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The Effects of Age and the Middle Ear on the Frequency Tuning of the cVEMP and oVEMP. 年龄和中耳对cemp和oVEMP频率调谐的影响。
IF 1.2 4区 医学 Q2 Health Professions Pub Date : 2022-05-01 DOI: 10.1055/s-0042-1758750
Gary P Jacobson
The featured article thismonth is a paper byour colleagues at James Madison University, Jha, Piker, and Romero. The title of the paper is “Effects of Age and Middle Ear on the Frequency Tuning of the cVEMP and oVEMP.” When a new method of assessment is developed, a flurry of activity normally occurs. This activity usually is focused on the determination of the optimal stimulating, subject, and recording variables. Also, we need to know what constitutes normal and abnormal performance on the new metric. The introduction to our profession of the cervical and ocular vestibular evoked myogenic potentials (cVEMP and oVEMP, respectively) was no exception. Clinical laboratories throughout the nation and the world contributed to this knowledge base. Among the many observations emanating from the international scientific community was that neither the cVEMP nor the oVEMP were present 100 percent of the time in “normal” subjects. In fact, Su and colleagues (2004)1 suggested that up to approximately 40 percent of “normal” individuals over the age of 60 years could be expected to fail to generate a cVEMP. Our group (Piker et al. 2013)2 and others have attempted to identify variables that are responsible for the absence of these evoked responses in “normal” subjects. Where the oVEMP is concerned, part of the explanation was attributable to the location of the inverting (i.e., reference) input (Piker et al. 2018).3 It was observed that, when the contralateral inverting electrodewasplaced immediately inferior to the non-inverting electrode input, there was a significant amount of reference contamination (i.e., cancellation of the evoked responsebecause the inverting electrode contained a significant amount of the non-inverting input). For the cVEMP, it was observed that the presence of the response often was absent when the stimulus was a 500Hz tone burst, but might be present when a higher frequency stimulus (e.g., a 750Hz or 1000Hz tone burst) was used as the evoking stimulus. When this observation was studied systematically, it was shown that subject age is a significant variable in the recording of VEMPs. In general, it was shown that older individuals (e.g.,>60 years) were more likely to generate VEMPs if the stimulus is>500Hz. It is significant that, for most clinical investigations, a 500Hz tone burst is the recommended stimulus frequency. This brings us to the current investigation. In this study, the investigators added to what we know by assessing the effect of tone burst frequency and middle ear status on the recording of cVEMP and oVEMP. They evaluated 107 subjects that were divided into three groups (young, middle-aged, and older adults). The researchers recorded VEMPs in response to 500Hz, 750Hz, and 1000Hz tone bursts. Further, theymeasured static admittance andmeasures ofmiddle ear resonant frequency. I am not going to give away the results of the study, but will say that they contribute significantly to our knowledge base on VEMP testing and ha
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引用次数: 0
Ego-resiliency and Tinnitus Annoyance. 自我弹性和耳鸣烦恼。
IF 1.2 4区 医学 Q2 Health Professions Pub Date : 2022-05-01 DOI: 10.1055/a-1804-6601
Małgorzata Fludra, Joanna Kobosko, Elżbieta Gos, Justyna Paluchowska, Henryk Skarżyński

Background: Tinnitus is a common and, in many cases, chronic condition. Coping with a chronic ailment is a long-term process, which also depends on the personality of the individual. One important personality resource is ego-resiliency, that is, how flexible the person is in adapting to the impulse to control their environment.

Purpose: The aim of the study was to determine whether ego-resiliency affects the perceived level of tinnitus annoyance.

Research design: This was a questionnaire study combined with a retrospective analysis of medical data.

Study sample: The study involved 176 people with diagnosed chronic tinnitus who volunteered to participate (53 men and 123 women aged 31-80 years).

Data collection and analysis: The following tools were used: Ego-Resiliency Scale to measure ego-resiliency, Tinnitus Functional Index to assess the impact of tinnitus on daily life, and a survey of sociodemographics and tinnitus history.

Results: The conducted research showed that men had higher ego-resiliency than women. Older subjects (older than 60 years) had higher ego-resiliency than younger ones. There was a negative correlation between ego-resiliency and the perceived annoyance of tinnitus. Regression analysis showed that a person's ability to cope and to tolerate negative emotions were the only factors of ego-resiliency that were a significant predictor of tinnitus annoyance.

