Speech Recognition Tests Research Articles

Individual Differences in Speech Recognition Changes After Cochlear Implantation

Cochlear implantation is highly effective at improving hearing outcomes, but results have been limited to groupwise analysis. That is, limited data are available for individual patients that report comparisons of preoperative aided speech recognition and postimplantation speech recognition. To assess changes in preoperative aided vs postoperative speech recognition scores for individual patients receiving cochlear implants when considering the measurement error for each speech recognition test. This cross-sectional study used a prospectively maintained database of patients who received cochlear implants between January 1, 2012, and December 31, 2017, at a tertiary, university-based referral center. Adults with bilateral sensorineural hearing loss undergoing cochlear implantation with 6- or 12-month postoperative measures using 1 or more speech recognition tests were studied. Cochlear implantation. Postoperative word recognition (consonant-nucleus-consonant word test), sentence recognition (AzBio sentences in quiet), and sentence recognition in noise (AzBio sentences in +10-dB signal-to-noise ratio) scores, and association of each speech recognition score change with aided preoperative score to each test's measurement error. Analysis of data from a total of 470 implants from 323 patients included 253 male (53.8%) patients; the mean (SD) age was 61.2 (18.3) years. Most patients had statistically significant improvement in all speech recognition tests postoperatively beyond measurement error, including 262 (84.8%) for word recognition, 226 (87.6%) for sentence recognition, and 33 (78.6%) for sentence recognition in noise. A small number of patients had equivalent preoperative and postoperative scores, including 45 (14.5%) for word recognition, 28 (10.9%) for sentence recognition, and 9 (21.4%) for sentence recognition in noise. Four patients (1.6%) had significantly poorer scores in sentence recognition after implantation. The associations between age at implantation and change in speech recognition scores were -0.12 (95% CI, -0.23 to -0.01) for word recognition, -0.22 (95% CI, -0.34 to -0.10) for sentence recognition, and -0.10 (95% CI, -0.39 to 0.21) for sentence recognition in noise. Patients with no significant improvement were similarly distributed between all preoperative aided speech scores for word recognition (range, 0%-58%) and sentence recognition (range, 0%-56%) testing. In this cross-sectional study, with respect to preoperative aided speech recognition, postoperative cochlear implant outcomes for individual patients were largely encouraging. However, improvements in scores for individual patients remained highly variable, which may not be adequately represented in groupwise analyses and reporting of mean scores. Presenting individual patient data from a large sample of individuals with cochlear implants provides a better understanding of individual differences in speech recognition outcomes and contributes to more complete interpretations of successful outcomes after cochlear implantation.

Relationships Between Daily Device Use and Early Communication Outcomes in Young Children With Cochlear Implants.

Children with significant hearing loss can gain access to sound via a cochlear implant (CI), but they must wear the device to reap the communication benefits of the device. That is, poor daily device use may result in underdeveloped perceptual and language skills in children and adolescents using CIs. This retrospective study focuses on the relationship between daily CI use and communication performance (auditory skills, speech recognition, expressive and receptive language) in young children, with the hypothesis that greater daily device use coincides with better communication outcomes. The authors conducted a clinical chart review of patients with CIs younger than 5 years old who used at least 1 CI speech processor with datalogging technology. Participants (n = 65) had a mean chronologic age of 3.5 years, mean implantation age of 1.9 years, and mean device experience of 1.6 years. Approximately one quarter of participants had additional disabilities. Daily device use (i.e., datalogging information), child characteristics (e.g., age at CI), and assessments of communication skills (i.e., parent questionnaires, speech recognition tests, standardized language assessments) were obtained from each child's records. The investigators performed correlational analyses to examine relationships between communication outcomes and daily device use, and they employed group comparisons and correlations to identify child characteristics that were significantly associated with daily device use (p < 0.05, corrections for family-wise error). Young children with CIs used their device, on average, 6.7 hr/d, with 63% below full-time use (<8 hr/d). Children without additional disabilities who wore their CI more hours per day had significantly better auditory, speech recognition, and language skills. A significant correlation also emerged between daily device use and early auditory skills in young CI users with additional disabilities, though relationships were more complicated for this subsample. Longer daily device use significantly correlated with younger age at CI and longer device experience. Differences in device use occurred in regards to absence versus presence of additional disabilities, bilateral versus unilateral device configuration, sign versus spoken language, and private versus government-assisted insurance. The strong relationship between daily device use and early communication suggests clinicians and parents should focus on increasing the number of hours per day young children wear their CIs to enhance auditory and language outcomes. However, intervention strategies must consider barriers to consistent device use and goals of the family to efficiently and effectively support families of young children with CIs who struggle with inconsistent device use.

