| 1. |
- Baigi, Amir, 1953, et al.
(författare)
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Tinnitus in the General Population With a Focus on Noise and Stress: A Public Health Study.
- 2011
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Ingår i: Ear and hearing. - 1538-4667 .- 0196-0202.
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES:: To evaluate the influence of noise and stress on the probability of tinnitus in the general population. DESIGN:: Questionnaire data from 12,166 subjects. RESULTS:: Each year of age increased the odds ratio of tinnitus by about 3%. Men generally showed a higher risk for tinnitus compared with women. Exposure to noise and stress emerged important for the probability of tinnitus. However, for the transition from mild to severe tinnitus, stress turned out to be especially important. CONCLUSIONS:: Stress management strategies should be included in hearing conservation programs, especially for individuals with mild tinnitus who report a high stress load.
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| 2. |
- Berninger, Erik, et al.
(författare)
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Analysis of Click-Evoked Auditory Brainstem Responses Using Time Domain Cross-Correlations Between Interleaved Responses
- 2014
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Ingår i: Ear and Hearing. - : Ovid Technologies (Wolters Kluwer Health). - 0196-0202 .- 1538-4667. ; 35:3, s. 318-329
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: The rapidly evolving field of early diagnostics after the introduction of newborn hearing screening requires rapid, valid, and objective methods, which have to be thoroughly evaluated in adults before use in infants. The aim was to study cross-correlation analysis of interleaved auditory brainstem responses (ABRs) in a wide dynamic range in normal-hearing adults. Off-line analysis allowed for comparison with psychoacoustical click threshold (PCT), pure-tone threshold, and determination of ABR input/output function. Specifically, nonfiltered and band-pass filtered ABRs were studied in various time segments along with time elapsed for ensemble of sweeps reaching a specific detection criterion. Design: Fourteen healthy normal-hearing subjects (18 to 35 years of age, 50% females) without any history of noise exposure participated. They all had pure-tone thresholds better than 20 dB HL (125 to 8000 Hz). ABRs were recorded in both ears using 100 sec clicks, from 71.5 dB nHL down to -18.5 dB nHL, in 10 dB steps (repetition rate, 39 Hz; time window, 15 msec; filter, 30 to 8000 Hz). The number of sweeps increased from 2000 at 71.5 dB nHL, up to 30000 at -18.5 dB nHL. Each sweep was stored in a data base for off-line analysis. Cross-correlation analysis between two subaverages of interleaved responses was performed in the time domain for nonfiltered and digitally band-pass filtered (300 to 1500 Hz) entire and time-windowed (1 to 11 and 5 to 11 msec) responses. PCTs were measured using a Bekesy technique with the same insert phone and stimulus as used for the ABR (repetition rate, 20 Hz). Time elapsed (approximate to number of accepted sweeps/repetition rate) for the ensemble of sweeps needed to reach a cross-correlation coefficient () of 0.70 (=3.7 dB signal-to-noise ratio [SNR]) was analyzed. Results: Mean cross-correlation coefficients exceeded 0.90 in both ears at stimulus levels 11.5 dB nHL for the entire nonfiltered ABR. At 1.5 dB nHL, mean(SD) was 0.53(0.32) and 0.44(0.40) for left and right ears, respectively (n = 14) (=0 dB SNR). In comparison, mean(SD) PCT was -1.9(2.9) and -2.5(3.2) dB nHL for left and right ears, respectively (n = 14), while mean pure-tone average (500 to 2000 Hz) was 2.5 dB HL (n = 28). Almost no effect of band-pass filtering or reduced analysis time window existed. Average time elapsed needed to reach = 0.70 was approximately 20 seconds or less at stimulus levels 41.5 dB nHL, and approximate to 30 seconds at 31.5 dB nHL. The average (interpolated) stimulus level corresponding to =0.70 for the entire nonfiltered ABR was 6.5 dB nHL (n = 28), which coincided with the estimated psychoacoustical threshold for single clicks. Conclusions: ABR could be identified in a short period of time using cross-correlation analysis between interleaved responses. The average stimulus level corresponding to 0 dB SNR in the entire nonfiltered ABR occurred at 1.5 dB nHL, 4 dB above the average PCT. The mean input/output function for the ensemble of sweeps required to reach = 0.70 increased monotonically with increasing stimulus level, in parallel with the ABR based on all sweeps (1.5 dB nHL). Time domain cross-correlation analysis of ABR might form the basis for automatic response identification and future threshold-seeking procedures.
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| 3. |
- Boisvert, Isabelle, et al.
