[article] 
inEar and hearing > Vol. 42, n°4 (Juillet- Aout 2021) . - p. 762-771

Titre :	Factors Associated With Self-Perceived Hearing Handicap in Adults From Hispanic/Latino Background: Findings From the Hispanic Community Health Study/Study of Latinos
Type de document :	Article
Auteurs :	Michelle L. Arnold ; Kathryn Hyer ; Brent J. Small ; Theresa H. Chisolm ; Gabrielle H. Saunders ; Cathy L. McEvoy ; Sumitrajit Dhar ; Kathleen E. Bainbridge ; David J. Lee
Année de publication :	2021
Article en page(s) :	p. 762-771
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Déficience auditive ; Santé publique Autres descripteurs Hearing handicap inventory for adults ; Minorite ethnique
Résumé :	Objectives: We sought to determine what factors, including acculturation (language and social contact preferences), were associated with self-perceived hearing handicap among adults from Hispanic/Latino background. We utilized the Aday-Andersen behavioral model of health services utilization to frame our hypotheses that predisposing characteristics (age, sex, education, city of residence, Hispanic/Latino background, and acculturation), enabling resources (annual income and current health insurance coverage), and need (measured hearing loss and self-reported hearing loss) would be related to clinically-significant self-perceived hearing handicap as measured by the Hearing Handicap Inventory - Screening (HHI-S) version. Design: We analyzed baseline data collected from 2008 to 2011 as part of the multisite Hispanic Community Health Study/Study of Latinos. Data were from 6585 adults with hearing loss (defined by a worse-ear 500, 1000, 2000, and 4000 Hz pure-tone average [PTA] of >=25 dB HL and/or a 4000, 6000, and 8000 Hz high-frequency PTA of >=25 dB HL) aged 18 to 74 years from various Hispanic/Latino backgrounds. We conducted a series of multivariable logistic regression models examining the roles of independent variables of interest representing predisposing, enabling, and need indicators on the occurrence of clinically-significant self-perceived hearing handicap (e.g., HHI-S score > 8). Results: Among included participants, 953 (14.5%) had an HHI-S score >8. The final model revealed significant associations between predisposing characteristics, enabling resources, need, and HHI-S outcome. Predisposing characteristics and need factors were associated with higher odds of reporting self-perceived hearing handicap (HHI-S score >8) including acculturation as measured by the Short Acculturation Scale for Hispanics (odds ratio [OR] = 1.28, 95% confidence interval [CI]: 1.09-1.50), female sex (OR = 1.72, 95% CI: 1.27-2.33), and poorer worse ear 500, 1000, 2000, and 4000 Hz PTA (OR = 1.02, 95% CI: 1.01-1.03); suggesting that a 5-decibel increase in a person's PTA was consistent with 10% higher odds of a HHI-S score of >8. Greater enabling resources were associated with lower odds of reporting clinically-significant self-perceived hearing handicap: compared with individuals with income $75,000/year was 0.28 (95% CI: 0.13-0.59]; p-trend Conclusions: Our findings suggest there are associations between predisposing, enabling and need variables consistent with the Aday-Andersen model and self-perceived hearing handicap among adults from Hispanic/Latino background. The influence of language and culture on perceived hearing loss and associated handicap is complex, and deserves more attention in future studies. Our findings warrant further investigation into understanding the role of language and language access in hearing health care utilization and outcomes, as the current body of literature is small and shows mixed outcomes.
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[article] Factors Associated With Self-Perceived Hearing Handicap in Adults From Hispanic/Latino Background: Findings From the Hispanic Community Health Study/Study of Latinos [Article] / Michelle L. Arnold ; Kathryn Hyer ; Brent J. Small ; Theresa H. Chisolm ; Gabrielle H. Saunders ; Cathy L. McEvoy ; Sumitrajit Dhar ; Kathleen E. Bainbridge ; David J. Lee . - 2021 . - p. 762-771.
Langues : Anglais (eng)
in Ear and hearing > Vol. 42, n°4 (Juillet- Aout 2021) . - p. 762-771

Descripteurs :	HE Vinci Déficience auditive ; Santé publique Autres descripteurs Hearing handicap inventory for adults ; Minorite ethnique
Résumé :	Objectives: We sought to determine what factors, including acculturation (language and social contact preferences), were associated with self-perceived hearing handicap among adults from Hispanic/Latino background. We utilized the Aday-Andersen behavioral model of health services utilization to frame our hypotheses that predisposing characteristics (age, sex, education, city of residence, Hispanic/Latino background, and acculturation), enabling resources (annual income and current health insurance coverage), and need (measured hearing loss and self-reported hearing loss) would be related to clinically-significant self-perceived hearing handicap as measured by the Hearing Handicap Inventory - Screening (HHI-S) version. Design: We analyzed baseline data collected from 2008 to 2011 as part of the multisite Hispanic Community Health Study/Study of Latinos. Data were from 6585 adults with hearing loss (defined by a worse-ear 500, 1000, 2000, and 4000 Hz pure-tone average [PTA] of >=25 dB HL and/or a 4000, 6000, and 8000 Hz high-frequency PTA of >=25 dB HL) aged 18 to 74 years from various Hispanic/Latino backgrounds. We conducted a series of multivariable logistic regression models examining the roles of independent variables of interest representing predisposing, enabling, and need indicators on the occurrence of clinically-significant self-perceived hearing handicap (e.g., HHI-S score > 8). Results: Among included participants, 953 (14.5%) had an HHI-S score >8. The final model revealed significant associations between predisposing characteristics, enabling resources, need, and HHI-S outcome. Predisposing characteristics and need factors were associated with higher odds of reporting self-perceived hearing handicap (HHI-S score >8) including acculturation as measured by the Short Acculturation Scale for Hispanics (odds ratio [OR] = 1.28, 95% confidence interval [CI]: 1.09-1.50), female sex (OR = 1.72, 95% CI: 1.27-2.33), and poorer worse ear 500, 1000, 2000, and 4000 Hz PTA (OR = 1.02, 95% CI: 1.01-1.03); suggesting that a 5-decibel increase in a person's PTA was consistent with 10% higher odds of a HHI-S score of >8. Greater enabling resources were associated with lower odds of reporting clinically-significant self-perceived hearing handicap: compared with individuals with income $75,000/year was 0.28 (95% CI: 0.13-0.59]; p-trend Conclusions: Our findings suggest there are associations between predisposing, enabling and need variables consistent with the Aday-Andersen model and self-perceived hearing handicap among adults from Hispanic/Latino background. The influence of language and culture on perceived hearing loss and associated handicap is complex, and deserves more attention in future studies. Our findings warrant further investigation into understanding the role of language and language access in hearing health care utilization and outcomes, as the current body of literature is small and shows mixed outcomes.
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[article] 
inEar and hearing > Vol. 42, n°4 (Juillet- Aout 2021) . - p. 772-781

Titre :	Communicating During COVID-19: The Effect of Transparent Masks for Speech Recognition in Noise
Type de document :	Article
Auteurs :	Linda Thibodeau ; Rachel B. Thibodeau-Nielsen ; Chi Mai Quynh Tran ; Regina Tangerino de Souza Jacob
Année de publication :	2021
Article en page(s) :	p. 772-781
Langues :	Anglais (eng)
Descripteurs :	HE Vinci COVID-19 ; Masques ; Pandémies ; Reconnaissance de la parole Autres descripteurs Rehabilitation audiologique
Résumé :	Objective: The purpose of this study was to assess the speech recognition in noise when using a transparent mask that allows greater visibility of the talker's face compared to an opaque mask in persons with normal and impaired hearing via an online format. Design: A repeated-measures design was used to evaluate the auditory-visual recognition of sentences recorded in background noise with transparent and opaque face masks, and without a mask (N = 154). In a smaller follow-up study (N = 29), the same files were presented via auditory-only presentation to determine if differences observed in the transparent and opaque mask conditions were attributable to additional visual cues or to acoustic differences between the recordings of the two mask types. Listeners completed the 40-minute online session on a computer, laptop, or tablet in a quiet room via their personal listening devices (earbuds or hearing assistive device). The adult volunteers who used English as their first language were recruited through social media links and email and categorized into three groups: normal hearing and confirmed or suspected hearing loss either with or without the use of assistive listening devices. Results: Auditory-visual recognition of sentences recorded with the transparent mask was significantly better (M = 68.9%) than for sentences recorded with the opaque mask (M = 58.9%) for all participants. There was a trend for those who used hearing assistive technology to score lower than the other two groups who had similar performance across all conditions regardless of the mask type. Subjective ratings of confidence and concentration followed the expected pattern based on objective scores. Results of the auditory-only presentation of the sentences to listeners with normal hearing suggested that the transparent mask benefits were not attributable to an acoustic advantage but rather to the addition of the visual cues of the talker's face available through the transparent mask. In fact, performance in the auditory-only presentation was significantly lower with the transparent mask (M = 40.7%) compared to the opaque mask (M = 58.2%). Conclusions: Use of transparent masks can significantly facilitate speech recognition in noise even for persons with normal hearing and thus may reduce stressful communication challenges experienced in medical, employment, and educational settings during the global pandemic. To mitigate the spread of COVID-19 and facilitate communication, safety-approved transparent masks are strongly encouraged over opaque masks.
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[article] Communicating During COVID-19: The Effect of Transparent Masks for Speech Recognition in Noise [Article] / Linda Thibodeau ; Rachel B. Thibodeau-Nielsen ; Chi Mai Quynh Tran ; Regina Tangerino de Souza Jacob . - 2021 . - p. 772-781.
Langues : Anglais (eng)
in Ear and hearing > Vol. 42, n°4 (Juillet- Aout 2021) . - p. 772-781

Descripteurs :	HE Vinci COVID-19 ; Masques ; Pandémies ; Reconnaissance de la parole Autres descripteurs Rehabilitation audiologique
Résumé :	Objective: The purpose of this study was to assess the speech recognition in noise when using a transparent mask that allows greater visibility of the talker's face compared to an opaque mask in persons with normal and impaired hearing via an online format. Design: A repeated-measures design was used to evaluate the auditory-visual recognition of sentences recorded in background noise with transparent and opaque face masks, and without a mask (N = 154). In a smaller follow-up study (N = 29), the same files were presented via auditory-only presentation to determine if differences observed in the transparent and opaque mask conditions were attributable to additional visual cues or to acoustic differences between the recordings of the two mask types. Listeners completed the 40-minute online session on a computer, laptop, or tablet in a quiet room via their personal listening devices (earbuds or hearing assistive device). The adult volunteers who used English as their first language were recruited through social media links and email and categorized into three groups: normal hearing and confirmed or suspected hearing loss either with or without the use of assistive listening devices. Results: Auditory-visual recognition of sentences recorded with the transparent mask was significantly better (M = 68.9%) than for sentences recorded with the opaque mask (M = 58.9%) for all participants. There was a trend for those who used hearing assistive technology to score lower than the other two groups who had similar performance across all conditions regardless of the mask type. Subjective ratings of confidence and concentration followed the expected pattern based on objective scores. Results of the auditory-only presentation of the sentences to listeners with normal hearing suggested that the transparent mask benefits were not attributable to an acoustic advantage but rather to the addition of the visual cues of the talker's face available through the transparent mask. In fact, performance in the auditory-only presentation was significantly lower with the transparent mask (M = 40.7%) compared to the opaque mask (M = 58.2%). Conclusions: Use of transparent masks can significantly facilitate speech recognition in noise even for persons with normal hearing and thus may reduce stressful communication challenges experienced in medical, employment, and educational settings during the global pandemic. To mitigate the spread of COVID-19 and facilitate communication, safety-approved transparent masks are strongly encouraged over opaque masks.
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[article] 
inEar and hearing > Vol. 42, n°4 (Juillet- Aout 2021) . - p. 782-792

Titre :	Idiopathic Sudden Sensorineural Hearing Loss: Speech Intelligibility Deficits Following Threshold Recovery
Type de document :	Article
Auteurs :	Masahiro Okada ; Aravindakshan Parthasarathy ; D. Bradley Welling ; M. Charles Liberman ; Stéphane Maison
Année de publication :	2021
Article en page(s) :	p. 782-792
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Audition dans le bruit ; Intelligibilité de la parole ; Nerf vestibulocochléaire ; Perte auditive soudaine (SSNHL) ; synaptopathie cochléaire
Résumé :	Objectives: This retrospective study tests the hypothesis that patients who have recovered from idiopathic sudden sensorineural hearing loss (SSNHL) show deficits in word recognition tasks that cannot be entirely explained by a loss in audibility. Design: We reviewed the audiologic profile of 166 patients presenting with a unilateral SSNHL. Hearing loss severity, degree of threshold recovery, residual hearing loss, and word recognition performance were considered as outcome variables. Age, route of treatment, delay between SSNHL onset and treatment, and audiogram configuration were considered as predictor variables. Results: Severity, residual hearing loss, and recovery were highly variable across patients. While age and onset-treatment delay could not account for the severity, residual hearing loss and recovery in thresholds, configuration of the SSNHL and overall inner ear status as measured by thresholds on the contralateral ear were predictive of threshold recovery. Speech recognition performance was significantly poorer than predicted by the speech intelligibility curve derived from the patient's audiogram. Conclusions: SSNHL is associated with (1) changes in thresholds that are consistent with ischemia and (2) speech intelligibility deficits that cannot be entirely explained by a change in hearing sensitivity.
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[article] Idiopathic Sudden Sensorineural Hearing Loss: Speech Intelligibility Deficits Following Threshold Recovery [Article] / Masahiro Okada ; Aravindakshan Parthasarathy ; D. Bradley Welling ; M. Charles Liberman ; Stéphane Maison . - 2021 . - p. 782-792.
Langues : Anglais (eng)
in Ear and hearing > Vol. 42, n°4 (Juillet- Aout 2021) . - p. 782-792

Descripteurs :	HE Vinci Audition dans le bruit ; Intelligibilité de la parole ; Nerf vestibulocochléaire ; Perte auditive soudaine (SSNHL) ; synaptopathie cochléaire
Résumé :	Objectives: This retrospective study tests the hypothesis that patients who have recovered from idiopathic sudden sensorineural hearing loss (SSNHL) show deficits in word recognition tasks that cannot be entirely explained by a loss in audibility. Design: We reviewed the audiologic profile of 166 patients presenting with a unilateral SSNHL. Hearing loss severity, degree of threshold recovery, residual hearing loss, and word recognition performance were considered as outcome variables. Age, route of treatment, delay between SSNHL onset and treatment, and audiogram configuration were considered as predictor variables. Results: Severity, residual hearing loss, and recovery were highly variable across patients. While age and onset-treatment delay could not account for the severity, residual hearing loss and recovery in thresholds, configuration of the SSNHL and overall inner ear status as measured by thresholds on the contralateral ear were predictive of threshold recovery. Speech recognition performance was significantly poorer than predicted by the speech intelligibility curve derived from the patient's audiogram. Conclusions: SSNHL is associated with (1) changes in thresholds that are consistent with ischemia and (2) speech intelligibility deficits that cannot be entirely explained by a change in hearing sensitivity.
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[article] 
inEar and hearing > Vol. 42, n°4 (Juillet- Aout 2021) . - p. 793-802

Titre :	Uptake of Hearing Aids and Hearing Assistive Technology in a Working Population: Longitudinal Analyses of The Netherlands Longitudinal Study on Hearing
Type de document :	Article
Auteurs :	Lisette M. van Leeuwen ; Thade P.M. Goderie ; Marieke F. van Wier ; Birgit I. Lissenberg-Witte ; Ulrike Lemke ; Sophia E. Kramer
Année de publication :	2021
Article en page(s) :	p. 793-802
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Absorption ; Aides auditives Autres descripteurs Technologie d'assistance
Résumé :	Objective: To identify predictors of the 5-year uptake of hearing aids (HAs) and hearing assistive technology (HAT) in a sample of Dutch employees eligible for HAs and/or HAT. The potential predictors included demographic factors (age, sex, marital status, and living situation), education, hearing factors (ability to recognize speech in noise and self-reported hearing disability), distress, self-efficacy, and work-related factors (job demand, job control, and need for recovery). Design: Five-year follow-up data of the Netherlands Longitudinal Study on Hearing (NL-SH) collected until January 2019 were included. An online digit-triplet in noise test, the National Hearing Test (NHT), was used to assess speech-recognition-in-noise ability. In addition, online questionnaires on demographic, socioeconomic, self-reported hearing disability, health, and work-related characteristics were administered. Adults who worked over 12 hours per week, who had not yet taken up HAs or HAT, but who would be eligible for HAs/HAT based on their NHT score (insufficient or poor hearing ability), were included in the study. The 5-year uptake of HAs/HAT was defined as a dichotomous variable of self-reported HA/HAT use reported 5 years later. Generalized Estimating Equations analyses were performed to analyze the associations between potential predicting factors and the 5-year uptake of HAs/HAT, taking into account the repeated measurements of the predicting factors and the 5-year uptake of HAs/HAT. Results: Data of 218 participants were included. The cumulative incidence of the 5-year uptake of HAs/HAT was 15 to 33%, of which 52 employees took up HAs and 11 employees took up HAT. Married participants had increased odds for 5-year uptake of HAs/HAT compared with unmarried participants (odds ratio [OR] = 2.13, 95% confidence interval [CI] = 1.05 to 4.35). Higher self-reported hearing disability (per one unit, scale range 0 to 74) was associated with increased odds for 5-year uptake of HAs/HAT (OR = 1.05, 95% CI = 1.03 to 1.07). Job demand showed a significant interaction with sex (p = 0.002), and therefore, stratified analyses were performed. In male participants, participants with higher job demand scores (per one unit, scale range 12 to 48) had increased odds for 5-year uptake of HAs/HAT (OR = 1.18, 95% CI = 1.05 to 1.35). No difference was seen in females. Conclusion: This study confirms that factors predicting the uptake of HAs/HAT in the general or older populations, including marital status and self-reported hearing disability, also extend to the working population. The identification of job demand as a predictor of the uptake of HAs/HAT (in males only) was a novel finding. It demonstrates the importance of considering work-related factors in aural rehabilitation.
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[article] Uptake of Hearing Aids and Hearing Assistive Technology in a Working Population: Longitudinal Analyses of The Netherlands Longitudinal Study on Hearing [Article] / Lisette M. van Leeuwen ; Thade P.M. Goderie ; Marieke F. van Wier ; Birgit I. Lissenberg-Witte ; Ulrike Lemke ; Sophia E. Kramer . - 2021 . - p. 793-802.
Langues : Anglais (eng)
in Ear and hearing > Vol. 42, n°4 (Juillet- Aout 2021) . - p. 793-802

Descripteurs :	HE Vinci Absorption ; Aides auditives Autres descripteurs Technologie d'assistance
Résumé :	Objective: To identify predictors of the 5-year uptake of hearing aids (HAs) and hearing assistive technology (HAT) in a sample of Dutch employees eligible for HAs and/or HAT. The potential predictors included demographic factors (age, sex, marital status, and living situation), education, hearing factors (ability to recognize speech in noise and self-reported hearing disability), distress, self-efficacy, and work-related factors (job demand, job control, and need for recovery). Design: Five-year follow-up data of the Netherlands Longitudinal Study on Hearing (NL-SH) collected until January 2019 were included. An online digit-triplet in noise test, the National Hearing Test (NHT), was used to assess speech-recognition-in-noise ability. In addition, online questionnaires on demographic, socioeconomic, self-reported hearing disability, health, and work-related characteristics were administered. Adults who worked over 12 hours per week, who had not yet taken up HAs or HAT, but who would be eligible for HAs/HAT based on their NHT score (insufficient or poor hearing ability), were included in the study. The 5-year uptake of HAs/HAT was defined as a dichotomous variable of self-reported HA/HAT use reported 5 years later. Generalized Estimating Equations analyses were performed to analyze the associations between potential predicting factors and the 5-year uptake of HAs/HAT, taking into account the repeated measurements of the predicting factors and the 5-year uptake of HAs/HAT. Results: Data of 218 participants were included. The cumulative incidence of the 5-year uptake of HAs/HAT was 15 to 33%, of which 52 employees took up HAs and 11 employees took up HAT. Married participants had increased odds for 5-year uptake of HAs/HAT compared with unmarried participants (odds ratio [OR] = 2.13, 95% confidence interval [CI] = 1.05 to 4.35). Higher self-reported hearing disability (per one unit, scale range 0 to 74) was associated with increased odds for 5-year uptake of HAs/HAT (OR = 1.05, 95% CI = 1.03 to 1.07). Job demand showed a significant interaction with sex (p = 0.002), and therefore, stratified analyses were performed. In male participants, participants with higher job demand scores (per one unit, scale range 12 to 48) had increased odds for 5-year uptake of HAs/HAT (OR = 1.18, 95% CI = 1.05 to 1.35). No difference was seen in females. Conclusion: This study confirms that factors predicting the uptake of HAs/HAT in the general or older populations, including marital status and self-reported hearing disability, also extend to the working population. The identification of job demand as a predictor of the uptake of HAs/HAT (in males only) was a novel finding. It demonstrates the importance of considering work-related factors in aural rehabilitation.
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[article] 
inEar and hearing > Vol. 42, n°4 (Juillet- Aout 2021) . - p. 803-813