Sound localization, speech and tone recognition for stimuli presented from the rear in bilateral cochlear implant users

Objective To assess any differences in spatial listening ability of cochlear implant recipients when using both or only one of two bilateral cochlear implants (BCIs) for stimuli originating from behind the subject. Design Twelve loudspeakers were placed in the rear horizontal plane of the subjects to test the sound localisation performance of BCI users and normal-hearing listeners (NHLs) with or without interfering noise. Stimuli were presented via two rear loudspeakers simultaneously during the speech recognition test. In the tone recognition test, another anechoic chamber was used with stimuli presenting from a loudspeaker behind the participants. Study sample Twenty-seven NHLs and eleven BCI users. Results Average root-mean-square (RMS) error for the bilateral condition was significantly lower than that for the right and left cochlear implant (CI) conditions with or without interfering noises (p < 0.05). Average speech or tone recognition scores for the bilateral condition and the right and left CI conditions were not statistically significant (p > 0.05). Conclusion Sound localisation with BCIs was significantly more accurate than with either implant alone. Speech and tone recognition scores were not better with two compared to those of one activated implant. Given the small number of subjects, the results should be considered as preliminary.

Modulation rate and age effect on intermittent speech recognition

ABSTRACT Purpose: to investigate the auditory recognition of intermittent speech in relation to different modulation rates and ages. Methods: 20 young people, 20 middle-aged adults, and 16 older adults, all of them with auditory thresholds equal to or lower than 25 dB HL up to the frequency of 4000 Hz. The participants were submitted to intermittent speech recognition tests presented in three modulation conditions: 4 Hz, 10 Hz, and 64 Hz. The percentages of correct answers were compared between age groups and modulation rates. ANOVA and post hoc tests were conducted to investigate the modulation rate effect, and the mixed linear regression model (p &lt; 0.001). Results: regarding the age effect, the data showed a significant difference between young people and older adults, and between middle-aged and older adults. As for the modulation rate effect, the indexes of correct answers were significantly lower at the slower rate (4 Hz) in the three age groups. Conclusion: an age effect was verified on intermittent speech recognition: older adults have greater difficulty. A modulation rate effect was also noticed in the three age groups: the higher the rate, the better the performance.

Cochlear Implantation in Adults With Single-sided Deafness: Outcomes and Device Use.

To describe our experience with adults undergoing cochlear implantation (CI) for treatment of single-sided deafness (SSD). Retrospective case review. Tertiary referral center. Fifty-three adults with SSD. Unilateral CI. Speech perception testing in quiet and noise, tinnitus suppression, and device usage from datalogs. The mean age at CI was 53.2 years (SD 11.9). The mean duration of deafness was 4.0 years (SD 7.8). The most common etiology was idiopathic sudden SNHL (50%). Word recognition improved from 8.7% (SD 15) preoperatively to 61.8% (SD 20) at a mean follow-up of 3.3 years (SD 1.8) (p < 0.0001). Adaptive speech recognition testing in the "binaural with CI" condition (speech directed toward the front and noise toward the normal hearing ear) revealed a significant improvement by 2.6-dB SNR compared to the preoperative unaided condition (p = 0.0002) and by 3.6-dB SNR compared to when a device to route sound to the contralateral side was used (p < 0.0001). Tinnitus suppression was reported to be complete in 23 patients (43%) and improved in 20 patients (38%) while the device was on. The addition of the CI did not lead to a decrement in hearing performance in any spatial configuration. Device usage averaged 8.7 (SD 3.7) hours/day. Cochlear implantation in adult SSD patients can suppress tinnitus and achieve speech perception outcomes comparable with CI in conventional candidates. Modest improvements in spatial hearing were also observed and primarily attributable to the head shadow effect. Careful patient selection and counseling regarding potential benefits are important to optimize outcomes.

