Ear and Hearing最新文献

Objectives: Live music creates a sense of connectedness in older adults, which can help alleviate the social isolation frequently associated with hearing loss and aging. However, most hearing-aid (HA) users are dissatisfied with the sound quality of live music and rate sound quality as important to them. Assistive listening systems are frequently independent of a user's HAs and fall short in tailoring to each individual's hearing loss. The present study thus tested whether the use of a hearing loop would improve sound quality during an orchestral concert.

Design: Participants with symmetrical moderate-to-severe hearing loss were assigned to use Sonova-provided HAs with a telecoil (n = 20) or their own HAs (n = 8) without a telecoil during a performance by the Hamilton Philharmonic Orchestra. We changed loop input to use one of three feeds every 5 minutes: a mix of microphones from the hall's standard assistive feed on the first balcony (house condition), a mix of microphones located on the stage (stage condition), or no input to the loop (no feed). After each 5-minute interval, we collected sound quality and naturalness ratings for the previous 5 minutes.

Results: Sound quality and naturalness ratings were highly related (rRM = 0.81), though each provided unique insight. Repeated measures analysis of variance found significant differences among the loop feed conditions for sound quality and naturalness, with the no feed condition significantly outperforming the house condition on sound quality [t(18) = -3.73, adj. p = 0.005] and naturalness [t(18) = -4.15, adj. p = 0.002]. Mixed effects models allowed us to retain the richness of a repeated observation dataset and provided point estimates of the overall quality and naturalness among conditions; however, assumption violations of normality and homoskedasticity prevented further interpretation.

Conclusions: Though HA-integrated assistive listening systems are a promising option for improving live music for people with hearing loss, a hearing loop does not seem to be crucial for orchestral music. Future directions include improving lyric understanding for music with vocals and customizing user experience via Bluetooth Low Energy Audio systems.

Objectives: The acoustic change complex (ACC) is a cortical auditory evoked potential that shows promise as an objective test of the neural capacity for speech and sound discrimination, particularly for difficult-to-test populations, for example, cognitively impaired adults. There is uncertainty, however, surrounding the performance of the ACC with behavioral measures. The objective of this study was to systematically review the literature, focusing on adult studies, to investigate the relationship between ACC responses and behavioral psychophysical measures.

Design: Original peer-reviewed articles conducting performance comparisons between ACCs and behavioral measures in adults were identified through systematic searches. The review was conducted using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for reporting, and the methodological quality of the included articles was assessed.

Results: A total of 66 studies were retrieved that conducted adult ACC measurements, of which 27 studies included performance comparisons. Meta-analysis revealed a total of 41 significant correlations between ACC responses (amplitudes, latencies, and thresholds) and behavioral measures of speech perception (2 weak, 28 moderate, and 11 strong correlations), and 12 significant moderate/strong correlations were identified with behavioral measures of frequency discrimination.

Conclusions: This systematic review finds that ACC responses are associated with speech perception and frequency discrimination, in addition to other types of sound discrimination. The choice of evoking stimuli, ACC outcome measure, and behavioral measure used may influence the strength and visibility of potential correlations between the objective (ACC) and behavioral measures. The performance of the ACC technique highlighted in this review suggests that this tool may serve as an alternative measure of auditory discrimination when corresponding behavioral measures prove challenging or unfeasible.

Objectives: This umbrella review aims to summarize the major benefits of hearing aid usage in adults by synthesizing findings from published review articles.

Design: A comprehensive search of databases, including MEDLINE, EMBASE, PsycINFO, and Google Scholar, was conducted. The search was limited to English-language review articles published between 1990 and 2023, focusing on hearing aid outcomes in at least 5 adults (aged ≥18 years). Two researchers independently screened titles, abstracts, and full-text articles, and conducted a quality assessment using the Joanna Briggs Checklist for Systematic Reviews and Research Syntheses. A third researcher was involved in discussions with the 2 researchers to resolve conflicts during the screening and quality assessment stages.