Conclusion: People with a high level of personal ability to cope and to tolerate negative emotions are likely to experience decreased tinnitus annoyance. Ego-resiliency levels should be considered when diagnosing and planning interventions for people with tinnitus. In psychological intervention programs for people with tinnitus, it is worthwhile developing ego-resiliency, paying particular attention to positive emotions which are crucial in building it. Research should be continued on other personal resources affecting perceived tinnitus annoyance.

背景:耳鸣是一种常见的慢性疾病。应对慢性疾病是一个长期的过程,这也取决于个人的个性。一个重要的人格资源是自我弹性,也就是说,一个人在适应控制环境的冲动方面有多灵活。目的:本研究的目的是确定自我弹性是否影响耳鸣烦恼的感知水平。研究设计:这是一项问卷调查研究,结合对医疗数据的回顾性分析。研究样本:该研究涉及176名诊断为慢性耳鸣的志愿者(53名男性和123名女性,年龄在31-80岁之间)。数据收集和分析:使用以下工具:自我恢复量表(Ego-Resiliency Scale)测量自我恢复能力,耳鸣功能指数(tinitus Functional Index)评估耳鸣对日常生活的影响,以及社会人口统计学和耳鸣病史调查。结果:研究表明,男性的自我弹性高于女性。年龄较大的受试者(60岁以上)比年轻人具有更高的自我弹性。自我恢复力与耳鸣烦恼感呈负相关。回归分析显示,一个人应对和容忍负面情绪的能力是自我弹性的唯一因素,是耳鸣烦恼的重要预测因素。结论:个人应对和容忍负面情绪能力高的人可能会减少耳鸣烦恼。在诊断和计划耳鸣患者的干预措施时应考虑自我恢复水平。在耳鸣患者的心理干预项目中,培养自我恢复能力是值得的,要特别注意积极的情绪,这对建立自我恢复能力至关重要。应继续研究影响耳鸣烦恼的其他个人资源。
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引用次数: 0
The Effect of Multichannel and Channel-Free Hearing Aids on Spectral-Temporal Resolution and Speech Understanding in Noise. 多通道和无通道助听器对噪声环境下频谱-时间分辨率和语音理解的影响。
IF 1.2 4区 医学 Q2 Health Professions Pub Date : 2022-05-01 DOI: 10.1055/a-1817-6840
Mert Kılıç, Eyyup Kara

Background: Identifying and understanding speech is difficult for individuals with sensorineural hearing loss, especially in noisy environments. Possible causes include less audibility of the signal, impaired temporal resolution, and low selectivity of frequency. The hearing aid is the most common option used to minimize the problems faced by individuals with sensorineural hearing loss.

Purpose: This article investigates the effects of multichannel and channel-free hearing aid signal processing techniques on spectral-temporal resolution and speech understanding in noise.

Research design: An experimental study was used in which the determined tests were applied to the participants.

Study sample: Thirty-four individuals with bilateral symmetrical sensorineural hearing loss between the ages of 18 and 70 were included in our study.

Data collection and analysis: Spectral-temporally modulated ripple test, random gap detection test (RGDT), and Turkish matrix test were applied to the participants using multichannel and channel-free hearing aids. All the data obtained were compared statistically in terms of the performances of the hearing aids.

Results: There was no significant difference between multichannel and channel-free hearing aids for spectral resolution and speech understanding in noise tests (p > 0.05). While there was no significant difference between the two hearing aids for 500 and 4,000 Hz RGDT in temporal resolution measurement (p > 0.05), for 1,000 Hz (p = 0.045), 2,000 Hz (p = 0.046), and composite RGDT (p = 0.001), statistically significant better performances were obtained with the channel-free hearing aids.

Conclusion: It is thought that faster processing of the incoming signal in the channel-free hearing aids improves the temporal resolution performance. It is predicted that our study findings might help to determine the signal processing technique that will maximize the communication skills of the patients in various conditions.

