How to improve a hearing aid fitting based on idiosyncratic consonant errors

Inter-trial coherence as a marker of cortical phase synchrony in children with sensorineural hearing loss and auditory neuropathy spectrum disorder fitted with hearing aids and cochlear implants

Interaural time just noticeable differences (JNDs) were obtained with a low-frequency (450-550 Hz) and high-frequency (3 750-4 250 Hz) narrow-band noise for 3 normally hearing subjects and 8 subjects with sensorineural hearing loss. Results for the hearing-impaired subjects were compared to those of the subjects with normal hearing at the same sound pressure level (85 dB SPL) and sensation level (30 dB SL). Although large individual differences were present, when considered as a group, interaural time discrimination for the subjects with sensorineural hearing loss was significantly poorer than that of the normal subjects for both signals at both intensity levels. There was no apparent relationship between configuration of hearing loss and time discrimination, but correlations of +0.8 were found between degree of hearing loss and time JNDs. Normal interaural intensity JNDs were obtained from 2 subjects with sensorineural hearing loss whose time JNDs were very poor, thus providing further evidence against the latency hypothesis.

Incorporating a Client-Centered Approach to Audiologic Rehabilitation

本研究目的在探討老年期聽損程度、聽覺表現、溝通策略與生活適應的關係。研究對象有195名，年紀都在55歲以上，聽力正常者37人，輕度、中度、中重度、重度以上聽損者各有39、40、43、以及36人，配戴助聽器者有62人，沒有配戴者131人。在聽力檢查室檢測完畢後，填寫老年聽覺表現量表（25題）、溝通策略量表（16題）、以及生活適應量表（22題）。研究結果發現不同聽損程度的年長者在溝通上較偏向於積極面對的因應策略；在聽覺表現上，隨著聽損程度的增加，其聽覺表現會愈差，亦即聽力損失愈多者，其社會情境的溝通與情緒的表現越差；在生活適應上，聽常年長者優於聽損程度輕度以上者，而聽損者之間則無顯著差異，亦即無論聽損程度多寡，都會造成生活適應上的問題。聽損程度、聽覺表現、溝通策略、以及生活適應的相關，僅有聽損程度與溝通策略沒有達到統計顯著外，其餘兩兩之間的相關都達到顯著。根據研究結果，本研究建議未來在實務與研究上，能找到更多和溝通策略一樣，能調節聽力損失對於聽覺表現與生活適應影響的變項，以促進年長者的聽覺表現與生活適應，並進一步探討變項間的關係，以建立老年期生活適應的理論模型。

Children with hearing loss require a more advantageous SNR than children with normal hearing to achieve comparable masked speech recognition performance. Although children with hearing loss continue to have difficulties even when appropriately fitted with hearing aids, individual differences are often substantial. This study evaluated the influence of age, degree of hearing loss, aided audibility, and daily hearing aid use on speech-in-noise and speech-in-speech recognition on a sample of 47 children (5-17 years) with bilateral, sensorineural hearing loss. Age-matched children with normal hearing were also tested. Each child completed open-set monosyllabic word recognition in two masker conditions; speech-shaped noise and two-talker speech. Thresholds for 50% correct were measured in each masker using an adaptive tracking procedure. Compared to children with normal hearing, thresholds for children with hearing loss were elevated by an average of 7.4 dB in the noise masker and 6.5 dB in the speech masker. Preliminary results indicate that both age and aided audibility were significant predictors of performance for children with hearing loss in both masker conditions. Hearing aid use was a significant predictor of performance in noise. Degree of hearing loss was not associated with performance in either masker when aided audibility was taken into account.

