| 1. |
- Maier, Hannes, et al.
(författare)
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Consensus Statement on Bone Conduction Devices and Active Middle Ear Implants in Conductive and Mixed Hearing Loss
- 2022
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Ingår i: Otology and Neurotology. - : Lippincott, Williams & Wilkins. - 1531-7129 .- 1537-4505. ; 43:5, s. 513-529
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Tidskriftsartikel (refereegranskat)abstract
- Nowadays, several options are available to treat patients with conductive or mixed hearing loss. Whenever surgical intervention is not possible or contra-indicated, and amplification by a conventional hearing device (e.g., behind-the-ear device) is not feasible, then implantable hearing devices are an indispensable next option. Implantable bone-conduction devices and middle-ear implants have advantages but also limitations concerning complexity/invasiveness of the surgery, medical complications, and effectiveness. To counsel the patient, the clinician should have a good overview of the options with regard to safety and reliability as well as unequivocal technical performance data. The present consensus document is the outcome of an extensive iterative process including ENT specialists, audiologists, health-policy scientists, and representatives/technicians of the main companies in this field. This document should provide a first framework for procedures and technical characterization to enhance effective communication between these stakeholders, improving health care.
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| 2. |
- Eeg-Olofsson, Måns, 1967, et al.
(författare)
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Transmission of bone conducted sound – Correlation between hearing perception and cochlear vibration
- 2013
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Ingår i: Hearing Research. - : Elsevier. - 0378-5955 .- 1878-5891. ; 306, s. 11-20
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Tidskriftsartikel (refereegranskat)abstract
- The vibration velocity of the lateral semicircular canal and the cochlear promontory was measured on 16 subjects with a unilateral middle ear common cavity, using a laser Doppler vibrometer, when the stimulation was by bone conduction (BC). Four stimulation positions were used: three ipsilateral positions and one contralateral position. Masked BC pure tone thresholds were measured with the stimulation at the same four positions. Valid vibration data were obtained at frequencies between 0.3 and 5.0 kHz. Large intersubject variation of the results was found with both methods. The difference in cochlear velocity with BC stimulation at the four positions varied as a function of frequency while the tone thresholds showed a tendency of lower thresholds with stimulation at positions close to the cochlea. The correlation between the vibration velocities of the two measuring sites of the otic capsule was high. Also, relative median data showed similar trends for both vibration and threshold measurements. However, due to the high variability for both vibration and perceptual data, low correlation between the two methods was found at the individual level. The results from this study indicated that human hearing perception from BC sound can be estimated from the measure of cochlear vibrations of the otic capsule. It also showed that vibration measurements of the cochlea in cadaver heads are similar to that measured in live humans.
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| 3. |
- Håkansson, Bo, 1953, et al.
(författare)
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A novel bone conduction implant (BCI): engineering aspects and pre-clinical studies.
- 2010
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Ingår i: International journal of audiology. - : Informa UK Limited. - 1499-2027 .- 1708-8186. ; 49:3, s. 203-15
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Tidskriftsartikel (refereegranskat)abstract
- Percutaneous bone anchored hearing aids (BAHA) are today an important rehabilitation alternative for patients suffering from conductive or mixed hearing loss. Despite their success they are associated with drawbacks such as skin infections, accidental or spontaneous loss of the bone implant, and patient refusal for treatment due to stigma. A novel bone conduction implant (BCI) system has been proposed as an alternative to the BAHA system because it leaves the skin intact. Such a BCI system has now been developed and the encapsulated transducer uses a non-screw attachment to a hollow recess of the lateral portion of the temporal bone. The aim of this study is to describe the basic engineering principals and some preclinical results obtained with the new BCI system. Laser Doppler vibrometer measurements on three cadaver heads show that the new BCI system produces 0-10 dB higher maximum output acceleration level at the ipsilateral promontory relative to conventional ear-level BAHA at speech frequencies. At the contralateral promontory the maximum output acceleration level was considerably lower for the BCI than for the BAHA.
