[article] 
inEar and hearing > Vol. 42, n°1 (Janvier-février) . - p. 1-11

Titre :	The Effect of Hearing Loss and Hearing Device Fitting on Fatigue in Adults
Type de document :	Article
Auteurs :	Jack A Holman ; Avril Drummond ; Graham Naylor
Année de publication :	2021
Article en page(s) :	p. 1-11
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Aides auditives ; Fatigue ; PERTE AUDITIVE DE PERCEPTION
Résumé :	AB Objectives: To conduct a systematic review to address two research questions: (Q1) Does hearing loss have an effect on fatigue? (Q2) Does hearing device fitting have an effect on fatigue? It was hypothesized that hearing loss would increase fatigue (H1), and hearing device fitting would reduce fatigue (H2). Design: Systematic searches were undertaken of five bibliographic databases: Embase, MedLine, Web of Science, Psychinfo, and the Cochrane Library. English language peer-reviewed research articles were included from inception until present. Inclusion and exclusion criteria were formulated using the Population, Intervention, Comparison, Outcomes and Study design strategy. Results: Initial searches for both research questions produced 1,227 unique articles, after removal of duplicates. After screening, the full text of 61 studies was checked, resulting in 12 articles with content relevant to the research questions. The reference lists of these studies were examined, and a final updated search was conducted on October 16, 2019. This resulted in a final total of 20 studies being selected for the review. For each study, the information relating to the Population, Intervention, Comparison, Outcomes and Study design criteria and the statistical outcomes relating to both questions (Q1 and Q2) were extracted. Evidence relating to Q1 was provided by 15 studies, reporting 24 findings. Evidence relating to Q2 was provided by six studies, reporting eight findings. One study provided evidence for both. Using the Grading of Recommendations Assessment, Development and Evaluation guidelines, the quality of evidence on both research questions was deemed to be "very low." It was impossible to perform a meta-analysis of the results due to a lack of homogeneity. Conclusions: As the studies were too heterogeneous to support a meta-analysis, it was not possible to provide statistically significant evidence to support the hypotheses that hearing loss results in increased fatigue (H1) or that hearing device fitting results in decreased fatigue (H2). Despite this, the comparative volume of positive results and the lack of any negative findings are promising for future research (particularly in respect of Q1). There was a very small number of studies deemed eligible for the review, and there was large variability between studies in terms of population, and quantification of hearing loss and fatigue. The review highlights the need for consistency when measuring fatigue, particularly when using self-report questionnaires, where the majority of the current evidence was generated.
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[article] The Effect of Hearing Loss and Hearing Device Fitting on Fatigue in Adults [Article] / Jack A Holman ; Avril Drummond ; Graham Naylor . - 2021 . - p. 1-11.
Langues : Anglais (eng)
in Ear and hearing > Vol. 42, n°1 (Janvier-février) . - p. 1-11

Descripteurs :	HE Vinci Aides auditives ; Fatigue ; PERTE AUDITIVE DE PERCEPTION
Résumé :	AB Objectives: To conduct a systematic review to address two research questions: (Q1) Does hearing loss have an effect on fatigue? (Q2) Does hearing device fitting have an effect on fatigue? It was hypothesized that hearing loss would increase fatigue (H1), and hearing device fitting would reduce fatigue (H2). Design: Systematic searches were undertaken of five bibliographic databases: Embase, MedLine, Web of Science, Psychinfo, and the Cochrane Library. English language peer-reviewed research articles were included from inception until present. Inclusion and exclusion criteria were formulated using the Population, Intervention, Comparison, Outcomes and Study design strategy. Results: Initial searches for both research questions produced 1,227 unique articles, after removal of duplicates. After screening, the full text of 61 studies was checked, resulting in 12 articles with content relevant to the research questions. The reference lists of these studies were examined, and a final updated search was conducted on October 16, 2019. This resulted in a final total of 20 studies being selected for the review. For each study, the information relating to the Population, Intervention, Comparison, Outcomes and Study design criteria and the statistical outcomes relating to both questions (Q1 and Q2) were extracted. Evidence relating to Q1 was provided by 15 studies, reporting 24 findings. Evidence relating to Q2 was provided by six studies, reporting eight findings. One study provided evidence for both. Using the Grading of Recommendations Assessment, Development and Evaluation guidelines, the quality of evidence on both research questions was deemed to be "very low." It was impossible to perform a meta-analysis of the results due to a lack of homogeneity. Conclusions: As the studies were too heterogeneous to support a meta-analysis, it was not possible to provide statistically significant evidence to support the hypotheses that hearing loss results in increased fatigue (H1) or that hearing device fitting results in decreased fatigue (H2). Despite this, the comparative volume of positive results and the lack of any negative findings are promising for future research (particularly in respect of Q1). There was a very small number of studies deemed eligible for the review, and there was large variability between studies in terms of population, and quantification of hearing loss and fatigue. The review highlights the need for consistency when measuring fatigue, particularly when using self-report questionnaires, where the majority of the current evidence was generated.
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[article] 
inEar and hearing > Vol. 42, n°1 (Janvier-février) . - p. 12-19

Titre :	Dorsomedial Prefrontal Cortex Repetitive Transcranial Magnetic Stimulation for Tinnitus: Promising Results of a Blinded, Randomized, Sham-Controlled Study
Type de document :	Article
Auteurs :	Patricia Ciminelli ; Sergio Machado ; Manoela Palmeira ; Evandro Silva Freire Coutinho ; David Sender ; Antonio Egidio Nardi
Année de publication :	2021
Article en page(s) :	p. 12-19
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Acouphène ; Stimulation magnétique transcranienne Autres descripteurs Cortex prefrontal dorso-lateral
Résumé :	AB Objectives: Tinnitus is the perception of sound in ears or head without corresponding external stimulus. Despite the great amount of literature concerning tinnitus treatment, there are still no evidence-based established treatments for curing or for effectively reducing tinnitus intensity. Sham-controlled studies revealed beneficial effects using repetitive transcranial magnetic stimulation (rTMS). Still, results show moderate, temporary improvement and high individual variability. Subcallosal area (ventral and dorsomedial prefrontal and anterior cingulate cortices) has been implicated in tinnitus pathophysiology. Our objective is to evaluate the use of bilateral, high frequency, dorsomedial prefrontal cortex (DMPFC) rTMS in treatment of chronic subjective tinnitus. Design: Randomized placebo-controlled, single-blinded clinical trial. Twenty sessions of bilateral, 10 Hz rTMS at 120% of resting motor threshold of extensor hallucis longus were applied over the DMPFC. Fourteen patients underwent sham rTMS and 15 were submitted to active stimulation. Tinnitus Handicap Inventory (THI), visual analog scale, and tinnitus loudness matching were obtained at baseline and on follow-up visits. The impact of intervention on outcome measures was evaluated using mixed-effects restricted maximum likelihood regression model for longitudinal data. Results: A difference of 11.53 points in the THI score was found, favoring the intervention group (p = 0.05). The difference for tinnitus loudness matching was of 4.46 dB also favoring the intervention group (p = 0.09). Conclusions: Tinnitus treatment with high frequency, bilateral, DMPFC rTMS was effective in reducing tinnitus severity measured by THI and matched tinnitus loudness when compared to sham stimulation.
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[article] Dorsomedial Prefrontal Cortex Repetitive Transcranial Magnetic Stimulation for Tinnitus: Promising Results of a Blinded, Randomized, Sham-Controlled Study [Article] / Patricia Ciminelli ; Sergio Machado ; Manoela Palmeira ; Evandro Silva Freire Coutinho ; David Sender ; Antonio Egidio Nardi . - 2021 . - p. 12-19.
Langues : Anglais (eng)
in Ear and hearing > Vol. 42, n°1 (Janvier-février) . - p. 12-19

Descripteurs :	HE Vinci Acouphène ; Stimulation magnétique transcranienne Autres descripteurs Cortex prefrontal dorso-lateral
Résumé :	AB Objectives: Tinnitus is the perception of sound in ears or head without corresponding external stimulus. Despite the great amount of literature concerning tinnitus treatment, there are still no evidence-based established treatments for curing or for effectively reducing tinnitus intensity. Sham-controlled studies revealed beneficial effects using repetitive transcranial magnetic stimulation (rTMS). Still, results show moderate, temporary improvement and high individual variability. Subcallosal area (ventral and dorsomedial prefrontal and anterior cingulate cortices) has been implicated in tinnitus pathophysiology. Our objective is to evaluate the use of bilateral, high frequency, dorsomedial prefrontal cortex (DMPFC) rTMS in treatment of chronic subjective tinnitus. Design: Randomized placebo-controlled, single-blinded clinical trial. Twenty sessions of bilateral, 10 Hz rTMS at 120% of resting motor threshold of extensor hallucis longus were applied over the DMPFC. Fourteen patients underwent sham rTMS and 15 were submitted to active stimulation. Tinnitus Handicap Inventory (THI), visual analog scale, and tinnitus loudness matching were obtained at baseline and on follow-up visits. The impact of intervention on outcome measures was evaluated using mixed-effects restricted maximum likelihood regression model for longitudinal data. Results: A difference of 11.53 points in the THI score was found, favoring the intervention group (p = 0.05). The difference for tinnitus loudness matching was of 4.46 dB also favoring the intervention group (p = 0.09). Conclusions: Tinnitus treatment with high frequency, bilateral, DMPFC rTMS was effective in reducing tinnitus severity measured by THI and matched tinnitus loudness when compared to sham stimulation.
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[article] 
inEar and hearing > Vol. 42, n°1 (Janvier-février) . - p. 20-28

Titre :	The Influence of Forced Social Isolation on the Auditory Ecology and Psychosocial Functions of Listeners With Cochlear Implants During COVID-19 Mitigation Efforts
Type de document :	Article
Auteurs :	Camille C. Dunn ; Elisabeth Stangl ; Jacob J. Oleson ; Michelle Smith ; Octav Chipara ; Yu-Hsiang Wu
Année de publication :	2021
Article en page(s) :	p. 20-28
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Confinement ; COVID-19 ; Déficience auditive ; Isolement social
Résumé :	AB Objectives: The impact of social distancing on communication and psychosocial variables among individuals with hearing impairment during COVID-19 pandemic. It was our concern that patients who already found themselves socially isolated ( Wie et al. 2010) as a result of their hearing loss would be perhaps more susceptible to changes in their communication habits resulting in further social isolation, anxiety, and depression. We wanted to better understand how forced social isolation (as part of COVID-19 mitigation) effected a group of individuals with hearing impairment from an auditory ecology and psychosocial perspective. We hypothesized that the listening environments would be different as a result of social isolation when comparing subject's responses regarding activities and participation before COVID-19 and during the COVID-19 pandemic. This change would lead to an increase in experienced and perceived social isolation, anxiety, and depression. Design: A total of 48 adults with at least 12 months of cochlear implant (CI) experience reported their listening contexts and experiences pre-COVID and during-COVID using Ecological Momentary Assessment (EMA; methodology collecting a respondent's self-reports in their natural environments) through a smartphone-based app, and six paper and pencil questionnaires. The Smartphone app and paper-pencil questionnaires address topics related to their listening environment, social isolation, depression, anxiety, lifestyle and demand, loneliness, and satisfaction with amplification. Data from these two-time points were compared to better understand the effects of social distancing on the CI recipients' communication abilities. Results: EMA demonstrated that during-COVID CI recipients were more likely to stay home or be outdoors. CI recipients reported that they were less likely to stay indoors outside of their home relative to the pre-COVID condition. Social distancing also had a significant effect on the overall signal-to-noise ratio of the environments indicating that the listening environments had better signal-to-noise ratios. CI recipients also reported better speech understanding, less listening effort, less activity limitation due to hearing loss, less social isolation due to hearing loss, and less anxiety due to hearing loss. Retrospective questionnaires indicated that social distancing had a significant effect on the social network size, participant's personal image of themselves, and overall loneliness. Conclusions: Overall, EMA provided us with a glimpse of the effect that forced social isolation has had on the listening environments and psychosocial perspectives of a select number of CI listeners. CI participants in this study reported that they were spending more time at home in a quieter environments during-COVID. Contrary to our hypothesis, CI recipients overall felt less socially isolated and reported less anxiety resulting from their hearing difficulties during-COVID in comparison to pre-COVID. This, perhaps, implies that having a more controlled environment with fewer speakers provided a more relaxing listening experience.
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[article] The Influence of Forced Social Isolation on the Auditory Ecology and Psychosocial Functions of Listeners With Cochlear Implants During COVID-19 Mitigation Efforts [Article] / Camille C. Dunn ; Elisabeth Stangl ; Jacob J. Oleson ; Michelle Smith ; Octav Chipara ; Yu-Hsiang Wu . - 2021 . - p. 20-28.
Langues : Anglais (eng)
in Ear and hearing > Vol. 42, n°1 (Janvier-février) . - p. 20-28

Descripteurs :	HE Vinci Confinement ; COVID-19 ; Déficience auditive ; Isolement social
Résumé :	AB Objectives: The impact of social distancing on communication and psychosocial variables among individuals with hearing impairment during COVID-19 pandemic. It was our concern that patients who already found themselves socially isolated ( Wie et al. 2010) as a result of their hearing loss would be perhaps more susceptible to changes in their communication habits resulting in further social isolation, anxiety, and depression. We wanted to better understand how forced social isolation (as part of COVID-19 mitigation) effected a group of individuals with hearing impairment from an auditory ecology and psychosocial perspective. We hypothesized that the listening environments would be different as a result of social isolation when comparing subject's responses regarding activities and participation before COVID-19 and during the COVID-19 pandemic. This change would lead to an increase in experienced and perceived social isolation, anxiety, and depression. Design: A total of 48 adults with at least 12 months of cochlear implant (CI) experience reported their listening contexts and experiences pre-COVID and during-COVID using Ecological Momentary Assessment (EMA; methodology collecting a respondent's self-reports in their natural environments) through a smartphone-based app, and six paper and pencil questionnaires. The Smartphone app and paper-pencil questionnaires address topics related to their listening environment, social isolation, depression, anxiety, lifestyle and demand, loneliness, and satisfaction with amplification. Data from these two-time points were compared to better understand the effects of social distancing on the CI recipients' communication abilities. Results: EMA demonstrated that during-COVID CI recipients were more likely to stay home or be outdoors. CI recipients reported that they were less likely to stay indoors outside of their home relative to the pre-COVID condition. Social distancing also had a significant effect on the overall signal-to-noise ratio of the environments indicating that the listening environments had better signal-to-noise ratios. CI recipients also reported better speech understanding, less listening effort, less activity limitation due to hearing loss, less social isolation due to hearing loss, and less anxiety due to hearing loss. Retrospective questionnaires indicated that social distancing had a significant effect on the social network size, participant's personal image of themselves, and overall loneliness. Conclusions: Overall, EMA provided us with a glimpse of the effect that forced social isolation has had on the listening environments and psychosocial perspectives of a select number of CI listeners. CI participants in this study reported that they were spending more time at home in a quieter environments during-COVID. Contrary to our hypothesis, CI recipients overall felt less socially isolated and reported less anxiety resulting from their hearing difficulties during-COVID in comparison to pre-COVID. This, perhaps, implies that having a more controlled environment with fewer speakers provided a more relaxing listening experience.
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[article] 
inEar and hearing > Vol. 42, n°1 (Janvier-février) . - p.29-41

Titre :	Peripheral Auditory Involvement in Childhood Listening Difficulty : Moore, David R.
Type de document :	Article
Auteurs :	Lisa L. Hunter ; Chelsea M. Blankenship ; Li Lin ; Nicholette Sloat ; Audrey Perdew ; Hannah Stewart ; David R. Moore
Année de publication :	2021
Article en page(s) :	p.29-41
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Déficience auditive ; Otoémission acoustique ; Wideband absorbance (WBA) Autres descripteurs Audiometrie hautes frequences
Résumé :	AB Objectives: This study tested the hypothesis that undetected peripheral hearing impairment occurs in children with idiopathic listening difficulties (LiDs), as reported by caregivers using the Evaluation of Children"s Listening and Processing Skills (ECLiPS) validated questionnaire, compared with children with typically developed (TD) listening abilities. Design: Children with LiD aged 6-14 years old (n = 60, mean age = 9.9 yr) and 54 typical age matched children were recruited from audiology clinical records and from IRB-approved advertisements at hospital locations and in the local and regional areas. Both groups completed standard and extended high-frequency (EHF) pure-tone audiometry, wideband absorbance tympanometry and middle ear muscle reflexes, distortion product and chirp transient evoked otoacoustic emissions. Univariate and multivariate mixed models and multiple regression analysis were used to examine group differences and continuous performance, as well as the influence of demographic factors and pressure equalization (PE) tube history. Results: There were no significant group differences between the LiD and TD groups for any of the auditory measures tested. However, analyses across all children showed that EHF hearing thresholds, wideband tympanometry, contralateral middle ear muscle reflexes, distortion product, and transient-evoked otoacoustic emissions were related to a history of PE tube surgery. The physiologic measures were also associated with EHF hearing loss, secondary to PE tube history. Conclusions: Overall, the results of this study in a sample of children with validated LiD compared with a TD group matched for age and sex showed no significant differences in peripheral function using highly sensitive auditory measures. Histories of PE tube surgery were significantly related to EHF hearing and to a range of physiologic measures in the combined sample.
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[article] Peripheral Auditory Involvement in Childhood Listening Difficulty : Moore, David R. [Article] / Lisa L. Hunter ; Chelsea M. Blankenship ; Li Lin ; Nicholette Sloat ; Audrey Perdew ; Hannah Stewart ; David R. Moore . - 2021 . - p.29-41.
Langues : Anglais (eng)
in Ear and hearing > Vol. 42, n°1 (Janvier-février) . - p.29-41

Descripteurs :	HE Vinci Déficience auditive ; Otoémission acoustique ; Wideband absorbance (WBA) Autres descripteurs Audiometrie hautes frequences
Résumé :	AB Objectives: This study tested the hypothesis that undetected peripheral hearing impairment occurs in children with idiopathic listening difficulties (LiDs), as reported by caregivers using the Evaluation of Children"s Listening and Processing Skills (ECLiPS) validated questionnaire, compared with children with typically developed (TD) listening abilities. Design: Children with LiD aged 6-14 years old (n = 60, mean age = 9.9 yr) and 54 typical age matched children were recruited from audiology clinical records and from IRB-approved advertisements at hospital locations and in the local and regional areas. Both groups completed standard and extended high-frequency (EHF) pure-tone audiometry, wideband absorbance tympanometry and middle ear muscle reflexes, distortion product and chirp transient evoked otoacoustic emissions. Univariate and multivariate mixed models and multiple regression analysis were used to examine group differences and continuous performance, as well as the influence of demographic factors and pressure equalization (PE) tube history. Results: There were no significant group differences between the LiD and TD groups for any of the auditory measures tested. However, analyses across all children showed that EHF hearing thresholds, wideband tympanometry, contralateral middle ear muscle reflexes, distortion product, and transient-evoked otoacoustic emissions were related to a history of PE tube surgery. The physiologic measures were also associated with EHF hearing loss, secondary to PE tube history. Conclusions: Overall, the results of this study in a sample of children with validated LiD compared with a TD group matched for age and sex showed no significant differences in peripheral function using highly sensitive auditory measures. Histories of PE tube surgery were significantly related to EHF hearing and to a range of physiologic measures in the combined sample.
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[article] 
inEar and hearing > Vol. 42, n°1 (Janvier-février) . - p. 42-52

Titre :	Better Hearing in Norway: A Comparison of Two HUNT Cohorts 20 Years Apart : Engdahl, Bo1; Strand, Bjorn Heine1; Aarhus, Lisa
Type de document :	Article
Auteurs :	Bo Engdahl ; Bjorn Heine Strand ; Lisa Aarhus
Année de publication :	2021
Article en page(s) :	p. 42-52
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Effet de cohorte ; Perte d'audition ; Prévalence ; Sujet âgé
Mots-clés :	ISO 7029
Résumé :	Objective: To obtain updated robust data on a age-specific prevalence of hearing loss in Norway and determine whether more recent birth cohorts have better hearing compared with earlier birth cohorts. Design: Cross-sectional analyzes of Norwegian representative demographic and audiometric data from the Nord-Trondelag Health Study (HUNT)-HUNT2 Hearing (1996-1998) and HUNT4 Hearing (2017-2019), with the following distribution: HUNT2 Hearing (N=50,277, 53% women, aged 20 to 101 years, mean = 50.1, standard deviation = 16.9); HUNT4 Hearing (N=28,339, 56% women, aged 19 to 100 years, mean = 53.2, standard deviation = 16.9). Pure-tone hearing thresholds were estimated using linear and quantile regressions with age and cohort as explanatory variables. Prevalences were estimated using logistic regression models for different severities of hearing loss averaged over 0.5, 1, 2, and 4 kHz in the better ear (BE PTA4). We also estimated prevalences at the population-level of Norway in 1997 and 2018. Results: Disabling hearing loss (BE PTA4 >= 35 dB) was less prevalent in the more recent born cohort at all ages in both men and women (p Conclusions: The age- and sex-specific prevalence of hearing impairment has decreased in Norway from 1996-1998 to 2017-2019
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[article] Better Hearing in Norway: A Comparison of Two HUNT Cohorts 20 Years Apart : Engdahl, Bo1; Strand, Bjorn Heine1; Aarhus, Lisa [Article] / Bo Engdahl ; Bjorn Heine Strand ; Lisa Aarhus . - 2021 . - p. 42-52.
Langues : Anglais (eng)
in Ear and hearing > Vol. 42, n°1 (Janvier-février) . - p. 42-52

Descripteurs :	HE Vinci Effet de cohorte ; Perte d'audition ; Prévalence ; Sujet âgé
Mots-clés :	ISO 7029
Résumé :	Objective: To obtain updated robust data on a age-specific prevalence of hearing loss in Norway and determine whether more recent birth cohorts have better hearing compared with earlier birth cohorts. Design: Cross-sectional analyzes of Norwegian representative demographic and audiometric data from the Nord-Trondelag Health Study (HUNT)-HUNT2 Hearing (1996-1998) and HUNT4 Hearing (2017-2019), with the following distribution: HUNT2 Hearing (N=50,277, 53% women, aged 20 to 101 years, mean = 50.1, standard deviation = 16.9); HUNT4 Hearing (N=28,339, 56% women, aged 19 to 100 years, mean = 53.2, standard deviation = 16.9). Pure-tone hearing thresholds were estimated using linear and quantile regressions with age and cohort as explanatory variables. Prevalences were estimated using logistic regression models for different severities of hearing loss averaged over 0.5, 1, 2, and 4 kHz in the better ear (BE PTA4). We also estimated prevalences at the population-level of Norway in 1997 and 2018. Results: Disabling hearing loss (BE PTA4 >= 35 dB) was less prevalent in the more recent born cohort at all ages in both men and women (p Conclusions: The age- and sex-specific prevalence of hearing impairment has decreased in Norway from 1996-1998 to 2017-2019
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[article] 
inEar and hearing > Vol. 42, n°1 (Janvier-février) . - p. 53-67

Titre :	Search for Electrophysiological Indices of Hidden Hearing Loss in Humans: Click Auditory Brainstem Response Across Sound Levels and in Background Noise
Type de document :	Article
Auteurs :	Chandan Suresh ; Ananthanarayan Krishnan
Année de publication :	2021
Article en page(s) :	p. 53-67
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Perte d'audition ; Potentiels évoqués auditifs du tronc cérébral (ABR) ; synaptopathie cochléaire
Résumé :	Objectives: Recent studies in animals indicate that even moderate levels of exposure to noise can damage synaptic ribbons between the inner hair cells and auditory nerve fibers without affecting audiometric thresholds, giving rise to the use of the term "hidden hearing loss" (HHL). Despite evidence across several animal species, there is little consistent evidence for HHL in humans. The aim of the study is to evaluate potential electrophysiological changes specific to individuals at risk for HHL. Design: Participants forming the high-risk experimental group consisted of 28 young normal-hearing adults who participated in marching band for at least 5 years. Twenty-eight age-matched normal-hearing adults who were not part of the marching band and had little or no history of recreational or occupational exposure to loud sounds formed the low-risk control group. Measurements included pure tone audiometry of conventional and high frequencies, distortion product otoacoustic emissions, and electrophysiological measures of auditory nerve and brainstem function as reflected in the click-evoked auditory brainstem response (ABR). In experiment 1, ABRs were recorded in a quiet background across stimulus levels (30-90 dB nHL) presented in 10 dB steps. In experiment 2, the ABR was elicited by a 70 dB nHL click stimulus presented in a quiet background, and in the presence of simultaneous ipsilateral continuous broadband noise presented at 50, 60, and 70 dB SPL using an insert earphone (Etymotic, ER2). Results: There were no differences between the low- and high-risk groups in audiometric thresholds or distortion product otoacoustic emission amplitude. Experiment 1 demonstrated smaller wave-I amplitudes at moderate and high sound levels for high-risk compared to low-risk group with similar wave III and wave V amplitude. Enhanced amplitude ratio V/I, particularly at moderate sound level (60 dB nHL), suggesting central compensation for reduced input from the periphery for high-risk group. The results of experiment 2 show that the decrease in wave I amplitude with increasing background noise level was relatively smaller for the high-risk compared to the low-risk group. However, wave V amplitude reduction was essentially similar for both groups. These results suggest that masking induced wave I amplitude reduction is smaller in individuals at high risk for cochlear synaptopathy. Unlike previous studies, we did not observe a difference in the noise-induced wave V latency shift between low- and high-risk groups. Conclusions: Results of experiment 1 are consistent with findings in both animal studies (that suggest cochlear synaptopathy involving selective damage of low-spontaneous rate and medium-spontaneous rate fibers), and in several human studies that show changes in a range of ABR metrics that suggest the presence of cochlear synaptopathy. However, without postmortem examination by harvesting human temporal bone (the gold standard for identifying synaptopathy) with different noise exposure background, no direct inferences can be derived for the presence/extent of cochlear synaptopathy in high-risk group with high sound over-exposure history. Results of experiment 2 demonstrate that to the extent response amplitude reflects both the number of neural elements responding and the neural synchrony of the responding elements, the relatively smaller change in response amplitude for the high-risk group would suggest a reduced susceptibility to masking. One plausible mechanism would be that suppressive effects that kick in at moderate to high levels are different in these two groups, particularly at moderate levels of the masking noise. Altogether, a larger scale dataset with different noise exposure background, longitudinal measurements (changes due to recreational over-exposure by studying middle-school to high-school students enrolled in marching band) with an array of behavioral and electrophysiological tests are needed to understand the complex pathogenesis of sound over-exposure damage in normal-hearing individuals.
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[article] Search for Electrophysiological Indices of Hidden Hearing Loss in Humans: Click Auditory Brainstem Response Across Sound Levels and in Background Noise [Article] / Chandan Suresh ; Ananthanarayan Krishnan . - 2021 . - p. 53-67.
Langues : Anglais (eng)
in Ear and hearing > Vol. 42, n°1 (Janvier-février) . - p. 53-67

