[article] 
inEar and hearing > Vol 42, n°2 (Mars-Avril) . - p. 249-457

Titre :	Ear and Hearing Care Workforce: Current Status and its Implications
Type de document :	Article
Auteurs :	Kaloyan Kamenov ; Ricardo Martinez ; Teena Kunjumen ; Shelly Chadha
Année de publication :	2021
Article en page(s) :	p. 249-457
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Accessibilité des services de santé ; Oto-rhino-laryngologie (ORL) ; Otologie ; Soins aux patients
Résumé :	This study aimed to provide comprehensive global evidence on the availability of ear and hearing care (EHC) professionals and real-life examples that showcase the impact of workforce shortages on the workload faced by existing professionals. Methods: Six sources of data were used to estimate availability of EHC workforce: a scoping literature review, World Health Organization (WHO) National Health Workforce Accounts platform, WHO Member States survey and regional consultations, hearing care organizations survey, and official government statistics. EHC professionals' workload undertaking common interventions was estimated through the WHO workload indicators of staffing need human resource management tool. Results: With data on otolaryngologists from 138, audiologists from 102, speech and language therapists from 124, and teachers of the deaf from 86 countries, this study revealed large gaps in availability of EHC cadres. The majority of countries in the African region had less than one professional in each cadre per million in comparison with most European countries having up to 50 times higher densities. Workload indicators of staffing need calculations revealed the challenging workload faced by existing EHC professionals, with ratios between existing and required staff of 0.01-0.86. Conclusion: There is an enormous shortage of EHC professionals and urgent actions are needed to ensure sufficient and equitable access to services. Task sharing, a novel approach for improving access to hearing care alongside the development of new cadres, can be a vital strategy in overcoming the shortage of highly qualified providers in many settings, even in well-resourced health systems, to facilitate equitable access to required EHC services
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[article] Ear and Hearing Care Workforce: Current Status and its Implications [Article] / Kaloyan Kamenov ; Ricardo Martinez ; Teena Kunjumen ; Shelly Chadha . - 2021 . - p. 249-457.
Langues : Anglais (eng)
in Ear and hearing > Vol 42, n°2 (Mars-Avril) . - p. 249-457

Descripteurs :	HE Vinci Accessibilité des services de santé ; Oto-rhino-laryngologie (ORL) ; Otologie ; Soins aux patients
Résumé :	This study aimed to provide comprehensive global evidence on the availability of ear and hearing care (EHC) professionals and real-life examples that showcase the impact of workforce shortages on the workload faced by existing professionals. Methods: Six sources of data were used to estimate availability of EHC workforce: a scoping literature review, World Health Organization (WHO) National Health Workforce Accounts platform, WHO Member States survey and regional consultations, hearing care organizations survey, and official government statistics. EHC professionals' workload undertaking common interventions was estimated through the WHO workload indicators of staffing need human resource management tool. Results: With data on otolaryngologists from 138, audiologists from 102, speech and language therapists from 124, and teachers of the deaf from 86 countries, this study revealed large gaps in availability of EHC cadres. The majority of countries in the African region had less than one professional in each cadre per million in comparison with most European countries having up to 50 times higher densities. Workload indicators of staffing need calculations revealed the challenging workload faced by existing EHC professionals, with ratios between existing and required staff of 0.01-0.86. Conclusion: There is an enormous shortage of EHC professionals and urgent actions are needed to ensure sufficient and equitable access to services. Task sharing, a novel approach for improving access to hearing care alongside the development of new cadres, can be a vital strategy in overcoming the shortage of highly qualified providers in many settings, even in well-resourced health systems, to facilitate equitable access to required EHC services
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[article] 
inEar and hearing > Vol 42, n°2 (Mars-Avril) . - p. 258-270

Titre :	Musical Experience Offsets Age-Related Decline in Understanding Speech-in-Noise: Type of Training Does Not Matter, Working Memory Is the Key
Type de document :	Article
Auteurs :	Lei Zhang ; Xueying Fu ; Dan Luo ; Lidongsheng Xing ; Yi Du
Année de publication :	2021
Article en page(s) :	p. 258-270
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Compréhension dans le bruit ; Médiation musicale ; Mémoire à court terme ; Sujet âgé
Résumé :	Speech comprehension under "cocktail party" scenarios deteriorates with age even in the absence of measurable hearing loss. Musical training is suggested to counteract the age-related decline in speech-in-noise (SIN) perception, yet which aspect of musical plasticity contributes to this compensation remains unclear. This study aimed to investigate the effects of musical experience and aging on SIN perception ability. We hypothesized a key mediation role of auditory working memory in ameliorating deficient SIN perception in older adults by musical training. Design: Forty-eight older musicians, 29 older nonmusicians, 48 young musicians, and 24 young nonmusicians all with (near) normal peripheral hearing were recruited. The SIN task was recognizing nonsense speech sentences either perceptually colocated or separated with a noise masker (energetic masking) or a two-talker speech masker (informational masking). Auditory working memory was measured by auditory digit span. Path analysis was used to examine the direct and indirect effects of musical expertise and age on SIN perception performance. Results: Older musicians outperformed older nonmusicians in auditory working memory and all SIN conditions (noise separation, noise colocation, speech separation, speech colocation), but such musician advantages were absent in young adults. Path analysis showed that age and musical training had opposite effects on auditory working memory, which played a significant mediation role in SIN perception. In addition, the type of musical training did not differentiate SIN perception regardless of age. Conclusions: These results provide evidence that musical training offsets age-related speech perception deficit at adverse listening conditions by preserving auditory working memory. Our findings highlight auditory working memory in supporting speech perception amid competing noise in older adults, and underline musical training as a means of "cognitive reserve" against declines in speech comprehension and cognition in aging populations.
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[article] Musical Experience Offsets Age-Related Decline in Understanding Speech-in-Noise: Type of Training Does Not Matter, Working Memory Is the Key [Article] / Lei Zhang ; Xueying Fu ; Dan Luo ; Lidongsheng Xing ; Yi Du . - 2021 . - p. 258-270.
Langues : Anglais (eng)
in Ear and hearing > Vol 42, n°2 (Mars-Avril) . - p. 258-270

Descripteurs :	HE Vinci Compréhension dans le bruit ; Médiation musicale ; Mémoire à court terme ; Sujet âgé
Résumé :	Speech comprehension under "cocktail party" scenarios deteriorates with age even in the absence of measurable hearing loss. Musical training is suggested to counteract the age-related decline in speech-in-noise (SIN) perception, yet which aspect of musical plasticity contributes to this compensation remains unclear. This study aimed to investigate the effects of musical experience and aging on SIN perception ability. We hypothesized a key mediation role of auditory working memory in ameliorating deficient SIN perception in older adults by musical training. Design: Forty-eight older musicians, 29 older nonmusicians, 48 young musicians, and 24 young nonmusicians all with (near) normal peripheral hearing were recruited. The SIN task was recognizing nonsense speech sentences either perceptually colocated or separated with a noise masker (energetic masking) or a two-talker speech masker (informational masking). Auditory working memory was measured by auditory digit span. Path analysis was used to examine the direct and indirect effects of musical expertise and age on SIN perception performance. Results: Older musicians outperformed older nonmusicians in auditory working memory and all SIN conditions (noise separation, noise colocation, speech separation, speech colocation), but such musician advantages were absent in young adults. Path analysis showed that age and musical training had opposite effects on auditory working memory, which played a significant mediation role in SIN perception. In addition, the type of musical training did not differentiate SIN perception regardless of age. Conclusions: These results provide evidence that musical training offsets age-related speech perception deficit at adverse listening conditions by preserving auditory working memory. Our findings highlight auditory working memory in supporting speech perception amid competing noise in older adults, and underline musical training as a means of "cognitive reserve" against declines in speech comprehension and cognition in aging populations.
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[article] 
inEar and hearing > Vol 42, n°2 (Mars-Avril) . - p. 271-289

Titre :	Effect of Spectral Contrast Enhancement on Speech-on-Speech Intelligibility and Voice Cue Sensitivity in Cochlear Implant Users
Type de document :	Article
Auteurs :	Nawal El Boghdady ; Florian Langner ; Etienne Gaudrain ; Deniz Baskent ; Waldo Nogueira
Année de publication :	2021
Article en page(s) :	p. 271-289
Langues :	Anglais (eng)
Descripteurs :	HE Vinci HAUTEUR TONALE ; Implants cochléaires ; Intelligibilité de la parole Autres descripteurs Frequence fondamentale (FO) ; Resolution spectrale
Résumé :	Speech intelligibility in the presence of a competing talker (speech-on-speech; SoS) presents more difficulties for cochlear implant (CI) users compared with normal-hearing listeners. A recent study implied that these difficulties may be related to CI users' low sensitivity to two fundamental voice cues, namely, the fundamental frequency (F0) and the vocal tract length (VTL) of the speaker. Because of the limited spectral resolution in the implant, important spectral cues carrying F0 and VTL information are expected to be distorted. This study aims to address two questions: (1) whether spectral contrast enhancement (SCE), previously shown to enhance CI users' speech intelligibility in the presence of steady state background noise, could also improve CI users' SoS intelligibility, and (2) whether such improvements in SoS from SCE processing are due to enhancements in CI users' sensitivity to F0 and VTL differences between the competing talkers. Design: The effect of SCE on SoS intelligibility and comprehension was measured in two separate tasks in a sample of 14 CI users with Cochlear devices. In the first task, the CI users were asked to repeat the sentence spoken by the target speaker in the presence of a single competing talker. The competing talker was the same target speaker whose F0 and VTL were parametrically manipulated to obtain the different experimental conditions. SoS intelligibility, in terms of the percentage of correctly repeated words from the target sentence, was assessed using the standard advanced combination encoder (ACE) strategy and SCE for each voice condition. In the second task, SoS comprehension accuracy and response times were measured using the same experimental setup as in the first task, but with a different corpus. In the final task, CI users' sensitivity to F0 and VTL differences were measured for the ACE and SCE strategies. The benefit in F0 and VTL discrimination from SCE processing was evaluated with respect to the improvement in SoS perception from SCE. Results: While SCE demonstrated the potential of improving SoS intelligibility in CI users, this effect appeared to stem from SCE improving the overall signal to noise ratio in SoS rather than improving the sensitivity to the underlying F0 and VTL differences. A second key finding of this study was that, contrary to what has been observed in a previous study for childlike voice manipulations, F0 and VTL manipulations of a reference female speaker (target speaker) toward male-like voices provided a small but significant release from masking for the CI users tested. Conclusions: The present findings, together with those previously reported in the literature, indicate that SCE could serve as a possible background-noise-reduction strategy in commercial CI speech processors that could enhance speech intelligibility especially in the presence of background talkers that have longer VTLs compared with the target speaker.
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[article] Effect of Spectral Contrast Enhancement on Speech-on-Speech Intelligibility and Voice Cue Sensitivity in Cochlear Implant Users [Article] / Nawal El Boghdady ; Florian Langner ; Etienne Gaudrain ; Deniz Baskent ; Waldo Nogueira . - 2021 . - p. 271-289.
Langues : Anglais (eng)
in Ear and hearing > Vol 42, n°2 (Mars-Avril) . - p. 271-289

Descripteurs :	HE Vinci HAUTEUR TONALE ; Implants cochléaires ; Intelligibilité de la parole Autres descripteurs Frequence fondamentale (FO) ; Resolution spectrale
Résumé :	Speech intelligibility in the presence of a competing talker (speech-on-speech; SoS) presents more difficulties for cochlear implant (CI) users compared with normal-hearing listeners. A recent study implied that these difficulties may be related to CI users' low sensitivity to two fundamental voice cues, namely, the fundamental frequency (F0) and the vocal tract length (VTL) of the speaker. Because of the limited spectral resolution in the implant, important spectral cues carrying F0 and VTL information are expected to be distorted. This study aims to address two questions: (1) whether spectral contrast enhancement (SCE), previously shown to enhance CI users' speech intelligibility in the presence of steady state background noise, could also improve CI users' SoS intelligibility, and (2) whether such improvements in SoS from SCE processing are due to enhancements in CI users' sensitivity to F0 and VTL differences between the competing talkers. Design: The effect of SCE on SoS intelligibility and comprehension was measured in two separate tasks in a sample of 14 CI users with Cochlear devices. In the first task, the CI users were asked to repeat the sentence spoken by the target speaker in the presence of a single competing talker. The competing talker was the same target speaker whose F0 and VTL were parametrically manipulated to obtain the different experimental conditions. SoS intelligibility, in terms of the percentage of correctly repeated words from the target sentence, was assessed using the standard advanced combination encoder (ACE) strategy and SCE for each voice condition. In the second task, SoS comprehension accuracy and response times were measured using the same experimental setup as in the first task, but with a different corpus. In the final task, CI users' sensitivity to F0 and VTL differences were measured for the ACE and SCE strategies. The benefit in F0 and VTL discrimination from SCE processing was evaluated with respect to the improvement in SoS perception from SCE. Results: While SCE demonstrated the potential of improving SoS intelligibility in CI users, this effect appeared to stem from SCE improving the overall signal to noise ratio in SoS rather than improving the sensitivity to the underlying F0 and VTL differences. A second key finding of this study was that, contrary to what has been observed in a previous study for childlike voice manipulations, F0 and VTL manipulations of a reference female speaker (target speaker) toward male-like voices provided a small but significant release from masking for the CI users tested. Conclusions: The present findings, together with those previously reported in the literature, indicate that SCE could serve as a possible background-noise-reduction strategy in commercial CI speech processors that could enhance speech intelligibility especially in the presence of background talkers that have longer VTLs compared with the target speaker.
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[article] 
inEar and hearing > Vol 42, n°2 (Mars-Avril) . - p. 290-300

Titre :	New Metrics Needed in the Evaluation of Hearing Hazard Associated With Industrial Noise Exposure
Type de document :	Article
Auteurs :	Meibian Zhang ; Hongwei Xie ; Jiena Zhou ; et al.
Année de publication :	2021
Article en page(s) :	p. 290-300
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Audition dans le bruit ; Bruit au travail ; Perte auditive induite par le bruit (NIHL) ; Seuil auditif
Résumé :	To evaluate (1) the accuracy of the International Organization for Standardization (ISO) standard ISO 1999 [(2013), International Organization for Standardization, Geneva, Switzerland] predictions of noise-induced permanent threshold shift (NIPTS) in workers exposed to various types of high-intensity noise levels, and (2) the role of the kurtosis metric in assessing noise-induced hearing loss (NIHL). Design: Audiometric and shift-long noise exposure data were acquired from a population (N = 2,333) of screened workers from 34 industries in China. The entire cohort was exclusively divided into subgroups based on four noise exposure levels (85 10 years), and four kurtosis categories (Gaussian, low-, medium-, and high-kurtosis). Predicted NIPTS was calculated using the ISO 1999 model for each participant and the actual measured NIPTS was corrected for age and sex also using ISO 1999. The prediction accuracy of the ISO 1999 model was evaluated by comparing the NIPTS predicted by ISO 1999 with the actual NIPTS. The relation between kurtosis and NIPTS was also investigated. Results: Overall, using the average NIPTS value across the four audiometric test frequencies (2, 3, 4, and 6 kHz), the ISO 1999 predictions significantly (p Conclusions: The applicability of the ISO 1999 prediction model to different types of noise exposures needs to be carefully reexamined. A better understanding of the role of the kurtosis metric in NIHL may lead to its incorporation into a new and more accurate model of hearing loss due to noise exposure.
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[article] New Metrics Needed in the Evaluation of Hearing Hazard Associated With Industrial Noise Exposure [Article] / Meibian Zhang ; Hongwei Xie ; Jiena Zhou ; et al. . - 2021 . - p. 290-300.
Langues : Anglais (eng)
in Ear and hearing > Vol 42, n°2 (Mars-Avril) . - p. 290-300

Descripteurs :	HE Vinci Audition dans le bruit ; Bruit au travail ; Perte auditive induite par le bruit (NIHL) ; Seuil auditif
Résumé :	To evaluate (1) the accuracy of the International Organization for Standardization (ISO) standard ISO 1999 [(2013), International Organization for Standardization, Geneva, Switzerland] predictions of noise-induced permanent threshold shift (NIPTS) in workers exposed to various types of high-intensity noise levels, and (2) the role of the kurtosis metric in assessing noise-induced hearing loss (NIHL). Design: Audiometric and shift-long noise exposure data were acquired from a population (N = 2,333) of screened workers from 34 industries in China. The entire cohort was exclusively divided into subgroups based on four noise exposure levels (85 10 years), and four kurtosis categories (Gaussian, low-, medium-, and high-kurtosis). Predicted NIPTS was calculated using the ISO 1999 model for each participant and the actual measured NIPTS was corrected for age and sex also using ISO 1999. The prediction accuracy of the ISO 1999 model was evaluated by comparing the NIPTS predicted by ISO 1999 with the actual NIPTS. The relation between kurtosis and NIPTS was also investigated. Results: Overall, using the average NIPTS value across the four audiometric test frequencies (2, 3, 4, and 6 kHz), the ISO 1999 predictions significantly (p Conclusions: The applicability of the ISO 1999 prediction model to different types of noise exposures needs to be carefully reexamined. A better understanding of the role of the kurtosis metric in NIHL may lead to its incorporation into a new and more accurate model of hearing loss due to noise exposure.
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[article] 
inEar and hearing > Vol 42, n°2 (Mars-Avril) . - p. 301-312

Titre :	Place-Pitch Interval Perception With a Cochlear Implant
Type de document :	Article
Auteurs :	Natalia Stupak ; Ann E. Todd ; David M. Landsberger
Année de publication :	2021
Article en page(s) :	p. 301-312
Langues :	Anglais (eng)
Descripteurs :	Autres descripteurs Codage des sons HE Vinci HAUTEUR TONALE ; Implants cochléaires
Résumé :	Pitch is poorly perceived by cochlear implant (CI) users. However, as it is not well understood how pitch is encoded with electric stimulation, improving pitch representation with a CI is challenging. Changes in place of stimulation along the cochlea have been described as changes in pitch and can be accurately ranked by CI users. However, it remains unknown if place-pitch can be used to encode musical intervals, which are a necessary attribute of pitch. The objective of these experiments is to determine if place-pitch coding can be used to represent musical intervals with a CI. Design: In the first experiment, 10 CI users and 10 normal hearing (NH) controls were tested on their sensitivity to changes in the semitone spacing between each of the notes in the melody "Happy Birthday." The changes were implemented by uniformly expanding or compressing the frequency differences between each note in the melody. The participant's task was to scale how "out-of-tune" the melody was for various semitone spacing distortions. The notes were represented by pure-tones >=440 Hz to minimize potential useful temporal information from the stimuli. A second experiment replicated the first experiment using single-sided deafened CI users allowing for a within-subject control. A third experiment verified that the CI users who participated in Experiment 1 were each able to determine pitch direction reliably. Results: Unlike NH listeners, CI listeners often ranked all distortions of interval spacing similarly in both the first and second experiment, and no effect of interval spacing was detected across CI users. Some participants found distorted interval spacings to be less out-of-tune than the nominally correct interval spacings. However, these patterns were inconsistent across listeners. Although performance was better for the NH listeners, the third experiment demonstrated that the CI listeners were able to reliably identify changes in pitch direction from place-pitch coding. Conclusions: The data suggest that place-pitch intervals are not properly represented through a CI sound processor. Some limited support is found for place-pitch being useful for interval encoding as some participants demonstrated improved ratings for certain interval distortions. Presumably the interval representation for these participants could be improved by a change to the frequencies represented by each electrode. However, as these patterns vary across listeners, there is not a universal correction to frequency representation that will solve this issue. As results are similar for single-sided deafened CI users, the limitations in ratings are likely not limited by an eroded representation of the melody caused by an extended duration of deafness.
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[article] Place-Pitch Interval Perception With a Cochlear Implant [Article] / Natalia Stupak ; Ann E. Todd ; David M. Landsberger . - 2021 . - p. 301-312.
Langues : Anglais (eng)
in Ear and hearing > Vol 42, n°2 (Mars-Avril) . - p. 301-312

Descripteurs :	Autres descripteurs Codage des sons HE Vinci HAUTEUR TONALE ; Implants cochléaires
Résumé :	Pitch is poorly perceived by cochlear implant (CI) users. However, as it is not well understood how pitch is encoded with electric stimulation, improving pitch representation with a CI is challenging. Changes in place of stimulation along the cochlea have been described as changes in pitch and can be accurately ranked by CI users. However, it remains unknown if place-pitch can be used to encode musical intervals, which are a necessary attribute of pitch. The objective of these experiments is to determine if place-pitch coding can be used to represent musical intervals with a CI. Design: In the first experiment, 10 CI users and 10 normal hearing (NH) controls were tested on their sensitivity to changes in the semitone spacing between each of the notes in the melody "Happy Birthday." The changes were implemented by uniformly expanding or compressing the frequency differences between each note in the melody. The participant's task was to scale how "out-of-tune" the melody was for various semitone spacing distortions. The notes were represented by pure-tones >=440 Hz to minimize potential useful temporal information from the stimuli. A second experiment replicated the first experiment using single-sided deafened CI users allowing for a within-subject control. A third experiment verified that the CI users who participated in Experiment 1 were each able to determine pitch direction reliably. Results: Unlike NH listeners, CI listeners often ranked all distortions of interval spacing similarly in both the first and second experiment, and no effect of interval spacing was detected across CI users. Some participants found distorted interval spacings to be less out-of-tune than the nominally correct interval spacings. However, these patterns were inconsistent across listeners. Although performance was better for the NH listeners, the third experiment demonstrated that the CI listeners were able to reliably identify changes in pitch direction from place-pitch coding. Conclusions: The data suggest that place-pitch intervals are not properly represented through a CI sound processor. Some limited support is found for place-pitch being useful for interval encoding as some participants demonstrated improved ratings for certain interval distortions. Presumably the interval representation for these participants could be improved by a change to the frequencies represented by each electrode. However, as these patterns vary across listeners, there is not a universal correction to frequency representation that will solve this issue. As results are similar for single-sided deafened CI users, the limitations in ratings are likely not limited by an eroded representation of the melody caused by an extended duration of deafness.
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[article] 
inEar and hearing > Vol 42, n°2 (Mars-Avril) . - p. 313-322

