| 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. |
- Ekberg, Mattias, 1987-, et al.
(författare)
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Acoustic Features Distinguishing Emotions in Swedish Speech.
- 2023
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Ingår i: Journal of Voice. - : Elsevier. - 0892-1997 .- 1873-4588.
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Tidskriftsartikel (refereegranskat)abstract
- Few studies have examined which acoustic features of speech can be used to distinguish between different emotions, and how combinations of acoustic parameters contribute to identification of emotions. The aim of the present study was to investigate which acoustic parameters in Swedish speech are most important for differentiation between, and identification of, the emotions anger, fear, happiness, sadness, and surprise in Swedish sentences. One-way ANOVAs were used to compare acoustic parameters between the emotions and both simple and multiple logistic regression models were used to examine the contribution of different acoustic parameters to differentiation between emotions. Results showed differences between emotions for several acoustic parameters in Swedish speech: surprise was the most distinct emotion, with significant differences compared to the other emotions across a range of acoustic parameters, while anger and happiness did not differ from each other on any parameter. The logistic regression models showed that fear was the best-predicted emotion while happiness was most difficult to predict. Frequency- and spectral-balance-related parameters were best at predicting fear. Amplitude- and temporal-related parameters were most important for surprise, while a combination of frequency-, amplitude- and spectral balance-related parameters are important for sadness. Assuming that there are similarities between acoustic models and how listeners infer emotions in speech, results suggest that individuals with hearing loss, who lack abilities of frequency detection, may compared to normal hearing individuals have difficulties in identifying fear in Swedish speech. Since happiness and fear relied primarily on amplitude- and spectral-balance-related parameters, detection of them are probably facilitated more by hearing aid use.
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| 4. |
- Ekberg, Mattias, 1987-, et al.
(författare)
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Effects of mild-to-moderate sensorineuralhearing loss and signal amplification on vocalemotion recognition in middle-aged–olderindividuals
- 2022
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Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 17:1
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Tidskriftsartikel (refereegranskat)abstract
- Previous research has shown deficits in vocal emotion recognition in sub-populations of individuals with hearing loss, making this a high priority research topic. However, previousresearch has only examined vocal emotion recognition using verbal material, in which emotions are expressed through emotional prosody. There is evidence that older individualswith hearing loss suffer from deficits in general prosody recognition, not specific to emotionalprosody. No study has examined the recognition of non-verbal vocalization, which constitutes another important source for the vocal communication of emotions. It might be thecase that individuals with hearing loss have specific difficulties in recognizing emotionsexpressed through prosody in speech, but not non-verbal vocalizations. We aim to examinewhether vocal emotion recognition difficulties in middle- aged-to older individuals with sensorineural mild-moderate hearing loss are better explained by deficits in vocal emotion recognition specifically, or deficits in prosody recognition generally by including both sentencesand non-verbal expressions. Furthermore a, some of the studies which have concluded thatindividuals with mild-moderate hearing loss have deficits in vocal emotion recognition abilityhave also found that the use of hearing aids does not improve recognition accuracy in thisgroup. We aim to examine the effects of linear amplification and audibility on the recognitionof different emotions expressed both verbally and non-verbally. Besides examining accuracy for different emotions we will also look at patterns of confusion (which specific emotionsare mistaken for other specific emotion and at which rates) during both amplified and nonamplified listening, and we will analyze all material acoustically and relate the acoustic content to performance. Together these analyses will provide clues to effects of amplification onthe perception of different emotions. For these purposes, a total of 70 middle-aged-olderindividuals, half with mild-moderate hearing loss and half with normal hearing will perform acomputerized forced-choice vocal emotion recognition task with and without amplification
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| 5. |
- Hengen, Johanna, et al.
(författare)
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Perception of Ones Own Voice After Hearing-Aid Fitting for Naive Hearing-Aid Users and Hearing-Aid Refitting for Experienced Hearing-Aid Users
- 2020
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Ingår i: TRENDS IN HEARING. - : SAGE PUBLICATIONS INC. - 2331-2165. ; 24
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Tidskriftsartikel (refereegranskat)abstract
- Dissatisfaction with the sound of ones own voice is common among hearing-aid users. Little is known regarding how hearing impairment and hearing aids separately affect own-voice perception. This study examined own-voice perception and associated issues before and after a hearing-aid fitting for new hearing-aid users and refitting for experienced users to investigate whether it was possible to differentiate between the effect of (unaided) hearing impairment and hearing aids. Further aims were to investigate whether First-Time and Experienced users as well as users with dome and mold inserts differed in the severity of own-voice problems. The study had a cohort design with three groups: First-Time hearing-aid users going from unaided to aided hearing (n = 70), Experienced hearing-aid users replacing their old hearing aids (n = 70), and an unaided control group (n = 70). The control group was surveyed once and the hearing-aid users twice; once before hearing-aid fitting/refitting and once after. The results demonstrated that own-voice problems are common among both First-Time and Experienced hearing-aid users with either dome- or mold-type fittings, while people with near-normal hearing and not using hearing aids report few problems. Hearing aids increased ratings of own-voice problems among First-Time users, particularly those with mold inserts. The results suggest that altered auditory feedback through unaided hearing impairment or through hearing aids is likely both to change own-voice perception and complicate regulation of vocal intensity, but hearing aids are the primary reason for poor perceived sound quality of ones own voice.
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| 6. |
- Hjertman, Heléne, et al.