Descripteurs :	HE Vinci Perte d'audition ; Potentiels évoqués auditifs du tronc cérébral (ABR) ; synaptopathie cochléaire
Résumé :	Objectives: Recent studies in animals indicate that even moderate levels of exposure to noise can damage synaptic ribbons between the inner hair cells and auditory nerve fibers without affecting audiometric thresholds, giving rise to the use of the term "hidden hearing loss" (HHL). Despite evidence across several animal species, there is little consistent evidence for HHL in humans. The aim of the study is to evaluate potential electrophysiological changes specific to individuals at risk for HHL. Design: Participants forming the high-risk experimental group consisted of 28 young normal-hearing adults who participated in marching band for at least 5 years. Twenty-eight age-matched normal-hearing adults who were not part of the marching band and had little or no history of recreational or occupational exposure to loud sounds formed the low-risk control group. Measurements included pure tone audiometry of conventional and high frequencies, distortion product otoacoustic emissions, and electrophysiological measures of auditory nerve and brainstem function as reflected in the click-evoked auditory brainstem response (ABR). In experiment 1, ABRs were recorded in a quiet background across stimulus levels (30-90 dB nHL) presented in 10 dB steps. In experiment 2, the ABR was elicited by a 70 dB nHL click stimulus presented in a quiet background, and in the presence of simultaneous ipsilateral continuous broadband noise presented at 50, 60, and 70 dB SPL using an insert earphone (Etymotic, ER2). Results: There were no differences between the low- and high-risk groups in audiometric thresholds or distortion product otoacoustic emission amplitude. Experiment 1 demonstrated smaller wave-I amplitudes at moderate and high sound levels for high-risk compared to low-risk group with similar wave III and wave V amplitude. Enhanced amplitude ratio V/I, particularly at moderate sound level (60 dB nHL), suggesting central compensation for reduced input from the periphery for high-risk group. The results of experiment 2 show that the decrease in wave I amplitude with increasing background noise level was relatively smaller for the high-risk compared to the low-risk group. However, wave V amplitude reduction was essentially similar for both groups. These results suggest that masking induced wave I amplitude reduction is smaller in individuals at high risk for cochlear synaptopathy. Unlike previous studies, we did not observe a difference in the noise-induced wave V latency shift between low- and high-risk groups. Conclusions: Results of experiment 1 are consistent with findings in both animal studies (that suggest cochlear synaptopathy involving selective damage of low-spontaneous rate and medium-spontaneous rate fibers), and in several human studies that show changes in a range of ABR metrics that suggest the presence of cochlear synaptopathy. However, without postmortem examination by harvesting human temporal bone (the gold standard for identifying synaptopathy) with different noise exposure background, no direct inferences can be derived for the presence/extent of cochlear synaptopathy in high-risk group with high sound over-exposure history. Results of experiment 2 demonstrate that to the extent response amplitude reflects both the number of neural elements responding and the neural synchrony of the responding elements, the relatively smaller change in response amplitude for the high-risk group would suggest a reduced susceptibility to masking. One plausible mechanism would be that suppressive effects that kick in at moderate to high levels are different in these two groups, particularly at moderate levels of the masking noise. Altogether, a larger scale dataset with different noise exposure background, longitudinal measurements (changes due to recreational over-exposure by studying middle-school to high-school students enrolled in marching band) with an array of behavioral and electrophysiological tests are needed to understand the complex pathogenesis of sound over-exposure damage in normal-hearing individuals.
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[article] 
inEar and hearing > Vol. 42, n°1 (Janvier-février) . - p. 68-75

Titre :	Selection Criteria for Cochlear Implantation in the United Kingdom and Flanders: Toward a Less Restrictive Standard
Type de document :	Article
Auteurs :	Tirza F.K. van der Straaten ; Jeroen J. Briaire ; Deborah A. Vickers ; Peter Paul B.M. Boermans ; Johan H.M. Frijns
Année de publication :	2021
Article en page(s) :	p. 68-75
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Implants cochléaires ; Surdité Autres descripteurs Critere d'implantation
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[article] Selection Criteria for Cochlear Implantation in the United Kingdom and Flanders: Toward a Less Restrictive Standard [Article] / Tirza F.K. van der Straaten ; Jeroen J. Briaire ; Deborah A. Vickers ; Peter Paul B.M. Boermans ; Johan H.M. Frijns . - 2021 . - p. 68-75.
Langues : Anglais (eng)
in Ear and hearing > Vol. 42, n°1 (Janvier-février) . - p. 68-75

Descripteurs :	HE Vinci Implants cochléaires ; Surdité Autres descripteurs Critere d'implantation
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[article] 
inEar and hearing > Vol. 42, n°1 (Janvier-février) . - p. 76-86

Titre :	Vestibular Function in Children With a Congenital Cytomegalovirus Infection: 3 Years of Follow-Up
Type de document :	Article
Auteurs :	Cleo Dhondt ; Leen Maes ; Lotte Rombaut ; Sarie Martens ; Saartje Vanaudenaerde ; Helen Van Hoecke ; Els De Leenheer ; Ingeborg Dhooge
Année de publication :	2021
Article en page(s) :	p. 76-86
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Audiologie pédiatrique ; Cytomegalovirus ; Vestibulométrie
Résumé :	Objectives: Congenital cytomegalovirus (cCMV) infection is the most common nongenetic cause of sensorineural hearing loss in children. Due to the close anatomical relationship between the auditory and the vestibular sensory organs, cCMV can also be an important cause of vestibular loss. However, the prevalence and nature of cCMV-induced vestibular impairment is still underexplored. The aim of this study was to investigate the occurrence and characteristics of vestibular loss in a large group of cCMV-infected children, representative of the overall cCMV-population. Design: Ninety-three children (41 boys, 52 girls) with a confirmed diagnosis of cCMV were enrolled in this prospective longitudinal study. They were born at the Ghent University Hospital or referred from another hospital for multidisciplinary follow-up in the context of cCMV. The test protocol consisted of regular vestibular follow-up around the ages of 6 months, 1 year, 2 years, and 3 years with the video Head Impulse Test, the rotatory test, and the cervical Vestibular Evoked Myogenic Potential test. Results: On average, the 93 patients (52 asymptomatic, 41 symptomatic) were followed for 10.2 months (SD: 10.1 mo) and had 2.2 examinations (SD: 1.1). Seventeen (18%) patients had sensorineural hearing loss (7 unilateral, 10 bilateral). Vestibular loss was detected in 13 (14%) patients (7 unilateral, 6 bilateral). There was a significant association between the occurrence of hearing loss and the presence of vestibular loss (p Conclusions: cCMV can impair not only the auditory but also the vestibular function. Similar to the hearing loss, vestibular loss in cCMV can be highly variable. It can be unilateral or bilateral, limited or extensive, stable or progressive, and early or delayed in onset. As the vestibular function can deteriorate over time and even normal-hearing subjects can be affected, vestibular evaluation should be part of the standard otolaryngology follow-up in all children with cCMV.
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[article] Vestibular Function in Children With a Congenital Cytomegalovirus Infection: 3 Years of Follow-Up [Article] / Cleo Dhondt ; Leen Maes ; Lotte Rombaut ; Sarie Martens ; Saartje Vanaudenaerde ; Helen Van Hoecke ; Els De Leenheer ; Ingeborg Dhooge . - 2021 . - p. 76-86.
Langues : Anglais (eng)
in Ear and hearing > Vol. 42, n°1 (Janvier-février) . - p. 76-86

Descripteurs :	HE Vinci Audiologie pédiatrique ; Cytomegalovirus ; Vestibulométrie
Résumé :	Objectives: Congenital cytomegalovirus (cCMV) infection is the most common nongenetic cause of sensorineural hearing loss in children. Due to the close anatomical relationship between the auditory and the vestibular sensory organs, cCMV can also be an important cause of vestibular loss. However, the prevalence and nature of cCMV-induced vestibular impairment is still underexplored. The aim of this study was to investigate the occurrence and characteristics of vestibular loss in a large group of cCMV-infected children, representative of the overall cCMV-population. Design: Ninety-three children (41 boys, 52 girls) with a confirmed diagnosis of cCMV were enrolled in this prospective longitudinal study. They were born at the Ghent University Hospital or referred from another hospital for multidisciplinary follow-up in the context of cCMV. The test protocol consisted of regular vestibular follow-up around the ages of 6 months, 1 year, 2 years, and 3 years with the video Head Impulse Test, the rotatory test, and the cervical Vestibular Evoked Myogenic Potential test. Results: On average, the 93 patients (52 asymptomatic, 41 symptomatic) were followed for 10.2 months (SD: 10.1 mo) and had 2.2 examinations (SD: 1.1). Seventeen (18%) patients had sensorineural hearing loss (7 unilateral, 10 bilateral). Vestibular loss was detected in 13 (14%) patients (7 unilateral, 6 bilateral). There was a significant association between the occurrence of hearing loss and the presence of vestibular loss (p Conclusions: cCMV can impair not only the auditory but also the vestibular function. Similar to the hearing loss, vestibular loss in cCMV can be highly variable. It can be unilateral or bilateral, limited or extensive, stable or progressive, and early or delayed in onset. As the vestibular function can deteriorate over time and even normal-hearing subjects can be affected, vestibular evaluation should be part of the standard otolaryngology follow-up in all children with cCMV.
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[article] 
inEar and hearing > Vol. 41, n°4 (Juillet-aout 2020) . - p. 705-719

Titre :	Audiovisual Enhancement of Speech Perception in Noise by School-Age Children Who Are Hard of Hearing
Type de document :	Article
Auteurs :	Kaylah Lalonde ; Ryan W. McCreery
Année de publication :	2020
Article en page(s) :	p. 705-719
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Attention auditive ; Déficience auditive ; Fonction exécutive ; Mémoire à court terme ; Perception de la parole Autres descripteurs Perception audiovisuelle
Résumé :	Objectives: The purpose of this study was to examine age- and hearing-related differences in school-age children's benefit from visual speech cues. The study addressed three questions: (1) Do age and hearing loss affect degree of audiovisual (AV) speech enhancement in school-age children? (2) Are there age- and hearing-related differences in the mechanisms underlying AV speech enhancement in school-age children? (3) What cognitive and linguistic variables predict individual differences in AV benefit among school-age children? Design: Forty-eight children between 6 and 13 years of age (19 with mild to severe sensorineural hearing loss; 29 with normal hearing) and 14 adults with normal hearing completed measures of auditory and AV syllable detection and/or sentence recognition in a two-talker masker type and a spectrally matched noise. Children also completed standardized behavioral measures of receptive vocabulary, visuospatial working memory, and executive attention. Mixed linear modeling was used to examine effects of modality, listener group, and masker on sentence recognition accuracy and syllable detection thresholds. Pearson correlations were used to examine the relationship between individual differences in children's AV enhancement (AV-auditory-only) and age, vocabulary, working memory, executive attention, and degree of hearing loss. Results: Significant AV enhancement was observed across all tasks, masker types, and listener groups. AV enhancement of sentence recognition was similar across maskers, but children with normal hearing exhibited less AV enhancement of sentence recognition than adults with normal hearing and children with hearing loss. AV enhancement of syllable detection was greater in the two-talker masker than the noise masker, but did not vary significantly across listener groups. Degree of hearing loss positively correlated with individual differences in AV benefit on the sentence recognition task in noise, but not on the detection task. None of the cognitive and linguistic variables correlated with individual differences in AV enhancement of syllable detection or sentence recognition. Conclusions: Although AV benefit to syllable detection results from the use of visual speech to increase temporal expectancy, AV benefit to sentence recognition requires that an observer extracts phonetic information from the visual speech signal. The findings from this study suggest that all listener groups were equally good at using temporal cues in visual speech to detect auditory speech, but that adults with normal hearing and children with hearing loss were better than children with normal hearing at extracting phonetic information from the visual signal and/or using visual speech information to access phonetic/lexical representations in long-term memory. These results suggest that standard, auditory-only clinical speech recognition measures likely underestimate real-world speech recognition skills of children with mild to severe hearing loss.
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[article] Audiovisual Enhancement of Speech Perception in Noise by School-Age Children Who Are Hard of Hearing [Article] / Kaylah Lalonde ; Ryan W. McCreery . - 2020 . - p. 705-719.
Langues : Anglais (eng)
in Ear and hearing > Vol. 41, n°4 (Juillet-aout 2020) . - p. 705-719

Descripteurs :	HE Vinci Attention auditive ; Déficience auditive ; Fonction exécutive ; Mémoire à court terme ; Perception de la parole Autres descripteurs Perception audiovisuelle
Résumé :	Objectives: The purpose of this study was to examine age- and hearing-related differences in school-age children's benefit from visual speech cues. The study addressed three questions: (1) Do age and hearing loss affect degree of audiovisual (AV) speech enhancement in school-age children? (2) Are there age- and hearing-related differences in the mechanisms underlying AV speech enhancement in school-age children? (3) What cognitive and linguistic variables predict individual differences in AV benefit among school-age children? Design: Forty-eight children between 6 and 13 years of age (19 with mild to severe sensorineural hearing loss; 29 with normal hearing) and 14 adults with normal hearing completed measures of auditory and AV syllable detection and/or sentence recognition in a two-talker masker type and a spectrally matched noise. Children also completed standardized behavioral measures of receptive vocabulary, visuospatial working memory, and executive attention. Mixed linear modeling was used to examine effects of modality, listener group, and masker on sentence recognition accuracy and syllable detection thresholds. Pearson correlations were used to examine the relationship between individual differences in children's AV enhancement (AV-auditory-only) and age, vocabulary, working memory, executive attention, and degree of hearing loss. Results: Significant AV enhancement was observed across all tasks, masker types, and listener groups. AV enhancement of sentence recognition was similar across maskers, but children with normal hearing exhibited less AV enhancement of sentence recognition than adults with normal hearing and children with hearing loss. AV enhancement of syllable detection was greater in the two-talker masker than the noise masker, but did not vary significantly across listener groups. Degree of hearing loss positively correlated with individual differences in AV benefit on the sentence recognition task in noise, but not on the detection task. None of the cognitive and linguistic variables correlated with individual differences in AV enhancement of syllable detection or sentence recognition. Conclusions: Although AV benefit to syllable detection results from the use of visual speech to increase temporal expectancy, AV benefit to sentence recognition requires that an observer extracts phonetic information from the visual speech signal. The findings from this study suggest that all listener groups were equally good at using temporal cues in visual speech to detect auditory speech, but that adults with normal hearing and children with hearing loss were better than children with normal hearing at extracting phonetic information from the visual signal and/or using visual speech information to access phonetic/lexical representations in long-term memory. These results suggest that standard, auditory-only clinical speech recognition measures likely underestimate real-world speech recognition skills of children with mild to severe hearing loss.
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[article] 
inEar and hearing > Vol. 41, n°4 (Juillet-aout 2020) . - p. 720-732

Titre :	Minimal and Mild Hearing Loss in Children: Association with Auditory Perception, Cognition, and Communication Problems
Type de document :	Article
Auteurs :	David R. Moore ; Oliver Zobay ; Melanie A. Ferguson
Année de publication :	2020
Article en page(s) :	p. 720-732
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Déficience auditive ; Enfant (6-12 ans) ; Trouble d'apprentissage du langage ; Troubles de la communication Autres descripteurs Developpement auditif ; Parole dans le bruit
Résumé :	Objectives: "Minimal" and "mild" hearing loss are the most common but least understood forms of hearing loss in children. Children with better ear hearing level as low as 30 dB HL have a global language impairment and, according to the World Health Organization, a "disabling level of hearing loss." We examined in a population of 6- to 11-year-olds how hearing level Design: School children (n = 1638) were recruited in 4 centers across the United Kingdom. They completed a battery of hearing (audiometry, filter width, temporal envelope, speech-in-noise) and cognitive (IQ, attention, verbal memory, receptive language, reading) tests. Caregivers assessed their children's communication and listening skills. Children included in this study (702 male; 752 female) had 4 reliable tone thresholds (1, 4 kHz each ear), and no caregiver reported medical or intellectual disorder. Normal-hearing children (n = 1124, 77.1%) had all 4 thresholds and PTA =15 dB HL for at least 1 threshold, and PTA =10 dB) was found in 28.9% of those with minimal and 39.8% of those with mild hearing loss. Results: Speech perception in noise, indexed by vowel-consonant-vowel pseudoword repetition in speech-modulated noise, was impaired in children with minimal and mild hearing loss, relative to normal-hearing children. Effect size was largest (d = 0.63) in asymmetric mild hearing loss and smallest (d = 0.21) in symmetric minimal hearing loss. Spectral (filter width) and temporal (backward masking) perceptions were impaired in children with both forms of hearing loss, but suprathreshold perception generally related only weakly to PTA. Speech-in-noise (nonsense syllables) and language (pseudoword repetition) were also impaired in both forms of hearing loss and correlated more strongly with PTA. Children with mild hearing loss were additionally impaired in working memory (digit span) and reading, and generally performed more poorly than those with minimal loss. Asymmetric hearing loss produced as much impairment overall on both auditory and cognitive tasks as symmetric hearing loss. Nonverbal IQ, attention, and caregiver-rated listening and communication were not significantly impaired in children with hearing loss. Modeling suggested that 15 dB HL is objectively an appropriate lower audibility limit for diagnosis of hearing loss. Conclusions: Hearing loss between 15 and 30 dB PTA is, at ~20%, much more prevalent in 6- to 11-year-old children than most current estimates. Key aspects of auditory and cognitive skills are impaired in both symmetric and asymmetric minimal and mild hearing loss. Hearing loss
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[article] Minimal and Mild Hearing Loss in Children: Association with Auditory Perception, Cognition, and Communication Problems [Article] / David R. Moore ; Oliver Zobay ; Melanie A. Ferguson . - 2020 . - p. 720-732.
Langues : Anglais (eng)
in Ear and hearing > Vol. 41, n°4 (Juillet-aout 2020) . - p. 720-732

Descripteurs :	HE Vinci Déficience auditive ; Enfant (6-12 ans) ; Trouble d'apprentissage du langage ; Troubles de la communication Autres descripteurs Developpement auditif ; Parole dans le bruit
Résumé :	Objectives: "Minimal" and "mild" hearing loss are the most common but least understood forms of hearing loss in children. Children with better ear hearing level as low as 30 dB HL have a global language impairment and, according to the World Health Organization, a "disabling level of hearing loss." We examined in a population of 6- to 11-year-olds how hearing level Design: School children (n = 1638) were recruited in 4 centers across the United Kingdom. They completed a battery of hearing (audiometry, filter width, temporal envelope, speech-in-noise) and cognitive (IQ, attention, verbal memory, receptive language, reading) tests. Caregivers assessed their children's communication and listening skills. Children included in this study (702 male; 752 female) had 4 reliable tone thresholds (1, 4 kHz each ear), and no caregiver reported medical or intellectual disorder. Normal-hearing children (n = 1124, 77.1%) had all 4 thresholds and PTA =15 dB HL for at least 1 threshold, and PTA =10 dB) was found in 28.9% of those with minimal and 39.8% of those with mild hearing loss. Results: Speech perception in noise, indexed by vowel-consonant-vowel pseudoword repetition in speech-modulated noise, was impaired in children with minimal and mild hearing loss, relative to normal-hearing children. Effect size was largest (d = 0.63) in asymmetric mild hearing loss and smallest (d = 0.21) in symmetric minimal hearing loss. Spectral (filter width) and temporal (backward masking) perceptions were impaired in children with both forms of hearing loss, but suprathreshold perception generally related only weakly to PTA. Speech-in-noise (nonsense syllables) and language (pseudoword repetition) were also impaired in both forms of hearing loss and correlated more strongly with PTA. Children with mild hearing loss were additionally impaired in working memory (digit span) and reading, and generally performed more poorly than those with minimal loss. Asymmetric hearing loss produced as much impairment overall on both auditory and cognitive tasks as symmetric hearing loss. Nonverbal IQ, attention, and caregiver-rated listening and communication were not significantly impaired in children with hearing loss. Modeling suggested that 15 dB HL is objectively an appropriate lower audibility limit for diagnosis of hearing loss. Conclusions: Hearing loss between 15 and 30 dB PTA is, at ~20%, much more prevalent in 6- to 11-year-old children than most current estimates. Key aspects of auditory and cognitive skills are impaired in both symmetric and asymmetric minimal and mild hearing loss. Hearing loss
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[article] 
inEar and hearing > Vol. 41, n°4 (Juillet-aout 2020) . - p. 733-746

Titre :	Cochlear Implant Data Logs Predict Children's Receptive Vocabulary
Type de document :	Article
Auteurs :	Tobias Busch ; Anneke Vermeulen ; Margreet Langereis ; Filiep J. Vanpoucke ; Astrid van Wieringen
Année de publication :	2020
Article en page(s) :	p. 733-746
Langues :	Anglais (eng)
Descripteurs :	Autres descripteurs Developpement de la parole ; Environnement sonore HE Vinci Acquisition du vocabulaire ; Implants cochléaires ; OBSERVATION DE L'ENFANT
Résumé :	Objectives: The data logs of Cochlear Nucleus cochlear implant (CI) sound processors show large interindividual variation in children's daily CI use and auditory environments. This study explored whether these differences are associated with differences in the receptive vocabulary of young implanted children. Design: Data of 52 prelingually deaf children, who had received a CI before 3 years of age, were obtained from their clinical records. In total, 73 Peabody Picture Vocabulary tests and CI data logs for 1 year preceding each test were collected. The data logs were used to determine the children's average daily amount of CI use and exposure to speech, speech in noise, noise, music, and quiet. In addition, information was collected about other potential predictors of language abilities, namely gender, age, age at implantation, etiology of deafness, educational placement, and implantation mode (unilateral, bilateral). Model selection with Akaike's information criterion was used to determine which data-logging metrics, other variables, and combinations of both best predict receptive vocabulary scores. Results: The data showed a strong positive association between receptive vocabulary and daily CI use, and a negative association between receptive vocabulary and daily exposure to music. Associations with the data logs' speech and noise metrics were less clear. The most important other variable was educational placement. The best model performance was achieved when data logs and other information were combined. Conclusions: The results emphasize the importance of consistent CI use and a rich auditory environment for the early language development of young CI users. The study also shows that CI data logs capture information about children's environment and CI use that are related to language performance and can help to detect and address problems and improve the auditory rehabilitation after cochlear implantation.
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[article] Cochlear Implant Data Logs Predict Children's Receptive Vocabulary [Article] / Tobias Busch ; Anneke Vermeulen ; Margreet Langereis ; Filiep J. Vanpoucke ; Astrid van Wieringen . - 2020 . - p. 733-746.
Langues : Anglais (eng)
in Ear and hearing > Vol. 41, n°4 (Juillet-aout 2020) . - p. 733-746

Descripteurs :	Autres descripteurs Developpement de la parole ; Environnement sonore HE Vinci Acquisition du vocabulaire ; Implants cochléaires ; OBSERVATION DE L'ENFANT
Résumé :	Objectives: The data logs of Cochlear Nucleus cochlear implant (CI) sound processors show large interindividual variation in children's daily CI use and auditory environments. This study explored whether these differences are associated with differences in the receptive vocabulary of young implanted children. Design: Data of 52 prelingually deaf children, who had received a CI before 3 years of age, were obtained from their clinical records. In total, 73 Peabody Picture Vocabulary tests and CI data logs for 1 year preceding each test were collected. The data logs were used to determine the children's average daily amount of CI use and exposure to speech, speech in noise, noise, music, and quiet. In addition, information was collected about other potential predictors of language abilities, namely gender, age, age at implantation, etiology of deafness, educational placement, and implantation mode (unilateral, bilateral). Model selection with Akaike's information criterion was used to determine which data-logging metrics, other variables, and combinations of both best predict receptive vocabulary scores. Results: The data showed a strong positive association between receptive vocabulary and daily CI use, and a negative association between receptive vocabulary and daily exposure to music. Associations with the data logs' speech and noise metrics were less clear. The most important other variable was educational placement. The best model performance was achieved when data logs and other information were combined. Conclusions: The results emphasize the importance of consistent CI use and a rich auditory environment for the early language development of young CI users. The study also shows that CI data logs capture information about children's environment and CI use that are related to language performance and can help to detect and address problems and improve the auditory rehabilitation after cochlear implantation.
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[article] 
inEar and hearing > Vol. 41, n°4 (Juillet-aout 2020) . - p. 747-761