Toward a New Evidence-Based Fitting Paradigm for Over-the-Counter Hearing Aids.

PurposeThis dual-aim study was intended to develop and validate a new fitting paradigm for over-the-counter (OTC) hearing aids. Aim 1 was undertaken to create a limited set of evidence-based preconfigured gain–frequency responses (“presets”) for use in OTC devices. Aim 2 tested the efficacy of the presets relative to best-practice verification and determined the best method(s) for older adults to self-select amplification from the set.MethodIn Aim 1, audiometry data from 267 older adults with mild-to-moderate sensorineural hearing loss were obtained from the National Health and Nutrition Examination Survey database. Using these data and the National Acoustic Laboratories–Non-Linear 2 (NAL-NL2) prescriptive formula, a set of four presets were created that can fit a large percentage of older Americans with presbycusis. In Aim 2, 37 older adults with hearing loss used five methods to select presets. The selection methods were select-by-audiogram, select-by-self-test, select-by-trying, select-by-questionnaire, and random assignment. Using a crossover design, each participant completed speech recognition testing and sound quality ratings in quiet and noise for all selection methods and a verified NAL-NL2 condition.ResultsThe set of presets can fit 67.9% of older Americans with mild-to-moderate hearing loss (Aim 1). Controlling for hearing thresholds and sound quality ratings, liner mixed-effects models indicated that speech recognition scores for select-by-audiogram, select-by-self-test, and select-by-trying were not statistically different from the NAL-NL2 condition. Statistical analysis indicated that select-by-self-test produced outcomes most consistent with individual outcomes for the NAL-NL2 condition (Aim 2).ConclusionThis newly developed fitting paradigm may provide efficacy comparable to best-practice verification and could be used in OTC hearing aids.

Linguistic Complexity of Speech Recognition Test Sentences and Its Influence on Children's Verbal Repetition Accuracy.

Speech recognition (SR)-tests have been developed for children without considering the linguistic complexity of the sentences used. However, linguistic complexity is hypothesized to influence correct sentence repetition. The aim of this study is to identify lexical and grammatical parameters influencing verbal repetition accuracy of sentences derived from a Dutch SR-test when performed by 6-year-old typically developing children. For this observational, cross-sectional study, 40 typically developing children aged 6 were recruited at four primary schools in the Netherlands. All children performed a sentence repetition task derived from an SR-test for adults. The sentence complexity was described beforehand with one lexical parameter, age of acquisition, and four grammatical parameters, specifically sentence length, prepositions, sentence structure, and verb inflection. A multiple logistic regression analysis was performed. Sentences with a higher age of acquisition (odds ratio [OR] = 1.59) or greater sentence length (OR = 1.28) had a higher risk of repetition inaccuracy. Sentences including a spatial (OR = 1.25) or other preposition (OR = 1.25) were at increased risk for incorrect repetition, as were complex sentences (OR = 1.69) and sentences in the present perfect (OR = 1.44) or future tense (OR = 2.32). The variation in verbal repetition accuracy in 6-year-old children is significantly influenced by both lexical and grammatical parameters. Linguistic complexity is an important factor to take into account when assessing speech intelligibility in children.