Results: Eleven articles were included in this review. There were three systematic reviews with meta-analysis and eight systematic reviews without meta-analysis. The quality assessment indicated that articles scored between 6 and 11 out of a total of 11 criteria. Three articles met all quality criteria. Study participants tended to be middle-aged (≥40 years) or older adults (≥65 years). Participant gender was less clear as this was not consistently reported but appeared to favor men. This umbrella review found that speech perception, communication function, hearing handicap, and self-assessed hearing aid benefit were consistently positively associated with hearing aid use in the analysis of included studies. Hearing handicap was the most frequently reported outcome with evidence from four different studies supporting its mitigation with hearing aid use. There was insufficient evidence in terms of benefit on balance, cognitive function, depression, tinnitus, loneliness, and social isolation. There was conflicting evidence on the impact of hearing aid use on quality of life. Among eligible studies, there were no reports of negative impacts of hearing aid use.

Conclusions: There are a number of potential benefits associated with hearing aid use. However, this review found that there was a clear lack of high-quality evidence and limited use of robust study design to support the benefits of hearing aids on other outcomes such as quality of life and cognition. Inconsistent use and interpretation of various outcome measures makes it difficult to produce homogenous data which is needed to make more conclusive statements about the benefits of hearing aids.

Objectives: Occupational hearing loss is a significant problem worldwide despite the fact that it can be mitigated by the wearing of hearing protection devices (HPDs). When surveyed, workers frequently report that worsened work performance while wearing HPDs is one reason why they choose not to wear them. However, there have been few studies to supplement these subjective reports with objective measures. Where they do exist, assessed performance measures have mostly characterized auditory situational awareness in gross terms (e.g., average speech comprehension scores over an entire session). The temporal dynamics of performance and HPD impacts on nonauditory aspects of work performance are largely unknown. In the present study, we aimed to fill this gap in the literature by measuring how HPD usage impacted sensorimotor tracking performance in relation to ongoing auditory events.

Design: In two experiments, listeners heard commands sourced from the coordinate response measure (CRM) corpus (i.e., sentences of the form "Ready go to now"). These commands informed listeners of which of nine moving on-screen objects to track with a computer mouse (e.g., "blue four" refers the listener to a blue square). The commands were presented in background street noise and were heard under either "No HPD" or "HPD" conditions. In experiment 1, HPD wearing was simulated with a digital filter designed to mimic the attenuation profile of a passive HPD. In experiment 2, actual HPDs were worn by listeners. Continuous recording of tracking error allowed us to simultaneously examine how HPD wearing impacted speech comprehension, the accuracy of tracking, and how tracking accuracy varied as a function of time on task and ongoing auditory events (e.g., the presentation of a critical CRM sentence).

Results: In both experiments, listeners spent less time tracking the correct object in the HPD condition. After trimming data to those time points in which the target object was known, worse performance was exhibited by the HPD condition than the No HPD condition. In the examination of the temporal dynamics of tracking error, it was apparent that differences arose strongly during the presentation of CRM sentences.

Conclusions: Workers' complaints of poorer performance while wearing HPDs are justified and extend beyond just diminished auditory situational awareness. The negative impact on nonauditory aspects of work performance may be strongest around critical listening periods. Addressing these aspects of performance will be an important part of addressing HPD nonuse in occupational settings.

Objectives: The aim of this study was to investigate the causal relationships between sleep-associated traits and hearing difficulties in noise (HDinN) by Mendelian randomization (MR) analysis.

Design: Single nucleotide polymorphisms associated with chronotype, insomnia, sleep duration, daytime dozing or sleeping, and ease of getting up in the morning were extracted from European population genome-wide association study pooled data for bidirectional MR analysis. The MR-Egger regression, the inverse variance weighted technique, and the weighted median method were used for data analysis. The study was then expanded to include South Asian, East Asian, African, and Greater Middle Eastern populations.