(författare)
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Relative Importance of Monaural Sound Deprivation and Bilateral Significant Hearing Loss in Predicting Cochlear Implantation Outcomes
- 2011
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Ingår i: Ear and Hearing. - : Lippincott, Williams and Wilkins. - 0196-0202 .- 1538-4667. ; 32:6, s. 758-766
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Making evidence-based recommendations to prospective unilateral cochlear implant recipients on the potential benefits of implanting one or the other ear is challenging for cochlear implant teams. This particularly occurs in cases where a hearing aid has only been used in one ear for many years (referred to here as the "hearing ear"), and the contralateral ear has, in essence, been sound-deprived. In such cases, research to date is inconclusive, and little anecdotal evidence exists to inform the debate and support best clinical practice. less thanbrgreater than less thanbrgreater thanDesign: Retrospective data on speech recognition outcomes of 16 adult participants who received a cochlear implant in an ear deprived of sound for a minimum of 15 yr were analyzed. All subjects were implanted through the Quebec Cochlear Implant Program and were provided with personalized intensive rehabilitation services. Data obtained from clinical records included demographic data and speech recognition scores measured after implantation with the sentences of a multimedia auditory test battery in the auditory-only condition. Speech recognition outcomes were compared with the duration of auditory deprivation in the implanted ear, bilateral significant hearing loss, and auditory stimulation before bilateral significant hearing loss. less thanbrgreater than less thanbrgreater thanResults: Using nonparametric correlation analyses, a strong negative correlation was demonstrated between speech recognition scores and the duration of bilateral significant hearing loss and with the duration of auditory stimulation before bilateral significant hearing loss. No significant correlation with the duration of auditory deprivation or with the duration of prior auditory stimulation in the implanted ear was found. less thanbrgreater than less thanbrgreater thanConclusions: These findings suggest that functional outcomes of cochlear implantation for unilateral sound deprivation may be more strongly influenced by central processes than peripheral effects stemming from the deprivation per se. This indicates the relevance of considering the clients history of binaural hearing rather than the hearing in each ear individually when discussing possible outcomes with a cochlear implant.
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| 4. |
- Feeney, Patrick, et al.
(författare)
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Consensus statement : Eriksholm workshop on wideband absorbance measures of the middle ear
- 2013
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Ingår i: Ear and Hearing. - : Lippincott Williams & Wilkins. - 0196-0202 .- 1538-4667. ; 34:Supplement 1, s. 78s-79s
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Tidskriftsartikel (refereegranskat)abstract
- The participants in the Eriksholm Workshop on Wideband Absorbance Measures of the Middle Ear developed statements for this consensus article on the final morning of the Workshop. The presentations of the first 2 days of the Workshop motivated the discussion on that day. The article is divided into three general areas: terminology; research needs; and clinical application.The varied terminology in the area was seen as potentially confusing, and there was consensus on adopting an organizational structure that grouped the family of measures into the term wideband acoustic immittance (WAI), and dropped the term transmittance in favor of absorbance. There is clearly still a need to conduct research on WAI measurements. Several areas of research were emphasized, including the establishment of a greater WAI normative database, especially developmental norms, and more data on a variety of disorders; increased research on the temporal aspects of WAI; and methods to ensure the validity of test data. The area of clinical application will require training of clinicians in WAI technology. The clinical implementation of WAI would be facilitated by developing feature detectors for various pathologies that, for example, might combine data across ear-canal pressures or probe frequencies.
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| 5. |
- Hodgetts, W. E., et al.
(författare)
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Technology-Limited and Patient-Derived Versus Audibility-Derived Fittings in Bone-Anchored Hearing Aid Users: A Validation Study
- 2011
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Ingår i: Ear and Hearing. - 1538-4667 .- 0196-0202. ; 32:1, s. 31-39
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Current approaches to fit bone-anchored hearing aid (Baha) rely heavily on patient feedback of "loudness" and "sound quality." Audiologists are limited to this approach for two reasons: (1) the technology in current models of Baha does not allow for much fine-tuning of frequency response or maximum output on an individual basis and (2) there has not been a valid approach to verify the frequency response or maximum output on an individual basis. The objectives of this study are to (1) describe an alternative approach to fit Baha, an "audibility-derived (AD)" fitting, and (2) test whether outcomes improve with this new fitting compared with the current "patient-derived (PD)" fitting. Design: This study used a repeated measures design where each subject experienced both the AD and PD fittings in random order. Subjects were tested on a variety of outcome measures including output levels of aided speech, hearing in noise test (quiet and in noise), consonant recognition in noise, aided loudness, and subjective percentage of words understood. Results: Electromechanical testing revealed significantly higher aided output with the AD fitting, especially in the high frequencies. Subjects performed significantly better in all outcome measures with the AD fitting approach except when testing aided loudness and subjective perception for which the differences were nonsignificant. When the input levels to the Baha were soft, advantages for the AD fitting were emerging on these tests, but they did not reach significance. Conclusions: This study presents a more objective, fitting approach for Baha that leads to better outcomes in the laboratory. The next steps will be to test these fittings in the real world and to make the approach generally available to clinicians fitting Bahas.