The influence of stimulation levels on auditory thresholds and speech recognition in adult cochlear implant users

Objective: This study aims to evaluate the influence of minimum and maximum stimulation levels on auditory thresholds and speech recognition abilities in adult cochlear implant users. Method: Fifteen adults implanted with a Cochlear® device with over 12 months listening experience. Participants underwent routine programming for optimization of minimum (T) and maximum comfort (C) stimulation levels, which was saved in Program 1 (MO). Three further maps were constructed artificially adjusting the measured levels: Program 2 – MO with 10 fewer electrical current units at C level (MC-); Program 3 – MO with 10 fewer electric current units at T level (MT−); and Program 4 – MO with 10 more electric current units at T level (MT+). Sound field thresholds, recorded sentence recognition and monosyllable tests were presented in quiet and in noise. Results: There were significantly better thresholds at 1, 3, 4, and 6 kHz frequencies in MT+ and worse in MC−. A statistically significant difference was observed for sentences in quiet and monosyllables in quiet and noise with changing C levels, with worsening of the results for MC− program. Conclusion: The results suggest that T levels above the behavioural threshold provided an improvement in sound field thresholds but did not influence performance on speech recognition tests in quiet and in noise. In contrast, C levels below the behavioural comfort level worsened sound field thresholds and led to poorer performance in tests of sentence recognition in quiet and monosyllable recognition in quiet and in noise.

Successful cochlear implantation in a patient with Epstein syndrome during long-term follow-up

Epstein syndrome is a rare disease characterized by macrothrombocytopenia, nephritis and progressive sensorineural hearing loss (SNHL). This syndrome is presently recognized as an autosomal dominant disease caused by mutations of non-muscle myosin heavy chain 9 (MYH9). Little information is available about the progress of SNHL, the efficacy of cochlear implants (CI) or the perioperative management of thrombocytopenia in patients with Epstein syndrome. We herein report a case of a patient with Epstein syndrome with the MYH9:c.2105G>A:p.R702H variant who underwent cochlear implantation after 27 years of follow-up for her progressive SNHL. The deterioration rates of hearing were 3.48 dB/year on the right ear and 2.46 dB/year on the left ear. The patient derived benefits from CI and had a speech recognition test result (for sentences) of 93% at 6-months postoperatively. Thrombocytopenia was successfully managed without any bleeding complications by using eltrombopag, an oral thrombopoietic agent, making transfusion of platelets unnecessary. The accurate diagnosis of Epstein syndrome was made only after long-term follow-up as the thrombocytopenia was initially diagnosed as idiopathic thrombocytopenic purpura. This case report highlights the perioperative management of thrombocytopenia, the progress of SNHL and the potential pitfalls of diagnosis.

Sequential Bilateral Cochlear Implantation With Prolonged Time Intervals.

Purpose The aim of the study was to assess whether sequential cochlear implantation (CI) with a prolonged interimplant interval (M = 15.2 years) between the first and second CIs benefited speech recognition and health-related quality of life. Method This prospective study included 14 prelingually deafened participants who received their second CI after a prolonged interimplant interval (M = 15.2 years). Additionally, speech recognition ability over a 12-month period of bilateral implant use was investigated. The results of the speech recognition test in both quiet and noisy conditions were statistically analyzed for each CI alone and both CIs together. Nijmegen Cochlear Implant Questionnaire scores were also collected at activation and at 12 months after activation. Results Improvements in speech recognition ability were observed following the use of the first implant alone and with the use of both implants together; however, progress was much slower with the use of the second implant alone, following its introduction. Furthermore, a significant difference in the trajectory of speech recognition ability was observed between the first and the second implanted ear. According to Nijmegen Cochlear Implant Questionnaire scores, all participants benefitted from bilateral CI after 12 months. Conclusions Prolonged interimplant intervals resulted in asymmetrical speech recognition abilities. A significant improvement in the speech recognition scores was observed with the first implanted ear, and much slower progress was observed with the second implanted ear. However, the "poorer" second implanted ear could provide a considerable beneficial effect on the improved speech recognition and health-related quality of life with the bilateral CI. Supplemental Material https://doi.org/10.23641/asha.12861152.