Titre :	Contribution of Stimulus Variability to Word Recognition in Noise Versus Two-Talker Speech for School-Age Children and Adults
Type de document :	Article
Auteurs :	Emily Buss ; Lauren Calandruccio ; Jacob J. Oleson ; Lori J. Leibold
Année de publication :	2021
Article en page(s) :	p. 313-322
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Audition dans le bruit ; Seuil de réception de la parole (SRT)
Résumé :	Speech-in-speech recognition scores tend to be more variable than the speech-in-noise recognition scores, both within and across listeners. This variability could be due to listener factors, such as individual differences in audibility or susceptibility to informational masking. It could also be due to stimulus variability, with some speech-in-speech samples posing more of a challenge than others. The purpose of this experiment was to test two hypotheses: (1) that stimulus variability affects adults' word recognition in a two-talker speech masker and (2) that stimulus variability plays a smaller role in children's performance due to relatively greater contributions of listener factors. Methods: Listeners were children (5 to 10 years) and adults (18 to 41 years) with normal hearing. Target speech was a corpus of 30 disyllabic words, each associated with an unambiguous illustration. Maskers were 30 samples of either two-talker speech or speech-shaped noise. The task was a four-alternative forced choice. Speech reception thresholds were measured adaptively, and those results were used to determine the signal-to-noise ratio associated with [almost equal to]65% correct for each listener and masker. Two 30-word blocks of fixed-level testing were then completed in each of the two conditions: (1) with the target-masker pairs randomly assigned prior to each block and (2) with frozen target-masker pairs. Results: Speech reception thresholds were lower for adults than for children, particularly for the two-talker speech masker. Listener responses in fixed-level testing were evaluated for consistency across listeners. Target sample was the best predictor of performance in the speech-shaped noise masker for both the random and frozen conditions. In contrast, both the target and masker samples affected performance in the two-talker masker. Results were qualitatively similar for children and adults, and the pattern of performance across stimulus samples was consistent, with differences in masked target audibility in both age groups. Conclusions: Although word recognition in speech-shaped noise differed consistently across target words, recognition in a two-talker speech masker depended on both the target and masker samples. These stimulus effects are broadly consistent with a simple model of masked target audibility. Although variability in speech-in-speech recognition is often thought to reflect differences in informational masking, the present results suggest that variability in energetic masking across stimuli can play an important role in performance.
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[article] Contribution of Stimulus Variability to Word Recognition in Noise Versus Two-Talker Speech for School-Age Children and Adults [Article] / Emily Buss ; Lauren Calandruccio ; Jacob J. Oleson ; Lori J. Leibold . - 2021 . - p. 313-322.
Langues : Anglais (eng)
in Ear and hearing > Vol 42, n°2 (Mars-Avril) . - p. 313-322

Descripteurs :	HE Vinci Audition dans le bruit ; Seuil de réception de la parole (SRT)
Résumé :	Speech-in-speech recognition scores tend to be more variable than the speech-in-noise recognition scores, both within and across listeners. This variability could be due to listener factors, such as individual differences in audibility or susceptibility to informational masking. It could also be due to stimulus variability, with some speech-in-speech samples posing more of a challenge than others. The purpose of this experiment was to test two hypotheses: (1) that stimulus variability affects adults' word recognition in a two-talker speech masker and (2) that stimulus variability plays a smaller role in children's performance due to relatively greater contributions of listener factors. Methods: Listeners were children (5 to 10 years) and adults (18 to 41 years) with normal hearing. Target speech was a corpus of 30 disyllabic words, each associated with an unambiguous illustration. Maskers were 30 samples of either two-talker speech or speech-shaped noise. The task was a four-alternative forced choice. Speech reception thresholds were measured adaptively, and those results were used to determine the signal-to-noise ratio associated with [almost equal to]65% correct for each listener and masker. Two 30-word blocks of fixed-level testing were then completed in each of the two conditions: (1) with the target-masker pairs randomly assigned prior to each block and (2) with frozen target-masker pairs. Results: Speech reception thresholds were lower for adults than for children, particularly for the two-talker speech masker. Listener responses in fixed-level testing were evaluated for consistency across listeners. Target sample was the best predictor of performance in the speech-shaped noise masker for both the random and frozen conditions. In contrast, both the target and masker samples affected performance in the two-talker masker. Results were qualitatively similar for children and adults, and the pattern of performance across stimulus samples was consistent, with differences in masked target audibility in both age groups. Conclusions: Although word recognition in speech-shaped noise differed consistently across target words, recognition in a two-talker speech masker depended on both the target and masker samples. These stimulus effects are broadly consistent with a simple model of masked target audibility. Although variability in speech-in-speech recognition is often thought to reflect differences in informational masking, the present results suggest that variability in energetic masking across stimuli can play an important role in performance.
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[article] 
inEar and hearing > Vol 42, n°2 (Mars-Avril) . - p. 323-333

Titre :	Modiolar Proximity of Slim Modiolar Electrodes and Cochlear Duct Length: Correlation for Potential Basis of Customized Cochlear Implantation With Perimodiolar Electrodes
Type de document :	Article
Auteurs :	Sang-Yeon Lee ; Yun Jung Bae ; Marge Carandang ; Yoojoong Kim ; et al.
Année de publication :	2021
Article en page(s) :	p. 323-333
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Electrodes ; Implants cochléaires Autres descripteurs Canal auriculaire
Résumé :	Recent studies have shown that cochlear duct length (CDL) varies among individuals and could significantly influence the final position of the electrode and its trajectory in the cochlea. Given this, we hypothesized that the degree of modiolar proximity of novel slim modiolar electrodes, such as CI532 and CI632, can also be affected by CDL. To test this hypothesis, we retrospectively evaluated individual CDL to determine if there is any significant correlation of CDL with degree of modiolar proximity. Methods: Fifty-one ears from 38 subjects implanted with slim modiolar electrodes by a single surgeon through the round window approach using the pull-back technique were included. Our cohort was classified according to the deafness onset (congenital versus postlingual) and the degree of modiolar proximity (less versus tight) with reference to the spiral diameter made by the slim modiolar electrodes in situ on transorbital x ray. We then analyzed the CDL and its metrics using a readily available surgical preplanning tool (OTOPLAN) to obtain comparable data. Results: Among 30 ears associated with congenital deafness, 9 ears (30%) showed less modiolar proximity, while none of the 21 ears from 19 subjects with postlingual deafness exhibited "less modiolar proximity" based on our criteria. In this study, CDL showed significant variation among subjects. Importantly, a significant inverse correlation between spiral diameter and CDL ([rho] = -0.581, p Conclusion: A preponderance of less modiolar proximity of the electrode was observed exclusively among congenital deafness cases, demonstrated by a less tight spiral configuration even under the pull-back technique. Our data suggest that shorter CDL is associated with a less tight spiral configuration of slim modiolar electrodes postoperatively. Depending on the insertion technique, the differential degree of modiolar proximity of slim modiolar electrodes can be alleviated in cases with short CDL, which justifies cochlear duct length-based customized insertion of slim modiolar electrodes
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[article] Modiolar Proximity of Slim Modiolar Electrodes and Cochlear Duct Length: Correlation for Potential Basis of Customized Cochlear Implantation With Perimodiolar Electrodes [Article] / Sang-Yeon Lee ; Yun Jung Bae ; Marge Carandang ; Yoojoong Kim ; et al. . - 2021 . - p. 323-333.
Langues : Anglais (eng)
in Ear and hearing > Vol 42, n°2 (Mars-Avril) . - p. 323-333

Descripteurs :	HE Vinci Electrodes ; Implants cochléaires Autres descripteurs Canal auriculaire
Résumé :	Recent studies have shown that cochlear duct length (CDL) varies among individuals and could significantly influence the final position of the electrode and its trajectory in the cochlea. Given this, we hypothesized that the degree of modiolar proximity of novel slim modiolar electrodes, such as CI532 and CI632, can also be affected by CDL. To test this hypothesis, we retrospectively evaluated individual CDL to determine if there is any significant correlation of CDL with degree of modiolar proximity. Methods: Fifty-one ears from 38 subjects implanted with slim modiolar electrodes by a single surgeon through the round window approach using the pull-back technique were included. Our cohort was classified according to the deafness onset (congenital versus postlingual) and the degree of modiolar proximity (less versus tight) with reference to the spiral diameter made by the slim modiolar electrodes in situ on transorbital x ray. We then analyzed the CDL and its metrics using a readily available surgical preplanning tool (OTOPLAN) to obtain comparable data. Results: Among 30 ears associated with congenital deafness, 9 ears (30%) showed less modiolar proximity, while none of the 21 ears from 19 subjects with postlingual deafness exhibited "less modiolar proximity" based on our criteria. In this study, CDL showed significant variation among subjects. Importantly, a significant inverse correlation between spiral diameter and CDL ([rho] = -0.581, p Conclusion: A preponderance of less modiolar proximity of the electrode was observed exclusively among congenital deafness cases, demonstrated by a less tight spiral configuration even under the pull-back technique. Our data suggest that shorter CDL is associated with a less tight spiral configuration of slim modiolar electrodes postoperatively. Depending on the insertion technique, the differential degree of modiolar proximity of slim modiolar electrodes can be alleviated in cases with short CDL, which justifies cochlear duct length-based customized insertion of slim modiolar electrodes
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[article] 
inEar and hearing > Vol 42, n°2 (Mars-Avril) . - p. 334-342

Titre :	Incidence, Time Course, and Implications of Electrode Abnormalities in Pediatric Cochlear Implant Recipients
Type de document :	Article
Auteurs :	Jennifer M. Harris ; Marilyn W. Neault ; Elizabeth E. O'Neill ; Amanda M. Griffin ; Kosuke Kawai ; Margaret A. Kenna ; Greg R. Licameli
Année de publication :	2021
Article en page(s) :	p. 334-342
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Electrodes ; Enfant implanté ; Impédancemétrie ; Implants cochléaires
Résumé :	Objectives: To identify the incidence of specific abnormal impedance patterns or electrode faults, and determine their implication and significance, in a pediatric population of cochlear implant recipients. Design: Nine hundred fifty-six cochlear implant devices (621 recipients) were included in this retrospective study. Devices were included if the implantation surgery was performed at our tertiary care hospital, and the recipient was 21 years of age or younger at the time the device was implanted. Device models incapable of producing impedance measures by telemetry were excluded from the study. Individual devices with abnormal impedance measures indicating an open circuit (OC), short circuit (SC), or partial short circuit (partial SC) were included in the study, unless these abnormalities occurred only in the OR and not postoperatively. Device and patient characteristics were examined to determine their relationship to increased incidence of electrode faults or atypical patterns. Results: The incidence of software-identified electrode faults in our exclusively pediatric population was similar to that reported in the literature containing mixed-age cohorts. Nine percent of devices experienced at least one OC or one pair of SCs. Although higher incidence of these faults was seen in some specific device models, the long-term average of these faults was equivalent across manufacturers. No factors examined in this study increased the likelihood of experiencing a software-identified electrode fault. Within the study period under examination (October 1997 to March 2018), partial SCs (presenting as zig-zag or low-flat impedance patterns) were only observed in Cochlear devices. While the incidence of these partial SC abnormalities (non-software-identified faults) was 6% across all models of Cochlear devices, the CI24RCS experienced the highest incidence of partial SCs. The incidence of this pattern was lower in models manufactured after CI24RCS. Conclusions: This study provides incidence of various cochlear implant electrode impedance abnormalities across a large cohort of pediatric recipients. The incidence of all electrode abnormalities was relatively low, particularly partial SCs, which are less well recognized and not currently identified by clinician-accessible software. Incidence of software-identified electrode faults (i.e., SCs and OCs) in our pediatric-only study is similar to the incidence reported in other mixed-population and adult-only studies. These common electrode faults generally are not associated with device failure, and clinicians should feel comfortable reassuring families that an individual electrode fault does not imply an impending device failure. Conversely, those atypical impedance patterns not currently flagged by the programming software as abnormal, but visible to the clinician's eye (i.e., partial SCs in zig-zag or low-flat patterns), have a higher likelihood of device damage and failure. Performance in patients with electrode arrays exhibiting these atypical patterns should be closely monitored for any functional decrement, and proactively managed to maintain performance whenever possible.
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[article] Incidence, Time Course, and Implications of Electrode Abnormalities in Pediatric Cochlear Implant Recipients [Article] / Jennifer M. Harris ; Marilyn W. Neault ; Elizabeth E. O'Neill ; Amanda M. Griffin ; Kosuke Kawai ; Margaret A. Kenna ; Greg R. Licameli . - 2021 . - p. 334-342.
Langues : Anglais (eng)
in Ear and hearing > Vol 42, n°2 (Mars-Avril) . - p. 334-342

Descripteurs :	HE Vinci Electrodes ; Enfant implanté ; Impédancemétrie ; Implants cochléaires
Résumé :	Objectives: To identify the incidence of specific abnormal impedance patterns or electrode faults, and determine their implication and significance, in a pediatric population of cochlear implant recipients. Design: Nine hundred fifty-six cochlear implant devices (621 recipients) were included in this retrospective study. Devices were included if the implantation surgery was performed at our tertiary care hospital, and the recipient was 21 years of age or younger at the time the device was implanted. Device models incapable of producing impedance measures by telemetry were excluded from the study. Individual devices with abnormal impedance measures indicating an open circuit (OC), short circuit (SC), or partial short circuit (partial SC) were included in the study, unless these abnormalities occurred only in the OR and not postoperatively. Device and patient characteristics were examined to determine their relationship to increased incidence of electrode faults or atypical patterns. Results: The incidence of software-identified electrode faults in our exclusively pediatric population was similar to that reported in the literature containing mixed-age cohorts. Nine percent of devices experienced at least one OC or one pair of SCs. Although higher incidence of these faults was seen in some specific device models, the long-term average of these faults was equivalent across manufacturers. No factors examined in this study increased the likelihood of experiencing a software-identified electrode fault. Within the study period under examination (October 1997 to March 2018), partial SCs (presenting as zig-zag or low-flat impedance patterns) were only observed in Cochlear devices. While the incidence of these partial SC abnormalities (non-software-identified faults) was 6% across all models of Cochlear devices, the CI24RCS experienced the highest incidence of partial SCs. The incidence of this pattern was lower in models manufactured after CI24RCS. Conclusions: This study provides incidence of various cochlear implant electrode impedance abnormalities across a large cohort of pediatric recipients. The incidence of all electrode abnormalities was relatively low, particularly partial SCs, which are less well recognized and not currently identified by clinician-accessible software. Incidence of software-identified electrode faults (i.e., SCs and OCs) in our pediatric-only study is similar to the incidence reported in other mixed-population and adult-only studies. These common electrode faults generally are not associated with device failure, and clinicians should feel comfortable reassuring families that an individual electrode fault does not imply an impending device failure. Conversely, those atypical impedance patterns not currently flagged by the programming software as abnormal, but visible to the clinician's eye (i.e., partial SCs in zig-zag or low-flat patterns), have a higher likelihood of device damage and failure. Performance in patients with electrode arrays exhibiting these atypical patterns should be closely monitored for any functional decrement, and proactively managed to maintain performance whenever possible.
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[article] 
inEar and hearing > Vol 42, n°2 (Mars-Avril) . - p. 343-354

Titre :	Cortical Tracking of Speech in Delta Band Relates to Individual Differences in Speech in Noise Comprehension in Older Adults
Type de document :	Article
Auteurs :	Jacie R. McHaney ; G. Nike Gnanateja ; Kirsten E. Smayda ; Benjamin D. Zinszer ; Bharath Chandrasekaran
Année de publication :	2021
Article en page(s) :	p. 343-354
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Compréhension dans le bruit ; Sujet âgé ; Ton sonore Autres descripteurs Perception corticale
Résumé :	Understanding speech in adverse listening environments is challenging for older adults. Individual differences in pure tone averages and working memory are known to be critical indicators of speech in noise comprehension. Recent studies have suggested that tracking of the speech envelope in cortical oscillations Design: Cortical tracking of continuous speech was assessed using electroencephalography in older adults (60 to 80 years). Participants listened to speech in quiet and in the presence of noise (time-reversed speech) and answered comprehension questions. Participants completed Forward Digit Span and Backward Digit Span as measures of working memory, and pure tone averages were collected. An index of reduction in noise (RIN) was calculated by normalizing the difference between raw cortical tracking in quiet and in noise. Results: Comprehension question performance was greater for speech in quiet than for speech in noise. The relationship between RIN and speech in noise comprehension was assessed while controlling for the effects of individual differences in pure tone averages and working memory. Delta band RIN correlated with speech in noise comprehension, while theta band RIN did not. Conclusions: Cortical tracking by delta oscillations is robust to the effects of noise. These findings demonstrate that the magnitude of delta band RIN relates to individual differences in speech in noise comprehension in older adults. Delta band RIN may serve as a neural metric of speech in noise comprehension beyond the effects of pure tone averages and working memory.
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[article] Cortical Tracking of Speech in Delta Band Relates to Individual Differences in Speech in Noise Comprehension in Older Adults [Article] / Jacie R. McHaney ; G. Nike Gnanateja ; Kirsten E. Smayda ; Benjamin D. Zinszer ; Bharath Chandrasekaran . - 2021 . - p. 343-354.
Langues : Anglais (eng)
in Ear and hearing > Vol 42, n°2 (Mars-Avril) . - p. 343-354

Descripteurs :	HE Vinci Compréhension dans le bruit ; Sujet âgé ; Ton sonore Autres descripteurs Perception corticale
Résumé :	Understanding speech in adverse listening environments is challenging for older adults. Individual differences in pure tone averages and working memory are known to be critical indicators of speech in noise comprehension. Recent studies have suggested that tracking of the speech envelope in cortical oscillations Design: Cortical tracking of continuous speech was assessed using electroencephalography in older adults (60 to 80 years). Participants listened to speech in quiet and in the presence of noise (time-reversed speech) and answered comprehension questions. Participants completed Forward Digit Span and Backward Digit Span as measures of working memory, and pure tone averages were collected. An index of reduction in noise (RIN) was calculated by normalizing the difference between raw cortical tracking in quiet and in noise. Results: Comprehension question performance was greater for speech in quiet than for speech in noise. The relationship between RIN and speech in noise comprehension was assessed while controlling for the effects of individual differences in pure tone averages and working memory. Delta band RIN correlated with speech in noise comprehension, while theta band RIN did not. Conclusions: Cortical tracking by delta oscillations is robust to the effects of noise. These findings demonstrate that the magnitude of delta band RIN relates to individual differences in speech in noise comprehension in older adults. Delta band RIN may serve as a neural metric of speech in noise comprehension beyond the effects of pure tone averages and working memory.
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[article] 
inEar and hearing > Vol 42, n°2 (Mars-Avril) . - p. 355-363

Titre :	Bone Conduction Vibration Vestibular Evoked Myogenic Potential (VEMP) Testing: Reliability in Children, Adolescents, and Young Adults
Type de document :	Article
Auteurs :	Nicole L. Greenwalt ; Jessie N. Patterson ; Amanda I. Rodriguez ; Dennis F. Fitzpatrick ; Katherine R. Gordon ; Kristen L. Janky
Année de publication :	2021
Article en page(s) :	p. 355-363
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Conduction osseuse ; Potentiel évoqué myogénique vestibulaire (oVEMP) (cVEMP)
Résumé :	Bone conduction vibration (BCV) vestibular evoked myogenic potentials (VEMP) are clinically desirable in children for multiple reasons. However, no accepted standard exists for stimulus type and the reliability of BCV devices has not been investigated in children. The objective of the current study was to determine which BCV VEMP method (B-71, impulse hammer, or Mini-shaker) yields the highest response rates and reliability in a group of adults, adolescents, and children. It was hypothesized that the Mini-shaker would yield the highest response rates and reliability because it provides frequency specificity, higher output levels without distortion, and the most consistent force output as compared to the impulse hammer and B-71. Design: Participants included 10 child (ages 5 to 10), 11 adolescent (ages 11 to 18), and 11 young adult (ages 23 to 39) normal controls. Cervical VEMP (cVEMP) and ocular VEMP (oVEMP) were measured in response to suprathreshold air-conducted, 500 Hz tone bursts and 3 types of BCV (B-71, impulse hammer, and Mini-shaker) across 2 test sessions to assess reliability. Results: For cVEMP, response rates were 100% for all methods in all groups with the exception of the adult group in response to the impulse hammer (95%). For oVEMP, response rates varied by group and BCV method. For cVEMP, reliability was highest in adults using the Mini-shaker, in adolescents using the impulse hammer, and in children using the B-71. For oVEMP, reliability was highest in adults using the Mini-shaker, in adolescents using the Mini-shaker or impulse hammer, and in children using the impulse hammer. Age positively correlated with air-conducted oVEMP amplitude, but not cVEMP amplitude or cVEMP corrected amplitude. Age negatively correlated with all BCV VEMP amplitudes with the exception of cVEMP corrected amplitude in response to the Mini-shaker. Conclusions: All BCV methods resulted in consistent cVEMP responses (response rates 95 to 100%) with at least moderate reliability (intraclass correlation coefficient >= 0.5) for all groups. Similarly, all BCV methods resulted in consistent oVEMP responses (89 to 100%) with at least moderate reliability (intraclass correlation coefficient >= 0.5) except for the B-71 in adults.
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[article] Bone Conduction Vibration Vestibular Evoked Myogenic Potential (VEMP) Testing: Reliability in Children, Adolescents, and Young Adults [Article] / Nicole L. Greenwalt ; Jessie N. Patterson ; Amanda I. Rodriguez ; Dennis F. Fitzpatrick ; Katherine R. Gordon ; Kristen L. Janky . - 2021 . - p. 355-363.
Langues : Anglais (eng)
in Ear and hearing > Vol 42, n°2 (Mars-Avril) . - p. 355-363