背景:感觉神经性听力损失患者很难识别和理解言语,尤其是在嘈杂的环境中。可能的原因包括信号的可听性降低、时间分辨率受损和频率选择性低。助听器是最常见的选择,用于最大限度地减少个人面临的问题感音神经性听力损失。目的:研究多通道和无通道助听器信号处理技术对噪声环境下频谱-时间分辨率和语音理解的影响。研究设计:采用实验研究,对参与者进行确定的测试。研究对象:34例18 ~ 70岁的双侧对称性感音神经性听力损失患者。数据收集与分析:对使用多通道助听器和无通道助听器的参与者进行频谱时序调制纹波测试、随机间隙检测测试(RGDT)和土耳其矩阵测试。所有获得的数据在助听器的性能方面进行统计比较。结果:多通道助听器与无通道助听器在噪声测试中的频谱分辨率和语音理解方面差异无统计学意义(p > 0.05)。虽然两种助听器在500 Hz和4,000 Hz RGDT的时间分辨率测量上没有显著差异(p > 0.05),但在1,000 Hz (p = 0.045), 2,000 Hz (p = 0.046)和复合RGDT (p = 0.001)时,无通道助听器获得了具有统计学意义的更好性能。结论:无通道助听器对输入信号的快速处理可以提高其时间分辨率。预计我们的研究结果可能有助于确定信号处理技术,以最大限度地提高患者在各种情况下的沟通技巧。
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引用次数: 1
The Maturation of the Acoustic Change Complex in Response to Iterated Ripple Noise in 'Normal'-Hearing Infants, Toddlers, and Adults. 在“正常”听力的婴儿、学步儿童和成人中,响应迭代波纹噪声的声学变化复合体的成熟。
IF 1.2 4区 医学 Q2 Health Professions Pub Date : 2022-05-01 DOI: 10.1055/a-1862-0198
S Strahm, S A Small, S Chan, D Y Tian, M Sharma

Background: Infants and toddlers are still being evaluated for their hearing sensitivity but not their auditory-processing skills. Iterated rippled noise (IRN) stimuli require the auditory system to utilize the temporal periodicity and autocorrelate the iterations to perceive pitch.

Purpose: This study investigated the acoustic change complex (ACC) elicited by IRN in "normal"-hearing infants, toddlers, and adults to determine the maturation of cortical processing of IRN stimuli.

Design: Cortical responses to filtered white noise (onset) concatenated with IRN stimuli (d = 10 milliseconds, gain = 0.7 dB: 4-32 iterations) were recorded in quiet, alert participants.

Study sample: Participants included 25 infants (2.5-15 months), 27 toddlers (22-59 months), and 8 adults (19-25 years) with "normal" hearing sensitivity.

Data collection and analysis: Cortical auditory-evoked responses were recorded for each participant, including the onset response to the noise and an ACC to the transition from noise to IRN. Group differences were assessed using repeated-measures analyses of variance.

Results: Most infants had a replicable onset (P) response, while only about half had a measurable ACC (PACC) response to the high-saliency IRN condition. Most toddlers had onset responses and showed a P-NACC response to the IRN16 and IRN32 conditions. Most of the toddler group had responses present to the onset and showed a P-NACC response to all IRN conditions. Toddlers and adults showed similar P-NACC amplitudes; however, adults showed an increase in N1ACC amplitude with increase in IRN iterations (i.e., increased salience).

Conclusion: While cortical responses to the percept of sound as determined by the onset response (P) to a stimulus are present in most infants, ACC responses to IRN stimuli are not mature in infancy. Most toddlers as young as 22 months, however, exhibited ACC responses to the IRN stimuli even when the pitch saliency was low (e.g., IRN4). The findings of the current study have implications for future research when investigating maturational effects on ACC and the optimal choice of stimuli.