Is the spread of excitation width correlated to the speech recognition in cochlear implant users?

To assess whether there is an interference of the spread of excitation (SOE) on speech recognition. Retrospective cross-sectional study, approved by the institution's ethics committee (CAAE03409212.8.0000.0068). Adult patients with intraoperative neural response telemetry (NRT) performed on electrodes 6, 11 and 16 implanted with Cochlear Ltd (Sydney, Australia) devices were selected. Patients with partial array insertion, pre-lingual hearing loss, deafness etiology due to and CI experience less than 12months were excluded. SOE was recorded at 10 current units above the NRT threshold (tNRT) and its width in millimeters was collected at point 0.75 of the function. Speech recognition test was 25-recorded monosyllables list, presented at 65dBHL at 0° azimuth in a sound treated booth. The analysis was divided into groups by electrode array type, regarding the tNRT, SOE width, SOE's peak amplitude and electrode peak. A 126 SOE measurements of the 3 tested electrodes were obtained from 43 patients. Patients with straight array had significantly wider SOE, greater peak amplitude at electrode 6 and higher tNRTs. In the perimodiolar array, there was a negative correlation between SOE and monosyllables recognition at electrodes 6 and 11, and in the combined average of the three electrodes, with a significant difference in electrode 11. Sixty-six percent of the SOE measurements had their peak shifted to adjacent electrodes. It was observed, in perimodiolar array, the greater the dispersion of electrical current, the worse the speech recognition, especially in the medial electrode.

The Impact of Speech Recognition Testing on State Anxiety in Young, Middle-Age, and Older Adults.

Purpose This study assessed state anxiety as a function of speech recognition testing using three clinical measures of speech in noise and one clinical measure of dichotic speech recognition. Method Thirty young adults, 30 middle-age adults, and 25 older adults participated. State anxiety was measured pre- and post-speech recognition testing using the State-Trait Anxiety Inventory. Speech recognition was measured with the Revised Speech Perception in Noise Test, the Quick Speech-in-Noise Test, the Words-in-Noise Test, and the Dichotic Digits Test (DDT). Results Speech recognition performance was as expected: Older adults performed significantly poorer on all measures as compared to the young adults and significantly poorer on the Revised Speech Perception in Noise Test, the Quick Speech-in-Noise Test, and the Words-in-Noise Test as compared to the middle-age adults. On average, State-Trait Anxiety Inventory scores increased posttesting, with the middle-age adults exhibiting significantly greater increases in state anxiety as compared to the young and older adults. Increases in state anxiety were significantly greater for the DDT relative to the speech-in-noise tests for the middle-age adults only. Poorer DDT recognition performance was associated with higher levels of state anxiety. Conclusions Increases in state anxiety were observed after speech-in-noise and dichotic listening testing for all groups, with significant increases seen for the young and middle-age adults. Although the exact mechanisms could not be determined, multiple factors likely influenced the observed increases in state anxiety, including task difficulty, individual proficiency, and age.

Rerouting Hearing Aid Systems for Overcoming Simulated Unilateral Hearing in Dynamic Listening Situations.