Descripteurs :	HE Vinci Conduction osseuse ; Potentiel évoqué myogénique vestibulaire (oVEMP) (cVEMP)
Résumé :	Bone conduction vibration (BCV) vestibular evoked myogenic potentials (VEMP) are clinically desirable in children for multiple reasons. However, no accepted standard exists for stimulus type and the reliability of BCV devices has not been investigated in children. The objective of the current study was to determine which BCV VEMP method (B-71, impulse hammer, or Mini-shaker) yields the highest response rates and reliability in a group of adults, adolescents, and children. It was hypothesized that the Mini-shaker would yield the highest response rates and reliability because it provides frequency specificity, higher output levels without distortion, and the most consistent force output as compared to the impulse hammer and B-71. Design: Participants included 10 child (ages 5 to 10), 11 adolescent (ages 11 to 18), and 11 young adult (ages 23 to 39) normal controls. Cervical VEMP (cVEMP) and ocular VEMP (oVEMP) were measured in response to suprathreshold air-conducted, 500 Hz tone bursts and 3 types of BCV (B-71, impulse hammer, and Mini-shaker) across 2 test sessions to assess reliability. Results: For cVEMP, response rates were 100% for all methods in all groups with the exception of the adult group in response to the impulse hammer (95%). For oVEMP, response rates varied by group and BCV method. For cVEMP, reliability was highest in adults using the Mini-shaker, in adolescents using the impulse hammer, and in children using the B-71. For oVEMP, reliability was highest in adults using the Mini-shaker, in adolescents using the Mini-shaker or impulse hammer, and in children using the impulse hammer. Age positively correlated with air-conducted oVEMP amplitude, but not cVEMP amplitude or cVEMP corrected amplitude. Age negatively correlated with all BCV VEMP amplitudes with the exception of cVEMP corrected amplitude in response to the Mini-shaker. Conclusions: All BCV methods resulted in consistent cVEMP responses (response rates 95 to 100%) with at least moderate reliability (intraclass correlation coefficient >= 0.5) for all groups. Similarly, all BCV methods resulted in consistent oVEMP responses (89 to 100%) with at least moderate reliability (intraclass correlation coefficient >= 0.5) except for the B-71 in adults.
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[article] 
inEar and hearing > Vol 42, n°2 (Mars-Avril) . - p. 364-372

Titre :	Rhythmic Abilities of Children With Hearing Loss
Type de document :	Article
Auteurs :	Céline Hidalgo ; Annabelle Zecri ; Jacques Pesnot-Lerousseau ; Eric Truy ; Stéphane Roman ; Simone Falk ; Simone Dalla Bela ; Daniele Schon
Année de publication :	2021
Article en page(s) :	p. 364-372
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Activité rythmique ; Enfant déficient auditif ; Implants cochléaires ; Structure temporelle fine Autres descripteurs Synchronisation sensorimotrice
Résumé :	Objectives: Children with hearing loss (HL), in spite of early cochlear implantation, often struggle considerably with language acquisition. Previous research has shown a benefit of rhythmic training on linguistic skills in children with HL, suggesting that improving rhythmic capacities could help attenuating language difficulties. However, little is known about general rhythmic skills of children with HL and how they relate to speech perception. The aim of this study is twofold: (1) to assess the abilities of children with HL in different rhythmic sensorimotor synchronization tasks compared to a normal-hearing control group and (2) to investigate a possible relation between sensorimotor synchronization abilities and speech perception abilities in children with HL. Design: A battery of sensorimotor synchronization tests with stimuli of varying acoustic and temporal complexity was used: a metronome, different musical excerpts, and complex rhythmic patterns. Synchronization abilities were assessed in 32 children (aged from 5 to 10 years) with a severe to profound HL mainly fitted with one or two cochlear implants (n = 28) or with hearing aids (n = 4). Working memory and sentence repetition abilities were also assessed. Performance was compared to an age-matched control group of 24 children with normal hearing. The comparison took into account variability in working memory capacities. For children with HL only, we computed linear regressions on speech, sensorimotor synchronization, and working memory abilities, including device-related variables such as onset of device use, type of device, and duration of use. Results: Compared to the normal-hearing group, children with HL performed poorly in all sensorimotor synchronization tasks, but the effect size was greater for complex as compared to simple stimuli. Group differences in working memory did not explain this result. Linear regression analysis revealed that working memory, synchronization to complex rhythms performances, age, and duration of device use predicted the number of correct syllables produced in a sentence repetition task. Conclusion: Despite early cochlear implantation or hearing aid use, hearing impairment affects the quality of temporal processing of acoustic stimuli in congenitally deaf children. This deficit seems to be more severe with stimuli of increasing rhythmic complexity highlighting a difficulty in structuring sounds according to a temporal hierarchy.
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[article] Rhythmic Abilities of Children With Hearing Loss [Article] / Céline Hidalgo ; Annabelle Zecri ; Jacques Pesnot-Lerousseau ; Eric Truy ; Stéphane Roman ; Simone Falk ; Simone Dalla Bela ; Daniele Schon . - 2021 . - p. 364-372.
Langues : Anglais (eng)
in Ear and hearing > Vol 42, n°2 (Mars-Avril) . - p. 364-372

Descripteurs :	HE Vinci Activité rythmique ; Enfant déficient auditif ; Implants cochléaires ; Structure temporelle fine Autres descripteurs Synchronisation sensorimotrice
Résumé :	Objectives: Children with hearing loss (HL), in spite of early cochlear implantation, often struggle considerably with language acquisition. Previous research has shown a benefit of rhythmic training on linguistic skills in children with HL, suggesting that improving rhythmic capacities could help attenuating language difficulties. However, little is known about general rhythmic skills of children with HL and how they relate to speech perception. The aim of this study is twofold: (1) to assess the abilities of children with HL in different rhythmic sensorimotor synchronization tasks compared to a normal-hearing control group and (2) to investigate a possible relation between sensorimotor synchronization abilities and speech perception abilities in children with HL. Design: A battery of sensorimotor synchronization tests with stimuli of varying acoustic and temporal complexity was used: a metronome, different musical excerpts, and complex rhythmic patterns. Synchronization abilities were assessed in 32 children (aged from 5 to 10 years) with a severe to profound HL mainly fitted with one or two cochlear implants (n = 28) or with hearing aids (n = 4). Working memory and sentence repetition abilities were also assessed. Performance was compared to an age-matched control group of 24 children with normal hearing. The comparison took into account variability in working memory capacities. For children with HL only, we computed linear regressions on speech, sensorimotor synchronization, and working memory abilities, including device-related variables such as onset of device use, type of device, and duration of use. Results: Compared to the normal-hearing group, children with HL performed poorly in all sensorimotor synchronization tasks, but the effect size was greater for complex as compared to simple stimuli. Group differences in working memory did not explain this result. Linear regression analysis revealed that working memory, synchronization to complex rhythms performances, age, and duration of device use predicted the number of correct syllables produced in a sentence repetition task. Conclusion: Despite early cochlear implantation or hearing aid use, hearing impairment affects the quality of temporal processing of acoustic stimuli in congenitally deaf children. This deficit seems to be more severe with stimuli of increasing rhythmic complexity highlighting a difficulty in structuring sounds according to a temporal hierarchy.
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[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 ; Elizabeth 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 ; Elizabeth 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 Audiométrie haute fréquence ; Déficience auditive ; Otoémission acoustique ; Wideband absorbance (WBA)
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 Audiométrie haute fréquence ; Déficience auditive ; Otoémission acoustique ; Wideband absorbance (WBA)
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. 42, n°1 (Janvier-février) . - p. 87-105

Titre :	Human Frequency Following Responses to Filtered Speech
Type de document :	Article
Auteurs :	Saradha Ananthakrishnan ; Laura Grinstead ; Danielle Yurjevich
Année de publication :	2021
Article en page(s) :	p. 87-105
Langues :	Anglais (eng)
Descripteurs :	Autres descripteurs Filtre auditif ; Frequence fondamentale (FO)
Résumé :	Objectives: There is increasing interest in using the frequency following response (FFR) to describe the effects of varying different aspects of hearing aid signal processing on brainstem neural representation of speech. To this end, recent studies have examined the effects of filtering on brainstem neural representation of the speech fundamental frequency (f0) in listeners with normal hearing sensitivity by measuring FFRs to low- and high-pass filtered signals. However, the stimuli used in these studies do not reflect the entire range of typical cutoff frequencies used in frequency-specific gain adjustments during hearing aid fitting. Further, there has been limited discussion on the effect of filtering on brainstem neural representation of formant-related harmonics. Here, the effects of filtering on brainstem neural representation of speech fundamental frequency (f0) and harmonics related to first formant frequency (F1) were assessed by recording envelope and spectral FFRs to a vowel low-, high-, and band-pass filtered at cutoff frequencies ranging from 0.125 to 8 kHz. Design: FFRs were measured to a synthetically generated vowel stimulus /u/ presented in a full bandwidth and low-pass (experiment 1), high-pass (experiment 2), and band-pass (experiment 3) filtered conditions. In experiment 1, FFRs were measured to a synthetically generated vowel stimulus /u/ presented in a full bandwidth condition as well as 11 low-pass filtered conditions (low-pass cutoff frequencies: 0.125, 0.25, 0.5, 0.75, 1, 1.5, 2, 3, 4, 6, and 8 kHz) in 19 adult listeners with normal hearing sensitivity. In experiment 2, FFRs were measured to the same synthetically generated vowel stimulus /u/ presented in a full bandwidth condition as well as 10 high-pass filtered conditions (high-pass cutoff frequencies: 0.125, 0.25, 0.5, 0.75, 1, 1.5, 2, 3, 4, and 6 kHz) in 7 adult listeners with normal hearing sensitivity. In experiment 3, in addition to the full bandwidth condition, FFRs were measured to vowel /u/ low-pass filtered at 2 kHz, band-pass filtered between 2-4 kHz and 4-6 kHz in 10 adult listeners with normal hearing sensitivity. A Fast Fourier Transform analysis was conducted to measure the strength of f0 and the F1-related harmonic relative to the noise floor in the brainstem neural responses obtained to the full bandwidth and filtered stimulus conditions. Results: Brainstem neural representation of f0 was reduced when the low-pass filter cutoff frequency was between 0.25 and 0.5 kHz; no differences in f0 strength were noted between conditions when the low-pass filter cutoff condition was at or greater than 0.75 kHz. While envelope FFR f0 strength was reduced when the stimulus was high-pass filtered at 6 kHz, there was no effect of high-pass filtering on brainstem neural representation of f0 when the high-pass filter cutoff frequency ranged from 0.125 to 4 kHz. There was a weakly significant global effect of band-pass filtering on brainstem neural phase-locking to f0. A trends analysis indicated that mean f0 magnitude in the brainstem neural response was greater when the stimulus was band-pass filtered between 2 and 4 kHz as compared to when the stimulus was band-pass filtered between 4 and 6 kHz, low-pass filtered at 2 kHz or presented in the full bandwidth condition. Last, neural phase-locking to f0 was reduced or absent in envelope FFRs measured to filtered stimuli that lacked spectral energy above 0.125 kHz or below 6 kHz. Similarly, little to no energy was seen at F1 in spectral FFRs obtained to low-, high-, or band-pass filtered stimuli that did not contain energy in the F1 region. For stimulus conditions that contained energy at F1, the strength of the peak at F1 in the spectral FFR varied little with low-, high-, or band-pass filtering. Conclusions: Energy at f0 in envelope FFRs may arise due to neural phase-locking to low-, mid-, or high-frequency stimulus components, provided the stimulus envelope is modulated by at least two interacting harmonics. Stronger neural responses at f0 are measured when filtering results in stimulus bandwidths that preserve stimulus energy at F1 and F2. In addition, results suggest that unresolved harmonics may favorably influence f0 strength in the neural response. Lastly, brainstem neural representation of the F1-related harmonic measured in spectral FFRs obtained to filtered stimuli is related to the presence or absence of stimulus energy at F1. These findings add to the existing literature exploring the viability of the FFR as an objective technique to evaluate hearing aid fitting where stimulus bandwidth is altered by design due to frequency-specific gain applied by amplification algorithms.
Note de contenu :	Envelope and spectral frequency following response, Filtering, Formant frequency, Fundamental frequency, Neural phase-locking, Stimulus bandwidth
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[article] Human Frequency Following Responses to Filtered Speech [Article] / Saradha Ananthakrishnan ; Laura Grinstead ; Danielle Yurjevich . - 2021 . - p. 87-105.
Langues : Anglais (eng)
in Ear and hearing > Vol. 42, n°1 (Janvier-février) . - p. 87-105

Descripteurs :	Autres descripteurs Filtre auditif ; Frequence fondamentale (FO)
Résumé :	Objectives: There is increasing interest in using the frequency following response (FFR) to describe the effects of varying different aspects of hearing aid signal processing on brainstem neural representation of speech. To this end, recent studies have examined the effects of filtering on brainstem neural representation of the speech fundamental frequency (f0) in listeners with normal hearing sensitivity by measuring FFRs to low- and high-pass filtered signals. However, the stimuli used in these studies do not reflect the entire range of typical cutoff frequencies used in frequency-specific gain adjustments during hearing aid fitting. Further, there has been limited discussion on the effect of filtering on brainstem neural representation of formant-related harmonics. Here, the effects of filtering on brainstem neural representation of speech fundamental frequency (f0) and harmonics related to first formant frequency (F1) were assessed by recording envelope and spectral FFRs to a vowel low-, high-, and band-pass filtered at cutoff frequencies ranging from 0.125 to 8 kHz. Design: FFRs were measured to a synthetically generated vowel stimulus /u/ presented in a full bandwidth and low-pass (experiment 1), high-pass (experiment 2), and band-pass (experiment 3) filtered conditions. In experiment 1, FFRs were measured to a synthetically generated vowel stimulus /u/ presented in a full bandwidth condition as well as 11 low-pass filtered conditions (low-pass cutoff frequencies: 0.125, 0.25, 0.5, 0.75, 1, 1.5, 2, 3, 4, 6, and 8 kHz) in 19 adult listeners with normal hearing sensitivity. In experiment 2, FFRs were measured to the same synthetically generated vowel stimulus /u/ presented in a full bandwidth condition as well as 10 high-pass filtered conditions (high-pass cutoff frequencies: 0.125, 0.25, 0.5, 0.75, 1, 1.5, 2, 3, 4, and 6 kHz) in 7 adult listeners with normal hearing sensitivity. In experiment 3, in addition to the full bandwidth condition, FFRs were measured to vowel /u/ low-pass filtered at 2 kHz, band-pass filtered between 2-4 kHz and 4-6 kHz in 10 adult listeners with normal hearing sensitivity. A Fast Fourier Transform analysis was conducted to measure the strength of f0 and the F1-related harmonic relative to the noise floor in the brainstem neural responses obtained to the full bandwidth and filtered stimulus conditions. Results: Brainstem neural representation of f0 was reduced when the low-pass filter cutoff frequency was between 0.25 and 0.5 kHz; no differences in f0 strength were noted between conditions when the low-pass filter cutoff condition was at or greater than 0.75 kHz. While envelope FFR f0 strength was reduced when the stimulus was high-pass filtered at 6 kHz, there was no effect of high-pass filtering on brainstem neural representation of f0 when the high-pass filter cutoff frequency ranged from 0.125 to 4 kHz. There was a weakly significant global effect of band-pass filtering on brainstem neural phase-locking to f0. A trends analysis indicated that mean f0 magnitude in the brainstem neural response was greater when the stimulus was band-pass filtered between 2 and 4 kHz as compared to when the stimulus was band-pass filtered between 4 and 6 kHz, low-pass filtered at 2 kHz or presented in the full bandwidth condition. Last, neural phase-locking to f0 was reduced or absent in envelope FFRs measured to filtered stimuli that lacked spectral energy above 0.125 kHz or below 6 kHz. Similarly, little to no energy was seen at F1 in spectral FFRs obtained to low-, high-, or band-pass filtered stimuli that did not contain energy in the F1 region. For stimulus conditions that contained energy at F1, the strength of the peak at F1 in the spectral FFR varied little with low-, high-, or band-pass filtering. Conclusions: Energy at f0 in envelope FFRs may arise due to neural phase-locking to low-, mid-, or high-frequency stimulus components, provided the stimulus envelope is modulated by at least two interacting harmonics. Stronger neural responses at f0 are measured when filtering results in stimulus bandwidths that preserve stimulus energy at F1 and F2. In addition, results suggest that unresolved harmonics may favorably influence f0 strength in the neural response. Lastly, brainstem neural representation of the F1-related harmonic measured in spectral FFRs obtained to filtered stimuli is related to the presence or absence of stimulus energy at F1. These findings add to the existing literature exploring the viability of the FFR as an objective technique to evaluate hearing aid fitting where stimulus bandwidth is altered by design due to frequency-specific gain applied by amplification algorithms.
Note de contenu :	Envelope and spectral frequency following response, Filtering, Formant frequency, Fundamental frequency, Neural phase-locking, Stimulus bandwidth
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[article] 
inEar and hearing > Vol. 42, n°1 (Janvier-février) . - p. 106-121

Titre :	Effects of Signal Type and Noise Background on Auditory Evoked Potential N1, P2, and P3 Measurements in Blast-Exposed Veterans
Type de document :	Article
Auteurs :	Melissa A. Papesh ; Alyssa A. Stefl ; Frederick Gallun ; Curtis J. Billings
Année de publication :	2021
Article en page(s) :	p. 106-121
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Compréhension dans le bruit ; Explosion ; Potentiel évoqué auditif (PEA) Autres descripteurs Bruit traumatisant ; Vetéran de guerre
Résumé :	Objectives: Veterans who have been exposed to high-intensity blast waves frequently report persistent auditory difficulties such as problems with speech-in-noise (SIN) understanding, even when hearing sensitivity remains normal. However, these subjective reports have proven challenging to corroborate objectively. Here, we sought to determine whether use of complex stimuli and challenging signal contrasts in auditory evoked potential (AEP) paradigms rather than traditional use of simple stimuli and easy signal contrasts improved the ability of these measures to (1) distinguish between blast-exposed Veterans with auditory complaints and neurologically normal control participants, and (2) predict behavioral measures of SIN perception. Design: A total of 33 adults (aged 19-56 years) took part in this study, including 17 Veterans exposed to high-intensity blast waves within the past 10 years and 16 neurologically normal control participants matched for age and hearing status with the Veteran participants. All participants completed the following test measures: (1) a questionnaire probing perceived hearing abilities; (2) behavioral measures of SIN understanding including the BKB-SIN, the AzBio presented in 0 and +5 dB signal to noise ratios (SNRs), and a word-level consonant-vowel-consonant test presented at +5 dB SNR; and (3) electrophysiological tasks involving oddball paradigms in response to simple tones (500 Hz standard, 1000 Hz deviant) and complex speech syllables (/ba/ standard, /da/ deviant) presented in quiet and in four-talker speech babble at a SNR of +5 dB. Results: Blast-exposed Veterans reported significantly greater auditory difficulties compared to control participants. Behavioral performance on tests of SIN perception was generally, but not significantly, poorer among the groups. Latencies of P3 responses to tone signals were significantly longer among blast-exposed participants compared to control participants regardless of background condition, though responses to speech signals were similar across groups. For cortical AEPs, no significant interactions were found between group membership and either stimulus type or background. P3 amplitudes measured in response to signals in background babble accounted for 30.9% of the variance in subjective auditory reports. Behavioral SIN performance was best predicted by a combination of N1 and P2 responses to signals in quiet which accounted for 69.6% and 57.4% of the variance on the AzBio at 0 dB SNR and the BKB-SIN, respectively. Conclusions: Although blast-exposed participants reported far more auditory difficulties compared to controls, use of complex stimuli and challenging signal contrasts in cortical and cognitive AEP measures failed to reveal larger group differences than responses to simple stimuli and easy signal contrasts. Despite this, only P3 responses to signals presented in background babble were predictive of subjective auditory complaints. In contrast, cortical N1 and P2 responses were predictive of behavioral SIN performance but not subjective auditory complaints, and use of challenging background babble generally did not improve performance predictions. These results suggest that challenging stimulus protocols are more likely to tap into perceived auditory deficits, but may not be beneficial for predicting performance on clinical measures of SIN understanding. Finally, these results should be interpreted with caution since blast-exposed participants did not perform significantly poorer on tests of SIN perception.
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[article] Effects of Signal Type and Noise Background on Auditory Evoked Potential N1, P2, and P3 Measurements in Blast-Exposed Veterans [Article] / Melissa A. Papesh ; Alyssa A. Stefl ; Frederick Gallun ; Curtis J. Billings . - 2021 . - p. 106-121.
Langues : Anglais (eng)
in Ear and hearing > Vol. 42, n°1 (Janvier-février) . - p. 106-121

