Speech Understanding In Noise Research Articles

Results in Adult Cochlear Implant Recipients With Varied Asymmetric Hearing: A Prospective Longitudinal Study of Speech Recognition, Localization, and Participant Report.

Asymmetric hearing with severe to profound hearing loss (SPHL) in one ear and better hearing in the other requires increased listening effort and is detrimental for understanding speech in noise and sound localization. Although a cochlear implant (CI) is the only treatment that can restore hearing to an ear with SPHL, current candidacy criteria often disallows this option for patients with asymmetric hearing. The present study aimed to evaluate longitudinal performance outcomes in a relatively large group of adults with asymmetric hearing who received a CI in the poor ear. Forty-seven adults with postlingual hearing loss participated. Test materials included objective and subjective measures meant to elucidate communication challenges encountered by those with asymmetric hearing. Test intervals included preimplant and 6 and 12 months postimplant. Preimplant testing was completed in participants' everyday listening condition: bilateral hearing aids (HAs) n = 9, better ear HA n = 29, and no HA n = 9; postimplant, each ear was tested separately and in the bimodal condition. Group mean longitudinal results in the bimodal condition postimplant compared with the preimplant everyday listening condition indicated significantly improved sentence scores at soft levels and in noise, improved localization, and higher ratings of communication function by 6 months postimplant. Group mean, 6-month postimplant results were significantly better in the bimodal condition compared with either ear alone. Audibility and speech recognition for the poor ear alone improved significantly with a CI compared with preimplant. Most participants had clinically meaningful benefit on most measures. Contributory factors reported for traditional CI candidates also impacted results for this population. In general, older participants had poorer bimodal speech recognition in noise and localization abilities than younger participants. Participants with early SPHL onset had better bimodal localization than those with later SPHL onset, and participants with longer SPHL duration had poorer CI alone speech understanding in noise but not in quiet. Better ear pure-tone average (PTA) correlated with all speech recognition measures in the bimodal condition. To understand the impact of better ear hearing on bimodal performance, participants were grouped by better ear PTA: group 1 PTA ≤40 dB HL (n = 19), group 2 PTA = 41 to 55 dB HL (n = 14), and group 3 PTA = 56 to 70 dB HL (n = 14). All groups showed bimodal benefit on speech recognition measures in quiet and in noise; however, only group 3 obtained benefit when noise was toward the CI ear. All groups showed improved localization and ratings of perceived communication. Receiving a CI for the poor ear was an effective treatment for this population. Improved audibility and speech recognition were evident by 6 months postimplant. Improvements in sound localization and self-reports of communication benefit were significant and not related to better ear hearing. Participants with more hearing in the better ear (group 1) showed less bimodal benefit but greater bimodal performance for speech recognition than groups 2 and 3. Test batteries for this population should include quality of life measures, sound localization, and adaptive speech recognition measures with spatially separated noise to capture the hearing loss deficits and treatment benefits reported by this patient population.

The Influence of Speech Rate on Acceptable Noise Levels.

Older adults often struggle with accurate perception of rate-altered speech and have difficulty understanding speech in noise. The acceptable noise level (ANL) quantifies a listener's willingness to listen to speech in background noise and has been found to accurately predict hearing aid success. Based on the difficulty older adults experience with rapid speech, we were interested in how older adults may change the amount of background noise they willingly accept in a variety of speech rate conditions. To determine the effects of age and speech rate on the ANL. A quasi-experimental mixed design was employed. Fifteen young adults (19-27 yr) and fifteen older adults (55-73 yr) with audiometrically normal hearing or hearing loss within age-normed limits served as participants. Most comfortable listening levels (MCLs) and background noise levels (BNLs) were measured using three different speech rates (slow, normal, and fast). The ANL was calculated by subtracting BNL from MCL. Repeated measures analysis of variances were used to analyze the effects of age and speech rate on ANL. A significant main effect of speech rate was observed; however, a significant main effect of age was not found. Results indicated that as speech rate increased the ANLs increased. This suggests that participants became less accepting of background noise as speech rates increased. The findings of the present study provide support for communication strategies that recommend slowing an individual's speaking rate and/or reducing background noise, if possible. Participants in the present study were better able to cope with background noise when the primary stimulus was presented at slow and normal speaking rates.

