Journal of the American Academy of Audiology最新文献

Background: Over 1 billion young adults are at risk for developing noise-induced hearing loss (NIHL) due to their habit of listening to music at loud levels. The gold standard for detecting NIHL is the audiometric notch around 3,000 to 6,000 Hz observed in pure tone audiogram. However, recent studies suggested that suprathreshold auditory measures might be more sensitive to detect early-stage NIHL in young adults.

Purpose: The present study compared suprathreshold measures in individuals with high and low noise exposure backgrounds (NEBs). We hypothesized that individuals with high NEB would exhibit reduced performance on suprathreshold measures than those with low NEB.

Study sample: An initial sample of 100 English-speaking healthy adults (18-35 years; females = 70) was obtained from five university classes. We identified 15 participants with the lowest NEB scores (10 females) and 15 participants with the highest NEB scores (10 females). We selected a sample of healthy young adults with no history of middle ear infection, and those in the low NEB group were selected with no history of impulse noise exposure.

Data collection and analysis: The study included conventional audiometry, extended high-frequency audiometry, middle ear muscle reflex (MEMR) thresholds, distortion-product otoacoustic emissions (DPOAEs), QuickSIN, and suprathreshold auditory brainstem response (ABR) measures. We used independent sample t-tests, correlation coefficients, and linear mixed model analysis to compare the audiometric measures between the NEB groups.

Results: The prevalence of audiometric notch was low in the study sample, even for individuals with high NEB. We found that: (1) individuals with high NEB revealed significantly reduced QuickSIN performance than those with low NEB; (2) music exposure via earphone revealed a significant association with QuickSIN; (3) individuals with high NEB revealed significantly reduced DPOAEs and ABR wave I amplitude compared with individuals with low NEB; (4) MEMR and ABR latency measures showed a modest association with NEB; and (5) audiometric thresholds across the frequency range did not show statistically significant association with NEB.

Conclusion: Our results suggest that young adults with high NEB might exhibit impaired peripheral neural coding deficits leading to reduced speech-in-noise (SIN) performance despite clinically normal hearing thresholds. SIN measures might be more sensitive than audiometric notch for detecting early-stage NIHL in young adults.

Background: Tinnitus, the phantom perception of sound, shares many properties with phantom limb pain, in that both may arise as a consequence of sensory deprivation. Prediction errors in multisensory integration, such as induced with mirror box therapy in phantom pain, can reduce phantom percepts.

Purpose: We evaluated if a device that swaps sound from the right pinna to the left ear canal, and from the left pinna to the right ear canal, can reduce tinnitus. We call this auditory mirror therapy (AMT).

Research design: Uncontrolled trial.

Study sample: Twenty subjects with chronic tinnitus.

Intervention: An AMT device consisting of a modified ear defender device with microphones that swaps sounds from left pinna to the right ear canal and from the right pinna to the left ear canal. Participants used the device at home for 2 weeks.

Data collection and analysis: Tinnitus Handicap Inventory (THI), Tinnitus Reaction Questionnaire, and visual analog scale ratings of symptoms were collected at baseline and posttreatment. Repeated measures t-test were performed, Bonferroni corrected for multiple comparisons.

Results: There was a significant reduction in THI and in awareness of tinnitus after the AMT intervention.

Conclusion: Exposing the audiovisual integration system to prediction errors can help retrain phantom percepts and reduce tinnitus handicap. Further studies on this concept are warranted.

Purpose: As bone-conduction thresholds vary with the coupling force between the vibrator and the head, it is important that the coupling force be within the range specified by audiometer standards. The development and validation of AMBAND, an elastic headband for coupling an audiometric bone vibrator to the head, in either the mastoid or forehead position, is described.

Methods: The headband was constructed from woven, fold-over elastic with Velcro attachment points to produce the proper force on the head for various head sizes. Force measurements were made with a digital force gauge on five artificial heads, representing adult females, adult males, children (age 6 years), infants (age 6 months), and newborns with the bone vibrator in the mastoid and forehead positions. Additional measurements were made with the Radioear P-3333 spring band that is in common use.

Results: Force measurements were highly repeatable within a given headband and across headbands. Force measurements for AMBAND were within the range specified by the ANSI S3.6-2018. The Radioear P-3333 spring band produced force levels that exceeded the specified range and had higher variability compared with AMBAND.

Conclusion: AMBAND can be used to couple audiometric bone vibrators to the head in the forehead and mastoid positions during bone-conduction testing to provide accurate threshold measurements.

Background: Spectral shaping is employed by hearing aids to make consonantal information, such as formant transitions, audible for listeners with hearing loss. How manipulations of the stimuli, such as spectral shaping, may alter encoding in the auditory brainstem has not been thoroughly studied.

Purpose: The aim of this study was to determine how spectral shaping of synthetic consonant-vowel (CV) syllables, varying in their second formant (F2) onset frequency, may affect encoding of the syllables in the auditory brainstem.

Research design: We employed a repeated measure design.