Descripteurs :	HE Vinci Compréhension dans le bruit ; Explosion ; Potentiel évoqué auditif (PEA) Autres descripteurs Bruit traumatisant ; Vetéran de guerre
Résumé :	Objectives: Veterans who have been exposed to high-intensity blast waves frequently report persistent auditory difficulties such as problems with speech-in-noise (SIN) understanding, even when hearing sensitivity remains normal. However, these subjective reports have proven challenging to corroborate objectively. Here, we sought to determine whether use of complex stimuli and challenging signal contrasts in auditory evoked potential (AEP) paradigms rather than traditional use of simple stimuli and easy signal contrasts improved the ability of these measures to (1) distinguish between blast-exposed Veterans with auditory complaints and neurologically normal control participants, and (2) predict behavioral measures of SIN perception. Design: A total of 33 adults (aged 19-56 years) took part in this study, including 17 Veterans exposed to high-intensity blast waves within the past 10 years and 16 neurologically normal control participants matched for age and hearing status with the Veteran participants. All participants completed the following test measures: (1) a questionnaire probing perceived hearing abilities; (2) behavioral measures of SIN understanding including the BKB-SIN, the AzBio presented in 0 and +5 dB signal to noise ratios (SNRs), and a word-level consonant-vowel-consonant test presented at +5 dB SNR; and (3) electrophysiological tasks involving oddball paradigms in response to simple tones (500 Hz standard, 1000 Hz deviant) and complex speech syllables (/ba/ standard, /da/ deviant) presented in quiet and in four-talker speech babble at a SNR of +5 dB. Results: Blast-exposed Veterans reported significantly greater auditory difficulties compared to control participants. Behavioral performance on tests of SIN perception was generally, but not significantly, poorer among the groups. Latencies of P3 responses to tone signals were significantly longer among blast-exposed participants compared to control participants regardless of background condition, though responses to speech signals were similar across groups. For cortical AEPs, no significant interactions were found between group membership and either stimulus type or background. P3 amplitudes measured in response to signals in background babble accounted for 30.9% of the variance in subjective auditory reports. Behavioral SIN performance was best predicted by a combination of N1 and P2 responses to signals in quiet which accounted for 69.6% and 57.4% of the variance on the AzBio at 0 dB SNR and the BKB-SIN, respectively. Conclusions: Although blast-exposed participants reported far more auditory difficulties compared to controls, use of complex stimuli and challenging signal contrasts in cortical and cognitive AEP measures failed to reveal larger group differences than responses to simple stimuli and easy signal contrasts. Despite this, only P3 responses to signals presented in background babble were predictive of subjective auditory complaints. In contrast, cortical N1 and P2 responses were predictive of behavioral SIN performance but not subjective auditory complaints, and use of challenging background babble generally did not improve performance predictions. These results suggest that challenging stimulus protocols are more likely to tap into perceived auditory deficits, but may not be beneficial for predicting performance on clinical measures of SIN understanding. Finally, these results should be interpreted with caution since blast-exposed participants did not perform significantly poorer on tests of SIN perception.
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[article] 
inEar and hearing > Vol. 42, n°1 (Janvier-février) . - p. 122-129

Titre :	Child- and Environment-Related Factors Influencing Daily Cochlear Implant Use : A Datalog Study
Type de document :	Article
Auteurs :	Tjeerd de Jong ; Marc P. van der Schroeff ; Jantien L. Vroegop
Année de publication :	2021
Article en page(s) :	p. 122-129
Langues :	Anglais (eng)
Descripteurs :	Autres descripteurs Influence de l'environnement HE Vinci Enfant implanté ; Implants cochléaires
Résumé :	Objectives: To understand the varying levels of daily cochlear implant (CI) use in children, previous studies have investigated factors that may be of influence. The objective of this study was to investigate the degree with which new child-related and environment-related characteristics were associated with consistent CI use. Design: The design of this study was retrospective. Data were reviewed of 81 children (51% females, mean age 6.4 years with a range of 1.3 to 17.7 years) who received a CI between 2012 and 2019. Developmental status, quantified burden of comorbidity, hearing experience, and hearing environment were investigated for correlation with consistency in daily CI use. The CIs datalog was used to objectively record the wearing times. Associations were examined using univariate correlation analyses and a linear regression analysis. Results: On average, the CI was worn 8.6 hr per day and 59% of the children wore it more than 8 hr daily. The latter children's hearing performance was significantly higher than that of the others. Consistency in CI use correlated significantly with the child-related characteristics chronological age, nonverbal intelligence quotient (IQ), American Society of Anesthesiologists physical status class, pre CI acoustic experience, CI experience, and one of the environment related characteristics "parental communication mode." In a multivariate linear regression model, consistency in CI use was significantly dependent on nonverbal IQ and parental communication mode. These together accounted for 47% of the variation in daily CI use. Conclusions: The findings indicate that children with lower nonverbal IQ scores and low exposure to oral communication by their parents are at risk of inconsistent CI use.
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[article] Child- and Environment-Related Factors Influencing Daily Cochlear Implant Use : A Datalog Study [Article] / Tjeerd de Jong ; Marc P. van der Schroeff ; Jantien L. Vroegop . - 2021 . - p. 122-129.
Langues : Anglais (eng)
in Ear and hearing > Vol. 42, n°1 (Janvier-février) . - p. 122-129

Descripteurs :	Autres descripteurs Influence de l'environnement HE Vinci Enfant implanté ; Implants cochléaires
Résumé :	Objectives: To understand the varying levels of daily cochlear implant (CI) use in children, previous studies have investigated factors that may be of influence. The objective of this study was to investigate the degree with which new child-related and environment-related characteristics were associated with consistent CI use. Design: The design of this study was retrospective. Data were reviewed of 81 children (51% females, mean age 6.4 years with a range of 1.3 to 17.7 years) who received a CI between 2012 and 2019. Developmental status, quantified burden of comorbidity, hearing experience, and hearing environment were investigated for correlation with consistency in daily CI use. The CIs datalog was used to objectively record the wearing times. Associations were examined using univariate correlation analyses and a linear regression analysis. Results: On average, the CI was worn 8.6 hr per day and 59% of the children wore it more than 8 hr daily. The latter children's hearing performance was significantly higher than that of the others. Consistency in CI use correlated significantly with the child-related characteristics chronological age, nonverbal intelligence quotient (IQ), American Society of Anesthesiologists physical status class, pre CI acoustic experience, CI experience, and one of the environment related characteristics "parental communication mode." In a multivariate linear regression model, consistency in CI use was significantly dependent on nonverbal IQ and parental communication mode. These together accounted for 47% of the variation in daily CI use. Conclusions: The findings indicate that children with lower nonverbal IQ scores and low exposure to oral communication by their parents are at risk of inconsistent CI use.
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[article] 
inEar and hearing > Vol. 42, n°1 (Janvier-février) . - p. 130-141

Titre :	The Effect of Auditory Residual Inhibition on Tinnitus and the Electroencephalogram
Type de document :	Article
Auteurs :	Rohan O.C. King ; Giriraj Singh Shekhawat ; Chris King ; Emily Chan ; Kei Kobayashi ; Grant D. Searchfield
Année de publication :	2021
Article en page(s) :	p. 130-141
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Acouphène ; Electroencéphalographie (EEG) ; Inhibition acoustique résiduelle (ARI)
Résumé :	Objectives: Tinnitus is the perception of sound in the absence of an external physical sound source, for some people it can severely reduce the quality of life. Acoustic residual inhibition (ARI) is a suppression of tinnitus following the cessation of a sound. The present study investigated the effect of ARI on brain activity measured using EEG. Design: Thirty adult participants (mean age of 58 years) experiencing chronic tinnitus (minimum 2 years) participated. Participants were presented broad band noise at 10 dB above minimum masking level (1 min followed by 4 min of silence, 4 times) counterbalanced with a control treatment of broad band noise at threshold (1 min followed by 4 min of silence, 4 times) while 64-channel EEG was simultaneously recorded. Tinnitus loudness was measured using a 9-point tinnitus loudness rating scale. Results: The ARI stimulation resulted in a self-reported reduction in tinnitus loudness in 17 of the 30 participants. Tinnitus rating reduced following stimulation but gradually returned to near baseline during 4 min of silence post sound exposure; successive sound exposures resulted in lower loudness ratings. No significant reductions in loudness rating were found with the control stimulation. The EEG showed increases in power spectral density, particularly in the alpha and gamma bands, during ARI compared to the control periods. Conclusions: These results contribute to the understanding of ARI and tinnitus. We recommend that there be a closer examination of the relationship between onset and offset of sound in both tinnitus and nontinnitus control participants to ascertain if EEG changes seen with ARI relate to tinnitus suppression or general postsound activity.
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[article] The Effect of Auditory Residual Inhibition on Tinnitus and the Electroencephalogram [Article] / Rohan O.C. King ; Giriraj Singh Shekhawat ; Chris King ; Emily Chan ; Kei Kobayashi ; Grant D. Searchfield . - 2021 . - p. 130-141.
Langues : Anglais (eng)
in Ear and hearing > Vol. 42, n°1 (Janvier-février) . - p. 130-141

Descripteurs :	HE Vinci Acouphène ; Electroencéphalographie (EEG) ; Inhibition acoustique résiduelle (ARI)
Résumé :	Objectives: Tinnitus is the perception of sound in the absence of an external physical sound source, for some people it can severely reduce the quality of life. Acoustic residual inhibition (ARI) is a suppression of tinnitus following the cessation of a sound. The present study investigated the effect of ARI on brain activity measured using EEG. Design: Thirty adult participants (mean age of 58 years) experiencing chronic tinnitus (minimum 2 years) participated. Participants were presented broad band noise at 10 dB above minimum masking level (1 min followed by 4 min of silence, 4 times) counterbalanced with a control treatment of broad band noise at threshold (1 min followed by 4 min of silence, 4 times) while 64-channel EEG was simultaneously recorded. Tinnitus loudness was measured using a 9-point tinnitus loudness rating scale. Results: The ARI stimulation resulted in a self-reported reduction in tinnitus loudness in 17 of the 30 participants. Tinnitus rating reduced following stimulation but gradually returned to near baseline during 4 min of silence post sound exposure; successive sound exposures resulted in lower loudness ratings. No significant reductions in loudness rating were found with the control stimulation. The EEG showed increases in power spectral density, particularly in the alpha and gamma bands, during ARI compared to the control periods. Conclusions: These results contribute to the understanding of ARI and tinnitus. We recommend that there be a closer examination of the relationship between onset and offset of sound in both tinnitus and nontinnitus control participants to ascertain if EEG changes seen with ARI relate to tinnitus suppression or general postsound activity.
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[article] 
inEar and hearing > Vol. 42, n°1 (Janvier-février) . - p. 142-162

Titre :	Band-Limited Chirp-Evoked Compound Action Potential in Guinea Pig: Comprehensive Neural Measure for Cochlear Implantation Monitoring
Type de document :	Article
Auteurs :	Youssef Adel ; Jochen Tillein ; Hannah Petzold ; Tobias Weissgerber ; Uwe Baumann
Année de publication :	2021
Article en page(s) :	p. 142-162
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Electrocochléographie ; Implants cochléaires ; Pépiement (Chirp) ; Stimulation électrique
Résumé :	Objectives: Patients with severely impaired high-frequency hearing and sufficient residual low-frequency hearing can be provided with a cochlear implant (CI), thereby facilitating ipsilateral electric and acoustic stimulation with established advantages over electric stimulation alone. However, partial or complete hearing loss often occurred after implantation due to, inter alia, acute mechanical trauma to cochlear structures during electrode insertion. Possibilities of intraoperative monitoring using electrocochleography (ECochG) have recently been studied in CI patients, primarily using the ongoing response to low-frequency tone bursts consisting of the cochlear microphonic (CM) and the auditory nerve neurophonic. By contrast, the transient neural response to tone bursts, that is, compound action potential (CAP), was generally less detectable or less sensitive as a monitoring measure, thus falling short of providing useful contribution to electrocochleography analysis. In this study, we investigate using chirps to evoke more robust CAP responses in a limited frequency band by synchronizing neural firing, and thereby improving CAP sensitivity to mechanical trauma in a guinea pig model of cochlear implantation. Design: Stimuli were band-limited between 100 Hz and 10 kHz to investigate their frequency range selectivity as a preliminary model for low-frequency hearing. They were constructed by adding a harmonic series either with zero phase delay (click) or by adjusting the phase delay at a rate that is inversely related to a traveling wave delay model (chirp), with three different parameters to examine level-dependent delay compression. The amplitude spectrum was thus identical between stimuli with differences only in phase. In Experiment 1, we compared input-output functions recorded at the round window in normal-hearing guinea pigs and implemented a high-pass noise masking paradigm to infer neural contribution to the CAP. In Experiment 2, guinea pigs were implanted with a custom-built CI electrode using a motorized micromanipulator. Acute mechanical trauma was simulated during the electrode insertion. At each insertion step, CAP and CM responses were measured at the round window for the following stimuli: broad-band click, band-limited click, and band-limited chirps (3 parameters), and tone bursts at frequencies 1, 2, 4, and 8 kHz. Results: Chirps compared with the equal-band click showed significantly lower thresholds and steeper slopes of sigmoid-fitted input-output functions. The shorter chirp evoked significantly larger amplitudes than click when compared at equal sensation level. However, the click evoked larger amplitudes than chirps at higher levels and correspondingly achieved larger saturation amplitudes. The results of the high-pass noise masking paradigm suggest that chirps could efficiently synchronize neural firing in their targeted frequency band, while the click recruited more basal fibers outside its limited band. Finally, monitoring sensitivity during electrode insertion, defined as relative amplitude change per unit distance, was higher for chirp-evoked CAP and tone burst-evoked CM, but smaller for CAP responses evoked by clicks or tone bursts. Conclusion: The chirp was shown to be an efficient stimulus in synchronizing neural firing for a limited frequency band in the guinea pig model. This study provides a proof of principle for using chirp-evoked CAP as a comprehensive neural measure in CI patients with residual hearing.
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[article] Band-Limited Chirp-Evoked Compound Action Potential in Guinea Pig: Comprehensive Neural Measure for Cochlear Implantation Monitoring [Article] / Youssef Adel ; Jochen Tillein ; Hannah Petzold ; Tobias Weissgerber ; Uwe Baumann . - 2021 . - p. 142-162.
Langues : Anglais (eng)
in Ear and hearing > Vol. 42, n°1 (Janvier-février) . - p. 142-162

Descripteurs :	HE Vinci Electrocochléographie ; Implants cochléaires ; Pépiement (Chirp) ; Stimulation électrique
Résumé :	Objectives: Patients with severely impaired high-frequency hearing and sufficient residual low-frequency hearing can be provided with a cochlear implant (CI), thereby facilitating ipsilateral electric and acoustic stimulation with established advantages over electric stimulation alone. However, partial or complete hearing loss often occurred after implantation due to, inter alia, acute mechanical trauma to cochlear structures during electrode insertion. Possibilities of intraoperative monitoring using electrocochleography (ECochG) have recently been studied in CI patients, primarily using the ongoing response to low-frequency tone bursts consisting of the cochlear microphonic (CM) and the auditory nerve neurophonic. By contrast, the transient neural response to tone bursts, that is, compound action potential (CAP), was generally less detectable or less sensitive as a monitoring measure, thus falling short of providing useful contribution to electrocochleography analysis. In this study, we investigate using chirps to evoke more robust CAP responses in a limited frequency band by synchronizing neural firing, and thereby improving CAP sensitivity to mechanical trauma in a guinea pig model of cochlear implantation. Design: Stimuli were band-limited between 100 Hz and 10 kHz to investigate their frequency range selectivity as a preliminary model for low-frequency hearing. They were constructed by adding a harmonic series either with zero phase delay (click) or by adjusting the phase delay at a rate that is inversely related to a traveling wave delay model (chirp), with three different parameters to examine level-dependent delay compression. The amplitude spectrum was thus identical between stimuli with differences only in phase. In Experiment 1, we compared input-output functions recorded at the round window in normal-hearing guinea pigs and implemented a high-pass noise masking paradigm to infer neural contribution to the CAP. In Experiment 2, guinea pigs were implanted with a custom-built CI electrode using a motorized micromanipulator. Acute mechanical trauma was simulated during the electrode insertion. At each insertion step, CAP and CM responses were measured at the round window for the following stimuli: broad-band click, band-limited click, and band-limited chirps (3 parameters), and tone bursts at frequencies 1, 2, 4, and 8 kHz. Results: Chirps compared with the equal-band click showed significantly lower thresholds and steeper slopes of sigmoid-fitted input-output functions. The shorter chirp evoked significantly larger amplitudes than click when compared at equal sensation level. However, the click evoked larger amplitudes than chirps at higher levels and correspondingly achieved larger saturation amplitudes. The results of the high-pass noise masking paradigm suggest that chirps could efficiently synchronize neural firing in their targeted frequency band, while the click recruited more basal fibers outside its limited band. Finally, monitoring sensitivity during electrode insertion, defined as relative amplitude change per unit distance, was higher for chirp-evoked CAP and tone burst-evoked CM, but smaller for CAP responses evoked by clicks or tone bursts. Conclusion: The chirp was shown to be an efficient stimulus in synchronizing neural firing for a limited frequency band in the guinea pig model. This study provides a proof of principle for using chirp-evoked CAP as a comprehensive neural measure in CI patients with residual hearing.
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[article] 
inEar and hearing > Vol. 42, n°1 (Janvier-février) . - p. 163-172

Titre :	Do Impedance Changes Correlate With a Delayed Hearing Loss After Hybrid L24 Implantation?
Type de document :	Article
Auteurs :	Simon Konrad ; Theodor Framke ; Eugen Kludt ; Andreas Buchner ; Thomas Lenarz ; Gerrit Paasche
Année de publication :	2021
Article en page(s) :	p. 163-172
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Impédancemétrie ; Implants cochléaires ; Seuil auditif Autres descripteurs Audition residuelle
Résumé :	Objectives: Preservation of residual hearing is one of the main goals in present cochlear implantation surgery. Especially for this purpose, smaller and softer electrode carriers were developed that are to be inserted through the round window membrane to minimize trauma. By using these electrodes and insertion technique, residual hearing can be preserved in a large number of patients. Unfortunately, some of these patients with initially preserved residual hearing after cochlear implantation lose it later on. The reason for this is unknown but it is speculated about a correlation with an increase in impedance, since increased impedance values are linked to intracochlear inflammation and tissue reaction. Our hypothesis for this study design was that an increase in impedance predicts changes in residual hearing under clinical conditions. Design: Data of all adult patients (N = 122) receiving a Hybrid-L24 cochlear implant at our center between 2005 and early 2015 were retrospectively evaluated. Impedance values in Common Ground mode as measured during clinical routine and referring audiological test data (audiometric thresholds under headphones) were collected. Changes between consecutive measurements were calculated for impedance values and hearing thresholds for each patient. Correlations between changes in impedances and acoustic hearing thresholds were calculated. Average values were compared as well as patients with largest impedance changes within the observation period were evaluated separately. Results: Group mean values of impedances were between 5 and 7 k[OMEGA] and stable over time with higher values on basal electrode contacts compared with apical contacts. Average hearing thresholds at the time of initial fitting were between 40 to 50 dB (250 Hz) and 90 dB (1 kHz) with a loss of about 10 dB compared with preoperative values. Correlation between impedance changes and threshold changes was found, but too inconsistently to imply a true relationship. When evaluating the 20 patients with the largest impedance changes during the observation period (all >1 k[OMEGA] from one appointment to the next one), some patients were found where hearing loss is timely connected and highly correlated with an unusual impedance change. But large impedance changes were also observed without affecting hearing thresholds and hearing loss was found without impedance change. Conclusions: Changes in impedance as measured during clinical routine cannot be taken as an indicator for a late acoustic hearing loss.
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[article] Do Impedance Changes Correlate With a Delayed Hearing Loss After Hybrid L24 Implantation? [Article] / Simon Konrad ; Theodor Framke ; Eugen Kludt ; Andreas Buchner ; Thomas Lenarz ; Gerrit Paasche . - 2021 . - p. 163-172.
Langues : Anglais (eng)
in Ear and hearing > Vol. 42, n°1 (Janvier-février) . - p. 163-172

Descripteurs :	HE Vinci Impédancemétrie ; Implants cochléaires ; Seuil auditif Autres descripteurs Audition residuelle
Résumé :	Objectives: Preservation of residual hearing is one of the main goals in present cochlear implantation surgery. Especially for this purpose, smaller and softer electrode carriers were developed that are to be inserted through the round window membrane to minimize trauma. By using these electrodes and insertion technique, residual hearing can be preserved in a large number of patients. Unfortunately, some of these patients with initially preserved residual hearing after cochlear implantation lose it later on. The reason for this is unknown but it is speculated about a correlation with an increase in impedance, since increased impedance values are linked to intracochlear inflammation and tissue reaction. Our hypothesis for this study design was that an increase in impedance predicts changes in residual hearing under clinical conditions. Design: Data of all adult patients (N = 122) receiving a Hybrid-L24 cochlear implant at our center between 2005 and early 2015 were retrospectively evaluated. Impedance values in Common Ground mode as measured during clinical routine and referring audiological test data (audiometric thresholds under headphones) were collected. Changes between consecutive measurements were calculated for impedance values and hearing thresholds for each patient. Correlations between changes in impedances and acoustic hearing thresholds were calculated. Average values were compared as well as patients with largest impedance changes within the observation period were evaluated separately. Results: Group mean values of impedances were between 5 and 7 k[OMEGA] and stable over time with higher values on basal electrode contacts compared with apical contacts. Average hearing thresholds at the time of initial fitting were between 40 to 50 dB (250 Hz) and 90 dB (1 kHz) with a loss of about 10 dB compared with preoperative values. Correlation between impedance changes and threshold changes was found, but too inconsistently to imply a true relationship. When evaluating the 20 patients with the largest impedance changes during the observation period (all >1 k[OMEGA] from one appointment to the next one), some patients were found where hearing loss is timely connected and highly correlated with an unusual impedance change. But large impedance changes were also observed without affecting hearing thresholds and hearing loss was found without impedance change. Conclusions: Changes in impedance as measured during clinical routine cannot be taken as an indicator for a late acoustic hearing loss.
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[article] 
inEar and hearing > Vol. 42, n°1 (Janvier-février) . - p. 173-179