The Bonebridge hearing aid (Med-EL, Innsbruck, Austria) is a semi-implantable hearing system with transcutaneous bone conduction that was implemented in Europe in 2012. It is indicated for patients with conductive and mixed hearing loss or unilateral profound sensorineural hearing loss, who do not obtain adequate benefits with conventional hearing aids and are not candidates for middle ear reconstructive surgery. The Bonebridge device, being an active transcutaneous bone conduction implant, can overcome the disadvantages of percutaneous bone conduction devices. The Vibrant Soundbridge hearing aid (Med-EL, Innsbruck, Austria) was implemented in Europe in 1996 as an implantable hearing device in the middle ear in patients with mild to severe sensorineural, conductive or mixed hearing loss with medical and audiological contraindications for the use of conventional hearing aids or with rapidly progressive sensorineural hearing loss. The Bonebridge and Vibrant Soundbridge devices, used in patients with the same indication criteria, had similar audiological results – adequate hearing rehabilitation with improvement of subjective hearing (perception of silent and noisy speech, spatial hearing, hearing quality, sound localization), a significant increase in perceived quality of life and patients’ satisfaction with the hearing aid (comfort, sound quality, cosmetic appearance). Because the Vibrant Soundbridge device requires the floating mass transducer to be coupled to the ossicles, round window, or oval window, this surgery carries a higher risk of inner ear injury than surgery with the Bonebridge device. The advantages of the Vibrant Soundbridge system, compared to the Bonebridge device, are the potential for greater stimulation power, especially at high frequencies, unilaterally stimulating the affected ear without influencing the contralateral ear through bone conduction.

Hearing aids have fundamental disadvantages: (1) stigmatization of the patient; (2) the sound is often found to be unsatisfactory due to the limited frequency range and undesired distortion; (3) in many patients, the ear canal fitting device generally necessary leads to an occlusion effect; (4) acoustic feedback when amplification is high. Conventional hearing aids transmit sound into the ear canal via a small microphone. Sound has the disadvantage of requiring high output sound pressure levels for its transmission. This along with the necessary miniaturization of the loudspeaker as well as the resonances and reflections in the closed ear canal contribute to the disadvantages mentioned. In contrast, implantable hearing aids do not make sound signals but micromechanical vibrations. An implantable hearing aid has an electromechanical transducer instead of the loudspeaker of a conventional hearing aid. The hearing signal does not leave the transducer as sound but as a mechanical vibration which is directly coupled to the auditory system bypassing the air. This implantable hearing aid is either coupled to the tympanic membrane, the ossicular chain, the perilymph of the inner ear, or the skull. An implantable hearing aid is expected to have: 1 Better sound fidelity than a hearing aid 2 No ear canal fitting device, free ear canal 3 No feedback 4 Invisibility Requirements on electronic hearing implants designed for patients with conductive hearing loss differ from those on implants for sensorineural hearing loss. Conductive hearing loss requires the implant to replace the impedance transformation, thus being an impedance transformation implant (ITI). In various respects, the demands on an ITI are lower than the demands on an electronic hearing aid for patients with sensorineural hearing loss. The latter are mostly patients with a failure of the cochlea amplifier (CA). A damage to the CA is clinically discernible by a positive recruitment and loss of otoacoustic emissions (OAE). Since these patients form the majority of cases with sensorineural hearing loss, an active hearing implant for such patients should partially replace the function of the CA. Therefore, the suggestion is to refer to a CAI (cochlea amplifier implant). The implant expressions ITI (for patients with conductive hearing loss) and CAI (for patients with sensorineural hearing loss) used in this context allow nomenclatural association with the CI (cochlear implant) for complete inner ear failure as well as with the BSI (brainstem implant) in the case of hearing nerve failure.

Regenerating Hearing: Researchers Begin First-Ever Study of Stem Cells to Treat Hearing Loss

ObjectiveThe number of steps required to regain balance is an easily obtainable clinical outcome measure. This study assessed whether number of steps during loss of balance could identify older adults with hearing loss who have balance deficits. We aimed to answer two questions: 1) Does hearing loss negatively affect the ability to regain balance, as reflected by an increased number of steps needed to respond to a perturbation while simultaneously attending to speech-in-noise; and 2) Do hearing aids improve balance control, reflected by a decrease in number of steps needed to regain balance?Methods20 young adults and 20 older adults with normal hearing, and 19 older adults with hearing loss performed an auditory-balance dual-task. Participants were asked to listen and repeat back sentences from a standardized audiology test, while simultaneously responding to backward surface translations. Outcome measures were performed on the auditory test and number of steps needed to regain balance. Repeated measures ANCOVA models were run in using group, time, hearing levels, and perturbation levels as predictors.ResultsAuditory scores confirmed difficulty hearing speech-in-noise in older adults with hearing loss and no hearing aids, and in young and older adults with normal hearing and simulated hearing loss. Results showed that group, auditory and balance conditions are significantly related to both outcomes measures and time is not significant for steps. Older adults with hearing loss had a significant increase in number of steps needed to regain balance compared to young adults and older adults with normal hearing.ConclusionNumber of steps may be an appropriate clinical assessment tool for identifying fall risk in older adults with hearing loss. Further research needs to be performed to identify proper assessments and treatment interventions for older adults with hearing loss who have balance deficits.