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| 6. |
- Koelewijn, Thomas, et al.
(författare)
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Pupil Dilation Uncovers Extra Listening Effort in the Presence of a Single-Talker Masker
- 2012
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Ingår i: Ear and Hearing. - : Lippincott, Williams and Wilkins. - 0196-0202 .- 1538-4667. ; 33:2, s. 291-300
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Recent research has demonstrated that pupil dilation, a measure of mental effort (cognitive processing load), is sensitive to differences in speech intelligibility. The present study extends this outcome by examining the effects of masker type and age on the speech reception threshold (SRT) and mental effort. less thanbrgreater than less thanbrgreater thanDesign: In young and middle-aged adults, pupil dilation was measured while they performed an SRT task, in which spoken sentences were presented in stationary noise, fluctuating noise, or together with a single-talker masker. The masker levels were adjusted to achieve 50% or 84% sentence intelligibility. less thanbrgreater than less thanbrgreater thanResults: The results show better SRTs for fluctuating noise and a single-talker masker compared with stationary noise, which replicates results of previous studies. The peak pupil dilation, reflecting mental effort, was larger in the single-interfering speaker condition compared with the other masker conditions. Remarkably, in contrast to the thresholds, no differences in peak dilation were observed between fluctuating noise and stationary noise. This effect was independent of the intelligibility level and age. less thanbrgreater than less thanbrgreater thanConclusions: To maintain similar intelligibility levels, participants needed more mental effort for speech perception in the presence of a single-talker masker and then with the two other types of maskers. This suggests an additive interfering effect of speech information from the single-talker masker. The dissociation between these performance and mental effort measures underlines the importance of including measurements of pupil dilation as an independent index of mental effort during speech processing in different types of noisy environments and at different intelligibility levels.
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| 7. |
- Laplante-Lévesque, Ariane, et al.
(författare)
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Optimal Hearing Aid Use: Focus Groups With Hearing Aid Clients and Audiologists
- 2013
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Ingår i: Ear and Hearing. - : Lippincott, Williams and Wilkins. - 0196-0202 .- 1538-4667. ; 34:2, s. 193-202
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: This study explored the meaning and determinants of optimal hearing aid use from the perspectives of hearing aid clients and audiologists. An additional objective was to contrast the perspectives of the clients and audiologists. less thanbrgreater than less thanbrgreater thanDesign: Four focus groups were conducted: (1) clients (n = 7) in Denmark, (2) clients (n = 10) in the United Kingdom, (3) audiologists (n = 6) in Denmark, and (4) audiologists (n = 7) in the United Kingdom. Clients owned hearing aids and audiologists had regular contact with clients. The focus group facilitators used a topic guide to generate the participants views on optimal hearing aid use. The focus groups were audio-recorded, transcribed verbatim, translated into English if conducted in Danish, and qualitatively analyzed with content analysis. less thanbrgreater than less thanbrgreater thanResults: Both clients and audiologists described optimal hearing aid use as being frequent and regular and driven by the individual needs of the clients. When describing determinants of optimal hearing aid use, both clients and audiologists mentioned the role of the client (e. g., adjustment to hearing aids), the role of the audiologist (e. g., audiologic practice and profession), and the role of the hearing aid (e. g., benefits and limitations of the hearing aid). They both highlighted the importance of client access to information. However, how clients and audiologists described the influence of these determinants varied somewhat. Clients emphasized the role of the hearing aid in achieving optimal hearing aid use. From a client perspective, hearing aids that performed well and had relevant features were most central. In contrast, audiologists emphasized the role of a good client-audiologist relationship in achieving optimal hearing aid use. From the audiologists perspective, audiologists who were able to understand the needs of the clients and to instruct clients appropriately were most central. less thanbrgreater than less thanbrgreater thanConclusions: This study highlights similarities and differences in how clients and audiologists describe optimal hearing aid use and its determinants. It is commendable that audiologists acknowledge the importance of the client-audiologist relationship, but given clients focus on hearing aids, audiologists might wish to describe more explicitly to their clients how their intervention can extend beyond provision of the optimal hearing aid. (Ear andamp; Hearing 2013;34;193-202)
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| 8. |
- Laplante-Lévesque, Ariane, et al.