Titre :	Loss to Follow-Up After Newborn Hearing Screening: Analysis of Risk Factors at a Massachusetts Urban Safety-Net Hospital
Type de document :	Article
Auteurs :	Alina Razak ; Darian Fard ; Richard Hubbell ; Michael A. Cohen ; Kristin Hartman-Joshi ; Jessica R. Levi
Année de publication :	2021
Article en page(s) :	p. 173-179
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Facteurs de risque ; Suivi médical Autres descripteurs Depistage auditif du nouveau-ne
Résumé :	Objectives: This study examines the unique factors that influence loss to follow-up after newborn hearing screening for patients at a Massachusetts urban safety-net hospital. We seek to characterize our patient population, investigate correlations between patient factors and rates of follow-up, and understand gaps in care. Design: A retrospective chart review was conducted of patients born at an urban safety-net hospital from January 2015 through May 2018 who did not pass the newborn hearing screening in one or both ears. A total of 197 infants were included in our study. Outcomes of interest included rates and latency of follow-up appointments, infant demographics (sex, race, birth weight, risk factors for hearing loss), and maternal factors (age, marital status, smoking status, number of children). Results: From January 2015 through May 2018, 17% (n = 34) of infants were lost to follow-up. Of those who attended an initial audiology evaluation, the median time between screening and appointment was 29 days. Newborns were 3.5 times at risk of being lost to follow-up if their mothers smoked during pregnancy compared to those whose mothers did not smoke. Further, newborns with multiple siblings in the home were less likely to utilize any audiological services. High-risk infants, such as those with an extended stay in the neonatal intensive care unit, were found to have higher rates of loss to follow-up. Conclusions: Our results indicate that patients at urban safety-net hospitals require increased support to decrease rates of loss to follow-up. In particular, strategies to aid mothers who smoke, have multiple children, or have high-risk infants can address gaps in care for newborns after hearing screening.
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[article] Loss to Follow-Up After Newborn Hearing Screening: Analysis of Risk Factors at a Massachusetts Urban Safety-Net Hospital [Article] / Alina Razak ; Darian Fard ; Richard Hubbell ; Michael A. Cohen ; Kristin Hartman-Joshi ; Jessica R. Levi . - 2021 . - p. 173-179.
Langues : Anglais (eng)
in Ear and hearing > Vol. 42, n°1 (Janvier-février) . - p. 173-179

Descripteurs :	HE Vinci Facteurs de risque ; Suivi médical Autres descripteurs Depistage auditif du nouveau-ne
Résumé :	Objectives: This study examines the unique factors that influence loss to follow-up after newborn hearing screening for patients at a Massachusetts urban safety-net hospital. We seek to characterize our patient population, investigate correlations between patient factors and rates of follow-up, and understand gaps in care. Design: A retrospective chart review was conducted of patients born at an urban safety-net hospital from January 2015 through May 2018 who did not pass the newborn hearing screening in one or both ears. A total of 197 infants were included in our study. Outcomes of interest included rates and latency of follow-up appointments, infant demographics (sex, race, birth weight, risk factors for hearing loss), and maternal factors (age, marital status, smoking status, number of children). Results: From January 2015 through May 2018, 17% (n = 34) of infants were lost to follow-up. Of those who attended an initial audiology evaluation, the median time between screening and appointment was 29 days. Newborns were 3.5 times at risk of being lost to follow-up if their mothers smoked during pregnancy compared to those whose mothers did not smoke. Further, newborns with multiple siblings in the home were less likely to utilize any audiological services. High-risk infants, such as those with an extended stay in the neonatal intensive care unit, were found to have higher rates of loss to follow-up. Conclusions: Our results indicate that patients at urban safety-net hospitals require increased support to decrease rates of loss to follow-up. In particular, strategies to aid mothers who smoke, have multiple children, or have high-risk infants can address gaps in care for newborns after hearing screening.
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[article] 
inEar and hearing > Vol. 42, n°1 (Janvier-février) . - p. 180-192

Titre :	Prediction of the Functional Status of the Cochlear Nerve in Individual Cochlear Implant Users Using Machine Learning and Electrophysiological Measures
Type de document :	Article
Auteurs :	Jeffrey Skidmore ; Lei Xu ; Xiuhua Chao ; William Riggs ; Angela Pellitieri ; Chloe Vaughan ; Xia Ning ; Ruijie Wang ; Jianfen Luo ; Shuman He
Année de publication :	2021
Article en page(s) :	p. 180-192
Langues :	Anglais (eng)
Descripteurs :	Autres descripteurs Electrophysiologie de la cochlee ; Nerf auditif ; Potentiels évoqués a action composée (eCAP) HE Vinci Implants cochléaires
Résumé :	Objectives: This study aimed to create an objective predictive model for assessing the functional status of the cochlear nerve (CN) in individual cochlear implant (CI) users. Design: Study participants included 23 children with cochlear nerve deficiency (CND), 29 children with normal-sized CNs (NSCNs), and 20 adults with various etiologies of hearing loss. Eight participants were bilateral CI users and were tested in both ears. As a result, a total of 80 ears were tested in this study. All participants used Cochlear Nucleus CIs in their test ears. For each participant, the CN refractory recovery function and input/output (I/O) function were measured using electrophysiological measures of the electrically evoked compound action potential (eCAP) at three electrode sites across the electrode array. Refractory recovery time constants were estimated using statistical modeling with an exponential decay function. Slopes of I/O functions were estimated using linear regression. The eCAP parameters used as input variables in the predictive model were absolute refractory recovery time estimated based on the refractory recovery function, eCAP threshold, slope of the eCAP I/O function, and negative-peak (i.e., N1) latency. The output variable of the predictive model was CN index, an indicator for the functional status of the CN. Predictive models were created by performing linear regression, support vector machine regression, and logistic regression with eCAP parameters from children with CND and the children with NSCNs. One-way analysis of variance with post hoc analysis with Tukey's honest significant difference criterion was used to compare study variables among study groups. Results: All three machine learning algorithms created two distinct distributions of CN indices for children with CND and children with NSCNs. Variations in CN index when calculated using different machine learning techniques were observed for adult CI users. Regardless of these variations, CN indices calculated using all three techniques in adult CI users were significantly correlated with Consonant-Nucleus-Consonant word and AzBio sentence scores measured in quiet. The five oldest CI users had smaller CN indices than the five youngest CI users in this study. Conclusions: The functional status of the CN for individual CI users was estimated by our newly developed analytical models. Model predictions of CN function for individual adult CI users were positively and significantly correlated with speech perception performance. The models presented in this study may be useful for understanding and/or predicting CI outcomes for individual patients.
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[article] Prediction of the Functional Status of the Cochlear Nerve in Individual Cochlear Implant Users Using Machine Learning and Electrophysiological Measures [Article] / Jeffrey Skidmore ; Lei Xu ; Xiuhua Chao ; William Riggs ; Angela Pellitieri ; Chloe Vaughan ; Xia Ning ; Ruijie Wang ; Jianfen Luo ; Shuman He . - 2021 . - p. 180-192.
Langues : Anglais (eng)
in Ear and hearing > Vol. 42, n°1 (Janvier-février) . - p. 180-192

Descripteurs :	Autres descripteurs Electrophysiologie de la cochlee ; Nerf auditif ; Potentiels évoqués a action composée (eCAP) HE Vinci Implants cochléaires
Résumé :	Objectives: This study aimed to create an objective predictive model for assessing the functional status of the cochlear nerve (CN) in individual cochlear implant (CI) users. Design: Study participants included 23 children with cochlear nerve deficiency (CND), 29 children with normal-sized CNs (NSCNs), and 20 adults with various etiologies of hearing loss. Eight participants were bilateral CI users and were tested in both ears. As a result, a total of 80 ears were tested in this study. All participants used Cochlear Nucleus CIs in their test ears. For each participant, the CN refractory recovery function and input/output (I/O) function were measured using electrophysiological measures of the electrically evoked compound action potential (eCAP) at three electrode sites across the electrode array. Refractory recovery time constants were estimated using statistical modeling with an exponential decay function. Slopes of I/O functions were estimated using linear regression. The eCAP parameters used as input variables in the predictive model were absolute refractory recovery time estimated based on the refractory recovery function, eCAP threshold, slope of the eCAP I/O function, and negative-peak (i.e., N1) latency. The output variable of the predictive model was CN index, an indicator for the functional status of the CN. Predictive models were created by performing linear regression, support vector machine regression, and logistic regression with eCAP parameters from children with CND and the children with NSCNs. One-way analysis of variance with post hoc analysis with Tukey's honest significant difference criterion was used to compare study variables among study groups. Results: All three machine learning algorithms created two distinct distributions of CN indices for children with CND and children with NSCNs. Variations in CN index when calculated using different machine learning techniques were observed for adult CI users. Regardless of these variations, CN indices calculated using all three techniques in adult CI users were significantly correlated with Consonant-Nucleus-Consonant word and AzBio sentence scores measured in quiet. The five oldest CI users had smaller CN indices than the five youngest CI users in this study. Conclusions: The functional status of the CN for individual CI users was estimated by our newly developed analytical models. Model predictions of CN function for individual adult CI users were positively and significantly correlated with speech perception performance. The models presented in this study may be useful for understanding and/or predicting CI outcomes for individual patients.
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[article] 
inEar and hearing > Vol. 42, n°1 (Janvier-février) . - p. 193-205

Titre :	Acclimatization to Hearing Aids by Older Adults
Type de document :	Article
Auteurs :	Dominique Wright ; Jean-Pierre Gagné
Année de publication :	2021
Article en page(s) :	p. 193-205
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Acclimatation ; Adaptation à l'aide auditive ; Aides auditives ; Reconnaissance auditive ; Sujet âgé
Résumé :	Objectives: Audiologists and hearing aid users (HAUs) generally agree that an adaptation period is needed following the first hearing aid (HA) experience. The main purpose of this study is to investigate the acclimatization of older adult listeners with hearing loss to HAs using listening effort and behavioral measures. Design: Participants (N=47) were older adults with mild to moderately severe sensorineural hearing loss. Thirty-two participants were new HAUs and 15 participants were experienced HAUs. New HAUs were randomly assigned to one of two groups: noise reduction algorithms and directional microphones activated or noise reduction algorithms and directional microphones deactivated. Speech recognition in noise and listening effort were assessed on 8 different occasions during a 10-month period. A dual-task paradigm was used to measure the listening effort deployed to recognize speech in noise. The primary task consisted of the Hearing in Noise Test which also served as the behavioral speech in noise measure. The secondary task was a tactile pattern-recognition task in which participants had to identify a sequence of three tactile stimuli that varied in duration. The two listening effort outcomes were the proportional dual-task cost and the response time on the secondary task. Cognitive abilities, including working memory and speed of processing, were evaluated using the Reading Span Test and the Digit Symbol Substitution Test, respectively. Results: Results show a significant time*group interaction. Both groups of new HAUs showed improvement over time in speech in noise performances (change of ~2 dB signal to noise ratio) and the experienced HAUs did not improve over time. The acclimatization effect was observed over a period of 4 weeks. There was no significant change over time on both measures of listening effort. There was no association between amplitude of acclimatization and the cognitive abilities measured. Conclusion: An acclimatization effect following HA experience was observed. Specifically, the new HAUs displayed a clinically significant change of 2 dB in signal to noise ratio on the Hearing in Noise Test 4 weeks following their initial fitting. The acclimatization effect is not correlated to cognitive abilities.
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[article] Acclimatization to Hearing Aids by Older Adults [Article] / Dominique Wright ; Jean-Pierre Gagné . - 2021 . - p. 193-205.
Langues : Anglais (eng)
in Ear and hearing > Vol. 42, n°1 (Janvier-février) . - p. 193-205

Descripteurs :	HE Vinci Acclimatation ; Adaptation à l'aide auditive ; Aides auditives ; Reconnaissance auditive ; Sujet âgé
Résumé :	Objectives: Audiologists and hearing aid users (HAUs) generally agree that an adaptation period is needed following the first hearing aid (HA) experience. The main purpose of this study is to investigate the acclimatization of older adult listeners with hearing loss to HAs using listening effort and behavioral measures. Design: Participants (N=47) were older adults with mild to moderately severe sensorineural hearing loss. Thirty-two participants were new HAUs and 15 participants were experienced HAUs. New HAUs were randomly assigned to one of two groups: noise reduction algorithms and directional microphones activated or noise reduction algorithms and directional microphones deactivated. Speech recognition in noise and listening effort were assessed on 8 different occasions during a 10-month period. A dual-task paradigm was used to measure the listening effort deployed to recognize speech in noise. The primary task consisted of the Hearing in Noise Test which also served as the behavioral speech in noise measure. The secondary task was a tactile pattern-recognition task in which participants had to identify a sequence of three tactile stimuli that varied in duration. The two listening effort outcomes were the proportional dual-task cost and the response time on the secondary task. Cognitive abilities, including working memory and speed of processing, were evaluated using the Reading Span Test and the Digit Symbol Substitution Test, respectively. Results: Results show a significant time*group interaction. Both groups of new HAUs showed improvement over time in speech in noise performances (change of ~2 dB signal to noise ratio) and the experienced HAUs did not improve over time. The acclimatization effect was observed over a period of 4 weeks. There was no significant change over time on both measures of listening effort. There was no association between amplitude of acclimatization and the cognitive abilities measured. Conclusion: An acclimatization effect following HA experience was observed. Specifically, the new HAUs displayed a clinically significant change of 2 dB in signal to noise ratio on the Hearing in Noise Test 4 weeks following their initial fitting. The acclimatization effect is not correlated to cognitive abilities.
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[article] 
inEar and hearing > Vol. 42, n°1 (Janvier-février) . - p. 206-213

Titre :	Test-Retest Reliability of the Dizziness Symptom Profile
Type de document :	Article
Auteurs :	Renée Landon-Lane ; Erin G. Piker ; Gary P. Jacobson ; Kelsey Hatton ; Richard A. Roberts
Année de publication :	2021
Article en page(s) :	p. 206-213
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Oto-rhino-laryngologie (ORL) ; Vertige ; Vestibulométrie Autres descripteurs Instabilite motrice ; Test retest
Résumé :	Objectives: This investigation was conducted to measure the test-retest reliability of the Dizziness Symptom Profile (DSP). The DSP was developed to assist primary care providers, general otolaryngologists, and other health care providers in the development of a differential diagnosis for patients who present with dizziness, vertigo, or unsteadiness. The DSP yields a score ranging from 0 to 100% for each of 7 subscales. Each subscale represents a different diagnosis including benign paroxysmal positional vertigo, Meniere's disease, persistent postural-perceptual dizziness (PPPD), superior semi-circular canal dehiscence, vestibular migraine, vestibular neuritis, and general unsteadiness. Design: Subjects were 150 adult patients (mean age 56.79 years, SD 15.69 years) referred to the Balance Disorders Clinic at Vanderbilt University Medical Center. Subjects completed two administrations of the DSP. The mean interval between test administrations was 1.58 days (SD 1.78 days). The response modes for the DSP were both a 0 to 100 mm visual analog scale (scored 0 mm = "strongly disagree" to 100 mm = "strongly agree") and, by extrapolation, the original 5-point Likert scale where the anchors were "strongly disagree" (scored 0 points) and "strongly agree" (scored 4 points). Results: Pearson correlation coefficients were calculated to assess test-retest reliability for individual DSP items, and ranged from r = 0.67 to 0.91 (mean 0.80; p 0.7) with the exception of PPPD which approached 0.7. Intraclass correlation coefficient estimates and their 95% confidence intervals were also calculated to assess the relative reliability of the subscales. All 7 subscales showed moderate to strong test-retest reliability, with intraclass correlation coefficients ranging from 0.85 to 0.94. Minimal detectable change (MDC) scores were calculated to assess absolute variability/measurement error for the seven subscale scores (which range from 0 to 100%). MDC values ranged from 16% (PPPD) to 25% (unsteadiness). Conclusions: (1) The test-retest reliability of the DSP is moderate to strong. (2) MDC values for each subscale were determined. (3) The DSP coupled with the Dizziness Handicap Inventory enables the clinician to evaluate the constructs of dizziness impairment, and disability/handicap. (4) The DSP may help provide a window to the natural history of dizziness disease(s). (5) The DSP provides a less biased assessment of the symptoms reported by the patient.
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[article] Test-Retest Reliability of the Dizziness Symptom Profile [Article] / Renée Landon-Lane ; Erin G. Piker ; Gary P. Jacobson ; Kelsey Hatton ; Richard A. Roberts . - 2021 . - p. 206-213.
Langues : Anglais (eng)
in Ear and hearing > Vol. 42, n°1 (Janvier-février) . - p. 206-213

Descripteurs :	HE Vinci Oto-rhino-laryngologie (ORL) ; Vertige ; Vestibulométrie Autres descripteurs Instabilite motrice ; Test retest
Résumé :	Objectives: This investigation was conducted to measure the test-retest reliability of the Dizziness Symptom Profile (DSP). The DSP was developed to assist primary care providers, general otolaryngologists, and other health care providers in the development of a differential diagnosis for patients who present with dizziness, vertigo, or unsteadiness. The DSP yields a score ranging from 0 to 100% for each of 7 subscales. Each subscale represents a different diagnosis including benign paroxysmal positional vertigo, Meniere's disease, persistent postural-perceptual dizziness (PPPD), superior semi-circular canal dehiscence, vestibular migraine, vestibular neuritis, and general unsteadiness. Design: Subjects were 150 adult patients (mean age 56.79 years, SD 15.69 years) referred to the Balance Disorders Clinic at Vanderbilt University Medical Center. Subjects completed two administrations of the DSP. The mean interval between test administrations was 1.58 days (SD 1.78 days). The response modes for the DSP were both a 0 to 100 mm visual analog scale (scored 0 mm = "strongly disagree" to 100 mm = "strongly agree") and, by extrapolation, the original 5-point Likert scale where the anchors were "strongly disagree" (scored 0 points) and "strongly agree" (scored 4 points). Results: Pearson correlation coefficients were calculated to assess test-retest reliability for individual DSP items, and ranged from r = 0.67 to 0.91 (mean 0.80; p 0.7) with the exception of PPPD which approached 0.7. Intraclass correlation coefficient estimates and their 95% confidence intervals were also calculated to assess the relative reliability of the subscales. All 7 subscales showed moderate to strong test-retest reliability, with intraclass correlation coefficients ranging from 0.85 to 0.94. Minimal detectable change (MDC) scores were calculated to assess absolute variability/measurement error for the seven subscale scores (which range from 0 to 100%). MDC values ranged from 16% (PPPD) to 25% (unsteadiness). Conclusions: (1) The test-retest reliability of the DSP is moderate to strong. (2) MDC values for each subscale were determined. (3) The DSP coupled with the Dizziness Handicap Inventory enables the clinician to evaluate the constructs of dizziness impairment, and disability/handicap. (4) The DSP may help provide a window to the natural history of dizziness disease(s). (5) The DSP provides a less biased assessment of the symptoms reported by the patient.
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[article] 
inEar and hearing > Vol. 42, n°1 (Janvier-février) . - p. 214-222

Titre :	Pinna-Imitating Microphone Directionality Improves Sound Localization and Discrimination in Bilateral Cochlear Implant Users
Type de document :	Article
Auteurs :	Tim Fischer ; Christoph Schmid ; Martin Kompis ; Georgios Mantokoudis ; Marco Caversaccio ; Wilhelm Wimmer
Année de publication :	2021
Article en page(s) :	p. 214-222
Langues :	Anglais (eng)
Descripteurs :	Autres descripteurs Embout auriculaire ; Implant cochleaire bilateral ; Localisation du son ; Source auditive HE Vinci CONFUSION AUDITIVE ; Mesure acoustique
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[article] Pinna-Imitating Microphone Directionality Improves Sound Localization and Discrimination in Bilateral Cochlear Implant Users [Article] / Tim Fischer ; Christoph Schmid ; Martin Kompis ; Georgios Mantokoudis ; Marco Caversaccio ; Wilhelm Wimmer . - 2021 . - p. 214-222.
Langues : Anglais (eng)
in Ear and hearing > Vol. 42, n°1 (Janvier-février) . - p. 214-222

Descripteurs :	Autres descripteurs Embout auriculaire ; Implant cochleaire bilateral ; Localisation du son ; Source auditive HE Vinci CONFUSION AUDITIVE ; Mesure acoustique
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[article] 
inEar and hearing > Vol. 42, n°1 (Janvier-février) . - p. 223-234