Unilateral hearing loss increases the risk of academic and behavioral challenges for school-aged children. Previous research suggests that remote microphone (RM) systems offer the most consistent benefits for children with unilateral hearing loss in classroom environments relative to other nonsurgical interventions. However, generalizability of previous laboratory work is limited because of the specific listening situations evaluated, which often included speech and noise signals originating from the side. In addition, early studies focused on speech recognition tasks requiring limited cognitive engagement. However, those laboratory conditions do not reflect characteristics of contemporary classrooms, which are cognitively demanding and typically include multiple talkers of interest in relatively diffuse background noise. The purpose of this study was to evaluate the potential effects of rerouting amplification systems, specifically a RM system and a contralateral routing of signal (CROS) system, on speech recognition and comprehension of school-age children in a laboratory environment designed to emulate the dynamic characteristics of contemporary classrooms. It was expected that listeners would benefit from the CROS system when the head shadow limits audibility (e.g., monaural indirect listening). It was also expected that listeners would benefit from the RM system only when the RM was near the talker of interest. Twenty-one children (10 to 14 years, M = 11.86) with normal hearing participated in laboratory tests of speech recognition and comprehension. Unilateral hearing loss was simulated by presenting speech-shaped masking noise to one ear via an insert earphone. Speech stimuli were presented from 1 of 4 loudspeakers located at either 0°, +45°, -90°, and -135° or 0°, -45°, +90°, and +135°. Cafeteria noise was presented from separate loudspeakers surrounding the listener. Participants repeated sentences (sentence recognition) and also answered questions after listening to an unfamiliar story (comprehension). They were tested unaided, with a RM system (microphone near the front loudspeaker), and with a CROS system (ear-level microphone on the ear with simulated hearing loss). Relative to unaided listening, both rerouting systems reduced sentence recognition performance for most signals originating near the ear with normal hearing (monaural direct loudspeakers). Only the RM system improved speech recognition for midline signals, which were near the RM. Only the CROS system significantly improved speech recognition for signals originating near the ear with simulated hearing loss (monaural indirect loudspeakers). Although the benefits were generally small (approximately 6.5 percentage points), the CROS system also improved comprehension scores, which reflect overall listening across all four loudspeakers. Conversely, the RM system did not improve comprehension scores relative to unaided listening. Benefits of the CROS system in this study were small, specific to situations where speech is directed toward the ear with hearing loss, and relative only to a RM system utilizing one microphone. Although future study is warranted to evaluate the generalizability of the findings, the data demonstrate both CROS and RM systems are nonsurgical interventions that have the potential to improve speech recognition and comprehension for children with limited useable unilateral hearing in dynamic, noisy classroom situations.

Auditory performance of post-lingually deafened adult cochlear implant recipients using electrode deactivation based on postoperative cone beam CT images.

The use of image processing techniques to estimate the position of intra-cochlear electrodes has enabled the creation of personalized maps to meet the individual stimulation needs of cochlear implant (CI) recipients. The aim of this study was to evaluate a novel technique of electrode deactivation based on postoperative cone beam computed tomography (CBCT) images in post-lingually deafened adult CI recipients. Based on postoperative CBCT images, the positioning of the electrodes was estimated in relation to the modiolus in 14 ears of 13 post-lingually deafened adult CI recipients. The electrodes sub-optimally positioned or involved in kinking and tip fold-over were deactivated. Speech perception scores in silence and in noise were obtained from subjects using the standard map and were followed up 4weeks after image-based electrode deactivation reprogramming technique (IBEDRT). The participants selected their preferred map after 4weeks of IBEDRT use. There were statistically significant improvements in the speech recognition tests in silence and noise when comparing IBEDRT performance to the standard map. All participants elected the IBEDRT as their new preferred map. IBEDRT is a promising technique for fitting CI recipients and minimizing channel interaction increased by the positioning of the electrodes sub-optimally placed, thereby improving their auditory performance. We propose a novel electrode deactivation technique based on postoperative CBCT imaging, with a limited number of deactivated electrodes and a low-dosing scanning which could be applied for clinical routine.

Balancing the Loudness in Speech Processors and Contralateral Hearing Aids in Users of Unilateral Cochlear Implants