Effects of lifetime noise exposure on the middle-age human auditory brainstem response, tinnitus and speech-in-noise intelligibility

Recent animal studies have shown that the synapses between inner hair cells and the dendrites of the spiral ganglion cells they innervate are the elements in the cochlea most vulnerable to excessive noise exposure. Particularly in rodents, several studies have concluded that exposure to high level octave-band noise for 2 h leads to an irreversible loss of around 50% of synaptic ribbons, leaving audiometric hearing thresholds unaltered. Cochlear synaptopathy following noise exposure is hypothesized to degrade the neural encoding of sounds at the subcortical level, which would help explain certain listening-in-noise difficulties reported by some subjects with otherwise ‘normal’ hearing. In response to this peripheral damage, increased gain of central stages of the auditory system has been observed across several species of mammals, particularly in association with tinnitus. The auditory brainstem response (ABR) wave I amplitude and waves I-V amplitude ratio have been suggested as non-invasive indicators of cochlear synaptopathy and central gain activation respectively, but the evidence for these hearing disorders in humans is inconclusive. In this study, we evaluated the influence of lifetime noise exposure (LNE) on the human ABR and on speech-in-noise intelligibility performance in a large cohort of adults aged 29 to 55. Despite large inter-subject variability, results showed a moderate, but statistically significant, negative correlation between the ABR wave I amplitude and LNE, consistent with cochlear synaptopathy. The results also showed (a) that central gain mechanisms observed in animal studies might also occur in humans, in which higher stages of the auditory pathway appear to compensate for reduced input from the cochlea; (b) that tinnitus was associated with activation of central gain mechanisms; (c) that relevant cognitive and subcortical factors influence speech-in-noise intelligibility, in particular, longer ABR waves I-V interpeak latencies were associated with poorer performance in understanding speech in noise when central gain mechanisms were active; and (d) absence of a significant relationship between LNE and tinnitus, central gain activation or speech-in-noise performance. Although this study supports the possible existence of cochlear synaptopathy in humans, the great degree of variability, the lack of uniformity in central gain activation and the significant involvement of attention in speech-in-noise performance suggests that noise-induced cochlear synaptopathy is, at most, one of several factors that play a role in humans' speech-in-noise performance.

Effectiveness of Auditory Measures for Detecting Hidden Hearing Loss and/or Cochlear Synaptopathy: A Systematic Review.

Standard audiometric evaluations are not sensitive enough to identify hidden hearing loss (HHL) and/or cochlear synaptopathy (CS). Patients with either of these conditions frequently present with difficulty understanding speech in noise or other complaints such as tinnitus. The purpose of this systematic review is to identify articles in peer-reviewed journals that assessed the sensitivity of audiologic measures for detecting HHL and/or CS, and which showed potential for use in a clinical test battery for these disorders. A reference librarian submitted specific boolean terminology to MEDLINE, Embase, and Web of Science. The authors used a consensus approach with specially designed score sheets for the selection of titles, abstracts, and then articles for inclusion in the systematic review and for quality assessment. Fifteen articles were included in the systematic review. Seven articles involved humans; seven involved animals, and one study used both humans and animals. Results showed that pure-tone audiometry to 20 kHz, otoacoustic emissions, electrocochleography, auditory brainstem response (ABR), electrophysiological tests, speech recognition in noise with and without temporal distortion, interviews, and self-report measures have been used to assess HHL and/or CS. For HHL, ultra-high-frequency audiometry may help identify persons with sensory hair cell loss that does not show up on standard audiograms. Promising nonbehavioral measures for CS included ABR wave I amplitude, the summating potential-to-action potential ratio, and speech recognition in noise with and without temporal distortion. Self-report questionnaires also may help identify auditory dysfunction in persons with normal hearing.