Titre :	The Relations Between Auditory Processing Scores and Cognitive, Listening and Reading Abilities
Type de document :	Article
Auteurs :	Mark Seeto ; Dani Tomlin ; Harvey Dillon
Année de publication :	2021
Article en page(s) :	p. 803-813
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Audition ; Lecture ; Modélisation ; Traitement auditif Autres descripteurs Cognition auditive
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[article] The Relations Between Auditory Processing Scores and Cognitive, Listening and Reading Abilities [Article] / Mark Seeto ; Dani Tomlin ; Harvey Dillon . - 2021 . - p. 803-813.
Langues : Anglais (eng)
in Ear and hearing > Vol. 42, n°4 (Juillet- Aout 2021) . - p. 803-813

Descripteurs :	HE Vinci Audition ; Lecture ; Modélisation ; Traitement auditif Autres descripteurs Cognition auditive
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[article] 
inEar and hearing > Vol. 42, n°3 (Mai- Juin 2021) . - p. 492-505

Titre :	Effects of Directionality, Compression, and Working Memory on Speech Recognition
Type de document :	Article
Auteurs :	Varsha Rallapalli ; Gregory M. Ellis ; Pamela E. Souza, Auteur
Année de publication :	2021
Article en page(s) :	p. 492-505
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Aides auditives ; Intelligibilité de la parole ; Rapport signal-bruit (SNRs) (RSB) ; Reconnaissance de la parole Autres descripteurs Benefice directionnel ; Compression dynamique
Mots-clés :	WDRC
Résumé :	Objectives: Previous research has shown that the association between hearing aid-processed speech recognition and individual working memory ability becomes stronger in more challenging conditions (e.g., higher background noise levels) and with stronger hearing aid processing (e.g., fast-acting wide dynamic range compression, WDRC). To date, studies have assumed omnidirectional microphone settings and collocated speech and noise conditions to study such relationships. Such conditions fail to recognize that most hearing aids are fit with directional processing that may improve the signal to noise ratio (SNR) and speech recognition in spatially separated speech and noise conditions. Here, we considered the possibility that directional processing may reduce the signal distortion arising from fast-acting WDRC and in turn influence the relationship between working memory ability and speech recognition with WDRC processing. The combined effects of hearing aid processing (WDRC and directionality) and SNR were quantified using a signal modification metric (cepstral correlation), which measures temporal envelope changes in the processed signal with respect to a linearly amplified reference. It was hypothesized that there will be a weaker association between working memory ability and speech recognition for hearing aid processing conditions that result in overall less signal modification (i.e., fewer changes to the processed envelope). Design: Twenty-three individuals with bilateral, mild to moderately severe sensorineural hearing loss participated in the study. Participants were fit with a commercially available hearing aid, and signal processing was varied in two dimensions: (1) Directionality (omnidirectional [OMNI] versus fixed-directional [DIR]), and (2) WDRC speed (fast-acting [FAST] versus slow-acting [SLOW]). Sentence recognition in spatially separated multi-talker babble was measured across a range of SNRs: 0 dB, 5 dB, 10 dB, and quiet. Cumulative signal modification was measured with individualized hearing aid settings, for all experimental conditions. A linear mixed-effects model was used to determine the relationship between speech recognition, working memory ability, and cumulative signal modification. Results: Signal modification results showed a complex relationship between directionality and WDRC speed, which varied by SNR. At 0 and 5 dB SNRs, signal modification was lower for SLOW than FAST regardless of directionality. However, at 10 dB SNR and in the DIR listening condition, there was no signal modification difference between FAST and SLOW. Consistent with previous studies, the association of speech recognition in noise with working memory ability depended on the level of signal modification. Contrary to the hypothesis above, however, there was a significant association of speech recognition with working memory only at lower levels of signal modification, and speech recognition increased at a faster rate for individuals with better working memory as signal modification decreased with DIR and SLOW. Conclusions: This research suggests that working memory ability remains a significant predictor of speech recognition when WDRC and directionality are applied. Our findings revealed that directional processing can reduce the detrimental effect of fast-acting WDRC on speech cues at higher SNRs, which affects speech recognition ability. Contrary to some previous research, this study showed that individuals with better working memory ability benefitted more from a decrease in signal modification than individuals with poorer working memory ability.
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[article] Effects of Directionality, Compression, and Working Memory on Speech Recognition [Article] / Varsha Rallapalli ; Gregory M. Ellis ; Pamela E. Souza, Auteur . - 2021 . - p. 492-505.
Langues : Anglais (eng)
in Ear and hearing > Vol. 42, n°3 (Mai- Juin 2021) . - p. 492-505

Descripteurs :	HE Vinci Aides auditives ; Intelligibilité de la parole ; Rapport signal-bruit (SNRs) (RSB) ; Reconnaissance de la parole Autres descripteurs Benefice directionnel ; Compression dynamique
Mots-clés :	WDRC
Résumé :	Objectives: Previous research has shown that the association between hearing aid-processed speech recognition and individual working memory ability becomes stronger in more challenging conditions (e.g., higher background noise levels) and with stronger hearing aid processing (e.g., fast-acting wide dynamic range compression, WDRC). To date, studies have assumed omnidirectional microphone settings and collocated speech and noise conditions to study such relationships. Such conditions fail to recognize that most hearing aids are fit with directional processing that may improve the signal to noise ratio (SNR) and speech recognition in spatially separated speech and noise conditions. Here, we considered the possibility that directional processing may reduce the signal distortion arising from fast-acting WDRC and in turn influence the relationship between working memory ability and speech recognition with WDRC processing. The combined effects of hearing aid processing (WDRC and directionality) and SNR were quantified using a signal modification metric (cepstral correlation), which measures temporal envelope changes in the processed signal with respect to a linearly amplified reference. It was hypothesized that there will be a weaker association between working memory ability and speech recognition for hearing aid processing conditions that result in overall less signal modification (i.e., fewer changes to the processed envelope). Design: Twenty-three individuals with bilateral, mild to moderately severe sensorineural hearing loss participated in the study. Participants were fit with a commercially available hearing aid, and signal processing was varied in two dimensions: (1) Directionality (omnidirectional [OMNI] versus fixed-directional [DIR]), and (2) WDRC speed (fast-acting [FAST] versus slow-acting [SLOW]). Sentence recognition in spatially separated multi-talker babble was measured across a range of SNRs: 0 dB, 5 dB, 10 dB, and quiet. Cumulative signal modification was measured with individualized hearing aid settings, for all experimental conditions. A linear mixed-effects model was used to determine the relationship between speech recognition, working memory ability, and cumulative signal modification. Results: Signal modification results showed a complex relationship between directionality and WDRC speed, which varied by SNR. At 0 and 5 dB SNRs, signal modification was lower for SLOW than FAST regardless of directionality. However, at 10 dB SNR and in the DIR listening condition, there was no signal modification difference between FAST and SLOW. Consistent with previous studies, the association of speech recognition in noise with working memory ability depended on the level of signal modification. Contrary to the hypothesis above, however, there was a significant association of speech recognition with working memory only at lower levels of signal modification, and speech recognition increased at a faster rate for individuals with better working memory as signal modification decreased with DIR and SLOW. Conclusions: This research suggests that working memory ability remains a significant predictor of speech recognition when WDRC and directionality are applied. Our findings revealed that directional processing can reduce the detrimental effect of fast-acting WDRC on speech cues at higher SNRs, which affects speech recognition ability. Contrary to some previous research, this study showed that individuals with better working memory ability benefitted more from a decrease in signal modification than individuals with poorer working memory ability.
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[article] 
inEar and hearing > Vol. 42, n°3 (Mai- Juin 2021) . - p. 506-519

Titre :	Age-Related Changes in Listening Effort for Children and Teenagers With Normal Hearing and Cochlear Implants
Type de document :	Article
Auteurs :	Benson Cheng-Lin Hsu ; Filiep J. Vanpoucke ; Margreet Langereis ; Ann Dierckx ; Astrid van Wieringen
Année de publication :	2021
Article en page(s) :	p. 506-519
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Adolescent ; Effort d'écoute ; Enfant implanté ; Implants cochléaires Autres descripteurs Double tâche ; Effet de l'age ; Maturation ; Mesure comportementale ; Profondeur de traitement
Résumé :	Objectives: A clinically viable measure of listening effort is crucial in safeguarding the educational success of hard-of-hearing students enrolled in mainstream schools. To this end, a novel behavioral paradigm of listening effort targeting school-age children has been designed and reported in Hsu et al. (2017). The current article consists of two follow-up experiments investigating the effects of noise, processing depth, and age in a similar paradigm, first in a group of participants with normal hearing (NH) followed by a sample of school-age cochlear implant (CI) users. Research objectives include the construction of normative values of listening effort and comparing outcomes between age-matched NH and CI participants. Design: In Experiment 1, the listening effort dual-task paradigm was evaluated in a group of 90 NH participants with roughly even age distribution between 6 and 26 years. The primary task asked a participant to verbally repeat each of the target words presented in either quiet or noise, while the secondary task consisted of categorization true-or-false questions "animal" and "dangerous," representing two levels of semantic processing depth. Two outcome measures were obtained for each condition: a classic word recognition score (WRS) and an average response time (RT) measured during the secondary task. The RT was defined as the main listening effort metric throughout the study. Each NH participant's long-term memory retrieval speed and working memory capacity were also assessed through standardized tests. It was hypothesized that adding noise would negatively affect both WRS and RT, whereas an increase in age would see significant improvement in both measures. A subsequent Experiment 2 administered a shortened version of the paradigm to 14 school-age CI users between 5 and 14 years old at a university clinic. The patterns of results from the CI group were expected to approximate those of the NH group, except with larger between-subject variability. Results: For NH participants, while WRS was significantly affected by age and noise levels, RT was significantly affected by age, noise levels, and depth of processing. RT was significantly correlated with long-term memory retrieval speed but not with working memory capacity. There was also a significant interaction effect between age and noise levels for both WRS and RT. The RT data set from the NH group served as a basis to establish age-dependent 95% prediction intervals for expected future observations. For CI participants, the effect of age on the two outcome measures was more visible when target words were presented in quiet. Depending on the condition, between 35.7% and 72.7% of the children with CI exhibited higher-than-norms listening effort as measured by categorization processing times. Conclusion: Listening effort appears to decrease with age from early school-age years to late teenage years. The effects of background noise and processing depth are comparable with those reported in Hsu et al. (2017). Future studies interested in expanding the paradigm's clinical viability should focus on the reduction of testing time while maintaining or increasing the sensitivity and external validity of its outcome measures.
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[article] Age-Related Changes in Listening Effort for Children and Teenagers With Normal Hearing and Cochlear Implants [Article] / Benson Cheng-Lin Hsu ; Filiep J. Vanpoucke ; Margreet Langereis ; Ann Dierckx ; Astrid van Wieringen . - 2021 . - p. 506-519.
Langues : Anglais (eng)
in Ear and hearing > Vol. 42, n°3 (Mai- Juin 2021) . - p. 506-519

Descripteurs :	HE Vinci Adolescent ; Effort d'écoute ; Enfant implanté ; Implants cochléaires Autres descripteurs Double tâche ; Effet de l'age ; Maturation ; Mesure comportementale ; Profondeur de traitement
Résumé :	Objectives: A clinically viable measure of listening effort is crucial in safeguarding the educational success of hard-of-hearing students enrolled in mainstream schools. To this end, a novel behavioral paradigm of listening effort targeting school-age children has been designed and reported in Hsu et al. (2017). The current article consists of two follow-up experiments investigating the effects of noise, processing depth, and age in a similar paradigm, first in a group of participants with normal hearing (NH) followed by a sample of school-age cochlear implant (CI) users. Research objectives include the construction of normative values of listening effort and comparing outcomes between age-matched NH and CI participants. Design: In Experiment 1, the listening effort dual-task paradigm was evaluated in a group of 90 NH participants with roughly even age distribution between 6 and 26 years. The primary task asked a participant to verbally repeat each of the target words presented in either quiet or noise, while the secondary task consisted of categorization true-or-false questions "animal" and "dangerous," representing two levels of semantic processing depth. Two outcome measures were obtained for each condition: a classic word recognition score (WRS) and an average response time (RT) measured during the secondary task. The RT was defined as the main listening effort metric throughout the study. Each NH participant's long-term memory retrieval speed and working memory capacity were also assessed through standardized tests. It was hypothesized that adding noise would negatively affect both WRS and RT, whereas an increase in age would see significant improvement in both measures. A subsequent Experiment 2 administered a shortened version of the paradigm to 14 school-age CI users between 5 and 14 years old at a university clinic. The patterns of results from the CI group were expected to approximate those of the NH group, except with larger between-subject variability. Results: For NH participants, while WRS was significantly affected by age and noise levels, RT was significantly affected by age, noise levels, and depth of processing. RT was significantly correlated with long-term memory retrieval speed but not with working memory capacity. There was also a significant interaction effect between age and noise levels for both WRS and RT. The RT data set from the NH group served as a basis to establish age-dependent 95% prediction intervals for expected future observations. For CI participants, the effect of age on the two outcome measures was more visible when target words were presented in quiet. Depending on the condition, between 35.7% and 72.7% of the children with CI exhibited higher-than-norms listening effort as measured by categorization processing times. Conclusion: Listening effort appears to decrease with age from early school-age years to late teenage years. The effects of background noise and processing depth are comparable with those reported in Hsu et al. (2017). Future studies interested in expanding the paradigm's clinical viability should focus on the reduction of testing time while maintaining or increasing the sensitivity and external validity of its outcome measures.
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[article] 
inEar and hearing > Vol. 42, n°3 (Mai- Juin 2021) . - p. 520-530

Titre :	Associations Between Hearing Health and Well-Being in Unilateral Hearing Impairment
Type de document :	Article
Auteurs :	Robert H. Pierzycki ; Mark Edmondsonson-Jones ; Piers Dawes ; Kevin J. Munro ; David R. Moore ; Pádraig Thomas Kitterick
Année de publication :	2021
Article en page(s) :	p. 520-530
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Acouphène ; Comorbidité ; Compréhension dans le bruit ; État de santé ; Solitude Autres descripteurs Appareillage unilateral
Résumé :	Objectives: To determine population-based risks of adverse effects on hearing and well-being outcomes associated with unilateral hearing impairment. Design: A group of 40- to 69-year-old adults (n = 861) who reported being able to hear only in one ear and having speech reception thresholds (SRTs) in noise indicating normal hearing in that ear (SRTN/-) was selected from the UK Biobank cohort. The UK Biobank participants with SRTs indicating either normal (SRTN/N, n = 95,514) or symmetrically impaired hearing in both ears (SRTI/I, n = 17,429) were selected as comparison groups. Self-reported difficulty following conversations in noise, tinnitus presence, feeling depressed, lonely, unhappy, and being in poor health or dissatisfied with health were selected as hearing and well-being outcomes. Logistic regression models were used to evaluate the risks of reporting adverse outcomes associated with SRTN/- compared with SRTN/N and SRTI/I while controlling for numerous factors linked to hearing and general health. Results: People with SRTN/- were significantly more likely to report difficulties following conversations in noise (odds ratio, 10.61; 95% confidence interval, 8.83 to 12.75), tinnitus (4.04; 3.51 to 4.66), poor health (1.35; 1.15 to 1.58), health dissatisfaction (1.22; 1.00 to 1.47), and loneliness (1.28; 1.08 to 1.51) compared with people with SRTN/N. Well-being outcomes were similar in the SRTN/- and SRTI/I groups. However, difficulties following conversations in noise (5.35; 4.44 to 6.44) and tinnitus presence (2.66; 2.31 to 3.08) were significantly more likely with SRTN/- than with SRTI/I. The SRTN/- was associated with increased risk of self-reported poor health by 18% (relative risk, 1.18; 95% confidence interval, 1.06 to 1.32) and loneliness by 24% (1.24; 1.07 to 1.43) compared with SRTN/N. The risk of reporting difficulties following conversations in noise increased by 64% (1.64; 1.58 to 1.71) and tinnitus presence by 84% (1.84; 1.69 to 2.01) compared with SRTI/I. The effect of SRTN/- on reporting poor health was similar to that from having other health problems such as hypertension or high cholesterol. Conclusions: The large increases in the risks of reporting adverse hearing-related outcomes associated with unilateral hearing impairment suggest its specific impact on hearing function in everyday situations. The increased risk of loneliness and poor health indicates that one normally functioning ear is also insufficient to protect against the adverse psychosocial impacts of unilateral hearing impairment. This impact was still significant after controlling for various health-related factors and can lead to perception of poor health comparable to that with having medical problems contributing to life-threatening conditions such as heart disease. The findings suggest the need for effective interventions to address the hearing-related problems and their impact on well-being in people with unilateral hearing impairment.
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[article] Associations Between Hearing Health and Well-Being in Unilateral Hearing Impairment [Article] / Robert H. Pierzycki ; Mark Edmondsonson-Jones ; Piers Dawes ; Kevin J. Munro ; David R. Moore ; Pádraig Thomas Kitterick . - 2021 . - p. 520-530.
Langues : Anglais (eng)
in Ear and hearing > Vol. 42, n°3 (Mai- Juin 2021) . - p. 520-530

Descripteurs :	HE Vinci Acouphène ; Comorbidité ; Compréhension dans le bruit ; État de santé ; Solitude Autres descripteurs Appareillage unilateral
Résumé :	Objectives: To determine population-based risks of adverse effects on hearing and well-being outcomes associated with unilateral hearing impairment. Design: A group of 40- to 69-year-old adults (n = 861) who reported being able to hear only in one ear and having speech reception thresholds (SRTs) in noise indicating normal hearing in that ear (SRTN/-) was selected from the UK Biobank cohort. The UK Biobank participants with SRTs indicating either normal (SRTN/N, n = 95,514) or symmetrically impaired hearing in both ears (SRTI/I, n = 17,429) were selected as comparison groups. Self-reported difficulty following conversations in noise, tinnitus presence, feeling depressed, lonely, unhappy, and being in poor health or dissatisfied with health were selected as hearing and well-being outcomes. Logistic regression models were used to evaluate the risks of reporting adverse outcomes associated with SRTN/- compared with SRTN/N and SRTI/I while controlling for numerous factors linked to hearing and general health. Results: People with SRTN/- were significantly more likely to report difficulties following conversations in noise (odds ratio, 10.61; 95% confidence interval, 8.83 to 12.75), tinnitus (4.04; 3.51 to 4.66), poor health (1.35; 1.15 to 1.58), health dissatisfaction (1.22; 1.00 to 1.47), and loneliness (1.28; 1.08 to 1.51) compared with people with SRTN/N. Well-being outcomes were similar in the SRTN/- and SRTI/I groups. However, difficulties following conversations in noise (5.35; 4.44 to 6.44) and tinnitus presence (2.66; 2.31 to 3.08) were significantly more likely with SRTN/- than with SRTI/I. The SRTN/- was associated with increased risk of self-reported poor health by 18% (relative risk, 1.18; 95% confidence interval, 1.06 to 1.32) and loneliness by 24% (1.24; 1.07 to 1.43) compared with SRTN/N. The risk of reporting difficulties following conversations in noise increased by 64% (1.64; 1.58 to 1.71) and tinnitus presence by 84% (1.84; 1.69 to 2.01) compared with SRTI/I. The effect of SRTN/- on reporting poor health was similar to that from having other health problems such as hypertension or high cholesterol. Conclusions: The large increases in the risks of reporting adverse hearing-related outcomes associated with unilateral hearing impairment suggest its specific impact on hearing function in everyday situations. The increased risk of loneliness and poor health indicates that one normally functioning ear is also insufficient to protect against the adverse psychosocial impacts of unilateral hearing impairment. This impact was still significant after controlling for various health-related factors and can lead to perception of poor health comparable to that with having medical problems contributing to life-threatening conditions such as heart disease. The findings suggest the need for effective interventions to address the hearing-related problems and their impact on well-being in people with unilateral hearing impairment.
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[article] 
inEar and hearing > Vol. 42, n°3 (Mai- Juin 2021) . - p. 531-546