Titre :	Reorganized Brain White Matter in Early- and Late-Onset Deafness With Diffusion Tensor Imaging
Type de document :	Article
Auteurs :	Eunkyung Kim ; Hyejin Kang ; Kyu-Hee Han ; Hyo-Jeong Lee ; Myung-Whan Suh ; Jae-Jin Song ; Seung-Ha Oh
Année de publication :	2021
Article en page(s) :	p. 223-234
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Imagerie par tenseur de diffusion ; Plasticité neuronale ; Surdité Autres descripteurs connectivité ; myéline
Résumé :	Objectives: Individuals with early- and late-onset deafness showed different functional and morphological brain changes, but white matter alterations in both deaf groups still need to be elucidated. This study aimed to investigate changes in white matter integrity and white matter anatomical connectivity in both early- and late-onset deaf groups compared with hearing group. Design: Diffusion tensor imaging data from 7 early-onset deaf (50.7 +/- 6.5 years), 11 late-onset deaf (50.9 +/- 12.3 years), and 9 hearing adults (48.9 +/- 9.5 years) were preprocessed using FSL software. To find changes in white matter integrity, tract-based spatial statistics was used, which implemented on FSL software. Fractional anisotropy (FA), axial diffusivity (AD) and radial diffusivity (RD) were calculated and compared among the groups with age as a nuisance variable. To find out the effect of onset age or duration of deafness to the white matter integrity, onset-age or duration of deafness was treated as a variable of interest in the general linear model implemented on tract-based spatial statistics. White matter connectivity was constructed by a deterministic tractography and compared among the groups. Results: In comparison to the hearing group, the early-onset deaf group did not show any significant changes but the late-onset deaf group showed decreased FA and increased RD in the several white matter areas. AD in the late-onset deaf group was not significantly different compared with the hearing group. The regions included the corpus callosum, posterior and superior corona radiata, internal capsule, posterior thalamic radiation, superior longitudinal fasciculus, and tapetum of the right hemisphere. Increased RD was also additionally observed in the right external capsule, fornix, and cerebral peduncle. The onset age or duration of deafness was not significantly correlated with the white matter integrity in the early-onset deaf group. In contrast, the onset age showed a significantly positive correlation with the RD, and a negative correlation with the FA, in the late-onset deaf group. The correlated white matter areas were also similar to the findings of comparison with the hearing group. In comparison to the hearing group, the early-onset deaf group did not show altered white matter connectivity, while the late-onset deaf group showed decreased white matter connectivity in between the right lingual and hippocampal areas. Conclusions: The present results suggest that late-onset deaf adults showed decreased FA and increased RD, and early-onset deaf adults showed no difference compared with the hearing group. In the late-onset deaf adults, onset-age showed a significantly positive correlation with RD and negative correlation with FA. Duration of deafness was not significantly correlated with the changes. Increased RD indicating demyelination occurred in the brain, and the changes were not limited to the auditory cortex but expanded to almost whole brain areas, suggesting significant effect of auditory deprivation on the brain later in life. The altered white matter connectivity in between the right limbic-occipital areas observed in the late-onset deaf group might be caused by altered language functions after auditory deprivation. Future studies are necessary incorporating functional and anatomical aspects of the brain changes in deaf group.
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[article] Reorganized Brain White Matter in Early- and Late-Onset Deafness With Diffusion Tensor Imaging [Article] / Eunkyung Kim ; Hyejin Kang ; Kyu-Hee Han ; Hyo-Jeong Lee ; Myung-Whan Suh ; Jae-Jin Song ; Seung-Ha Oh . - 2021 . - p. 223-234.
Langues : Anglais (eng)
in Ear and hearing > Vol. 42, n°1 (Janvier-février) . - p. 223-234

Descripteurs :	HE Vinci Imagerie par tenseur de diffusion ; Plasticité neuronale ; Surdité Autres descripteurs connectivité ; myéline
Résumé :	Objectives: Individuals with early- and late-onset deafness showed different functional and morphological brain changes, but white matter alterations in both deaf groups still need to be elucidated. This study aimed to investigate changes in white matter integrity and white matter anatomical connectivity in both early- and late-onset deaf groups compared with hearing group. Design: Diffusion tensor imaging data from 7 early-onset deaf (50.7 +/- 6.5 years), 11 late-onset deaf (50.9 +/- 12.3 years), and 9 hearing adults (48.9 +/- 9.5 years) were preprocessed using FSL software. To find changes in white matter integrity, tract-based spatial statistics was used, which implemented on FSL software. Fractional anisotropy (FA), axial diffusivity (AD) and radial diffusivity (RD) were calculated and compared among the groups with age as a nuisance variable. To find out the effect of onset age or duration of deafness to the white matter integrity, onset-age or duration of deafness was treated as a variable of interest in the general linear model implemented on tract-based spatial statistics. White matter connectivity was constructed by a deterministic tractography and compared among the groups. Results: In comparison to the hearing group, the early-onset deaf group did not show any significant changes but the late-onset deaf group showed decreased FA and increased RD in the several white matter areas. AD in the late-onset deaf group was not significantly different compared with the hearing group. The regions included the corpus callosum, posterior and superior corona radiata, internal capsule, posterior thalamic radiation, superior longitudinal fasciculus, and tapetum of the right hemisphere. Increased RD was also additionally observed in the right external capsule, fornix, and cerebral peduncle. The onset age or duration of deafness was not significantly correlated with the white matter integrity in the early-onset deaf group. In contrast, the onset age showed a significantly positive correlation with the RD, and a negative correlation with the FA, in the late-onset deaf group. The correlated white matter areas were also similar to the findings of comparison with the hearing group. In comparison to the hearing group, the early-onset deaf group did not show altered white matter connectivity, while the late-onset deaf group showed decreased white matter connectivity in between the right lingual and hippocampal areas. Conclusions: The present results suggest that late-onset deaf adults showed decreased FA and increased RD, and early-onset deaf adults showed no difference compared with the hearing group. In the late-onset deaf adults, onset-age showed a significantly positive correlation with RD and negative correlation with FA. Duration of deafness was not significantly correlated with the changes. Increased RD indicating demyelination occurred in the brain, and the changes were not limited to the auditory cortex but expanded to almost whole brain areas, suggesting significant effect of auditory deprivation on the brain later in life. The altered white matter connectivity in between the right limbic-occipital areas observed in the late-onset deaf group might be caused by altered language functions after auditory deprivation. Future studies are necessary incorporating functional and anatomical aspects of the brain changes in deaf group.
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[article] 
inEar and hearing > Vol. 42, n°1 (Janvier-février) . - p. 235-243

Titre :	Insomnia, Anxiety and Depression in Adult Cochlear Implant Users With Tinnitus
Type de document :	Article
Auteurs :	Robert H. Pierzycki ; Pádraig Thomas Kitterick
Année de publication :	2021
Article en page(s) :	p. 235-243
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Acouphène ; Anxiété ; Dépression ; Implants cochléaires ; Troubles de l'endormissement et du maintien du sommeil
Résumé :	Objective: Determine the prevalence of clinical insomnia and its associations with anxiety, depression, and tinnitus in adult cochlear implant (CI) users. Design: Self-reported information on tinnitus, sleep, and demographic variables was collected from adult CI users (n = 127). Tinnitus presence, its persistence, related emotional distress, and difficulties with sleep were assessed using questions from the UK Biobank study ( www.ukbiobank.ac.uk ). Tinnitus-related handicap was assessed using the Tinnitus Handicap Inventory. Clinical insomnia symptoms were characterized using the Insomnia Severity Index (ISI), and clinical anxiety and depression symptoms using the Hospital Anxiety and Depression Scale (HADS). Regression models were used to compare the data from CI users with and without tinnitus, and to test the associations between clinical insomnia, anxiety, depression and tinnitus handicap. Results: About a half (53%) of CI users reported tinnitus, of whom 54% described it as persistent, 41% as emotionally distressing and 73% reported having difficulties with sleep based on the UK Biobank questions. The ISI suggested that clinically abnormal insomnia symptoms were more likely to occur with tinnitus (odds ratio [OR] = 2.60, 95% confidence interval 1.04 to 6.45; p = 0.040) and were found in 41% of CI users with tinnitus. Post-hoc exploratory analyses on the ISI suggested that CI users with tinnitus experienced greater levels of difficulty falling asleep, lower satisfaction with sleep patterns, greater interference of sleep problems with daily activities, and a greater impact on their quality of life. The HADS scores suggested that those with tinnitus were also more likely to have clinically abnormal anxiety (42%; OR = 3.50, 95% confidence interval 1.49 to 8.22; p = 0.004) and depression symptoms (14%; OR = 6.18, 95% confidence interval 1.17 to 32.82; p = 0.032). The clinical insomnia observed in CI users with tinnitus was associated with tinnitus handicap (p = 0.028), and the levels of clinical anxiety (p = 0.012) and depression (p Conclusions: Clinically abnormal insomnia symptoms are prevalent, potentially affecting over 40% of CI users with tinnitus. The associations between clinical insomnia, anxiety, and depression symptoms, and tinnitus-related handicap suggest that all of these symptoms should be considered when assessing the tinnitus-related burden and its impact on the quality of life after cochlear implantation. The present findings also have potential implications for the clinical management of CI recipients with tinnitus, in whom it may be advisable to monitor sleep problems so that they can be addressed where appropriate. Further research is needed to investigate the mechanisms and causal links behind insomnia and tinnitus-related symptoms in this population. Future studies should also investigate the feasibility and effectiveness of night time use of CIs to alleviate tinnitus-related insomnia. The potential impact of insomnia on the quality of life of CI users with tinnitus highlights the importance of including sleep measures in future evaluations of the effectiveness of cochlear implantation for the alleviation of tinnitus.
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[article] Insomnia, Anxiety and Depression in Adult Cochlear Implant Users With Tinnitus [Article] / Robert H. Pierzycki ; Pádraig Thomas Kitterick . - 2021 . - p. 235-243.
Langues : Anglais (eng)
in Ear and hearing > Vol. 42, n°1 (Janvier-février) . - p. 235-243

Descripteurs :	HE Vinci Acouphène ; Anxiété ; Dépression ; Implants cochléaires ; Troubles de l'endormissement et du maintien du sommeil
Résumé :	Objective: Determine the prevalence of clinical insomnia and its associations with anxiety, depression, and tinnitus in adult cochlear implant (CI) users. Design: Self-reported information on tinnitus, sleep, and demographic variables was collected from adult CI users (n = 127). Tinnitus presence, its persistence, related emotional distress, and difficulties with sleep were assessed using questions from the UK Biobank study ( www.ukbiobank.ac.uk ). Tinnitus-related handicap was assessed using the Tinnitus Handicap Inventory. Clinical insomnia symptoms were characterized using the Insomnia Severity Index (ISI), and clinical anxiety and depression symptoms using the Hospital Anxiety and Depression Scale (HADS). Regression models were used to compare the data from CI users with and without tinnitus, and to test the associations between clinical insomnia, anxiety, depression and tinnitus handicap. Results: About a half (53%) of CI users reported tinnitus, of whom 54% described it as persistent, 41% as emotionally distressing and 73% reported having difficulties with sleep based on the UK Biobank questions. The ISI suggested that clinically abnormal insomnia symptoms were more likely to occur with tinnitus (odds ratio [OR] = 2.60, 95% confidence interval 1.04 to 6.45; p = 0.040) and were found in 41% of CI users with tinnitus. Post-hoc exploratory analyses on the ISI suggested that CI users with tinnitus experienced greater levels of difficulty falling asleep, lower satisfaction with sleep patterns, greater interference of sleep problems with daily activities, and a greater impact on their quality of life. The HADS scores suggested that those with tinnitus were also more likely to have clinically abnormal anxiety (42%; OR = 3.50, 95% confidence interval 1.49 to 8.22; p = 0.004) and depression symptoms (14%; OR = 6.18, 95% confidence interval 1.17 to 32.82; p = 0.032). The clinical insomnia observed in CI users with tinnitus was associated with tinnitus handicap (p = 0.028), and the levels of clinical anxiety (p = 0.012) and depression (p Conclusions: Clinically abnormal insomnia symptoms are prevalent, potentially affecting over 40% of CI users with tinnitus. The associations between clinical insomnia, anxiety, and depression symptoms, and tinnitus-related handicap suggest that all of these symptoms should be considered when assessing the tinnitus-related burden and its impact on the quality of life after cochlear implantation. The present findings also have potential implications for the clinical management of CI recipients with tinnitus, in whom it may be advisable to monitor sleep problems so that they can be addressed where appropriate. Further research is needed to investigate the mechanisms and causal links behind insomnia and tinnitus-related symptoms in this population. Future studies should also investigate the feasibility and effectiveness of night time use of CIs to alleviate tinnitus-related insomnia. The potential impact of insomnia on the quality of life of CI users with tinnitus highlights the importance of including sleep measures in future evaluations of the effectiveness of cochlear implantation for the alleviation of tinnitus.
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[article] 
inEar and hearing > Vol. 42, n°1 (Janvier-février) . - p. 244-247

Titre :	The Effect of Increasing Interphase Gap on N1 Latency of the Electrically Evoked Compound Action Potential and the Stimulation Level Offset in Human Cochlear Implant Users
Type de document :	Article
Auteurs :	Jeffrey Skidmore ; Shuman He
Année de publication :	2021
Article en page(s) :	p. 244-247
Langues :	Anglais (eng)
Descripteurs :	Autres descripteurs Electrophysiologie de la cochlee ; Nerf auditif HE Vinci Implants cochléaires
Résumé :	Objective: This study reports two potential biomarkers of the physiological status of the cochlear nerve (CN) in cochlear implant users. Design: This project represents a complementary analysis on a subset of electrophysiological data from our recently published study. This study compared changes in N1 latency and stimulation level (i.e., N1 latency offset and stimulation level offset) with increasing interphase gap of a biphasic pulse between children with cochlear nerve deficiency and children with normal-sized CNs. Results: Children with cochlear nerve deficiency showed smaller N1 latency offsets and larger stimulation level offsets than children with normal-sized CNs at all electrode locations tested. Conclusions: The N1 latency and stimulation level offsets differ in two patient populations with different physiological statuses of the CN. These parameters may be useful for evaluating CN function in individual cochlear implant patients.
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[article] The Effect of Increasing Interphase Gap on N1 Latency of the Electrically Evoked Compound Action Potential and the Stimulation Level Offset in Human Cochlear Implant Users [Article] / Jeffrey Skidmore ; Shuman He . - 2021 . - p. 244-247.
Langues : Anglais (eng)
in Ear and hearing > Vol. 42, n°1 (Janvier-février) . - p. 244-247

Descripteurs :	Autres descripteurs Electrophysiologie de la cochlee ; Nerf auditif HE Vinci Implants cochléaires
Résumé :	Objective: This study reports two potential biomarkers of the physiological status of the cochlear nerve (CN) in cochlear implant users. Design: This project represents a complementary analysis on a subset of electrophysiological data from our recently published study. This study compared changes in N1 latency and stimulation level (i.e., N1 latency offset and stimulation level offset) with increasing interphase gap of a biphasic pulse between children with cochlear nerve deficiency and children with normal-sized CNs. Results: Children with cochlear nerve deficiency showed smaller N1 latency offsets and larger stimulation level offsets than children with normal-sized CNs at all electrode locations tested. Conclusions: The N1 latency and stimulation level offsets differ in two patient populations with different physiological statuses of the CN. These parameters may be useful for evaluating CN function in individual cochlear implant patients.
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[article] 
inEar and hearing > Vol. 41, n°6 (Novembre-décembre) . - p. 1417-1430

Titre :	Systematic Review on Late Cochlear Implantation in Early-Deafened Adults and Adolescents: Clinical Effectiveness
Type de document :	Article
Auteurs :	Joke A. Debruyne ; A. Miranda L. Janssen ; Jan P.-L. Brokx
Année de publication :	2020
Article en page(s) :	p. 1417-1430
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Implants cochléaires ; Perception de la parole ; Recherche en audiologie ; Surdité
Résumé :	Objectives: Cochlear implantation in early-deafened patients, implanted as adolescents or adults, is not always advised due to poor expected outcomes. In order to judge whether such reluctance is justified, the current systematic review aimed to gather all available evidence on postoperative outcomes obtained by early-deafened patients using a state-of-the art cochlear implant (CI). Design: Five electronic databases (PubMed, Embase, the Cochrane library, CINAHL, and PsycInfo) were systematically searched for studies in English, French, German, or Dutch, published between 2000 and September 2017. Studies that reported pre- and postoperative outcomes on any measure of speech or sound perception, audiovisual or subjective benefit (quality of life) were included. Study quality was assessed with the Institute of Health Economics quality appraisal tool for case series studies. Results: The systematic search and subsequent full-text evaluation identified 38 studies meeting the inclusion criteria. Only a limited number of studies were judged to be of high quality according to the Institute of Health Economics tool, with lack of (clear) presentation of relevant study information being a recurring problem. Twenty-five studies presented viable outcomes on open-set speech understanding in quiet: mean postoperative scores obtained with CI remained below 50% for the vast majority of studies; significant postoperative improvements were found in 16 studies, although this number might have been higher if appropriate statistical testing had been performed in all studies. Eight studies observed increased audiovisual performance after implantation, which was statistically significant in six studies. A validated measure of hearing-related quality of life was used in only 5 of the 16 studies assessing subjective outcomes, showing significant postoperative improvements for most questionnaire domains. The relation between auditory and subjective outcomes was assessed in two studies, with contradictory results. Conclusions: The current review showed that late cochlear implantation in early-deafened subjects resulted in significantly improved open-set speech perception, audiovisual speech perception, and (hearing-related) quality of life in the majority of the studies involved. Nonetheless, more and especially higher-quality research is needed in order to gain a more detailed understanding of the outcomes of cochlear implantation in this population.
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[article] Systematic Review on Late Cochlear Implantation in Early-Deafened Adults and Adolescents: Clinical Effectiveness [Article] / Joke A. Debruyne ; A. Miranda L. Janssen ; Jan P.-L. Brokx . - 2020 . - p. 1417-1430.
Langues : Anglais (eng)
in Ear and hearing > Vol. 41, n°6 (Novembre-décembre) . - p. 1417-1430

Descripteurs :	HE Vinci Implants cochléaires ; Perception de la parole ; Recherche en audiologie ; Surdité
Résumé :	Objectives: Cochlear implantation in early-deafened patients, implanted as adolescents or adults, is not always advised due to poor expected outcomes. In order to judge whether such reluctance is justified, the current systematic review aimed to gather all available evidence on postoperative outcomes obtained by early-deafened patients using a state-of-the art cochlear implant (CI). Design: Five electronic databases (PubMed, Embase, the Cochrane library, CINAHL, and PsycInfo) were systematically searched for studies in English, French, German, or Dutch, published between 2000 and September 2017. Studies that reported pre- and postoperative outcomes on any measure of speech or sound perception, audiovisual or subjective benefit (quality of life) were included. Study quality was assessed with the Institute of Health Economics quality appraisal tool for case series studies. Results: The systematic search and subsequent full-text evaluation identified 38 studies meeting the inclusion criteria. Only a limited number of studies were judged to be of high quality according to the Institute of Health Economics tool, with lack of (clear) presentation of relevant study information being a recurring problem. Twenty-five studies presented viable outcomes on open-set speech understanding in quiet: mean postoperative scores obtained with CI remained below 50% for the vast majority of studies; significant postoperative improvements were found in 16 studies, although this number might have been higher if appropriate statistical testing had been performed in all studies. Eight studies observed increased audiovisual performance after implantation, which was statistically significant in six studies. A validated measure of hearing-related quality of life was used in only 5 of the 16 studies assessing subjective outcomes, showing significant postoperative improvements for most questionnaire domains. The relation between auditory and subjective outcomes was assessed in two studies, with contradictory results. Conclusions: The current review showed that late cochlear implantation in early-deafened subjects resulted in significantly improved open-set speech perception, audiovisual speech perception, and (hearing-related) quality of life in the majority of the studies involved. Nonetheless, more and especially higher-quality research is needed in order to gain a more detailed understanding of the outcomes of cochlear implantation in this population.
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[article] 
inEar and hearing > Vol. 41, n°6 (Novembre-décembre) . - p. 1442-1449

Titre :	Covid-19 Lockdown Affects Hearing Disability and Handicap in Diverse Ways: A Rapid Online Survey Study
Type de document :	Article
Auteurs :	Graham Naylor ; Louise A. Burke ; Jack A Holman
Année de publication :	2020
Article en page(s) :	p. 1442-1449
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Confinement physique ; COVID-19 ; Déficience auditive ; Vie sociale Autres descripteurs Distanciation
Résumé :	Objectives: The aim of this study was to explore the perceived effects of coronavirus disease 2019 (Covid-19) social distancing restrictions and safety measures on people with hearing loss. Design: Participants were 129 adults (48.1% female, mean age 64.4 years) with an audiometric hearing loss, living in Glasgow, Scotland. A rapidly deployed 24-item online questionnaire asked about the effects of certain aspects of lockdown, including face masks, social distancing, and video calling, on participants' behavior, emotions, hearing performance, practical issues, and tinnitus. Data were analyzed descriptively across the entire sample, and with Chi-squared tests for differences between subgroups self-reporting relatively good and relatively poor unaided hearing, respectively. Additional free-text responses provided further perspectives. Results: Behavior: Video calls are used more frequently than prelockdown. The better-hearing group use their hearing aids less. Emotions: There is increased anxiety (especially among the worse hearing group) concerning verbal communication situations and access to audiology services, and greater rumination about one's own hearing loss. Enjoyment of group video calls is mixed. The worse hearing group shows substantial relief at not being obliged to attend challenging social gatherings. Across both groups, a majority would like to see all key workers equipped with transparent face masks. Hearing performance: A large majority finds it hard to converse with people in face masks due to muffled sound and lack of speechreading cues, but conversing at a safe distance is not universally problematic. In the worse hearing group, performance in video calls is generally inferior to face-to-face, but similar to telephone calls. Those who use live subtitling in video calls appreciate their value. TV and radio updates about Covid-19 are easy to follow for most respondents. There is only weak evidence of face mask fixtures interfering with hearing aids on the ear, and of tinnitus having worsened during lockdown. Conclusions: With due regard for the limitations of this rapid study, we find that there are many negative-and a few positive-effects of Covid-19 restrictions and safety measures on people with hearing loss. From a societal perspective, the widespread adoption of clear face masks may alleviate some of the difficulties and anxieties this population experience. From an individual perspective, one may consider using live subtitles on video calls. Manufacturers of hearing devices should consider developing processing modes and accessories specifically designed for video calls. Finally, repair and maintenance services should be resumed as soon as it is safe to do so.
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[article] Covid-19 Lockdown Affects Hearing Disability and Handicap in Diverse Ways: A Rapid Online Survey Study [Article] / Graham Naylor ; Louise A. Burke ; Jack A Holman . - 2020 . - p. 1442-1449.
Langues : Anglais (eng)
in Ear and hearing > Vol. 41, n°6 (Novembre-décembre) . - p. 1442-1449

