Ear and Hearing最新文献

Objectives: The objective of this study is to explore the lived experiences and perspectives of Black adults who meet audiometric candidacy criteria for cochlear implantation, as well as their communication partners. While disparities in cochlear implant (CI) uptake among Black adults are well-documented, the reasons for these inequities are less understood. This study examines how Social Determinants of Health shape access and engagement with hearing healthcare, identifying factors that influence CI utilization.

Design: This study is the first phase of the Memphis SOUND (Serving Our Underrepresented Neighbors who are Deaf and Hard of Hearing) Project, a community-engaged research initiative to address hearing health disparities among underserved populations. Guided by the PRECEDE-PROCEED Model, we conducted qualitative interviews with Black adults who met audiometric criteria for cochlear implantation and their communication partners. Using iterative inductive and deductive coding, we identified predisposing, reinforcing, and enabling factors across individual, family, and systemic levels that influence hearing healthcare engagement.

Results: Semi-structured interviews with 15 participants, including 6 individuals with CIs, 4 without CIs, and 5 communication partners, revealed limited awareness of hearing loss as a health condition and reported no prior knowledge of CIs until suggested by a healthcare professional. Common barriers included delays in care, poor healthcare coordination, and negative provider interactions. Several participants cited medical mistrust as influencing decision-making. Facilitators included trust in the provider and receiving clear, satisfactory information on CIs. Socioeconomic factors also affected some participants' access. All participants expressed a desire for community-based efforts to improve awareness of hearing healthcare and CIs.

Conclusions: Underutilization of CIs among Black adults is driven by systemic barriers. Participants described complex, individual pathways from the onset of hearing loss to their decision on cochlear implantation, with delays linked to late awareness, inadequate provider communication, and limited specialist referrals. Participants who proceeded with cochlear implantation felt well-informed, while non-users cited skepticism and insufficient information as key obstacles. Medical mistrust further shaped participants' engagement with hearing healthcare. Findings underscore the need for accessible, trustworthy hearing health information within Black communities and highlight the potential of community-level engagement to build trust and improve hearing health outcomes in underserved populations.

Objectives: The mathematical tools of network science were used to examine the English version of the Vanderbilt Fatigue Scale for Adults with Hearing Loss (VFS-A) to illustrate one way in which this approach could be used in the speech, language, and hearing sciences.

Design: Nodes represented items in the scale, and connections between nodes represented the correlation in the responses to those items, forming a fully connected, web-like network. Various measures of network structure at the microlevel (i.e., node strength), and at the mesolevel (i.e., communities and subsets of nodes based on node strength) revealed information about individual nodes/items and groups of items, respectively, that could not be observed using more conventional analysis techniques.

Results: Specifically, average node strength distinguished between the pattern of VFS-A responses among listeners with no/slight hearing loss and listeners with mild hearing loss, even though listening-related fatigue, as measured using conventional summed scores, was not statistically different between these groups. This highlights the importance of the relationship between items and not just the item score itself. Although the communities that were detected did not replicate the four subscales in the VFS-A, our analysis of subsets of nodes based on node strength illustrates how the network approach might be used to reduce the number of items in a large scale to a more focused set of nodes/items that might be useful for evaluating treatment effects.

Conclusions: We discuss other ways the network approach could be useful to researchers and clinicians, and can advance the speech, language, and hearing sciences.

Objectives: Vestibular-evoked myogenic potentials (VEMP) are elicited using high-intensity signals, often 125 dB peSPL or higher. Evidence from human experiments documenting cochlear hypofunction after VEMP test using stimulus intensities of 133 and 130 dB peSPL is concerning. However, recent reports found 125 dB peSPL safe as it caused no significant change in pure-tone thresholds and otoacoustic emissions. Nonetheless, previous studies have reported that loud sounds can affect several auditory processes, including temporal resolution, despite no significant change in pure-tone thresholds or otoacoustic emissions. However, all the studies to date investigating the effects of VEMP-eliciting stimuli have used pure-tone audiometry and/or otoacoustic emission. The possibility of a post-VEMP change in temporal resolution remains unexplored. Therefore, the present study aimed to investigate the potential effects of VEMP-eliciting stimuli on temporal resolution by evaluating gap detection thresholds (GDT).

Design: In an experimental time-series research design, 30 young adults underwent a 500-Hz tone burst evoked cervical and ocular VEMP testing. They also underwent GDT testing just before the VEMP test and at 4 other time points (5 min, 1 hr, 24 hr, and 2 wk) after it. In cases of a persistently higher GDT than the baseline, the participants were re-evaluated after 2 mo.

Results: A significant change in GDT at the post-VEMP measurement points of 5 min and 2 wk (p < 0.008, α-corrected, Wilcoxon signed-rank test after Friedman test) was observed. Nearly 23% of VEMP ears had significantly worse GDT at 5 min after exposure; however, everyone recovered to the pre-exposure GDT level by the end of the experimental paradigm.

Conclusions: Acoustic stimuli presented at an intensity of 125 dB peSPL to elicit VEMP can potentially influence the auditory system temporarily. Nevertheless, comparing the potential benefits of the VEMP test to its temporary ill effects weighs the odds in favor of the VEMP test, especially given that cVEMP is the only possible assessment tool for the saccular function.