(författare)
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Stages of change in adults with acquired hearing impairment seeking help for the first time : application of the transtheoretical model in audiologic rehabilitation
- 2013
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Ingår i: Ear and Hearing. - : Lippincott Williams & Wilkins. - 0196-0202 .- 1538-4667. ; 34:4, s. 447-457
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES:This study investigated the application of the transtheoretical (stages-of-change) model in audiologic rehabilitation. More specifically, it described the University of Rhode Island Change Assessment (URICA) scores of adults with acquired hearing impairment. It reported the psychometric properties (construct, concurrent, and predictive validity) of the stages-of-change model in this population.DESIGN:At baseline, 153 adults with acquired hearing impairment seeking help for the first time completed the URICA as well as measures of degree of hearing impairment, self-reported hearing disability, and years since hearing impairment onset. Participants were subsequently offered intervention options: hearing aids, communication programs, and no intervention. Their intervention uptake and adherence were assessed 6 months later and their intervention outcomes were assessed 3 months after intervention completion. First, the stages-of-change construct validity was evaluated by investigating the URICA factor structure (principal component analysis), internal consistency, and correlations between stage scores. The URICA scores were reported in terms of the scores for each stage of change, composite scores, stages with highest scores, and stage clusters (cluster analysis). Second, the concurrent validity was assessed by examining associations between stages of change and degree of hearing impairment, self-reported hearing disability, and years since hearing impairment onset. Third, the predictive validity was evaluated by investigating associations between stages of change and intervention uptake, adherence, and outcomes.RESULTS:First, in terms of construct validity, the principal component analysis identified four instead of three stages (precontemplation, contemplation, preparation, and action) for which the internal consistency was good. Most of the sample was in the action stage. Correlations between stage scores supported the model. Cluster analysis identified four stages-of-change clusters, which the authors named active change, initiation, disengagement, and ambivalence. In terms of concurrent validity, participants who reported a more advanced stage of change had a more severe hearing impairment, reported greater hearing disability, and had a hearing impairment for a longer period of time. In terms of predictive validity, participants who reported a more advanced stage of change were more likely to take up an intervention and to report successful intervention outcomes. However, stages of change did not predict intervention adherence.CONCLUSIONS:The majority of the sample was in the action stage. The construct, concurrent, and predictive validity of the stages-of-change model were good. The stages-of-change model has some validity in the rehabilitation of adults with hearing impairment. The data support that change might be better represented on a continuum rather than by movement from one step to the next. Of all the measures, the precontemplation stage score had the best concurrent and predictive validity. Therefore, further research should focus on addressing the precontemplation stage with a measure suitable for clinical use.
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| 9. |
- Laplante-Lévesque, Ariane, et al.
(författare)
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What makes adults with hearing impairment take up hearing AIDS or communication programs and achieve successful outcomes?
- 2012
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Ingår i: Ear and Hearing. - : Lippincott Williams & Wilkins. - 0196-0202 .- 1538-4667. ; 33:1, s. 79-93
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES:Client involvement in health decision making, or shared decision making, is increasingly being advocated. For example, rehabilitation interventions such as hearing aids and communication programs can be presented as options to adults with hearing impairment seeking help for the first time. Our previous research focused on the predictors of intervention decisions when options were presented with a decision aid. However, not all participants took up the intervention they initially decided upon. Although it is interesting to understand what informs adults with hearing impairment's intervention decisions, it is their intervention uptake and outcomes which best represent the ultimate end result of the rehabilitation process. This prospective study investigated the predictors of uptake and of successful outcomes of hearing aids and communication programs in middle-aged and older adults with hearing impairment seeking help for the first time.DESIGN:Using shared decision making, 153 participants with hearing impairment (average of air conduction thresholds at 0.5, 1, 2, and 4 kHz greater than 25 dB HL in at least one ear) aged 50 yr and older were presented with intervention options: hearing aids, communication programs (group or individual), and no intervention. Each participant received a decision aid and had at least 1 wk to consider intervention options before the intervention decision was made. Outcome measures for both hearing aids and communication programs at 3 mo after intervention completion were benefit (measured with the Client-Oriented Scale of Improvement), composite outcomes (measured with the International Outcome Inventory), and reduction in self-reported hearing disability (measured with the Hearing Handicap Questionnaire). Multivariate analysis (logistic and linear regression) identified predictors of intervention uptake and of successful outcomes when all other variables were held constant.RESULTS:Almost a quarter of the 153 participants (24%) did not take up the intervention they initially decided upon: 6 mo after making their intervention decision, 66 participants (43%) obtained hearing aids, 28 participants (18%) completed communication programs, and 59 participants (39%) did not complete an intervention. Seven intervention uptake predictors were identified: (1) application for subsidized hearing services (participants more likely to obtain hearing aids and less likely to complete no intervention); (2) higher socioeconomic status (no intervention less likely); (3) greater communication self-efficacy (hearing aids less likely); (4) greater contemplation stage of change (no intervention less likely); (5) greater hearing disability perceived by others and self (communication programs less likely); (6) greater perceived communication program effectiveness (communication programs more likely); and (7) greater perceived suitability of individual communication program (hearing aids less likely and communication programs more likely). Six predictors of successful intervention outcomes were identified: (1) higher socioeconomic status; (2) greater initial self-reported hearing disability; (3) lower precontemplation stage of change; (4) greater action stage of change; (5) lower chance locus of control; and (6) greater hearing disability perceived by others and self.CONCLUSIONS:Self-reported hearing disability and stages of change are the two most robust predictors of intervention uptake and successful outcomes. Clinicians should offer intervention options and should discuss these predictors when helping adults with hearing impairment make optimal decisions.