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| 4. |
- Petersen, Eline Borch, 1986-
(författare)
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Neural and Cognitive Effects of Hearing Loss on Speech Processing
- 2017
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Understanding speech in the presence of noise can be difficult, especially when suffering from a hearing loss. This thesis examined behavioural and electrophysiological measures of speech processing with the aim of establishing how they were influenced by hearing loss (internal degradation) and listening condition (external degradation). The hypothesis that more internal and external degradation of a speech signal would result in higher working memory (WM) involvement was investigated in four studies. The behavioural measure of speech recognition consistently decreased with worse hearing, whereas lower WM capacity only resulted in poorer speech recognition when sound were spatially co-located. Electrophysiological data (EEG) recorded during speech processing, revealed that worse hearing was associated with an increase in inhibitory alpha activity (~10 Hz). This indicates that listeners with worse hearing experienced a higher degree of WM involvement during the listening task. When increasing the level of background noise, listeners with poorer hearing exhibited a breakdown in alpha activity, suggesting that these listeners reached a ceiling at which no more WM resources could be released through neural inhibition. Worse hearing was also associated with a reduced ability to selectively attend to one of two simultaneous talkers, brought on by a reduced neural inhibition of the to-be-ignored speech. Increasing the level of background noise reduced the ability to neurally track the to-be-attended speech. That internal and external degradation affected the tracking of ignored and attended speech, respectively, indicates that the two speech streams were neurally processed as independent objects. This thesis demonstrates for the first time that hearing loss causes changes in the induced neural activity during speech processing. In the last paper of the thesis, it is tentatively suggested that neural activity can be utilized from electrodes positioned in the ear canal (EarEEG) for adapting hearing-aid processing to suite the individual listeners and situation.
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| 5. |
- Eeg-Olofsson, Måns, 1967, et al.
(författare)
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Implications for contralateral bone-conducted transmission as measured by cochlear vibrations.
- 2011
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Ingår i: Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology. - : LWW. - 1537-4505 .- 1531-7129. ; 32:2, s. 192-8
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Tidskriftsartikel (refereegranskat)abstract
- The velocity response at the contralateral cochlea from bone-conducted (BC) stimulation depends on the stimulation position.
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| 6. |
- Eeg-Olofsson, Måns, 1967, et al.
(författare)
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Transmission of bone-conducted sound in the human skull measured by cochlear vibrations.
- 2008
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Ingår i: International journal of audiology. - : Informa UK Limited. - 1708-8186 .- 1499-2027. ; 47:12, s. 761-9
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Tidskriftsartikel (refereegranskat)abstract
- One limitation with the Bone Anchored Hearing Aid (Baha) is too poor amplification for patients with moderate to severe sensorineural hearing losses. Therefore, we investigated if bone conducted (BC) sound transmission improves when the stimulation approaches the cochlea. Also the influence from the squamosal suture on BC sound transmission was investigated. Both sides of the heads on seven human cadavers were used and vibrational stimulation was applied at eight positions on each side with a frequency range of 0.1-10 kHz. A laser Doppler vibrometer was used to measure the resulting velocity of the cochlear promontory. It was found that the velocity of the promontory increases as the stimulation position approaches the cochlea; this was especially apparent at distances within 2.5 cm from the ear canal opening and when the stimulation position was in the opened mastoid. At frequencies above 500 Hz there was on average 10 to 20 dB greater vibrational response at the cochlea when the stimulation was close to the cochlea compared with the normal Baha position. Moreover, even if there were general indications of attenuation of BC sound when passing the squamosal suture, an effect from the suture could not be conclusively determined.
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| 7. |
- Saremi, Amin, et al.
(författare)
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The effects of noise-induced hair cell lesions on cochlear electromechanical responses : a computational approach using a biophysical model
- 2022
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Ingår i: International Journal for Numerical Methods in Biomedical Engineering. - : John Wiley & Sons. - 2040-7939 .- 2040-7947. ; 38:5
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Tidskriftsartikel (refereegranskat)abstract
- A biophysically inspired signal processing model of the human cochlea is deployed to simulate the effects of specific noise-induced inner hair cell (IHC) and outer hair cell (OHC) lesions on hearing thresholds, cochlear compression, and the spectral and temporal features of the auditory nerve (AN) coding. The model predictions were evaluated by comparison with corresponding data from animal studies as well as human clinical observations. The hearing thresholds were simulated for specific OHC and IHC damages and the cochlear nonlinearity was assessed at 0.5 and 4 kHz. The tuning curves were estimated at 1 kHz and the contributions of the OHC and IHC pathologies to the tuning curve were distinguished by the model. Furthermore, the phase locking of AN spikes were simulated in quiet and in presence of noise. The model predicts that the phase locking drastically deteriorates in noise indicating the disturbing effect of background noise on the temporal coding in case of hearing impairment. Moreover, the paper presents an example wherein the model is inversely configured for diagnostic purposes using a machine learning optimization technique (Nelder–Mead method). Accordingly, the model finds a specific pattern of OHC lesions that gives the audiometric hearing loss measured in a group of noise-induced hearing impaired humans.