Titre :	Acoustic Hearing Can Interfere With Single-Sided Deafness Cochlear-Implant Speech Perception
Type de document :	Article
Auteurs :	Joshua G. W. Bernstein ; Olga A. Stakhovskaya ; Kenneth Kragh Jensen ; Matthew J. Goupell
Année de publication :	2020
Article en page(s) :	p. 747-761
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Implants cochléaires ; Masquage ; Perte auditive unilatérale (USNHL) ; Sujet âgé Autres descripteurs Appareillage asymetrique ; Attention selective ; Audition binaurale
Résumé :	Objectives: Cochlear implants (CIs) restore some spatial advantages for speech understanding in noise to individuals with single-sided deafness (SSD). In addition to a head-shadow advantage when the CI ear has a better signal-to-noise ratio, a CI can also provide a binaural advantage in certain situations, facilitating the perceptual separation of spatially separated concurrent voices. While some bilateral-CI listeners show a similar binaural advantage, bilateral-CI listeners with relatively large asymmetries in monaural speech understanding can instead experience contralateral speech interference. Based on the interference previously observed for asymmetric bilateral-CI listeners, this study tested the hypothesis that in a multiple-talker situation, the acoustic ear would interfere with rather than improve CI speech understanding for SSD-CI listeners. Design: Experiment 1 measured CI-ear speech understanding in the presence of competing speech or noise for 13 SSD-CI listeners. Target speech from the closed-set coordinate response-measure corpus was presented to the CI ear along with one same-gender competing talker or stationary noise at target-to-masker ratios between -8 and 20 dB. The acoustic ear was presented with silence (monaural condition) or with a copy of the competing speech or noise (bilateral condition). Experiment 2 tested a subset of 6 listeners in the reverse configuration for which SSD-CI listeners have previously shown a binaural benefit (target and competing speech presented to the acoustic ear; silence or competing speech presented to the CI ear). Experiment 3 examined the possible influence of a methodological difference between experiments 1 and 2: whether the competing talker spoke keywords that were inside or outside the response set. For each experiment, the data were analyzed using repeated-measures logistic regression. For experiment 1, a correlation analysis compared the difference between bilateral and monaural speech-understanding scores to several listener-specific factors: speech understanding in the CI ear, preimplantation duration of deafness, duration of CI experience, ear of deafness (left/right), acoustic-ear audiometric thresholds, and listener age. Results: In experiment 1, presenting a copy of the competing speech to the acoustic ear reduced CI speech-understanding scores for target-to-masker ratios >=4 dB. This interference effect was limited to competing-speech conditions and was not observed for a noise masker. There was dramatic intersubject variability in the magnitude of the interference (range: 1 to 43 rationalized arcsine units), which was found to be significantly correlated with listener age. The interference effect contrasted sharply with the reverse configuration (experiment 2), whereby presenting a copy of the competing speech to the contralateral CI ear significantly improved performance relative to monaural acoustic-ear performance. Keyword condition (experiment 3) did not influence the observed pattern of interference. Conclusions: Most SSD-CI listeners experienced interference when they attended to the CI ear and competing speech was added to the acoustic ear, although there was a large amount of intersubject variability in the magnitude of the effect, with older listeners particularly susceptible to interference. While further research is needed to investigate these effects under free-field listening conditions, these results suggest that for certain spatial configurations in a multiple-talker situation, contralateral speech interference could reduce the benefit that an SSD-CI otherwise provides.
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[article] Acoustic Hearing Can Interfere With Single-Sided Deafness Cochlear-Implant Speech Perception [Article] / Joshua G. W. Bernstein ; Olga A. Stakhovskaya ; Kenneth Kragh Jensen ; Matthew J. Goupell . - 2020 . - p. 747-761.
Langues : Anglais (eng)
in Ear and hearing > Vol. 41, n°4 (Juillet-aout 2020) . - p. 747-761

Descripteurs :	HE Vinci Implants cochléaires ; Masquage ; Perte auditive unilatérale (USNHL) ; Sujet âgé Autres descripteurs Appareillage asymetrique ; Attention selective ; Audition binaurale
Résumé :	Objectives: Cochlear implants (CIs) restore some spatial advantages for speech understanding in noise to individuals with single-sided deafness (SSD). In addition to a head-shadow advantage when the CI ear has a better signal-to-noise ratio, a CI can also provide a binaural advantage in certain situations, facilitating the perceptual separation of spatially separated concurrent voices. While some bilateral-CI listeners show a similar binaural advantage, bilateral-CI listeners with relatively large asymmetries in monaural speech understanding can instead experience contralateral speech interference. Based on the interference previously observed for asymmetric bilateral-CI listeners, this study tested the hypothesis that in a multiple-talker situation, the acoustic ear would interfere with rather than improve CI speech understanding for SSD-CI listeners. Design: Experiment 1 measured CI-ear speech understanding in the presence of competing speech or noise for 13 SSD-CI listeners. Target speech from the closed-set coordinate response-measure corpus was presented to the CI ear along with one same-gender competing talker or stationary noise at target-to-masker ratios between -8 and 20 dB. The acoustic ear was presented with silence (monaural condition) or with a copy of the competing speech or noise (bilateral condition). Experiment 2 tested a subset of 6 listeners in the reverse configuration for which SSD-CI listeners have previously shown a binaural benefit (target and competing speech presented to the acoustic ear; silence or competing speech presented to the CI ear). Experiment 3 examined the possible influence of a methodological difference between experiments 1 and 2: whether the competing talker spoke keywords that were inside or outside the response set. For each experiment, the data were analyzed using repeated-measures logistic regression. For experiment 1, a correlation analysis compared the difference between bilateral and monaural speech-understanding scores to several listener-specific factors: speech understanding in the CI ear, preimplantation duration of deafness, duration of CI experience, ear of deafness (left/right), acoustic-ear audiometric thresholds, and listener age. Results: In experiment 1, presenting a copy of the competing speech to the acoustic ear reduced CI speech-understanding scores for target-to-masker ratios >=4 dB. This interference effect was limited to competing-speech conditions and was not observed for a noise masker. There was dramatic intersubject variability in the magnitude of the interference (range: 1 to 43 rationalized arcsine units), which was found to be significantly correlated with listener age. The interference effect contrasted sharply with the reverse configuration (experiment 2), whereby presenting a copy of the competing speech to the contralateral CI ear significantly improved performance relative to monaural acoustic-ear performance. Keyword condition (experiment 3) did not influence the observed pattern of interference. Conclusions: Most SSD-CI listeners experienced interference when they attended to the CI ear and competing speech was added to the acoustic ear, although there was a large amount of intersubject variability in the magnitude of the effect, with older listeners particularly susceptible to interference. While further research is needed to investigate these effects under free-field listening conditions, these results suggest that for certain spatial configurations in a multiple-talker situation, contralateral speech interference could reduce the benefit that an SSD-CI otherwise provides.
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[article] 
inEar and hearing > Vol. 41, n°4 (Juillet-aout 2020) . - p. 762-774

Titre :	Family Environment in Children With Hearing Aids and Cochlear Implants: Associations With Spoken Language, Psychosocial Functioning, and Cognitive Development
Type de document :	Article
Auteurs :	Rachel Frush Holt ; Jessica Beer ; William Kronenberger ; David B. Pisoni ; Kaylah Lalonde ; Lindsay Mulinaro
Année de publication :	2020
Article en page(s) :	p. 762-774
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Aide auditive ; Développement du langage ; Environnement familial ; Fonction exécutive ; Implants cochléaires
Résumé :	Objectives: To examine differences in family environment and associations between family environment and key speech, language, and cognitive outcomes in samples of children with normal hearing and deaf and hard-of-hearing (DHH) children who use hearing aids and cochlear implants. Design: Thirty families of children with normal hearing (n = 10), hearing aids (n = 10), or cochlear implants (n = 10) completed questionnaires evaluating executive function, social skills, and problem behaviors. Children's language and receptive vocabulary were evaluated using standardized measures in the children's homes. In addition, families were administered a standardized in-home questionnaire and observational assessment regarding the home environment. Results: Family environment overall was similar across hearing level and sensory aid, although some differences were found on parental responsivity and physical environment. The level of supportiveness and enrichment within family relationships accounted for much of the relations between family environment and the psychosocial and neurocognitive development of DHH children. In contrast, the availability of objects and experiences to stimulate learning in the home was related to the development of spoken language. Conclusions: Whereas broad characteristics of the family environments of DHH children may not differ from those of hearing children, variability in family functioning is related to DHH children's at-risk speech, language, and cognitive outcomes. Results support the importance of further research to clarify and explain these relations, which might suggest novel methods and targets of family-based interventions to improve developmental outcomes.
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[article] Family Environment in Children With Hearing Aids and Cochlear Implants: Associations With Spoken Language, Psychosocial Functioning, and Cognitive Development [Article] / Rachel Frush Holt ; Jessica Beer ; William Kronenberger ; David B. Pisoni ; Kaylah Lalonde ; Lindsay Mulinaro . - 2020 . - p. 762-774.
Langues : Anglais (eng)
in Ear and hearing > Vol. 41, n°4 (Juillet-aout 2020) . - p. 762-774

Descripteurs :	HE Vinci Aide auditive ; Développement du langage ; Environnement familial ; Fonction exécutive ; Implants cochléaires
Résumé :	Objectives: To examine differences in family environment and associations between family environment and key speech, language, and cognitive outcomes in samples of children with normal hearing and deaf and hard-of-hearing (DHH) children who use hearing aids and cochlear implants. Design: Thirty families of children with normal hearing (n = 10), hearing aids (n = 10), or cochlear implants (n = 10) completed questionnaires evaluating executive function, social skills, and problem behaviors. Children's language and receptive vocabulary were evaluated using standardized measures in the children's homes. In addition, families were administered a standardized in-home questionnaire and observational assessment regarding the home environment. Results: Family environment overall was similar across hearing level and sensory aid, although some differences were found on parental responsivity and physical environment. The level of supportiveness and enrichment within family relationships accounted for much of the relations between family environment and the psychosocial and neurocognitive development of DHH children. In contrast, the availability of objects and experiences to stimulate learning in the home was related to the development of spoken language. Conclusions: Whereas broad characteristics of the family environments of DHH children may not differ from those of hearing children, variability in family functioning is related to DHH children's at-risk speech, language, and cognitive outcomes. Results support the importance of further research to clarify and explain these relations, which might suggest novel methods and targets of family-based interventions to improve developmental outcomes.
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[article] 
inEar and hearing > Vol. 41, n°4 (Juillet-aout 2020) . - p. 775-789

Titre :	Aided Hearing Moderates the Academic Outcomes of Children With Mild to Severe Hearing Loss
Type de document :	Article
Auteurs :	J. Bruce Tomblin ; Jake Oleson ; Sophie E. Ambrose ; Elizabeth A. Walker ; Ryan W. McCreery ; Mary Pat Moeller
Année de publication :	2020
Article en page(s) :	p. 775-789
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Aides auditives ; Enfant déficient auditif Autres descripteurs Surdité congénitale ou héréditaire
Résumé :	Objectives: There are very limited data regarding the spoken language and academic outcomes of children with mild to severe hearing loss (HL) during the elementary school years, and the findings of these studies are inconsistent. None of these studies have examined the possible role of aided hearing in these outcomes. This study used a large cohort of children to examine these outcomes and in particular to examine whether aided hearing moderates the effect of HL with regard to these outcomes. Design: The spoken language, reading, writing, and calculation abilities were measured after second and fourth grades in children with mild to severe HL (children who are hard of hearing; CHH, n = 183) and a group of children with normal hearing (CNH, n = 91) after the completion of second and fourth grades. Also, among the CHH who wore hearing aids, aided better-ear speech intelligibility index values at the age of school entry were obtained. Results: Oral language abilities of the CHH with mild and moderate HL were similar to the CNH at each grade. Children with moderately-severe HL (better-ear pure tone threshold >59 but Conclusions: As a group, children with mild and moderate HL have good outcomes with regard to language and academic performance. Children with moderately-severe losses were less skilled in language and reading than the CNH and CHH children with mild and moderate losses. Audibility provided by hearing aids was found to moderate the effects of HL with respect to these outcomes. These findings emphasize the importance of including the effects of clinical interventions such as aided hearing when examining outcomes of CHH.
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[article] Aided Hearing Moderates the Academic Outcomes of Children With Mild to Severe Hearing Loss [Article] / J. Bruce Tomblin ; Jake Oleson ; Sophie E. Ambrose ; Elizabeth A. Walker ; Ryan W. McCreery ; Mary Pat Moeller . - 2020 . - p. 775-789.
Langues : Anglais (eng)
in Ear and hearing > Vol. 41, n°4 (Juillet-aout 2020) . - p. 775-789

Descripteurs :	HE Vinci Aides auditives ; Enfant déficient auditif Autres descripteurs Surdité congénitale ou héréditaire
Résumé :	Objectives: There are very limited data regarding the spoken language and academic outcomes of children with mild to severe hearing loss (HL) during the elementary school years, and the findings of these studies are inconsistent. None of these studies have examined the possible role of aided hearing in these outcomes. This study used a large cohort of children to examine these outcomes and in particular to examine whether aided hearing moderates the effect of HL with regard to these outcomes. Design: The spoken language, reading, writing, and calculation abilities were measured after second and fourth grades in children with mild to severe HL (children who are hard of hearing; CHH, n = 183) and a group of children with normal hearing (CNH, n = 91) after the completion of second and fourth grades. Also, among the CHH who wore hearing aids, aided better-ear speech intelligibility index values at the age of school entry were obtained. Results: Oral language abilities of the CHH with mild and moderate HL were similar to the CNH at each grade. Children with moderately-severe HL (better-ear pure tone threshold >59 but Conclusions: As a group, children with mild and moderate HL have good outcomes with regard to language and academic performance. Children with moderately-severe losses were less skilled in language and reading than the CNH and CHH children with mild and moderate losses. Audibility provided by hearing aids was found to moderate the effects of HL with respect to these outcomes. These findings emphasize the importance of including the effects of clinical interventions such as aided hearing when examining outcomes of CHH.
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[article] 
inEar and hearing > Vol. 41, n°4 (Juillet-aout 2020) . - p. 790-803

Titre :	Rerouting Hearing Aid Systems for Overcoming Simulated Unilateral Hearing in Dynamic Listening Situations
Type de document :	Article
Auteurs :	Erin M. Picou ; Dawna E. Lewis ; Gina P. Angley ; Anne Marie Tharpe
Année de publication :	2020
Article en page(s) :	p. 790-803
Langues :	Anglais (eng)
Descripteurs :	Autres descripteurs Bruit ambiant HE Vinci Aide auditive controlatérale ; Microphone à distance sans fil (RM) ; Perte auditive unilatérale (USNHL) ; Reconnaissance de la parole
Résumé :	Objectives: 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. Design: 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[degrees], +45[degrees], -90[degrees], and -135[degrees] or 0[degrees], -45[degrees], +90[degrees], and +135[degrees]. 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). Results: 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. Conclusions: 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.
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[article] Rerouting Hearing Aid Systems for Overcoming Simulated Unilateral Hearing in Dynamic Listening Situations [Article] / Erin M. Picou ; Dawna E. Lewis ; Gina P. Angley ; Anne Marie Tharpe . - 2020 . - p. 790-803.
Langues : Anglais (eng)
in Ear and hearing > Vol. 41, n°4 (Juillet-aout 2020) . - p. 790-803

Descripteurs :	Autres descripteurs Bruit ambiant HE Vinci Aide auditive controlatérale ; Microphone à distance sans fil (RM) ; Perte auditive unilatérale (USNHL) ; Reconnaissance de la parole
Résumé :	Objectives: 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. Design: 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[degrees], +45[degrees], -90[degrees], and -135[degrees] or 0[degrees], -45[degrees], +90[degrees], and +135[degrees]. 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). Results: 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. Conclusions: 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.
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[article] 
inEar and hearing > Vol. 41, n°4 (Juillet-aout 2020) . - p. 804-810

Titre :	Superior Canal Dehiscence Similarly Affects Cochlear Pressures in Temporal Bones and Audiograms in Patients
Type de document :	Article
Auteurs :	Y. Song Cheng ; Stefan Raufer ; Xiying Guan ; Christopher Halpin ; Daniel J. Lee ; Hideko H. Nakajima
Année de publication :	2020
Article en page(s) :	p. 804-810
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Canal semi-circulaire ; Cochlée ; Niveau de pression sonore (SPL)
Mots-clés :	syndrome de déhiscence du canal semi-circulaire supérieur
Résumé :	Objectives: The diagnosis of superior canal dehiscence (SCD) is challenging and audiograms play an important role in raising clinical suspicion of SCD. The typical audiometric finding in SCD is the combination of increased air conduction (AC) thresholds and decreased bone conduction thresholds at low frequencies. However, this pattern is not always apparent in audiograms of patients with SCD, and some have hearing thresholds that are within the normal reference range despite subjective reports of hearing impairment. In this study, we used a human temporal bone model to measure the differential pressure across the cochlear partition (PDiff) before and after introduction of an SCD. PDiff estimates the cochlear input drive and provides a mechanical audiogram of the temporal bone. We measured PDiff across a wider frequency range than in previous studies and investigated whether the changes in PDiff in the temporal bone model and changes of audiometric thresholds in patients with SCD were similar, as both are thought to reflect the same physical phenomenon. Design: We measured PDiff across the cochlear partition in fresh human cadaveric temporal bones before and after creating an SCD. Measurements were made for a wide frequency range (20 Hz to 10 kHz), which extends down to lower frequencies than in previous studies and audiograms. PDiff = PSV- PST is calculated from pressures measured simultaneously at the base of the cochlea in scala vestibuli (PSV) and scala tympani (PST) during sound stimulation. The change in PDiff after an SCD is created quantifies the effect of SCD on hearing. We further included an important experimental control-by patching the SCD, to confirm that PDiff was reversed back to the initial state. To provide a comparison of temporal bone data to clinical data, we analyzed AC audiograms (250 Hz to 8kHz) of patients with symptomatic unilateral SCD (radiographically confirmed). To achieve this, we used the unaffected ear to estimate the baseline hearing function for each patient, and determined the influence of SCD by referencing AC hearing thresholds of the SCD-affected ear with the unaffected contralateral ear. Results: PDiff measured in temporal bones (n = 6) and AC thresholds in patients (n = 53) exhibited a similar pattern of SCD-related change. With decreasing frequency, SCD caused a progressive decrease in PDiff at low frequencies for all temporal bones and a progressive increase in AC thresholds at low frequencies. SCD decreases the cochlear input drive by approximately 6 dB per octave at frequencies below ~1 kHz for both PDiff and AC thresholds. Individual data varied in frequency and magnitude of this SCD effect, where some temporal-bone ears had noticeable effects only below 250 Hz. Conclusions: We found that with decrease in frequency the progressive decrease in low-frequency PDiff in our temporal bone experiments mirrors the progressive elevation in AC hearing thresholds observed in patients. This hypothesis remains to be tested in the clinical setting, but our findings suggest that that measuring AC thresholds at frequencies below 250 Hz would detect a larger change, thus improving audiograms as a diagnostic tool for SCD.
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[article] Superior Canal Dehiscence Similarly Affects Cochlear Pressures in Temporal Bones and Audiograms in Patients [Article] / Y. Song Cheng ; Stefan Raufer ; Xiying Guan ; Christopher Halpin ; Daniel J. Lee ; Hideko H. Nakajima . - 2020 . - p. 804-810.
Langues : Anglais (eng)
in Ear and hearing > Vol. 41, n°4 (Juillet-aout 2020) . - p. 804-810

Descripteurs :	HE Vinci Canal semi-circulaire ; Cochlée ; Niveau de pression sonore (SPL)
Mots-clés :	syndrome de déhiscence du canal semi-circulaire supérieur
Résumé :	Objectives: The diagnosis of superior canal dehiscence (SCD) is challenging and audiograms play an important role in raising clinical suspicion of SCD. The typical audiometric finding in SCD is the combination of increased air conduction (AC) thresholds and decreased bone conduction thresholds at low frequencies. However, this pattern is not always apparent in audiograms of patients with SCD, and some have hearing thresholds that are within the normal reference range despite subjective reports of hearing impairment. In this study, we used a human temporal bone model to measure the differential pressure across the cochlear partition (PDiff) before and after introduction of an SCD. PDiff estimates the cochlear input drive and provides a mechanical audiogram of the temporal bone. We measured PDiff across a wider frequency range than in previous studies and investigated whether the changes in PDiff in the temporal bone model and changes of audiometric thresholds in patients with SCD were similar, as both are thought to reflect the same physical phenomenon. Design: We measured PDiff across the cochlear partition in fresh human cadaveric temporal bones before and after creating an SCD. Measurements were made for a wide frequency range (20 Hz to 10 kHz), which extends down to lower frequencies than in previous studies and audiograms. PDiff = PSV- PST is calculated from pressures measured simultaneously at the base of the cochlea in scala vestibuli (PSV) and scala tympani (PST) during sound stimulation. The change in PDiff after an SCD is created quantifies the effect of SCD on hearing. We further included an important experimental control-by patching the SCD, to confirm that PDiff was reversed back to the initial state. To provide a comparison of temporal bone data to clinical data, we analyzed AC audiograms (250 Hz to 8kHz) of patients with symptomatic unilateral SCD (radiographically confirmed). To achieve this, we used the unaffected ear to estimate the baseline hearing function for each patient, and determined the influence of SCD by referencing AC hearing thresholds of the SCD-affected ear with the unaffected contralateral ear. Results: PDiff measured in temporal bones (n = 6) and AC thresholds in patients (n = 53) exhibited a similar pattern of SCD-related change. With decreasing frequency, SCD caused a progressive decrease in PDiff at low frequencies for all temporal bones and a progressive increase in AC thresholds at low frequencies. SCD decreases the cochlear input drive by approximately 6 dB per octave at frequencies below ~1 kHz for both PDiff and AC thresholds. Individual data varied in frequency and magnitude of this SCD effect, where some temporal-bone ears had noticeable effects only below 250 Hz. Conclusions: We found that with decrease in frequency the progressive decrease in low-frequency PDiff in our temporal bone experiments mirrors the progressive elevation in AC hearing thresholds observed in patients. This hypothesis remains to be tested in the clinical setting, but our findings suggest that that measuring AC thresholds at frequencies below 250 Hz would detect a larger change, thus improving audiograms as a diagnostic tool for SCD.
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[article] 
inEar and hearing > Vol. 41, n°4 (Juillet-aout 2020) . - p. 811-824

Titre :	Assessing the Effect of Middle Ear Effusions on Wideband Acoustic Immittance Using Optical Coherence Tomography
Type de document :	Article
Auteurs :	Jungeun Won ; Guillermo Monroy ; Pin-Chieh Huang ; [et al.]
Année de publication :	2020
Article en page(s) :	p. 811-824
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Imagerie medicale ; Oreille moyenne ; Tomographie Autres descripteurs Immitance acoustique
Résumé :	Objectives: Wideband acoustic immittance (WAI) noninvasively assesses middle ear function by measuring the sound conduction over a range of audible frequencies. Although several studies have shown the potential of WAI for detecting the presence of middle ear effusions (MEEs), determining the effects of MEE type and amount on WAI in vivo has been challenging due to the anatomical location of middle ear cavity. The purpose of this study is to correlate WAI measurements with physical characteristics of the middle ear and MEEs determined by optical coherence tomography (OCT), a noninvasive optical imaging technique. Design: Sixteen pediatric subjects (average age of 7 +/- 4 years) were recruited from the primary care clinic at Carle Foundation Hospital (Urbana, IL). A total of 22 ears (normal: 15 ears, otitis media with effusion: 6 ears, and acute otitis media: 1 ear, based on physician's diagnosis) were examined via standard otoscopy, tympanometry, OCT imaging, and WAI measurements in a busy, community-based clinical setting. Cross-sectional OCT images were analyzed to quantitatively assess the presence, type (relative turbidity based on the amount of scattering), and amount (relative fluid level) of MEEs. These OCT metrics were utilized to categorize subject ears into no MEE (control), biofilm without a MEE, serous-scant, serous-severe, mucoid-scant, and mucoid-severe MEE groups. The absorbance levels in each group were statistically evaluated at [alpha] = 0.05. Results: The absorbance of the control group showed a similar trend when compared with a pediatric normative dataset, and the presence of an MEE generally decreased the power absorbance. The mucoid MEE group showed significantly less power absorbance from 2.74 to 4.73 kHz (p Conclusions: Physical characteristics of the middle ear and MEEs quantified from noninvasive OCT images can be helpful to understand abnormal WAI measurements. Mucoid MEEs decrease the power absorbance more than serous MEEs, and the greater amounts of MEE decreases the power absorbance, especially at higher (>2 kHz) frequencies. As both the type and amount of MEE can significantly affect WAI measurements, further investigations to correlate acoustic measurements with physical characteristics of middle ear conditions in vivo is needed.
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[article] Assessing the Effect of Middle Ear Effusions on Wideband Acoustic Immittance Using Optical Coherence Tomography [Article] / Jungeun Won ; Guillermo Monroy ; Pin-Chieh Huang ; [et al.] . - 2020 . - p. 811-824.
Langues : Anglais (eng)
in Ear and hearing > Vol. 41, n°4 (Juillet-aout 2020) . - p. 811-824

Descripteurs :	HE Vinci Imagerie medicale ; Oreille moyenne ; Tomographie Autres descripteurs Immitance acoustique
Résumé :	Objectives: Wideband acoustic immittance (WAI) noninvasively assesses middle ear function by measuring the sound conduction over a range of audible frequencies. Although several studies have shown the potential of WAI for detecting the presence of middle ear effusions (MEEs), determining the effects of MEE type and amount on WAI in vivo has been challenging due to the anatomical location of middle ear cavity. The purpose of this study is to correlate WAI measurements with physical characteristics of the middle ear and MEEs determined by optical coherence tomography (OCT), a noninvasive optical imaging technique. Design: Sixteen pediatric subjects (average age of 7 +/- 4 years) were recruited from the primary care clinic at Carle Foundation Hospital (Urbana, IL). A total of 22 ears (normal: 15 ears, otitis media with effusion: 6 ears, and acute otitis media: 1 ear, based on physician's diagnosis) were examined via standard otoscopy, tympanometry, OCT imaging, and WAI measurements in a busy, community-based clinical setting. Cross-sectional OCT images were analyzed to quantitatively assess the presence, type (relative turbidity based on the amount of scattering), and amount (relative fluid level) of MEEs. These OCT metrics were utilized to categorize subject ears into no MEE (control), biofilm without a MEE, serous-scant, serous-severe, mucoid-scant, and mucoid-severe MEE groups. The absorbance levels in each group were statistically evaluated at [alpha] = 0.05. Results: The absorbance of the control group showed a similar trend when compared with a pediatric normative dataset, and the presence of an MEE generally decreased the power absorbance. The mucoid MEE group showed significantly less power absorbance from 2.74 to 4.73 kHz (p Conclusions: Physical characteristics of the middle ear and MEEs quantified from noninvasive OCT images can be helpful to understand abnormal WAI measurements. Mucoid MEEs decrease the power absorbance more than serous MEEs, and the greater amounts of MEE decreases the power absorbance, especially at higher (>2 kHz) frequencies. As both the type and amount of MEE can significantly affect WAI measurements, further investigations to correlate acoustic measurements with physical characteristics of middle ear conditions in vivo is needed.
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[article] 
inEar and hearing > Vol. 41, n°4 (Juillet-aout 2020) . - p. 825-837