Objectives: The audible contrast threshold (ACT) test is a behavioral spectro-temporal modulation detection test used to approximate speech-in-noise performance. This study focused on the clinical reliability and validity of an electrophysiological version of the ACT test (E-ACT). The primary objectives were to evaluate the test-retest reliability of the E-ACT and explore its relationship with the behavioral ACT test and aided speech-in-noise performance. Since the E-ACT employs stimuli based on a tonal carrier while the ACT uses a noise carrier, a secondary objective was to investigate the behavioral correlation between performance with noise-carrier and tonal-carrier stimuli. We hypothesized that there would be a significant relationship between the E-ACT and the behavioral ACT.

Design: The E-ACT utilizes the auditory change complex, a cortical response to suprathreshold sound changes, elicited here by changes between spectro-temporal modulated targets and non-modulated references. The 4-Hz temporal and two-cycles/octave spectral modulation rates were identical to those used in the ACT test. Two experiments were conducted to evaluate the E-ACT: The first experiment (experiment A) was conducted in a university setting with 18 adult participants. The second experiment (experiment B) was conducted in a hospital setting with 47 hearing-impaired adult participants. Both experiments included ACT and E-ACT measurements. In addition, experiment A incorporated behavioral tonal-ACT measurements, while experiment B included assessments of speech-in-noise performance. Electroencephalogram data were analyzed using the objective Fmpi (individualized multi-point F test) detector to determine the presence of responses.

Results: The E-ACT test and retest were significantly correlated (R2 = 0.62, p < 0.001). The E-ACT values correlated significantly with ACT values (R2 = 0.18, p < 0.001), with most participants showing better thresholds for ACT compared with E-ACT. However, unexpectedly, some participants had worse ACT values compared with E-ACT. E-ACT values also correlated with aided speech-in-noise performance (R2 = 0.09, p = 0.04). Last, ACT and tonal-ACT values were significantly correlated (R2 = 0.53, p < 0.001), with thresholds obtained using tonal-ACT averaging 1.6 dB lower than those obtained using ACT.

Conclusions: The E-ACT provides clinicians with an objective discrimination measure that can be utilized with patients unable to participate in behavioral tests. Both E-ACT and ACT offer insights into suprathreshold hearing, which can supplement the audiogram.

Objectives: Spectrotemporal acoustical markers enable humans to distinguish between speech and song across diverse cultures. Prior research revealed an asymmetric sensitivity in auditory processing: melody perception is more susceptible to spectral degradation, whereas speech sentence perception is more affected by temporal degradation. However, these findings have primarily been based on non-tonal languages, raising questions about how tonal languages, such as Mandarin, might influence these sensitivity patterns. This study investigates how Mandarin speakers process spectrotemporal features in speech and melody, addressing whether tonal language experience modulates the asymmetric spectrotemporal modulation sensitivity patterns observed in non-tonal languages.

Design: Twenty-five Mandarin-speaking participants were recruited in the main experiment to discriminate speech or melody content of Mandarin songs under conditions of varying spectral or temporal degradation. An additional 25 participants in the control experiment listened to degraded hummed melodies or spoken sentences under similar degradation conditions.

Results: Consistent with findings in non-tonal language speakers, Mandarin listeners were more sensitive to temporal degradation in speech and spectral degradation in melody. In addition, they exhibited heightened susceptibility to spectral degradation around 2 cyc/kHz in melody perception, indicating enhanced pitch sensitivity in music, possibly due to tonal language experience. Control analyses revealed reduced sensitivity when hummed melodies or spoken sentences were presented in a single domain, suggesting the influence of cognitive load on auditory processing.

Conclusions: These findings underscore the quasi-universality of spectrotemporal cues in speech and melody perception across languages. However, tonal language experience subtly enhances spectral processing in music, providing new insights into the interaction between speech and music perception across different linguistic backgrounds.

Objectives: Following deafness, a cochlear implant (CI) can be used for the restoration of hearing. CI effectiveness relies on the condition of the auditory nerve, which typically degenerates after deafness. The nerve's condition can be assessed with the electrically evoked compound action potential (eCAP), the whole-nerve response to an electric pulse. Changes in the eCAP following an increase in the inter-phase gap (IPG) of a biphasic pulse have been reported to be informative of neural survival. This IPG effect can be explained by the temporal separation of the hyperpolarizing phase from the depolarizing phase. We hypothesize that increasing the phase duration (PD) has a similar effect.

Design: We investigated the PD effect in normal hearing and in ototoxically deafened guinea pigs (total N = 40) with various conditions of the auditory nerve by recording eCAPs to biphasic current pulses with alternating polarity and with varying PD and IPG. The eCAP data were obtained from both chronically and acutely implanted guinea pigs by using CI stimulation paradigms with a fixed charge and varying PD (30, 50, or 100 µs) and IPG (2.1 or 30 µs). We evaluated six eCAP measures: five derived from the amplitude growth function and the N1 latency. We examined the relationships of PD and IPG effects with the survival of the spiral ganglion cells.

Results: The PD effects were stronger for latency than IPG effects, but weaker for the other five evaluated eCAP measures. The PD effect did not correlate as well with neural survival as the IPG effect. The IPG effect decreased with increasing PD, and accordingly, the stronger correlations between the IPG effect and neural survival were found for a short PD. Notably, the latency increase with increasing PD was greater than 1, which indicates the second phase of the pulse significantly contributes to the eCAP. This second-phase contribution was larger for lower neural survival.

Conclusions: The PD effect of latency has predictive power in assessing neural survival. When using other eCAP measures than latency, the best approach to assess neural survival is using the IPG effect with a short PD (around 30 µs).