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| 8. |
- Skagerstrand, Åsa, 1969-, et al.
(författare)
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Loudness and annoyance of disturbing sounds : perception by normal hearing subjects
- 2017
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Ingår i: International Journal of Audiology. - : Taylor & Francis. - 1499-2027 .- 1708-8186. ; 56:10, s. 775-783
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: Sounds in the daily environment may cause loudness and annoyance. The present study investigated the perception of loudness and annoyance for eight different sounds present in a daily sound environment and at nine different levels varying by ±20 dB around the recorded level. The outcomes were related to tests of participants' auditory and cognitive abilities.DESIGN: The participants undertook auditory and working memory (WM) tests prior to ratings of everyday sounds previously shown to be disturbing for persons with hearing impairment (hearing aid users).STUDY SAMPLE: Twenty-one participants aged between 24 and 71 years, with normal hearing threshold levels.RESULTS: Both perceived loudness and annoyance were primarily driven by the sound level. Sounds emitted from paper were rated as having greater loudness and being more annoying than the other sound sources at the same sound level. Auditory and cognitive abilities did not influence the perception of loudness and annoyance.CONCLUSIONS: Loudness and annoyance ratings were mainly driven by sound level. Expectations of a sound seemed to influence the assessment of loudness and annoyance while auditory performance and WM capacity showed no influence on the ratings.
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| 9. |
- Priwin, Claudia, 1971, et al.
(författare)
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Bilateral bone-anchored hearing aids (BAHAs): an audiometric evaluation
- 2004
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Ingår i: Laryngoscope. - : Laryngoscope. - 0023-852X .- 1531-4995. ; 114:1, s. 77-84
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: Since the technique to implant bone-anchored hearing aids (BAHAs) with the use of osseointegrated implants was developed in 1977, more than 15,000 patients have been fitted with BAHAs worldwide. Although the majority have bilateral hearing loss, they are primarily fitted unilaterally. The main objective of this study was to reveal benefits and drawbacks of bilateral fitting of BAHAs in patients with symmetric or slight asymmetric bone-conduction thresholds. The possible effects were divided into three categories: hearing thresholds, directional hearing, and binaural hearing. STUDY DESIGN: Prospective study of 12 patients with bilateral BAHAs. METHODS: Baseline audiometry, directional hearing, speech reception thresholds in quiet and in noise, and binaural masking level difference were tested when BAHAs were fitted unilaterally and bilaterally. RESULTS: Eleven of the 12 patients used bilateral BAHAs on a daily basis. Tests performed in the study show a significant improvement in sound localization with bilateral BAHAs; the results with unilateral fitting were close to the chance level. Furthermore, with bilateral application, the improvement of the speech reception threshold in quiet was 5.4 dB. An improvement with bilateral fitting was also found for speech reception in noise. CONCLUSIONS: Overall, the results with bilateral fitted BAHAs were better than with unilaterally fitted BAHA; the benefit is not only caused simply by bilateral stimulation but also, to some extent, by binaural hearing. Bilateral BAHAs should be considered for patients with bilateral hearing loss otherwise suitable for BAHAs.
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| 10. |
- Skagerstrand, Åsa, 1969-, et al.
(författare)
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Sounds perceived as annoying by hearing-aid users in their daily soundscape
- 2014
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Ingår i: International Journal of Audiology. - London : Informa Healthcare. - 1499-2027 .- 1708-8186. ; 53:4, s. 259-269
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Tidskriftsartikel (refereegranskat)abstract
- Background: The noises in modern soundscapes continue to increase and are a major origin for annoyance. For a hearing-impaired person, a hearing aid is often beneficial, but noise and annoying sounds can result in non-use of the hearing aid, temporary or permanently.Objective: The purpose of this study was to identify annoying sounds in a daily soundscape for hearing-aid users.Design: A diary was used to collect data where the participants answered four questions per day about annoying sounds in the daily soundscape over a two-week period.Study sample: Sixty adult hearing-aid users. Results: Of the 60 participants 91% experienced annoying sounds daily when using hearing aids. The annoying sound mentioned by most users, was verbal human sounds, followed by other daily sound sources categorized into 17 groups such as TV/radio, vehicles, and machine tools. When the hearing-aid users were grouped in relation to age, hearing loss, gender, hearing-aid experience, and type of signal processing used in their hearing aids, small and only few significant differences were found when comparing their experience of annoying sounds.Conclusions: The results indicate that hearing-aid users often experience annoying sounds and improved clinical fitting routines may reduce the problem.
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