Musician effect on perception of spectro-temporally degraded speech, vocal emotion, and music in young adolescents.

In adult normal-hearing musicians, perception of music, vocal emotion, and speech in noise has been previously shown to be better than non-musicians, sometimes even with spectro-temporally degraded stimuli. In this study, melodic contour identification, vocal emotion identification, and speech understanding in noise were measured in young adolescent normal-hearing musicians and non-musicians listening to unprocessed or degraded signals. Different from adults, there was no musician effect for vocal emotion identification or speech in noise. Melodic contour identification with degraded signals was significantly better in musicians, suggesting potential benefits from music training for young cochlear-implant users, who experience similar spectro-temporal signal degradations.

Speech in Noise Perception as a Marker of Cognitive Impairment in HIV Infection.

Human immunodeficiency virus positive (HIV+) individuals report hearing difficulties, but standard audiological tests show no, or small, changes in peripheral hearing ability. The hearing complaints may reflect central nervous system (CNS) auditory processing deficits, rather than middle or inner ear problems, and may result from CNS damage due to HIV infection or treatment. If central auditory task performance and cognitive deficits in HIV+ individuals are shown to be related, then central auditory tests might serve as a "window" into CNS function in these patients. We measured cognitive performance (Mandarin Montreal Cognitive Assessment [MoCA]) and speech in noise perception (Mandarin hearing-in-noise test [HINT]) in 166 normal-hearing HIV+ individuals (158 men, 8 women, average age 36 years) at the Shanghai Public Health Clinical Center in Shanghai, China. Data collection included audiometry, tympanometry, and the Amsterdam Inventory of Auditory Handicap (AIAH), which assesses the subjective ability to understand speech and localize sound. Subjects had no middle ear disease and met criteria for normal-hearing sensitivity (all thresholds 20 dB HL or less). A significant negative relationship between speech reception thresholds (SRT) and MoCA scores (r = 0.15, F = 28.2, p < 0.001) existed. Stepwise linear regression showed that when the factors of age, MoCA scores, hearing thresholds, and education level were considered, only age and MoCA scores contributed independently to the SRT results (overall model r = 0.30, F = 38.8, p < 0.001). Subjective hearing complaints from the AIAH supported the HINT results. AIAH and MoCA scores were also related (r = 0.05, F = 8.5, p = 0.004), with those with worse MoCA scores having more problems on the AIAH. When the cohort was divided into those with normal and abnormal performance on the MoCA, those with abnormal performance on the MoCA had significantly higher average SRTs (p < 0.001). Understanding speech in noise measured both objectively with the HINT and subjectively with the AIAH was inversely related to cognitive abilities despite a normal ability to hear soft sounds determined by audiometry. Although age was also an important independent factor affecting speech perception, the age relationship within the speech findings in this study may represent more than just age-related declines in speech in noise understanding. Although reliable data on disease duration are not available, the older members of this cohort likely had HIV longer and probably had more severe symptoms at presentation than the younger members because early detection and treatment of HIV in Shanghai has improved over time. Therefore, the age relationship may also include elements of disease duration and severity. Speech perception, especially in challenging listening conditions, involves cortical and subcortical centers and is a demanding neurological task. The problems interpreting speech in noise HIV+ individuals have may reflect HIV-related or HIV treatment-related, central nervous damage, suggesting that CNS complications in HIV+ individuals could potentially be diagnosed and monitored using central auditory tests.

Effect of audibility on better-ear glimpsing as a function of frequency in normal-hearing and hearing-impaired listeners.