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| 10. |
- Lunner, Thomas, et al.
(författare)
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Effect of Speech Material on the Benefit of Temporal Fine Structure Information in Speech for Normal-Hearing and Hearing-Impaired Participants
- 2012
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Ingår i: Ear and Hearing. - : Lippincott Williams & Wilkins. - 0196-0202 .- 1538-4667. ; 33:3, s. 377-388
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE:The purpose of this study was to investigate the influence of the type of speech material on the benefit obtained from temporal fine structure (TFS) information in speech for young normal-hearing (YNH) and older hearing-impaired (OHI) participants.DESIGN:The design was based on the work of . They measured the speech reception thresholds for a target talker in a background talker as a function of the frequency range over which TFS information was available. The signal was split into 32 channels, each with a bandwidth equal to the equivalent rectangular bandwidth of the "normal" auditory filter at the same center frequency. Above a cutoff (CO) channel, channels were vocoded and contained only temporal envelope information. Channels up to and including CO were not processed. Hopkins et al. found that, as CO was increased, speech reception thresholds decreased more for normal-hearing participants than for participants with cochlear hearing loss, suggesting that the latter were less able to use TFS information. We used the same design, but compared results when the target speech materials were open-set sentences, as used by Hopkins et al., and when they were more predictable sentences with a closed word set (Danish Dantale 2).RESULTS:With the open-set material, YNH listeners benefited more from TFS information than OHI listeners, replicating . For the YNH participants, the benefit of adding TFS was greater for the open-set material than for the closed-set material, while no difference in TFS benefit across speech materials was found for the OHI participants.CONCLUSIONS:The choice of speech material is important when assessing the benefit of TFS. Several factors may facilitate recognition in the absence of TFS cues, including small set size, predictable temporal structure of the target speech, and contextual effects. We speculate that TFS information is useful for reducing informational masking, by providing cues for the perceptual segregation of the target and background. When the target speech is highly predictable, informational masking may be minimal, rendering TFS cues unnecessary.
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| 11. |
- Neely, Stephen, et al.
(författare)
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Alternative ear-canal measures related to absorbance
- 2013
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Ingår i: Ear and Hearing. - : Lippincott Williams & Wilkins. - 0196-0202 .- 1538-4667. ; 34:Supplement 1, s. 72s-77s
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Tidskriftsartikel (refereegranskat)abstract
- Several alternative ear-canal measures are similar to absorbance in their requirement for prior determination of a Thévenin-equivalent sound source. Examples are (1) sound intensity level, (2) forward pressure level, (3) time-domain ear-canal reflectance, and (4) cochlear reflectance. These four related measures are similar to absorbance in their utilization of wideband stimuli and their focus on recording ear-canal sound pressure. The related measures differ from absorbance in how the ear-canal pressure is analyzed and in the type of information that is extracted from the recorded response. Sound intensity level and forward pressure level have both been shown to be better as measures of sound level in the ear canal compared with sound pressure level because they reduced calibration errors due to standing waves in studies of behavioral thresholds and otoacoustic emissions. Time-domain ear-canal reflectance may be used to estimate ear-canal geometry and may have the potential to assess middle ear pathology. Cochlear reflectance reveals information about the inner ear that is similar to what is provided by other types of otoacoustic emissions, and may have theoretical advantages that strengthen its interpretation.
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| 12. |
- Preminger, Jill E., et al.