Titre :	Modality Effects on Lexical Encoding and Memory Representations of Spoken Words
Type de document :	Article
Auteurs :	Lynn M. Bielski ; Lindsey Byom ; Philip F. Seitz ; Ken W. Grant
Année de publication :	2020
Article en page(s) :	p. 825-837
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Mémoire à court terme ; Scintigraphie ; Sujet âgé ; Surdité neurosensorielle (SNHL) Autres descripteurs Encodage de la parole ; Fonctions visuo-perceptives
Résumé :	Objectives: The present study investigated presentation modality differences in lexical encoding and working memory representations of spoken words of older, hearing-impaired adults. Two experiments were undertaken: a memory-scanning experiment and a stimulus gating experiment. The primary objective of experiment 1 was to determine whether memory encoding and retrieval and scanning speeds are different for easily identifiable words presented in auditory-visual (AV), auditory-only (AO), and visual-only (VO) modalities. The primary objective of experiment 2 was to determine if memory encoding and retrieval speed differences observed in experiment 1 could be attributed to the early availability of AV speech information compared with AO or VO conditions. Design: Twenty-six adults over age 60 years with bilateral mild to moderate sensorineural hearing loss participated in experiment 1, and 24 adults who took part in experiment 1 participated in experiment 2. An item recognition reaction-time paradigm (memory-scanning) was used in experiment 1 to measure (1) lexical encoding speed, that is, the speed at which an easily identifiable word was recognized and placed into working memory, and (2) retrieval speed, that is, the speed at which words were retrieved from memory and compared with similarly encoded words (memory scanning) presented in AV, AO, and VO modalities. Experiment 2 used a time-gated word identification task to test whether the time course of stimulus information available to participants predicted the modality-related memory encoding and retrieval speed results from experiment 1. Results: The results of experiment 1 revealed significant differences among the modalities with respect to both memory encoding and retrieval speed, with AV fastest and VO slowest. These differences motivated an examination of the time course of stimulus information available as a function of modality. Results from experiment 2 indicated the encoding and retrieval speed advantages for AV and AO words compared with VO words were mostly driven by the time course of stimulus information. The AV advantage seen in encoding and retrieval speeds is likely due to a combination of robust stimulus information available to the listener earlier in time and lower attentional demands compared with AO or VO encoding and retrieval. Conclusions: Significant modality differences in lexical encoding and memory retrieval speeds were observed across modalities. The memory scanning speed advantage observed for AV compared with AO or VO modalities was strongly related to the time course of stimulus information. In contrast, lexical encoding and retrieval speeds for VO words could not be explained by the time-course of stimulus information alone. Working memory processes for the VO modality may be impacted by greater attentional demands and less information availability compared with the AV and AO modalities. Overall, these results support the hypothesis that the presentation modality for speech inputs (AV, AO, or VO) affects how older adult listeners with hearing loss encode, remember, and retrieve what they hear.
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[article] Modality Effects on Lexical Encoding and Memory Representations of Spoken Words [Article] / Lynn M. Bielski ; Lindsey Byom ; Philip F. Seitz ; Ken W. Grant . - 2020 . - p. 825-837.
Langues : Anglais (eng)
in Ear and hearing > Vol. 41, n°4 (Juillet-aout 2020) . - p. 825-837

Descripteurs :	HE Vinci Mémoire à court terme ; Scintigraphie ; Sujet âgé ; Surdité neurosensorielle (SNHL) Autres descripteurs Encodage de la parole ; Fonctions visuo-perceptives
Résumé :	Objectives: The present study investigated presentation modality differences in lexical encoding and working memory representations of spoken words of older, hearing-impaired adults. Two experiments were undertaken: a memory-scanning experiment and a stimulus gating experiment. The primary objective of experiment 1 was to determine whether memory encoding and retrieval and scanning speeds are different for easily identifiable words presented in auditory-visual (AV), auditory-only (AO), and visual-only (VO) modalities. The primary objective of experiment 2 was to determine if memory encoding and retrieval speed differences observed in experiment 1 could be attributed to the early availability of AV speech information compared with AO or VO conditions. Design: Twenty-six adults over age 60 years with bilateral mild to moderate sensorineural hearing loss participated in experiment 1, and 24 adults who took part in experiment 1 participated in experiment 2. An item recognition reaction-time paradigm (memory-scanning) was used in experiment 1 to measure (1) lexical encoding speed, that is, the speed at which an easily identifiable word was recognized and placed into working memory, and (2) retrieval speed, that is, the speed at which words were retrieved from memory and compared with similarly encoded words (memory scanning) presented in AV, AO, and VO modalities. Experiment 2 used a time-gated word identification task to test whether the time course of stimulus information available to participants predicted the modality-related memory encoding and retrieval speed results from experiment 1. Results: The results of experiment 1 revealed significant differences among the modalities with respect to both memory encoding and retrieval speed, with AV fastest and VO slowest. These differences motivated an examination of the time course of stimulus information available as a function of modality. Results from experiment 2 indicated the encoding and retrieval speed advantages for AV and AO words compared with VO words were mostly driven by the time course of stimulus information. The AV advantage seen in encoding and retrieval speeds is likely due to a combination of robust stimulus information available to the listener earlier in time and lower attentional demands compared with AO or VO encoding and retrieval. Conclusions: Significant modality differences in lexical encoding and memory retrieval speeds were observed across modalities. The memory scanning speed advantage observed for AV compared with AO or VO modalities was strongly related to the time course of stimulus information. In contrast, lexical encoding and retrieval speeds for VO words could not be explained by the time-course of stimulus information alone. Working memory processes for the VO modality may be impacted by greater attentional demands and less information availability compared with the AV and AO modalities. Overall, these results support the hypothesis that the presentation modality for speech inputs (AV, AO, or VO) affects how older adult listeners with hearing loss encode, remember, and retrieve what they hear.
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[article] 
inEar and hearing > Vol. 41, n°4 (Juillet-aout 2020) . - p. 838-846

Titre :	Evaluating the Effect of Training Along With Fit Testing on Premolded Earplug Users in a Chinese Petrochemical Plant
Type de document :	Article
Auteurs :	Yufei Liu ; Wei Gong ; Xin Liu ; Ling Li
Année de publication :	2020
Article en page(s) :	p. 838-846
Langues :	Anglais (eng)
Descripteurs :	Autres descripteurs Attenuation HE Vinci Dispositifs de protection des oreilles ; Protection auditive
Résumé :	Objectives: To gain insight into the current practice of hearing protection of Chinese workers and the value of hearing protection device (HPD) fit testing. Design: HPD fit testing was conducted on workers (N = 774) in a petrochemical plant in Eastern China who were on duty during the period of this study. The 3M E-A-Rfit Dual-Ear Validation System was used to measure the personal attenuation ratings (PARs) of a premolded earplug used at the work site. Repeated fit testing was conducted at approximately 6- or 12-month intervals. Wilcoxon signed rank tests were conducted to analyze the pairwise differences between the baseline, postintervention, and follow-up visit PARs, and Mann-Whitney tests were used to compare the PARs obtained by two follow-up groups. Results: The median PAR baseline was 11 dB; significant improvement was shown on the postintervention PARs (p 0.05). Comparing PARs of follow-up visits with the baseline PAR demonstrated a significant improvement (p Conclusions: HPD fit testing showed value added as to verify the sufficiency of attenuation. The training along with fit testing showed contributions to improve PARs, maintained effectiveness over time, and assisted in HPD selection. Follow-up is believed to be important to ensure that the HPDs are continually used correctly. There was no significant difference in the sustained effectiveness of the follow-up when observe 6- and 12-month subsequent to intervention.
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[article] Evaluating the Effect of Training Along With Fit Testing on Premolded Earplug Users in a Chinese Petrochemical Plant [Article] / Yufei Liu ; Wei Gong ; Xin Liu ; Ling Li . - 2020 . - p. 838-846.
Langues : Anglais (eng)
in Ear and hearing > Vol. 41, n°4 (Juillet-aout 2020) . - p. 838-846

Descripteurs :	Autres descripteurs Attenuation HE Vinci Dispositifs de protection des oreilles ; Protection auditive
Résumé :	Objectives: To gain insight into the current practice of hearing protection of Chinese workers and the value of hearing protection device (HPD) fit testing. Design: HPD fit testing was conducted on workers (N = 774) in a petrochemical plant in Eastern China who were on duty during the period of this study. The 3M E-A-Rfit Dual-Ear Validation System was used to measure the personal attenuation ratings (PARs) of a premolded earplug used at the work site. Repeated fit testing was conducted at approximately 6- or 12-month intervals. Wilcoxon signed rank tests were conducted to analyze the pairwise differences between the baseline, postintervention, and follow-up visit PARs, and Mann-Whitney tests were used to compare the PARs obtained by two follow-up groups. Results: The median PAR baseline was 11 dB; significant improvement was shown on the postintervention PARs (p 0.05). Comparing PARs of follow-up visits with the baseline PAR demonstrated a significant improvement (p Conclusions: HPD fit testing showed value added as to verify the sufficiency of attenuation. The training along with fit testing showed contributions to improve PARs, maintained effectiveness over time, and assisted in HPD selection. Follow-up is believed to be important to ensure that the HPDs are continually used correctly. There was no significant difference in the sustained effectiveness of the follow-up when observe 6- and 12-month subsequent to intervention.
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[article] 
inEar and hearing > Vol. 41, n°4 (Juillet-aout 2020) . - p. 847-854

Titre :	Maximum Output and Low-Frequency Limitations of B71 and B81 Clinical Bone Vibrators: Implications for Vestibular Evoked Potentials
Type de document :	Article
Auteurs :	Christopher G. Clinard ; Erin G. Piker ; Andrew P. Thorne ; [et al.]
Année de publication :	2020
Article en page(s) :	p. 847-854
Langues :	Anglais (eng)
Descripteurs :	Autres descripteurs Transduction cochleaire HE Vinci Potentiel évoqué auditif (PEA) ; Potentiel évoqué myogénique vestibulaire (oVEMP) (cVEMP) ; Vestibulométrie
Résumé :	Objectives: Bone-conducted vestibular evoked myogenic potentials (VEMPs) are tuned to have their maximum amplitude in response to tone bursts at or below 250 Hz. The low-frequency limitations of clinical bone vibrators have not been established for transient, tone burst stimuli at frequencies that are optimal for eliciting VEMPs. Design: Tone bursts with frequencies of 250 to 2000 Hz were delivered to B71 and B81 bone vibrators and their output was examined using an artificial mastoid. The lower-frequency limit of the transducers was evaluated by examining the spectral output of the bone vibrators. Maximum output levels were evaluated by measuring input-output functions across a range of stimulus levels. Results: Both the B71 and B81 could produce transient tone bursts with frequency as low as 400 Hz. However, tone bursts with frequencies of 250 and 315 Hz resulted in output with peak spectral energy at approximately 400 Hz. From 500 to 2000 Hz, maximum output levels within the linear range were between 120 and 128 dB peak force level. The newer B81 bone vibrator had a maximum output approximately 5 dB higher than the B71 at several frequencies. Conclusions: These findings demonstrate that both transducers can reach levels appropriate to elicit bone-conducted VEMPs, but the low-frequency limitations of these clinical bone vibrators limit tone burst frequency to approximately 400 Hz when attempting to stimulate the otolith organs via tone bursts.
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[article] Maximum Output and Low-Frequency Limitations of B71 and B81 Clinical Bone Vibrators: Implications for Vestibular Evoked Potentials [Article] / Christopher G. Clinard ; Erin G. Piker ; Andrew P. Thorne ; [et al.] . - 2020 . - p. 847-854.
Langues : Anglais (eng)
in Ear and hearing > Vol. 41, n°4 (Juillet-aout 2020) . - p. 847-854

Descripteurs :	Autres descripteurs Transduction cochleaire HE Vinci Potentiel évoqué auditif (PEA) ; Potentiel évoqué myogénique vestibulaire (oVEMP) (cVEMP) ; Vestibulométrie
Résumé :	Objectives: Bone-conducted vestibular evoked myogenic potentials (VEMPs) are tuned to have their maximum amplitude in response to tone bursts at or below 250 Hz. The low-frequency limitations of clinical bone vibrators have not been established for transient, tone burst stimuli at frequencies that are optimal for eliciting VEMPs. Design: Tone bursts with frequencies of 250 to 2000 Hz were delivered to B71 and B81 bone vibrators and their output was examined using an artificial mastoid. The lower-frequency limit of the transducers was evaluated by examining the spectral output of the bone vibrators. Maximum output levels were evaluated by measuring input-output functions across a range of stimulus levels. Results: Both the B71 and B81 could produce transient tone bursts with frequency as low as 400 Hz. However, tone bursts with frequencies of 250 and 315 Hz resulted in output with peak spectral energy at approximately 400 Hz. From 500 to 2000 Hz, maximum output levels within the linear range were between 120 and 128 dB peak force level. The newer B81 bone vibrator had a maximum output approximately 5 dB higher than the B71 at several frequencies. Conclusions: These findings demonstrate that both transducers can reach levels appropriate to elicit bone-conducted VEMPs, but the low-frequency limitations of these clinical bone vibrators limit tone burst frequency to approximately 400 Hz when attempting to stimulate the otolith organs via tone bursts.
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[article] 
inEar and hearing > Vol. 41, n°4 (Juillet-aout 2020) . - p. 855-867

Titre :	Evidence of Vowel Discrimination Provided by the Acoustic Change Complex
Type de document :	Article
Auteurs :	Diane Cheek ; Barbara Cone-Wesson
Année de publication :	2020
Article en page(s) :	p. 855-867
Langues :	Anglais (eng)
Descripteurs :	Autres descripteurs Changement acoustique complexe ; électrophysiologie ; Perception des voyelles HE Vinci Discrimination auditive ; Perception de la parole ; Potentiel évoqué cortical sonore (CAEP)
Résumé :	Objectives: The objectives of this study were to measure the effects of level and vowel contrast on the latencies and amplitudes of acoustic change complex (ACC) in the mature auditory system. This was done to establish how the ACC in healthy young adults is affected by these stimulus parameters that could then be used to inform translation of the ACC into a clinical measure for the pediatric population. Another aim was to demonstrate that a normalized amplitude metric, calculated by dividing the ACC amplitude in the vowel contrast condition by the ACC amplitude obtained in a control condition (no vowel change) would demonstrate good sensitivity with respect to perceptual measures of vowel-contrast detection. The premises underlying this research were that: (1) ACC latencies and amplitudes would vary with level, in keeping with principles of an increase in neural synchrony and activity that takes place as a function of increasing stimulus level; (2) ACC latencies and amplitudes would vary with vowel contrast, because cortical auditory evoked potentials are known to be sensitive to the spectro-temporal characteristics of speech. Design: Nineteen adults, 14 of them female, with a mean age of 24.2 years (range 20 to 38 years) participated in this study. All had normal-hearing thresholds. Cortical auditory evoked potentials were obtained from all participants in response to synthesized vowel tokens (/a/, /i/, /o/, /u/), presented in a quasi-steady state fashion at a rate of 2/sec in an oddball stimulus paradigm, with a 25% probability of the deviant stimulus. The ACC was obtained in response to the deviant stimulus. All combinations of vowel tokens were tested at 2 stimulus levels: 40 and 70 dBA. In addition, listeners were tested for their ability to detect the vowel contrasts using behavioral methods. Results: ACC amplitude varied systematically with level, and test condition (control versus contrast) and vowel token, but ACC latency did not. ACC amplitudes were significantly larger when tested at 70 dBA compared with 40 dBA and for contrast trials compared with control trials at both levels. Amplitude ratios (normalized amplitudes) were largest for contrast pairs in which /a/ was the standard token. The amplitude ratio metric at the individual level demonstrated up to 97% sensitivity with respect to perceptual measures of discrimination. Conclusions: The present study establishes the effects of stimulus level and vowel type on the latency and amplitude of the ACC in the young adult auditory system and supports the amplitude ratio as a sensitive metric for cortical acoustic salience of vowel spectral features. Next steps are to evaluate these methods in infants and children with hearing loss with the long-term goal of its translation into a clinical method for estimating speech feature discrimination.
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[article] Evidence of Vowel Discrimination Provided by the Acoustic Change Complex [Article] / Diane Cheek ; Barbara Cone-Wesson . - 2020 . - p. 855-867.
Langues : Anglais (eng)
in Ear and hearing > Vol. 41, n°4 (Juillet-aout 2020) . - p. 855-867

Descripteurs :	Autres descripteurs Changement acoustique complexe ; électrophysiologie ; Perception des voyelles HE Vinci Discrimination auditive ; Perception de la parole ; Potentiel évoqué cortical sonore (CAEP)
Résumé :	Objectives: The objectives of this study were to measure the effects of level and vowel contrast on the latencies and amplitudes of acoustic change complex (ACC) in the mature auditory system. This was done to establish how the ACC in healthy young adults is affected by these stimulus parameters that could then be used to inform translation of the ACC into a clinical measure for the pediatric population. Another aim was to demonstrate that a normalized amplitude metric, calculated by dividing the ACC amplitude in the vowel contrast condition by the ACC amplitude obtained in a control condition (no vowel change) would demonstrate good sensitivity with respect to perceptual measures of vowel-contrast detection. The premises underlying this research were that: (1) ACC latencies and amplitudes would vary with level, in keeping with principles of an increase in neural synchrony and activity that takes place as a function of increasing stimulus level; (2) ACC latencies and amplitudes would vary with vowel contrast, because cortical auditory evoked potentials are known to be sensitive to the spectro-temporal characteristics of speech. Design: Nineteen adults, 14 of them female, with a mean age of 24.2 years (range 20 to 38 years) participated in this study. All had normal-hearing thresholds. Cortical auditory evoked potentials were obtained from all participants in response to synthesized vowel tokens (/a/, /i/, /o/, /u/), presented in a quasi-steady state fashion at a rate of 2/sec in an oddball stimulus paradigm, with a 25% probability of the deviant stimulus. The ACC was obtained in response to the deviant stimulus. All combinations of vowel tokens were tested at 2 stimulus levels: 40 and 70 dBA. In addition, listeners were tested for their ability to detect the vowel contrasts using behavioral methods. Results: ACC amplitude varied systematically with level, and test condition (control versus contrast) and vowel token, but ACC latency did not. ACC amplitudes were significantly larger when tested at 70 dBA compared with 40 dBA and for contrast trials compared with control trials at both levels. Amplitude ratios (normalized amplitudes) were largest for contrast pairs in which /a/ was the standard token. The amplitude ratio metric at the individual level demonstrated up to 97% sensitivity with respect to perceptual measures of discrimination. Conclusions: The present study establishes the effects of stimulus level and vowel type on the latency and amplitude of the ACC in the young adult auditory system and supports the amplitude ratio as a sensitive metric for cortical acoustic salience of vowel spectral features. Next steps are to evaluate these methods in infants and children with hearing loss with the long-term goal of its translation into a clinical method for estimating speech feature discrimination.
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[article] 
inEar and hearing > Vol. 41, n°4 (Juillet-aout 2020) . - p. 868-882

Titre :	Interaction Between Electric and Acoustic Stimulation Influences Speech Perception in Ipsilateral EAS Users
Type de document :	Article
Auteurs :	Marina Imsiecke ; Benjamin Kruger ; Andreas Buchner ; Thomas Lenarz ; Waldo Nogueira
Année de publication :	2020
Article en page(s) :	p. 868-882
Langues :	Anglais (eng)
Descripteurs :	Autres descripteurs Audition residuelle ; Stimulation electrocochleaire HE Vinci Implants cochléaires ; Masquage ; Perception de la parole ; Stratégie d'ajustement
Résumé :	Objectives: The aim of this study was to determine electric-acoustic masking in cochlear implant users with ipsilateral residual hearing and different electrode insertion depths and to investigate the influence on speech reception. The effects of different fitting strategies-meet, overlap, and a newly developed masking adjusted fitting (UNMASKfit)-on speech reception are compared. If electric-acoustic masking has a detrimental effect on speech reception, the individualized UNMASKfit map might be able to reduce masking and thereby enhance speech reception. Design: Fifteen experienced MED-EL Flex electrode recipients with ipsilateral residual hearing participated in a crosssover design study using three fitting strategies for 4 weeks each. The following strategies were compared: (1) a meet fitting, dividing the frequency range between electric and acoustic stimulation, (2) an overlap fitting, delivering part of the frequency range both acoustically and electrically, and (3) the UNMASKfit, reducing the electric stimulation according to the individual electric-on-acoustic masking strength. A psychoacoustic masking procedure was used to measure the changes in acoustic thresholds due to the presence of electric maskers. Speech reception was measured in noise with the Oldenburg Matrix Sentence test. Results: Behavioral thresholds of acoustic probe tones were significantly elevated in the presence of electric maskers. A maximum of masking was observed when the difference in location between the electric and acoustic stimulation was around one octave in place frequency. Speech reception scores and strength of masking showed a dependency on residual hearing, and speech reception was significantly reduced in the overlap fitting strategy. Electric- acoustic stimulation significantly improved speech reception over electric stimulation alone, with a tendency toward a larger benefit with the UNMASKfit map. In addition, masking was significantly inversely correlated to the speech reception performance difference between the overlap and the meet fitting. Conclusions: (1) This study confirmed the interaction between ipsilateral electric and acoustic stimulation in a psychoacoustic masking experiment. (2) The overlap fitting yielded poorer speech reception performance in stationary noise especially in subjects with strong masking. (3) The newly developed UNMASKfit strategy yielded similar speech reception thresholds with an enhanced acoustic benefit, while at the same time reducing the electric stimulation. This could be beneficial in the long-term if applied as a standard fitting, as hair cells are exposed to less possibly adverse electric stimulation. In this study, the UNMASKfit allowed the participants a better use of their natural hearing even after 1 month of adaptation. It might be feasible to transfer these results to the clinic, by fitting patients with the UNMASKfit upon their first fitting appointment, so that longer adaptation times can further improve speech reception.
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[article] Interaction Between Electric and Acoustic Stimulation Influences Speech Perception in Ipsilateral EAS Users [Article] / Marina Imsiecke ; Benjamin Kruger ; Andreas Buchner ; Thomas Lenarz ; Waldo Nogueira . - 2020 . - p. 868-882.
Langues : Anglais (eng)
in Ear and hearing > Vol. 41, n°4 (Juillet-aout 2020) . - p. 868-882

Descripteurs :	Autres descripteurs Audition residuelle ; Stimulation electrocochleaire HE Vinci Implants cochléaires ; Masquage ; Perception de la parole ; Stratégie d'ajustement
Résumé :	Objectives: The aim of this study was to determine electric-acoustic masking in cochlear implant users with ipsilateral residual hearing and different electrode insertion depths and to investigate the influence on speech reception. The effects of different fitting strategies-meet, overlap, and a newly developed masking adjusted fitting (UNMASKfit)-on speech reception are compared. If electric-acoustic masking has a detrimental effect on speech reception, the individualized UNMASKfit map might be able to reduce masking and thereby enhance speech reception. Design: Fifteen experienced MED-EL Flex electrode recipients with ipsilateral residual hearing participated in a crosssover design study using three fitting strategies for 4 weeks each. The following strategies were compared: (1) a meet fitting, dividing the frequency range between electric and acoustic stimulation, (2) an overlap fitting, delivering part of the frequency range both acoustically and electrically, and (3) the UNMASKfit, reducing the electric stimulation according to the individual electric-on-acoustic masking strength. A psychoacoustic masking procedure was used to measure the changes in acoustic thresholds due to the presence of electric maskers. Speech reception was measured in noise with the Oldenburg Matrix Sentence test. Results: Behavioral thresholds of acoustic probe tones were significantly elevated in the presence of electric maskers. A maximum of masking was observed when the difference in location between the electric and acoustic stimulation was around one octave in place frequency. Speech reception scores and strength of masking showed a dependency on residual hearing, and speech reception was significantly reduced in the overlap fitting strategy. Electric- acoustic stimulation significantly improved speech reception over electric stimulation alone, with a tendency toward a larger benefit with the UNMASKfit map. In addition, masking was significantly inversely correlated to the speech reception performance difference between the overlap and the meet fitting. Conclusions: (1) This study confirmed the interaction between ipsilateral electric and acoustic stimulation in a psychoacoustic masking experiment. (2) The overlap fitting yielded poorer speech reception performance in stationary noise especially in subjects with strong masking. (3) The newly developed UNMASKfit strategy yielded similar speech reception thresholds with an enhanced acoustic benefit, while at the same time reducing the electric stimulation. This could be beneficial in the long-term if applied as a standard fitting, as hair cells are exposed to less possibly adverse electric stimulation. In this study, the UNMASKfit allowed the participants a better use of their natural hearing even after 1 month of adaptation. It might be feasible to transfer these results to the clinic, by fitting patients with the UNMASKfit upon their first fitting appointment, so that longer adaptation times can further improve speech reception.
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[article] 
inEar and hearing > Vol. 41, n°4 (Juillet-aout 2020) . - p. 883-895