Better-ear glimpsing (BEG) is an auditory phenomenon that helps understanding speech in noise by utilizing interaural level differences (ILDs). The benefit provided by BEG is limited in hearing-impaired (HI) listeners by reduced audibility at high frequencies. Rana and Buchholz [(2016). J. Acoust. Soc. Am. 140(2), 1192-1205] have shown that artificially enhancing ILDs at low and mid frequencies can help HI listeners understanding speech in noise, but the achieved benefit is smaller than in normal-hearing (NH) listeners. To understand how far this difference is explained by differences in audibility, audibility was carefully controlled here in ten NH and ten HI listeners and speech reception thresholds (SRTs) in noise were measured in a spatially separated and co-located condition as a function of frequency and sensation level. Maskers were realized by noise-vocoded speech and signals were spatialized using artificially generated broadband ILDs. The spatial benefit provided by BEG and SRTs improved consistently with increasing sensation level, but was limited in the HI listeners by loudness discomfort. Further, the HI listeners performed similar to NH listeners when differences in audibility were compensated. The results help to understand the hearing aid gain that is required to maximize the spatial benefit provided by ILDs as a function of frequency.

Protecting the hearing-impaired worker: speech understanding with electronic hearing protection devices

Introduction: In many military and civilian occupations, the use of a hearing protection device (HPD) is required while working in noisy environments. When a worker has a pre-existing hearing loss, wearing traditional passive HPDs further impedes auditory communication. Our aim was to study speech understanding in noise with electronic HPDs under simulated hearing loss conditions to assess their effectiveness for use as hearing enhancement devices. Methods: Speech understanding was tested with 18 participants using the Speech Recognition in Noise Test (SPRINT). The three ear conditions were: unprotected, the wearing of an electronic earmuff (3M PELTOR Tactical 6–S), and the wearing of an electronic earplug (INVISIO V60 and an X5 headset). The two listener conditions were normal-hearing SPRINT, and simulated hearing loss SPRINT (SHL SPRINT). In the latter condition, the SPRINT audio files were digitally filtered to simulate a high-frequency hearing loss. Results: Participants obtained the highest scores with ears unprotected, especially in the SHL SPRINT condition. The external microphones of the electronic earmuff and earplug were found to have limited bandwidth, which could have reduced speech clarity and resulted in the low SPRINT scores. Discussion: The electronic HPDs did not improve speech understanding under simulated hearing loss conditions when compared to unprotected hearing. However, in noisy environments where HPDs are required, they provide a benefit over passive HPDs by reducing the risk of overprotection for the hearing-impaired worker.

Comparisons of electric and acoustic ITD coding in normal hearing gerbils

Small differences in the arrival time of sound between the two ears [interaural time differences (ITDs)] provide important cues for directional hearing and speech understanding in noise. Deaf subjects with bilateral cochlear implants (CIs) show relatively poor sensitivity to ITDs. It is unclear whether these limitations are due to differences in binaural brain circuits activated by electric compared to acoustic stimulation, mismatches in electric activation site across ears, or deafness-induced degradations in neural ITD processing. To identify potential limitations of electric ITD coding, we compared electric and acoustic ITD coding (i.e., ITD tuning and discrimination thresholds) in the same population of auditory brainstem and midbrain neurons in normal hearing gerbils. When compared in the same neurons, ITD coding to acoustic stimulation did not predict coding to electric stimulation. However, on a population level, neurons demonstrated surprising similarities in acoustic and electric ITD processing. ...

Speech Understanding and Sound Source Localization by Cochlear Implant Listeners Using a Pinna-Effect Imitating Microphone and an Adaptive Beamformer.