Titre :	Refining Measurements of Power Absorbance in Newborns: Probe Fit and Intrasubject Variability
Type de document :	Article
Auteurs :	Hammam A. AlMakadma ; Beth A. Prieve
Année de publication :	2021
Article en page(s) :	p. 531-546
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Dépistage précoce de la surdité ; Nouveau-né ; Wideband absorbance (WBA) Autres descripteurs Absorbance ; Test retest
Résumé :	Objectives: Because unresolved debris in the ear canal or middle ear of newborns may produce high false positive rates on hearing screening tests, it has been suggested that an outer/middle ear measure can be included at the time of hearing screening. A potential measure is power absorbance (absorbance), which indicates the proportion of power in a broadband acoustic stimulus that is absorbed through the outer/middle ear. Although absorbance is sensitive to outer/middle dysfunction at birth, there is large variability that limits its accuracy. Acoustic leaks caused by poor probe fitting further exacerbate this issue. The objectives of this work were to: (1) develop criteria to indicate whether a change in absorbance occurs in association with probe fit; (2) describe the variability in absorbance due to poor fitting; and (3) evaluate test-retest variability with probe reinsertions, excluding poor fits. Design: An observational cross-sectional design was used to evaluate changes in absorbance due to probe fit and probe reinsertion. Repeated measurements were recorded in 50 newborns (98 ears) who passed TEOAE screenings and were Results: Based on the analysis of 12 moderate-strong correlations, the following criteria were adopted to identify measurements with poor fits: (1) impedance phase-based criterion (500 to 1000 Hz) > -0.11 cycles and (2) absorbance-based criterion (250 to 1000 Hz) > 0.58. Poor-fit measurements introduced statistically significant increases in absorbance up to 0.1 for 1000 to 6000 Hz, and up to 0.4 for frequencies Conclusions: Poor probe fits introduced the greatest inflation in absorbance for frequencies
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[article] Refining Measurements of Power Absorbance in Newborns: Probe Fit and Intrasubject Variability [Article] / Hammam A. AlMakadma ; Beth A. Prieve . - 2021 . - p. 531-546.
Langues : Anglais (eng)
in Ear and hearing > Vol. 42, n°3 (Mai- Juin 2021) . - p. 531-546

Descripteurs :	HE Vinci Dépistage précoce de la surdité ; Nouveau-né ; Wideband absorbance (WBA) Autres descripteurs Absorbance ; Test retest
Résumé :	Objectives: Because unresolved debris in the ear canal or middle ear of newborns may produce high false positive rates on hearing screening tests, it has been suggested that an outer/middle ear measure can be included at the time of hearing screening. A potential measure is power absorbance (absorbance), which indicates the proportion of power in a broadband acoustic stimulus that is absorbed through the outer/middle ear. Although absorbance is sensitive to outer/middle dysfunction at birth, there is large variability that limits its accuracy. Acoustic leaks caused by poor probe fitting further exacerbate this issue. The objectives of this work were to: (1) develop criteria to indicate whether a change in absorbance occurs in association with probe fit; (2) describe the variability in absorbance due to poor fitting; and (3) evaluate test-retest variability with probe reinsertions, excluding poor fits. Design: An observational cross-sectional design was used to evaluate changes in absorbance due to probe fit and probe reinsertion. Repeated measurements were recorded in 50 newborns (98 ears) who passed TEOAE screenings and were Results: Based on the analysis of 12 moderate-strong correlations, the following criteria were adopted to identify measurements with poor fits: (1) impedance phase-based criterion (500 to 1000 Hz) > -0.11 cycles and (2) absorbance-based criterion (250 to 1000 Hz) > 0.58. Poor-fit measurements introduced statistically significant increases in absorbance up to 0.1 for 1000 to 6000 Hz, and up to 0.4 for frequencies Conclusions: Poor probe fits introduced the greatest inflation in absorbance for frequencies
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[article] 
inEar and hearing > Vol. 42, n°3 (Mai- Juin 2021) . - p. 547-557

Titre :	Effects of Otosclerosis on Middle Ear Function Assessed With Wideband Absorbance and Absorbed Power
Type de document :	Article
Auteurs :	M. Patrick Feeney ; Douglas H. Keefe ; Lisa L. Hunter ; Dennis F. Fitzpatrick ; Daniel B. Putterman ; Angela C. Garinis
Année de publication :	2021
Article en page(s) :	p. 547-557
Langues :	Anglais (eng)
Descripteurs :	Autres descripteurs Absorbance ; Otosclerose ; Reflectance acoustique HE Vinci Oreille moyenne ; Tympanométrie ; Wideband absorbance (WBA)
Résumé :	Objective: Wideband absorbance and absorbed power were evaluated in a group of subjects with surgically confirmed otosclerosis (Oto group), mean age 51.6 years. This is the first use of absorbed power in the assessment of middle ear disorders. Results were compared with control data from two groups of adults, one with normal hearing (NH group) mean age of 31 years, and one that was age- and sex-matched with the Oto group and had sensorineural hearing loss (SNHL group). The goal was to assess group differences using absorbance and absorbed power, to determine test performance in detecting otosclerosis, and to evaluate preoperative and postoperative test results. Design: Audiometric and wideband tests were performed over frequencies up to 8 kHz. The three groups were compared on wideband tests using analysis of variance to assess group mean differences. Receiver operating characteristic (ROC) curve analysis was also used to assess test accuracy at classifying ears as belonging to the Oto or control groups using the area under the ROC curve (AUC). A longitudinal design was used to compare preoperative and postoperative results at 3 and 6 months. Results: There were significant mean differences in the wideband parameters between the Oto and control groups with generally lower absorbance and absorbed power for the Oto group at ambient and tympanometric peak pressure (TPP) depending on frequency. The SNHL group had more significant differences with the Oto group than did the NH group in the high frequencies for absorbed power at ambient pressure and tympanometric absorbed power at TPP, as well as for the tympanometric tails. The greatest accuracy for classifying ears as being in the Oto group or a control group was for absorbed power at ambient pressure at 0.71 kHz with an AUC of 0.81 comparing the Oto and NH groups. The greatest accuracy for an absorbance measure was for the comparison between the Oto and NH groups for the peak-to-negative tail condition with an AUC of 0.78. In contrast, the accuracy for classifying ears into the control or Oto groups for static acoustic admittance at 226 Hz was near chance performance, which is consistent with previous findings. There were significant mean differences between preoperative and postoperative tests for absorbance and absorbed power. Conclusions: Consistent with previous studies, wideband absorbance showed better sensitivity for detecting the effects of otosclerosis on middle ear function than static acoustic admittance at 226 Hz. This study showed that wideband absorbed power is similarly sensitive and may perform even better in some instances than absorbance at classifying ears as having otosclerosis. The use of a group that was age- and sex-matched to the Oto group generally resulted in greater differences between groups in the high frequencies for absorbed power, suggesting that age-related norms in adults may be useful for the wideband clinical applications. Absorbance and absorbed power appear useful for monitoring changes in middle ear function following surgery for otosclerosis.
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[article] Effects of Otosclerosis on Middle Ear Function Assessed With Wideband Absorbance and Absorbed Power [Article] / M. Patrick Feeney ; Douglas H. Keefe ; Lisa L. Hunter ; Dennis F. Fitzpatrick ; Daniel B. Putterman ; Angela C. Garinis . - 2021 . - p. 547-557.
Langues : Anglais (eng)
in Ear and hearing > Vol. 42, n°3 (Mai- Juin 2021) . - p. 547-557

Descripteurs :	Autres descripteurs Absorbance ; Otosclerose ; Reflectance acoustique HE Vinci Oreille moyenne ; Tympanométrie ; Wideband absorbance (WBA)
Résumé :	Objective: Wideband absorbance and absorbed power were evaluated in a group of subjects with surgically confirmed otosclerosis (Oto group), mean age 51.6 years. This is the first use of absorbed power in the assessment of middle ear disorders. Results were compared with control data from two groups of adults, one with normal hearing (NH group) mean age of 31 years, and one that was age- and sex-matched with the Oto group and had sensorineural hearing loss (SNHL group). The goal was to assess group differences using absorbance and absorbed power, to determine test performance in detecting otosclerosis, and to evaluate preoperative and postoperative test results. Design: Audiometric and wideband tests were performed over frequencies up to 8 kHz. The three groups were compared on wideband tests using analysis of variance to assess group mean differences. Receiver operating characteristic (ROC) curve analysis was also used to assess test accuracy at classifying ears as belonging to the Oto or control groups using the area under the ROC curve (AUC). A longitudinal design was used to compare preoperative and postoperative results at 3 and 6 months. Results: There were significant mean differences in the wideband parameters between the Oto and control groups with generally lower absorbance and absorbed power for the Oto group at ambient and tympanometric peak pressure (TPP) depending on frequency. The SNHL group had more significant differences with the Oto group than did the NH group in the high frequencies for absorbed power at ambient pressure and tympanometric absorbed power at TPP, as well as for the tympanometric tails. The greatest accuracy for classifying ears as being in the Oto group or a control group was for absorbed power at ambient pressure at 0.71 kHz with an AUC of 0.81 comparing the Oto and NH groups. The greatest accuracy for an absorbance measure was for the comparison between the Oto and NH groups for the peak-to-negative tail condition with an AUC of 0.78. In contrast, the accuracy for classifying ears into the control or Oto groups for static acoustic admittance at 226 Hz was near chance performance, which is consistent with previous findings. There were significant mean differences between preoperative and postoperative tests for absorbance and absorbed power. Conclusions: Consistent with previous studies, wideband absorbance showed better sensitivity for detecting the effects of otosclerosis on middle ear function than static acoustic admittance at 226 Hz. This study showed that wideband absorbed power is similarly sensitive and may perform even better in some instances than absorbance at classifying ears as having otosclerosis. The use of a group that was age- and sex-matched to the Oto group generally resulted in greater differences between groups in the high frequencies for absorbed power, suggesting that age-related norms in adults may be useful for the wideband clinical applications. Absorbance and absorbed power appear useful for monitoring changes in middle ear function following surgery for otosclerosis.
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[article] 
inEar and hearing > Vol. 42, n°3 (Mai- Juin 2021) . - p. 558-564

Titre :	Investigation of an Outcomes-Driven, Computer-Assisted Approach to CI Fitting in Newly Implanted Patients
Type de document :	Article
Auteurs :	Teresa A. Zwolan ; Regina Presley ; Laura Chenier ; Barbara Buck
Année de publication :	2021
Article en page(s) :	p. 558-564
Langues :	Anglais (eng)
Descripteurs :	HE Vinci FITTING OUTCOME EXPERT (FOX) ; Implants cochléaires ; Intelligence artificielle (IA)
Résumé :	Objective: To evaluate the efficacy of outcomes received by newly implanted cochlear implant recipients when an outcomes-driven, computer-assisted approach to cochlear implantation fitting was used. This approach, referred to as "Fitting to Outcome eXpert," or FOX, was developed by Otoconsult in Antwerp, Belgium. Design: Thirty-one newly implanted subjects participated in a nonrandomized, single-subject, repeated measures design that involved a within-subject comparison of preoperative and postoperative speech recognition scores. Sound processors for all subjects were programmed using the FOX software that utilized the evidence-based results of various psychoacoustic tests to adjust MAP parameters and improve performance. Additionally, mean word and sentence recognition scores obtained by the subjects programmed with FOX were compared to results obtained by newly implanted patients enrolled in the Nucleus CI532 clinical trial whose devices were programmed using traditional methods. Results: Subjects whose sound processors were programmed using FOX obtained a mean 6-month postactivation Consonant Nucleus Consonant word score of 60.2% correct. This represented an improvement of 46% age points when mean preactivation and postactivation scores were compared and represented a statistically significant change in score (p Conclusion: The results of this study support the use of an outcomes-driven, computer-assisted approach to supplement the management of newly implanted cochlear implant recipients. Subjects whose devices were programmed using such an approach demonstrated mean postoperative word in quiet and sentence in noise scores comparable to those obtained by subjects in the Nucleus CI532 clinical trial whose devices were programmed using traditional programming techniques. Use of this approach positively impacted patient care by reducing the number of postoperative visits needed to optimize sound processor programs, simplified patient testing via the use of direct streaming, and ensured that patients received consistent programming of their sound processor, regardless of the location where the programming was performed.
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[article] Investigation of an Outcomes-Driven, Computer-Assisted Approach to CI Fitting in Newly Implanted Patients [Article] / Teresa A. Zwolan ; Regina Presley ; Laura Chenier ; Barbara Buck . - 2021 . - p. 558-564.
Langues : Anglais (eng)
in Ear and hearing > Vol. 42, n°3 (Mai- Juin 2021) . - p. 558-564

Descripteurs :	HE Vinci FITTING OUTCOME EXPERT (FOX) ; Implants cochléaires ; Intelligence artificielle (IA)
Résumé :	Objective: To evaluate the efficacy of outcomes received by newly implanted cochlear implant recipients when an outcomes-driven, computer-assisted approach to cochlear implantation fitting was used. This approach, referred to as "Fitting to Outcome eXpert," or FOX, was developed by Otoconsult in Antwerp, Belgium. Design: Thirty-one newly implanted subjects participated in a nonrandomized, single-subject, repeated measures design that involved a within-subject comparison of preoperative and postoperative speech recognition scores. Sound processors for all subjects were programmed using the FOX software that utilized the evidence-based results of various psychoacoustic tests to adjust MAP parameters and improve performance. Additionally, mean word and sentence recognition scores obtained by the subjects programmed with FOX were compared to results obtained by newly implanted patients enrolled in the Nucleus CI532 clinical trial whose devices were programmed using traditional methods. Results: Subjects whose sound processors were programmed using FOX obtained a mean 6-month postactivation Consonant Nucleus Consonant word score of 60.2% correct. This represented an improvement of 46% age points when mean preactivation and postactivation scores were compared and represented a statistically significant change in score (p Conclusion: The results of this study support the use of an outcomes-driven, computer-assisted approach to supplement the management of newly implanted cochlear implant recipients. Subjects whose devices were programmed using such an approach demonstrated mean postoperative word in quiet and sentence in noise scores comparable to those obtained by subjects in the Nucleus CI532 clinical trial whose devices were programmed using traditional programming techniques. Use of this approach positively impacted patient care by reducing the number of postoperative visits needed to optimize sound processor programs, simplified patient testing via the use of direct streaming, and ensured that patients received consistent programming of their sound processor, regardless of the location where the programming was performed.
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[article] 
inEar and hearing > Vol. 42, n°3 (Mai- Juin 2021) . - p. 565-573

Titre :	Improved Sensitivity of Digits-in-Noise Test to High-Frequency Hearing Loss
Type de document :	Article
Auteurs :	Lina Motlagh Zadeha ; Noah H. Silbert ; De Wet Swanepoel ; David R. Moore
Année de publication :	2021
Article en page(s) :	p. 565-573
Langues :	Anglais (eng)
Descripteurs :	Autres descripteurs Filtre auditif HE Vinci Audiométrie haute fréquence ; Compréhension dans le bruit ; Dépistage précoce de la surdité ; Perception de la parole ; Seuil de réception de la parole (SRT)
Résumé :	Objectives: Hearing loss is most commonly observed at high frequencies. High-frequency hearing loss (HFHL) precedes and predicts hearing loss at lower frequencies. It was previously shown that an automated, self-administered digits-in-noise (DIN) test can be sensitized for detection of HFHL by low-pass filtering the speech-shaped masking noise at 1.5 kHz. This study was designed to investigate whether sensitivity of the DIN to HFHL can be enhanced further using low-pass noise filters with higher cutoff frequencies. Design: The US-English digits 0 to 9, homogenized for audibility, were binaurally presented in different noise maskers including one broadband and three low-pass (cutoff at 2, 4, and 8 kHz) filtered speech-shaped noises. DIN-speech reception thresholds (SRTs) were obtained from 60 normal hearing (NH), and 40 mildly hearing impaired listeners with bilateral symmetric sensorineural hearing loss. Standard and extended high-frequency audiometric pure-tone averages (PTAs) were compared with the DIN-SRTs. Results: Narrower masking noise bandwidth generally produced better (more sensitive) mean DIN-SRTs. There were strong and significant correlations between SRT and PTA in the hearing impaired group. Lower frequency PTALF 0.5,1, 2, 4 kHz had the highest correlation and the steepest slope with SRTs obtained from the 2-kHz filter. Higher frequency PTAHF 4,8,10,12.5 kHz correlated best with SRTs obtained from 4- and 8-kHz filtered noise. The 4-kHz low-pass filter also had the highest sensitivity (92%) and equally highest (with the 8-kHz filter) specificity (90%) for detecting an average PTAHF of 20 dB or more. Conclusions: Of the filters used, DIN sensitivity to higher frequency hearing loss was greatest using the 4-kHz low-pass filter. These results suggest that low-pass filtered noise may be usefully substituted for broadband noise to improve earlier detection of HFHL using DIN.
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[article] Improved Sensitivity of Digits-in-Noise Test to High-Frequency Hearing Loss [Article] / Lina Motlagh Zadeha ; Noah H. Silbert ; De Wet Swanepoel ; David R. Moore . - 2021 . - p. 565-573.
Langues : Anglais (eng)
in Ear and hearing > Vol. 42, n°3 (Mai- Juin 2021) . - p. 565-573

Descripteurs :	Autres descripteurs Filtre auditif HE Vinci Audiométrie haute fréquence ; Compréhension dans le bruit ; Dépistage précoce de la surdité ; Perception de la parole ; Seuil de réception de la parole (SRT)
Résumé :	Objectives: Hearing loss is most commonly observed at high frequencies. High-frequency hearing loss (HFHL) precedes and predicts hearing loss at lower frequencies. It was previously shown that an automated, self-administered digits-in-noise (DIN) test can be sensitized for detection of HFHL by low-pass filtering the speech-shaped masking noise at 1.5 kHz. This study was designed to investigate whether sensitivity of the DIN to HFHL can be enhanced further using low-pass noise filters with higher cutoff frequencies. Design: The US-English digits 0 to 9, homogenized for audibility, were binaurally presented in different noise maskers including one broadband and three low-pass (cutoff at 2, 4, and 8 kHz) filtered speech-shaped noises. DIN-speech reception thresholds (SRTs) were obtained from 60 normal hearing (NH), and 40 mildly hearing impaired listeners with bilateral symmetric sensorineural hearing loss. Standard and extended high-frequency audiometric pure-tone averages (PTAs) were compared with the DIN-SRTs. Results: Narrower masking noise bandwidth generally produced better (more sensitive) mean DIN-SRTs. There were strong and significant correlations between SRT and PTA in the hearing impaired group. Lower frequency PTALF 0.5,1, 2, 4 kHz had the highest correlation and the steepest slope with SRTs obtained from the 2-kHz filter. Higher frequency PTAHF 4,8,10,12.5 kHz correlated best with SRTs obtained from 4- and 8-kHz filtered noise. The 4-kHz low-pass filter also had the highest sensitivity (92%) and equally highest (with the 8-kHz filter) specificity (90%) for detecting an average PTAHF of 20 dB or more. Conclusions: Of the filters used, DIN sensitivity to higher frequency hearing loss was greatest using the 4-kHz low-pass filter. These results suggest that low-pass filtered noise may be usefully substituted for broadband noise to improve earlier detection of HFHL using DIN.
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[article] 
inEar and hearing > Vol. 42, n°3 (Mai- Juin 2021) . - p. 574-583