Titre :	Wideband Acoustic Immittance in Cochlear Implant Recipients: Reflectance and Stapedial Reflexes
Type de document :	Article
Auteurs :	Rachel A. Scheperle ; Joshua J. Hajicek
Année de publication :	2020
Article en page(s) :	p. 883-895
Langues :	Anglais (eng)
Descripteurs :	Autres descripteurs Immitance acoustique ; Reflexe stapedien HE Vinci Implants cochléaires
Résumé :	Objectives: to characterize differences in wideband power reflectance for ears with and without cochlear implants (CIs), to describe electrically evoked stapedial reflex (eSR)-induced changes in reflectance, and to evaluate the benefit of a broadband probe for reflex threshold determination for CI recipients. It was hypothesized that reflectance patterns in ears with CIs would be consistent with increased middle ear stiffness and that reflex thresholds measured with a broadband probe would be lower compared with thresholds obtained with a single-frequency probe. Design: Eleven CI recipients participated in both wideband reflectance and eSR testing. Ipsilateral reflexes were measured with three probes: a broadband chirp (swept from 200 to 8000 Hz), a 226 Hz tone, and a 678 Hz tone. Wideband reflectance measures acquired from 28 adults without CIs and with normal middle ear function served as a normative data set for comparison. Results: Considering the group data, average reflectance was significantly greater for ears with CIs across 250 to 891 Hz and 4238 to 4490 Hz compared with the normative data set, although individual reflectance curves were variable. Some CI recipients also had low 226 Hz admittance, which contributed to the group finding, considering the control group had clinically normal 226 Hz admittance by design. Electrically evoked stapedial reflexes were measurable in nine of 14 ears (64.3%) and in 24 of 46 electrodes (52.5%) tested. Reflex-induced changes in reflectance patterns were unique to the participant/ear, but similar across activators (electrodes) within a given ear. In addition, reflectance values at or above 1000 Hz were affected most by activating the stapedial reflex, even in ears with clinically normal 226 Hz admittance. This is a higher-frequency range than has been reported for acoustically evoked reflex-induced reflectance changes and is consistent with increased middle ear stiffness at rest. Electrically evoked reflexes could be measured more often with the 678 Hz or the broadband probe compared with the 226 Hz probe tone. Although reflex thresholds were lower with the broadband probe compared with the 678 Hz probe in 16 of 24 conditions, this was not a statistically significant finding (Wilcoxon signed-rank test; p = 0.072). Conclusions: The applications of wideband acoustic immittance measurements (reflectance and reflexes) should also be considered for ears with CIs. Further work is needed to describe changes across time in ears with CIs to more fully understand the reflectance pattern indicating increased middle ear stiffness and to optimize measuring eSRs with a broadband probe.
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[article] Wideband Acoustic Immittance in Cochlear Implant Recipients: Reflectance and Stapedial Reflexes [Article] / Rachel A. Scheperle ; Joshua J. Hajicek . - 2020 . - p. 883-895.
Langues : Anglais (eng)
in Ear and hearing > Vol. 41, n°4 (Juillet-aout 2020) . - p. 883-895

Descripteurs :	Autres descripteurs Immitance acoustique ; Reflexe stapedien HE Vinci Implants cochléaires
Résumé :	Objectives: to characterize differences in wideband power reflectance for ears with and without cochlear implants (CIs), to describe electrically evoked stapedial reflex (eSR)-induced changes in reflectance, and to evaluate the benefit of a broadband probe for reflex threshold determination for CI recipients. It was hypothesized that reflectance patterns in ears with CIs would be consistent with increased middle ear stiffness and that reflex thresholds measured with a broadband probe would be lower compared with thresholds obtained with a single-frequency probe. Design: Eleven CI recipients participated in both wideband reflectance and eSR testing. Ipsilateral reflexes were measured with three probes: a broadband chirp (swept from 200 to 8000 Hz), a 226 Hz tone, and a 678 Hz tone. Wideband reflectance measures acquired from 28 adults without CIs and with normal middle ear function served as a normative data set for comparison. Results: Considering the group data, average reflectance was significantly greater for ears with CIs across 250 to 891 Hz and 4238 to 4490 Hz compared with the normative data set, although individual reflectance curves were variable. Some CI recipients also had low 226 Hz admittance, which contributed to the group finding, considering the control group had clinically normal 226 Hz admittance by design. Electrically evoked stapedial reflexes were measurable in nine of 14 ears (64.3%) and in 24 of 46 electrodes (52.5%) tested. Reflex-induced changes in reflectance patterns were unique to the participant/ear, but similar across activators (electrodes) within a given ear. In addition, reflectance values at or above 1000 Hz were affected most by activating the stapedial reflex, even in ears with clinically normal 226 Hz admittance. This is a higher-frequency range than has been reported for acoustically evoked reflex-induced reflectance changes and is consistent with increased middle ear stiffness at rest. Electrically evoked reflexes could be measured more often with the 678 Hz or the broadband probe compared with the 226 Hz probe tone. Although reflex thresholds were lower with the broadband probe compared with the 678 Hz probe in 16 of 24 conditions, this was not a statistically significant finding (Wilcoxon signed-rank test; p = 0.072). Conclusions: The applications of wideband acoustic immittance measurements (reflectance and reflexes) should also be considered for ears with CIs. Further work is needed to describe changes across time in ears with CIs to more fully understand the reflectance pattern indicating increased middle ear stiffness and to optimize measuring eSRs with a broadband probe.
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[article] 
inEar and hearing > Vol. 41, n°4 (Juillet-aout 2020) . - p. 896-906

Titre :	Evidence of a Vestibular Origin for Crossed-Sternocleidomastoid Muscle Responses to Air-Conducted Sound
Type de document :	Article
Auteurs :	Rachael L. Taylor ; Roger W. Winton ; Sally M. Rosengren ; Emma C. Argaet ; Miriam S. Welgampola
Année de publication :	2020
Article en page(s) :	p. 896-906
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Electromyographie ; Potentiel évoqué myogénique vestibulaire (oVEMP) (cVEMP) ; SACULE ; Utricule Autres descripteurs Canal auriculaire
Résumé :	Objectives: Small, excitatory surface potentials can sometimes be recorded from the contralateral sternocleidomastoid muscle (SCM) following monaural acoustic stimulation. Little is known about the physiological properties of these crossed reflexes. In this study, we sought the properties of crossed SCM responses and through comparison with other cochlear and vestibular myogenic potentials, their likely receptor origin. Design: Surface potentials were recorded from the ipsilateral and contralateral SCM and postauricular (PAM) muscles of 11 healthy volunteers, 4 patients with superior canal dehiscence and 1 with profound hearing loss. Air-conducted clicks of 105 dB nHL and tone bursts (250 to 4000 Hz) of 100 dB nHL were presented monaurally through TDH 49 headphones during head elevation. Click-evoked responses were recorded under two conditions of gaze in random order: gaze straight ahead and rotated hard toward the contralateral recording electrodes. Amplitudes (corrected and uncorrected) and latencies for crossed SCM responses were compared with vestibular (ipsilateral SCM) and cochlear (PAM) responses between groups and across the different recording conditions. Results: Surface waveforms were biphasic; positive-negative for the ipsilateral SCM, and negative-positive for the contralateral SCM and PAM. There were significant differences in the amplitudes and latencies (p = 0.004) for click responses of healthy controls across recording sites. PAM responses had the largest mean-corrected amplitudes (2.3 +/- 2.8) and longest latencies (13.0 +/- 1.2 msec), compared with ipsilateral (1.6 +/- 0.5; 12.0 +/- 0.7 msec) and contralateral (0.8 +/- 0.3; 10.4 +/- 1.0 msec) SCM responses. Uncorrected amplitudes and muscle activation for PAM increased by 104.4% and 46.8% with lateral gaze respectively, whereas SCM responses were not significantly affected. Click responses of patients with superior canal dehiscence followed a similar latency, amplitude, and gaze modulation trend as controls. SCM responses were preserved in the patient with profound hearing loss, yet all PAM were absent. There were significant differences in the frequency tuning of the three reflexes (p Conclusions: Properties of crossed SCM responses were similar, though not identical, to those of ipsilateral SCM responses and are likely to be predominantly vestibular in origin. They are unlikely to represent volume conduction from the PAM as they were unaffected by lateral gaze, were shorter in latency, and had different tuning properties. The influence of crossed vestibulo-collic pathways should be considered when interpreting cervical vestibular-evoked myogenic potentials recorded under conditions of binaural stimulation.
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[article] Evidence of a Vestibular Origin for Crossed-Sternocleidomastoid Muscle Responses to Air-Conducted Sound [Article] / Rachael L. Taylor ; Roger W. Winton ; Sally M. Rosengren ; Emma C. Argaet ; Miriam S. Welgampola . - 2020 . - p. 896-906.
Langues : Anglais (eng)
in Ear and hearing > Vol. 41, n°4 (Juillet-aout 2020) . - p. 896-906

Descripteurs :	HE Vinci Electromyographie ; Potentiel évoqué myogénique vestibulaire (oVEMP) (cVEMP) ; SACULE ; Utricule Autres descripteurs Canal auriculaire
Résumé :	Objectives: Small, excitatory surface potentials can sometimes be recorded from the contralateral sternocleidomastoid muscle (SCM) following monaural acoustic stimulation. Little is known about the physiological properties of these crossed reflexes. In this study, we sought the properties of crossed SCM responses and through comparison with other cochlear and vestibular myogenic potentials, their likely receptor origin. Design: Surface potentials were recorded from the ipsilateral and contralateral SCM and postauricular (PAM) muscles of 11 healthy volunteers, 4 patients with superior canal dehiscence and 1 with profound hearing loss. Air-conducted clicks of 105 dB nHL and tone bursts (250 to 4000 Hz) of 100 dB nHL were presented monaurally through TDH 49 headphones during head elevation. Click-evoked responses were recorded under two conditions of gaze in random order: gaze straight ahead and rotated hard toward the contralateral recording electrodes. Amplitudes (corrected and uncorrected) and latencies for crossed SCM responses were compared with vestibular (ipsilateral SCM) and cochlear (PAM) responses between groups and across the different recording conditions. Results: Surface waveforms were biphasic; positive-negative for the ipsilateral SCM, and negative-positive for the contralateral SCM and PAM. There were significant differences in the amplitudes and latencies (p = 0.004) for click responses of healthy controls across recording sites. PAM responses had the largest mean-corrected amplitudes (2.3 +/- 2.8) and longest latencies (13.0 +/- 1.2 msec), compared with ipsilateral (1.6 +/- 0.5; 12.0 +/- 0.7 msec) and contralateral (0.8 +/- 0.3; 10.4 +/- 1.0 msec) SCM responses. Uncorrected amplitudes and muscle activation for PAM increased by 104.4% and 46.8% with lateral gaze respectively, whereas SCM responses were not significantly affected. Click responses of patients with superior canal dehiscence followed a similar latency, amplitude, and gaze modulation trend as controls. SCM responses were preserved in the patient with profound hearing loss, yet all PAM were absent. There were significant differences in the frequency tuning of the three reflexes (p Conclusions: Properties of crossed SCM responses were similar, though not identical, to those of ipsilateral SCM responses and are likely to be predominantly vestibular in origin. They are unlikely to represent volume conduction from the PAM as they were unaffected by lateral gaze, were shorter in latency, and had different tuning properties. The influence of crossed vestibulo-collic pathways should be considered when interpreting cervical vestibular-evoked myogenic potentials recorded under conditions of binaural stimulation.
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[article] 
inEar and hearing > Vol. 41, n°4 (Juillet-aout 2020) . - p. 907-917

Titre :	Effects of Cognitive Load on Pure-Tone Audiometry Thresholds in Younger and Older Adults
Type de document :	Article
Auteurs :	Antje Heinrich ; Melanie A. Ferguson ; Sven L. Mattys
Année de publication :	2020
Article en page(s) :	p. 907-917
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Sujet âgé Autres descripteurs Attention divisee ; Charge cognitive ; Perception des sons purs
Résumé :	Objectives: Cognitive load (CL) impairs listeners' ability to comprehend sentences, recognize words, and identify speech sounds. Recent findings suggest that this effect originates in a disruption of low-level perception of acoustic details. Here, we attempted to quantify such a disruption by measuring the effect of CL (a two-back task) on pure-tone audiometry (PTA) thresholds. We also asked whether the effect of CL on PTA was greater in older adults, on account of their reduced ability to divide cognitive resources between simultaneous tasks. To specify the mechanisms and representations underlying the interface between auditory and cognitive processes, we contrasted CL requiring visual encoding with CL requiring auditory encoding. Finally, the link between the cost of performing PTA under CL, working memory, and speech-in-noise (SiN) perception was investigated and compared between younger and older participants. Design: Younger and older adults (44 in each group) did a PTA test at 0.5, 1, 2, and 4 kHz pure tones under CL and no CL. CL consisted of a visual two-back task running throughout the PTA test. The two-back task involved either visual encoding of the stimuli (meaningless images) or subvocal auditory encoding (a rhyme task on written nonwords). Participants also underwent a battery of SiN tests and a working memory test (letter number sequencing). Results: Younger adults showed elevated PTA thresholds under CL, but only when CL involved subvocal auditory encoding. CL had no effect when it involved purely visual encoding. In contrast, older adults showed elevated thresholds under both types of CL. When present, the PTA CL cost was broadly comparable in younger and older adults (approximately 2 dB HL). The magnitude of PTA CL cost did not correlate significantly with SiN perception or working memory in either age group. In contrast, PTA alone showed strong links to both SiN and letter number sequencing in older adults. Conclusions: The results show that CL can exert its effect at the level of hearing sensitivity. However, in younger adults, this effect is only found when CL involves auditory mental representations. When CL involves visual representations, it has virtually no impact on hearing thresholds. In older adults, interference is found in both conditions. The results suggest that hearing progresses from engaging primarily modality-specific cognition in early adulthood to engaging cognition in a more undifferentiated way in older age. Moreover, hearing thresholds measured under CL did not predict SiN perception more accurately than standard PTA thresholds.
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[article] Effects of Cognitive Load on Pure-Tone Audiometry Thresholds in Younger and Older Adults [Article] / Antje Heinrich ; Melanie A. Ferguson ; Sven L. Mattys . - 2020 . - p. 907-917.
Langues : Anglais (eng)
in Ear and hearing > Vol. 41, n°4 (Juillet-aout 2020) . - p. 907-917

Descripteurs :	HE Vinci Sujet âgé Autres descripteurs Attention divisee ; Charge cognitive ; Perception des sons purs
Résumé :	Objectives: Cognitive load (CL) impairs listeners' ability to comprehend sentences, recognize words, and identify speech sounds. Recent findings suggest that this effect originates in a disruption of low-level perception of acoustic details. Here, we attempted to quantify such a disruption by measuring the effect of CL (a two-back task) on pure-tone audiometry (PTA) thresholds. We also asked whether the effect of CL on PTA was greater in older adults, on account of their reduced ability to divide cognitive resources between simultaneous tasks. To specify the mechanisms and representations underlying the interface between auditory and cognitive processes, we contrasted CL requiring visual encoding with CL requiring auditory encoding. Finally, the link between the cost of performing PTA under CL, working memory, and speech-in-noise (SiN) perception was investigated and compared between younger and older participants. Design: Younger and older adults (44 in each group) did a PTA test at 0.5, 1, 2, and 4 kHz pure tones under CL and no CL. CL consisted of a visual two-back task running throughout the PTA test. The two-back task involved either visual encoding of the stimuli (meaningless images) or subvocal auditory encoding (a rhyme task on written nonwords). Participants also underwent a battery of SiN tests and a working memory test (letter number sequencing). Results: Younger adults showed elevated PTA thresholds under CL, but only when CL involved subvocal auditory encoding. CL had no effect when it involved purely visual encoding. In contrast, older adults showed elevated thresholds under both types of CL. When present, the PTA CL cost was broadly comparable in younger and older adults (approximately 2 dB HL). The magnitude of PTA CL cost did not correlate significantly with SiN perception or working memory in either age group. In contrast, PTA alone showed strong links to both SiN and letter number sequencing in older adults. Conclusions: The results show that CL can exert its effect at the level of hearing sensitivity. However, in younger adults, this effect is only found when CL involves auditory mental representations. When CL involves visual representations, it has virtually no impact on hearing thresholds. In older adults, interference is found in both conditions. The results suggest that hearing progresses from engaging primarily modality-specific cognition in early adulthood to engaging cognition in a more undifferentiated way in older age. Moreover, hearing thresholds measured under CL did not predict SiN perception more accurately than standard PTA thresholds.
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[article] 
inEar and hearing > Vol. 41, n°4 (Juillet-aout 2020) . - p. 918-934

Titre :	The Effect of Interphase Gap on Neural Response of the Electrically Stimulated Cochlear Nerve in Children With Cochlear Nerve Deficiency and Children With Normal-Sized Cochlear Nerves
Type de document :	Article
Auteurs :	Shuman He ; Lei Xu ; Jeffrey Skidmore ; Fuh-Cherng Jeng ; [et al.]
Année de publication :	2020
Article en page(s) :	p. 918-934
Langues :	Anglais (eng)
Descripteurs :	Autres descripteurs Deficience auditive cochleaire ; Nerf auditif
Mots-clés :	Electrically evoked auditory compound action potentials, Interphase gap, Neural survival
Résumé :	Objectives: This study aimed to compare the effects of increasing the interphase gap (IPG) on the neural response of the electrically stimulated cochlear nerve (CN) between children with CN deficiency (CND) and children with normal-sized CNs. Design: Study participants included 30 children with CND and 30 children with normal-sized CNs. All subjects were implanted with a Cochlear Nucleus device with the internal electrode array 24RE[CA] in the test ear. The stimulus was a charge-balanced, cathodic leading, biphasic pulse with a pulse-phase duration of 50 [mu]sec. For each subject, the electrically evoked compound action potential (eCAP) input/output (I/O) function was measured for 6 IPGs (i.e., 7, 14, 21, 28, 35, and 42 [mu]sec) at 3 electrode locations across the electrode array. For each subject and each testing electrode, the highest stimulation used to measure the eCAP I/O function was the maximum comfortable level measured with an IPG of 42 [mu]sec. Dependent variables (DVs) were the maximum eCAP amplitude, the eCAP threshold, and the slope of the eCAP I/O function estimated using both linear and sigmoidal regression functions. For each DV, the size of the IPG effect was defined as the proportional change relative to the result measured for the 7 [mu]sec IPG at the basal electrode location. Generalized linear mixed effect models with subject group, electrode location, and IPG duration as the fixed effects and subject as the random effect were used to compare these DVs and the size of the IPG effect on these DVs. Results: Children with CND showed smaller maximum eCAP amplitudes, higher eCAP thresholds, and smaller slopes of eCAP I/O function estimated using either linear or sigmoidal regression function than children with normal-sized CNs. Increasing the IPG duration resulted in larger maximum eCAP amplitudes, lower eCAP thresholds and larger slopes of eCAP I/O function estimated using sigmoidal regression function at all three electrode locations in both study groups. Compared with children with normal-sized CNs, children with CND showed larger IPG effects on both the maximum eCAP amplitude and the slope of the eCAP I/O function estimated using either linear or sigmoidal regression function, and a smaller IPG effect on the eCAP threshold than those measured in children with normal-sized CNs. Conclusions: Increasing the IPG increases responsiveness of the electrically stimulated CN in both children with CND and children with normal-sized CNs. The maximum eCAP amplitude and the slope of the eCAP I/O function measured in human listeners with poorer CN survival are more sensitive to changes in the IPG. In contrast, the eCAP threshold in listeners with poorer CN survival is less sensitive to increases in the IPG. Further studies are warranted to identify the best parameters of eCAP results for predicting CN survival before this eCAP testing paradigm can be used as a clinical tool for evaluating neural health for individual cochlear implant patients.
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[article] The Effect of Interphase Gap on Neural Response of the Electrically Stimulated Cochlear Nerve in Children With Cochlear Nerve Deficiency and Children With Normal-Sized Cochlear Nerves [Article] / Shuman He ; Lei Xu ; Jeffrey Skidmore ; Fuh-Cherng Jeng ; [et al.] . - 2020 . - p. 918-934.
Langues : Anglais (eng)
in Ear and hearing > Vol. 41, n°4 (Juillet-aout 2020) . - p. 918-934

Descripteurs :	Autres descripteurs Deficience auditive cochleaire ; Nerf auditif
Mots-clés :	Electrically evoked auditory compound action potentials, Interphase gap, Neural survival
Résumé :	Objectives: This study aimed to compare the effects of increasing the interphase gap (IPG) on the neural response of the electrically stimulated cochlear nerve (CN) between children with CN deficiency (CND) and children with normal-sized CNs. Design: Study participants included 30 children with CND and 30 children with normal-sized CNs. All subjects were implanted with a Cochlear Nucleus device with the internal electrode array 24RE[CA] in the test ear. The stimulus was a charge-balanced, cathodic leading, biphasic pulse with a pulse-phase duration of 50 [mu]sec. For each subject, the electrically evoked compound action potential (eCAP) input/output (I/O) function was measured for 6 IPGs (i.e., 7, 14, 21, 28, 35, and 42 [mu]sec) at 3 electrode locations across the electrode array. For each subject and each testing electrode, the highest stimulation used to measure the eCAP I/O function was the maximum comfortable level measured with an IPG of 42 [mu]sec. Dependent variables (DVs) were the maximum eCAP amplitude, the eCAP threshold, and the slope of the eCAP I/O function estimated using both linear and sigmoidal regression functions. For each DV, the size of the IPG effect was defined as the proportional change relative to the result measured for the 7 [mu]sec IPG at the basal electrode location. Generalized linear mixed effect models with subject group, electrode location, and IPG duration as the fixed effects and subject as the random effect were used to compare these DVs and the size of the IPG effect on these DVs. Results: Children with CND showed smaller maximum eCAP amplitudes, higher eCAP thresholds, and smaller slopes of eCAP I/O function estimated using either linear or sigmoidal regression function than children with normal-sized CNs. Increasing the IPG duration resulted in larger maximum eCAP amplitudes, lower eCAP thresholds and larger slopes of eCAP I/O function estimated using sigmoidal regression function at all three electrode locations in both study groups. Compared with children with normal-sized CNs, children with CND showed larger IPG effects on both the maximum eCAP amplitude and the slope of the eCAP I/O function estimated using either linear or sigmoidal regression function, and a smaller IPG effect on the eCAP threshold than those measured in children with normal-sized CNs. Conclusions: Increasing the IPG increases responsiveness of the electrically stimulated CN in both children with CND and children with normal-sized CNs. The maximum eCAP amplitude and the slope of the eCAP I/O function measured in human listeners with poorer CN survival are more sensitive to changes in the IPG. In contrast, the eCAP threshold in listeners with poorer CN survival is less sensitive to increases in the IPG. Further studies are warranted to identify the best parameters of eCAP results for predicting CN survival before this eCAP testing paradigm can be used as a clinical tool for evaluating neural health for individual cochlear implant patients.
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[article] 
inEar and hearing > Vol. 41, n°1 (Janvier-Février 2020) . - p. 25-38

Titre :	Middle Ear Muscle Reflex and Word Recognition in "Normal-Hearing" Adults: Evidence for Cochlear Synaptopathy?
Type de document :	Article
Auteurs :	Anita M. Mepani ; Sarah A. Kirk ; Kenneth E. Hancock ; [et al.]
Année de publication :	2020
Article en page(s) :	p. 25-38
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Audition dans le bruit ; Electrocochléographie ; Reconnaissance auditive du mot ; Réflexe acoustique ; synaptopathie cochléaire Autres descripteurs Reflexe de l'oreille moyenne
Résumé :	Objectives: Permanent threshold elevation after noise exposure, ototoxic drugs, or aging is caused by loss of sensory cells; however, animal studies show that hair cell loss is often preceded by degeneration of synapses between sensory cells and auditory nerve fibers. The silencing of these neurons, especially those with high thresholds and low spontaneous rates, degrades auditory processing and may contribute to difficulties in understanding speech in noise. Although cochlear synaptopathy can be diagnosed in animals by measuring suprathreshold auditory brainstem responses, its diagnosis in humans remains a challenge. In mice, cochlear synaptopathy is also correlated with measures of middle ear muscle (MEM) reflex strength, possibly because the missing high-threshold neurons are important drivers of this reflex. The authors hypothesized that measures of the MEM reflex might be better than other assays of peripheral function in predicting difficulties hearing in difficult listening environments in human subjects. Design: The authors recruited 165 normal-hearing healthy subjects, between 18 and 63 years of age, with no history of ear or hearing problems, no history of neurologic disorders, and unremarkable otoscopic examinations. Word recognition in quiet and in difficult listening situations was measured in four ways: using isolated words from the Northwestern University auditory test number six corpus with either (a) 0 dB signal to noise, (b) 45% time compression with reverberation, or (c) 65% time compression with reverberation, and (d) with a modified version of the QuickSIN. Audiometric thresholds were assessed at standard and extended high frequencies. Outer hair cell function was assessed by distortion product otoacoustic emissions (DPOAEs). Middle ear function and reflexes were assessed using three methods: the acoustic reflex threshold as measured clinically, wideband tympanometry as measured clinically, and a custom wideband method that uses a pair of click probes flanking an ipsilateral noise elicitor. Other aspects of peripheral auditory function were assessed by measuring click-evoked gross potentials, that is, summating potential (SP) and action potential (AP) from ear canal electrodes. Results: After adjusting for age and sex, word recognition scores were uncorrelated with audiometric or DPOAE thresholds, at either standard or extended high frequencies. MEM reflex thresholds were significantly correlated with scores on isolated word recognition, but not with the modified version of the QuickSIN. The highest pairwise correlations were seen using the custom assay. AP measures were correlated with some of the word scores, but not as highly as seen for the MEM custom assay, and only if amplitude was measured from SP peak to AP peak, rather than baseline to AP peak. The highest pairwise correlations with word scores, on all four tests, were seen with the SP/AP ratio, followed closely by SP itself. When all predictor variables were combined in a stepwise multivariate regression, SP/AP dominated models for all four word score outcomes. MEM measures only enhanced the adjusted r2 values for the 45% time compression test. The only other predictors that enhanced model performance (and only for two outcome measures) were measures of interaural threshold asymmetry. Conclusions: Results suggest that, among normal-hearing subjects, there is a significant peripheral contribution to diminished hearing performance in difficult listening environments that is not captured by either threshold audiometry or DPOAEs. The significant univariate correlations between word scores and either SP/AP, SP, MEM reflex thresholds, or AP amplitudes (in that order) are consistent with a type of primary neural degeneration. However, interpretation is clouded by uncertainty as to the mix of pre- and postsynaptic contributions to the click-evoked SP. None of the assays presented here has the sensitivity to diagnose neural degeneration on a case-by-case basis; however, these tests may be useful in longitudinal studies to track accumulation of neural degeneration in individual subjects.
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[article] Middle Ear Muscle Reflex and Word Recognition in "Normal-Hearing" Adults: Evidence for Cochlear Synaptopathy? [Article] / Anita M. Mepani ; Sarah A. Kirk ; Kenneth E. Hancock ; [et al.] . - 2020 . - p. 25-38.
Langues : Anglais (eng)
in Ear and hearing > Vol. 41, n°1 (Janvier-Février 2020) . - p. 25-38