Sentence understanding scores for patients with cochlear implants (CIs) when tested in quiet are relatively high. However, sentence understanding scores for patients with CIs plummet with the addition of noise. To assess, for patients with CIs (MED-EL), (1) the value to speech understanding of two new, noise-reducing microphone settings and (2) the effect of the microphone settings on sound source localization. Single-subject, repeated measures design. For tests of speech understanding, repeated measures on (1) number of CIs (one, two), (2) microphone type (omni, natural, adaptive beamformer), and (3) type of noise (restaurant, cocktail party). For sound source localization, repeated measures on type of signal (low-pass [LP], high-pass [HP], broadband noise). Ten listeners, ranging in age from 48 to 83 yr (mean = 57 yr), participated in this prospective study. Speech understanding was assessed in two noise environments using monaural and bilateral CIs fit with three microphone types. Sound source localization was assessed using three microphone types. In Experiment 1, sentence understanding scores (in terms of percent words correct) were obtained in quiet and in noise. For each patient, noise was first added to the signal to drive performance off of the ceiling in the bilateral CI-omni microphone condition. The other conditions were then administered at that signal-to-noise ratio in quasi-random order. In Experiment 2, sound source localization accuracy was assessed for three signal types using a 13-loudspeaker array over a 180° arc. The dependent measure was root-mean-score error. Both the natural and adaptive microphone settings significantly improved speech understanding in the two noise environments. The magnitude of the improvement varied between 16 and 19 percentage points for tests conducted in the restaurant environment and between 19 and 36 percentage points for tests conducted in the cocktail party environment. In the restaurant and cocktail party environments, both the natural and adaptive settings, when implemented on a single CI, allowed scores that were as good as, or better, than scores in the bilateral omni test condition. Sound source localization accuracy was unaltered by either the natural or adaptive settings for LP, HP, or wideband noise stimuli. The data support the use of the natural microphone setting as a default setting. The natural setting (1) provides better speech understanding in noise than the omni setting, (2) does not impair sound source localization, and (3) retains low-frequency sensitivity to signals from the rear. Moreover, bilateral CIs equipped with adaptive beamforming technology can engender speech understanding scores in noise that fall only a little short of scores for a single CI in quiet.

Estimating the relative interaural place mismatch for bilateral cochlear-implant listeners

Frequency-matched bilateral input is important for the optimum encoding of binaural cues to facilitate sound localization, auditory scene analysis, and speech understanding in noise. Current bilateral cochlear-implant (CI) programming procedures do not account for potential interaural place-of-stimulation mismatch. This study investigated whether a perceptual test of interaural-time-difference (ITD) sensitivity can effectively estimate relative interaural mismatch for bilateral CI listeners. Ten bilateral CI listeners were tested on a two-interval left-right ITD discrimination task. Loudness balanced 300-ms, 100 pulse-per-second constant-amplitude pulse trains were delivered to single-electrode pairs using direct stimulation. Measurements were made for five reference electrodes evenly distributed along the array in one ear, and for at least five closely spaced comparison electrodes in the other ear for each reference electrode. The pair with the smallest thresholds was assumed to be the most closely place matched. ITD sensitivity was variable across listeners, with thresholds ranging from 80-2000 μs. ITD tuning curves varied across and within listeners, ranging from widths of approximately one (sharp tuning) to eight electrodes (broad tuning). While cases with narrower tuning provide clear suggestions for frequency programming to minimize interaural mismatch, estimates of mismatch were difficult to ascertain for cases with broad tuning.

Auditory, cognitive, and linguistic processing skills in individuals with hearing loss

Hearing impairment affects a person’s ability to communicate effectively. People with hearing loss (HL) report difficulty communicating in noise, even when the HL is compensated by conventional amplification. This study aims to investigate factors that contribute to understanding speech in noise. Nine adults with HL and nine controls participated in the study. The test-battery include auditory, cognitive and linguistic tests. For the HL group, auditory stimuli were filtered with NAL-RP prescription to compensate for their HL. Results indicate a significant difference in performance between the groups on the Modulation Detection Threshold (MDT) test [F (1, 15) = 3.24, p =0.04] and the speech recognition in noise test [f (1, 15) = 25.6, p&amp;lt;0.001]. HL group performed better on the MDT and poorer at recognising speech in noise possibly due to broadening of auditory filters. With the broadened auditory filters in mind, this result supports the fact that they would have poor frequency specificity, detrimental for speech recognition. HL group performed better than the control group on the cognitive spare capacity test [f (1, 15) = 4.72, p= 0.04]. Preliminary data suggests that adults with HL may compensate for hearing-related difficulties in certain situations by using their cognitive skills.