Introduction The use of cochlear implants and hearing aids (bimodal) has been growing with the expansion of the indication for them, and it is important to ensure protocols so that there is a balance of the loudness regarding the two devices. Objective To evaluate if the limited complex sounds present in the frequency bands of the current devices enable the balance of the loudness in adult users of bimodal stimulation, and to analyze if speech recognition improves after balancing. Methods A prospective cross-sectional study with convenience sampling. The sample was composed of 25 adults who had used either a cochlear implant for at least 6 months or a contralateral hearing aid, with a mean age of 46 years. The balancing of the loudness was performed in an acoustic room with the computer's sound box (0° azimuth at 70 dB SPL). The instrumental sounds were filtered through eight different frequency bands. The patients used both hearing devices and were asked if the sound was perceived to be louder in one of the ears or centrally. The speech test was evaluated with sentence silence (65 dB SPL) and/or noise signal ratio of 0 dB/+ 10 dB in free field at 0° azimuth, before and after balancing. Results : Out of the 25 patients, 5 failed to achieve balance at every tested frequency, and 3 achieved balance at almost every frequency, except 8 kHz. There was a significant difference between the speech recognition test only in silence before and after balancing. Conclusion : Most patients achieved sound equalization at all evaluated frequencies under the complex-sound protocol. Additionally, most patients experienced improved speech recognition after balancing.

Pediatric Speech Audiometry Web Application for Hearing Detection in the Home Environment

This paper describes the development of the speech audiometry application for pediatric patients in Slovak language and experiences obtained during testing with healthy children, hearing-impaired children, and elderly persons. The first motivation behind the presented work was to reduce the stress and fear of the children, who must undergo postoperative audiometry, but over time, we changed our direction to the simple game-like mobile application for the detection of possible hearing problems of children in the home environment. Conditioned play audiometry principles were adopted to create a speech audiometry application, where children help the virtual robot Thomas assign words to pictures; this can be described as a speech recognition test. Several game scenarios together with the setting condition issues were created, tested, and discussed. First experiences show a positive influence on the children’s mood and motivation.

Clinical Application of Spectral Modulation Detection: Speech Recognition Benefit for Combining a Cochlear Implant and Contralateral Hearing Aid.

Purpose The purpose of this study was to investigate the relationship between speech recognition benefit derived from the addition of a hearing aid (HA) to the nonimplanted ear (i.e., bimodal benefit) and spectral modulation detection (SMD) performance in the nonimplanted ear in a large clinical sample. An additional purpose was to investigate the influence of low-frequency pure-tone average (PTA) of the nonimplanted ear and age at implantation on the variance in bimodal benefit. Method Participants included 311 unilateral cochlear implant (CI) users who wore an HA in the nonimplanted ear. Participants completed speech recognition testing in quiet and in noise with the CI-alone and in the bimodal condition (i.e., CI and contralateral HA) and SMD in the nonimplanted ear. Results SMD performance in the nonimplanted ear was significantly correlated with bimodal benefit in quiet and in noise. However, this relationship was much weaker than previous reports with smaller samples. SMD, low-frequency PTA of the nonimplanted ear from 125 to 750 Hz, and age at implantation together accounted for, at most, 19.1% of the variance in bimodal benefit. Conclusions Taken together, SMD, low-frequency PTA, and age at implantation account for the greatest amount of variance in bimodal benefit than each variable alone. A large portion of variance (~80%) in bimodal benefit is not explained by these variables. Supplemental Material https://doi.org/10.23641/asha.12185493.

A Preliminary Study of the Effects of Attentive Music Listening on Cochlear Implant Users' Speech Perception, Quality of Life, and Behavioral and Objective Measures of Frequency Change Detection.