Descripteurs :	HE Vinci Audition dans le bruit ; Electrocochléographie ; Reconnaissance auditive du mot ; Réflexe acoustique ; synaptopathie cochléaire Autres descripteurs Reflexe de l'oreille moyenne
Résumé :	Objectives: Permanent threshold elevation after noise exposure, ototoxic drugs, or aging is caused by loss of sensory cells; however, animal studies show that hair cell loss is often preceded by degeneration of synapses between sensory cells and auditory nerve fibers. The silencing of these neurons, especially those with high thresholds and low spontaneous rates, degrades auditory processing and may contribute to difficulties in understanding speech in noise. Although cochlear synaptopathy can be diagnosed in animals by measuring suprathreshold auditory brainstem responses, its diagnosis in humans remains a challenge. In mice, cochlear synaptopathy is also correlated with measures of middle ear muscle (MEM) reflex strength, possibly because the missing high-threshold neurons are important drivers of this reflex. The authors hypothesized that measures of the MEM reflex might be better than other assays of peripheral function in predicting difficulties hearing in difficult listening environments in human subjects. Design: The authors recruited 165 normal-hearing healthy subjects, between 18 and 63 years of age, with no history of ear or hearing problems, no history of neurologic disorders, and unremarkable otoscopic examinations. Word recognition in quiet and in difficult listening situations was measured in four ways: using isolated words from the Northwestern University auditory test number six corpus with either (a) 0 dB signal to noise, (b) 45% time compression with reverberation, or (c) 65% time compression with reverberation, and (d) with a modified version of the QuickSIN. Audiometric thresholds were assessed at standard and extended high frequencies. Outer hair cell function was assessed by distortion product otoacoustic emissions (DPOAEs). Middle ear function and reflexes were assessed using three methods: the acoustic reflex threshold as measured clinically, wideband tympanometry as measured clinically, and a custom wideband method that uses a pair of click probes flanking an ipsilateral noise elicitor. Other aspects of peripheral auditory function were assessed by measuring click-evoked gross potentials, that is, summating potential (SP) and action potential (AP) from ear canal electrodes. Results: After adjusting for age and sex, word recognition scores were uncorrelated with audiometric or DPOAE thresholds, at either standard or extended high frequencies. MEM reflex thresholds were significantly correlated with scores on isolated word recognition, but not with the modified version of the QuickSIN. The highest pairwise correlations were seen using the custom assay. AP measures were correlated with some of the word scores, but not as highly as seen for the MEM custom assay, and only if amplitude was measured from SP peak to AP peak, rather than baseline to AP peak. The highest pairwise correlations with word scores, on all four tests, were seen with the SP/AP ratio, followed closely by SP itself. When all predictor variables were combined in a stepwise multivariate regression, SP/AP dominated models for all four word score outcomes. MEM measures only enhanced the adjusted r2 values for the 45% time compression test. The only other predictors that enhanced model performance (and only for two outcome measures) were measures of interaural threshold asymmetry. Conclusions: Results suggest that, among normal-hearing subjects, there is a significant peripheral contribution to diminished hearing performance in difficult listening environments that is not captured by either threshold audiometry or DPOAEs. The significant univariate correlations between word scores and either SP/AP, SP, MEM reflex thresholds, or AP amplitudes (in that order) are consistent with a type of primary neural degeneration. However, interpretation is clouded by uncertainty as to the mix of pre- and postsynaptic contributions to the click-evoked SP. None of the assays presented here has the sensitivity to diagnose neural degeneration on a case-by-case basis; however, these tests may be useful in longitudinal studies to track accumulation of neural degeneration in individual subjects.
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[article] 
inEar and hearing > Vol. 41, n°1 (Janvier-Février 2020) . - p.39-54

Titre :	Predicting Speech-in-Noise Deficits from the Audiogram
Type de document :	Article
Auteurs :	Daniel E. Shub ; Matthew J. Makashay ; Douglas Brungart
Année de publication :	2020
Article en page(s) :	p.39-54
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Audiogramme ; Audition dans le bruit ; Conservation auditive ; Militaire
Résumé :	Objectives: In occupations that involve hearing critical tasks, individuals need to undergo periodic hearing screenings to ensure that they have not developed hearing losses that could impair their ability to safely and effectively perform their jobs. Most periodic hearing screenings are limited to pure-tone audiograms, but in many cases, the ability to understand speech in noisy environments may be more important to functional job performance than the ability to detect quiet sounds. The ability to use audiometric threshold data to identify individuals with poor speech-in-noise performance is of particular interest to the U.S. military, which has an ongoing responsibility to ensure that its service members (SMs) have the hearing abilities they require to accomplish their mission. This work investigates the development of optimal strategies for identifying individuals with poor speech-in-noise performance from the audiogram. Design: Data from 5487 individuals were used to evaluate a range of classifiers, based exclusively on the pure-tone audiogram, for identifying individuals who have deficits in understanding speech in noise. The classifiers evaluated were based on generalized linear models (GLMs), the speech intelligibility index (SII), binary threshold criteria, and current standards used by the U.S. military. The classifiers were evaluated in a detection theoretic framework where the sensitivity and specificity of the classifiers were quantified. In addition to the performance of these classifiers for identifying individuals with deficits understanding speech in noise, data from 500,733 U.S. Army SMs were used to understand how the classifiers would affect the number of SMs being referred for additional testing. Results: A classifier based on binary threshold criteria that was identified through an iterative search procedure outperformed a classifier based on the SII and ones based on GLMs with large numbers of fitted parameters. This suggests that the saturating nature of the SII is important, but that the weights of frequency channels are not optimal for identifying individuals with deficits understanding speech in noise. It is possible that a highly complicated model with many free parameters could outperform the classifiers considered here, but there was only a modest difference between the performance of a classifier based on a GLM with 26 fitted parameters and one based on a simple all-frequency pure-tone average. This suggests that the details of the audiogram are a relatively insensitive predictor of performance in speech-in-noise tasks. Conclusions: The best classifier identified in this study, which was a binary threshold classifier derived from an iterative search process, does appear to reliably outperform the current thresholds criteria used by the U.S. military to identify individuals with abnormally poor speech-in-noise performance, both in terms of fewer false alarms and a greater hit rate. Substantial improvements in the ability to detect SMs with impaired speech-in-noise performance can likely only be obtained by adding some form of speech-in-noise testing to the hearing monitoring program. While the improvements were modest, the overall benefit of adopting the proposed classifier is likely substantial given the number of SMs enrolled in U.S. military hearing conservation and readiness programs.
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[article] Predicting Speech-in-Noise Deficits from the Audiogram [Article] / Daniel E. Shub ; Matthew J. Makashay ; Douglas Brungart . - 2020 . - p.39-54.
Langues : Anglais (eng)
in Ear and hearing > Vol. 41, n°1 (Janvier-Février 2020) . - p.39-54

Descripteurs :	HE Vinci Audiogramme ; Audition dans le bruit ; Conservation auditive ; Militaire
Résumé :	Objectives: In occupations that involve hearing critical tasks, individuals need to undergo periodic hearing screenings to ensure that they have not developed hearing losses that could impair their ability to safely and effectively perform their jobs. Most periodic hearing screenings are limited to pure-tone audiograms, but in many cases, the ability to understand speech in noisy environments may be more important to functional job performance than the ability to detect quiet sounds. The ability to use audiometric threshold data to identify individuals with poor speech-in-noise performance is of particular interest to the U.S. military, which has an ongoing responsibility to ensure that its service members (SMs) have the hearing abilities they require to accomplish their mission. This work investigates the development of optimal strategies for identifying individuals with poor speech-in-noise performance from the audiogram. Design: Data from 5487 individuals were used to evaluate a range of classifiers, based exclusively on the pure-tone audiogram, for identifying individuals who have deficits in understanding speech in noise. The classifiers evaluated were based on generalized linear models (GLMs), the speech intelligibility index (SII), binary threshold criteria, and current standards used by the U.S. military. The classifiers were evaluated in a detection theoretic framework where the sensitivity and specificity of the classifiers were quantified. In addition to the performance of these classifiers for identifying individuals with deficits understanding speech in noise, data from 500,733 U.S. Army SMs were used to understand how the classifiers would affect the number of SMs being referred for additional testing. Results: A classifier based on binary threshold criteria that was identified through an iterative search procedure outperformed a classifier based on the SII and ones based on GLMs with large numbers of fitted parameters. This suggests that the saturating nature of the SII is important, but that the weights of frequency channels are not optimal for identifying individuals with deficits understanding speech in noise. It is possible that a highly complicated model with many free parameters could outperform the classifiers considered here, but there was only a modest difference between the performance of a classifier based on a GLM with 26 fitted parameters and one based on a simple all-frequency pure-tone average. This suggests that the details of the audiogram are a relatively insensitive predictor of performance in speech-in-noise tasks. Conclusions: The best classifier identified in this study, which was a binary threshold classifier derived from an iterative search process, does appear to reliably outperform the current thresholds criteria used by the U.S. military to identify individuals with abnormally poor speech-in-noise performance, both in terms of fewer false alarms and a greater hit rate. Substantial improvements in the ability to detect SMs with impaired speech-in-noise performance can likely only be obtained by adding some form of speech-in-noise testing to the hearing monitoring program. While the improvements were modest, the overall benefit of adopting the proposed classifier is likely substantial given the number of SMs enrolled in U.S. military hearing conservation and readiness programs.
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[article] 
inEar and hearing > Vol. 41, n°1 (Janvier-Février 2020) . - p. 55-66

Titre :	Children With Congenital Unilateral Sensorineural Hearing Loss: Effects of Late Hearing Aid Amplification-A Pilot Study
Type de document :	Article
Auteurs :	Marlin Johansson ; Filip Asp ; Erik Berninger
Année de publication :	2020
Article en page(s) :	p. 55-66
Langues :	Anglais (eng)
Descripteurs :	Autres descripteurs électrophysiologie ; Plasticite auditive HE Vinci Aide auditive ; Localisation auditive ; Perte auditive unilatérale (USNHL)
Résumé :	Objectives: Although children with unilateral hearing loss (uHL) have high risk of experiencing academic difficulties, speech-language delays, poor sound localization, and speech recognition in noise, studies on hearing aid (HA) outcomes are few. Consequently, it is unknown when and how amplification is optimally provided. The aim was to study whether children with mild-to-moderate congenital unilateral sensorineural hearing loss (uSNHL) benefit from HAs. Design: All 6- to 11-year-old children with nonsyndromic congenital uSNHL and at least 6 months of HA use were invited (born in Stockholm county council, n = 7). Participants were 6 children (9.7- to 10.8-years-old) with late HA fittings (>4.8 years of age). Unaided and aided hearing was studied with a comprehensive test battery in a within-subject design. Questionnaires were used to study overall hearing performance and disability. Sound localization accuracy (SLA) and speech recognition thresholds (SRTs) in competing speech were measured in sound field to study hearing under demanding listening conditions. SLA was measured by recording eye-gaze in response to auditory-visual stimuli presented from 12 loudspeaker-video display pairs arranged equidistantly within +/-55[degrees] in the frontal horizontal plane. The SRTs were measured for target sentences at 0[degrees] in spatially separated (+/-30[degrees] and +/-150[degrees]) continuous speech. Auditory brainstem responses (ABRs) were obtained in both ears separately to study auditory nerve function at the brainstem level. Results: The mean +/- SD pure-tone average (0.5, 1, 2, and 4 kHz) was 45 +/- 8 dB HL and 6 +/- 4 dB HL in the impaired and normal hearing ear, respectively (n = 6). Horizontal SLA was significantly poorer in the aided compared with unaided condition. A significant relationship was found between aided SLA (quantified by an error index) and the impaired ear's ABR I to V interval, suggesting a relationship between the two. Results from questionnaires revealed aided benefit in one-to-one communication, whereas no significant benefit was found for communication in background noise or reverberation. No aided benefit was found for the SRTs in competing speech. Conclusions: Children with congenital uSNHL benefit from late HA intervention in one-to-one communication but not in demanding listening situations, and there is a risk of degraded SLA. The results indicate that neural transmission time from the impaired cochlea to the upper brainstem may have an important role in unilaterally aided spatial hearing, warranting further study in children with uHL receiving early HA intervention.
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[article] Children With Congenital Unilateral Sensorineural Hearing Loss: Effects of Late Hearing Aid Amplification-A Pilot Study [Article] / Marlin Johansson ; Filip Asp ; Erik Berninger . - 2020 . - p. 55-66.
Langues : Anglais (eng)
in Ear and hearing > Vol. 41, n°1 (Janvier-Février 2020) . - p. 55-66

Descripteurs :	Autres descripteurs électrophysiologie ; Plasticite auditive HE Vinci Aide auditive ; Localisation auditive ; Perte auditive unilatérale (USNHL)
Résumé :	Objectives: Although children with unilateral hearing loss (uHL) have high risk of experiencing academic difficulties, speech-language delays, poor sound localization, and speech recognition in noise, studies on hearing aid (HA) outcomes are few. Consequently, it is unknown when and how amplification is optimally provided. The aim was to study whether children with mild-to-moderate congenital unilateral sensorineural hearing loss (uSNHL) benefit from HAs. Design: All 6- to 11-year-old children with nonsyndromic congenital uSNHL and at least 6 months of HA use were invited (born in Stockholm county council, n = 7). Participants were 6 children (9.7- to 10.8-years-old) with late HA fittings (>4.8 years of age). Unaided and aided hearing was studied with a comprehensive test battery in a within-subject design. Questionnaires were used to study overall hearing performance and disability. Sound localization accuracy (SLA) and speech recognition thresholds (SRTs) in competing speech were measured in sound field to study hearing under demanding listening conditions. SLA was measured by recording eye-gaze in response to auditory-visual stimuli presented from 12 loudspeaker-video display pairs arranged equidistantly within +/-55[degrees] in the frontal horizontal plane. The SRTs were measured for target sentences at 0[degrees] in spatially separated (+/-30[degrees] and +/-150[degrees]) continuous speech. Auditory brainstem responses (ABRs) were obtained in both ears separately to study auditory nerve function at the brainstem level. Results: The mean +/- SD pure-tone average (0.5, 1, 2, and 4 kHz) was 45 +/- 8 dB HL and 6 +/- 4 dB HL in the impaired and normal hearing ear, respectively (n = 6). Horizontal SLA was significantly poorer in the aided compared with unaided condition. A significant relationship was found between aided SLA (quantified by an error index) and the impaired ear's ABR I to V interval, suggesting a relationship between the two. Results from questionnaires revealed aided benefit in one-to-one communication, whereas no significant benefit was found for communication in background noise or reverberation. No aided benefit was found for the SRTs in competing speech. Conclusions: Children with congenital uSNHL benefit from late HA intervention in one-to-one communication but not in demanding listening situations, and there is a risk of degraded SLA. The results indicate that neural transmission time from the impaired cochlea to the upper brainstem may have an important role in unilaterally aided spatial hearing, warranting further study in children with uHL receiving early HA intervention.
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[article] 
inEar and hearing > Vol. 41, n°1 (Janvier-Février 2020) . - p. 67-71

Titre :	Otitis Media in Childhood and Disease in Adulthood: A 40-Year Follow-Up Study
Type de document :	Article
Auteurs :	Lisa Aarhus ; Preben Homoe ; Bo Engdahl
Année de publication :	2020
Article en page(s) :	p. 67-71
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Acouphène ; Déficience auditive ; Inflammation ; Maladies auto-immunes ; Maladies cardiovasculaires ; Maladies vestibulaires ; Otite
Résumé :	Objectives: The pathogenesis of chronic suppurative otitis media (CSOM) includes complex interactions between microbial, immunologic, and genetic factors. To our knowledge, no study has focused on the association between childhood otitis media, immune regulation, inflammatory conditions, and chronic disease in adulthood. The present study aims to assess whether CSOM in childhood predicts immune-related inflammatory disorders or cardiovascular disease in adulthood. Another aim is to assess the association with oto-vestibular diseases in adulthood. Design: Population cohort study in Norway comprised 51,626 participants (mean age 52 years) who underwent a hearing investigation at 7 to 13 years of age where 189 were diagnosed with CSOM (otorhinolaryngologist diagnose) and 51,437 had normal hearing thresholds (controls). Data on adult disease were obtained from the Norwegian Patient Registry (ICD-10 codes from the specialist health services). We estimated associations with logistic regression analyses. Results: The associations between CSOM in childhood and disease in adulthood were as follows: chronic sinusitis (odds ratio 3.13, 95% confidence interval 1.15 to 8.52); cardiovascular disease (1.38, 1.01 to 1.88); hearing loss (5.58, 3.78 to 8.22); tinnitus (2.62, 1.07 to 6.41). The adult hearing loss among cases with childhood CSOM was most frequently registered as sensorineural. There was no statistically significant increased risk of later asthma (1.84 [0.98 to 3.48]), inflammatory bowel disease, inflammatory joint disease, systemic tissue disease, or vestibulopathy. The estimates were adjusted for age, sex, socio-economic status, and smoking. Conclusion: Our large cohort study, which is the first to focus on the link between otitis media in childhood and immune-related inflammatory disorders later in life, does not confer a clear association. CSOM in childhood was strongly related to adult tinnitus and hearing loss, which was most frequently registered as sensorineural.
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[article] Otitis Media in Childhood and Disease in Adulthood: A 40-Year Follow-Up Study [Article] / Lisa Aarhus ; Preben Homoe ; Bo Engdahl . - 2020 . - p. 67-71.
Langues : Anglais (eng)
in Ear and hearing > Vol. 41, n°1 (Janvier-Février 2020) . - p. 67-71

Descripteurs :	HE Vinci Acouphène ; Déficience auditive ; Inflammation ; Maladies auto-immunes ; Maladies cardiovasculaires ; Maladies vestibulaires ; Otite
Résumé :	Objectives: The pathogenesis of chronic suppurative otitis media (CSOM) includes complex interactions between microbial, immunologic, and genetic factors. To our knowledge, no study has focused on the association between childhood otitis media, immune regulation, inflammatory conditions, and chronic disease in adulthood. The present study aims to assess whether CSOM in childhood predicts immune-related inflammatory disorders or cardiovascular disease in adulthood. Another aim is to assess the association with oto-vestibular diseases in adulthood. Design: Population cohort study in Norway comprised 51,626 participants (mean age 52 years) who underwent a hearing investigation at 7 to 13 years of age where 189 were diagnosed with CSOM (otorhinolaryngologist diagnose) and 51,437 had normal hearing thresholds (controls). Data on adult disease were obtained from the Norwegian Patient Registry (ICD-10 codes from the specialist health services). We estimated associations with logistic regression analyses. Results: The associations between CSOM in childhood and disease in adulthood were as follows: chronic sinusitis (odds ratio 3.13, 95% confidence interval 1.15 to 8.52); cardiovascular disease (1.38, 1.01 to 1.88); hearing loss (5.58, 3.78 to 8.22); tinnitus (2.62, 1.07 to 6.41). The adult hearing loss among cases with childhood CSOM was most frequently registered as sensorineural. There was no statistically significant increased risk of later asthma (1.84 [0.98 to 3.48]), inflammatory bowel disease, inflammatory joint disease, systemic tissue disease, or vestibulopathy. The estimates were adjusted for age, sex, socio-economic status, and smoking. Conclusion: Our large cohort study, which is the first to focus on the link between otitis media in childhood and immune-related inflammatory disorders later in life, does not confer a clear association. CSOM in childhood was strongly related to adult tinnitus and hearing loss, which was most frequently registered as sensorineural.
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[article] 
inEar and hearing > Vol. 41, n°1 (Janvier-Février 2020) . - p. 72-81

Titre :	The Use of Static and Dynamic Cues for Vowel Identification by Children Wearing Hearing Aids or Cochlear Implants
Type de document :	Article
Auteurs :	Mark Hedrick ; Kristen E.T. Thornton ; Kelly R. Yeager ; Patrick N. Plyler ; Patty M. Johnstone
Année de publication :	2020
Article en page(s) :	p. 72-81
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Aide auditive ; Amplification ; Audiologie pédiatrique ; Implants cochléaires
Résumé :	Objective: To examine vowel perception based on dynamic formant transition and/or static formant pattern cues in children with hearing loss while using their hearing aids or cochlear implants. We predicted that the sensorineural hearing loss would degrade formant transitions more than static formant patterns, and that shortening the duration of cues would cause more difficulty for vowel identification for these children than for their normal-hearing peers. Design: A repeated-measures, between-group design was used. Children 4 to 9 years of age from a university hearing services clinic who were fit for hearing aids (13 children) or who wore cochlear implants (10 children) participated. Chronologically age-matched children with normal hearing served as controls (23 children). Stimuli included three naturally produced syllables (/ba/, /bi/, and /bu/), which were presented either in their entirety or segmented to isolate the formant transition or the vowel static formant center. The stimuli were presented to listeners via loudspeaker in the sound field. Aided participants wore their own devices and listened with their everyday settings. Participants chose the vowel presented by selecting from corresponding pictures on a computer screen. Results: Children with hearing loss were less able to use shortened transition or shortened vowel centers to identify vowels as compared to their normal-hearing peers. Whole syllable and initial transition yielded better identification performance than the vowel center for /[Latin small letter alpha]/, but not for /i/ or /u/. Conclusions: The children with hearing loss may require a longer time window than children with normal hearing to integrate vowel cues over time because of altered peripheral encoding in spectrotemporal domains. Clinical implications include cognizance of the importance of vowel perception when developing habilitative programs for children with hearing loss.
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[article] The Use of Static and Dynamic Cues for Vowel Identification by Children Wearing Hearing Aids or Cochlear Implants [Article] / Mark Hedrick ; Kristen E.T. Thornton ; Kelly R. Yeager ; Patrick N. Plyler ; Patty M. Johnstone . - 2020 . - p. 72-81.
Langues : Anglais (eng)
in Ear and hearing > Vol. 41, n°1 (Janvier-Février 2020) . - p. 72-81

Descripteurs :	HE Vinci Aide auditive ; Amplification ; Audiologie pédiatrique ; Implants cochléaires
Résumé :	Objective: To examine vowel perception based on dynamic formant transition and/or static formant pattern cues in children with hearing loss while using their hearing aids or cochlear implants. We predicted that the sensorineural hearing loss would degrade formant transitions more than static formant patterns, and that shortening the duration of cues would cause more difficulty for vowel identification for these children than for their normal-hearing peers. Design: A repeated-measures, between-group design was used. Children 4 to 9 years of age from a university hearing services clinic who were fit for hearing aids (13 children) or who wore cochlear implants (10 children) participated. Chronologically age-matched children with normal hearing served as controls (23 children). Stimuli included three naturally produced syllables (/ba/, /bi/, and /bu/), which were presented either in their entirety or segmented to isolate the formant transition or the vowel static formant center. The stimuli were presented to listeners via loudspeaker in the sound field. Aided participants wore their own devices and listened with their everyday settings. Participants chose the vowel presented by selecting from corresponding pictures on a computer screen. Results: Children with hearing loss were less able to use shortened transition or shortened vowel centers to identify vowels as compared to their normal-hearing peers. Whole syllable and initial transition yielded better identification performance than the vowel center for /[Latin small letter alpha]/, but not for /i/ or /u/. Conclusions: The children with hearing loss may require a longer time window than children with normal hearing to integrate vowel cues over time because of altered peripheral encoding in spectrotemporal domains. Clinical implications include cognizance of the importance of vowel perception when developing habilitative programs for children with hearing loss.
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[article] 
inEar and hearing > Vol. 41, n°1 (Janvier-Février 2020) . - p. 82-94

Titre :	The Effect of Hearing-Protection Devices on Auditory Situational Awareness and Listening Effort
Type de document :	Article
Auteurs :	Christopher J. Smalt ; Paul T. Calamia ; Andrew P. Dumas ; [et al.]
Année de publication :	2020
Article en page(s) :	p. 82-94
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Condition d'écoute ; Perte auditive induite par le bruit (NIHL) ; Protection auditive ; Sensibilité auditive
Résumé :	Objectives: Hearing-protection devices (HPDs) are made available, and often are required, for industrial use as well as military training exercises and operational duties. However, these devices often are disliked, and consequently not worn, in part because they compromise situational awareness through reduced sound detection and localization performance as well as degraded speech intelligibility. In this study, we carried out a series of tests, involving normal-hearing subjects and multiple background-noise conditions, designed to evaluate the performance of four HPDs in terms of their modifications of auditory-detection thresholds, sound-localization accuracy, and speech intelligibility. In addition, we assessed their impact on listening effort to understand how the additional effort required to perceive and process auditory signals while wearing an HPD reduces available cognitive resources for other tasks. Design: Thirteen normal-hearing subjects participated in a protocol, which included auditory tasks designed to measure detection and localization performance, speech intelligibility, and cognitive load. Each participant repeated the battery of tests with unoccluded ears and four hearing protectors, two active (electronic) and two passive. The tasks were performed both in quiet and in background noise. Results: Our findings indicate that, in variable degrees, all of the tested HPDs induce performance degradation on most of the conducted tasks as compared to the open ear. Of particular note in this study is the finding of increased cognitive load or listening effort, as measured by visual reaction time, for some hearing protectors during a dual-task, which added working-memory demands to the speech-intelligibility task. Conclusions: These results indicate that situational awareness can vary greatly across the spectrum of HPDs, and that listening effort is another aspect of performance that should be considered in future studies. The increased listening effort induced by hearing protectors may lead to earlier cognitive fatigue in noisy environments. Further study is required to characterize how auditory performance is limited by the combination of hearing impairment and the use of HPDs, and how the effects of such limitations can be linked to safe and effective use of hearing protection to maximize job performance.
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[article] The Effect of Hearing-Protection Devices on Auditory Situational Awareness and Listening Effort [Article] / Christopher J. Smalt ; Paul T. Calamia ; Andrew P. Dumas ; [et al.] . - 2020 . - p. 82-94.
Langues : Anglais (eng)
in Ear and hearing > Vol. 41, n°1 (Janvier-Février 2020) . - p. 82-94