Descripteurs :	HE Vinci Confinement physique ; COVID-19 ; Déficience auditive ; Vie sociale Autres descripteurs Distanciation
Résumé :	Objectives: The aim of this study was to explore the perceived effects of coronavirus disease 2019 (Covid-19) social distancing restrictions and safety measures on people with hearing loss. Design: Participants were 129 adults (48.1% female, mean age 64.4 years) with an audiometric hearing loss, living in Glasgow, Scotland. A rapidly deployed 24-item online questionnaire asked about the effects of certain aspects of lockdown, including face masks, social distancing, and video calling, on participants' behavior, emotions, hearing performance, practical issues, and tinnitus. Data were analyzed descriptively across the entire sample, and with Chi-squared tests for differences between subgroups self-reporting relatively good and relatively poor unaided hearing, respectively. Additional free-text responses provided further perspectives. Results: Behavior: Video calls are used more frequently than prelockdown. The better-hearing group use their hearing aids less. Emotions: There is increased anxiety (especially among the worse hearing group) concerning verbal communication situations and access to audiology services, and greater rumination about one's own hearing loss. Enjoyment of group video calls is mixed. The worse hearing group shows substantial relief at not being obliged to attend challenging social gatherings. Across both groups, a majority would like to see all key workers equipped with transparent face masks. Hearing performance: A large majority finds it hard to converse with people in face masks due to muffled sound and lack of speechreading cues, but conversing at a safe distance is not universally problematic. In the worse hearing group, performance in video calls is generally inferior to face-to-face, but similar to telephone calls. Those who use live subtitling in video calls appreciate their value. TV and radio updates about Covid-19 are easy to follow for most respondents. There is only weak evidence of face mask fixtures interfering with hearing aids on the ear, and of tinnitus having worsened during lockdown. Conclusions: With due regard for the limitations of this rapid study, we find that there are many negative-and a few positive-effects of Covid-19 restrictions and safety measures on people with hearing loss. From a societal perspective, the widespread adoption of clear face masks may alleviate some of the difficulties and anxieties this population experience. From an individual perspective, one may consider using live subtitles on video calls. Manufacturers of hearing devices should consider developing processing modes and accessories specifically designed for video calls. Finally, repair and maintenance services should be resumed as soon as it is safe to do so.
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[article] 
inEar and hearing > Vol. 41, n°6 (Novembre-décembre) . - p. 1450-1460

Titre :	Binaural Pitch Fusion: Binaural Pitch Averaging in Cochlear Implant Users With Broad Binaural Fusion
Type de document :	Article
Auteurs :	Yonghee Oh ; Lina A. Reiss
Année de publication :	2020
Article en page(s) :	p. 1450-1460
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Aides auditives ; HAUTEUR TONALE ; Implants cochléaires ; PERCEPTION BINAURALE
Résumé :	Objectives: Individuals who use hearing aids (HAs) or cochlear implants (CIs) can experience broad binaural pitch fusion, such that sounds differing in pitch by as much as 3 to 4 octaves are perceptually integrated across ears. Previously, it was shown in HA users that the fused pitch is a weighted average of the two monaural pitches, ranging from equal weighting to dominance by the lower pitch. The goal of this study was to systematically measure the fused pitches in adult CI users, and determine whether CI users experience similar pitch averaging effects as observed in HA users. Design: Twelve adult CI users (Cochlear Ltd, Sydney, Australia) participated in this study: six bimodal CI users, who wear a CI with a contralateral HA, and six bilateral CI users. Stimuli to HA ears were acoustic pure tones, and stimuli to CI ears were biphasic pulse trains delivered to individual electrodes. Fusion ranges, the ranges of frequencies/electrodes in the comparison ear that were fused with a single electrode (electrode 22, 18, 12, or 6) in the reference ear, were measured using simultaneous, dichotic presentation of reference and comparison stimuli in opposite ears, and varying the comparison stimulus. Once the fusion ranges were measured, the fused binaural pitch of a reference-pair stimulus combination was measured by finding a pitch match to monaural comparison stimuli presented to the paired stimulus ear. Results: Fusion pitch weighting in CI users varied depending on the pitch difference of the reference-pair stimulus combination, with equal pitch averaging occurring for stimuli closer in pitch and lower pitch dominance occurring for stimuli farther apart in pitch. The averaging region was typically 0.5 to 2.3 octaves around the reference for bimodal CI users and 0.4 to 1.5 octaves for bilateral CI users. In some cases, a bias in the averaging region was observed toward the ear with greater stimulus variability. Conclusions: Fusion pitch weighting effects in CI users were similar to those observed previously in HA users. However, CI users showed greater inter-subject variability in both pitch averaging ranges and bias effects. These findings suggest that binaural pitch averaging could be a common underlying mechanism in hearing-impaired listeners.
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[article] Binaural Pitch Fusion: Binaural Pitch Averaging in Cochlear Implant Users With Broad Binaural Fusion [Article] / Yonghee Oh ; Lina A. Reiss . - 2020 . - p. 1450-1460.
Langues : Anglais (eng)
in Ear and hearing > Vol. 41, n°6 (Novembre-décembre) . - p. 1450-1460

Descripteurs :	HE Vinci Aides auditives ; HAUTEUR TONALE ; Implants cochléaires ; PERCEPTION BINAURALE
Résumé :	Objectives: Individuals who use hearing aids (HAs) or cochlear implants (CIs) can experience broad binaural pitch fusion, such that sounds differing in pitch by as much as 3 to 4 octaves are perceptually integrated across ears. Previously, it was shown in HA users that the fused pitch is a weighted average of the two monaural pitches, ranging from equal weighting to dominance by the lower pitch. The goal of this study was to systematically measure the fused pitches in adult CI users, and determine whether CI users experience similar pitch averaging effects as observed in HA users. Design: Twelve adult CI users (Cochlear Ltd, Sydney, Australia) participated in this study: six bimodal CI users, who wear a CI with a contralateral HA, and six bilateral CI users. Stimuli to HA ears were acoustic pure tones, and stimuli to CI ears were biphasic pulse trains delivered to individual electrodes. Fusion ranges, the ranges of frequencies/electrodes in the comparison ear that were fused with a single electrode (electrode 22, 18, 12, or 6) in the reference ear, were measured using simultaneous, dichotic presentation of reference and comparison stimuli in opposite ears, and varying the comparison stimulus. Once the fusion ranges were measured, the fused binaural pitch of a reference-pair stimulus combination was measured by finding a pitch match to monaural comparison stimuli presented to the paired stimulus ear. Results: Fusion pitch weighting in CI users varied depending on the pitch difference of the reference-pair stimulus combination, with equal pitch averaging occurring for stimuli closer in pitch and lower pitch dominance occurring for stimuli farther apart in pitch. The averaging region was typically 0.5 to 2.3 octaves around the reference for bimodal CI users and 0.4 to 1.5 octaves for bilateral CI users. In some cases, a bias in the averaging region was observed toward the ear with greater stimulus variability. Conclusions: Fusion pitch weighting effects in CI users were similar to those observed previously in HA users. However, CI users showed greater inter-subject variability in both pitch averaging ranges and bias effects. These findings suggest that binaural pitch averaging could be a common underlying mechanism in hearing-impaired listeners.
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[article] 
inEar and hearing > Vol. 41, n°6 (Novembre-décembre) . - p. 1461-1469

Titre :	Stability of Early Auditory Evoked Potential Components Over Extended Test-Retest Intervals in Young Adults
Type de document :	Article
Auteurs :	Rebecca R. Bieber ; Katharine Fernandez ; Chris Zalewski ; Hui Cheng ; Carmen C. Brewer
Année de publication :	2020
Article en page(s) :	p. 1461-1469
Langues :	Anglais (eng)
Descripteurs :	Autres descripteurs Test retest HE Vinci Potentiels évoqués auditifs précoces (PEAP)
Résumé :	Objectives: Synaptic damage from noise exposures can occur even in the absence of changes in hearing sensitivity in animal models. There is an unmet clinical need for measurements sensitive to such damage to the human auditory system that can augment the pure-tone audiogram. Early components (i.e.,
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[article] Stability of Early Auditory Evoked Potential Components Over Extended Test-Retest Intervals in Young Adults [Article] / Rebecca R. Bieber ; Katharine Fernandez ; Chris Zalewski ; Hui Cheng ; Carmen C. Brewer . - 2020 . - p. 1461-1469.
Langues : Anglais (eng)
in Ear and hearing > Vol. 41, n°6 (Novembre-décembre) . - p. 1461-1469

Descripteurs :	Autres descripteurs Test retest HE Vinci Potentiels évoqués auditifs précoces (PEAP)
Résumé :	Objectives: Synaptic damage from noise exposures can occur even in the absence of changes in hearing sensitivity in animal models. There is an unmet clinical need for measurements sensitive to such damage to the human auditory system that can augment the pure-tone audiogram. Early components (i.e.,
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[article] 
inEar and hearing > Vol. 41, n°6 (Novembre-décembre) . - p. 1470-1482

Titre :	Practice Makes Transfer Imperfect: Evidence From Auditory Learning
Type de document :	Article
Auteurs :	Yael Zaltz ; Liat Kishon-Rabin ; Avi Karni ; Daphne Ari-Even Roth
Année de publication :	2020
Article en page(s) :	p. 1470-1482
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Discrimination auditive ; Entrainement auditif ; Seuil différentiel de fréquence (DLF)
Résumé :	Evidence from motor and visual studies suggests that the ability to generalize learning gains to untrained conditions decreases as the training progresses. This decrease in generalization was suggested to reflect a shift from higher to lower levels of neuronal representations of the task following prolonged training. In the auditory modality, however, the few studies that tested the influence of prolonging training on generalization ability showed no decrease and sometimes even an increase in generalization. Objective: To test the impact of extending training in a basic psychoacoustic task on the ability to generalize the gains attained in training to untrained conditions. Design: Eighty-two young adults participated in two experiments that differed in the specific training regimen. In both experiments, training was conducted using a difference limen for frequency (DLF) task with an adaptive forced-choice procedure, for either a single- or nine-session training. Following training, generalization to the untrained ear and to an untrained frequency was assessed. Results: (a) Training induced significant learning (i.e., smaller DLF thresholds) following a single session of training, and more so following nine training sessions; (b) results from the combined data from both experiments showed that the ability to generalize the learning gains to the untrained ear and frequency was limited after the extended DLF training; (c) larger improvements under the trained condition resulted in smaller generalization to the untrained conditions. Conclusions: The findings of increased specificity with training in the auditory modality support the notion that gradual changes, both quantitative and qualitative, occur in the neural representations of an auditory task during its acquisition. These findings suggest common underlying mechanisms in basic skill learning across different modalities.
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[article] Practice Makes Transfer Imperfect: Evidence From Auditory Learning [Article] / Yael Zaltz ; Liat Kishon-Rabin ; Avi Karni ; Daphne Ari-Even Roth . - 2020 . - p. 1470-1482.
Langues : Anglais (eng)
in Ear and hearing > Vol. 41, n°6 (Novembre-décembre) . - p. 1470-1482

Descripteurs :	HE Vinci Discrimination auditive ; Entrainement auditif ; Seuil différentiel de fréquence (DLF)
Résumé :	Evidence from motor and visual studies suggests that the ability to generalize learning gains to untrained conditions decreases as the training progresses. This decrease in generalization was suggested to reflect a shift from higher to lower levels of neuronal representations of the task following prolonged training. In the auditory modality, however, the few studies that tested the influence of prolonging training on generalization ability showed no decrease and sometimes even an increase in generalization. Objective: To test the impact of extending training in a basic psychoacoustic task on the ability to generalize the gains attained in training to untrained conditions. Design: Eighty-two young adults participated in two experiments that differed in the specific training regimen. In both experiments, training was conducted using a difference limen for frequency (DLF) task with an adaptive forced-choice procedure, for either a single- or nine-session training. Following training, generalization to the untrained ear and to an untrained frequency was assessed. Results: (a) Training induced significant learning (i.e., smaller DLF thresholds) following a single session of training, and more so following nine training sessions; (b) results from the combined data from both experiments showed that the ability to generalize the learning gains to the untrained ear and frequency was limited after the extended DLF training; (c) larger improvements under the trained condition resulted in smaller generalization to the untrained conditions. Conclusions: The findings of increased specificity with training in the auditory modality support the notion that gradual changes, both quantitative and qualitative, occur in the neural representations of an auditory task during its acquisition. These findings suggest common underlying mechanisms in basic skill learning across different modalities.
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[article] 
inEar and hearing > Vol. 41, n°6 (Novembre-décembre) . - p. 1483-1491

Titre :	Development of Abbreviated Versions of the Word Auditory Recognition and Recall Measure
Type de document :	Article
Auteurs :	Sherri L. Smith ; David B. Ryan ; Kathleen Pichora-Fuller
Année de publication :	2020
Article en page(s) :	p. 1483-1491
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Mémoire à court terme ; Perception de la parole ; Perte d'audition Autres descripteurs Rehabilitation audiologique
Résumé :	Objectives: The objective of this study was to develop and evaluate abbreviated versions of the Word Auditory Recognition and Recall Measure (WARRM) as part of an iterative process in the development of a feasible test for potential future clinical use. Design: The three original WARRM (O-WARRM) randomizations were modified by altering the presentation paradigm. Instead of presenting 5 trials per set size with set size increasing from 2 to 6 as in the O-WARRM (n = 100 words), the experimental WARRM (E-WARRM) paradigm consisted of one trial from each of set sizes 2 to 6 to create a "run" (n = 20 words) with each randomization consisting of 5 runs (n = 100 words). A total of 24 younger listeners with normal hearing and 48 older listeners with hearing loss (OHL) were administered 1 randomization of the O-WARRM and 1 different randomization of the E-WARRM. Results: The recognition and recall performances on the O-WARRM and all versions of the E-WARRM (five individual runs and overall) were similar within each listener group, with the younger listeners with normal hearing outperforming the OHL listeners on all measures. Correlation analyses revealed moderate to strong associations between the abbreviated WARRM runs and the O-WARRM for the OHL listener group. Hierarchical regression modeling suggested that run 1 of the E-WARRM was a good predictor of O-WARRM performance and that adding additional runs did not improve the prediction. Taken together, these findings suggest that administering one run from the E-WARRM warrants further examination for clinical use. Additional analyses revealed equivalent scores on all five runs from the three E-WARRM randomizations for both listener groups. Conclusions: Abbreviated versions of the O-WARRM were developed as part of this study. This was accomplished by modifying the original presentation paradigm and creating 15 unique "runs" among the original 3 randomizations. The resulting 15 runs could be considered 15 unique and abbreviated WARRM lists that have potential, in the future after further studies are conducted to establish important properties, for clinic use. The abbreviated WARRM lists may be useful for quantifying auditory working memory of listeners with hearing loss during the audiologic rehabilitation process.
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[article] Development of Abbreviated Versions of the Word Auditory Recognition and Recall Measure [Article] / Sherri L. Smith ; David B. Ryan ; Kathleen Pichora-Fuller . - 2020 . - p. 1483-1491.
Langues : Anglais (eng)
in Ear and hearing > Vol. 41, n°6 (Novembre-décembre) . - p. 1483-1491

Descripteurs :	HE Vinci Mémoire à court terme ; Perception de la parole ; Perte d'audition Autres descripteurs Rehabilitation audiologique
Résumé :	Objectives: The objective of this study was to develop and evaluate abbreviated versions of the Word Auditory Recognition and Recall Measure (WARRM) as part of an iterative process in the development of a feasible test for potential future clinical use. Design: The three original WARRM (O-WARRM) randomizations were modified by altering the presentation paradigm. Instead of presenting 5 trials per set size with set size increasing from 2 to 6 as in the O-WARRM (n = 100 words), the experimental WARRM (E-WARRM) paradigm consisted of one trial from each of set sizes 2 to 6 to create a "run" (n = 20 words) with each randomization consisting of 5 runs (n = 100 words). A total of 24 younger listeners with normal hearing and 48 older listeners with hearing loss (OHL) were administered 1 randomization of the O-WARRM and 1 different randomization of the E-WARRM. Results: The recognition and recall performances on the O-WARRM and all versions of the E-WARRM (five individual runs and overall) were similar within each listener group, with the younger listeners with normal hearing outperforming the OHL listeners on all measures. Correlation analyses revealed moderate to strong associations between the abbreviated WARRM runs and the O-WARRM for the OHL listener group. Hierarchical regression modeling suggested that run 1 of the E-WARRM was a good predictor of O-WARRM performance and that adding additional runs did not improve the prediction. Taken together, these findings suggest that administering one run from the E-WARRM warrants further examination for clinical use. Additional analyses revealed equivalent scores on all five runs from the three E-WARRM randomizations for both listener groups. Conclusions: Abbreviated versions of the O-WARRM were developed as part of this study. This was accomplished by modifying the original presentation paradigm and creating 15 unique "runs" among the original 3 randomizations. The resulting 15 runs could be considered 15 unique and abbreviated WARRM lists that have potential, in the future after further studies are conducted to establish important properties, for clinic use. The abbreviated WARRM lists may be useful for quantifying auditory working memory of listeners with hearing loss during the audiologic rehabilitation process.
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[article] 
inEar and hearing > Vol. 41, n°6 (Novembre-décembre) . - p. 1492-1510

Titre :	Speech-in-Noise Recognition With More Realistic Implementations of a Binaural Cochlear-Implant Sound Coding Strategy Inspired by the Medial Olivocochlear Reflex
Type de document :	Article
Auteurs :	Enrique A. Lopez-Poveda ; Almudena Eustaquio-Martin ; Milagros J. Fumero ; Jose M. Gorospe ; Ruben Polo Lopez ; Auxiliadora M. Gutierrez Revilla ; Reinhold Schatzer ; Peter Nopp ; Joshua Stohl
Année de publication :	2020
Article en page(s) :	p. 1492-1510
Langues :	Anglais (eng)
Descripteurs :	Autres descripteurs Systeme efferent olivocochleaire HE Vinci Compréhension dans le bruit ; Implants cochléaires ; Masquage ; PERCEPTION BINAURALE
Résumé :	Objectives: Cochlear implant (CI) users continue to struggle understanding speech in noisy environments with current clinical devices. We have previously shown that this outcome can be improved by using binaural sound processors inspired by the medial olivocochlear (MOC) reflex, which involve dynamic (contralaterally controlled) rather than fixed compressive acoustic-to-electric maps. The present study aimed at investigating the potential additional benefits of using more realistic implementations of MOC processing. Design: Eight users of bilateral CIs and two users of unilateral CIs participated in the study. Speech reception thresholds (SRTs) for sentences in competition with steady state noise were measured in unilateral and bilateral listening modes. Stimuli were processed through two independently functioning sound processors (one per ear) with fixed compression, the current clinical standard (STD); the originally proposed MOC strategy with fast contralateral control of compression (MOC1); a MOC strategy with slower control of compression (MOC2); and a slower MOC strategy with comparatively greater contralateral inhibition in the lower-frequency than in the higher-frequency channels (MOC3). Performance with the four strategies was compared for multiple simulated spatial configurations of the speech and noise sources. Based on a previously published technical evaluation of these strategies, we hypothesized that SRTs would be overall better (lower) with the MOC3 strategy than with any of the other tested strategies. In addition, we hypothesized that the MOC3 strategy would be advantageous over the STD strategy in listening conditions and spatial configurations where the MOC1 strategy was not. Results: In unilateral listening and when the implant ear had the worse acoustic signal-to-noise ratio, the mean SRT was 4 dB worse for the MOC1 than for the STD strategy (as expected), but it became equal or better for the MOC2 or MOC3 strategies than for the STD strategy. In bilateral listening, mean SRTs were 1.6 dB better for the MOC3 strategy than for the STD strategy across all spatial configurations tested, including a condition with speech and noise sources colocated at front where the MOC1 strategy was slightly disadvantageous relative to the STD strategy. All strategies produced significantly better SRTs for spatially separated than for colocated speech and noise sources. A statistically significant binaural advantage (i.e., better mean SRTs across spatial configurations and participants in bilateral than in unilateral listening) was found for the MOC2 and MOC3 strategies but not for the STD or MOC1 strategies. Conclusions: Overall, performance was best with the MOC3 strategy, which maintained the benefits of the originally proposed MOC1 strategy over the STD strategy for spatially separated speech and noise sources and extended those benefits to additional spatial configurations. In addition, the MOC3 strategy provided a significant binaural advantage, which did not occur with the STD or the original MOC1 strategies.
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[article] Speech-in-Noise Recognition With More Realistic Implementations of a Binaural Cochlear-Implant Sound Coding Strategy Inspired by the Medial Olivocochlear Reflex [Article] / Enrique A. Lopez-Poveda ; Almudena Eustaquio-Martin ; Milagros J. Fumero ; Jose M. Gorospe ; Ruben Polo Lopez ; Auxiliadora M. Gutierrez Revilla ; Reinhold Schatzer ; Peter Nopp ; Joshua Stohl . - 2020 . - p. 1492-1510.
Langues : Anglais (eng)
in Ear and hearing > Vol. 41, n°6 (Novembre-décembre) . - p. 1492-1510