Titre :	Efficient Detection of Cortical Auditory Evoked Potentials in Adults Using Bootstrapped Methods
Type de document :	Article
Auteurs :	Michael Alexander Chesnaye ; Lisbeth Birkelund Simonsen ; James M. Harte ; Anisa S. Visram ; Steven Lewis Bell ; Michael A. Stone ; Kevin J. Munro ; David Martin Simpson
Année de publication :	2021
Article en page(s) :	p. 574-583
Langues :	Anglais (eng)
Descripteurs :	Autres descripteurs Amorcage auditif ; Depistage auditif HE Vinci Potentiel évoqué cortical sonore (CAEP)
Résumé :	Background: Statistical detection methods are useful tools for assisting clinicians with cortical auditory evoked potential (CAEP) detection, and can help improve the overall efficiency and reliability of the test. However, many of these detection methods rely on parametric distributions when evaluating test significance, and thus make various assumptions regarding the electroencephalogram (EEG) data. When these assumptions are violated, reduced test sensitivities and/or increased or decreased false-positive rates can be expected. As an alternative to the parametric approach, test significance can be evaluated using a bootstrap, which does not require some of the aforementioned assumptions. Bootstrapping also permits a large amount of freedom when choosing or designing the statistical test for response detection, as the distributions underlying the test statistic no longer need to be known prior to the test. Objectives: To improve the reliability and efficiency of CAEP-related applications by improving the specificity and sensitivity of objective CAEP detection methods. Design: The methods included in the assessment were Hotelling's T2 test, the Fmp, four modified q-sample statistics, and various template-based detection methods (calculated between the ensemble coherent average and some predefined template), including the correlation coefficient, covariance, and dynamic time-warping (DTW). The assessment was carried out using both simulations and a CAEP threshold series collected from 23 adults with normal hearing. Results: The most sensitive method was DTW, evaluated using the bootstrap, with maximum increases in test sensitivity (relative to the conventional Hotelling's T2 test) of up to 30%. An important factor underlying the performance of DTW is that the template adopted for the analysis correlates well with the subjects' CAEP. Conclusion: When subjects' CAEP morphology is approximately known before the test, then the DTW algorithm provides a highly sensitive method for CAEP detection.
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[article] Efficient Detection of Cortical Auditory Evoked Potentials in Adults Using Bootstrapped Methods [Article] / Michael Alexander Chesnaye ; Lisbeth Birkelund Simonsen ; James M. Harte ; Anisa S. Visram ; Steven Lewis Bell ; Michael A. Stone ; Kevin J. Munro ; David Martin Simpson . - 2021 . - p. 574-583.
Langues : Anglais (eng)
in Ear and hearing > Vol. 42, n°3 (Mai- Juin 2021) . - p. 574-583

Descripteurs :	Autres descripteurs Amorcage auditif ; Depistage auditif HE Vinci Potentiel évoqué cortical sonore (CAEP)
Résumé :	Background: Statistical detection methods are useful tools for assisting clinicians with cortical auditory evoked potential (CAEP) detection, and can help improve the overall efficiency and reliability of the test. However, many of these detection methods rely on parametric distributions when evaluating test significance, and thus make various assumptions regarding the electroencephalogram (EEG) data. When these assumptions are violated, reduced test sensitivities and/or increased or decreased false-positive rates can be expected. As an alternative to the parametric approach, test significance can be evaluated using a bootstrap, which does not require some of the aforementioned assumptions. Bootstrapping also permits a large amount of freedom when choosing or designing the statistical test for response detection, as the distributions underlying the test statistic no longer need to be known prior to the test. Objectives: To improve the reliability and efficiency of CAEP-related applications by improving the specificity and sensitivity of objective CAEP detection methods. Design: The methods included in the assessment were Hotelling's T2 test, the Fmp, four modified q-sample statistics, and various template-based detection methods (calculated between the ensemble coherent average and some predefined template), including the correlation coefficient, covariance, and dynamic time-warping (DTW). The assessment was carried out using both simulations and a CAEP threshold series collected from 23 adults with normal hearing. Results: The most sensitive method was DTW, evaluated using the bootstrap, with maximum increases in test sensitivity (relative to the conventional Hotelling's T2 test) of up to 30%. An important factor underlying the performance of DTW is that the template adopted for the analysis correlates well with the subjects' CAEP. Conclusion: When subjects' CAEP morphology is approximately known before the test, then the DTW algorithm provides a highly sensitive method for CAEP detection.
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[article] 
inEar and hearing > Vol. 42, n°3 (Mai- Juin 2021) . - p. 584-595

Titre :	Slower Speaking Rate Reduces Listening Effort Among Listeners With Cochlear Implants
Type de document :	Article
Auteurs :	Matthew B. Winn ; Katherine H. Teece
Année de publication :	2021
Article en page(s) :	p. 584-595
Langues :	Anglais (eng)
Descripteurs :	Autres descripteurs Rythme de la parole HE Vinci Effort d'écoute ; Implants cochléaires ; Perception de la parole
Résumé :	Objectives: Slowed speaking rate was examined for its effects on speech intelligibility, its interaction with the benefit of contextual cues, and the impact of these factors on listening effort in adults with cochlear implants. Design: Participants (n = 21 cochlear implant users) heard high- and low-context sentences that were played at the original speaking rate, as well as a slowed (1.4x duration) speaking rate, using uniform pitch-synchronous time warping. In addition to intelligibility measures, changes in pupil dilation were measured as a time-varying index of processing load or listening effort. Slope of pupil size recovery to baseline after the sentence was used as an index of resolution of perceptual ambiguity. Results: Speech intelligibility was better for high-context compared to low-context sentences and slightly better for slower compared to original-rate speech. Speech rate did not affect magnitude and latency of peak pupil dilation relative to sentence offset. However, baseline pupil size recovered more substantially for slower-rate sentences, suggesting easier processing in the moment after the sentence was over. The effect of slowing speech rate was comparable to changing a sentence from low context to high context. The effect of context on pupil dilation was not observed until after the sentence was over, and one of two analyses suggested that context had greater beneficial effects on listening effort when the speaking rate was slower. These patterns maintained even at perfect sentence intelligibility, suggesting that correct speech repetition does not guarantee efficient or effortless processing. With slower speaking rates, there was less variability in pupil dilation slopes following the sentence, implying mitigation of some of the difficulties shown by individual listeners who would otherwise demonstrate prolonged effort after a sentence is heard. Conclusions: Slowed speaking rate provides release from listening effort when hearing an utterance, particularly relieving effort that would have lingered after a sentence is over. Context arguably provides even more release from listening effort when speaking rate is slower. The pattern of prolonged pupil dilation for faster speech is consistent with increased need to mentally correct errors, although that exact interpretation cannot be verified with intelligibility data alone or with pupil data alone. A pattern of needing to dwell on a sentence to disambiguate misperceptions likely contributes to difficulty in running conversation where there are few opportunities to pause and resolve recently heard utterances.
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[article] Slower Speaking Rate Reduces Listening Effort Among Listeners With Cochlear Implants [Article] / Matthew B. Winn ; Katherine H. Teece . - 2021 . - p. 584-595.
Langues : Anglais (eng)
in Ear and hearing > Vol. 42, n°3 (Mai- Juin 2021) . - p. 584-595

Descripteurs :	Autres descripteurs Rythme de la parole HE Vinci Effort d'écoute ; Implants cochléaires ; Perception de la parole
Résumé :	Objectives: Slowed speaking rate was examined for its effects on speech intelligibility, its interaction with the benefit of contextual cues, and the impact of these factors on listening effort in adults with cochlear implants. Design: Participants (n = 21 cochlear implant users) heard high- and low-context sentences that were played at the original speaking rate, as well as a slowed (1.4x duration) speaking rate, using uniform pitch-synchronous time warping. In addition to intelligibility measures, changes in pupil dilation were measured as a time-varying index of processing load or listening effort. Slope of pupil size recovery to baseline after the sentence was used as an index of resolution of perceptual ambiguity. Results: Speech intelligibility was better for high-context compared to low-context sentences and slightly better for slower compared to original-rate speech. Speech rate did not affect magnitude and latency of peak pupil dilation relative to sentence offset. However, baseline pupil size recovered more substantially for slower-rate sentences, suggesting easier processing in the moment after the sentence was over. The effect of slowing speech rate was comparable to changing a sentence from low context to high context. The effect of context on pupil dilation was not observed until after the sentence was over, and one of two analyses suggested that context had greater beneficial effects on listening effort when the speaking rate was slower. These patterns maintained even at perfect sentence intelligibility, suggesting that correct speech repetition does not guarantee efficient or effortless processing. With slower speaking rates, there was less variability in pupil dilation slopes following the sentence, implying mitigation of some of the difficulties shown by individual listeners who would otherwise demonstrate prolonged effort after a sentence is heard. Conclusions: Slowed speaking rate provides release from listening effort when hearing an utterance, particularly relieving effort that would have lingered after a sentence is over. Context arguably provides even more release from listening effort when speaking rate is slower. The pattern of prolonged pupil dilation for faster speech is consistent with increased need to mentally correct errors, although that exact interpretation cannot be verified with intelligibility data alone or with pupil data alone. A pattern of needing to dwell on a sentence to disambiguate misperceptions likely contributes to difficulty in running conversation where there are few opportunities to pause and resolve recently heard utterances.
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[article] 
inEar and hearing > Vol. 42, n°3 (Mai- Juin 2021) . - p. 596-605

Titre :	Comparison of Bone-Conducted Cervical VEMPs Elicited by B71 and B81 Bone Vibrators
Type de document :	Article
Auteurs :	Daniel J. Romero ; Erin G. Piker ; Andrew P. Thorne ; Christopher G. Clinard
Année de publication :	2021
Article en page(s) :	p. 596-605
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Conduction osseuse ; Electromyographie ; Potentiels évoqués myogéniques vestibulaires (oVEMP) (cVEMP) ; Vibration
Résumé :	Objective: A variety of stimulus delivery methods can elicit vestibular evoked myogenic potentials (VEMPs). The current study compared bone conduction (BC) cervical VEMPs (cVEMPs) across two different clinical bone vibrators. It was hypothesized that the B81 transducer would be more effective for producing larger BC-cVEMP peak to peak amplitudes due to its low-frequency advantages in pure-tone audiometry applications. Design: Twenty young adults under the age of 40 years with no reported history of hearing or balance disorders participated in the study. BC cVEMPs were elicited using two clinical bone transducers: the Radioear B71 bone vibrator and the Radioear B81 bone vibrator. Both transducers were calibrated using the acoustic method of calibration before data collection, and the linear dynamic range of the transducers was determined. Participants were asked to sit and match a fixed electromyography (EMG) target level of 100 [micro]V, while BC cVEMPs were recorded using stimulus frequencies of 250, 500, and 750 Hz. Results: Statistically significant differences in raw amplitude at 250 and 750 Hz between the B71 and B81 were observed; the B71 produced larger peak to peak amplitudes over the B81. At 500 Hz, larger amplitudes were observed with the B71, but results were not statistically significant. The B71 produced significantly lower cVEMP thresholds at all three frequencies. Across both transducers, 500 Hz produced the largest peak to peak amplitude compared with 250 and 750 Hz. Peak to peak amplitude did not increase above 55 dB nHL for 250 and 500 Hz, but amplitude continued to increase at 750 Hz. Discussion: The present study found statistically significant differences in BC-cVEMP amplitude and threshold between the B71 and B81, but results were not what we hypothesized. In general, the B71 elicited larger BC-cVEMP amplitudes and lower thresholds compared with the B81. Additionally, 500 Hz was found to be the best frequency for both BC transducers, contrasting previous studies suggesting lower frequencies yield larger BC-cVEMP amplitudes. It is possible that these average differences could also be clinically significant when looking at individual amplitude differences. Larger peak to peak amplitudes at 500 Hz may be partially due to the underlying physical levels used in the current study, as well as the output spectra of the transducers, and may explain the larger response amplitudes observed at 500 Hz compared with 250 Hz.
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[article] Comparison of Bone-Conducted Cervical VEMPs Elicited by B71 and B81 Bone Vibrators [Article] / Daniel J. Romero ; Erin G. Piker ; Andrew P. Thorne ; Christopher G. Clinard . - 2021 . - p. 596-605.
Langues : Anglais (eng)
in Ear and hearing > Vol. 42, n°3 (Mai- Juin 2021) . - p. 596-605

Descripteurs :	HE Vinci Conduction osseuse ; Electromyographie ; Potentiels évoqués myogéniques vestibulaires (oVEMP) (cVEMP) ; Vibration
Résumé :	Objective: A variety of stimulus delivery methods can elicit vestibular evoked myogenic potentials (VEMPs). The current study compared bone conduction (BC) cervical VEMPs (cVEMPs) across two different clinical bone vibrators. It was hypothesized that the B81 transducer would be more effective for producing larger BC-cVEMP peak to peak amplitudes due to its low-frequency advantages in pure-tone audiometry applications. Design: Twenty young adults under the age of 40 years with no reported history of hearing or balance disorders participated in the study. BC cVEMPs were elicited using two clinical bone transducers: the Radioear B71 bone vibrator and the Radioear B81 bone vibrator. Both transducers were calibrated using the acoustic method of calibration before data collection, and the linear dynamic range of the transducers was determined. Participants were asked to sit and match a fixed electromyography (EMG) target level of 100 [micro]V, while BC cVEMPs were recorded using stimulus frequencies of 250, 500, and 750 Hz. Results: Statistically significant differences in raw amplitude at 250 and 750 Hz between the B71 and B81 were observed; the B71 produced larger peak to peak amplitudes over the B81. At 500 Hz, larger amplitudes were observed with the B71, but results were not statistically significant. The B71 produced significantly lower cVEMP thresholds at all three frequencies. Across both transducers, 500 Hz produced the largest peak to peak amplitude compared with 250 and 750 Hz. Peak to peak amplitude did not increase above 55 dB nHL for 250 and 500 Hz, but amplitude continued to increase at 750 Hz. Discussion: The present study found statistically significant differences in BC-cVEMP amplitude and threshold between the B71 and B81, but results were not what we hypothesized. In general, the B71 elicited larger BC-cVEMP amplitudes and lower thresholds compared with the B81. Additionally, 500 Hz was found to be the best frequency for both BC transducers, contrasting previous studies suggesting lower frequencies yield larger BC-cVEMP amplitudes. It is possible that these average differences could also be clinically significant when looking at individual amplitude differences. Larger peak to peak amplitudes at 500 Hz may be partially due to the underlying physical levels used in the current study, as well as the output spectra of the transducers, and may explain the larger response amplitudes observed at 500 Hz compared with 250 Hz.
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[article] 
inEar and hearing > Vol. 42, n°3 (Mai- Juin 2021) . - p. 606-614

Titre :	Cognitive Improvement After Cochlear Implantation in Older Adults With Severe or Profound Hearing Impairment: A Prospective, Longitudinal, Controlled, Multicenter Study
Type de document :	Article
Auteurs :	Griet Mertens ; Ellen Andries ; Annes J. Claes ; Vedat Topsakal ; et al.
Année de publication :	2021
Article en page(s) :	p. 606-614
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Implants cochléaires ; Perte d'audition ; Repeatable Battery for the Assessment of Neuropsychological Status for Hearing (RBANS-H) ; Sujet âgé
Résumé :	Objective: To compare the cognitive evolution of older adults with severe or profound hearing impairment after cochlear implantation with that of a matched group of older adults with severe hearing impairment who do not receive a cochlear implant (CI). Design: In this prospective, longitudinal, controlled, and multicenter study, 24 older CI users were included in the intervention group and 24 adults without a CI in the control group. The control group matched the intervention group in terms of gender, age, formal education, cognitive functioning, and residual hearing. Assessments were made at baseline and 14 months later. Primary outcome measurements included the change in the total score on the Repeatable Battery for the Assessment of Neuropsychological Status for Hearing impaired individuals score and on its subdomain score to assess cognitive evolution in both groups. Secondary outcome measurements included self-reported changes in sound quality (Hearing Implant Sound Quality Index), self-perceived hearing disability (Speech, Spatial, and Qualities of Hearing Scale), states of anxiety and depression (Hospital Anxiety and Depression Scale), and level of negative affectivity and social inhibition (Type D questionnaire). Results: Improvements of the overall cognitive functioning (p = 0.05) and the subdomain "Attention" (p = 0.02) were observed after cochlear implantation in the intervention group; their scores were compared to the corresponding scores in the control group. Significant positive effects of cochlear implantation on sound quality and self-perceived hearing outcomes were found in the intervention group. Notably, 20% fewer traits of Type D personalities were measured in the intervention group after cochlear implantation. In the control group, traits of Type D personalities increased by 13%. Conclusion: Intervention with a CI improved cognitive functioning (domain Attention in particular) in older adults with severe hearing impairment compared to that of the matched controls with hearing impairment without a CI. However, older CI users did not, in terms of cognition, bridge the performance gap with adults with normal hearing after 1 year of CI use. The fact that experienced, older CI users still present subnormal cognitive functioning may highlight the need for additional cognitive rehabilitation in the long term after implantation.
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[article] Cognitive Improvement After Cochlear Implantation in Older Adults With Severe or Profound Hearing Impairment: A Prospective, Longitudinal, Controlled, Multicenter Study [Article] / Griet Mertens ; Ellen Andries ; Annes J. Claes ; Vedat Topsakal ; et al. . - 2021 . - p. 606-614.
Langues : Anglais (eng)
in Ear and hearing > Vol. 42, n°3 (Mai- Juin 2021) . - p. 606-614

Descripteurs :	HE Vinci Implants cochléaires ; Perte d'audition ; Repeatable Battery for the Assessment of Neuropsychological Status for Hearing (RBANS-H) ; Sujet âgé
Résumé :	Objective: To compare the cognitive evolution of older adults with severe or profound hearing impairment after cochlear implantation with that of a matched group of older adults with severe hearing impairment who do not receive a cochlear implant (CI). Design: In this prospective, longitudinal, controlled, and multicenter study, 24 older CI users were included in the intervention group and 24 adults without a CI in the control group. The control group matched the intervention group in terms of gender, age, formal education, cognitive functioning, and residual hearing. Assessments were made at baseline and 14 months later. Primary outcome measurements included the change in the total score on the Repeatable Battery for the Assessment of Neuropsychological Status for Hearing impaired individuals score and on its subdomain score to assess cognitive evolution in both groups. Secondary outcome measurements included self-reported changes in sound quality (Hearing Implant Sound Quality Index), self-perceived hearing disability (Speech, Spatial, and Qualities of Hearing Scale), states of anxiety and depression (Hospital Anxiety and Depression Scale), and level of negative affectivity and social inhibition (Type D questionnaire). Results: Improvements of the overall cognitive functioning (p = 0.05) and the subdomain "Attention" (p = 0.02) were observed after cochlear implantation in the intervention group; their scores were compared to the corresponding scores in the control group. Significant positive effects of cochlear implantation on sound quality and self-perceived hearing outcomes were found in the intervention group. Notably, 20% fewer traits of Type D personalities were measured in the intervention group after cochlear implantation. In the control group, traits of Type D personalities increased by 13%. Conclusion: Intervention with a CI improved cognitive functioning (domain Attention in particular) in older adults with severe hearing impairment compared to that of the matched controls with hearing impairment without a CI. However, older CI users did not, in terms of cognition, bridge the performance gap with adults with normal hearing after 1 year of CI use. The fact that experienced, older CI users still present subnormal cognitive functioning may highlight the need for additional cognitive rehabilitation in the long term after implantation.
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[article] 
inEar and hearing > Vol. 42, n°3 (Mai- Juin 2021) . - p. 615-628

Titre :	The Cost of Intrinsic and Extrinsic Cognitive Demands on Auditory Functioning in Older Adults With Normal Hearing or Using Hearing Aids
Type de document :	Article
Auteurs :	Annelies Devesse ; Astrid van Wieringen ; Jan Wouters
Année de publication :	2021
Article en page(s) :	p. 615-628
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Aides auditives ; Capacité cognitive ; Effort d'écoute ; Sujet âgé
Résumé :	Objectives: We investigated the impact of both intrinsic and extrinsic cognitive demands on auditory and secondary task performance in older adults with normal hearing (NH) and adults using hearing aids (HAs) in an ecologically relevant listening environment. Design: Fifteen adults with NH and 15 adults using HAs (60 to 72 years of age) were recruited to perform the "Audiovisual True-to-Life Assessment of Auditory Rehabilitation"-paradigm (AVATAR), which combines an auditory-visual speech-in-noise task with three secondary tasks on either auditory localization or visual short-term memory in a preload multitask paradigm. Intrinsic demands were altered by presenting speech either at equivalent speech accuracy levels of 50% correct (SPIN50%) or equivalent speech-to-noise ratios of +5dB SNR (SPIN+5dB). We manipulated the amount of extrinsic cognitive demands by including one (dual condition) or three secondary tasks (quadruple condition). Performance decrements on the secondary tasks were considered to reflect an increase in resource allocation to speech understanding and thus an increase in listening effort. In addition, we administered a cognitive test battery as well as a questionnaire on self-reported hearing difficulties and subjective measures of effort and motivation. Results: Speech understanding and secondary task performance on the visual short-term memory task were lower in the SPIN50% condition compared to SPIN+5dB. Whereas speech understanding at SPIN50% was equally high in the dual and quadruple conditions, the quadruple condition resulted in lower secondary task performance on the visual short-term memory task, higher levels of self-reported effort, and lower motivation compared to the dual-task condition. The same was true for experimental conditions at SPIN+5dB. Additionally, adults with NH outperformed adults using HAs on speech understanding, auditory localization, and self-reported hearing abilities, but no group differences were observed on secondary task costs or cognitive measures. Conclusions: This study showed that, irrespective of the hearing status of the listener, speech performance was not affected by the amount of extrinsic cognitive demands, but was worse and required more effort under conditions with a more negative SNR. Also, increasing the extrinsic cognitive demands resulted in lower performance on one of the secondary tasks, suggesting that more complex listening environments require more effort. Although adults with NH outperformed HA users on speech understanding and auditory localization, the two groups did not differ with respect to secondary task costs.
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[article] The Cost of Intrinsic and Extrinsic Cognitive Demands on Auditory Functioning in Older Adults With Normal Hearing or Using Hearing Aids [Article] / Annelies Devesse ; Astrid van Wieringen ; Jan Wouters . - 2021 . - p. 615-628.
Langues : Anglais (eng)
in Ear and hearing > Vol. 42, n°3 (Mai- Juin 2021) . - p. 615-628