(författare)
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Perceptions of age and brain in relation to hearing help seeking and rehabilitation
- 2014
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Ingår i: Ear and Hearing. - : Lippincott Williams & Wilkins. - 0196-0202 .- 1538-4667. ; 35:1, s. 19-29
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Tidskriftsartikel (refereegranskat)abstract
- Objectives:This study used a qualitative approach to explore the perspectives of adults with hearing impairment on hearing help-seeking and rehabilitation. Two superordinate themes, Age and Brain, emerged from prior analyses and are investigated in the present article.Design:In-depth semistructured interviews were completed in four countries with 34 adults (aged 26 to 96 years) with hearing impairment. Participants were asked to “Tell the story of your hearing.” Participants included individuals with different levels of experiences in hearing help-seeking and rehabilitation. The themes of Age and Brain emerged from the data based on qualitative content analysis. These major themes were analyzed further using interpretative phenomenology to create models of themes and subthemes as they related to hearing help-seeking and rehabilitation expectations and experience.Results:Age was discussed by 68% of the 34 participants. The data were sorted into three themes: Expectations, Self-Image, and Ways of Coping. Brain was discussed by 50% of the participants. The data were sorted into three themes: Cognitive Operations, Plasticity, and Mental Effort.Conclusions:Adults with hearing impairment think of their age and their brain as contributing to their hearing impairment, disability, help-seeking, and rehabilitation. Although hearing impairment associated with older age was typically construed as a stigma, not all perceptions of aging and hearing impairment were negative. Some participants viewed older age and its influence on relationships or priorities as a reason for seeking out hearing health care or as the determining factor in deciding to wear hearing aids (HAs). Some expected hearing impairment with older age, thus they found it easier to accept wearing HAs than they may have at a younger age. They discussed the brain in terms of the cognitive operations that may either inhibit or improve speech communication. Participants believed that they could train their brains to improve their communication (and sometimes avoid the need for HAs) or to increase their HA benefit. Age and Brain interconnected in a number of ways. Participants believed that older age led to cognitive decline, which resulted in decreased speech understanding. Participants also believed that the cognitive decline that accompanies older age may limit HA benefit. Hearing healthcare providers may wish to clarify negative messages about age and brain with their patients and provide information about how older brains are capable of changing and benefiting from HA use and comprehensive audiologic rehabilitation programs.
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| 13. |
- Prieve, Beth, et al.
(författare)
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Prediction of conductive hearing loss using wideband acoustic immittance
- 2013
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Ingår i: Ear and Hearing. - : Lippincott Williams & Wilkins. - 0196-0202 .- 1538-4667. ; 34:Supplement 1, s. 54s-59s
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of this article was to review the effectiveness of wideband acoustic immittance (WAI) and tympanometry in detecting conductive hearing loss (CHL). Eight studies were included that measured CHL through air-and bone-conducted thresholds in at least a portion of their participants. One study included infants, three studies included children, one study included older children and adults, and three studies included adults. WAI identified CHL well in all populations. In infants and children, WAI in several single-frequency bands identified CHL with equal accuracy to measures of middle ear admittance using clinical tympanometry with a single probe tone (1000 Hz for infants; 226 Hz for children and adults). When WAI was combined across frequency bands, it identified CHL superior to traditional, single-frequency tympanometry. Only two studies used WAI tympanometry, which assesses the outer/middle ear across both frequency and introduced air pressure, and differing results were reported as to whether introducing pressure into the ear canal provides better identification of CHL. In general, WAI appears to be a promising clinical tool, and further investigation is warranted.
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| 14. |
- Rosowski, John, et al.
(författare)
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An overview of wideband immittance measurements techniques and terminology : you say absorbance, I say reflectance
- 2013
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Ingår i: Ear and Hearing. - : Lippincott Williams & Wilkins. - 0196-0202 .- 1538-4667. ; 34:Supplement 1, s. 9s-16s
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Tidskriftsartikel (refereegranskat)abstract
- This article reviews the relationships among different acoustic measurements of the mobility of the tympanic membrane, including impedance, admittance, reflectance, and absorbance, which the authors group under the rubric of immittance measures. Each of these quantities is defined and related to the others. The relationship is most easily grasped in terms of a straight rigid ear canal of uniform area terminated by a uniform middle ear immittance placed perpendicular to the long axis of the ear canal. Complications due to variations from this geometry are discussed. Different methods for measuring these quantities are described, and the assumptions inherent within each method are made explicit. The benefits of wideband measurements of these quantities are described, as are the benefits and limitations of different components of immittance and reflectance/absorbance. While power reflectance (the square of the magnitude of pressure reflectance) is relatively invariant along the length of the ear canal, it has the disadvantage that it ignores phase information that may be useful in assessing the presence of acoustic leaks in ear-canal measurements and identifying other potential error sources. A combination of reflectance and impedance magnitude and angle give a more complete description of the middle ear from measurements in the ear canal.