Descripteurs :	Autres descripteurs Systeme efferent olivocochleaire HE Vinci Compréhension dans le bruit ; Implants cochléaires ; Masquage ; PERCEPTION BINAURALE
Résumé :	Objectives: Cochlear implant (CI) users continue to struggle understanding speech in noisy environments with current clinical devices. We have previously shown that this outcome can be improved by using binaural sound processors inspired by the medial olivocochlear (MOC) reflex, which involve dynamic (contralaterally controlled) rather than fixed compressive acoustic-to-electric maps. The present study aimed at investigating the potential additional benefits of using more realistic implementations of MOC processing. Design: Eight users of bilateral CIs and two users of unilateral CIs participated in the study. Speech reception thresholds (SRTs) for sentences in competition with steady state noise were measured in unilateral and bilateral listening modes. Stimuli were processed through two independently functioning sound processors (one per ear) with fixed compression, the current clinical standard (STD); the originally proposed MOC strategy with fast contralateral control of compression (MOC1); a MOC strategy with slower control of compression (MOC2); and a slower MOC strategy with comparatively greater contralateral inhibition in the lower-frequency than in the higher-frequency channels (MOC3). Performance with the four strategies was compared for multiple simulated spatial configurations of the speech and noise sources. Based on a previously published technical evaluation of these strategies, we hypothesized that SRTs would be overall better (lower) with the MOC3 strategy than with any of the other tested strategies. In addition, we hypothesized that the MOC3 strategy would be advantageous over the STD strategy in listening conditions and spatial configurations where the MOC1 strategy was not. Results: In unilateral listening and when the implant ear had the worse acoustic signal-to-noise ratio, the mean SRT was 4 dB worse for the MOC1 than for the STD strategy (as expected), but it became equal or better for the MOC2 or MOC3 strategies than for the STD strategy. In bilateral listening, mean SRTs were 1.6 dB better for the MOC3 strategy than for the STD strategy across all spatial configurations tested, including a condition with speech and noise sources colocated at front where the MOC1 strategy was slightly disadvantageous relative to the STD strategy. All strategies produced significantly better SRTs for spatially separated than for colocated speech and noise sources. A statistically significant binaural advantage (i.e., better mean SRTs across spatial configurations and participants in bilateral than in unilateral listening) was found for the MOC2 and MOC3 strategies but not for the STD or MOC1 strategies. Conclusions: Overall, performance was best with the MOC3 strategy, which maintained the benefits of the originally proposed MOC1 strategy over the STD strategy for spatially separated speech and noise sources and extended those benefits to additional spatial configurations. In addition, the MOC3 strategy provided a significant binaural advantage, which did not occur with the STD or the original MOC1 strategies.
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[article] 
inEar and hearing > Vol. 41, n°6 (Novembre-décembre) . - p. 1511-1517

Titre :	Linguistic Complexity of Speech Recognition Test Sentences and Its Influence on Children's Verbal Repetition Accuracy
Type de document :	Article
Auteurs :	Anneke E.M. van der Hoek-Snieders ; Inge Stegeman ; Adriana L. Smit ; Koenraad S. Rhebergen
Année de publication :	2020
Article en page(s) :	p. 1511-1517
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Audiologie pédiatrique ; Perception de la parole ; Seuil de réception de la parole (SRT) Autres descripteurs Test de reconnaissance de la parole
Résumé :	Objectives: Speech recognition (SR)-tests have been developed for children without considering the linguistic complexity of the sentences used. However, linguistic complexity is hypothesized to influence correct sentence repetition. The aim of this study is to identify lexical and grammatical parameters influencing verbal repetition accuracy of sentences derived from a Dutch SR-test when performed by 6-year-old typically developing children. Design: For this observational, cross-sectional study, 40 typically developing children aged 6 were recruited at four primary schools in the Netherlands. All children performed a sentence repetition task derived from an SR-test for adults. The sentence complexity was described beforehand with one lexical parameter, age of acquisition, and four grammatical parameters, specifically sentence length, prepositions, sentence structure, and verb inflection. A multiple logistic regression analysis was performed. Results: Sentences with a higher age of acquisition (odds ratio [OR] = 1.59) or greater sentence length (OR = 1.28) had a higher risk of repetition inaccuracy. Sentences including a spatial (OR = 1.25) or other preposition (OR = 1.25) were at increased risk for incorrect repetition, as were complex sentences (OR = 1.69) and sentences in the present perfect (OR = 1.44) or future tense (OR = 2.32). Conclusions: The variation in verbal repetition accuracy in 6-year-old children is significantly influenced by both lexical and grammatical parameters. Linguistic complexity is an important factor to take into account when assessing speech intelligibility in children
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[article] Linguistic Complexity of Speech Recognition Test Sentences and Its Influence on Children's Verbal Repetition Accuracy [Article] / Anneke E.M. van der Hoek-Snieders ; Inge Stegeman ; Adriana L. Smit ; Koenraad S. Rhebergen . - 2020 . - p. 1511-1517.
Langues : Anglais (eng)
in Ear and hearing > Vol. 41, n°6 (Novembre-décembre) . - p. 1511-1517

Descripteurs :	HE Vinci Audiologie pédiatrique ; Perception de la parole ; Seuil de réception de la parole (SRT) Autres descripteurs Test de reconnaissance de la parole
Résumé :	Objectives: Speech recognition (SR)-tests have been developed for children without considering the linguistic complexity of the sentences used. However, linguistic complexity is hypothesized to influence correct sentence repetition. The aim of this study is to identify lexical and grammatical parameters influencing verbal repetition accuracy of sentences derived from a Dutch SR-test when performed by 6-year-old typically developing children. Design: For this observational, cross-sectional study, 40 typically developing children aged 6 were recruited at four primary schools in the Netherlands. All children performed a sentence repetition task derived from an SR-test for adults. The sentence complexity was described beforehand with one lexical parameter, age of acquisition, and four grammatical parameters, specifically sentence length, prepositions, sentence structure, and verb inflection. A multiple logistic regression analysis was performed. Results: Sentences with a higher age of acquisition (odds ratio [OR] = 1.59) or greater sentence length (OR = 1.28) had a higher risk of repetition inaccuracy. Sentences including a spatial (OR = 1.25) or other preposition (OR = 1.25) were at increased risk for incorrect repetition, as were complex sentences (OR = 1.69) and sentences in the present perfect (OR = 1.44) or future tense (OR = 2.32). Conclusions: The variation in verbal repetition accuracy in 6-year-old children is significantly influenced by both lexical and grammatical parameters. Linguistic complexity is an important factor to take into account when assessing speech intelligibility in children
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[article] 
inEar and hearing > Vol. 41, n°6 (Novembre-décembre) . - 1518-1532

Titre :	Daily-Life Fatigue in Mild to Moderate Hearing Impairment: An Ecological Momentary Assessment Study
Type de document :	Article
Auteurs :	Louise A. Burke ; Graham Naylor
Année de publication :	2020
Article en page(s) :	1518-1532
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Déficience auditive ; Fatigue ; Vie quotidienne
Résumé :	Objectives: Previous research has indicated an association between hearing impairment (HI) and daily-life fatigue. However, the temporal and contextual correlates of such fatigue are largely unexplored. The present study used ecological momentary assessment (EMA) to examine (1) whether people with HI are more fatigued than people with normal hearing, (2) whether individuals with HI and normal hearing (NH) show similar diurnal patterns of fatigue, (3) whether people with HI spend less time in challenging listening situations compared with NH controls, and (4) whether more challenging listening situations are associated with more fatigue and whether hearing ability influences any observed association. Design: After excluding 22 participants with self-reported fatiguing health conditions from analyses, the participant sample consisted of 24 adults with HI and 20 adults with NH, aged 44 to 77 years (M = 65.4, SD = 7.5). Data were collected using smartphones and a commercially available EMA app, which ran the specified EMA protocol for this study. Participants responded to six smartphone surveys per day for two weeks. "In-the-moment" questions asked participants to report on their listening situation and to rate their current level of fatigue ("momentary fatigue") at quasi-random time points throughout the day. Data were analyzed using multilevel modeling. Results: Hearing group (HI versus NH) was unrelated to trait, daily, and momentary fatigue; both participants with HI and NH became increasingly fatigued throughout the day and at a similar rate. Challenging listening situations occurred infrequently both for HI and NH groups. Participants with NH were more likely to report that there were people speaking in the background whom they were trying to ignore, but participants with HI were more likely to report a greater number of background speakers. No associations were found between within-person listening situations and momentary fatigue, but person-mean listening activity and conversational status were related to momentary fatigue. Notably, having tinnitus was positively related to momentary fatigue, after controlling for other covariates. Finally, having a fatiguing health condition was a strong predictor of both trait and momentary fatigue. Conclusions: This is the first study to explore and compare fatigue across HI and NH groups using EMA. Contrary to expectations, the groups showed similar levels and diurnal patterns of fatigue, and fatigue was mostly unrelated to aspects of the listening environment. Between-person differences, although statistically significant, produced small effect sizes and therefore must be accepted cautiously. Issues with group matching, the measurement of fatigue, and perceived hearing-related difficulties among participants with NH are notable limitations. However, this study makes a novel contribution to both EMA and hearing research and demonstrates the importance of screening for fatiguing health conditions. Further research is warranted, particularly with individuals with more severe HI
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[article] Daily-Life Fatigue in Mild to Moderate Hearing Impairment: An Ecological Momentary Assessment Study [Article] / Louise A. Burke ; Graham Naylor . - 2020 . - 1518-1532.
Langues : Anglais (eng)
in Ear and hearing > Vol. 41, n°6 (Novembre-décembre) . - 1518-1532

Descripteurs :	HE Vinci Déficience auditive ; Fatigue ; Vie quotidienne
Résumé :	Objectives: Previous research has indicated an association between hearing impairment (HI) and daily-life fatigue. However, the temporal and contextual correlates of such fatigue are largely unexplored. The present study used ecological momentary assessment (EMA) to examine (1) whether people with HI are more fatigued than people with normal hearing, (2) whether individuals with HI and normal hearing (NH) show similar diurnal patterns of fatigue, (3) whether people with HI spend less time in challenging listening situations compared with NH controls, and (4) whether more challenging listening situations are associated with more fatigue and whether hearing ability influences any observed association. Design: After excluding 22 participants with self-reported fatiguing health conditions from analyses, the participant sample consisted of 24 adults with HI and 20 adults with NH, aged 44 to 77 years (M = 65.4, SD = 7.5). Data were collected using smartphones and a commercially available EMA app, which ran the specified EMA protocol for this study. Participants responded to six smartphone surveys per day for two weeks. "In-the-moment" questions asked participants to report on their listening situation and to rate their current level of fatigue ("momentary fatigue") at quasi-random time points throughout the day. Data were analyzed using multilevel modeling. Results: Hearing group (HI versus NH) was unrelated to trait, daily, and momentary fatigue; both participants with HI and NH became increasingly fatigued throughout the day and at a similar rate. Challenging listening situations occurred infrequently both for HI and NH groups. Participants with NH were more likely to report that there were people speaking in the background whom they were trying to ignore, but participants with HI were more likely to report a greater number of background speakers. No associations were found between within-person listening situations and momentary fatigue, but person-mean listening activity and conversational status were related to momentary fatigue. Notably, having tinnitus was positively related to momentary fatigue, after controlling for other covariates. Finally, having a fatiguing health condition was a strong predictor of both trait and momentary fatigue. Conclusions: This is the first study to explore and compare fatigue across HI and NH groups using EMA. Contrary to expectations, the groups showed similar levels and diurnal patterns of fatigue, and fatigue was mostly unrelated to aspects of the listening environment. Between-person differences, although statistically significant, produced small effect sizes and therefore must be accepted cautiously. Issues with group matching, the measurement of fatigue, and perceived hearing-related difficulties among participants with NH are notable limitations. However, this study makes a novel contribution to both EMA and hearing research and demonstrates the importance of screening for fatiguing health conditions. Further research is warranted, particularly with individuals with more severe HI
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[article] 
inEar and hearing > Vol. 41, n°6 (Novembre-décembre) . - p. 1533-1544

Titre :	Operationalization of the Brief ICF Core Set for Hearing Loss: An ICF-Based e-Intake Tool in Clinical Otology and Audiology Practice
Type de document :	Article
Auteurs :	Lisette M. van Leeuwen ; Marieke Pronk ; Paul Merkus ; S. Theo Goverts ; Caroline B. Terwee ; Sophia E. Kramer
Année de publication :	2020
Article en page(s) :	p. 1533-1544
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Admission du patient ; Brief ICF Core Set for Hearing Loss (CSHL) ; Etudes de validation ; Oto-rhino-laryngologie (ORL) ; Pratique audiologique
Résumé :	Objectives: According to the International Classification of Functioning, Disability and Health (ICF), functioning reflects the interplay between an individual's body structures and functions, activities, participation, environmental, and personal factors. To be useful in clinical practice, these concepts need to be operationalized into a practical and integral instrument. The Brief ICF Core Set for Hearing Loss (CSHL) provides a minimum standard for the assessment of functioning in adults with hearing loss. The objective of the present study was to operationalize the Brief CSHL into a digital intake tool that could be used in the otology-audiology practice for adults with ear and hearing problems as part of their intake assessment. Design: A three-step approach was followed: (1) Selecting and formulating questionnaire items and response formats, using the 27 categories of the Brief CSHL as a basis. Additional categories were selected based on relevant literature and clinical expertise. Items were selected from existing, commonly used disease-specific questionnaires, generic questionnaires, or the WHO's official descriptions of ICF categories. The response format was based on the existing item's response categories or on the ICF qualifiers. (2) Carrying out an expert survey and a pilot study (using the three-step test interview. Relevant stakeholders and patients were asked to comment on the relevance, comprehensiveness, and comprehensibility of the items. Results were discussed in the project group, and items were modified based on consensus. (3) Integration of the intake tool into a computer-based system for use in clinical routine. Results: The Brief CSHL was operationalized into 62 items, clustered into six domains: (1) general information, including reason for visit, sociodemographic, and medical background; (2) general body functions; (3) ear and hearing structures and functions; (4) activities and participation (A&P); (5) environmental factors (EF); and (6) personal factors (mastery and coping). Based on stakeholders' responses, the instructions of the items on A&P and EF were adapted. The three-step test interview showed that the tool had sufficient content validity but that some items on EF were redundant. Overall, the stakeholders and patients indicated that the intake tool was relevant and had a logical and clear structure. The tool was integrated in an online portal. Conclusions: In the current study, an ICF-based e-intake tool was developed that aims to screen self-reported functioning problems in adults with an ear/hearing problem. The relevance, comprehensiveness, and comprehensibility of the originally proposed item list was supported, although the stakeholder and patient feedback resulted into some changes of the tool on item-level. Ultimately, the functioning information obtained with the tool could be used to promote patient-centered ear and hearing care taking a biopsychosocial perspective into account.
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[article] Operationalization of the Brief ICF Core Set for Hearing Loss: An ICF-Based e-Intake Tool in Clinical Otology and Audiology Practice [Article] / Lisette M. van Leeuwen ; Marieke Pronk ; Paul Merkus ; S. Theo Goverts ; Caroline B. Terwee ; Sophia E. Kramer . - 2020 . - p. 1533-1544.
Langues : Anglais (eng)
in Ear and hearing > Vol. 41, n°6 (Novembre-décembre) . - p. 1533-1544

Descripteurs :	HE Vinci Admission du patient ; Brief ICF Core Set for Hearing Loss (CSHL) ; Etudes de validation ; Oto-rhino-laryngologie (ORL) ; Pratique audiologique
Résumé :	Objectives: According to the International Classification of Functioning, Disability and Health (ICF), functioning reflects the interplay between an individual's body structures and functions, activities, participation, environmental, and personal factors. To be useful in clinical practice, these concepts need to be operationalized into a practical and integral instrument. The Brief ICF Core Set for Hearing Loss (CSHL) provides a minimum standard for the assessment of functioning in adults with hearing loss. The objective of the present study was to operationalize the Brief CSHL into a digital intake tool that could be used in the otology-audiology practice for adults with ear and hearing problems as part of their intake assessment. Design: A three-step approach was followed: (1) Selecting and formulating questionnaire items and response formats, using the 27 categories of the Brief CSHL as a basis. Additional categories were selected based on relevant literature and clinical expertise. Items were selected from existing, commonly used disease-specific questionnaires, generic questionnaires, or the WHO's official descriptions of ICF categories. The response format was based on the existing item's response categories or on the ICF qualifiers. (2) Carrying out an expert survey and a pilot study (using the three-step test interview. Relevant stakeholders and patients were asked to comment on the relevance, comprehensiveness, and comprehensibility of the items. Results were discussed in the project group, and items were modified based on consensus. (3) Integration of the intake tool into a computer-based system for use in clinical routine. Results: The Brief CSHL was operationalized into 62 items, clustered into six domains: (1) general information, including reason for visit, sociodemographic, and medical background; (2) general body functions; (3) ear and hearing structures and functions; (4) activities and participation (A&P); (5) environmental factors (EF); and (6) personal factors (mastery and coping). Based on stakeholders' responses, the instructions of the items on A&P and EF were adapted. The three-step test interview showed that the tool had sufficient content validity but that some items on EF were redundant. Overall, the stakeholders and patients indicated that the intake tool was relevant and had a logical and clear structure. The tool was integrated in an online portal. Conclusions: In the current study, an ICF-based e-intake tool was developed that aims to screen self-reported functioning problems in adults with an ear/hearing problem. The relevance, comprehensiveness, and comprehensibility of the originally proposed item list was supported, although the stakeholder and patient feedback resulted into some changes of the tool on item-level. Ultimately, the functioning information obtained with the tool could be used to promote patient-centered ear and hearing care taking a biopsychosocial perspective into account.
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[article] 
inEar and hearing > Vol. 41, n°6 (Novembre-décembre) . - p. 1545-1559

Titre :	Binaural Pitch Fusion in Children With Normal Hearing, Hearing Aids, and Cochlear Implants
Type de document :	Article
Auteurs :	Curtis L. Hartling ; Jennifer R. Fowler ; Gemaine Stark ; Bess Glickman ; Morgan Eddolls ; Yonghee Oh ; Katrina Ramsey ; Lina A. Reiss
Année de publication :	2020
Article en page(s) :	p. 1545-1559
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Audition bimodale ; Implants cochléaires ; Pitch shift ; Système binaural
Résumé :	Objectives: Binaural pitch fusion is the perceptual integration of stimuli that evoke different pitches between the ears into a single auditory image. Adults who use hearing aids (HAs) or cochlear implants (CIs) often experience abnormally broad binaural pitch fusion, such that sounds differing in pitch by as much as 3 to 4 octaves are fused across ears, leading to spectral averaging and speech perception interference. The main goal of this study was to measure binaural pitch fusion in children with different hearing device combinations and compare results across groups and with adults. A second goal was to examine the relationship of binaural pitch fusion to interaural pitch differences or pitch match range, a measure of sequential pitch discriminability. Design: Binaural pitch fusion was measured in children between the ages of 6.1 and 11.1 years with bilateral HAs (n = 9), bimodal CI (n = 10), bilateral CIs (n = 17), as well as normal-hearing (NH) children (n = 21). Depending on device combination, stimuli were pure tones or electric pulse trains delivered to individual electrodes. Fusion ranges were measured using simultaneous, dichotic presentation of reference and comparison stimuli in opposite ears, and varying the comparison stimulus to find the range that fused with the reference stimulus. Interaural pitch match functions were measured using sequential presentation of reference and comparison stimuli, and varying the comparison stimulus to find the pitch match center and range. Results: Children with bilateral HAs had significantly broader binaural pitch fusion than children with NH, bimodal CI, or bilateral CIs. Children with NH and bilateral HAs, but not children with bimodal or bilateral CIs, had significantly broader fusion than adults with the same hearing status and device configuration. In children with bilateral CIs, fusion range was correlated with several variables that were also correlated with each other: pure-tone average in the second implanted ear before CI, and duration of prior bilateral HA, bimodal CI, or bilateral CI experience. No relationship was observed between fusion range and pitch match differences or range. Conclusions: The findings suggest that binaural pitch fusion is still developing in this age range and depends on hearing device combination but not on interaural pitch differences or discriminability.
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[article] Binaural Pitch Fusion in Children With Normal Hearing, Hearing Aids, and Cochlear Implants [Article] / Curtis L. Hartling ; Jennifer R. Fowler ; Gemaine Stark ; Bess Glickman ; Morgan Eddolls ; Yonghee Oh ; Katrina Ramsey ; Lina A. Reiss . - 2020 . - p. 1545-1559.
Langues : Anglais (eng)
in Ear and hearing > Vol. 41, n°6 (Novembre-décembre) . - p. 1545-1559

Descripteurs :	HE Vinci Audition bimodale ; Implants cochléaires ; Pitch shift ; Système binaural
Résumé :	Objectives: Binaural pitch fusion is the perceptual integration of stimuli that evoke different pitches between the ears into a single auditory image. Adults who use hearing aids (HAs) or cochlear implants (CIs) often experience abnormally broad binaural pitch fusion, such that sounds differing in pitch by as much as 3 to 4 octaves are fused across ears, leading to spectral averaging and speech perception interference. The main goal of this study was to measure binaural pitch fusion in children with different hearing device combinations and compare results across groups and with adults. A second goal was to examine the relationship of binaural pitch fusion to interaural pitch differences or pitch match range, a measure of sequential pitch discriminability. Design: Binaural pitch fusion was measured in children between the ages of 6.1 and 11.1 years with bilateral HAs (n = 9), bimodal CI (n = 10), bilateral CIs (n = 17), as well as normal-hearing (NH) children (n = 21). Depending on device combination, stimuli were pure tones or electric pulse trains delivered to individual electrodes. Fusion ranges were measured using simultaneous, dichotic presentation of reference and comparison stimuli in opposite ears, and varying the comparison stimulus to find the range that fused with the reference stimulus. Interaural pitch match functions were measured using sequential presentation of reference and comparison stimuli, and varying the comparison stimulus to find the pitch match center and range. Results: Children with bilateral HAs had significantly broader binaural pitch fusion than children with NH, bimodal CI, or bilateral CIs. Children with NH and bilateral HAs, but not children with bimodal or bilateral CIs, had significantly broader fusion than adults with the same hearing status and device configuration. In children with bilateral CIs, fusion range was correlated with several variables that were also correlated with each other: pure-tone average in the second implanted ear before CI, and duration of prior bilateral HA, bimodal CI, or bilateral CI experience. No relationship was observed between fusion range and pitch match differences or range. Conclusions: The findings suggest that binaural pitch fusion is still developing in this age range and depends on hearing device combination but not on interaural pitch differences or discriminability.
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