Descripteurs :	HE Vinci Aides auditives ; Capacité cognitive ; Effort d'écoute ; Sujet âgé
Résumé :	Objectives: We investigated the impact of both intrinsic and extrinsic cognitive demands on auditory and secondary task performance in older adults with normal hearing (NH) and adults using hearing aids (HAs) in an ecologically relevant listening environment. Design: Fifteen adults with NH and 15 adults using HAs (60 to 72 years of age) were recruited to perform the "Audiovisual True-to-Life Assessment of Auditory Rehabilitation"-paradigm (AVATAR), which combines an auditory-visual speech-in-noise task with three secondary tasks on either auditory localization or visual short-term memory in a preload multitask paradigm. Intrinsic demands were altered by presenting speech either at equivalent speech accuracy levels of 50% correct (SPIN50%) or equivalent speech-to-noise ratios of +5dB SNR (SPIN+5dB). We manipulated the amount of extrinsic cognitive demands by including one (dual condition) or three secondary tasks (quadruple condition). Performance decrements on the secondary tasks were considered to reflect an increase in resource allocation to speech understanding and thus an increase in listening effort. In addition, we administered a cognitive test battery as well as a questionnaire on self-reported hearing difficulties and subjective measures of effort and motivation. Results: Speech understanding and secondary task performance on the visual short-term memory task were lower in the SPIN50% condition compared to SPIN+5dB. Whereas speech understanding at SPIN50% was equally high in the dual and quadruple conditions, the quadruple condition resulted in lower secondary task performance on the visual short-term memory task, higher levels of self-reported effort, and lower motivation compared to the dual-task condition. The same was true for experimental conditions at SPIN+5dB. Additionally, adults with NH outperformed adults using HAs on speech understanding, auditory localization, and self-reported hearing abilities, but no group differences were observed on secondary task costs or cognitive measures. Conclusions: This study showed that, irrespective of the hearing status of the listener, speech performance was not affected by the amount of extrinsic cognitive demands, but was worse and required more effort under conditions with a more negative SNR. Also, increasing the extrinsic cognitive demands resulted in lower performance on one of the secondary tasks, suggesting that more complex listening environments require more effort. Although adults with NH outperformed HA users on speech understanding and auditory localization, the two groups did not differ with respect to secondary task costs.
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[article] 
inEar and hearing > Vol. 42, n°3 (Mai- Juin 2021) . - p. 629-643

Titre :	Normative Study of the Binaural Interaction Component of the Human Auditory Brainstem Response as a Function of Interaural Time Differences
Type de document :	Article
Auteurs :	Carol Sammeth ; Nathaniel T. Greene ; Andrew D. Brown ; Daniel Tollin
Année de publication :	2021
Article en page(s) :	p. 629-643
Langues :	Anglais (eng)
Descripteurs :	Autres descripteurs Difference interauriculaire HE Vinci Intégration binaurale ; Potentiels évoqués auditifs du tronc cérébral (ABR)
Résumé :	Objectives: The binaural interaction component (BIC) of the auditory brainstem response (ABR) is obtained by subtracting the sum of the monaural right and left ear ABRs from the binaurally evoked ABR. The result is a small but prominent negative peak (herein called "DN1"), indicating a smaller binaural than summed ABR, which occurs around the latency of wave V or its roll-off slope. The BIC has been proposed to have diagnostic value as a biomarker of binaural processing abilities; however, there have been conflicting reports regarding the reliability of BIC measures in human subjects. The objectives of the current study were to: (1) examine prevalence of BIC across a large group of normal-hearing young adults; (2) determine effects of interaural time differences (ITDs) on BIC; and (3) examine any relationship between BIC and behavioral ITD discrimination acuity. Design: Subjects were 40 normal-hearing adults (20 males and 20 females), aged 21 to 48 years, with no history of otologic or neurologic disorders. Midline ABRs were recorded from electrodes at high forehead (Fz) referenced to the nape of the neck (near the seventh cervical vertebra), with Fpz (low forehead) as the ground. ABRs were also recorded with a conventional earlobe reference for comparison to midline results. Stimuli were 90 dB peSPL biphasic clicks. For BIC measurements, stimuli were presented in a block as interleaved right monaural, left monaural, and binaural stimuli with 2000+ presentations per condition. Four measurements were averaged for a total of 8000+ stimuli per analyzed waveform. BIC was measured for ITD = 0 (simultaneous bilateral) and for ITDs of +/-500 and +/-750 [micro]s. Subjects separately performed a lateralization task, using the same stimuli, to determine ITD discrimination thresholds. Results: An identifiable BIC DN1 was obtained in 39 of 40 subjects at ITD = 0 [micro]s in at least one of two measurement sessions, but was seen in lesser numbers of subjects in a single session or as ITD increased. BIC was most often seen when a subject was relaxed or sleeping, and less often when they fidgeted or reported neck tension, suggesting myogenic activity as a possible factor in disrupting BIC measurements. Mean BIC latencies systematically increased with increasing ITD, and mean BIC amplitudes tended to decrease. However, across subjects, there was no significant relationship between the amplitude or latency of the BIC and behavioral ITD thresholds. Conclusions: Consistent with previous studies, measurement of the BIC was time consuming and a BIC was sometimes difficult to obtain in awake normal-hearing subjects. The BIC will thus continue to be of limited clinical utility unless stimulus parameters and measurement techniques can be identified that produce a more robust response. Nonetheless, modulation of BIC characteristics by ITD supports the concept that the ABR BIC indexes aspects of binaural brainstem processing and thus may prove useful in selected research applications, e.g. in the examination of populations expected to have aberrant binaural signal processing ability.
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[article] Normative Study of the Binaural Interaction Component of the Human Auditory Brainstem Response as a Function of Interaural Time Differences [Article] / Carol Sammeth ; Nathaniel T. Greene ; Andrew D. Brown ; Daniel Tollin . - 2021 . - p. 629-643.
Langues : Anglais (eng)
in Ear and hearing > Vol. 42, n°3 (Mai- Juin 2021) . - p. 629-643

Descripteurs :	Autres descripteurs Difference interauriculaire HE Vinci Intégration binaurale ; Potentiels évoqués auditifs du tronc cérébral (ABR)
Résumé :	Objectives: The binaural interaction component (BIC) of the auditory brainstem response (ABR) is obtained by subtracting the sum of the monaural right and left ear ABRs from the binaurally evoked ABR. The result is a small but prominent negative peak (herein called "DN1"), indicating a smaller binaural than summed ABR, which occurs around the latency of wave V or its roll-off slope. The BIC has been proposed to have diagnostic value as a biomarker of binaural processing abilities; however, there have been conflicting reports regarding the reliability of BIC measures in human subjects. The objectives of the current study were to: (1) examine prevalence of BIC across a large group of normal-hearing young adults; (2) determine effects of interaural time differences (ITDs) on BIC; and (3) examine any relationship between BIC and behavioral ITD discrimination acuity. Design: Subjects were 40 normal-hearing adults (20 males and 20 females), aged 21 to 48 years, with no history of otologic or neurologic disorders. Midline ABRs were recorded from electrodes at high forehead (Fz) referenced to the nape of the neck (near the seventh cervical vertebra), with Fpz (low forehead) as the ground. ABRs were also recorded with a conventional earlobe reference for comparison to midline results. Stimuli were 90 dB peSPL biphasic clicks. For BIC measurements, stimuli were presented in a block as interleaved right monaural, left monaural, and binaural stimuli with 2000+ presentations per condition. Four measurements were averaged for a total of 8000+ stimuli per analyzed waveform. BIC was measured for ITD = 0 (simultaneous bilateral) and for ITDs of +/-500 and +/-750 [micro]s. Subjects separately performed a lateralization task, using the same stimuli, to determine ITD discrimination thresholds. Results: An identifiable BIC DN1 was obtained in 39 of 40 subjects at ITD = 0 [micro]s in at least one of two measurement sessions, but was seen in lesser numbers of subjects in a single session or as ITD increased. BIC was most often seen when a subject was relaxed or sleeping, and less often when they fidgeted or reported neck tension, suggesting myogenic activity as a possible factor in disrupting BIC measurements. Mean BIC latencies systematically increased with increasing ITD, and mean BIC amplitudes tended to decrease. However, across subjects, there was no significant relationship between the amplitude or latency of the BIC and behavioral ITD thresholds. Conclusions: Consistent with previous studies, measurement of the BIC was time consuming and a BIC was sometimes difficult to obtain in awake normal-hearing subjects. The BIC will thus continue to be of limited clinical utility unless stimulus parameters and measurement techniques can be identified that produce a more robust response. Nonetheless, modulation of BIC characteristics by ITD supports the concept that the ABR BIC indexes aspects of binaural brainstem processing and thus may prove useful in selected research applications, e.g. in the examination of populations expected to have aberrant binaural signal processing ability.
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[article] 
inEar and hearing > Vol. 42, n°3 (Mai- Juin 2021) . - p. 644-653

Titre :	Natural Course of Residual Hearing with Reference to GJB2 and SLC26A4 Genotypes: Clinical Implications for Hearing Rehabilitation
Type de document :	Article
Auteurs :	Sang-Yeon Lee ; Seung Cheol Han ; Jin Hee Han ; Min Young Kim ; et al.
Année de publication :	2021
Article en page(s) :	p. 644-653
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Gènes Autres descripteurs Audition residuelle
Résumé :	Background: Understanding the characteristics of residual hearing at low frequencies and its natural course in relation to molecular genetic etiology may be important in developing rehabilitation strategies. Thus, we aimed to explore the characteristics and natural course of residual hearing at low frequencies associated with the two most frequent deafness genes: GJB2 and SLC26A4. Methods: Initially, 53 GJB2 and 65 SLC26A4 subjects were enrolled, respectively. Only those whose audiograms exhibited hearing thresholds Results: Among the ears with complete serial audiogram data set, significant residual hearing at low frequencies at the time of inclusion was observed in 18.8% of those with GJB2 variants (15 out of 80 ears) and 42.6% of those with SLC26A4 variants (46 out of 108 ears), revealing a difference between two deafness genes. Subsequently, ears with SLC26A4 variants (11 of 46 ears, 23.9%) turned out to have a higher dropout rate for cochlear implantation due to hearing deterioration within the first year than those with GJB2 variants (1 of 15, 6.7%), albeit with no statistical significance. Throughout the follow-up period (mean: 37.2 +/- 6.8, range: 12 to 80 months), deterioration of residual hearing at low frequencies at 250 Hz (dB HL/y) and 500 Hz (dB HL/y) of those with GJB2 variants exhibited 3.1 +/- 1.3 (range: 0 to 15) and 5.2 +/- 1.6 (range: 0 to 20), respectively, suggesting the deterioration of residual hearing in GJB2 variants was rather slow and gradual. Specifically, GJB2 p.Leu79Cysfs*3 show less remarkable residual hearing at low frequencies, but then a relatively stable nature. In contrast, SLC26A4 variants demonstrated a significantly higher dropout rate due to severe hearing deterioration requiring cochlear implantation compared with the GJB2 variants. This trend was observed not only in the first-year follow-up period but also in the follow-up periods thereafter. The p.His723Arg;c.919-2A>G genotype of SLC26A4, in particular, was associated with a high propensity for sudden hearing deterioration, as indicated by the dropout rate, which was as high as 46.2% for cochlear implantation due to hearing deterioration during the first year follow-up period. Furthermore, the dropout rate for cochlear implantation was observed in 7.1% of those with GJB2 variants (one out of 14 ears) and 30.3% of those with SLC26A4 variants (10 out of 33 ears) throughout the entire follow-up period. Conclusions: Our results suggest that there is a difference with respect to the progressive nature of residual hearing at low frequencies between the two most common genes responsible for hearing loss, which may provide clinical implications of having individualized rehabilitation and timely intervention.
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[article] Natural Course of Residual Hearing with Reference to GJB2 and SLC26A4 Genotypes: Clinical Implications for Hearing Rehabilitation [Article] / Sang-Yeon Lee ; Seung Cheol Han ; Jin Hee Han ; Min Young Kim ; et al. . - 2021 . - p. 644-653.
Langues : Anglais (eng)
in Ear and hearing > Vol. 42, n°3 (Mai- Juin 2021) . - p. 644-653

Descripteurs :	HE Vinci Gènes Autres descripteurs Audition residuelle
Résumé :	Background: Understanding the characteristics of residual hearing at low frequencies and its natural course in relation to molecular genetic etiology may be important in developing rehabilitation strategies. Thus, we aimed to explore the characteristics and natural course of residual hearing at low frequencies associated with the two most frequent deafness genes: GJB2 and SLC26A4. Methods: Initially, 53 GJB2 and 65 SLC26A4 subjects were enrolled, respectively. Only those whose audiograms exhibited hearing thresholds Results: Among the ears with complete serial audiogram data set, significant residual hearing at low frequencies at the time of inclusion was observed in 18.8% of those with GJB2 variants (15 out of 80 ears) and 42.6% of those with SLC26A4 variants (46 out of 108 ears), revealing a difference between two deafness genes. Subsequently, ears with SLC26A4 variants (11 of 46 ears, 23.9%) turned out to have a higher dropout rate for cochlear implantation due to hearing deterioration within the first year than those with GJB2 variants (1 of 15, 6.7%), albeit with no statistical significance. Throughout the follow-up period (mean: 37.2 +/- 6.8, range: 12 to 80 months), deterioration of residual hearing at low frequencies at 250 Hz (dB HL/y) and 500 Hz (dB HL/y) of those with GJB2 variants exhibited 3.1 +/- 1.3 (range: 0 to 15) and 5.2 +/- 1.6 (range: 0 to 20), respectively, suggesting the deterioration of residual hearing in GJB2 variants was rather slow and gradual. Specifically, GJB2 p.Leu79Cysfs*3 show less remarkable residual hearing at low frequencies, but then a relatively stable nature. In contrast, SLC26A4 variants demonstrated a significantly higher dropout rate due to severe hearing deterioration requiring cochlear implantation compared with the GJB2 variants. This trend was observed not only in the first-year follow-up period but also in the follow-up periods thereafter. The p.His723Arg;c.919-2A>G genotype of SLC26A4, in particular, was associated with a high propensity for sudden hearing deterioration, as indicated by the dropout rate, which was as high as 46.2% for cochlear implantation due to hearing deterioration during the first year follow-up period. Furthermore, the dropout rate for cochlear implantation was observed in 7.1% of those with GJB2 variants (one out of 14 ears) and 30.3% of those with SLC26A4 variants (10 out of 33 ears) throughout the entire follow-up period. Conclusions: Our results suggest that there is a difference with respect to the progressive nature of residual hearing at low frequencies between the two most common genes responsible for hearing loss, which may provide clinical implications of having individualized rehabilitation and timely intervention.
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[article] 
inEar and hearing > Vol. 42, n°3 (Mai- Juin 2021) . - p. 654-661

Titre :	How to Interpret Tinnitus Functional Index Scores: A Proposal for a Grading System Based on a Large Sample of Tinnitus Patients
Type de document :	Article
Auteurs :	Elżbieta Gos ; Joanna J. Rajchel ; Beata Dziendziel ; Justyna Kutyba ; Katarzyna Bienkowska ; Weronika Swierniak ; Maria Gocel ; Danuta Raj-Koziak ; Piotr H. Skarzynski ; Henryk Skarzynski
Année de publication :	2021
Article en page(s) :	p. 654-661
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Acouphène ; Normes de référence ; Questionnaire sur l'indice fonctionnel des acouphènes (TFI)
Résumé :	Objectives: The Tinnitus Functional Index (TFI) is considered the gold standard in measuring tinnitus severity. The aim of the study was to establish reference values to improve the interpretability of TFI scores. Design: Results from 1114 patients with tinnitus were retrospectively analyzed. The participants were consecutive patients who attended our tertiary referral Ear, Nose, and Throat Center. The eligibility criteria were: at least 18 years old, persistent tinnitus, completed pure-tone audiometry, and answered all 25 items on the TFI. Hearing status (normal hearing vs. hearing impairment) was established according to the recommendation of the Bureau International d'Audiophonologie. Means (M) and SD on the TFI were the basis for grading tinnitus severity on four levels: low, lower moderate, upper moderate, and high. To gauge individual scores in clinical practice, percentiles are also proposed. Results: All 1114 patients (586 women and 528 men) were Caucasian and aged from 19 to 87 years (M = 50.96; SD = 13.10 years). Tinnitus duration ranged from 0.5 to 50 years (M = 7.17; SD = 7.71 years). There were 258 patients with normal hearing and 856 patients with hearing loss. A score of above 65 points on TFI was established as the cutoff point for diagnosing high tinnitus severity. A regression model associating tinnitus severity with gender, age, tinnitus duration, and hearing loss was statistically significant: F(4,1109) = 8.99; p Conclusions: The reference values proposed here support those reported previously by Meikle et al. They are empirically based and can be used as benchmarks in clinical practice and scientific research. They make it possible to assess tinnitus severity, evaluate individual scores, and categorize individuals with tinnitus. This allows researchers to set inclusion or exclusion criteria when assigning patients to specific groups during clinical trials involving tinnitus intervention strategies.
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[article] How to Interpret Tinnitus Functional Index Scores: A Proposal for a Grading System Based on a Large Sample of Tinnitus Patients [Article] / Elżbieta Gos ; Joanna J. Rajchel ; Beata Dziendziel ; Justyna Kutyba ; Katarzyna Bienkowska ; Weronika Swierniak ; Maria Gocel ; Danuta Raj-Koziak ; Piotr H. Skarzynski ; Henryk Skarzynski . - 2021 . - p. 654-661.
Langues : Anglais (eng)
in Ear and hearing > Vol. 42, n°3 (Mai- Juin 2021) . - p. 654-661

Descripteurs :	HE Vinci Acouphène ; Normes de référence ; Questionnaire sur l'indice fonctionnel des acouphènes (TFI)
Résumé :	Objectives: The Tinnitus Functional Index (TFI) is considered the gold standard in measuring tinnitus severity. The aim of the study was to establish reference values to improve the interpretability of TFI scores. Design: Results from 1114 patients with tinnitus were retrospectively analyzed. The participants were consecutive patients who attended our tertiary referral Ear, Nose, and Throat Center. The eligibility criteria were: at least 18 years old, persistent tinnitus, completed pure-tone audiometry, and answered all 25 items on the TFI. Hearing status (normal hearing vs. hearing impairment) was established according to the recommendation of the Bureau International d'Audiophonologie. Means (M) and SD on the TFI were the basis for grading tinnitus severity on four levels: low, lower moderate, upper moderate, and high. To gauge individual scores in clinical practice, percentiles are also proposed. Results: All 1114 patients (586 women and 528 men) were Caucasian and aged from 19 to 87 years (M = 50.96; SD = 13.10 years). Tinnitus duration ranged from 0.5 to 50 years (M = 7.17; SD = 7.71 years). There were 258 patients with normal hearing and 856 patients with hearing loss. A score of above 65 points on TFI was established as the cutoff point for diagnosing high tinnitus severity. A regression model associating tinnitus severity with gender, age, tinnitus duration, and hearing loss was statistically significant: F(4,1109) = 8.99; p Conclusions: The reference values proposed here support those reported previously by Meikle et al. They are empirically based and can be used as benchmarks in clinical practice and scientific research. They make it possible to assess tinnitus severity, evaluate individual scores, and categorize individuals with tinnitus. This allows researchers to set inclusion or exclusion criteria when assigning patients to specific groups during clinical trials involving tinnitus intervention strategies.
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[article] 
inEar and hearing > Vol. 42, n°3 (Mai- Juin 2021) . - p. 662-672