IntroductionMost cochlear implant (CI) users have difficulty in listening tasks that rely strongly on perception of frequency changes (e.g., speech perception in noise, musical melody perception, etc.). Some previous studies using behavioral or subjective assessments have shown that short-term music training can benefit CI users’ perception of music and speech. Electroencephalographic (EEG) recordings may reveal the neural basis for music training benefits in CI users.ObjectiveTo examine the effects of short-term music training on CI hearing outcomes using a comprehensive test battery of subjective evaluation, behavioral tests, and EEG measures.DesignTwelve adult CI users were recruited for a home-based music training program that focused on attentive listening to music genres and materials that have an emphasis on melody. The participants used a music streaming program (i.e., Pandora) downloaded onto personal electronic devices for training. The participants attentively listened to music through a direct audio cable or through Bluetooth streaming. The training schedule was 40 min/session/day, 5 days/week, for either 4 or 8 weeks. The pre-training and post-training tests included: hearing thresholds, Speech, Spatial and Qualities of Hearing Scale (SSQ12) questionnaire, psychoacoustic tests of frequency change detection threshold (FCDT), speech recognition tests (CNC words, AzBio sentences, and QuickSIN), and EEG responses to tones that contained different magnitudes of frequency changes.ResultsAll participants except one finished the 4- or 8-week training, resulting in a dropout rate of 8.33%. Eleven participants performed all tests except for two who did not participate in EEG tests. Results showed a significant improvement in the FCDTs as well as performance on CNC and QuickSIN after training (p < 0.05), but no significant improvement in SSQ scores (p > 0.05). Results of the EEG tests showed larger post-training cortical auditory evoked potentials (CAEPs) in seven of the nine participants, suggesting a better cortical processing of both stimulus onset and within-stimulus frequency changes.ConclusionThese preliminary data suggest that extensive, focused music listening can improve frequency perception and speech perception in CI users. Further studies that include a larger sample size and control groups are warranted to determine the efficacy of short-term music training in CI users.

Effectiveness of Wireless Streaming on Telephone Conversation in Users of Hearing Aids

Background and Objectives The purpose of this study was to figure out the clinical effectiveness of the bluetooth wireless streaming when used with a hearing aid during cell phone conversation for hearing-impaired listeners.Subjects and Method Twenty-four adults with hearing loss participated (mild: 3, moderate: 13, moderately severe: 8) in the study. The following three objective tests and one subjective questionnaire were administered to all participants; 1) consonant and Monosyllabic test in an noisy environment, 2) speech recognition test in quiet and noisy conditions, 3) listening effort test, and 4) questionnaire about sound quality and preference. Each objective test was conducted in three different cell phone conversation environments as follows; 1) unaided condition, 2) aided condition, with the bluetooth function off, and 3) aided condition, with the bluetooth function on.Results In the aided condition with the bluetooth function off, performance on consonant and monosyllabic tests was the lowest (&lt;i&gt;p&lt;/i&gt;＜0.05). However, when the bluetooth function was turned on, the result showed statistically significant superior performance (&lt;i&gt;p&lt;/i&gt;＜0.05). For the words and sentences test in noisy conditions, using wireless streaming feature with the hearing aids were beneficial compared to not using the feature (&lt;i&gt;p&lt;/i&gt;＜0.05). However, no significant difference was found between the bluetooth off and on conditions in quiet conditions. Listening effort was significantly lower in noisy background for aided bluetooth on condition (&lt;i&gt;p&lt;/i&gt;＜0.05). There was no significant difference in sound quality according to each condition, but the preference of Bluetooth feature was overwhelmingly high.Conclusion Bluetooth wireless streaming is beneficial during phone conversation in noisy environments for users of hearing aids.

Cochlear implantation in Ménière’s disease: a systematic review of literature and pooled analysis

Objective: The aim of this study was to evaluate the effect of cochlear implantation (CI) in advanced Ménière’s disease (MD).Design: The initial search on PubMed, EMBASE, and Cochrane databases yielded 171 articles; no language restriction was applied.Study sample: A total of 11 articles met the inclusion criteria and were included in this systematic review. Six articles provided patient-level data on improvement in speech recognition testing after CI.Results: The methodological quality of included studies was assessed by examining the study design, level of evidence, method of measurement and adequacy of outcome reporting. A random-effect model was fitted for calculating weighted means. Post-operative improvement in word recognition score (WCS) was 50.8% (95% confidence interval: 34.6–67.1%); general improvement of vestibular symptoms after CI was found in 67% of the pooled patients; when reported in the studies, quality of life (QoL) and tinnitus were also generally improved after CI.Conclusions: CI in advanced MD is a valid option providing good outcomes in terms of speech performances, regardless of the disease duration, uni- or bilaterality, age at implantation, previous therapeutic procedures and stage of activity of MD.