Descripteurs :	HE Vinci Condition d'écoute ; Perte auditive induite par le bruit (NIHL) ; Protection auditive ; Sensibilité auditive
Résumé :	Objectives: Hearing-protection devices (HPDs) are made available, and often are required, for industrial use as well as military training exercises and operational duties. However, these devices often are disliked, and consequently not worn, in part because they compromise situational awareness through reduced sound detection and localization performance as well as degraded speech intelligibility. In this study, we carried out a series of tests, involving normal-hearing subjects and multiple background-noise conditions, designed to evaluate the performance of four HPDs in terms of their modifications of auditory-detection thresholds, sound-localization accuracy, and speech intelligibility. In addition, we assessed their impact on listening effort to understand how the additional effort required to perceive and process auditory signals while wearing an HPD reduces available cognitive resources for other tasks. Design: Thirteen normal-hearing subjects participated in a protocol, which included auditory tasks designed to measure detection and localization performance, speech intelligibility, and cognitive load. Each participant repeated the battery of tests with unoccluded ears and four hearing protectors, two active (electronic) and two passive. The tasks were performed both in quiet and in background noise. Results: Our findings indicate that, in variable degrees, all of the tested HPDs induce performance degradation on most of the conducted tasks as compared to the open ear. Of particular note in this study is the finding of increased cognitive load or listening effort, as measured by visual reaction time, for some hearing protectors during a dual-task, which added working-memory demands to the speech-intelligibility task. Conclusions: These results indicate that situational awareness can vary greatly across the spectrum of HPDs, and that listening effort is another aspect of performance that should be considered in future studies. The increased listening effort induced by hearing protectors may lead to earlier cognitive fatigue in noisy environments. Further study is required to characterize how auditory performance is limited by the combination of hearing impairment and the use of HPDs, and how the effects of such limitations can be linked to safe and effective use of hearing protection to maximize job performance.
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[article] 
inEar and hearing > Vol. 41, n°1 (Janvier-Février 2020) . - p. 95-105

Titre :	The Revised Hearing Handicap Inventory and Screening Tool Based on Psychometric Reevaluation of the Hearing Handicap Inventories for the Elderly and Adults
Type de document :	Article
Auteurs :	Christy Cassarly ; Lois J. Matthews ; Annie N. Simpson ; Judy R. Dubno
Année de publication :	2020
Article en page(s) :	p. 95-105
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Handicap auditif ; Mesures des résultats rapportés par les patients (PROM) ; Perte d'audition Autres descripteurs Depistage auditif
Résumé :	Objectives: The present study evaluates the items of the Hearing Handicap Inventory for the Elderly and Hearing Handicap Inventory for Adults (HHIE/A) using Mokken scale analysis (MSA), a type of nonparametric item response theory, and develops updated tools with optimal psychometric properties. Design: In a longitudinal study of age-related hearing loss, 1447 adults completed the HHIE/A and audiometric testing at baseline. Discriminant validity of the emotional consequences and social/situational effects subscales of the HHIE/A was assessed, and nonparametric item response theory was used to explore dimensionality of the items of the HHIE/A and to refine the scales. Results: The HHIE/A items form strong unidimensional scales measuring self-perceived hearing handicap, but with a lack of discriminant validity of the two distinct subscales. Two revised scales, the 18-item Revised Hearing Handicap Inventory and the 10-item Revised Hearing Handicap Inventory-Screening, were developed from the common items of the original HHIE/A that met the assumptions of MSA. The items on both of the revised scales can be ordered in terms of increasing difficulty. Conclusions: The results of the present study suggest that the newly developed Revised Hearing Handicap Inventory and Revised Hearing Handicap Inventory-Screening are strong unidimensional, clinically informative measures of self-perceived hearing handicap that can be used for adults of all ages. The real-data example also demonstrates that MSA is a valuable alternative to classical psychometric analysis.
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[article] The Revised Hearing Handicap Inventory and Screening Tool Based on Psychometric Reevaluation of the Hearing Handicap Inventories for the Elderly and Adults [Article] / Christy Cassarly ; Lois J. Matthews ; Annie N. Simpson ; Judy R. Dubno . - 2020 . - p. 95-105.
Langues : Anglais (eng)
in Ear and hearing > Vol. 41, n°1 (Janvier-Février 2020) . - p. 95-105

Descripteurs :	HE Vinci Handicap auditif ; Mesures des résultats rapportés par les patients (PROM) ; Perte d'audition Autres descripteurs Depistage auditif
Résumé :	Objectives: The present study evaluates the items of the Hearing Handicap Inventory for the Elderly and Hearing Handicap Inventory for Adults (HHIE/A) using Mokken scale analysis (MSA), a type of nonparametric item response theory, and develops updated tools with optimal psychometric properties. Design: In a longitudinal study of age-related hearing loss, 1447 adults completed the HHIE/A and audiometric testing at baseline. Discriminant validity of the emotional consequences and social/situational effects subscales of the HHIE/A was assessed, and nonparametric item response theory was used to explore dimensionality of the items of the HHIE/A and to refine the scales. Results: The HHIE/A items form strong unidimensional scales measuring self-perceived hearing handicap, but with a lack of discriminant validity of the two distinct subscales. Two revised scales, the 18-item Revised Hearing Handicap Inventory and the 10-item Revised Hearing Handicap Inventory-Screening, were developed from the common items of the original HHIE/A that met the assumptions of MSA. The items on both of the revised scales can be ordered in terms of increasing difficulty. Conclusions: The results of the present study suggest that the newly developed Revised Hearing Handicap Inventory and Revised Hearing Handicap Inventory-Screening are strong unidimensional, clinically informative measures of self-perceived hearing handicap that can be used for adults of all ages. The real-data example also demonstrates that MSA is a valuable alternative to classical psychometric analysis.
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[article] 
inEar and hearing > Vol. 41, n°1 (Janvier-Février 2020) . - p. 106-113

Titre :	Electro-Tactile Stimulation Enhances Cochlear-Implant Melody Recognition: Effects of Rhythm and Musical Training
Type de document :	Article
Auteurs :	Juan Huang ; Thomas Lu ; Benjamin M. Sheffield ; Fan-Gang Zeng
Année de publication :	2020
Article en page(s) :	p. 106-113
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Aide tactile ; Implant résorbable Autres descripteurs Electroacoustique ; Integration sensorielle ; Melodie ; Stimulation auditive
Résumé :	Objectives: Electro-acoustic stimulation (EAS) enhances speech and music perception in cochlear-implant (CI) users who have residual low-frequency acoustic hearing. For CI users who do not have low-frequency acoustic hearing, tactile stimulation may be used in a similar fashion as residual low-frequency acoustic hearing to enhance CI performance. Previous studies showed that electro-tactile stimulation (ETS) enhanced speech recognition in noise and tonal language perception for CI listeners. Here, we examined the effect of ETS on melody recognition in both musician and nonmusician CI users. Design: Nine musician and eight nonmusician CI users were tested in a melody recognition task with or without rhythmic cues in three testing conditions: CI only (E), tactile only (T), and combined CI and tactile stimulation (ETS). Results: Overall, the combined electrical and tactile stimulation enhanced the melody recognition performance in CI users by 9% points. Two additional findings were observed. First, musician CI users outperformed nonmusicians CI users in melody recognition, but the size of the enhancement effect was similar between the two groups. Second, the ETS enhancement was significantly higher with nonrhythmic melodies than rhythmic melodies in both groups. Conclusions: These findings suggest that, independent of musical experience, the size of the ETS enhancement depends on integration efficiency between tactile and auditory stimulation, and that the mechanism of the ETS enhancement is improved electric pitch perception. The present study supports the hypothesis that tactile stimulation can be used to improve pitch perception in CI users.
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[article] Electro-Tactile Stimulation Enhances Cochlear-Implant Melody Recognition: Effects of Rhythm and Musical Training [Article] / Juan Huang ; Thomas Lu ; Benjamin M. Sheffield ; Fan-Gang Zeng . - 2020 . - p. 106-113.
Langues : Anglais (eng)
in Ear and hearing > Vol. 41, n°1 (Janvier-Février 2020) . - p. 106-113

Descripteurs :	HE Vinci Aide tactile ; Implant résorbable Autres descripteurs Electroacoustique ; Integration sensorielle ; Melodie ; Stimulation auditive
Résumé :	Objectives: Electro-acoustic stimulation (EAS) enhances speech and music perception in cochlear-implant (CI) users who have residual low-frequency acoustic hearing. For CI users who do not have low-frequency acoustic hearing, tactile stimulation may be used in a similar fashion as residual low-frequency acoustic hearing to enhance CI performance. Previous studies showed that electro-tactile stimulation (ETS) enhanced speech recognition in noise and tonal language perception for CI listeners. Here, we examined the effect of ETS on melody recognition in both musician and nonmusician CI users. Design: Nine musician and eight nonmusician CI users were tested in a melody recognition task with or without rhythmic cues in three testing conditions: CI only (E), tactile only (T), and combined CI and tactile stimulation (ETS). Results: Overall, the combined electrical and tactile stimulation enhanced the melody recognition performance in CI users by 9% points. Two additional findings were observed. First, musician CI users outperformed nonmusicians CI users in melody recognition, but the size of the enhancement effect was similar between the two groups. Second, the ETS enhancement was significantly higher with nonrhythmic melodies than rhythmic melodies in both groups. Conclusions: These findings suggest that, independent of musical experience, the size of the ETS enhancement depends on integration efficiency between tactile and auditory stimulation, and that the mechanism of the ETS enhancement is improved electric pitch perception. The present study supports the hypothesis that tactile stimulation can be used to improve pitch perception in CI users.
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[article] 
inEar and hearing > Vol. 41, n°1 (Janvier-Février 2020) . - p. 114-124

Titre :	Genetic Inheritance of Late-Onset, Down-Sloping Hearing Loss and Its Implications for Auditory Rehabilitation
Type de document :	Article
Auteurs :	Mee Hyun Song ; Jinsei Jung ; John Hoon Rim ; [et al.]
Année de publication :	2020
Article en page(s) :	p. 114-124
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Genetique ; Implants cochléaires ; Perte d'audition Autres descripteurs Implant d'oreille moyenne
Résumé :	Objectives: Late-onset, down-sloping sensorineural hearing loss has many genetic and nongenetic etiologies, but the proportion of this commonly encountered type of hearing loss attributable to genetic causes is not well known. In this study, the authors performed genetic analysis using next-generation sequencing techniques in patients showing late-onset, down-sloping sensorineural hearing loss with preserved low-frequency hearing, and investigated the clinical implications of the variants identified. Design: From a cohort of patients with hearing loss at a tertiary referral hospital, 18 unrelated probands with down-sloping sensorineural hearing loss of late onset were included in this study. Down-sloping hearing loss was defined as a mean low-frequency threshold at 250 Hz and 500 Hz less than or equal to 40 dB HL and a mean high-frequency threshold at 1, 2, and 4 kHz greater than 40 dB HL. The authors performed whole-exome sequencing and segregation analysis to identify the genetic causes and evaluated the outcomes of auditory rehabilitation in the patients. Results: There were nine simplex and nine multiplex families included, in which the causative variants were found in six of 18 probands, demonstrating a detection rate of 33.3%. Various types of variants, including five novel and three known variants, were detected in the MYH14, MYH9, USH2A, COL11A2, and TMPRSS3 genes. The outcome of cochlear and middle ear implants in patients identified with pathogenic variants was satisfactory. There was no statistically significant difference between pathogenic variant-positive and pathogenic variant-negative groups in terms of onset age, family history of hearing loss, pure-tone threshold, or speech discrimination scores. Conclusions: The proportion of patients with late-onset, down-sloping hearing loss identified with potentially causative variants was unexpectedly high. Identification of the causative variants will offer insights on hearing loss progression and prognosis regarding various modes of auditory rehabilitation, as well as possible concomitant syndromic features.
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[article] Genetic Inheritance of Late-Onset, Down-Sloping Hearing Loss and Its Implications for Auditory Rehabilitation [Article] / Mee Hyun Song ; Jinsei Jung ; John Hoon Rim ; [et al.] . - 2020 . - p. 114-124.
Langues : Anglais (eng)
in Ear and hearing > Vol. 41, n°1 (Janvier-Février 2020) . - p. 114-124

Descripteurs :	HE Vinci Genetique ; Implants cochléaires ; Perte d'audition Autres descripteurs Implant d'oreille moyenne
Résumé :	Objectives: Late-onset, down-sloping sensorineural hearing loss has many genetic and nongenetic etiologies, but the proportion of this commonly encountered type of hearing loss attributable to genetic causes is not well known. In this study, the authors performed genetic analysis using next-generation sequencing techniques in patients showing late-onset, down-sloping sensorineural hearing loss with preserved low-frequency hearing, and investigated the clinical implications of the variants identified. Design: From a cohort of patients with hearing loss at a tertiary referral hospital, 18 unrelated probands with down-sloping sensorineural hearing loss of late onset were included in this study. Down-sloping hearing loss was defined as a mean low-frequency threshold at 250 Hz and 500 Hz less than or equal to 40 dB HL and a mean high-frequency threshold at 1, 2, and 4 kHz greater than 40 dB HL. The authors performed whole-exome sequencing and segregation analysis to identify the genetic causes and evaluated the outcomes of auditory rehabilitation in the patients. Results: There were nine simplex and nine multiplex families included, in which the causative variants were found in six of 18 probands, demonstrating a detection rate of 33.3%. Various types of variants, including five novel and three known variants, were detected in the MYH14, MYH9, USH2A, COL11A2, and TMPRSS3 genes. The outcome of cochlear and middle ear implants in patients identified with pathogenic variants was satisfactory. There was no statistically significant difference between pathogenic variant-positive and pathogenic variant-negative groups in terms of onset age, family history of hearing loss, pure-tone threshold, or speech discrimination scores. Conclusions: The proportion of patients with late-onset, down-sloping hearing loss identified with potentially causative variants was unexpectedly high. Identification of the causative variants will offer insights on hearing loss progression and prognosis regarding various modes of auditory rehabilitation, as well as possible concomitant syndromic features.
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[article] 
inEar and hearing > Vol. 41, n°1 (Janvier-Février 2020) . - p. 125-135

Titre :	Use of Commercial Virtual Reality Technology to Assess Verticality Perception in Static and Dynamic Visual Backgrounds
Type de document :	Article
Auteurs :	Ashley Zaleski-King ; Robin Pinto ; General Lee ; Douglas Brungart
Année de publication :	2020
Article en page(s) :	p. 125-135
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Perception visuelle ; Réalité virtuelle ; Vertige Autres descripteurs Mesure subjective
Résumé :	Objectives: The Subjective Visual Vertical (SVV) test and the closely related Rod and Disk Test (RDT) are measures of perceived verticality measured in static and dynamic visual backgrounds. However, the equipment used for these tests is variable across clinics and is often too expensive or too primitive to be appropriate for widespread use. Commercial virtual reality technology, which is now widely available, may provide a more suitable alternative for collecting these measures in clinical populations. This study was designed to investigate verticality perception in symptomatic patients using a modified RDT paradigm administered through a head-mounted display (HMD). Design: A group of adult patients referred by a physician for vestibular testing based on the presence of dizziness symptoms and a group of healthy adults without dizziness symptoms were included. We investigated degree of visual dependence in both groups by measuring SVV as a function of kinematic changes to the visual background. Results: When a dynamic background was introduced into the HMD to simulate the RDT, significantly greater shifts in SVV were found for the patient population than for the control population. In patients referred for vestibular testing, the SVV measured with the HMD was significantly correlated with traditional measures of SVV collected in a rotary chair when accounting for head tilt. Conclusions: This study provides initial proof of concept evidence that reliable SVV measures in static and dynamic visual backgrounds can be obtained using a low-cost commercial HMD system. This initial evidence also suggests that this tool can distinguish individuals with dizziness symptomatology based on SVV performance in dynamic visual backgrounds.
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[article] Use of Commercial Virtual Reality Technology to Assess Verticality Perception in Static and Dynamic Visual Backgrounds [Article] / Ashley Zaleski-King ; Robin Pinto ; General Lee ; Douglas Brungart . - 2020 . - p. 125-135.
Langues : Anglais (eng)
in Ear and hearing > Vol. 41, n°1 (Janvier-Février 2020) . - p. 125-135

Descripteurs :	HE Vinci Perception visuelle ; Réalité virtuelle ; Vertige Autres descripteurs Mesure subjective
Résumé :	Objectives: The Subjective Visual Vertical (SVV) test and the closely related Rod and Disk Test (RDT) are measures of perceived verticality measured in static and dynamic visual backgrounds. However, the equipment used for these tests is variable across clinics and is often too expensive or too primitive to be appropriate for widespread use. Commercial virtual reality technology, which is now widely available, may provide a more suitable alternative for collecting these measures in clinical populations. This study was designed to investigate verticality perception in symptomatic patients using a modified RDT paradigm administered through a head-mounted display (HMD). Design: A group of adult patients referred by a physician for vestibular testing based on the presence of dizziness symptoms and a group of healthy adults without dizziness symptoms were included. We investigated degree of visual dependence in both groups by measuring SVV as a function of kinematic changes to the visual background. Results: When a dynamic background was introduced into the HMD to simulate the RDT, significantly greater shifts in SVV were found for the patient population than for the control population. In patients referred for vestibular testing, the SVV measured with the HMD was significantly correlated with traditional measures of SVV collected in a rotary chair when accounting for head tilt. Conclusions: This study provides initial proof of concept evidence that reliable SVV measures in static and dynamic visual backgrounds can be obtained using a low-cost commercial HMD system. This initial evidence also suggests that this tool can distinguish individuals with dizziness symptomatology based on SVV performance in dynamic visual backgrounds.
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[article] 
inEar and hearing > Vol. 41, n°1 (Janvier-Février 2020) . - p. 136-142

Titre :	Impact of Lexical Parameters and Audibility on the Recognition of the Freiburg Monosyllabic Speech Test
Type de document :	Article
Auteurs :	Alexandra Winkler ; Rebecca Carroll ; Inga Holube
Année de publication :	2020
Article en page(s) :	p. 136-142
Langues :	Anglais (eng)
Descripteurs :	Autres descripteurs Audibilite ; Frequence lexicale ; Voisinage lexical HE Vinci Reconnaissance de la parole ; Reconnaissance des mots
Résumé :	Objective: Correct word recognition is generally determined by audibility, but lexical parameters also play a role. The focus of this study was to examine both the impact of audibility and lexical parameters on speech recognition of test words of the clinical German Freiburg monosyllabic speech test, and subsequently on the perceptual imbalance of test lists observed in the literature. Design: For 160 participants with normal hearing that were divided into three groups with different simulated hearing thresholds, monaural speech recognition for the Freiburg monosyllabic speech test was obtained via headphones in quiet at different presentation levels. A software manipulated the original speech material to simulate two different hearing thresholds. All monosyllables were classified according to their frequency of occurrence in contemporary language and the number of lexical neighbors using the Cross-Linguistic Easy-Access Resource for Phonological and Orthographic Neighborhood Density database. Generalized linear mixed-effects regression models were used to evaluate the influences of audibility in terms of the Speech Intelligibility Index and lexical properties of the monosyllables in terms of word frequency (WF) and neighborhood density (ND) on the observed speech recognition per word and per test list, respectively. Results: Audibility and interactions of audibility with WF and ND correctly predicted identification of the individual monosyllables. Test list recognition was predicted by test list choice, audibility, and ND, as well as by interactions of WF and test list, audibility and ND, ND and test list, and audibility per test list. Conclusions: Observed differences in speech recognition of the Freiburg monosyllabic speech test, which are well reported in the literature, depend not only on audibility but also on WF, neighborhood density, and test list choice and their interactions. The authors conclude that future creations of speech test material should take these lexical parameters into account
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[article] Impact of Lexical Parameters and Audibility on the Recognition of the Freiburg Monosyllabic Speech Test [Article] / Alexandra Winkler ; Rebecca Carroll ; Inga Holube . - 2020 . - p. 136-142.
Langues : Anglais (eng)
in Ear and hearing > Vol. 41, n°1 (Janvier-Février 2020) . - p. 136-142

Descripteurs :	Autres descripteurs Audibilite ; Frequence lexicale ; Voisinage lexical HE Vinci Reconnaissance de la parole ; Reconnaissance des mots
Résumé :	Objective: Correct word recognition is generally determined by audibility, but lexical parameters also play a role. The focus of this study was to examine both the impact of audibility and lexical parameters on speech recognition of test words of the clinical German Freiburg monosyllabic speech test, and subsequently on the perceptual imbalance of test lists observed in the literature. Design: For 160 participants with normal hearing that were divided into three groups with different simulated hearing thresholds, monaural speech recognition for the Freiburg monosyllabic speech test was obtained via headphones in quiet at different presentation levels. A software manipulated the original speech material to simulate two different hearing thresholds. All monosyllables were classified according to their frequency of occurrence in contemporary language and the number of lexical neighbors using the Cross-Linguistic Easy-Access Resource for Phonological and Orthographic Neighborhood Density database. Generalized linear mixed-effects regression models were used to evaluate the influences of audibility in terms of the Speech Intelligibility Index and lexical properties of the monosyllables in terms of word frequency (WF) and neighborhood density (ND) on the observed speech recognition per word and per test list, respectively. Results: Audibility and interactions of audibility with WF and ND correctly predicted identification of the individual monosyllables. Test list recognition was predicted by test list choice, audibility, and ND, as well as by interactions of WF and test list, audibility and ND, ND and test list, and audibility per test list. Conclusions: Observed differences in speech recognition of the Freiburg monosyllabic speech test, which are well reported in the literature, depend not only on audibility but also on WF, neighborhood density, and test list choice and their interactions. The authors conclude that future creations of speech test material should take these lexical parameters into account
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[article] 
inEar and hearing > Vol. 41, n°1 (Janvier-Février 2020) . - p. 143-149

Titre :	Prediction Model for Audiological Outcomes in Patients With GJB2 Mutations
Type de document :	Article
Auteurs :	Pey-Yu Chen ; Yin-Hung Lin ; Tien-Chen Liu ; Chen-Chi Wu ; [et al.]
Année de publication :	2020
Article en page(s) :	p. 143-149
Langues :	Anglais (eng)
Descripteurs :	HE Vinci EVALUATION PREDICTIVE ; Gène ; Surdité neurosensorielle (SNHL)
Résumé :	Objectives: Recessive mutations in GJB2 are the most common genetic cause of sensorineural hearing impairment (SNHI) in humans. SNHI related to GJB2 mutations demonstrates a wide variation in audiological features, and there has been no reliable prediction model for hearing outcomes until now. The objectives of this study were to clarify the predominant factors determining hearing outcome and to establish a predictive model for SNHI in patients with GJB2 mutations. Design: A total of 434 patients confirmed to have biallelic GJB2 mutations were enrolled and divided into three groups according to their GJB2 genotypes. Audiological data, including hearing levels and audiogram configurations, were compared between patients with different genotypes. Univariate and multivariate generalized estimating equation (GEE) analyses were performed to analyze longitudinal data of patients with multiple audiological records. Results: Of the 434 patients, 346 (79.7%) were homozygous for the GJB2 p.V37I mutation, 55 (12.7%) were compound heterozygous for p.V37I and another GJB2 mutation, and 33 (7.6%) had biallelic GJB2 mutations other than p.V37I. There was a significant difference in hearing level and the distribution of audiogram configurations between the three groups. Multivariate GEE analyses on 707 audiological records of 227 patients revealed that the baseline hearing level and the duration of follow-up were the predominant predictors of hearing outcome, and that hearing levels in patients with GJB2 mutations could be estimated based on these two parameters: (Predicted Hearing Level [dBHL]) = 3.78 + 0.96 x (Baseline Hearing Level [dBHL]) + 0.55 x (Duration of Follow-Up [y]). Conclusion: The baseline hearing level and the duration of follow-up are the main prognostic factors for outcome of GJB2-related SNHI. These findings may have important clinical implications in guiding follow-up protocols and designing treatment plans in patients with GJB2 mutations.
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[article] Prediction Model for Audiological Outcomes in Patients With GJB2 Mutations [Article] / Pey-Yu Chen ; Yin-Hung Lin ; Tien-Chen Liu ; Chen-Chi Wu ; [et al.] . - 2020 . - p. 143-149.
Langues : Anglais (eng)
in Ear and hearing > Vol. 41, n°1 (Janvier-Février 2020) . - p. 143-149

Descripteurs :	HE Vinci EVALUATION PREDICTIVE ; Gène ; Surdité neurosensorielle (SNHL)
Résumé :	Objectives: Recessive mutations in GJB2 are the most common genetic cause of sensorineural hearing impairment (SNHI) in humans. SNHI related to GJB2 mutations demonstrates a wide variation in audiological features, and there has been no reliable prediction model for hearing outcomes until now. The objectives of this study were to clarify the predominant factors determining hearing outcome and to establish a predictive model for SNHI in patients with GJB2 mutations. Design: A total of 434 patients confirmed to have biallelic GJB2 mutations were enrolled and divided into three groups according to their GJB2 genotypes. Audiological data, including hearing levels and audiogram configurations, were compared between patients with different genotypes. Univariate and multivariate generalized estimating equation (GEE) analyses were performed to analyze longitudinal data of patients with multiple audiological records. Results: Of the 434 patients, 346 (79.7%) were homozygous for the GJB2 p.V37I mutation, 55 (12.7%) were compound heterozygous for p.V37I and another GJB2 mutation, and 33 (7.6%) had biallelic GJB2 mutations other than p.V37I. There was a significant difference in hearing level and the distribution of audiogram configurations between the three groups. Multivariate GEE analyses on 707 audiological records of 227 patients revealed that the baseline hearing level and the duration of follow-up were the predominant predictors of hearing outcome, and that hearing levels in patients with GJB2 mutations could be estimated based on these two parameters: (Predicted Hearing Level [dBHL]) = 3.78 + 0.96 x (Baseline Hearing Level [dBHL]) + 0.55 x (Duration of Follow-Up [y]). Conclusion: The baseline hearing level and the duration of follow-up are the main prognostic factors for outcome of GJB2-related SNHI. These findings may have important clinical implications in guiding follow-up protocols and designing treatment plans in patients with GJB2 mutations.
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[article] 
inEar and hearing > Vol. 41, n°1 (Janvier-Février 2020) . - p. 150-164