Titre :	The Influence of Vowel Identity, Vowel Production Variability, and Consonant Environment on Envelope Following Responses
Type de document :	Article
Auteurs :	Vijayalakshmi Easwar ; Emma Bridgwater ; David W. Purcell
Année de publication :	2021
Article en page(s) :	p. 662-672
Langues :	Anglais (eng)
Descripteurs :	Autres descripteurs Frequence fondamentale (FO) ; Perception des voyelles HE Vinci Potentiel évoqué auditif (PEA)
Résumé :	Objectives: The vowel-evoked envelope following response (EFR) is a useful tool for studying brainstem processing of speech in natural consonant-vowel productions. Previous work, however, demonstrates that the amplitude of EFRs is highly variable across vowels. To clarify factors contributing to the variability observed, the objectives of the present study were to evaluate: (1) the influence of vowel identity and the consonant context surrounding each vowel on EFR amplitude and (2) the effect of variations in repeated productions of a vowel on EFR amplitude while controlling for the consonant context. Design: In Experiment 1, EFRs were recorded in response to seven English vowels (/ij/, /[IOTA]/, /ej/, /[epsilon]/, /ae/, /u/, and / /) embedded in each of four consonant contexts (/hVd/, /sVt/, /zVf/, and / Vv/). In Experiment 2, EFRs were recorded in response to four different variants of one of the four possible vowels (/ij/, /[epsilon]/, /ae/, or / /), embedded in the same consonant-vowel-consonant environments used in Experiment 1. All vowels were edited to minimize formant transitions before embedding in a consonant context. Different talkers were used for the two experiments. Data from a total of 30 and 64 (16 listeners/vowel) young adults with normal hearing were included in Experiments 1 and 2, respectively. EFRs were recorded using a single-channel electrode montage between the vertex and nape of the neck while stimuli were presented monaurally. Results: In Experiment 1, vowel identity had a significant effect on EFR amplitude with the vowel /ae/ eliciting the highest amplitude EFRs (170 nV, on average), and the vowel /ej/ eliciting the lowest amplitude EFRs (106 nV, on average). The consonant context surrounding each vowel stimulus had no statistically significant effect on EFR amplitude. Similarly in Experiment 2, consonant context did not influence the amplitude of EFRs elicited by the vowel variants. Vowel identity significantly altered EFR amplitude with /[epsilon]/ eliciting the highest amplitude EFRs (104 nV, on average). Significant, albeit small, differences ( Conclusion: Based on a comprehensive set of naturally produced vowel samples in carefully controlled consonant contexts, the present study provides additional evidence for the sensitivity of EFRs to vowel identity and variations in vowel production. The surrounding consonant context (after removal of formant transitions) has no measurable effect on EFRs, irrespective of vowel identity and variant. The sensitivity of EFRs to nuances in vowel acoustics emphasizes the need for adequate control and evaluation of stimuli proposed for clinical and research purposes.
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[article] The Influence of Vowel Identity, Vowel Production Variability, and Consonant Environment on Envelope Following Responses [Article] / Vijayalakshmi Easwar ; Emma Bridgwater ; David W. Purcell . - 2021 . - p. 662-672.
Langues : Anglais (eng)
in Ear and hearing > Vol. 42, n°3 (Mai- Juin 2021) . - p. 662-672

Descripteurs :	Autres descripteurs Frequence fondamentale (FO) ; Perception des voyelles HE Vinci Potentiel évoqué auditif (PEA)
Résumé :	Objectives: The vowel-evoked envelope following response (EFR) is a useful tool for studying brainstem processing of speech in natural consonant-vowel productions. Previous work, however, demonstrates that the amplitude of EFRs is highly variable across vowels. To clarify factors contributing to the variability observed, the objectives of the present study were to evaluate: (1) the influence of vowel identity and the consonant context surrounding each vowel on EFR amplitude and (2) the effect of variations in repeated productions of a vowel on EFR amplitude while controlling for the consonant context. Design: In Experiment 1, EFRs were recorded in response to seven English vowels (/ij/, /[IOTA]/, /ej/, /[epsilon]/, /ae/, /u/, and / /) embedded in each of four consonant contexts (/hVd/, /sVt/, /zVf/, and / Vv/). In Experiment 2, EFRs were recorded in response to four different variants of one of the four possible vowels (/ij/, /[epsilon]/, /ae/, or / /), embedded in the same consonant-vowel-consonant environments used in Experiment 1. All vowels were edited to minimize formant transitions before embedding in a consonant context. Different talkers were used for the two experiments. Data from a total of 30 and 64 (16 listeners/vowel) young adults with normal hearing were included in Experiments 1 and 2, respectively. EFRs were recorded using a single-channel electrode montage between the vertex and nape of the neck while stimuli were presented monaurally. Results: In Experiment 1, vowel identity had a significant effect on EFR amplitude with the vowel /ae/ eliciting the highest amplitude EFRs (170 nV, on average), and the vowel /ej/ eliciting the lowest amplitude EFRs (106 nV, on average). The consonant context surrounding each vowel stimulus had no statistically significant effect on EFR amplitude. Similarly in Experiment 2, consonant context did not influence the amplitude of EFRs elicited by the vowel variants. Vowel identity significantly altered EFR amplitude with /[epsilon]/ eliciting the highest amplitude EFRs (104 nV, on average). Significant, albeit small, differences ( Conclusion: Based on a comprehensive set of naturally produced vowel samples in carefully controlled consonant contexts, the present study provides additional evidence for the sensitivity of EFRs to vowel identity and variations in vowel production. The surrounding consonant context (after removal of formant transitions) has no measurable effect on EFRs, irrespective of vowel identity and variant. The sensitivity of EFRs to nuances in vowel acoustics emphasizes the need for adequate control and evaluation of stimuli proposed for clinical and research purposes.
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[article] 
inEar and hearing > Vol. 42, n°3 (Mai- Juin 2021) . - p. 673-690

Titre :	Errors on a Speech-in-Babble Sentence Recognition Test Reveal Individual Differences in Acoustic Phonetic Perception and Babble Misallocations
Type de document :	Article
Auteurs :	Lynne E. Bernstein ; Silvio P. Eberhardt ; Edward T. Auer
Année de publication :	2021
Article en page(s) :	p. 673-690
Langues :	Anglais (eng)
Descripteurs :	Autres descripteurs Modele computationnel HE Vinci Babillage ; Perception de la parole ; Reconnaissance auditive du mot
Résumé :	Objectives: The ability to recognize words in connected speech under noisy listening conditions is critical to everyday communication. Many processing levels contribute to the individual listener's ability to recognize words correctly against background speech, and there is clinical need for measures of individual differences at different levels. Typical listening tests of speech recognition in noise require a list of items to obtain a single threshold score. Diverse abilities measures could be obtained through mining various open-set recognition errors during multi-item tests. This study sought to demonstrate that an error mining approach using open-set responses from a clinical sentence-in-babble-noise test can be used to characterize abilities beyond signal-to-noise ratio (SNR) threshold. A stimulus-response phoneme-to-phoneme sequence alignment software system was used to achieve automatic, accurate quantitative error scores. The method was applied to a database of responses from normal-hearing (NH) adults. Relationships between two types of response errors and words correct scores were evaluated through use of mixed models regression. Design: Two hundred thirty-three NH adults completed three lists of the Quick Speech in Noise test. Their individual open-set speech recognition responses were automatically phonemically transcribed and submitted to a phoneme-to-phoneme stimulus-response sequence alignment system. The computed alignments were mined for a measure of acoustic phonetic perception, a measure of response text that could not be attributed to the stimulus, and a count of words correct. The mined data were statistically analyzed to determine whether the response errors were significant factors beyond stimulus SNR in accounting for the number of words correct per response from each participant. This study addressed two hypotheses: (1) Individuals whose perceptual errors are less severe recognize more words correctly under difficult listening conditions due to babble masking and (2) Listeners who are better able to exclude incorrect speech information such as from background babble and filling in recognize more stimulus words correctly. Results: Statistical analyses showed that acoustic phonetic accuracy and exclusion of babble background were significant factors, beyond the stimulus sentence SNR, in accounting for the number of words a participant recognized. There was also evidence that poorer acoustic phonetic accuracy could occur along with higher words correct scores. This paradoxical result came from a subset of listeners who had also performed subjective accuracy judgments. Their results suggested that they recognized more words while also misallocating acoustic cues from the background into the stimulus, without realizing their errors. Because the Quick Speech in Noise test stimuli are locked to their own babble sample, misallocations of whole words from babble into the responses could be investigated in detail. The high rate of common misallocation errors for some sentences supported the view that the functional stimulus was the combination of the target sentence and its babble. Conclusions: Individual differences among NH listeners arise both in terms of words accurately identified and errors committed during open-set recognition of sentences in babble maskers. Error mining to characterize individual listeners can be done automatically at the levels of acoustic phonetic perception and the misallocation of background babble words into open-set responses. Error mining can increase test information and the efficiency and accuracy of characterizing individual listeners.
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[article] Errors on a Speech-in-Babble Sentence Recognition Test Reveal Individual Differences in Acoustic Phonetic Perception and Babble Misallocations [Article] / Lynne E. Bernstein ; Silvio P. Eberhardt ; Edward T. Auer . - 2021 . - p. 673-690.
Langues : Anglais (eng)
in Ear and hearing > Vol. 42, n°3 (Mai- Juin 2021) . - p. 673-690

Descripteurs :	Autres descripteurs Modele computationnel HE Vinci Babillage ; Perception de la parole ; Reconnaissance auditive du mot
Résumé :	Objectives: The ability to recognize words in connected speech under noisy listening conditions is critical to everyday communication. Many processing levels contribute to the individual listener's ability to recognize words correctly against background speech, and there is clinical need for measures of individual differences at different levels. Typical listening tests of speech recognition in noise require a list of items to obtain a single threshold score. Diverse abilities measures could be obtained through mining various open-set recognition errors during multi-item tests. This study sought to demonstrate that an error mining approach using open-set responses from a clinical sentence-in-babble-noise test can be used to characterize abilities beyond signal-to-noise ratio (SNR) threshold. A stimulus-response phoneme-to-phoneme sequence alignment software system was used to achieve automatic, accurate quantitative error scores. The method was applied to a database of responses from normal-hearing (NH) adults. Relationships between two types of response errors and words correct scores were evaluated through use of mixed models regression. Design: Two hundred thirty-three NH adults completed three lists of the Quick Speech in Noise test. Their individual open-set speech recognition responses were automatically phonemically transcribed and submitted to a phoneme-to-phoneme stimulus-response sequence alignment system. The computed alignments were mined for a measure of acoustic phonetic perception, a measure of response text that could not be attributed to the stimulus, and a count of words correct. The mined data were statistically analyzed to determine whether the response errors were significant factors beyond stimulus SNR in accounting for the number of words correct per response from each participant. This study addressed two hypotheses: (1) Individuals whose perceptual errors are less severe recognize more words correctly under difficult listening conditions due to babble masking and (2) Listeners who are better able to exclude incorrect speech information such as from background babble and filling in recognize more stimulus words correctly. Results: Statistical analyses showed that acoustic phonetic accuracy and exclusion of babble background were significant factors, beyond the stimulus sentence SNR, in accounting for the number of words a participant recognized. There was also evidence that poorer acoustic phonetic accuracy could occur along with higher words correct scores. This paradoxical result came from a subset of listeners who had also performed subjective accuracy judgments. Their results suggested that they recognized more words while also misallocating acoustic cues from the background into the stimulus, without realizing their errors. Because the Quick Speech in Noise test stimuli are locked to their own babble sample, misallocations of whole words from babble into the responses could be investigated in detail. The high rate of common misallocation errors for some sentences supported the view that the functional stimulus was the combination of the target sentence and its babble. Conclusions: Individual differences among NH listeners arise both in terms of words accurately identified and errors committed during open-set recognition of sentences in babble maskers. Error mining to characterize individual listeners can be done automatically at the levels of acoustic phonetic perception and the misallocation of background babble words into open-set responses. Error mining can increase test information and the efficiency and accuracy of characterizing individual listeners.
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[article] 
inEar and hearing > Vol. 42, n°3 (Mai- Juin 2021) . - p. 691-699

Titre :	Binaural Frequency Modulation Detection in School-Age Children, Young Adults, and Older Adults: Effects of Interaural Modulator Phase
Type de document :	Article
Auteurs :	Stacey G. Kane ; Emily Buss ; John H. Grose
Année de publication :	2021
Article en page(s) :	p. 691-699
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Structure temporelle fine ; Sujet âgé Autres descripteurs Audition binaurale ; Resolution temporelle
Résumé :	Objectives: The purpose of this study was to measure low-rate binaural frequency modulation (FM) detection across the lifespan as a gauge of temporal fine structure processing. Children and older adults were expected to perform more poorly than young adults but for different reasons. Design: Detection of 2-Hz FM carried by a 500-Hz pure tone was measured for modulators that were either in-phase or out-of-phase across ears. Thresholds were measured in quiet and in noise. Participants were school-age children (n = 44), young adults (n = 11), and older adults (n = 17) with normal or near-normal hearing. Results: Thresholds were lower for out-of-phase than in-phase modulators among all listening groups. Detection thresholds improved with child age, with larger effects of age for dichotic than diotic FM. Introduction of masking noise tended to elevate thresholds; this effect was larger for the dichotic condition than the diotic condition, and larger for older adults than young adults. In noise, young adults received the greatest dichotic benefit, followed by older adults, then young children. The relative effects of noise on dichotic benefit did not differ for young adults compared to young children and older adults; however, young children saw greater reduction in benefit due to noise than older adults. Conclusion: The difference in dichotic benefit between children and young adults is consistent with maturation of central auditory processing. Differences in the effect of noise on dichotic benefit in young children and older adults support the idea that different factors or combinations of factors limit performance in these two groups. Although dichotic FM detection appears to be more sensitive to the effects of development and aging than diotic FM detection, the positive correlation between diotic and dichotic FM detection thresholds for all listeners suggests contribution of one or more factors common to both conditions.
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[article] Binaural Frequency Modulation Detection in School-Age Children, Young Adults, and Older Adults: Effects of Interaural Modulator Phase [Article] / Stacey G. Kane ; Emily Buss ; John H. Grose . - 2021 . - p. 691-699.
Langues : Anglais (eng)
in Ear and hearing > Vol. 42, n°3 (Mai- Juin 2021) . - p. 691-699

Descripteurs :	HE Vinci Structure temporelle fine ; Sujet âgé Autres descripteurs Audition binaurale ; Resolution temporelle
Résumé :	Objectives: The purpose of this study was to measure low-rate binaural frequency modulation (FM) detection across the lifespan as a gauge of temporal fine structure processing. Children and older adults were expected to perform more poorly than young adults but for different reasons. Design: Detection of 2-Hz FM carried by a 500-Hz pure tone was measured for modulators that were either in-phase or out-of-phase across ears. Thresholds were measured in quiet and in noise. Participants were school-age children (n = 44), young adults (n = 11), and older adults (n = 17) with normal or near-normal hearing. Results: Thresholds were lower for out-of-phase than in-phase modulators among all listening groups. Detection thresholds improved with child age, with larger effects of age for dichotic than diotic FM. Introduction of masking noise tended to elevate thresholds; this effect was larger for the dichotic condition than the diotic condition, and larger for older adults than young adults. In noise, young adults received the greatest dichotic benefit, followed by older adults, then young children. The relative effects of noise on dichotic benefit did not differ for young adults compared to young children and older adults; however, young children saw greater reduction in benefit due to noise than older adults. Conclusion: The difference in dichotic benefit between children and young adults is consistent with maturation of central auditory processing. Differences in the effect of noise on dichotic benefit in young children and older adults support the idea that different factors or combinations of factors limit performance in these two groups. Although dichotic FM detection appears to be more sensitive to the effects of development and aging than diotic FM detection, the positive correlation between diotic and dichotic FM detection thresholds for all listeners suggests contribution of one or more factors common to both conditions.
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[article] 
inEar and hearing > Vol. 42, n°3 (Mai- Juin 2021) . - p. 700-708

Titre :	Auditory Development of Frequency Discrimination at Extended High Frequencies
Type de document :	Article
Auteurs :	Srikanta K. Mishra ; Lauren Renken ; Michelle Hernandez ; Hansapani Rodrigo
Année de publication :	2021
Article en page(s) :	p. 700-708
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Audiométrie haute fréquence ; Repérage dans l'espace ; Temporalité Autres descripteurs Developpement auditif ; Discrimination de frequence
Résumé :	Objectives: Hearing in the extended high frequencies (EHFs; >8 kHz) is perceptually and clinically relevant. Recent work suggests the possible role of EHF audibility in natural listening environments (e.g., spatial hearing) and hidden hearing loss. In this article, we examine the development of frequency discrimination (FD) in the EHFs. Specifically, the objectives of the present study were to answer if the developmental timeline for FD is different for EHFs; and whether the discontinuity of FD thresholds across frequency-representing the hypothetical shift from a temporal to place code-for children occurs at about the same frequency as adults. Design: Thirty-one normal-hearing children (5 to 12 years) and 15 young adults participated in this study. FD thresholds were measured for standard frequencies (1, 2, 4, 6, and 8 kHz) and EHFs (10 and 12.5 kHz) using a three-alternative (odd-ball) forced-choice paradigm. Statistical analysis focused on examining the change of FD thresholds as a function of age and estimating the breakpoints in the discrimination threshold-frequency functions. Results: FD performance in younger children for EHFs was nearly six times poorer relative to older children and adults; however, there was no effect of test frequency on the child-adult difference. Change-point detection on group data revealed a higher knot frequency-representing the putative transition from temporal to place mechanisms-for adults (9.8 kHz) than children (~6 kHz). Individual spline functions suggest that the knot frequency varied from 2 to 10 kHz across participants. Conclusions: The present study provides evidence for a similar rate of maturation of FD for EHFs and standard frequencies. FD at EHFs matures by 10 to 12 years of age. Adult listeners may not all use temporal cues up to 10 kHz. Young children are relatively inefficient in using temporal fine-structure cues for FD at frequencies above 6 kHz
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[article] Auditory Development of Frequency Discrimination at Extended High Frequencies [Article] / Srikanta K. Mishra ; Lauren Renken ; Michelle Hernandez ; Hansapani Rodrigo . - 2021 . - p. 700-708.
Langues : Anglais (eng)
in Ear and hearing > Vol. 42, n°3 (Mai- Juin 2021) . - p. 700-708

Descripteurs :	HE Vinci Audiométrie haute fréquence ; Repérage dans l'espace ; Temporalité Autres descripteurs Developpement auditif ; Discrimination de frequence
Résumé :	Objectives: Hearing in the extended high frequencies (EHFs; >8 kHz) is perceptually and clinically relevant. Recent work suggests the possible role of EHF audibility in natural listening environments (e.g., spatial hearing) and hidden hearing loss. In this article, we examine the development of frequency discrimination (FD) in the EHFs. Specifically, the objectives of the present study were to answer if the developmental timeline for FD is different for EHFs; and whether the discontinuity of FD thresholds across frequency-representing the hypothetical shift from a temporal to place code-for children occurs at about the same frequency as adults. Design: Thirty-one normal-hearing children (5 to 12 years) and 15 young adults participated in this study. FD thresholds were measured for standard frequencies (1, 2, 4, 6, and 8 kHz) and EHFs (10 and 12.5 kHz) using a three-alternative (odd-ball) forced-choice paradigm. Statistical analysis focused on examining the change of FD thresholds as a function of age and estimating the breakpoints in the discrimination threshold-frequency functions. Results: FD performance in younger children for EHFs was nearly six times poorer relative to older children and adults; however, there was no effect of test frequency on the child-adult difference. Change-point detection on group data revealed a higher knot frequency-representing the putative transition from temporal to place mechanisms-for adults (9.8 kHz) than children (~6 kHz). Individual spline functions suggest that the knot frequency varied from 2 to 10 kHz across participants. Conclusions: The present study provides evidence for a similar rate of maturation of FD for EHFs and standard frequencies. FD at EHFs matures by 10 to 12 years of age. Adult listeners may not all use temporal cues up to 10 kHz. Young children are relatively inefficient in using temporal fine-structure cues for FD at frequencies above 6 kHz
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[article] 
inEar and hearing > Vol. 42, n°3 (Mai- Juin 2021) . - p. 709-717