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| 15. |
- Singh, Gurjit, et al.
(författare)
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The Aging Hand and the Ergonomics of Hearing Aid Controls
- 2013
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Ingår i: Ear and Hearing. - : Lippincott, Williams and Wilkins. - 0196-0202 .- 1538-4667. ; 34:1, s. E1-E13
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: The authors investigated the effects of hand function and aging on the ability to manipulate different hearing instrument controls. Over the past quarter century, hearing aids and hearing aid controls have become increasingly miniaturized. It is important to investigate the aging hand and hearing aid ergonomics because most hearing aid wearers are adults aged 65 years and above, who may have difficulty handling these devices. less thanbrgreater than less thanbrgreater thanDesign: In Experiment 1, the effect of age on the ability to manipulate two different open-fit behind-the-ear style hearing aids was investigated by comparing the performance of 20 younger (18-25 years of age), 20 young-old (60-70 years of age), and 20 older adults (71-80 years of age). In Experiment 2, ability to manipulate 11 different hearing instrument controls was investigated in 28 older adults who self-reported having arthritis in their hand, wrist, or finger and 28 older adults who did not report arthritis. For both experiments, the relationship between performance on the measures of ability to manipulate the devices and performance on a battery of tests to assess hand function was investigated. less thanbrgreater than less thanbrgreater thanResults: In Experiment 1, age-related differences in performance were observed in all the tasks assessing hand function and in the tasks assessing ability to manipulate a hearing aid. In Experiment 2, although minimal differences were observed between the two groups, significant differences were observed depending on the type of hearing instrument control. Performance on several of the objective tests of hand function was associated with the ability to manipulate hearing instruments. less thanbrgreater than less thanbrgreater thanConclusions: The overall pattern of findings suggest that haptic (touch) sensitivity in the fingertips and manual dexterity, as well as disability, pain, and joint stiffness of the hand, all contribute to the successful operation of a hearing instrument. However, although aging is associated with declining hand function and co-occurring declines in ability to manipulate a hearing instrument, for the sample of individuals in this study, including those who self-reported having arthritis, only minimal declines were observed.
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| 16. |
- Smith, Sherri L, et al.
(författare)
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Word Recognition for Temporally and Spectrally Distorted Materials : The Effects of Age and Hearing Loss
- 2012
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Ingår i: Ear and Hearing. - : Lippincott, Williams and Wilkins. - 0196-0202 .- 1538-4667. ; 33:3, s. 349-366
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: The purpose of Experiment 1 was to measure word recognition in younger adults with normal hearing when speech or babble was temporally or spectrally distorted. In Experiment 2, older listeners with near-normal hearing and with hearing loss (for pure tones) were tested to evaluate their susceptibility to changes in speech level and distortion types. The results across groups and listening conditions were compared to assess the extent to which the effects of the distortions on word recognition resembled the effects of age-related differences in auditory processing or pure-tone hearing loss. less thanbrgreater than less thanbrgreater thanDesign: In Experiment 1, word recognition was measured in 16 younger adults with normal hearing using Northwestern University Auditory Test No. 6 words in quiet and the Words-in-Noise test distorted by temporal jittering, spectral smearing, or combined jittering and smearing. Another 16 younger adults were evaluated in four conditions using the Words-in-Noise test in combinations of unaltered or jittered speech and unaltered or jittered babble. In Experiment 2, word recognition in quiet and in babble was measured in 72 older adults with near-normal hearing and 72 older adults with hearing loss in four conditions: unaltered, jittered, smeared, and combined jittering and smearing. less thanbrgreater than less thanbrgreater thanResults: For the listeners in Experiment 1, word recognition was poorer in the distorted conditions compared with the unaltered condition. The signal to noise ratio at 50% correct word recognition was 4.6 dB for the unaltered condition, 6.3 dB for the jittered, 6.8 dB for the smeared, 6.9 dB for the double-jitter, and 8.2 dB for the combined jitter-smear conditions. Jittering both the babble and speech signals did not significantly reduce performance compared with jittering only the speech. In Experiment 2, the older listeners with near-normal hearing and hearing loss performed best in the unaltered condition, followed by the jitter and smear conditions, with the poorest performance in the combined jitter-smear condition in both quiet and noise. Overall, listeners with near-normal hearing performed better than listeners with hearing loss by similar to 30% in quiet and similar to 6 dB in noise. In the quiet distorted conditions, when the level of the speech was increased, performance improved for the hearing loss group, but decreased for the older group with near-normal hearing. Recognition performance of younger listeners in the jitter-smear condition and the performance of older listeners with near-normal hearing in the unaltered conditions were similar. Likewise, the performance of older listeners with near-normal hearing in the jitter-smear condition and the performance of older listeners with hearing loss in the unaltered conditions were similar. less thanbrgreater than less thanbrgreater thanConclusions: The present experiments advance our understanding regarding how spectral or temporal distortions of the fine structure of speech affect word recognition in older listeners with and without clinically significant hearing loss. The Speech Intelligibility Index was able to predict group differences, but not the effects of distortion. Individual differences in performance were similar across all distortion conditions with both age and hearing loss being implicated. The speech materials needed to be both spectrally and temporally distorted to mimic the effects of age-related differences in auditory processing and hearing loss.