Defibrinogenation therapy with batroxobin for idiopathic pediatric sudden sensorineural hearing loss: Report of three cases

This study examined the relationship between behavioural thresholds as measured by pure tone audiometry and electrophysiological thresholds measured by the Auditory Steady-State Response (ASSR) in children with normal hearing and sensorineural hearing loss. After being assessed, 45 children of both sexes, ranging in age from 5 to 15, were split into four groups: 10 with moderate to moderately severe sensorineural hearing loss (G2M); 10 with steeply sloping sensorineural hearing loss (G2D); 10 with profound and severe sensorineural hearing loss (G2S); and 15 with normal hearing (G1). ASSR, tympanometry, acoustic reflex testing, pure tone audiometry, and speech audiometry (SRT and SDT) were performed. The electrophysiological maximum in the group with normal hearing thresholds varied from 19 to 27 dB NA. The correlation in the group with moderate to moderately severe hearing loss was 0.42-0.74. The correlation in the steeply sloping hearing loss group was 0.68-0.94. The correlation in the group of people with profound and severe hearing loss was 0.59-0.86. The normal hearing group's mean differences in ASSR threshold and audiometric threshold ranged from -0.3 to 12 dB, in the moderate and moderately severe hearing loss group from -9 to 2 dB, in the steeply sloping hearing loss group from 1.4 to 7.5 dB, and in the severe and profound hearing loss group from -0.40 to 8.5 dB. As expected, there was no strong relationship between behavioural and electrophysiological thresholds in the group with normal hearing. But in children with hearing loss, there was a strong correlation between electrophysiological and behavioural thresholds; this relationship was especially evident in children with severe and profound hearing loss and those with steeply sloping hearing loss.

Army Moves to Higher Level of Hearing Protection

Evaluation of Hearing Loss after Failed Neonatal Hearing Screening

Clinical guidelines recommend genetic testing when evaluating congenital and late-onset sensorineural hearing loss (SNHL). Genetic diagnoses can provide parents additional information regarding anticipated hearing loss progression, comorbid conditions, and family planning. Additionally, obtaining a genetic diagnosis may increase parental acceptance of hearing loss and subsequent pursuit of intervention. This study evaluates the association between genetic diagnoses and hearing loss intervention. We included children ages 0-18 years with SNHL who were hearing aid or cochlear implant candidates but non-users and underwent hearing-loss gene panel testing prior to initiating intervention. Univariate analyses were performed to identify predictors of hearing aid fitting or cochlear implantation. Multivariate logistic regression evaluated the impact of demographic and clinical factors on subsequent intervention. Of the 385 children with SNHL who underwent hearing loss gene panel testing, 111 were included. Median age was 7.5 years. 56% were underrepresented minorities, 71% were non-White, and 71% were publicly insured. Those found to have a genetic diagnosis were 4.6 times as likely to subsequently undergo intervention (p=0.035). Additionally, bilateral hearing loss and earlier age of genetic testing were associated with increased likelihood of intervention. Up to half of children with SNHL are suspected to have an underlying genetic etiology. Children diagnosed with a genetic diagnosis are significantly more likely to subsequently utilize hearing aids or cochlear implantation. This provides additional support for clinical guidelines recommending genetic testing not only due to the impact of prognostication but also on treatment decision-making. 4 Laryngoscope, 133:1982-1986, 2023.

Prognostic indicators for sensorineural hearing loss in temporal bone histiocytosis