Titre :	Speech Segregation in Active Middle Ear Stimulation: Masking Release With Changing Fundamental Frequency
Type de document :	Article
Auteurs :	Alice Barbara Auinger ; Rudolfs Liepins ; Alexandra Kaider ; Erich Viskocil ; Dominik Riss ; Christoph Arnoldner
Année de publication :	2021
Article en page(s) :	p. 709-717
Langues :	Anglais (eng)
Descripteurs :	Autres descripteurs Frequence fondamentale (FO) ; Implant d'oreille moyenne HE Vinci Masquage
Résumé :	Objectives: Temporal fine structure information such as low-frequency sounds including the fundamental frequency (F0) is important to separate different talkers in noisy environments. Speech perception in noise is negatively affected by reduced temporal fine structure resolution in cochlear hearing loss. It has been shown that normal-hearing (NH) people as well as cochlear implant patients with preserved acoustic low-frequency hearing benefit from different F0 between concurrent talkers. Though patients with an active middle ear implant (AMEI) report better sound quality compared with hearing aids, they often struggle when listening in noise. The primary objective was to evaluate whether or not patients with a Vibrant Soundbridge AMEI were able to benefit from F0 differences in a concurrent talker situation and if the effect was comparable to NH individuals. Design: A total of 13 AMEI listeners and 13 NH individuals were included. A modified variant of the Oldenburg sentence test was used to emulate a concurrent talker scenario. One sentence from the test corpus served as the masker and the remaining sentences as target speech. The F0 of the masker sentence was shifted upward by 4, 8, and 12 semitones. The target and masker sentences were presented simultaneously to the study subjects and the speech reception threshold was assessed by adaptively varying the masker level. To evaluate any impact of the occlusion effect on speech perception, AMEI listeners were tested in two configurations: with a plugged ear-canal contralateral to the implant side, indicated as AMEIcontra, or with both ears plugged, indicated as AMEIboth. Results: In both study groups, speech perception improved when the F0 difference between target and masker increased. This was significant when the difference was at least 8 semitones; the F0-based release from masking was 3.0 dB in AMEIcontra (p = 0.009) and 2.9 dB in AMEIboth (p = 0.015), compared with 5.6 dB in NH listeners (p Conclusions: Though AMEI users deal with problems resulting from cochlear damage, hearing amplification with the implant enables a masking release based on F0 differences when F0 between a target and masker sentence was at least 8 semitones. Additional occlusion of the ear canal on the implant side did not affect speech performance. The current results complement the knowledge about the benefit of F0 within the acoustic low-frequency hearing.
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[article] Speech Segregation in Active Middle Ear Stimulation: Masking Release With Changing Fundamental Frequency [Article] / Alice Barbara Auinger ; Rudolfs Liepins ; Alexandra Kaider ; Erich Viskocil ; Dominik Riss ; Christoph Arnoldner . - 2021 . - p. 709-717.
Langues : Anglais (eng)
in Ear and hearing > Vol. 42, n°3 (Mai- Juin 2021) . - p. 709-717

Descripteurs :	Autres descripteurs Frequence fondamentale (FO) ; Implant d'oreille moyenne HE Vinci Masquage
Résumé :	Objectives: Temporal fine structure information such as low-frequency sounds including the fundamental frequency (F0) is important to separate different talkers in noisy environments. Speech perception in noise is negatively affected by reduced temporal fine structure resolution in cochlear hearing loss. It has been shown that normal-hearing (NH) people as well as cochlear implant patients with preserved acoustic low-frequency hearing benefit from different F0 between concurrent talkers. Though patients with an active middle ear implant (AMEI) report better sound quality compared with hearing aids, they often struggle when listening in noise. The primary objective was to evaluate whether or not patients with a Vibrant Soundbridge AMEI were able to benefit from F0 differences in a concurrent talker situation and if the effect was comparable to NH individuals. Design: A total of 13 AMEI listeners and 13 NH individuals were included. A modified variant of the Oldenburg sentence test was used to emulate a concurrent talker scenario. One sentence from the test corpus served as the masker and the remaining sentences as target speech. The F0 of the masker sentence was shifted upward by 4, 8, and 12 semitones. The target and masker sentences were presented simultaneously to the study subjects and the speech reception threshold was assessed by adaptively varying the masker level. To evaluate any impact of the occlusion effect on speech perception, AMEI listeners were tested in two configurations: with a plugged ear-canal contralateral to the implant side, indicated as AMEIcontra, or with both ears plugged, indicated as AMEIboth. Results: In both study groups, speech perception improved when the F0 difference between target and masker increased. This was significant when the difference was at least 8 semitones; the F0-based release from masking was 3.0 dB in AMEIcontra (p = 0.009) and 2.9 dB in AMEIboth (p = 0.015), compared with 5.6 dB in NH listeners (p Conclusions: Though AMEI users deal with problems resulting from cochlear damage, hearing amplification with the implant enables a masking release based on F0 differences when F0 between a target and masker sentence was at least 8 semitones. Additional occlusion of the ear canal on the implant side did not affect speech performance. The current results complement the knowledge about the benefit of F0 within the acoustic low-frequency hearing.
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[article] 
inEar and hearing > Vol. 42, n°3 (Mai- Juin 2021) . - p. 718-731

Titre :	Investigating the Influences of Task Demand and Reward on Cardiac Pre-Ejection Period Reactivity During a Speech-in-Noise Task
Type de document :	Article
Auteurs :	Bethany Plain ; Michael Richter ; Adriana A. Zekveld ; Thomas Lunner ; Tanveer Bhuiyan ; Sophia E. Kramer
Année de publication :	2021
Article en page(s) :	p. 718-731
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Compréhension dans le bruit ; Effort d'écoute ; Injection
Résumé :	Objectives: Effort investment during listening varies as a function of task demand and motivation. Several studies have manipulated both these factors to elicit and measure changes in effort associated with listening. The cardiac pre-ejection period (PEP) is a relatively novel measure in the field of cognitive hearing science. This measure, which reflects sympathetic nervous system activity on the heart, has previously been implemented during a tone discrimination task but not during a speech-in-noise task. Therefore, the primary goal of this study was to explore the influences of signal to noise ratio (SNR) and monetary reward level on PEP reactivity during a speech-in-noise task. Design: Thirty-two participants with normal hearing (mean age = 22.22 years, SD = 3.03) were recruited at VU University Medical Center. Participants completed a Dutch speech-in-noise test with a single-interfering-talker masking noise. Six fixed SNRs, selected to span the entire psychometric performance curve, were presented in a block-wise fashion. Participants could earn a low ([Euro sign]0.20) or high ([Euro sign]5.00) reward by obtaining a score of >=70% of words correct in each block. The authors analyzed PEP reactivity: the change in PEP measured during the task, relative to the baseline during rest. Two separate methods of PEP analysis were used, one including data from the whole task block and the other including data obtained during presentation of the target sentences only. After each block, participants rated their effort investment, performance, tendency to give up, and the perceived difficulty of the task. They also completed the need for recovery questionnaire and the reading span test, which are indices of additional factors (fatigue and working memory capacity, respectively) that are known to influence listening effort. Results: Average sentence perception scores ranged from 2.73 to 91.62%, revealing a significant effect of SNR. In addition, an improvement in performance was elicited by the high, compared to the low reward level. A linear relationship between SNR and PEP reactivity was demonstrated: at the lower SNRs PEP reactivity was the most negative, indicating greater effort investment compared to the higher SNRs. The target stimuli method of PEP analysis was more sensitive to this effect than the block-wise method. Contrary to expectations, no significant impact of reward on PEP reactivity was found in the present dataset. Also, there was no physiological evidence that participants were disengaged, even when performance was poor. A significant correlation between need for recovery scores and average PEP reactivity was demonstrated, indicating that a lower need for recovery was associated with less effort investment. Conclusions: This study successfully implemented the measurement of PEP during a standard speech-in-noise test and included two distinct methods of PEP analysis. The results revealed for the first time that PEP reactivity varies linearly with task demand during a speech-in-noise task, although the effect size was small. No effect of reward on PEP was demonstrated. Finally, participants with a higher need for recovery score invested more effort, as shown by average PEP reactivity, than those with a lower need for recovery score.
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[article] Investigating the Influences of Task Demand and Reward on Cardiac Pre-Ejection Period Reactivity During a Speech-in-Noise Task [Article] / Bethany Plain ; Michael Richter ; Adriana A. Zekveld ; Thomas Lunner ; Tanveer Bhuiyan ; Sophia E. Kramer . - 2021 . - p. 718-731.
Langues : Anglais (eng)
in Ear and hearing > Vol. 42, n°3 (Mai- Juin 2021) . - p. 718-731

Descripteurs :	HE Vinci Compréhension dans le bruit ; Effort d'écoute ; Injection
Résumé :	Objectives: Effort investment during listening varies as a function of task demand and motivation. Several studies have manipulated both these factors to elicit and measure changes in effort associated with listening. The cardiac pre-ejection period (PEP) is a relatively novel measure in the field of cognitive hearing science. This measure, which reflects sympathetic nervous system activity on the heart, has previously been implemented during a tone discrimination task but not during a speech-in-noise task. Therefore, the primary goal of this study was to explore the influences of signal to noise ratio (SNR) and monetary reward level on PEP reactivity during a speech-in-noise task. Design: Thirty-two participants with normal hearing (mean age = 22.22 years, SD = 3.03) were recruited at VU University Medical Center. Participants completed a Dutch speech-in-noise test with a single-interfering-talker masking noise. Six fixed SNRs, selected to span the entire psychometric performance curve, were presented in a block-wise fashion. Participants could earn a low ([Euro sign]0.20) or high ([Euro sign]5.00) reward by obtaining a score of >=70% of words correct in each block. The authors analyzed PEP reactivity: the change in PEP measured during the task, relative to the baseline during rest. Two separate methods of PEP analysis were used, one including data from the whole task block and the other including data obtained during presentation of the target sentences only. After each block, participants rated their effort investment, performance, tendency to give up, and the perceived difficulty of the task. They also completed the need for recovery questionnaire and the reading span test, which are indices of additional factors (fatigue and working memory capacity, respectively) that are known to influence listening effort. Results: Average sentence perception scores ranged from 2.73 to 91.62%, revealing a significant effect of SNR. In addition, an improvement in performance was elicited by the high, compared to the low reward level. A linear relationship between SNR and PEP reactivity was demonstrated: at the lower SNRs PEP reactivity was the most negative, indicating greater effort investment compared to the higher SNRs. The target stimuli method of PEP analysis was more sensitive to this effect than the block-wise method. Contrary to expectations, no significant impact of reward on PEP reactivity was found in the present dataset. Also, there was no physiological evidence that participants were disengaged, even when performance was poor. A significant correlation between need for recovery scores and average PEP reactivity was demonstrated, indicating that a lower need for recovery was associated with less effort investment. Conclusions: This study successfully implemented the measurement of PEP during a standard speech-in-noise test and included two distinct methods of PEP analysis. The results revealed for the first time that PEP reactivity varies linearly with task demand during a speech-in-noise task, although the effect size was small. No effect of reward on PEP was demonstrated. Finally, participants with a higher need for recovery score invested more effort, as shown by average PEP reactivity, than those with a lower need for recovery score.
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[article] 
inEar and hearing > Vol. 42, n°3 (Mai- Juin 2021) . - p. 732-743

Titre :	Computed Tomography-Based Measurements of the Cochlear Duct: Implications for Cochlear Implant Pitch Tuning
Type de document :	Article
Auteurs :	Nicole T. Jiam ; Mélanie Gilbert ; Jonathan Mo ; Patpong Jiradejvong ; Charles J. Limb
Année de publication :	2021
Article en page(s) :	p. 732-743
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Cartographie ; Conduction osseuse ; Implants cochléaires ; Tomographie Autres descripteurs Percussion osseuse ; Transduction cochleaire
Résumé :	Objectives: To determine the sources of variability for cochlear duct length (CDL) measurements for the purposes of fine-tuning cochlear implants (CI) and to propose a set of standardized landmarks for computed tomography (CT) pitch mapping. Design: This was a retrospective cohort study involving 21 CI users at a tertiary referral center. The intervention involved flat-panel CT image acquisition and secondary reconstructions of CIs in vivo. The main outcome measures were CDL measurements, CI electrode localization measurements, and frequency calculations. Results: Direct CT-based measurements of CI and intracochlear landmarks are methodologically valid, with a percentage of error of 1.0% +/- 0.9%. Round window (RW) position markers (anterior edge, center, or posterior edge) and bony canal wall localization markers (medial edge, duct center, or lateral edge) significantly impact CDL calculations [F(2, 78) = 9.9, p Conclusions: A lack of standardization regarding RW and bony canal wall landmarks results in great CDL measurement variability and distorted pitch map calculations. We propose using the posterior edge of the RW and lateral bony wall as standardized anatomical parameters for CDL calculations in CI users to improve pitch map calculations. More accurate and precise pitch maps may improve CI-associated pitch outcomes.
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[article] Computed Tomography-Based Measurements of the Cochlear Duct: Implications for Cochlear Implant Pitch Tuning [Article] / Nicole T. Jiam ; Mélanie Gilbert ; Jonathan Mo ; Patpong Jiradejvong ; Charles J. Limb . - 2021 . - p. 732-743.
Langues : Anglais (eng)
in Ear and hearing > Vol. 42, n°3 (Mai- Juin 2021) . - p. 732-743

Descripteurs :	HE Vinci Cartographie ; Conduction osseuse ; Implants cochléaires ; Tomographie Autres descripteurs Percussion osseuse ; Transduction cochleaire
Résumé :	Objectives: To determine the sources of variability for cochlear duct length (CDL) measurements for the purposes of fine-tuning cochlear implants (CI) and to propose a set of standardized landmarks for computed tomography (CT) pitch mapping. Design: This was a retrospective cohort study involving 21 CI users at a tertiary referral center. The intervention involved flat-panel CT image acquisition and secondary reconstructions of CIs in vivo. The main outcome measures were CDL measurements, CI electrode localization measurements, and frequency calculations. Results: Direct CT-based measurements of CI and intracochlear landmarks are methodologically valid, with a percentage of error of 1.0% +/- 0.9%. Round window (RW) position markers (anterior edge, center, or posterior edge) and bony canal wall localization markers (medial edge, duct center, or lateral edge) significantly impact CDL calculations [F(2, 78) = 9.9, p Conclusions: A lack of standardization regarding RW and bony canal wall landmarks results in great CDL measurement variability and distorted pitch map calculations. We propose using the posterior edge of the RW and lateral bony wall as standardized anatomical parameters for CDL calculations in CI users to improve pitch map calculations. More accurate and precise pitch maps may improve CI-associated pitch outcomes.
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[article] 
inEar and hearing > Vol. 42, n°2 (Mars-Avril 2021) . - 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 2021) . - 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 2021) . - 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 2021) . - 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 2021) . - 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 2021) . - 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 2021) . - 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 2021) . - 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 2021) . - 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 2021) . - 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 2021) . - 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 2021) . - 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 2021) . - 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 2021) . - 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 2021) . - 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 2021) . - 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 2021) . - 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 2021) . - 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 2021) . - 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 ; Potentiels évoqués myogéniques vestibulaires (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 2021) . - p. 355-363

Descripteurs :	HE Vinci Conduction osseuse ; Potentiels évoqués myogéniques vestibulaires (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 2021) . - 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 2021) . - 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°2 (Mars-Avril 2021) . - p. 373-380

Titre :	Congenital CMV-Associated Hearing Loss: Can Brain Imaging Predict Hearing Outcome?
Type de document :	Article
Auteurs :	Helen Van Hoecke ; Els De Leenheer ; An Boudewyns ; Ingeborg Dhooge
Année de publication :	2021
Article en page(s) :	p. 373-380
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Cytomegalovirus ; Déficience auditive ; Imagerie par résonance magnétique ; Neuroimagerie ; Ondes ultrasonores
Résumé :	Objectives: Congenital cytomegalovirus (cCMV) infection is the leading cause of nonhereditary sensorineural hearing loss in childhood and is also associated with CNS abnormalities. The main objective is to investigate the prognostic value of neonatal cranial ultrasound (cUS) and cranial magnetic resonance imaging (cMRI) in predicting long-term hearing outcome in a large cohort of cCMV-infected symptomatic and asymptomatic patients. Design: Data were prospectively collected from a multicentre Flemish registry of children with cCMV infection born between 2007 and 2016. Neonatal cUS and cMRI scans were examined for lesions related to cCMV infection. Audiometric results at different time points were analyzed. The imaging and audiometric results were linked and diagnostic values of cUS and cMRI were calculated for the different hearing outcomes. Results: We were able to include 411 cCMV patients, of whom 40% was considered symptomatic at birth. Cranial ultrasound abnormalities associated with cCMV infection were found in 76 children (22.2% of the cUS scans), whereas cMRI revealed abnormalities in 74 patients (26.9% of the cMRI scans). A significant relation could be found between the presence of cUS or cMRI abnormalities and hearing loss at baseline and last follow-up. Cranial ultrasound and cMRI findings were not significantly correlated with the development of delayed-onset hearing loss. Specificity and sensitivity of an abnormal cUS to predict hearing loss at final follow-up were 84% and 43%, respectively compared with 78% and 39% for cMRI. Normal cUS and cMRI findings have a negative predictive value of 91% and 92%, respectively, for the development of delayed-onset hearing loss. Conclusions: Neuroimaging evidence of CNS involvement in the neonatal period is associated with the presence of hearing loss in children with a cCMV infection. Imaging abnormalities are not predictive for the development of delayed-onset hearing loss.
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[article] Congenital CMV-Associated Hearing Loss: Can Brain Imaging Predict Hearing Outcome? [Article] / Helen Van Hoecke ; Els De Leenheer ; An Boudewyns ; Ingeborg Dhooge . - 2021 . - p. 373-380.
Langues : Anglais (eng)
in Ear and hearing > Vol. 42, n°2 (Mars-Avril 2021) . - p. 373-380

Descripteurs :	HE Vinci Cytomegalovirus ; Déficience auditive ; Imagerie par résonance magnétique ; Neuroimagerie ; Ondes ultrasonores
Résumé :	Objectives: Congenital cytomegalovirus (cCMV) infection is the leading cause of nonhereditary sensorineural hearing loss in childhood and is also associated with CNS abnormalities. The main objective is to investigate the prognostic value of neonatal cranial ultrasound (cUS) and cranial magnetic resonance imaging (cMRI) in predicting long-term hearing outcome in a large cohort of cCMV-infected symptomatic and asymptomatic patients. Design: Data were prospectively collected from a multicentre Flemish registry of children with cCMV infection born between 2007 and 2016. Neonatal cUS and cMRI scans were examined for lesions related to cCMV infection. Audiometric results at different time points were analyzed. The imaging and audiometric results were linked and diagnostic values of cUS and cMRI were calculated for the different hearing outcomes. Results: We were able to include 411 cCMV patients, of whom 40% was considered symptomatic at birth. Cranial ultrasound abnormalities associated with cCMV infection were found in 76 children (22.2% of the cUS scans), whereas cMRI revealed abnormalities in 74 patients (26.9% of the cMRI scans). A significant relation could be found between the presence of cUS or cMRI abnormalities and hearing loss at baseline and last follow-up. Cranial ultrasound and cMRI findings were not significantly correlated with the development of delayed-onset hearing loss. Specificity and sensitivity of an abnormal cUS to predict hearing loss at final follow-up were 84% and 43%, respectively compared with 78% and 39% for cMRI. Normal cUS and cMRI findings have a negative predictive value of 91% and 92%, respectively, for the development of delayed-onset hearing loss. Conclusions: Neuroimaging evidence of CNS involvement in the neonatal period is associated with the presence of hearing loss in children with a cCMV infection. Imaging abnormalities are not predictive for the development of delayed-onset hearing loss.
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[article] 
inEar and hearing > Vol. 42, n°2 (Mars-Avril 2021) . - p. 381-392

