| 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. |
- Ghoncheh, Mohammad, et al.
(författare)
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Output performance of the novel active transcutaneous bone conduction implant Sentio at different stimulation sites
- 2022
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Ingår i: Hearing Research. - : ELSEVIER. - 0378-5955 .- 1878-5891. ; 421
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: The output performance of a novel semi-implantable transcutaneous bone conduction device was compared to an established percutaneous bone-anchored hearing system device using cadaver heads. The influence of actuator position, tissue growth below the actuator and mounting it on the surface or in a flattened bone bed on the performance of the implanted actuator was investigated.Materials and Methods: The percutaneous and the new transcutaneous device were sequentially implanted at two sites in five human cadaver heads: 55 mm superior-posterior to the ear canal opening (position A) and, closer to the cochlea, about 20 mm inferior-posterior to the ear canal opening behind the pinna on the mastoid (position B). The ipsi-and contralateral cochlear promontory (CP) velocity magnitude responses to percutaneous and transcutaneous stimulation were measured using laser Doppler vibrometry. In addition, the CP vibration of the transcutaneous device placed directly on the skull bone surface was compared with the placement in a flattened bone bed at a depth of about 3 mm. Finally, the influence of placing a thin silicone interposition layer under the implanted transducer was also explored.Results: The percutaneous device provided about an 11 dB higher average CP vibration level than the transcutaneous device at frequencies between 0.5 and 10 kHz. The ipsilateral CP vibration responses with stimulations at position B were on average 13 dB higher compared to stimulation at position A. The placement of the transcutaneous transducer at position B provided similar or higher average vibration magnitudes than the percutaneous transducer at position A. The 3 mm deep flattened bone bed had no significant effects on the output performance. Placing a thin silicone layer under the transcutaneous transducer had no significant influence on the output of the transcutaneous device.Conclusions: Our results using the CP vibration responses show that at frequencies above 500 Hz the new transcutaneous device at position B provides similar output levels as the percutaneous device at position A. The results also indicated that neither a bone bed for the placement of the transcutaneous transducer nor a simulated tissue growth between the actuator and the bone affect the output performance of the device.
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| 3. |
- Aazh, H, et al.
(författare)
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Influence of ear canal occlusion and static pressure difference on bone conduction thresholds: Implications for mechanisms of bone conduction
- 2005
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Ingår i: International Journal of Audiology. - : Informa Healthcare. - 1499-2027 .- 1708-8186. ; 44:5, s. 302-306
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Tidskriftsartikel (refereegranskat)abstract
- The effect of air pressure change on bone conduction (BC) hearing thresholds in the occluded ear was investigated. The pump manometer system of an impedance bridge was used to change the air pressure in the ear canal of twenty-two normally hearing subjects. BC thresholds were measured with: (1) open ear; (2) the ear canal occluded with a probe tube and application of 0 daPa air pressure; and (3) the ear canal occluded with a probe tube and application of -350 daPa air pressure. Thresholds were lower in condition 2 than in condition 1, the difference decreasing from 27 dB at 2500 Hz to 4.5 dB at 2000 Hz. Thresholds were higher in condition 3 than in condition 2. The results are interpreted in terms of changes in the relative contribution of the three routes of transmission for BC sound produced by occlusion and by a static pressure difference.
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| 4. |
- Asp, Filip, et al.
(författare)
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A longitudinal study of the bilateral benefit in children with bilateral cochlear implants
- 2015
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Ingår i: International Journal of Audiology. - : Taylor & Francis. - 1499-2027 .- 1708-8186. ; 54:2, s. 77-88
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To study the development of the bilateral benefit in children using bilateral cochlear implants by measurements of speech recognition and sound localization.DESIGN: Bilateral and unilateral speech recognition in quiet, in multi-source noise, and horizontal sound localization was measured at three occasions during a two-year period, without controlling for age or implant experience. Longitudinal and cross-sectional analyses were performed. Results were compared to cross-sectional data from children with normal hearing.STUDY SAMPLE: Seventy-eight children aged 5.1-11.9 years, with a mean bilateral cochlear implant experience of 3.3 years and a mean age of 7.8 years, at inclusion in the study. Thirty children with normal hearing aged 4.8-9.0 years provided normative data.RESULTS: For children with cochlear implants, bilateral and unilateral speech recognition in quiet was comparable whereas a bilateral benefit for speech recognition in noise and sound localization was found at all three test occasions. Absolute performance was lower than in children with normal hearing. Early bilateral implantation facilitated sound localization.CONCLUSIONS: A bilateral benefit for speech recognition in noise and sound localization continues to exist over time for children with bilateral cochlear implants, but no relative improvement is found after three years of bilateral cochlear implant experience.
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| 5. |
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| 6. |
- Asp, Filip, et al.
(författare)
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Bilateral versus unilateral cochlear implants in children: Speech recognition, sound localization, and parental reports
- 2012
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Ingår i: International Journal of Audiology. - : Informa Healthcare. - 1499-2027 .- 1708-8186. ; 51:11, s. 817-832
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To compare bilateral and unilateral speech recognition in quiet and in multi-source noise, and horizontal sound localization of low and high frequency sounds in children with bilateral cochlear implants. Design: Bilateral performance was compared to performance of the implanted side with the best monaural speech recognition in quiet result. Parental reports were collected in a questionnaire. Results from the CI children were compared to binaural and monaural performance of normal-hearing peers. Study sample: Sixty-four children aged 5.1-11.9 years who were daily users of bilateral cochlear implants. Thirty normal-hearing children aged 4.8-9.0 years were recruited as controls. Results and Conclusions : Group data showed a statistically significant bilateral speech recognition and sound localization benefit, both behaviorally and in parental reports. The bilateral speech recognition benefit was smaller in quiet than in noise. The majority of subjects localized high and low frequency sounds significantly better than chance using bilateral implants, while localization accuracy was close to chance using unilateral implants. Binaural normal-hearing performance was better than bilateral performance in implanted children across tests, while bilaterally implanted children showed better localization than normal-hearing children under acute monaural conditions.