Study sample: Sixteen young adults (mean = 20.94 years, 6 males) and 11 older adults (mean = 58.60 years, 4 males) participated in this study.

Data collection and analysis: Speech-evoked auditory brainstem responses (speech-ABRs) were obtained from each participant using three CV exemplars selected from synthetic stimuli generated for a /ba-da-ga/ continuum. Brainstem responses were also recorded to corresponding three CV exemplars that were spectrally shaped to decrease low-frequency information and provide gain for middle and high frequencies according to a Desired Sensation Level function. In total, six grand average waveforms (3 phonemes [/ba/, /da/, /ga/] X 2 shaping conditions [unshaped, shaped]) were produced for each participant. Peak latencies and amplitudes, referenced to prestimulus baseline, were identified for 15 speech-ABR peaks. Peaks were marked manually using the program cursor on each individual waveform. Repeated-measures analysis of variances were used to determine the effects of shaping on the latencies and amplitudes of the speech-ABR peaks.

Results: Shaping effects produced changes within participants in ABR latencies and amplitudes involving onset and major peaks of the speech-ABR waveform for certain phonemes. Specifically, data from onset peaks showed that shaping decreased latency for /ga/ in older listeners, and decreased amplitude onset for /ba/ in younger listeners. Shaping also increased the amplitudes of major peaks for /ga/ stimuli in both groups.

Conclusions: Encoding of speech in the ABR waveform may be more complex and multidimensional than a simple demarcation of source and filter information, and may also be influenced by cue intensity and age. These results suggest a more complex subcortical encoding of vocal tract filter information in the ABR waveform, which may also be influenced by cue intensity and age.

Background: Psychiatric conditions are common in individuals with tinnitus. Therefore, the ways individuals cope with such conditions and personality can influence the characteristics of tinnitus.

Purpose: The study aims to investigate the direct and indirect effects of resilience, personality traits, and psychiatric symptoms on the tinnitus perception.

Research design: This is a descriptive, cross-sectional, and observational study involving quantitative results.

Study sample: Thirty-seven individuals with chronic tinnitus (for more than 6 months) sought the tinnitus care service (mean age = 44.6 years; SD = 11.7 years).

Data collection and analysis: The specific anamnesis of tinnitus, adult self-report questionnaire, resilience scale, big five inventory, Tinnitus Handicap Inventory (M = 45.0; SD = 24.1), and visual analog scale (M = 6.4; SD = 2.7) were used. Psychoacoustic measurements (loudness: M = 25.4; SD = 12.8) of tinnitus were performed to characterize the condition in terms of pitch and loudness. The study analyzed the relationship between tinnitus (annoyance, severity, and loudness), psychiatric symptoms, personality, and resilience using multiple mediations.

Results: Resilience did not influence tinnitus severity (BCa: -1.12 to 0.51), annoyance (BCa: -0.10 to 0.11), or loudness (BCa: -0.44 to 0.28) when mediated by anxiety and depression. Additionally, there was only a direct effect of resilience for annoyance (t = - 2.14, p = 0.03; BCa: -0.10 to 0.11). There was no direct influence of anxiety and depression on the tinnitus severity (b = 0.53, p > 0.05), annoyance (b = - 0.01, p > 0.05), or loudness (b = 0.11, p > 0.05). However, there was an association of personality traits (neuroticism) with the tinnitus severity (b = 1.16, 95% CI: 0.15-2.17; t = 2.53, p = 0.02) and annoyance (b = 0.12, 95% CI: 0.003-0.24; t = 2.09, p = 0.04).

Conclusion: Resilience and psychiatric symptoms did not have a direct or indirect influence on the tinnitus annoyance, severity, or loudness. However with a direct association of resilience and annoyance, and neuroticism trait with the tinnitus annoyance and severity. Our results suggest that patients with chronic tinnitus and high neuroticism should receive personalized treatment.

Background: Frequency tuning of ocular vestibular evoked myogenic potential (oVEMP) refers to the frequency of tone burst that produces the largest amplitude oVEMP. There is an ever-growing pool of published studies that found the frequency tuning of oVEMP distinctly different in Ménière's disease than the age-matched controls and benign paroxysmal positional vertigo. However, recording oVEMP in response to many frequencies makes an already lengthy vestibular test battery even more cumbersome and time-consuming.

Purpose: The aim of this study was to develop a novel time-saving stimulus that produces reliable results.

Research design: Prospective study.

Study sample: The study included 25 young, healthy adults.

Data collection: The tone-bursts of 2000, 1500, 1000, 750, 500, and 250 Hz were generated and sequenced in this order to prepare a stimulus for simultaneous multifrequency (SiMFy) oVEMP. The response parameters of SiMFy and conventional oVEMP methods were compared.

Results: No significant difference in peak-to-peak amplitude and frequency tuning existed between conventional and SiMFy oVEMP (p > 0.05). SiMFy had better test-retest reliability and was less time-consuming than the conventional oVEMP.