Titre :	SoftVoice Improves Speech Recognition and Reduces Listening Effort in Cochlear Implant Users
Type de document :	Article
Auteurs :	Christiaan H. Stronks ; Eline Apperloo ; Raphael Koning ; Jeroen J. Briaire ; Johan H.M. Frijns
Année de publication :	2021
Article en page(s) :	p. 381-392
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Compréhension dans le bruit ; Effort d'écoute ; Implants cochléaires ; Surdité neurosensorielle (SNHL) ; Troubles pupillaires Autres descripteurs Processeur vocal
Résumé :	Objectives: The ability to perceive soft speech by cochlear implant (CI) users is restricted in part by the inherent system noise produced by the speech processor, and in particular by the microphone(s). The algorithm "SoftVoice" (SV) was developed by Advanced Bionics to enhance the perception of soft speech by reducing the system noise in speech processors. The aim of this study was to examine the effects of SV on speech recognition and listening effort. Design: Seventeen adult Advanced Bionics CI recipients were recruited and tested in two sessions. The effect of SV on speech recognition was tested by determining the SRT in quiet using the Matrix test. Based on the individual subjects' SRTs, we investigated speech-recognition scores at fixed speech levels, namely SRT -5 dB, SRT +0 dB, SRT +5 dB, and SRT +10 dB, again in quiet and using the Matrix test. Listening effort was measured at each of these speech levels subjectively by using a rating scale, and objectively by determining pupil dilation with pupillometry. To verify whether SoftVoice had any negative effects on speech perception in noise, we determined the SRT in steady state, speech-weighted noise of 60 dBA. Results: Our results revealed a significant improvement of 2.0 dB on the SRT in quiet with SoftVoice. The average SRT in quiet without SoftVoice was 38 dBA. SoftVoice did not affect the SRT in steady state, speech-weighted noise of 60 dB. At an average speech level of 33 dBA (SRT -5 dB) and 38 dBA (SRT +0 dB) in quiet, significant improvements of 17% and 9% on speech-recognition scores were found with SoftVoice, respectively. At higher speech levels, SoftVoice did not significantly affect speech recognition. Pupillometry did not show significant effects of SoftVoice at any speech level. However, subjective ratings of listening effort indicated a decrease of listening effort with SoftVoice at a speech level of 33 dBA. Conclusions: We conclude that SoftVoice substantially improves recognition of soft speech and lowers subjective listening effort at low speech levels in quiet. However, no significant effect of SoftVoice was found on pupil dilation. As SRTs in noise were not statistically significantly affected by SoftVoice, we conclude that SoftVoice can be used in noisy listening conditions with little negative impact on speech recognition, if any. The increased power demands of the algorithm are considered to be negligible. It is expected that SoftVoice will reduce power consumption at low ambient sound levels. These results support the use of SoftVoice as a standard feature of Advanced Bionics CI fittings for everyday use.
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[article] SoftVoice Improves Speech Recognition and Reduces Listening Effort in Cochlear Implant Users [Article] / Christiaan H. Stronks ; Eline Apperloo ; Raphael Koning ; Jeroen J. Briaire ; Johan H.M. Frijns . - 2021 . - p. 381-392.
Langues : Anglais (eng)
in Ear and hearing > Vol. 42, n°2 (Mars-Avril 2021) . - p. 381-392

Descripteurs :	HE Vinci Compréhension dans le bruit ; Effort d'écoute ; Implants cochléaires ; Surdité neurosensorielle (SNHL) ; Troubles pupillaires Autres descripteurs Processeur vocal
Résumé :	Objectives: The ability to perceive soft speech by cochlear implant (CI) users is restricted in part by the inherent system noise produced by the speech processor, and in particular by the microphone(s). The algorithm "SoftVoice" (SV) was developed by Advanced Bionics to enhance the perception of soft speech by reducing the system noise in speech processors. The aim of this study was to examine the effects of SV on speech recognition and listening effort. Design: Seventeen adult Advanced Bionics CI recipients were recruited and tested in two sessions. The effect of SV on speech recognition was tested by determining the SRT in quiet using the Matrix test. Based on the individual subjects' SRTs, we investigated speech-recognition scores at fixed speech levels, namely SRT -5 dB, SRT +0 dB, SRT +5 dB, and SRT +10 dB, again in quiet and using the Matrix test. Listening effort was measured at each of these speech levels subjectively by using a rating scale, and objectively by determining pupil dilation with pupillometry. To verify whether SoftVoice had any negative effects on speech perception in noise, we determined the SRT in steady state, speech-weighted noise of 60 dBA. Results: Our results revealed a significant improvement of 2.0 dB on the SRT in quiet with SoftVoice. The average SRT in quiet without SoftVoice was 38 dBA. SoftVoice did not affect the SRT in steady state, speech-weighted noise of 60 dB. At an average speech level of 33 dBA (SRT -5 dB) and 38 dBA (SRT +0 dB) in quiet, significant improvements of 17% and 9% on speech-recognition scores were found with SoftVoice, respectively. At higher speech levels, SoftVoice did not significantly affect speech recognition. Pupillometry did not show significant effects of SoftVoice at any speech level. However, subjective ratings of listening effort indicated a decrease of listening effort with SoftVoice at a speech level of 33 dBA. Conclusions: We conclude that SoftVoice substantially improves recognition of soft speech and lowers subjective listening effort at low speech levels in quiet. However, no significant effect of SoftVoice was found on pupil dilation. As SRTs in noise were not statistically significantly affected by SoftVoice, we conclude that SoftVoice can be used in noisy listening conditions with little negative impact on speech recognition, if any. The increased power demands of the algorithm are considered to be negligible. It is expected that SoftVoice will reduce power consumption at low ambient sound levels. These results support the use of SoftVoice as a standard feature of Advanced Bionics CI fittings for everyday use.
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[article] 
inEar and hearing > Vol. 42, n°2 (Mars-Avril 2021) . - p. 393-404

Titre :	Association Between Nonoptimal Blood Pressure and Cochlear Function
Type de document :	Article
Auteurs :	Rachael R. Baiduc ; Michael Ramsey ; Amy Sanders ; Eric A. Vance
Année de publication :	2021
Article en page(s) :	p. 393-404
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Audiométrie haute fréquence ; Pression sanguine ; Produit de distorsion acoustique
Résumé :	Objectives: The association between hearing loss and risk factors for cardiovascular disease, including high blood pressure (BP), has been evaluated in numerous studies. However, data from population- and laboratory-based studies remain inconclusive. Furthermore, most prior work has focused on the effects of BP level on behavioral hearing sensitivity. In this study, we investigated cochlear integrity using distortion product otoacoustic emissions (DPOAEs) in persons with subtle elevation in BP levels (nonoptimal BP) hypothesizing that nonoptimal BP would be associated with poorer cochlear function. Design: Sixty individuals [55% male, mean age = 31.82 (SD = 11.17) years] took part in the study. The authors measured pure-tone audiometric thresholds from 0.25 to 16 kHz and computed four pure-tone averages (PTAs) for the following frequency combinations (in kHz): PTA0.25, 0.5, 0.75, PTA1, 1.5, 2, 3, PTA4, 6, 8, and PTA10, 12.5, 16. DPOAEs at the frequency 2f1-f2 were recorded for L1/L2 = 65/55 dB SPL using an f2/f1 ratio of 1.22. BP was measured, and subjects were categorized as having either optimal BP (systolic/diastolic =120 or diastolic >=80 mm Hg or use of antihypertensives). Between-group differences in behavioral thresholds and DPOAE levels were evaluated using 95% confidence intervals. Pearson product-moment correlations were run to assess the relationships between: (1) thresholds (all four PTAs) and BP level and (2) DPOAE [at low (f2 2 kHz and 10 kHz) frequency bins] and BP level. Linear mixed-effects models were constructed to account for the effects of BP status, stimulus frequency, age and sex on thresholds, and DPOAE amplitudes. Results: Significant positive correlations between diastolic BP and all four PTAs and systolic BP and PTA0.25, 0.5, 0.75 and PTA4, 6, 8 were observed. There was not a significant effect of BP status on hearing thresholds from 0.5 to 16 kHz after adjustment for age, sex, and frequency. Correlations between diastolic and systolic BP and DPOAE levels were statistically significant at the high frequencies and for the relationship between diastolic BP and DPOAE level at the mid frequencies. Averaged across frequency, the nonoptimal BP group had DPOAE levels 1.50 dB lower (poorer) than the optimal BP group and differences were statistically significant (p = 0.03). Conclusions: Initial findings suggest significant correlations between diastolic BP and behavioral thresholds and diastolic BP and mid-frequency DPOAE levels. However, adjusted models indicate other factors are more important drivers of impaired auditory function. Contrary to our hypothesis, we found that subtle BP elevation was not associated with poorer hearing sensitivity or cochlear dysfunction. We consider explanations for the null results. Greater elevation in BP (i.e., hypertension itself) may be associated with more pronounced effects on cochlear function, warranting further investigation. This study suggests that OAEs may be a viable tool to characterize the relationship between cardiometabolic risk factors (and in particular, stage 2 hypertension) and hearing health
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[article] Association Between Nonoptimal Blood Pressure and Cochlear Function [Article] / Rachael R. Baiduc ; Michael Ramsey ; Amy Sanders ; Eric A. Vance . - 2021 . - p. 393-404.
Langues : Anglais (eng)
in Ear and hearing > Vol. 42, n°2 (Mars-Avril 2021) . - p. 393-404

Descripteurs :	HE Vinci Audiométrie haute fréquence ; Pression sanguine ; Produit de distorsion acoustique
Résumé :	Objectives: The association between hearing loss and risk factors for cardiovascular disease, including high blood pressure (BP), has been evaluated in numerous studies. However, data from population- and laboratory-based studies remain inconclusive. Furthermore, most prior work has focused on the effects of BP level on behavioral hearing sensitivity. In this study, we investigated cochlear integrity using distortion product otoacoustic emissions (DPOAEs) in persons with subtle elevation in BP levels (nonoptimal BP) hypothesizing that nonoptimal BP would be associated with poorer cochlear function. Design: Sixty individuals [55% male, mean age = 31.82 (SD = 11.17) years] took part in the study. The authors measured pure-tone audiometric thresholds from 0.25 to 16 kHz and computed four pure-tone averages (PTAs) for the following frequency combinations (in kHz): PTA0.25, 0.5, 0.75, PTA1, 1.5, 2, 3, PTA4, 6, 8, and PTA10, 12.5, 16. DPOAEs at the frequency 2f1-f2 were recorded for L1/L2 = 65/55 dB SPL using an f2/f1 ratio of 1.22. BP was measured, and subjects were categorized as having either optimal BP (systolic/diastolic =120 or diastolic >=80 mm Hg or use of antihypertensives). Between-group differences in behavioral thresholds and DPOAE levels were evaluated using 95% confidence intervals. Pearson product-moment correlations were run to assess the relationships between: (1) thresholds (all four PTAs) and BP level and (2) DPOAE [at low (f2 2 kHz and 10 kHz) frequency bins] and BP level. Linear mixed-effects models were constructed to account for the effects of BP status, stimulus frequency, age and sex on thresholds, and DPOAE amplitudes. Results: Significant positive correlations between diastolic BP and all four PTAs and systolic BP and PTA0.25, 0.5, 0.75 and PTA4, 6, 8 were observed. There was not a significant effect of BP status on hearing thresholds from 0.5 to 16 kHz after adjustment for age, sex, and frequency. Correlations between diastolic and systolic BP and DPOAE levels were statistically significant at the high frequencies and for the relationship between diastolic BP and DPOAE level at the mid frequencies. Averaged across frequency, the nonoptimal BP group had DPOAE levels 1.50 dB lower (poorer) than the optimal BP group and differences were statistically significant (p = 0.03). Conclusions: Initial findings suggest significant correlations between diastolic BP and behavioral thresholds and diastolic BP and mid-frequency DPOAE levels. However, adjusted models indicate other factors are more important drivers of impaired auditory function. Contrary to our hypothesis, we found that subtle BP elevation was not associated with poorer hearing sensitivity or cochlear dysfunction. We consider explanations for the null results. Greater elevation in BP (i.e., hypertension itself) may be associated with more pronounced effects on cochlear function, warranting further investigation. This study suggests that OAEs may be a viable tool to characterize the relationship between cardiometabolic risk factors (and in particular, stage 2 hypertension) and hearing health
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[article] 
inEar and hearing > Vol. 42, n°2 (Mars-Avril 2021) . - p. 405-413

Titre :	A Cross-Language Comparison of Sentence Recognition Using American English and Mandarin Chinese HINT and AzBio Sentences
Type de document :	Article
Auteurs :	Li Xu ; Xin Xi ; Alexa Patton ; Xianhui Wang ; Beier Qi ; Lauren Johnson
Année de publication :	2021
Article en page(s) :	p. 405-413
Langues :	Anglais (eng)
Descripteurs :	Autres descripteurs Comparaison linguistique ; Hearing in Noise Test (HINT) ; Vocodeur HE Vinci Masquage ; Reconnaissance des phrases
Résumé :	bjectives: The aim of this study was to perform a cross-language comparison of two commonly used sentence-recognition materials (i.e., Hearing in Noise Test [HINT] and AzBio) in American English (AE) and Mandarin Chinese (MC). Designs: Sixty normal-hearing, native English-speaking and 60 normal-hearing, native Chinese-speaking young adults were recruited to participate in three experiments. In each experiment, the subjects were tested in their native language. In experiments I and II, noise and tone vocoders were used to process the HINT and AzBio sentences, respectively. The number of channels varied from 1 to 9, with an envelope cutoff frequency of 160 Hz. In experiment III, the AE AzBio and the MC HINT sentences were tested in speech-shaped noise at various signal to noise ratios (i.e., -20, -15, -10, -5, and 0 dB). The performance-intensity functions of sentence recognition using the two sets of sentence materials were compared. Results: Results of experiments I and II using vocoder processing indicated that the AE and MC versions of HINT and AzBio sentences differed in level of difficulty. The AE version yielded higher recognition performance than the MC version for both HINT and AzBio sentences. The type of vocoder processing (i.e., tone and noise vocoders) produced little differences in sentence-recognition performance in both languages. Incidentally, the AE AzBio sentences and the MC HINT sentences had similar recognition performance under vocoder processing. Such similarity was further confirmed under noise conditions in experiment III, where the performance-intensity functions of the two sets of sentences were closely matched. Conclusions: The HINT and AzBio sentence materials developed in AE and MC differ in level of difficulty. The AE AzBio and the MC HINT sentence materials are similar in level of difficulty. In cross-language comparative research, the MC HINT and the AE AzBio sentences should be chosen for the respective language as the target sentence-recognition test materials.
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[article] A Cross-Language Comparison of Sentence Recognition Using American English and Mandarin Chinese HINT and AzBio Sentences [Article] / Li Xu ; Xin Xi ; Alexa Patton ; Xianhui Wang ; Beier Qi ; Lauren Johnson . - 2021 . - p. 405-413.
Langues : Anglais (eng)
in Ear and hearing > Vol. 42, n°2 (Mars-Avril 2021) . - p. 405-413

Descripteurs :	Autres descripteurs Comparaison linguistique ; Hearing in Noise Test (HINT) ; Vocodeur HE Vinci Masquage ; Reconnaissance des phrases
Résumé :	bjectives: The aim of this study was to perform a cross-language comparison of two commonly used sentence-recognition materials (i.e., Hearing in Noise Test [HINT] and AzBio) in American English (AE) and Mandarin Chinese (MC). Designs: Sixty normal-hearing, native English-speaking and 60 normal-hearing, native Chinese-speaking young adults were recruited to participate in three experiments. In each experiment, the subjects were tested in their native language. In experiments I and II, noise and tone vocoders were used to process the HINT and AzBio sentences, respectively. The number of channels varied from 1 to 9, with an envelope cutoff frequency of 160 Hz. In experiment III, the AE AzBio and the MC HINT sentences were tested in speech-shaped noise at various signal to noise ratios (i.e., -20, -15, -10, -5, and 0 dB). The performance-intensity functions of sentence recognition using the two sets of sentence materials were compared. Results: Results of experiments I and II using vocoder processing indicated that the AE and MC versions of HINT and AzBio sentences differed in level of difficulty. The AE version yielded higher recognition performance than the MC version for both HINT and AzBio sentences. The type of vocoder processing (i.e., tone and noise vocoders) produced little differences in sentence-recognition performance in both languages. Incidentally, the AE AzBio sentences and the MC HINT sentences had similar recognition performance under vocoder processing. Such similarity was further confirmed under noise conditions in experiment III, where the performance-intensity functions of the two sets of sentences were closely matched. Conclusions: The HINT and AzBio sentence materials developed in AE and MC differ in level of difficulty. The AE AzBio and the MC HINT sentence materials are similar in level of difficulty. In cross-language comparative research, the MC HINT and the AE AzBio sentences should be chosen for the respective language as the target sentence-recognition test materials.
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[article] 
inEar and hearing > Vol. 42, n°2 (Mars-Avril 2021) . - p. 414-424

Titre :	Simultaneous Intra- and Extracochlear Electrocochleography During Electrode Insertion
Type de document :	Article
Auteurs :	Adrian Dalbert ; Leanne Sijgers ; Julian Grosse ; Dorothe Veraguth ; Christof Röösli ; Alexander Huber ; Flurin Pfiffner
Année de publication :	2021
Article en page(s) :	p. 414-424
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Electrocochléographie Autres descripteurs Audition residuelle ; Implantation cochleaire simultanee
Résumé :	Objectives: (1) To correlate simultaneously recorded intra- and extracochlear electrocochleography (ECochG) signals during electrode insertion into the cochlea, (2) to track changes in the ECochG signal during insertion and removal of an electrode, and (3) to correlate the findings with the preoperative residual hearing. We hypothesized that intracochlear ECochG recordings show signal changes not reflected in simultaneous extracochlear ECochG recordings. Design: During cochlear implantation in human cochlear implant recipients, a short, slim, custom-made electrode was inserted and removed in a stepwise manner. At each step, ECochG recordings were simultaneously recorded by an extracochlear electrode near the round window and via the inserted electrode. The acoustic stimulus was a 500 Hz tone burst at 110 to 130 dB SPL. Results: The mean amplitude difference between intra- and extracochlear ongoing ECochG responses was 14 dB (range 9 to 24 dB; n = 10) at the beginning of insertion. Intracochlear ECochG responses were larger in all cases. Extracochlear ECochG responses remained stable while intracochlear recordings showed large variations regarding amplitude and phase during the electrode array insertion. Intracochlear signal changes during insertion were reversible with retraction of the electrode. There were only weak to moderate (rs = 0.006 to 0.4), nonsignificant correlations of residual preoperative hearing with maximum amplitudes and amplitude changes during electrode insertion and removal in intracochlear recordings. Conclusions: Signals in intracochlear ECochG recordings are reliably larger than ECochG signals recorded simultaneously from an extracochlear location. Intracochlear ECochG recordings show reversible amplitude and phase changes during insertion, not reflected in simultaneous extracochlear ECochG recordings. Such changes are most likely due to the movement of the recording electrode in relation to the signal generators. Residual high-frequency hearing is associated with larger ECochG signal amplitudes. Modeling of expected intracochlear ECochG changes during electrode insertions may allow detection of cochlear trauma in the future.
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[article] Simultaneous Intra- and Extracochlear Electrocochleography During Electrode Insertion [Article] / Adrian Dalbert ; Leanne Sijgers ; Julian Grosse ; Dorothe Veraguth ; Christof Röösli ; Alexander Huber ; Flurin Pfiffner . - 2021 . - p. 414-424.
Langues : Anglais (eng)
in Ear and hearing > Vol. 42, n°2 (Mars-Avril 2021) . - p. 414-424

Descripteurs :	HE Vinci Electrocochléographie Autres descripteurs Audition residuelle ; Implantation cochleaire simultanee
Résumé :	Objectives: (1) To correlate simultaneously recorded intra- and extracochlear electrocochleography (ECochG) signals during electrode insertion into the cochlea, (2) to track changes in the ECochG signal during insertion and removal of an electrode, and (3) to correlate the findings with the preoperative residual hearing. We hypothesized that intracochlear ECochG recordings show signal changes not reflected in simultaneous extracochlear ECochG recordings. Design: During cochlear implantation in human cochlear implant recipients, a short, slim, custom-made electrode was inserted and removed in a stepwise manner. At each step, ECochG recordings were simultaneously recorded by an extracochlear electrode near the round window and via the inserted electrode. The acoustic stimulus was a 500 Hz tone burst at 110 to 130 dB SPL. Results: The mean amplitude difference between intra- and extracochlear ongoing ECochG responses was 14 dB (range 9 to 24 dB; n = 10) at the beginning of insertion. Intracochlear ECochG responses were larger in all cases. Extracochlear ECochG responses remained stable while intracochlear recordings showed large variations regarding amplitude and phase during the electrode array insertion. Intracochlear signal changes during insertion were reversible with retraction of the electrode. There were only weak to moderate (rs = 0.006 to 0.4), nonsignificant correlations of residual preoperative hearing with maximum amplitudes and amplitude changes during electrode insertion and removal in intracochlear recordings. Conclusions: Signals in intracochlear ECochG recordings are reliably larger than ECochG signals recorded simultaneously from an extracochlear location. Intracochlear ECochG recordings show reversible amplitude and phase changes during insertion, not reflected in simultaneous extracochlear ECochG recordings. Such changes are most likely due to the movement of the recording electrode in relation to the signal generators. Residual high-frequency hearing is associated with larger ECochG signal amplitudes. Modeling of expected intracochlear ECochG changes during electrode insertions may allow detection of cochlear trauma in the future.
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