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| 7. |
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| 8. |
- Bernstein, Joshua G, et al.
(författare)
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Spectrotemporal modulation sensitivity as a predictor of speech intelligibility in noise with hearing aids
- 2014
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Ingår i: Spectrotemporal modulation sensitivity as a predictor of speech intelligibility in noise with hearing aids.
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Konferensbidrag (refereegranskat)abstract
- The audiogram predicts less than a third of the variance in speech reception thresholds (SRTs) for hearing-impaired (HI) listeners properly fit with individualized frequency-dependent gain. The remaining variance is often attributed to a combination of su-prathreshold distortion in the auditory pathway and non-auditory factors such as cogni-tive processing. Distinguishing between these factors requires a measure of suprathresh-old auditory processing to account for the non-cognitive contributions. Preliminary re-sults in 12 HI listeners identified a correlation between spectrotemporal modulation (STM) sensitivity and speech intelligibility in noise presented over headphones. The cur-IHCON 2014 27 August 13-17, 2014rent study assessed the effectiveness of STM sensitivity as a measure of suprathreshold auditory function to predict free-field SRTs in noise for a larger group of 47 HI listeners with hearing aids.SRTs were measured for Hagerman sentences presented at 65 dB SPL in stationary speech-weighted noise or four-talker babble. Pre-recorded speech and masker stimuli were played through a small anechoic chamber equipped with a master hearing aid pro-grammed with individualized gain. The output from an IEC711 Ear Simulator was played binaurally through insert earphones. Three processing algorithms were examined: linear gain, linear gain plus noise reduction, or fast-acting compressive gain.STM stimuli consist of spectrally-rippled noise with spectral-peak frequencies that shift over time. STM with a 2-cycle/octave spectral-ripple density and a 4-Hz modulation rate was applied to a 2-kHz lowpass-filtered pink-noise carrier. Stimuli were presented over headphones at 80 dB SPL (±5-dB roving). The threshold modulation depth was estimated adaptively in a two-alternative forced-choice task.STM sensitivity was strongly correlated (R2=0.48) with the global SRT (i.e., the SRTs averaged across masker and processing conditions). The high-frequency pure-tone aver-age (3-8 kHz) and age together accounted for 23% of the variance in global SRT. STM sensitivity accounted for an additional 28% of the variance in global SRT (total R2=0.51) when combined with these two other metrics in a multiple-regression analysis. Correla-tions between STM sensitivity and SRTs for individual conditions were weaker for noise reduction than for the other algorithms, and marginally stronger for babble than for sta-tionary noise.The results are discussed in the context of previous work suggesting that STM sensitivity for low rates and low carrier frequencies is impaired by a reduced ability to use temporal fine-structure information to detect slowly shifting spectral peaks. STM detection is a fast, simple test of suprathreshold auditory function that accounts for a substantial pro-portion of variability in hearing-aid outcomes for speech perception in noise.
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| 9. |
- Bernstein, Joshua G. W., et al.
(författare)
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Spectrotemporal Modulation Sensitivity as a Predictor of Speech-Reception Performance in Noise With Hearing Aids
- 2016
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Ingår i: TRENDS IN HEARING. - : SAGE PUBLICATIONS INC. - 2331-2165. ; 20
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Tidskriftsartikel (refereegranskat)abstract
- The audiogram predicts amp;lt;30% of the variance in speech-reception thresholds (SRTs) for hearing-impaired (HI) listeners fitted with individualized frequency-dependent gain. The remaining variance could reflect suprathreshold distortion in the auditory pathways or nonauditory factors such as cognitive processing. The relationship between a measure of suprathreshold auditory function-spectrotemporal modulation (STM) sensitivity-and SRTs in noise was examined for 154 HI listeners fitted with individualized frequency-specific gain. SRTs were measured for 65-dB SPL sentences presented in speech-weighted noise or four-talker babble to an individually programmed master hearing aid, with the output of an ear-simulating coupler played through insert earphones. Modulation-depth detection thresholds were measured over headphones for STM (2cycles/octave density, 4-Hz rate) applied to an 85-dB SPL, 2-kHz lowpass-filtered pink-noise carrier. SRTs were correlated with both the high-frequency (2-6 kHz) pure-tone average (HFA; R-2 = .31) and STM sensitivity (R-2 = .28). Combined with the HFA, STM sensitivity significantly improved the SRT prediction (Delta R-2 = .13; total R-2 = .44). The remaining unaccounted variance might be attributable to variability in cognitive function and other dimensions of suprathreshold distortion. STM sensitivity was most critical in predicting SRTs for listenersamp;lt;65 years old or with HFA amp;lt;53 dB HL. Results are discussed in the context of previous work suggesting that STM sensitivity for low rates and low-frequency carriers is impaired by a reduced ability to use temporal fine-structure information to detect dynamic spectra. STM detection is a fast test of suprathreshold auditory function for frequencies amp;lt;2 kHz that complements the HFA to predict variability in hearing-aid outcomes for speech perception in noise.
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| 10. |
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