背景:婴幼儿仍在评估他们的听觉敏感度,而不是他们的听觉处理技能。迭代纹波噪声(IRN)刺激要求听觉系统利用时间周期性和自相关的迭代来感知音高。目的:本研究研究了“正常”听力婴儿、幼儿和成人的IRN诱发的声学变化复合体(ACC),以确定IRN刺激皮层加工的成熟度。设计:记录安静,警觉的参与者对过滤白噪声(开始)与IRN刺激(d = 10毫秒,增益= 0.7 dB: 4-32次迭代)的皮质反应。研究样本:参与者包括25名婴儿(2.5-15个月),27名幼儿(22-59个月)和8名听力正常的成年人(19-25岁)。数据收集和分析:记录每个参与者的皮层听觉诱发反应,包括对噪音的开始反应和从噪音到IRN过渡的ACC。采用重复测量方差分析评估组间差异。结果:大多数婴儿有可复制的发病(P)反应,而只有大约一半的婴儿对高显著性IRN有可测量的ACC (PACC)反应。大多数幼儿对IRN16和IRN32条件均有起效反应,并表现出P-NACC反应。大多数幼儿组在发病时都有反应,并对所有IRN条件表现出P-NACC反应。幼儿和成人表现出相似的P-NACC振幅;然而,成人的N1ACC振幅随着IRN迭代次数的增加而增加(即显著性增加)。结论:虽然大多数婴儿对声音感知的皮层反应是由刺激的开始反应(P)决定的,但ACC对IRN刺激的反应在婴儿时期并不成熟。然而,即使音调显著性较低(例如,IRN4),大多数22个月大的幼儿对IRN刺激也表现出ACC反应。目前的研究结果对未来研究ACC的成熟效应和刺激的最佳选择具有启示意义。
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引用次数: 1
Psychometric Evaluation of the Hyperacusis Impact Questionnaire (HIQ) and Sound Sensitivity Symptoms Questionnaire (SSSQ) Using a Clinical Population of Adult Patients with Tinnitus Alone or Combined with Hyperacusis. 使用单独或合并耳鸣的成年患者临床人群对耳鸣影响问卷(HIQ)和声音敏感症状问卷(SSSQ)进行心理测量评估。
IF 1.2 4区 医学 Q2 Health Professions Pub Date : 2022-05-01 DOI: 10.1055/a-1780-4002
Hashir Aazh, Chloe Hayes, Brian C J Moore, Ali A Danesh, Silia Vitoratou

Background: Hyperacusis can be defined as an intolerance of certain everyday sounds, which are perceived as too loud or uncomfortable and which cause significant distress and impairment in the individual's day-to-day activities. It is important to assess symptoms of sound intolerance and their impact on the patient's life, so as to evaluate the need for treatment and to assess the effectiveness of treatments.

Purpose: The aim was to evaluate the psychometric properties of the Hyperacusis Impact Questionnaire (HIQ), and the Sound Sensitivity Symptoms Questionnaire (SSSQ). The 8-item HIQ focuses on assessing the impact of hyperacusis on the patient, while the 5-item SSSQ is designed to assess the type and severity of sound intolerance symptoms.

Research design: This was a retrospective cross-sectional study.

Study sample: In total, 266 consecutive patients who attended a Tinnitus and Hyperacusis Therapy Clinic in the United Kingdom within a 6-month period. Fifty-five percent were female. The average age was 54 years (standard deviation = 16 years).

Data collection and analysis: Data were collected retrospectively from the records of patients held at the audiology department. Audiological measures were pure-tone audiometry and Uncomfortable Loudness Levels (ULLs). Questionnaires administered in addition to the HIQ and SSSQ were: Tinnitus Handicap Inventory, Hyperacusis Questionnaire (HQ), and Screening for Anxiety and Depression in Tinnitus.

Results: Exploratory factor analysis suggested one-factor solutions for both the HIQ and SSSQ. Multiple-causes multiple-indicators (MIMIC) models showed some small influences of gender but negligible effects of age for both the HIQ and SSSQ. Receiver Operating Characteristic (ROC) analysis showed no significant effects of covariates on the ROC curves. Cronbach's α was 0.93 for the HIQ, and 0.87 for the SSSQ, indicating high internal consistency. Convergent validity was supported by moderate correlations between HQ and HIQ scores and between SSSQ scores and ULLs.

Conclusion: The HIQ and SSSQ are internally consistent questionnaires that can be used in clinical and research settings.

背景:听觉亢进可以定义为对某些日常声音的不耐受,这些声音被认为太大声或不舒服,并导致个人日常活动的严重痛苦和损害。评估声音不耐受的症状及其对患者生活的影响非常重要,以便评估治疗的必要性和评估治疗的有效性。目的:评价超音冲击问卷(HIQ)和声敏感症状问卷(SSSQ)的心理测量特性。8项HIQ侧重于评估听觉过敏对患者的影响,而5项SSSQ旨在评估声音不耐受症状的类型和严重程度。研究设计:本研究为回顾性横断面研究。研究样本:在6个月的时间里,总共有266名连续的患者在英国的耳鸣和听觉亢进治疗诊所就诊。55%是女性。平均年龄54岁(标准差= 16岁)。资料收集和分析:回顾性收集听力学科患者的资料。听力学测量为纯音听力学和不舒服响度水平(ULLs)。除HIQ和SSSQ外,还进行了问卷调查:耳鸣障碍量表、耳鸣过敏问卷(HQ)和耳鸣焦虑和抑郁筛查。结果:探索性因子分析提示HIQ和SSSQ均为单因素解决方案。多原因多指标(MIMIC)模型显示性别对HIQ和SSSQ的影响很小,但年龄的影响可以忽略不计。受试者工作特征(ROC)分析显示协变量对ROC曲线无显著影响。HIQ的Cronbach’s α为0.93,SSSQ的Cronbach’s α为0.87,表明内部一致性较高。HQ和HIQ得分之间、SSSQ得分和ull之间存在适度相关,支持了收敛效度。结论:HIQ和SSSQ问卷具有内在一致性,可用于临床和研究。
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引用次数: 11
Change Resistance and Clinical Practice Strategies in Audiology. 听力学变化阻力与临床实践策略。
IF 1.2 4区 医学 Q2 Health Professions Pub Date : 2022-05-01 DOI: 10.1055/a-1840-9737
Jessica Wince, Diana C Emanuel, Nhung Hendy, Nicholas Reed