Speech understanding in noise in elderly adults: the effect of inhibitory control and syntactic complexity.

Previous research has suggested that speech perception in elderly adults is influenced not only by age-related hearing loss or presbycusis but also by declines in cognitive abilities, by background noise and by the syntactic complexity of the message. To gain further insight into the influence of these cognitive as well as acoustic and linguistic factors on speech perception in elderly adults by investigating inhibitory control as a listener characteristic and background noise type and syntactic complexity as input characteristics. Phoneme identification was measured in different noise conditions and in different linguistic contexts (single words, sentences with varying syntactic complexity). Additionally, inhibitory control was measured using a visual stimulus-response matching task. Fifty-one adults participated in this study, including elderly adults with age-related hearing loss (n = 9) and with normal hearing (n = 17), and a control group of normal hearing younger adults (n = 25). The analysis revealed that elderly adults with normal hearing and with hearing loss were less likely to identify successfully phonemes in single words than younger normal hearing controls. In the context of sentences, only elderly adults with hearing loss had a lower odds of correct phoneme perception than the control group. Additionally, in elderly adults with hearing loss, phoneme-in-sentence perception was linked to age-related declines in inhibitory control. In all participants, phoneme identification in sentences was influenced by both noise type and syntactic complexity. Inhibitory control and syntactic complexity might play a significant role in speech perception, especially in elderly listeners. These factors might also influence the results of clinical assessments of speech perception. Testing procedures thus need to be selected and their results interpreted carefully with these influences in mind.

Effects of a transient noise reduction algorithm on speech intelligibility in noise, noise tolerance and perceived annoyance in cochlear implant users

Objective: To evaluate the validity and efficacy of a transient noise reduction algorithm (TNR) in cochlear implant processing and the interaction of TNR with a continuous noise reduction algorithm (CNR). Design: We studied the effects of TNR and CNR on the perception of realistic sound samples with transients, using subjective ratings of annoyance, a speech-in-noise test and a noise tolerance test. Study sample: Participants were 16 experienced cochlear implant recipients wearing an Advanced Bionics Naida Q70 processor. Results: CI users rated sounds with transients as moderately annoying. Annoyance was slightly, but significantly reduced by TNR. Transients caused a large decrease in speech intelligibility in noise and a moderate decrease in noise tolerance, measured on the Acceptable Noise Level test. The TNR had no significant effect on noise tolerance or on speech intelligibility in noise. The combined application of TNR and CNR did not result in interactions. Conclusions: The TNR algorithm was effective in reducing annoyance from transient sounds, but was not able to prevent a decreasing effect of transients on speech understanding in noise and noise tolerance. TNR did not reduce the beneficial effect of CNR on speech intelligibility in noise, but no cumulated improvement was found either.

Evaluation of Two-Channel Source Separation Using Exploratory Projection Pursuit Technique

Difficulty of understanding speech in noise among the elderly necessitates the need for Auditory Training which has made a renewal of interest in the last decade with the auditory training applications. This interest is perhaps spurred by advances in computer-based technology. In computer-based auditory training, speech signals are considered as auditory training stimuli where input speech signals need to be verified prior to training as the speech signals are mixed with noise signals. Computer-based Auditory Training System can be embedded with input speech verifying module. Input speech verifying module is employed with speech and noise separator simulator. This simulator needs to guarantee accurate separation of speech from noise signals. Therefore, in this research, Exploratory Projection Pursuit (EPP) technique under semi-Blind Source Separation (BSS) method is intended to separate the speech source signals which are mixed with competing speech (multitalker speech babble). This training uses Malay language based sentences which differ in word length and hence number of sample values. The experimental simulation considers two-channel random, linear mixing of speech sources and competing speech. The aim of this study is to evaluate the performance of source separation using the anticipated EPP technique for various sample values of speech signals which varies in time duration due to word length dissimilarity. Simulation results show that EPP technique is feasible for source separation. As a consequence, high correlation value of r ≥ 0.99 is obtained between extracted speech signal and original speech signal for all categories of speech signals. It is further verified by the maximum nongaussianity of extracted speech signal which has high kurtosis value of 32 approximately. DOI : http://dx.doi.org./10.17576/JSKM-2018-28

Music and Speech Perception in Children Using Sung Speech.

