Localization by unilateral BAHA users

2005 ◽  
Vol 132 (6) ◽  
pp. 928-932 ◽  
Author(s):  
Jack J. Wazen ◽  
Soha N. Ghossaini ◽  
Jaclyn B. Spitzer ◽  
Mary Kuller

OBJECTIVES: Patients with unilateral hearing loss report difficulty hearing conversation on their impaired side, localizing sound, and understanding of speech in background noise. The bone-anchored cochlear stimulator (BAHA) (Entific, Gothenburg, Sweden) has been shown to improve performance in persons with unilateral severe-profound sensorineural loss (USNHL). The purpose of this study is to evaluate the effectiveness of BAHA in sound localization for USNHL listeners. STUDY DESIGN: Prospective study of 12 USNHL subjects, 9 of whom received implants on the poorer hearing side. A control group of 10 normal hearing subjects were assessed for comparison. Localization with and without BAHA was assessed using an array of 8 speakers at head level separated by 45 degrees. Error analysis matrix was generated to evaluate the confusions, accuracy in response, and laterality judgment. RESULTS: The average accuracy of speaker localization was 16% in the unaided condition, with no improvement with BAHA use. Laterality judgment was poorer than 43% in both aided and nonaided conditions. CONCLUSIONS: Patients with UNSNHL had poor sound localization and laterality judgment abilities that did not improve with BAHA use.

2019 ◽  
Vol 30 (07) ◽  
pp. 564-578
Author(s):  
Oscar M. Cañete ◽  
Suzanne C. Purdy ◽  
Colin R. S. Brown ◽  
Michel Neeff ◽  
Peter R. Thorne

AbstractA unilateral hearing loss (UHL) can have a significant functional and social impact on children and adults, affecting their quality of life. In adults, UHL is typically associated with difficulties understanding speech in noise and sound localization, and UHL increases the self-perception of auditory disability for a range of listening situations. Furthermore, despite evidence for the negative effects of reduced unilateral auditory input on the neural encoding of binaural cues, the perceptual consequences of these changes are still not well understood.Determine effects of UHL on auditory abilities and speech-evoked cortical auditory evoked potentials (CAEPs).CAEPs, sound localization, speech perception in noise and self-perception of auditory abilities (speech, spatial, and qualities hearing scale) were assessed.Thirteen adults with UHL with a range of etiologies, duration of hearing loss, and severity and a control group of eleven binaural listeners with normal hearing.Participants with UHL varied greatly in their ability to localize sound and reported speech recognition and listening effort were the greatest problem. There was a greater effect of right ear than left ear hearing loss on N1 amplitude hemispheric asymmetry and N1 latencies evoked by speech syllables in noise. As duration of hearing loss increased, contralateral dominance (N1 amplitude asymmetry) decreased. N1 amplitudes correlated with speech scores, larger N1 amplitudes were associated with better speech recognition in noise scores. N1 latencies are delayed (in the better ear) and amplitude hemisphere asymmetry differed across UHL participants as function of side of deafness, mainly for right-sided deafness.UHL affects a range of auditory abilities, including speech detection in noise, sound localization, and self-perceived hearing disability. CAEPs elicited by speech sounds are sensitive enough to evidence changes within the auditory cortex due to an UHL.


2019 ◽  
Author(s):  
Lindsey Ryan-Warden ◽  
Eva Ng ◽  
Peter Keating

AbstractMany listening abilities become more difficult in noisy environments, particularly following hearing loss. Sound localization can be disrupted even if target sounds are clearly audible and distinct from background noise. Since subjects locate sounds by comparing the input to the two ears, sound localization is also considerably impaired by unilateral hearing loss. Currently, however, it is unclear whether the effects of unilateral hearing loss are worsened by background noise. To address this, we measured sound localization abilities in the presence or absence of broadband background noise. Adult human subjects of either sex were tested with normal hearing or with a simulated hearing loss in one ear (earplug). To isolate the role of binaural processing, we tested subjects with narrowband target sounds. Surprisingly, we found that continuous background noise improved narrowband sound localization following simulated unilateral hearing loss. By contrast, we found the opposite effect under normal hearing conditions, with background noise producing illusory shifts in sound localization. Previous attempts to model these shifts are inconsistent with behavioural and neurophysiological data. However, here we found that a simple hemispheric model of sound localization provides an explanation for our results, and provides key hypotheses for future neurophysiological studies. Overall, our results suggest that continuous background noise may be used to improve sound localization under the right circumstances. This has important implications for real-world hearing, both in normal-hearing subjects and the hearing-impaired.Significance StatementIn noisy environments, many listening abilities become more difficult, even if target sounds are clearly audible. For example, background noise can produce illusory shifts in the perceived direction of target sounds. Because sound localization relies on the two ears working together, it is also distorted by a hearing loss in one ear. We might therefore expect background noise to worsen the effects of unilateral hearing loss. Surprisingly, we found the opposite, with background noise improving sound localization when we simulated a hearing loss in one ear. A simple hemispheric model of sound localization also helped explain the negative effects of background noise under normal hearing conditions. Overall, our results highlight the potential for using background noise to improve sound localization.


2018 ◽  
Vol 159 (6) ◽  
pp. 1043-1050 ◽  
Author(s):  
Patricia L. Purcell ◽  
Todd C. Edwards ◽  
Meghan Wisneski ◽  
Dylan K. Chan ◽  
Henry Ou ◽  
...  