Conclusions: SiMFy is a time-saving and reliable stimulus for obtaining frequency tuning of oVEMP with no compromise on the outcomes. It can be immediately applied in most commercially available evoked potential systems with a facility for loading an external stimulus.

Background: Hearing aid manufacturers offer several different levels of technology that vary in sophistication and cost. It would stand to reason that higher technology hearing aids would provide greater benefit in the daily life of the user; however, research does not support this assumption for all users. Recent research in experienced hearing aid users indicated noise acceptance and satisfaction for speech in a large group were significantly improved when using the premium devices and suggested noise acceptance may be useful when comparing hearing aid technology levels.

Purpose: The purpose of this study was to determine the effect of hearing aid technology level on listener outcome measures for new hearing aid users.

Research design: A repeated measures, single-blinded research design was utilized.

Study sample: Twenty-four adults with no previous hearing aid experience were recruited using flyers posted at the University of Tennessee Audiology Clinic and on social media (19 males, 5 females). The average age of the participants was 61 years (48-81 years).

Data collection and analysis: Participants completed two, 4-week trial periods using Unitron T Moxi Fit FLEX:TRIAL devices programmed with basic or premium technology. Following each trial, laboratory evaluations were conducted using the QuickSIN, Hearing in Noise Test (HINT), and the Acceptable Noise Level (ANL). Subjective data was obtained using the Speech, Spatial, and Qualities of Hearing Short Form, satisfaction ratings, and preference. Data was analyzed using one-way repeated-measures analysis of variance.

Results: Speech perception results did not reveal significant differences between technology level on the HINT or QuickSIN; however, ANL was significantly improved for the premium devices. Subjective results revealed significantly improved satisfaction for speech in a large group and overall preference when using premium technology.

Conclusion: Group data revealed similar outcomes between technology levels on most measures; however, noise acceptance, satisfaction for speech in a large group, and overall preference were significantly improved when using the premium devices. Individual characteristics such as noise acceptance, age, and degree of hearing loss may be useful when comparing hearing aid technology levels for new hearing aid users.

Purpose: Cochlear implant (CI) recipients often experience speech recognition difficulty in noise in small group settings with multiple talkers. In traditional remote microphones systems, one talker wears a remote microphone that wirelessly delivers speech to the CI processor. This system will not transmit signals from multiple talkers in a small group. However, remote microphone systems with multiple microphones allowing for adaptive beamforming may be beneficial for small group situations with multiple talkers. Specifically, a remote microphone with an adaptive multiple-microphone beamformer may be placed in the center of the small group, and the beam (i.e., polar lobe) may be automatically steered toward the direction associated with the most favorable speech-to-noise ratio. The signal from the remote microphone can then be wirelessly delivered to the CI sound processor. Alternately, each of the talkers in a small group may use a remote microphone that is part of a multi-talker network that wirelessly delivers the remote microphone signal to the CI sound processor. The purpose of this study was to compare the potential benefit of an adaptive multiple-microphone beamformer remote microphone system and a multi-talker network remote microphone system.

Method: Twenty recipients, ages 12 to 84 years, with Advanced Bionics CIs completed sentence-recognition-in-noise tasks while seated at a desk surrounded by three loudspeakers at 0, 90, and 270 degrees. These speakers randomly presented the target speech while competing noise was presented from four loudspeakers located in the corners of the room. Testing was completed in three conditions: 1) CI alone, 2) Remote microphone system with an adaptive multiple-microphone beamformer, and 3) and a multi-talker network remote microphone system each with five different signal levels (15 total conditions).

Results: Significant differences were found across all signal levels and technology conditions. Relative to the CI alone, sentence recognition improvements ranged from 14-23 percentage points with the adaptive multiple-microphone beamformer and 27-47 percentage points with the multi-talker network with superior performance for the latter remote microphone system.

Conclusions: Both remote microphone systems significantly improved speech recognition in noise of CI recipients when listening in small group settings, but the multi-talker network provided superior performance.

Background: The acceptable noise level (ANL) is the maximum level of background noise that an individual is willing to accept while listening to speech. The type of background noise does not affect ANL results except for music.

Purpose: The purpose of this study was to determine if ANL differed due to music genre or music genre preference.

Research design: A repeated-measures experimental design was employed.

Study sample: Thirty-three young adults with normal hearing served as listeners.

Data collection and analysis: Most comfortable listening level and background noise level were measured to twelve-talker babble and five music samples from different genres: blues, classical, country, jazz, and rock. Additionally, music preference was evaluated via rank ordering of genre and by completion of the Short Test of Music Preference (STOMP) questionnaire.

Results: The ANL for music differed based on music genre; however, the difference was unrelated to music genre preference. Also, those with low ANLs tended to prefer the intense and rebellious music-preference dimension compared with those with high ANLs.

Conclusions: For instrumental music, ANL was lower for blues and rock music compared with classical, country, and jazz. The differences identified were not related to music genre preference; however, this finding may be related to the music-preference dimension of intense and rebellious music. Future work should evaluate the psychological variables that make up music-preference dimension to determine if these relate to our ANL.