This study examined music and speech perception in normal-hearing children with some or no musical training. Thirty children (mean age = 11.3 years), 15 with and 15 without formal music training participated in the study. Music perception was measured using a melodic contour identification (MCI) task; stimuli were a piano sample or sung speech with a fixed timbre (same word for each note) or a mixed timbre (different words for each note). Speech perception was measured in quiet and in steady noise using a matrix-styled sentence recognition task; stimuli were naturally intonated speech or sung speech with a fixed pitch (same note for each word) or a mixed pitch (different notes for each word). Significant musician advantages were observed for MCI and speech in noise but not for speech in quiet. MCI performance was significantly poorer with the mixed timbre stimuli. Speech performance in noise was significantly poorer with the fixed or mixed pitch stimuli than with spoken speech. Across all subjects, age at testing and MCI performance were significantly correlated with speech performance in noise. MCI and speech performance in quiet was significantly poorer for children than for adults from a related study using the same stimuli and tasks; speech performance in noise was significantly poorer for young than for older children. Long-term music training appeared to benefit melodic pitch perception and speech understanding in noise in these pediatric listeners.

Influence of Multi-microphone Signal Enhancement Algorithms on the Acoustics and Detectability of Angular and Radial Source Movements.

Hearing-impaired listeners are known to have difficulties not only with understanding speech in noise but also with judging source distance and movement, and these deficits are related to perceived handicap. It is possible that the perception of spatially dynamic sounds can be improved with hearing aids (HAs), but so far this has not been investigated. In a previous study, older hearing-impaired listeners showed poorer detectability for virtual left-right (angular) and near-far (radial) source movements due to lateral interfering sounds and reverberation, respectively. In the current study, potential ways of improving these deficits with HAs were explored. Using stimuli very similar to before, detailed acoustic analyses were carried out to examine the influence of different HA algorithms for suppressing noise and reverberation on the acoustic cues previously shown to be associated with source movement detectability. For an algorithm that combined unilateral directional microphones with binaural coherence-based noise reduction and for a bilateral beamformer with binaural cue preservation, movement-induced changes in spectral coloration, signal-to-noise ratio, and direct-to-reverberant energy ratio were greater compared with no HA processing. To evaluate these two algorithms perceptually, aided measurements of angular and radial source movement detectability were performed with 20 older hearing-impaired listeners. The analyses showed that, in the presence of concurrent interfering sounds and reverberation, the bilateral beamformer could restore source movement detectability in both spatial dimensions, whereas the other algorithm only improved detectability in the near-far dimension. Together, these results provide a basis for improving the detectability of spatially dynamic sounds with HAs.

Contralateral Routing of Signal Yields Significant Speech in Noise Benefit for Unilateral Cochlear Implant Recipients.

Bilateral cochlear implantation is the standard of care for individuals with moderate sloping-to-profound sensorineural hearing loss who do not receive benefit from appropriately fit hearing aids. Because of financial, insurance, or medical reasons, some unilateral cochlear implant (CI) recipients are unable to obtain a second CI. Here, we evaluated the first clinically available solution for individuals who have been unilaterally implanted and who do not or cannot use technology (e.g., hearing aid or CI) on the non-implanted ear. We aimed to investigate how the addition of a contralateral routing of signal (CROS) device could provide objective and/or subjective benefit to adult CI recipients with moderate-to-profound hearing loss in the non-implanted ear. Single-center prospective study using a within-subjects repeated-measures design. Participants included ten experienced unilateral CI recipients with severe-to-profound (n = 9) or moderate-to-profound (n = 1) sensorineural hearing loss in the non-implanted ear. At the time of study enrollment, participants did not use any technology on the non-implanted ear. No other exclusion criteria were used. Individuals were tested with and without a CROS device worn on the non-implanted ear. We obtained measures of speech understanding in quiet (50 and 65 dBA) and in noise (+5-dB signal-to-noise ratio with a 65-dBA speech signal) both with and without the CROS device in an acute listening condition. Subjective benefit was assessed via the Speech, Spatial and Qualities 12-item questionnaire before CROS fitting and after two weeks of continuous use. A mixed-model, repeated-measures analysis of variance was completed with three talker locations and three presentation levels included as within-subjects factors and the presence or absence of a CROS device as a between-subjects factor. There was an 11% improvement in speech understanding in noise with the addition of the CROS device when speech was located at 0° azimuth. Subjective benefit in the speech domain of the SSQ was also observed. Use of CROS provided both subjective and objective speech recognition benefit for unilateral CI recipients who do not have access to bilateral cochlear implantation.