(författare)
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The Swedish hearing in noise test for children, HINT-C
- 2021
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Ingår i: International Journal of Pediatric Otorhinolaryngology. - : Elsevier. - 0165-5876 .- 1872-8464. ; 141
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The aim of this study was to develop and evaluate a Swedish version of the Hearing In Noise Test for Children (HINT-C).DESIGN: In the first part, the Swedish HINT lists for adults was evaluated by children at three signal to noise ratios (SNRs), -4, -1 and +2 dB. Lists including sentences not reaching 50% recognition at +2 dB SNR were excluded and the rest constituted the HINT-C. In the second part, HINT-C was evaluated in children and adults using an adaptive procedure to determine the SNR for 50% correctly repeated sentences. Study Sample In the first part, 112 children aged 6-11 years participated while another 28 children and 9 adults participated in the second part.RESULTS: Eight out of 24 tested adult HINT lists did not reach the inclusion criteria. The remaining 16 lists formed the Swedish HINT-C which was evaluated in children 6-11 years old. A regression analysis showed that the predicted SNR threshold (dB) was 0.495-0.365*age (years + months/12) and the children reached the mean adult score at an age of 10.5 years.CONCLUSIONS: A Swedish version of HINT-C was developed and evaluated in children six years and older.
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| 7. |
- Lim, Jongwoo, et al.
(författare)
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Development of a finite element model of a human head including auditory periphery for understanding of bone-conducted hearing
- 2022
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Ingår i: Hearing Research. - : ELSEVIER. - 0378-5955 .- 1878-5891. ; 421
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Tidskriftsartikel (refereegranskat)abstract
- A three-dimensional finite-element (FE) model of a human head including the auditory periphery was developed to obtain a better understanding of bone-conducted (BC) hearing. The model was validated by comparison of cochlear and head responses in both air-conducted (AC) and BC hearing with experimental data. Specifically, the FE model provided the cochlear responses such as basilar membrane velocity and intracochlear pressure corresponding to BC stimulations applied to the mastoid or the conventional bone-anchored-hearing-aid (BAHA) positions. This is a strength of the model because it is difficult to obtain the cochlear responses from experiments corresponding to the BC stimulation applied at a specific position on the head surface. In addition, there have been few studies based on an FE model that can calculate the head and cochlear responses simultaneously from a BC stimulation. Moreover, in this study, the intracochlear sound pressure at multi-positions along the BM length was calculated and used to clarify the effect of stimulating force direction on the cochlear and promontory velocities in BC hearing. Also, the relationship between BC and AC stimulation and the basilar membrane velocity in the FE model was used to calculate the stimulation level at hearing thresholds which has been investigated only by psychoacoustical methods.
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| 8. |
- Prodanovic, Srdan, et al.
(författare)
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Consequences of Mastoidectomy on Bone Conducted Sound Based on Simulations in a Whole Human Head
- 2020
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Ingår i: Otology and Neurotology. - : LIPPINCOTT WILLIAMS & WILKINS. - 1531-7129 .- 1537-4505. ; 41:9, s. E1158-E1166
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Tidskriftsartikel (refereegranskat)abstract
- Hypothesis: The aim of this study is to investigate how a mastoidectomy surgery affects bone conduction (BC) sound transmission using a whole head finite element model. Background: Air conduction (AC) and BC hearing thresholds are normally used to evaluate the effect of an ear surgery. It is then assumed that the BC hearing thresholds are unaffected by the surgery. Moreover, BC hearing aids are used in cases of unilateral or conductive hearing loss in heads that have undergone a mastoidectomy surgery. Given the invasiveness of the surgery, the BC hearing sensitivity may be altered by the surgery itself. Methods: Two types of mastoid surgery, canal wall up and canal wall down, with and without obliteration, were simulated in a whole head finite element model for BC stimulation, the LiUHead. The evaluations were conducted for two different methods of applying the BC sound, at the skin surface (B71 transducer) and directly at the bone (BC hearing aid). Results: The results showed that a mastoidectomy surgery increased the cochlear vibration responses with BC stimulation. The increase was less than 5 dB, except for a canal wall down surgery which gave an increase of up to 8 dB at frequencies close to 10 kHz. The increase was greater at the ipsilateral cochlea compared with the contralateral cochlea. Conclusion: A mastoidectomy surgery increases the vibration at both cochleae for BC stimulation and the increase generally improved with frequency. Obliteration of the surgical cavity does not influence BC sound transmission.
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| 9. |
- Prodanovic, Srdan, et al.
(författare)
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Review of Whole Head Experimental Cochlear Promontory Vibration with Bone Conduction Stimulation and Investigation of Experimental Setup Effects
- 2021
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Ingår i: Trends in Hearing. - : Sage Publications. - 2331-2165. ; 25
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Forskningsöversikt (refereegranskat)abstract
- Bone conduction sound transmission in humans has been extensively studied using cochlear promontory vibrations. These studies use vibration data collected from measurements in live humans, whole cadavers, and severed cadaver heads, with stimulation applied either at an implant in the skull bone or directly on the skin. Experimental protocols, methods, and preparation of cadavers or cadaver heads vary among the studies, and it is currently unknown to what extent the aforementioned variables affect the outcome of those studies. The current study has two aims. The first aim is to review and compare available experimental data and assess the effects of the experimental protocol and methods. The second aim is to investigate similarities and differences found between the experimental studies based on simulations in a finite element model, the LiUHead. With implant stimulation, the average cochlear promontory vibration levels were within 10 dB, independent of the experimental setup and preparations of the cadavers or cadaver heads. With on-skin stimulation, the results were consistent between cadaver heads and living humans. Partial or complete replacement of the brain with air does not affect the cochlear promontory vibration, whereas replacing the brain with liquid reduces the vibration level by up to 5 dB. An intact head-neck connection affects the vibration of the head at frequencies below 300-400 Hz with a significant vibration reduction at frequencies below 200 Hz. Removing all soft tissue, brain tissue, and intracranial fluid from the head increases the overall cochlear promontory vibration level by around 5 dB.
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| 10. |
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