International Journal of Audiology最新文献

Objective: This study aimed to provide normative ranges of Chinese smartphone-based digits-in-noise (DIN) test results, to explore the association between speech reception threshold (SRT) and pure-tone average (PTA) threshold, and to verify the effectiveness and feasibility of the Chinese DIN.

Design: Chinese-speaking adult subjects with varying types, symmetry and degrees of hearing loss, were recruited. All participants completed a pure-tone audiometric hearing test and DIN test with dichotic and antiphasic stimulus presentation.

Study sample: The overall sample consisted of 191 subjects, 24 with normal hearing and 167 with hearing loss.

Results: There was a positive correlation between antiphasic DIN SRTs and PTA thresholds. Receiver operating characteristic curves (ROC) were calculated based on the classification of poorer ears. When SRT was ≥ -15.8 dB, it suggested the possible presence of mild or more severe hearing loss; when SRT was ≥ -14.2 dB, it suggested the possible presence of moderate or more severe hearing loss.

Conclusion: The Chinese DIN SRT showed a highly positive correlation with PTA and exhibited high sensitivity and specificity in detecting hearing loss. Poorer ear PTA was the primary predictor of the antiphasic DIN SRT. The present results verify the validity of the Chinese DIN in its purpose of hearing screening.

Objective: To assess the feasibility of implementing a fast-track process (single-session assess-and-fit appointment with no ENT specialist's examination) in hearing rehabilitation by investigating the accuracy of the protocol assignment applying various cut-off criteria and describing the audiometric profile of patients being evaluated for their first hearing aids.

Design: Retrospective chart review.

Study sample: Patients from a single institution (n = 1807, median age 75 years, IQR 67-82 years) undergoing the evaluation for their first hearing aid fitting.

Results: There were no audiometric signs warranting further diagnostic evaluation in 1259 subjects (69.7%). These subjects could be identified using a single criterion: the average threshold difference between the ears in the frequencies from 0.5 to 4 kHz less than 10 dB. Age was found to be a good predictor for the success of a single-session evaluation and fitting, with a cut-off value of 75 years. Altogether, 593 persons (32.8%) were candidates for a fast-track process. The time-saving from a single-session process was estimated to be 1.0%.

Conclusions: It is feasible to have a fast-track hearing aid fitting protocol. Patients can be preselected with excellent accuracy using a single audiometric criterion and an age limit of 75. Time savings for a single-session process are insignificant.

Objective: The frequency specific maximum output (MO) of active middle ear implants is the most crucial parameter for speech intelligibility. We determined individual MO from clinical routine data in round window (RW) coupling of the Vibrant Soundbridge (VSB).

Design: Monocentric, retrospective analysis.

Study sample: 68 ears implanted with the VSB at the RW were analysed. Using bone conduction and direct threshold, MO was determined for combinations of implants (VORP502, VORP503) and processors (Samba, Amadé). Coupling modes were: (A) without coupler (N = 28), (B) spherical coupler (N = 19), (C) soft coupler (N = 10) or (D) custom-made "Hannover coupler" (N = 11).

Results: The MO frequency dependence was similar for coupling types (A-D) with a maximum at 1.5 kHz. No differences between groups were observed, although the average MO of the soft coupler was 10 dB lower. The average MO (0.5, 1.0, 2.0, 4.0 kHz) was (A) 77.6 ± 15.0 dB HL, (B) 81.0 ± 11.1 dB HL, (C) 67.6 ± 17.9 dB HL (C), and (D) 79.6 ± 11.7 dB HL (D).

Conclusion: The individual MO can be determined from patients' clinical data. It permits in-depth analyses of patient outcomes and definition of evidence-based indication and decision criteria.

Objectives: To develop and evaluate Cochlear™ Remote Assist (RA), a smartphone-based cochlear implant (CI) teleaudiology solution. The development phase aimed to identify the minimum features needed to remotely address most issues typically experienced by CI recipients. The clinical evaluation phase assessed ease of use, call clarity, system latency, and CI recipient feedback.

Design: The development phase involved mixed methods research with experienced CI clinicians. The clinical evaluation phase involved a prospective single-site clinical study and real-world use across 16 clinics.

Study sample: CI clinicians (N = 23), CI recipients in a clinical study (N = 15 adults) and real-world data (N = 57 CI recipients).

Results: The minimum feature set required for remote programming in RA, combined with sending replacements by post, should enable the clinician to address 80% of the issues typically seen in CI follow-up sessions. Most recipients completed the RA primary tasks without prior training and gave positive ratings for usefulness, ease of use, effectiveness, reliability, and satisfaction on the Telehealth Usability Questionnaire. System latency was reported to be acceptable.

Conclusion: RA is designed to help clinicians address a significant proportion of issues typically encountered by CI recipients. Clinical study and real-world evaluation confirm RA's ease of use, call quality, and responsiveness.

Objective: Adults typically receive only one cochlear implant (CI) due to cost constraints, with a contralateral hearing aid recommended when there is aidable hearing. Standard hearing aids differ from a CI in terms of processing strategy and function as a separate entity, requiring the user to integrate the disparate signals. Integrated bimodal technology has recently been introduced to address this challenge. The aim of the study was to investigate the performance of unilateral CI users with and without an integrated bimodal fitting and determine whether binaural streaming technology offers additional benefit.

Study sample: Twenty-six CI users using integrated bimodal technology.