Effect of Tinnitus and Duration of Deafness on Sound Localization and Speech Recognition in Noise in Patients With Single-Sided Deafness

Patients with single-sided deafness (SSD) often experience poor sound localization, reduced speech understanding in noise, reduced quality of life, and tinnitus. The present study aims to evaluate effects of tinnitus and duration of deafness on sound localization and speech recognition in noise by SSD subjects. Sound localization and speech recognition in noise were measured in 26 SSD and 10 normal-hearing (NH) subjects. Speech was always presented directly in front of the listener. Noise was presented to the deaf ear, in front of the listener, or to the better hearing ear. Tinnitus severity was measured using visual analog scale and Tinnitus Handicap Inventory. Relative to NH subjects, SSD subjects had significant deficits in sound localization and speech recognition in all listening conditions (p < .001). For SSD subjects, speech recognition in noise was correlated with mean hearing thresholds in the better hearing ear (p < .001) but not in the deaf ear. SSD subjects with tinnitus performed poorer in sound localization and speech recognition in noise than those without tinnitus. Shorter duration of deafness was associated with greater tinnitus and sound localization difficulty. Tinnitus visual analog scale and Tinnitus Handicap Inventory were highly correlated; the degree of tinnitus was negatively correlated with sound localization and speech recognition in noise. Those experiencing noticeable tinnitus may benefit more from cochlear implantation than those without; subjective tinnitus reduction may be correlated with improved sound localization and speech recognition in noise. Subjects with longer duration of deafness demonstrated better sound localization, suggesting long-term compensation for loss of binaural cues.

Envelope-based inter-aural time difference localization training to improve speech-in-noise perception in the elderly.

Background: Many elderly individuals complain of difficulty in understanding speech in noise despite having normal hearing thresholds. According to previous studies, auditory training leads to improvement in speech-in-noise perception, but these studies did not consider the etiology, so their results cannot be generalized. The present study aimed at investigating the effectiveness of envelopebased interaural time difference (ITD ENV) localization training on improving ITD threshold and speech-in-noise perception. Methods: Thirty-two elderly males aged 55 to 65 years with clinically diagnosed normal hearing at 250-2000 Hertz, who suffered from speech-in-noise perception difficulty participated in this study. These individuals were randomly divided into training and control groups: 16 elderlies in the experimental group received envelope-based interaural time difference localization training in 9 sessions, but 16 matched elderlies in the control group did not receive any training. The ITD ENV threshold and spatial word recognition score (WRS) in noise were analyzed before and after the localization training. Results: Findings demonstrated that following the training program, the interaural time difference envelope threshold and spatial word recognition score (WRS) in noise were improved significantly in the experimental group (p≤ 0.001). Moreover, a significant difference was detected in interaural time difference envelope threshold and spatial word recognition score (WRS) in noise (p≤ 0.001) before and after the training in the experimental group. Conclusion: The results of the present study revealed the effectiveness of envelope- based interaural time difference localization training in localization ability and speech in noise perception in the elderlies with normal hearing up to 2000 Hz who suffered from speech-in-noise perception difficulty.