss. Predictive SRS-noise with consideration taken to hearing function and age are presented. SRS-noise correlated stronger with pure-tone audiometry and age than SRS-quiet. Controls performed better (by 10 to 20%) than their same-aged peers with similar hearing loss. It is recommended that speech recognition tests be performed in background noise. SRS-noise is a valuable tool for audiologists and audiological physicians to identify patients in need of pedagogic rehabilitation programs or further diagnostic investigations.

Do “adaptive frequency response” (AFR) hearing aids reduce upward spread of masking?

Speech recognition scores in noise are improved for some subjects wearing hearing aids that reduce low‐frequency noise with an adjustable high‐pass filter circuit. Fabry and Van Tasell (1989) argued that because speech‐to‐noise ratios are not altered by AFR hearing aids, improvements in speech recognition may be related to a reduction in upward spread of masking experienced by the listener [D. Fabry and D. Van Tasell, J. Acoust. Soc. Am. Suppl. I 85, S25 (1989)]. To evaluate this hypothesis, pure‐tone masking patterns for a low‐frequency bandpass noise were measured in normal and hearing‐impaired subjects. The noise skirt of the masker was very steep, with attenuation above the 1000‐Hz cutoff greater than 100 dB/oct. Masking patterns for the same noise were also obtained in the presence of a high‐pass filter that simulated the effects of an AFR hearing aid. Differences in the masking patterns can be taken as a measure of upward spread of masking. Subjects with high‐frequency hearing loss tended to demonstrate greater amounts of upward spread of masking than did normal‐hearing listeners. Further, monosyllabic speech recognition in noise testing indicated improvements in performance of the hearing‐impaired subjects related to the decrease of upward spread of masking in the high‐pass filtering conditions.