Design: Repeated measures where outcomes and user experience were assessed using a functional test battery more representative of real life listening (speech perception in noise tests, localisation test, tracking test) and the speech, spatial and qualities-of-hearing scale (SSQ).

Results: Bimodal outcomes were significantly better than for CI alone. Speech perception in noise improvements ranged from 1.4 dB to 3.5 dB depending on the location of speech and noise. The localisation and tracking tests, and the SSQ also showed significant improvements. Binaural streaming offered additional improvement (1.2 dB to 6.1 dB on the different speech tests).

Conclusions: Integrated bimodal and binaural streaming technology improved the performance of unilateral CI users.

Objective: To examine the origin of cervical vestibular evoked myogenic potential (cVEMP) late waves (n34-p44) elicited with air-conducted click stimuli.

Design: Using a retrospective design, cVEMPs from normal volunteers were compared to those obtained from patients with vestibular and auditory pathologies.

Study sample: (1) Normal volunteers (n = 56); (2) severe-to-profound sensorineural hearing loss (SNHL) with normal vestibular function (n = 21); (3) peripheral vestibular impairment with preserved hearing (n = 16); (4) total vestibulocochlear deficit (n = 23).

Results: All normal volunteers had ipsilateral-dominant early p13-n23 peaks. Late peaks were present bilaterally in 78%. The p13-n23 response was present in all patients with SNHL but normal vestibular function, and 43% had late waves. Statistical comparison of these patients to a subset of age-matched controls showed no significant difference in the frequencies, amplitudes or latencies of their ipsilateral early and late peaks. cVEMPs were absent in all patients with vestibular impairment.

Conclusion: The presence of long-latency cVEMP waves was not dependent on the integrity of sensorineural hearing pathways, but instead correlated with intact vestibular function. This finding conflicts with the view that these late waves are cochlear in origin, and suggests that vestibular afferents may assume a more prominent role in their generation.

Objective: To investigate speech recognition in school-age children with early-childhood otitis media (OM) in conditions with noise or speech maskers with or without interaural differences. To also investigate the effects of three otologic history factors.

Design: Using headphone presentation, speech recognition thresholds (SRTs) were measured with simple sentences. As maskers, stationary speech-shaped noise (SSN) or two-talker running speech (TTS) were used. The stimuli were presented in a monaural and binaural condition (SSN) or a co-located and spatially separated condition (TTS). Based on the available medical records, overall OM duration, OM onset age, and time since the last OM episode were estimated.

Study sample: 6-13-year-olds with a history of recurrent OM (N = 42) or without any ear diseases (N = 20) with normal tympanograms and audiograms at the time of testing.

Results: Mixed-model regression analyses that controlled for age showed poorer SRTs for the OM group (Δ-value = 0.84 dB, p = 0.009). These appeared driven by the spatially separated, binaural, and monaural conditions. The OM group showed large inter-individual differences, which were unrelated to the otologic history factors.

Conclusions: Early-childhood OM can affect speech recognition in different acoustic conditions. The effects of the otologic history warrant further investigation.

Objective: The dynamic range (DR) available to the patient is a central parameter to determine speech intelligibility in quiet.

Design: In this retrospective study, the DR for the Vibrant Soundbridge implanted in individual patients was calculated using in situ thresholds of the patients and technical data of the implant system. The average DR across frequencies (0.5, 1, 2, 4 kHz) was correlated with the patients' assigned word recognition score (WRS) in quiet.

Study sample: A data set of 66 cases (4 bilateral and 2 revised cases) from 60 implanted patients between 14.3-81.8 years were analysed.

Results: The relationship between DR and WRS was described by a sigmoidal growth function with R²=0.6371 and a maximum WRS (upper asymptote) of 93.5%. Word recognition scores in quiet improved with increasing DR. A significant shift in performance was detected from DR bin 2 (10-20 dB, median WRS 55%) to bin 3 (20-30 dB, median WRS 80%) and from DR bin 4 (30-40 dB, median WRS 82.5%) to bin 5 (40-50 dB, median WRS 90%).

Conclusion: A minimum DR of 20 dB can yield sufficient speech intelligibility in quiet in implanted patients, however, an optimum DR is suggested to be 40 dB.

Objective: To evaluate the short- and long-term effect of remote synchronous fine-tuning and follow-up visits on hearing-related problems and hearing aid (HA) benefits for first-time HA users.

Design: A randomised controlled trial.

Study sample: Patients at public tax-funded HA clinics in Sweden due for aural rehabilitation (AR) were randomised to either an intervention group (n = 33) or a control group (n = 36). Both groups completed the conventional AR process, but the intervention group received synchronous remote fine-tuning of HAs and online follow-up visits. Outcome measures were used before and after intervention, and 6 months and 1 year after intervention.

Results: Both groups improved hearing-related problems measured with the Hearing Handicap Inventory for the Elderly/Adults over time, and no significant differences were found between the groups. Such improvements were also found for the Abbreviated Profile of Hearing Aid Benefit except for the subscale aversiveness. Both groups decreased the use of HAs in hours/day over time. The intervention group reported significant improvements in activity limitation when measured directly after the intervention, compared to the control group.

Conclusion: Synchronous remote fine-tuning and follow-ups for first-time HA users did not influence the outcomes of hearing-related problems and HA benefits differently from standard care at our clinic.