Background: Audiology is experiencing pressure from market forces that may change the profession's nature. Research suggests that understanding resistance needs to change and organizational culture may provide insights that can facilitate change.

Purpose: This study was designed to examine audiologists' resistance to change, organizational culture, and clinical practices related to hearing aid pricing and audiology assistants.

Research design: This study utilized a cross-sectional and nonexperimental survey design.

Study sample: Participants were 205 U.S. audiologists, representing diversity across experience, work setting, and location.

Data collection: This survey examined demographics and clinical practice strategies. Resistance to change (RTC) scale examined disposition toward change. Organizational culture profile (OCP) examined organizational culture perspectives.

Results: The majority (52%) of respondents use bundled pricing but 42% of these repondents anticipate transitioning to unbundling. Use of hybrid pricing is increasing. Service-extender personnel were reported by 41%. Although the majority (66%) do not work with audiology assistants currently, 32% of these participants anticipate they will do so in the future. Results indicated lower RTC and greater years of experience were associated with more positive perceptions about organizational culture. Pricing structure was related to experience.

Conclusion: Trends indicate use of bundled pricing is decreasing, use of hybrid pricing is increasing, and employment of audiology assistants is increasing. Experienced audiologists are more likely to report unbundled and hybrid pricing compared with less experienced audiologists.

背景:听力学正面临着来自市场力量的压力,这可能会改变该行业的性质。研究表明,了解变革的阻力和组织文化可能会提供促进变革的见解。目的:本研究旨在调查与助听器定价和听力学助理相关的听力学家对变革的抗拒、组织文化和临床实践。研究设计:本研究采用横断面和非实验调查设计。研究样本:参与者是205名美国听力学家,代表了经验、工作环境和地点的多样性。数据收集:这项调查检查了人口统计学和临床实践策略。变革阻力(RTC)量表考察了对变革的倾向。组织文化概况(OCP)考察了组织文化的观点。结果:大多数(52%)的受访者使用捆绑定价,但42%的受访者预计将过渡到非捆绑定价。混合定价的使用正在增加。服务扩展人员占41%。虽然大多数人(66%)目前没有与听力学助理一起工作,但这些参与者中有32%预计他们将来会这样做。结果表明,较低的RTC和较长的工作经验与对组织文化的更积极的看法有关。定价结构与经验有关。结论:趋势表明,捆绑定价的使用正在减少,混合定价的使用正在增加,听力学助理的就业正在增加。与经验不足的听力学家相比,经验丰富的听力学家更有可能报告非捆绑和混合定价。
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引用次数: 1
Effects of Age and Middle Ear on the Frequency Tuning of the cVEMP and oVEMP. 年龄和中耳对cemp和oVEMP频率调谐的影响。
IF 1.2 4区 医学 Q2 Health Professions Pub Date : 2022-05-01 DOI: 10.1055/s-0042-1747910
Raghav Hira Jha, Erin G Piker, Daniel Romero

Background: Upward shift in the air conducted (AC) frequency tuning of vestibular evoked myogenic potentials (VEMPs) as an effect of aging is hypothesized to be due to the microstructural stiffening changes in the inner ear. However, with an AC stimulus, it may be possible that the shift in the frequency tuning of VEMPs as an effect of aging may also be due to contributions from the middle ear.

Purpose: The main aim of this study was to examine the effects of age on the frequency tuning of the cervical VEMP (cVEMP) and ocular VEMP (oVEMP) and determine the role of middle ear transmission characteristics in shaping these effects.

Research design: Standard group comparison.