Objective This study interviewed youth with unilateral hearing, utilizing their responses to generate candidate items for a condition-specific patient-reported instrument. Study Design Mixed methods, cross-sectional. Setting Tertiary care children’s hospital. Participants and Methods Youth with unilateral hearing loss and normal hearing in the contralateral ear were identified and recruited for participation through query of an audiometric database and through hearing loss clinics. Interviews with the youth were qualitatively analyzed to identify common themes and generate items related to functional impact. A multi-institutional expert panel reviewed items with prespecified item selection criteria. Participants rated items for impact on daily life. For preliminary criterion validity assessment, statistical analyses explored correlations between functional scores and type and severity of hearing loss. Results Thirty-nine youth aged 9 to 18 years with unilateral hearing loss participated; 31% used a hearing device. Fifteen youth participated in interviews; thematic analysis, item crafting, and expert panel item review resulted in 41 items. Twenty-six youth responded to the items, reporting low functional scores in the domains of sound localization, ear positioning, and noise environment. They reported better levels of function in carrying out group conversations, focusing on schoolwork, and feeling safe during activities. Multivariate linear regression found that youth scored 0.4 points (or approximately 8%) lower on the functional impact scale with every 20–dB HL increase in pure tone average in the abnormal ear. Conclusion Youth with unilateral hearing loss report functional impact, particularly related to sound localization, ear positioning, and noise environment; therefore, they may benefit from a condition-specific functional assessment instrument.


Author(s):  
Pedro Luiz Mangabeira-Albernaz ◽  
Andrea Felice dos Santos Malerbi

Abstract Introduction Cochlear implants have been proposed for cases of unilateral hearing loss, especially in patients with tinnitus impairment. Several studies have shown that they result in definite improvement of sound localization and speech understanding, both in quiet and noisy environments. On the other hand, there are few references regarding cochlear implants in patients whose better ears present hearing loss. Objective To report the audiological outcomes of three patients with unilateral deafness, in whom the better ears presented hearing losses, submitted to cochlear implants. Methods Three patients with unilateral profound hearing loss underwent a cochlear implant performed by the same surgeon. Results The patients' data are presented in detail. Conclusion The indications for cochlear implants are becoming more diverse with the expansion of clinical experience and the observation that they definitely help patients with special hearing problems.


2017 ◽  
Vol 157 (4) ◽  
pp. 565-571 ◽  
Author(s):  
Swathi Appachi ◽  
Jessica. L. Specht ◽  
Nikhila Raol ◽  
Judith E. C. Lieu ◽  
Michael S. Cohen ◽  
...  

Objective Options for management of unilateral hearing loss (UHL) in children include conventional hearing aids, bone-conduction hearing devices, contralateral routing of signal (CROS) aids, and frequency-modulating (FM) systems. The objective of this study was to systematically review the current literature to characterize auditory outcomes of hearing rehabilitation options in UHL. Data Sources PubMed, EMBASE, Medline, CINAHL, and Cochrane Library were searched from inception to January 2016. Manual searches of bibliographies were also performed. Review Methods Studies analyzing auditory outcomes of hearing amplification in children with UHL were included. Outcome measures included functional and objective auditory results. Two independent reviewers evaluated each abstract and article. Results Of the 249 articles identified, 12 met inclusion criteria. Seven articles solely focused on outcomes with bone-conduction hearing devices. Outcomes favored improved pure-tone averages, speech recognition thresholds, and sound localization in implanted patients. Five studies focused on FM systems, conventional hearing aids, or CROS hearing aids. Limited data are available but suggest a trend toward improvement in speech perception with hearing aids. FM systems were shown to have the most benefit for speech recognition in noise. Studies evaluating CROS hearing aids demonstrated variable outcomes. Conclusions Data evaluating functional and objective auditory measures following hearing amplification in children with UHL are limited. Most studies do suggest improvement in speech perception, speech recognition in noise, and sound localization with a hearing rehabilitation device.


2008 ◽  
Vol 69 (9) ◽  
pp. 804-811 ◽  
Author(s):  
Sharon M. Abel ◽  
Katie Lam

Author(s):  
Susan Gordon-Hickey ◽  
Shelby Davis ◽  
Leah Lewis ◽  
James Van Haneghan

Background: Acceptance of background noise serves as a means to predict likelihood of hearing aidsuccess. Individuals that are able to accept background noise are more likely to be successful with hearingaids.Purpose: The aim of the study was to assess the impact of sound enrichment on the acceptable noiselevel (ANL).Study Sample: Nineteen young adult participants served as listeners. Participants were randomlyassigned to the experimental or control group.Research Design: An experimental design with random assignment to experimental or control groupwas used.Data Collection and Analysis: One group used sound enrichment procedures for 2 weeks, whereas theother group served as a control group. Sound enrichment procedures required that participants add lowlevelbackground sound to any quiet environment encountered during the study. Most comfortable listeninglevel (MCL) and background noise level (BNL) were measured at three sessions, each 1 weekapart (baseline, after 1 week of treatment, and after 2 weeks of treatment).Results: Analytical statistics revealed that ANL improved for the sound enrichment group but remainedthe same for the control group. For both groups, there was no significant change in MCL across sessions.However, for the experimental group, BNL improved (increased) over the 2-week period while usingsound enrichment.Conclusions: Results of this study indicate that ANL can be improved with the use of sound enrichmentprocedures over a 2-week period. Future work should examine the use of sound enrichment proceduresfor older adults with hearing loss.


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