Titre :	Test-Retest Variability in the Characteristics of Envelope Following Responses Evoked by Speech Stimuli
Type de document :	Article
Auteurs :	Vijayalakshmi Easwar ; Susan D. Scollie ; Steven J. Aiken ; David W. Purcell
Année de publication :	2020
Article en page(s) :	p. 150-164
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Amplitude articulaire ; fricative ; Potentiel évoqué stationnaire (ASSR) ; Voyelle Autres descripteurs Repetabilite ; Transformée de Fourier rapide (fft)
Résumé :	Objectives: The objective of the present study was to evaluate the between-session test-retest variability in the characteristics of envelope following responses (EFRs) evoked by modified natural speech stimuli in young normal hearing adults. Design: EFRs from 22 adults were recorded in two sessions, 1 to 12 days apart. EFRs were evoked by the token /susa[integral] i/ (2.05 sec) presented at 65 dB SPL and recorded from the vertex referenced to the neck. The token /susa[integral] i/, spoken by a male with an average fundamental frequency [f0] of 98.53 Hz, was of interest because of its potential utility as an objective hearing aid outcome measure. Each vowel was modified to elicit two EFRs simultaneously by lowering the f0 in the first formant while maintaining the original f0 in the higher formants. Fricatives were amplitude-modulated at 93.02 Hz and elicited one EFR each. EFRs evoked by vowels and fricatives were estimated using Fourier analyzer and discrete Fourier transform, respectively. Detection of EFRs was determined by an F-test. Test-retest variability in EFR amplitude and phase coherence were quantified using correlation, repeated-measures analysis of variance, and the repeatability coefficient. The repeatability coefficient, computed as twice the standard deviation (SD) of test-retest differences, represents the +/-95% limits of test-retest variation around the mean difference. Test-retest variability of EFR amplitude and phase coherence were compared using the coefficient of variation, a normalized metric, which represents the ratio of the SD of repeat measurements to its mean. Consistency in EFR detection outcomes was assessed using the test of proportions. Results: EFR amplitude and phase coherence did not vary significantly between sessions, and were significantly correlated across repeat measurements. The repeatability coefficient for EFR amplitude ranged from 38.5 nV to 45.6 nV for all stimuli, except for /[integral]/ (71.6 nV). For any given stimulus, the test-retest differences in EFR amplitude of individual participants were not correlated with their test-retest differences in noise amplitude. However, across stimuli, higher repeatability coefficients of EFR amplitude tended to occur when the group mean noise amplitude and the repeatability coefficient of noise amplitude were higher. The test-retest variability of phase coherence was comparable to that of EFR amplitude in terms of the coefficient of variation, and the repeatability coefficient varied from 0.1 to 0.2, with the highest value of 0.2 for /[integral]/. Mismatches in EFR detection outcomes occurred in 11 of 176 measurements. For each stimulus, the tests of proportions revealed a significantly higher proportion of matched detection outcomes compared to mismatches. Conclusions: Speech-evoked EFRs demonstrated reasonable repeatability across sessions. Of the eight stimuli, the shortest stimulus /[integral]/ demonstrated the largest variability in EFR amplitude and phase coherence. The test-retest variability in EFR amplitude could not be explained by test-retest differences in noise amplitude for any of the stimuli. This lack of explanation argues for other sources of variability, one possibility being the modulation of cortical contributions imposed on brainstem-generated EFRs.
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[article] Test-Retest Variability in the Characteristics of Envelope Following Responses Evoked by Speech Stimuli [Article] / Vijayalakshmi Easwar ; Susan D. Scollie ; Steven J. Aiken ; David W. Purcell . - 2020 . - p. 150-164.
Langues : Anglais (eng)
in Ear and hearing > Vol. 41, n°1 (Janvier-Février 2020) . - p. 150-164

Descripteurs :	HE Vinci Amplitude articulaire ; fricative ; Potentiel évoqué stationnaire (ASSR) ; Voyelle Autres descripteurs Repetabilite ; Transformée de Fourier rapide (fft)
Résumé :	Objectives: The objective of the present study was to evaluate the between-session test-retest variability in the characteristics of envelope following responses (EFRs) evoked by modified natural speech stimuli in young normal hearing adults. Design: EFRs from 22 adults were recorded in two sessions, 1 to 12 days apart. EFRs were evoked by the token /susa[integral] i/ (2.05 sec) presented at 65 dB SPL and recorded from the vertex referenced to the neck. The token /susa[integral] i/, spoken by a male with an average fundamental frequency [f0] of 98.53 Hz, was of interest because of its potential utility as an objective hearing aid outcome measure. Each vowel was modified to elicit two EFRs simultaneously by lowering the f0 in the first formant while maintaining the original f0 in the higher formants. Fricatives were amplitude-modulated at 93.02 Hz and elicited one EFR each. EFRs evoked by vowels and fricatives were estimated using Fourier analyzer and discrete Fourier transform, respectively. Detection of EFRs was determined by an F-test. Test-retest variability in EFR amplitude and phase coherence were quantified using correlation, repeated-measures analysis of variance, and the repeatability coefficient. The repeatability coefficient, computed as twice the standard deviation (SD) of test-retest differences, represents the +/-95% limits of test-retest variation around the mean difference. Test-retest variability of EFR amplitude and phase coherence were compared using the coefficient of variation, a normalized metric, which represents the ratio of the SD of repeat measurements to its mean. Consistency in EFR detection outcomes was assessed using the test of proportions. Results: EFR amplitude and phase coherence did not vary significantly between sessions, and were significantly correlated across repeat measurements. The repeatability coefficient for EFR amplitude ranged from 38.5 nV to 45.6 nV for all stimuli, except for /[integral]/ (71.6 nV). For any given stimulus, the test-retest differences in EFR amplitude of individual participants were not correlated with their test-retest differences in noise amplitude. However, across stimuli, higher repeatability coefficients of EFR amplitude tended to occur when the group mean noise amplitude and the repeatability coefficient of noise amplitude were higher. The test-retest variability of phase coherence was comparable to that of EFR amplitude in terms of the coefficient of variation, and the repeatability coefficient varied from 0.1 to 0.2, with the highest value of 0.2 for /[integral]/. Mismatches in EFR detection outcomes occurred in 11 of 176 measurements. For each stimulus, the tests of proportions revealed a significantly higher proportion of matched detection outcomes compared to mismatches. Conclusions: Speech-evoked EFRs demonstrated reasonable repeatability across sessions. Of the eight stimuli, the shortest stimulus /[integral]/ demonstrated the largest variability in EFR amplitude and phase coherence. The test-retest variability in EFR amplitude could not be explained by test-retest differences in noise amplitude for any of the stimuli. This lack of explanation argues for other sources of variability, one possibility being the modulation of cortical contributions imposed on brainstem-generated EFRs.
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[article] 
inEar and hearing > Vol. 41, n°1 (Janvier-Février 2020) . - p. 165-172

Titre :	Long-Term Sensorineural Hearing Loss in Patients With Blast-Induced Tympanic Membrane Perforations
Type de document :	Article
Auteurs :	Philip D. Littlefield ; Douglas Brungart
Année de publication :	2020
Article en page(s) :	p. 165-172
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Explosion ; Surdité neurosensorielle (SNHL) Autres descripteurs Perforation tympanique
Résumé :	Objective: To describe characteristics of sensorineural hearing loss (SNHL) in patients with blast-induced tympanic membrane (TM) perforations that required surgery. Design: A retrospective review of hearing outcomes in those who had tympanoplasty for combat blast-induced TM perforations. These were sequential cases from one military otolaryngologist from 2007 to 2012. A total of 87 patients were reviewed, and of those, 49 who had appropriate preinjury, preoperative, and long-term audiograms were included. Those with pre-existing hearing loss were excluded. Preinjury audiograms were used to assess how sensorineural thresholds changed in the ruptured ears, and in the contralateral ear in those with unilateral perforations. Results: The mean time from injury to the final postoperative audiogram was 522 days. In the ears with TM perforations, 70% had SNHLs of 10 dB or less (by bone conduction pure tone averages). Meanwhile, approximately 8% had threshold shifts >30 dB, averaging 50 dB. The strongest predictor of severe or profound hearing loss was ossicular discontinuity. Thresholds also correlated with bilateral injury and perforation size. In those with unilateral perforations, the SNHL was almost always larger on the side with the perforation. Those with SNHL often had a low-to-mid frequency threshold shift and, in general, audiograms that were flatter across frequencies than those of a typical population of military personnel with similar levels of overall hearing loss. Conclusions: There is a bimodal distribution of hearing loss in those who experience a blast exposure severe enough to perforate at least one TM. Most ears recover close to their preinjury thresholds, but a minority experience much larger sensorineural threshold shifts. Blast exposed ears also tend to have a flatter audiogram than most service members with similar levels of hearing loss.
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[article] Long-Term Sensorineural Hearing Loss in Patients With Blast-Induced Tympanic Membrane Perforations [Article] / Philip D. Littlefield ; Douglas Brungart . - 2020 . - p. 165-172.
Langues : Anglais (eng)
in Ear and hearing > Vol. 41, n°1 (Janvier-Février 2020) . - p. 165-172

Descripteurs :	HE Vinci Explosion ; Surdité neurosensorielle (SNHL) Autres descripteurs Perforation tympanique
Résumé :	Objective: To describe characteristics of sensorineural hearing loss (SNHL) in patients with blast-induced tympanic membrane (TM) perforations that required surgery. Design: A retrospective review of hearing outcomes in those who had tympanoplasty for combat blast-induced TM perforations. These were sequential cases from one military otolaryngologist from 2007 to 2012. A total of 87 patients were reviewed, and of those, 49 who had appropriate preinjury, preoperative, and long-term audiograms were included. Those with pre-existing hearing loss were excluded. Preinjury audiograms were used to assess how sensorineural thresholds changed in the ruptured ears, and in the contralateral ear in those with unilateral perforations. Results: The mean time from injury to the final postoperative audiogram was 522 days. In the ears with TM perforations, 70% had SNHLs of 10 dB or less (by bone conduction pure tone averages). Meanwhile, approximately 8% had threshold shifts >30 dB, averaging 50 dB. The strongest predictor of severe or profound hearing loss was ossicular discontinuity. Thresholds also correlated with bilateral injury and perforation size. In those with unilateral perforations, the SNHL was almost always larger on the side with the perforation. Those with SNHL often had a low-to-mid frequency threshold shift and, in general, audiograms that were flatter across frequencies than those of a typical population of military personnel with similar levels of overall hearing loss. Conclusions: There is a bimodal distribution of hearing loss in those who experience a blast exposure severe enough to perforate at least one TM. Most ears recover close to their preinjury thresholds, but a minority experience much larger sensorineural threshold shifts. Blast exposed ears also tend to have a flatter audiogram than most service members with similar levels of hearing loss.
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[article] 
inEar and hearing > Vol. 41, n°1 (Janvier-Février 2020) . - p. 173-181

Titre :	Synchrotron Radiation-Based Reconstruction of the Human Spiral Ganglion: Implications for Cochlear Implantation
Type de document :	Article
Auteurs :	Hao Li ; Nadine Schart-Moren ; Seyed Alireza Rohani ; Hanif M. Ladak ; Helge Rask-Andersen ; Sumit Agrawal
Année de publication :	2020
Article en page(s) :	p. 173-181
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Cochlée ; Ganglion ; Synchrotrons Autres descripteurs Organe de Corti
Résumé :	Objective: To three-dimensionally reconstruct Rosenthal's canal (RC) housing the human spiral ganglion (SG) using synchrotron radiation phase-contrast imaging (SR-PCI). Straight cochlear implant electrode arrays were inserted to better comprehend the electro-cochlear interface in cochlear implantation (CI). Design: SR-PCI was used to reconstruct the human cochlea with and without cadaveric CI. Twenty-eight cochleae were volume rendered, of which 12 underwent cadaveric CI with a straight electrode via the round window (RW). Data were input into the 3D Slicer software program and anatomical structures were modeled using a threshold paint tool. Results: The human RC and SG were reproduced three-dimensionally with artefact-free imaging of electrode arrays. The anatomy of the SG and its relationship to the sensory organ (Corti) and soft and bony structures were assessed. Conclusions: SR-PCI and computer-based three-dimensional reconstructions demonstrated the relationships among implanted electrodes, angular insertion depths, and the SG for the first time in intact, unstained, and nondecalcified specimens. This information can be used to assess stimulation strategies and future electrode designs, as well as create place-frequency maps of the SG for optimal stimulation strategies of the human auditory nerve in CI.
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[article] Synchrotron Radiation-Based Reconstruction of the Human Spiral Ganglion: Implications for Cochlear Implantation [Article] / Hao Li ; Nadine Schart-Moren ; Seyed Alireza Rohani ; Hanif M. Ladak ; Helge Rask-Andersen ; Sumit Agrawal . - 2020 . - p. 173-181.
Langues : Anglais (eng)
in Ear and hearing > Vol. 41, n°1 (Janvier-Février 2020) . - p. 173-181

Descripteurs :	HE Vinci Cochlée ; Ganglion ; Synchrotrons Autres descripteurs Organe de Corti
Résumé :	Objective: To three-dimensionally reconstruct Rosenthal's canal (RC) housing the human spiral ganglion (SG) using synchrotron radiation phase-contrast imaging (SR-PCI). Straight cochlear implant electrode arrays were inserted to better comprehend the electro-cochlear interface in cochlear implantation (CI). Design: SR-PCI was used to reconstruct the human cochlea with and without cadaveric CI. Twenty-eight cochleae were volume rendered, of which 12 underwent cadaveric CI with a straight electrode via the round window (RW). Data were input into the 3D Slicer software program and anatomical structures were modeled using a threshold paint tool. Results: The human RC and SG were reproduced three-dimensionally with artefact-free imaging of electrode arrays. The anatomy of the SG and its relationship to the sensory organ (Corti) and soft and bony structures were assessed. Conclusions: SR-PCI and computer-based three-dimensional reconstructions demonstrated the relationships among implanted electrodes, angular insertion depths, and the SG for the first time in intact, unstained, and nondecalcified specimens. This information can be used to assess stimulation strategies and future electrode designs, as well as create place-frequency maps of the SG for optimal stimulation strategies of the human auditory nerve in CI.
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[article] 
inEar and hearing > Vol. 41, n°1 (Janvier-Février 2020) . - p. 182-193

Titre :	Children With Normal Hearing Are Efficient Users of Fundamental Frequency and Vocal Tract Length Cues for Voice Discrimination
Type de document :	Article
Auteurs :	Yael Zaltz ; Raymond Goldsworthy ; Laurie S. Eisenberg ; Liat Kishon-Rabin
Année de publication :	2020
Article en page(s) :	p. 182-193
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Discrimination auditive Autres descripteurs Developpement auditif ; Frequence fondamentale ; Longueur des productions verbales ; Reconnaissance automatique du locuteur ; Vocodeur
Résumé :	Background: The ability to discriminate between talkers assists listeners in understanding speech in a multitalker environment. This ability has been shown to be influenced by sensory processing of vocal acoustic cues, such as fundamental frequency (F0) and formant frequencies that reflect the listener's vocal tract length (VTL), and by cognitive processes, such as attention and memory. It is, therefore, suggested that children who exhibit immature sensory and/or cognitive processing will demonstrate poor voice discrimination (VD) compared with young adults. Moreover, greater difficulties in VD may be associated with spectral degradation as in children with cochlear implants. Objectives: The aim of this study was as follows: (1) to assess the use of F0 cues, VTL cues, and the combination of both cues for VD in normal-hearing (NH) school-age children and to compare their performance with that of NH adults; (2) to assess the influence of spectral degradation by means of vocoded speech on the use of F0 and VTL cues for VD in NH children; and (3) to assess the contribution of attention, working memory, and nonverbal reasoning to performance. Design: Forty-one children, 8 to 11 years of age, were tested with nonvocoded stimuli. Twenty-one of them were also tested with eight-channel, noise-vocoded stimuli. Twenty-one young adults (18 to 35 years) were tested for comparison. A three-interval, three-alternative forced-choice paradigm with an adaptive tracking procedure was used to estimate the difference limens (DLs) for VD when F0, VTL, and F0 + VTL were manipulated separately. Auditory memory, visual attention, and nonverbal reasoning were assessed for all participants. Results: (a) Children' F0 and VTL discrimination abilities were comparable to those of adults, suggesting that most school-age children utilize both cues effectively for VD. (b) Children's VD was associated with trail making test scores that assessed visual attention abilities and speed of processing, possibly reflecting their need to recruit cognitive resources for the task. (c) Best DLs were achieved for the combined (F0 + VTL) manipulation for both children and adults, suggesting that children at this age are already capable of integrating spectral and temporal cues. (d) Both children and adults found the VTL manipulations more beneficial for VD compared with the F0 manipulations, suggesting that formant frequencies are more reliable for identifying a specific speaker than F0. (e) Poorer DLs were achieved with the vocoded stimuli, though the children maintained similar thresholds and pattern of performance among manipulations as the adults
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[article] Children With Normal Hearing Are Efficient Users of Fundamental Frequency and Vocal Tract Length Cues for Voice Discrimination [Article] / Yael Zaltz ; Raymond Goldsworthy ; Laurie S. Eisenberg ; Liat Kishon-Rabin . - 2020 . - p. 182-193.
Langues : Anglais (eng)
in Ear and hearing > Vol. 41, n°1 (Janvier-Février 2020) . - p. 182-193

Descripteurs :	HE Vinci Discrimination auditive Autres descripteurs Developpement auditif ; Frequence fondamentale ; Longueur des productions verbales ; Reconnaissance automatique du locuteur ; Vocodeur
Résumé :	Background: The ability to discriminate between talkers assists listeners in understanding speech in a multitalker environment. This ability has been shown to be influenced by sensory processing of vocal acoustic cues, such as fundamental frequency (F0) and formant frequencies that reflect the listener's vocal tract length (VTL), and by cognitive processes, such as attention and memory. It is, therefore, suggested that children who exhibit immature sensory and/or cognitive processing will demonstrate poor voice discrimination (VD) compared with young adults. Moreover, greater difficulties in VD may be associated with spectral degradation as in children with cochlear implants. Objectives: The aim of this study was as follows: (1) to assess the use of F0 cues, VTL cues, and the combination of both cues for VD in normal-hearing (NH) school-age children and to compare their performance with that of NH adults; (2) to assess the influence of spectral degradation by means of vocoded speech on the use of F0 and VTL cues for VD in NH children; and (3) to assess the contribution of attention, working memory, and nonverbal reasoning to performance. Design: Forty-one children, 8 to 11 years of age, were tested with nonvocoded stimuli. Twenty-one of them were also tested with eight-channel, noise-vocoded stimuli. Twenty-one young adults (18 to 35 years) were tested for comparison. A three-interval, three-alternative forced-choice paradigm with an adaptive tracking procedure was used to estimate the difference limens (DLs) for VD when F0, VTL, and F0 + VTL were manipulated separately. Auditory memory, visual attention, and nonverbal reasoning were assessed for all participants. Results: (a) Children' F0 and VTL discrimination abilities were comparable to those of adults, suggesting that most school-age children utilize both cues effectively for VD. (b) Children's VD was associated with trail making test scores that assessed visual attention abilities and speed of processing, possibly reflecting their need to recruit cognitive resources for the task. (c) Best DLs were achieved for the combined (F0 + VTL) manipulation for both children and adults, suggesting that children at this age are already capable of integrating spectral and temporal cues. (d) Both children and adults found the VTL manipulations more beneficial for VD compared with the F0 manipulations, suggesting that formant frequencies are more reliable for identifying a specific speaker than F0. (e) Poorer DLs were achieved with the vocoded stimuli, though the children maintained similar thresholds and pattern of performance among manipulations as the adults
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[article] 
inEar and hearing > Vol. 41, n°1 (Janvier-Février 2020) . - p. 194-207

Titre :	The Effects of GJB2 or SLC26A4 Gene Mutations on Neural Response of the Electrically Stimulated Auditory Nerve in Children , Chao, Xiuhua1,2; Wang, Ruijie1,2; Pellittieri, Angela3; Bai, Xiaohui1,2; Fan, Zhaomin1,2; Wang, Haibo1,2; He, Shuman3,4
Type de document :	Article
Auteurs :	Jianfen Luo ; Lien Xu ; Xiuhua Chao ; [et al.]
Année de publication :	2020
Article en page(s) :	p. 194-207
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Gène ; Implants cochléaires Autres descripteurs Nerf auditif ; Polarite ; Potentiels évoqués a action composée (ECAP)
Résumé :	Objectives: This study aimed to (1) investigate the effect of GJB2 and SLC26A4 gene mutations on auditory nerve function in pediatric cochlear implant users and (2) compare their results with those measured in implanted children with idiopathic hearing loss. Design: Participants included 20 children with biallelic GJB2 mutations, 16 children with biallelic SLC26A4 mutations, and 19 children with idiopathic hearing loss. All subjects except for two in the SLC26A4 group had concurrent Mondini malformation and enlarged vestibular aqueduct. All subjects used Cochlear Nucleus devices in their test ears. For each subject, electrophysiological measures of the electrically evoked compound action potential (eCAP) were recorded using both anodic- and cathodic-leading biphasic pulses. Dependent variables (DVs) of interest included slope of eCAP input/output (I/O) function, the eCAP threshold, and eCAP amplitude measured at the maximum comfortable level (C level) of the anodic-leading stimulus (i.e., the anodic C level). Slopes of eCAP I/O functions were estimated using statistical modeling with a linear regression function. These DVs were measured at three electrode locations across the electrode array. Generalized linear mixed effect models were used to evaluate the effects of study group, stimulus polarity, and electrode location on each DV. Results: Steeper slopes of eCAP I/O function, lower eCAP thresholds, and larger eCAP amplitude at the anodic C level were measured for the anodic-leading stimulus compared with the cathodic-leading stimulus in all subject groups. Children with GJB2 mutations showed steeper slopes of eCAP I/O function and larger eCAP amplitudes at the anodic C level than children with SLC26A4 mutations and children with idiopathic hearing loss for both the anodic- and cathodic-leading stimuli. In addition, children with GJB2 mutations showed a smaller increase in eCAP amplitude when the stimulus changed from the cathodic-leading pulse to the anodic-leading pulse (i.e., smaller polarity effect) than children with idiopathic hearing loss. There was no statistically significant difference in slope of eCAP I/O function, eCAP amplitude at the anodic C level, or the size of polarity effect on all three DVs between children with SLC26A4 mutations and children with idiopathic hearing loss. These results suggested that better auditory nerve function was associated with GJB2 but not with SLC26A4 mutations when compared with idiopathic hearing loss. In addition, significant effects of electrode location were observed for slope of eCAP I/O function and the eCAP threshold. Conclusions: GJB2 and SLC26A4 gene mutations did not alter polarity sensitivity of auditory nerve fibers to electrical stimulation. The anodic-leading stimulus was generally more effective in activating auditory nerve fibers than the cathodic-leading stimulus, despite the presence of GJB2 or SLC26A4 mutations. Patients with GJB2 mutations appeared to have better functional status of the auditory nerve than patients with SLC26A4 mutations who had concurrent Mondini malformation and enlarged vestibular aqueduct and patients with idiopathic hearing loss.
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[article] The Effects of GJB2 or SLC26A4 Gene Mutations on Neural Response of the Electrically Stimulated Auditory Nerve in Children , Chao, Xiuhua1,2; Wang, Ruijie1,2; Pellittieri, Angela3; Bai, Xiaohui1,2; Fan, Zhaomin1,2; Wang, Haibo1,2; He, Shuman3,4 [Article] / Jianfen Luo ; Lien Xu ; Xiuhua Chao ; [et al.] . - 2020 . - p. 194-207.
Langues : Anglais (eng)
in Ear and hearing > Vol. 41, n°1 (Janvier-Février 2020) . - p. 194-207

Descripteurs :	HE Vinci Gène ; Implants cochléaires Autres descripteurs Nerf auditif ; Polarite ; Potentiels évoqués a action composée (ECAP)
Résumé :	Objectives: This study aimed to (1) investigate the effect of GJB2 and SLC26A4 gene mutations on auditory nerve function in pediatric cochlear implant users and (2) compare their results with those measured in implanted children with idiopathic hearing loss. Design: Participants included 20 children with biallelic GJB2 mutations, 16 children with biallelic SLC26A4 mutations, and 19 children with idiopathic hearing loss. All subjects except for two in the SLC26A4 group had concurrent Mondini malformation and enlarged vestibular aqueduct. All subjects used Cochlear Nucleus devices in their test ears. For each subject, electrophysiological measures of the electrically evoked compound action potential (eCAP) were recorded using both anodic- and cathodic-leading biphasic pulses. Dependent variables (DVs) of interest included slope of eCAP input/output (I/O) function, the eCAP threshold, and eCAP amplitude measured at the maximum comfortable level (C level) of the anodic-leading stimulus (i.e., the anodic C level). Slopes of eCAP I/O functions were estimated using statistical modeling with a linear regression function. These DVs were measured at three electrode locations across the electrode array. Generalized linear mixed effect models were used to evaluate the effects of study group, stimulus polarity, and electrode location on each DV. Results: Steeper slopes of eCAP I/O function, lower eCAP thresholds, and larger eCAP amplitude at the anodic C level were measured for the anodic-leading stimulus compared with the cathodic-leading stimulus in all subject groups. Children with GJB2 mutations showed steeper slopes of eCAP I/O function and larger eCAP amplitudes at the anodic C level than children with SLC26A4 mutations and children with idiopathic hearing loss for both the anodic- and cathodic-leading stimuli. In addition, children with GJB2 mutations showed a smaller increase in eCAP amplitude when the stimulus changed from the cathodic-leading pulse to the anodic-leading pulse (i.e., smaller polarity effect) than children with idiopathic hearing loss. There was no statistically significant difference in slope of eCAP I/O function, eCAP amplitude at the anodic C level, or the size of polarity effect on all three DVs between children with SLC26A4 mutations and children with idiopathic hearing loss. These results suggested that better auditory nerve function was associated with GJB2 but not with SLC26A4 mutations when compared with idiopathic hearing loss. In addition, significant effects of electrode location were observed for slope of eCAP I/O function and the eCAP threshold. Conclusions: GJB2 and SLC26A4 gene mutations did not alter polarity sensitivity of auditory nerve fibers to electrical stimulation. The anodic-leading stimulus was generally more effective in activating auditory nerve fibers than the cathodic-leading stimulus, despite the presence of GJB2 or SLC26A4 mutations. Patients with GJB2 mutations appeared to have better functional status of the auditory nerve than patients with SLC26A4 mutations who had concurrent Mondini malformation and enlarged vestibular aqueduct and patients with idiopathic hearing loss.
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