Results: MR analysis indicated that in European populations, ease of getting up in the morning is a protective factor for HDinN (odds ratio [OR] = 0.932, p = 4.22 × 10-5, pFDR = 5.62 × 10-4), while shorter sleep duration was a risk factor (undersleepers: OR = 1.164, p = 0.002, pFDR = 0.014). In addition, there was an indicative causal association between daytime dozing and HDinN (OR = 1.089, p = 0.046, pFDR = 0.123). The conclusions were consistent in African populations (ease of getting up: OR = 0.696, p = 0.012, pFDR = 0.041, sleep duration: OR = 0.677, p = 0.032 pFDR = 0.091, daytime dozing: OR = 1.164, p = 0.002, pFDR = 0.014). In the reverse direction, there was a significant causal association between HDinN and both chronotype (OR = 1.413, p = 0.011, pFDR = 0.042) and ease of getting up in the morning (OR = 0.668, p = 1.75 × 10-5, pFDR = 3.49 × 10-4) in European populations, with similar conclusions respectively reached in East Asian (OR = 1.085, p = 0.010, pFDR = 0.045) and African populations (OR = 0.936, p = 0.002, pFDR = 0.012). Furthermore, although not observed in European populations, exploratory studies in non-European populations suggested a potential association between insomnia and HDinN (East Asian: OR = 1.920, p = 0.011, pFDR = 0.043, African: OR = 2.080, p = 0.004, pFDR = 0.019, South Asian: OR = 1.981, p = 1.59 × 10-4, PFDR = 0.002, Greater Middle Eastern: OR = 2.394, p = 0.002, pFDR = 0.012), and vice versa (Greater Middle Eastern: OR = 1.056, p = 0.014, pFDR = 0.044).

Conclusions: This study identified a potential bidirectional causal relationship between sleep-associated traits and HDinN. However, the underlying mechanisms of the causal relationships reported here have yet to be elucidated.

Objectives: This study was designed to (1) compare preactivation and postactivation performance with a cochlear implant for children with functional preoperative low-frequency hearing, (2) compare outcomes of electric-acoustic stimulation (EAS) versus electric-only stimulation (ES) for children with versus without hearing preservation to understand the benefits of low-frequency acoustic cues, and (3) to investigate the relationship between postoperative acoustic hearing thresholds and performance.

Design: This was a prospective, 12-month between-subjects trial including 24 pediatric cochlear implant recipients with preoperative low-frequency functional hearing. Participant ages ranged from 5 to 17 years old. They were recruited at their device activation and fit with EAS or ES based on their postoperative thresholds. Group outcomes were compared for single-word recognition, masked sentence recognition, perceived hearing abilities, speech production, receptive language, expressive language, and prosodic identification.

Results: Children experienced improvements in word recognition, subjective hearing, speech production, and expressive language with EAS or ES as compared with their preoperative abilities. Children using EAS performed better on a prosodic identification task and had higher subjective hearing scores postactivation as compared with children using ES. There was a significant relationship between postoperative thresholds at 125 Hz and prosodic identification.

Conclusions: The results of this study support cochlear implantation for children with normal-to-moderate low-frequency hearing thresholds and severe-to-profound high-frequency hearing loss. They also highlight the benefits of postoperative hearing preservation for language development.

Objectives: One important aspect in facilitating language access for children with hearing loss (HL) is the auditory environment. An optimal auditory environment is characterized by high signal to noise ratios (SNRs), low background noise levels, and low reverberation times. In this study, the authors describe the auditory environment of early intervention groups specifically equipped for young children with HL.

Design: Seven early intervention groups for children with HL were included in the study. A total of 26 young children (22 to 46 months) visiting those groups participated. Language Environmental Analysis recorders were used to record all sounds around a child during one group visit. The recordings were analyzed to estimate SNR levels and background noise levels during the intervention groups. The unoccupied noise levels and reverberation times were measured in the unoccupied room either directly before or after the group visit.

Results: The average SNR encountered by the children in the intervention groups was +13 dB SNR. The detected speech of the attending professionals achieved the +15 dB SNR recommended by the American Speech-Language-Hearing Association in approximately 42% of the time. The unoccupied noise levels were between 29 and 39 dBA, complying with acoustic norms for classroom environments (≤35 dBA, by ANSI/ASA 12.60-2010 Part 1) for six out of seven groups. Reverberation time was between 0.3 and 0.6 sec for all groups, which complies to the acoustic norms for classroom environments for children without HL (0.6 or 0.7 sec, depending on the room size), while only one group complied to the stricter norm for children with HL (0.3 sec).

Conclusions: The current findings show characteristics of the auditory environment of a setting that is specifically equipped and designed for groups of children with HL. Maintaining favorable SNRs seems to be the largest challenge to achieve within the constraints of an environment where young children gather, play, and learn. The results underscore the importance of staying attentive to keep spoken language accessible for children with HL in a group setting.