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| 17. |
- Voss, Susan, et al.
(författare)
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Factors that introduce intrasubject variability into ear-canal absorbance measurements
- 2013
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Ingår i: Ear and Hearing. - : Lippincott Williams & Wilkins. - 0196-0202 .- 1538-4667. ; 34:Supplement 1, s. 60s-64s
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Tidskriftsartikel (refereegranskat)abstract
- Wideband immittance measures can be useful in analyzing acoustic sound flow through the ear and also have diagnostic potential for the identification of conductive hearing loss as well as causes of conductive hearing loss. To interpret individual measurements, the variability in test–retest data must be described and quantified. Contributors to variability in ear-canal absorbance–based measurements are described in this article. These include assumptions related to methodologies and issues related to the probe fit within the ear and potential acoustic leaks. Evidence suggests that variations in ear-canal cross-sectional area or measurement location are small relative to variability within a population. Data are shown to suggest that the determination of the Thévenin equivalent of the ER-10C probe introduces minimal variability and is independent of the foam ear tip itself. It is suggested that acoustic leaks in the coupling of the ear tip to the ear canal lead to substantial variations and that this issue needs further work in terms of potential criteria to identify an acoustic leak. In addition, test–retest data from the literature are reviewed.
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| 18. |
- Zekveld, Adriana, et al.
(författare)
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The Influence of Semantically Related and Unrelated Text Cues on the Intelligibility of Sentences in Noise
- 2011
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Ingår i: Ear and Hearing. - : Lippincott, Williams and Wilkins. - 0196-0202 .- 1538-4667. ; 32:6, s. E16-E25
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: In two experiments with different subject groups, we explored the relationship between semantic context and intelligibility by examining the influence of visually presented, semantically related, and unrelated three-word text cues on perception of spoken sentences in stationary noise across a range of speech-to-noise ratios (SNRs). In addition, in Experiment (Exp) 2, we explored the relationship between individual differences in cognitive factors and the effect of the cues on speech intelligibility. less thanbrgreater than less thanbrgreater thanDesign: In Exp 1, cues had been generated by participants themselves in a previous test session (own) or by someone else (alien). These cues were either appropriate for that sentence (match) or for a different sentence (mismatch). A condition with nonword cues, generated by the experimenter, served as a control. Experimental sentences were presented at three SNRs (dB SNR) corresponding to the entirely correct repetition of 29%, 50%, or 71% of sentences (speech reception thresholds; SRTs). In Exp 2, semantically matching or mismatching cues and nonword cues were presented before sentences at SNRs corresponding to SRTs of 16% and 29%. The participants in Exp 2 also performed tests of verbal working memory capacity and the ability to read partially masked text. less thanbrgreater than less thanbrgreater thanResults: In Exp 1, matching cues improved perception relative to the nonword and mismatching cues, with largest benefits at the SNR corresponding to 29% performance in the SRT task. Mismatching cues did not impair speech perception relative to the nonword cue condition, and no difference in the effect of own and alien matching cues was observed. In Exp 2, matching cues improved speech perception as measured using both the percentage of correctly reported words and the percentage of entirely correctly reported sentences. Mismatching cues reduced the percentage of repeated words (but not the sentence-based scores) compared with the nonword cue condition. Working memory capacity and ability to read partly masked sentences were positively associated with the number of sentences repeated entirely correctly in the mismatch condition at the 29% SNR. less thanbrgreater than less thanbrgreater thanConclusions: In difficult listening conditions, both relevant and irrelevant semantic context can influence speech perception in noise. High working memory capacity and good linguistic skills are associated with a greater ability to inhibit irrelevant context when uncued sentence intelligibility is around 29% correct.
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| 19. |
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