Study sample: One-hundred seven participants divided in three groups: young adult, middle-age, and older adults with "normal" middle ear and negative history of neurological or vestibular complaints.

Data collection and analyses: Middle ear measures included static admittance and middle ear resonant frequency. cVEMP and oVEMPs were elicited with AC tone bursts at 500, 750, and 1,000 Hz.

Results: No significant effect of age was observed on any of the middle ear measures. There was a significant effect of age on the amplitude of the cVEMP, but this effect was frequency specific. The age-related reduction in cVEMP corrected amplitude was only observed when the eliciting stimulus was 500 or 750 Hz, with no significant effect observed with a 1,000 Hz stimulus. For the oVEMP, the effects of age were apparent at all stimulus frequencies. We also observed a general upward shift in the frequency tuning of both the cVEMP and oVEMP for middle-age and older adults, with 750 and 1,000 Hz yielding higher response rates and larger amplitudes among middle-aged and older adults. Measurements of middle ear did not significantly contribute to the observed findings.

Conclusions: The upward shift in frequency tuning of VEMPs among middle age and older adults could be due to the changes in the vestibular system and not from the middle ear. These results support the use of different frequency stimuli (i.e., 750 or 1,000 Hz) to elicit a VEMP if a response is absent using a 500 Hz stimulus, especially in patients over the age of 40.

背景:前庭诱发肌电位(VEMPs)在空气传导(AC)频率调谐中向上移动作为衰老的影响被假设是由于内耳微结构硬化的变化。然而,在交流刺激下,vemp频率调谐的变化作为衰老的影响也可能是由于中耳的贡献。目的:本研究的主要目的是研究年龄对颈部VEMP (cemp)和眼部VEMP (oVEMP)频率调谐的影响,并确定中耳传输特性在形成这些影响中的作用。研究设计:标准组比较。研究样本:117名参与者分为三组:年轻人、中年人和老年人,他们的中耳“正常”,神经或前庭疾病史阴性。数据收集与分析:中耳测量包括静态导纳和中耳谐振频率。cevemp和ovemp是用500、750和1000 Hz的交流音脉冲激发的。结果:年龄对任何中耳测量均无显著影响。年龄对cemp的振幅有显著影响,但这种影响是频率特异性的。cemp校正幅度的年龄相关性降低仅在激发刺激为500或750 Hz时观察到,而在激发刺激为1000 Hz时没有观察到明显的影响。对于oVEMP,年龄的影响在所有刺激频率下都很明显。我们还观察到,在中年和老年人中,cemp和oVEMP的频率调谐总体上呈上升趋势,750 Hz和1000 Hz在中年和老年人中产生更高的响应率和更大的振幅。中耳的测量对观察结果没有显著影响。结论:中老年vemp频率调谐的上升可能是由于前庭系统的变化,而不是来自中耳。这些结果支持使用不同频率的刺激(即750或1,000 Hz)来引发VEMP,如果使用500 Hz的刺激没有反应,特别是在40岁以上的患者中。
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引用次数: 0
JAAA CEU Program. JAAA CEU程序。
IF 1.2 4区 医学 Q2 Health Professions Pub Date : 2022-05-01 DOI: 10.1055/s-0042-1760304
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引用次数: 0
Stimulus for Simultaneous Multifrequency (SiMFy) oVEMP: A More Efficient Approach for Determining Otolith Tuning. 同步多频(SiMFy) oVEMP的刺激:一种更有效的耳石调谐方法。
IF 1.2 4区 医学 Q2 Health Professions Pub Date : 2022-04-01 Epub Date: 2022-11-18 DOI: 10.1055/s-0042-1757930
Devin L McCaslin
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引用次数: 0
Low-Level Speech Recognition of Children with Hearing Aids. 使用助听器的儿童低水平语音识别。
IF 1.2 4区 医学 Q2 Health Professions Pub Date : 2022-04-01 Epub Date: 2021-11-10 DOI: 10.1055/a-1692-9670
Jace Wolfe, Mila Duke, Sharon Miller, Erin Schafer, Christine Jones, Lori Rakita, Andrea Dunn, Jarrod Battles, Sara Neumann, Jacy Manning

Background: For children with hearing loss, the primary goal of hearing aids is to provide improved access to the auditory environment within the limits of hearing aid technology and the child's auditory abilities. However, there are limited data examining aided speech recognition at very low (40 decibels A [dBA]) and low (50 dBA) presentation levels.

Purpose: Due to the paucity of studies exploring aided speech recognition at low presentation levels for children with hearing loss, the present study aimed to (1) compare aided speech recognition at different presentation levels between groups of children with "normal" hearing and hearing loss, (2) explore the effects of aided pure tone average and aided Speech Intelligibility Index (SII) on aided speech recognition at low presentation levels for children with hearing loss ranging in degree from mild to severe, and (3) evaluate the effect of increasing low-level gain on aided speech recognition of children with hearing loss.

Research design: In phase 1 of this study, a two-group, repeated-measures design was used to evaluate differences in speech recognition. In phase 2 of this study, a single-group, repeated-measures design was used to evaluate the potential benefit of additional low-level hearing aid gain for low-level aided speech recognition of children with hearing loss.

Study sample: The first phase of the study included 27 school-age children with mild to severe sensorineural hearing loss and 12 school-age children with "normal" hearing. The second phase included eight children with mild to moderate sensorineural hearing loss.

Intervention: Prior to the study, children with hearing loss were fitted binaurally with digital hearing aids. Children in the second phase were fitted binaurally with digital study hearing aids and completed a trial period with two different gain settings: (1) gain required to match hearing aid output to prescriptive targets (i.e., primary program), and (2) a 6-dB increase in overall gain for low-level inputs relative to the primary program. In both phases of this study, real-ear verification measures were completed to ensure the hearing aid output matched prescriptive targets.

Data collection and analysis: Phase 1 included monosyllabic word recognition and syllable-final plural recognition at three presentation levels (40, 50, and 60 dBA). Phase 2 compared speech recognition performance for the same test measures and presentation levels with two differing gain prescriptions.

Conclusion: In phase 1 of the study, aided speech recognition was significantly poorer in children with hearing loss at all presentation levels. Higher aided SII in the better ear (55 dB sound pressure level input) was associated with higher Consonant-Nucleus-Consonant word recognition at a 40 dBA presentation level. In phase 2, increasing t

背景:对于听力损失的儿童,助听器的主要目标是在助听器技术和儿童听觉能力的限制下提供更好的听觉环境。然而,在非常低(40分贝A [dBA])和低(50分贝)表示水平下检查辅助语音识别的数据有限。目的:由于缺乏对听力损失儿童低呈现水平辅助语音识别的研究,本研究旨在(1)比较听力正常儿童和听力损失儿童在不同呈现水平下的辅助语音识别;(2)探讨辅助纯音平均和辅助语音清晰度指数(SII)对轻度至重度听力损失儿童低呈现水平辅助语音识别的影响;(3)评价提高低呈现水平对听力损失儿童辅助语音识别的影响。研究设计:在本研究的第一阶段,采用两组重复测量设计来评估语音识别的差异。在本研究的第二阶段,采用单组重复测量设计来评估额外的低水平助听器增益对听力损失儿童低水平辅助语音识别的潜在益处。研究样本:研究的第一阶段包括27名轻度至重度感音神经性听力损失的学龄儿童和12名听力正常的学龄儿童。第二阶段包括8名轻度至中度感音神经性听力损失的儿童。干预措施:在研究之前,听力损失的儿童被安装双耳数字助听器。第二阶段的儿童双耳配备数字学习助听器,并完成了两种不同增益设置的试验期:(1)将助听器输出与规定目标(即初级程序)相匹配所需的增益;(2)相对于初级程序,低水平输入的总增益增加6db。在本研究的两个阶段都完成了实耳验证措施,以确保助听器输出符合规定的目标。数据收集和分析:第一阶段包括单音节词识别和音节末复数识别,在三个表示级别(40、50和60 dBA)。第二阶段比较了两种不同增益处方下相同测试措施和表示水平下的语音识别性能。结论:在第一阶段的研究中,所有表现水平的听力损失儿童的辅助语音识别都明显较差。在较好的耳朵(55 dB声压级输入)中,较高的辅助SII与在40 dBA呈现水平下较高的辅音-核-辅音单词识别相关。在第二阶段,增加低水平输入的助听器增益可以显著改善极低水平输入时的音节末复数识别,并导致极低呈现水平时单音节单词识别的不显著趋势。需要进一步的研究来证明使用助听器的儿童在现实世界中可能遇到的低水平语音识别困难,以及提供额外的低水平助听器增益的潜在利弊。
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Journal of the American Academy of Audiology
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