Implanting outside the Guidelines: A Case Study

2008 ◽  
Vol 19 (03) ◽  
pp. 197-203
Author(s):  
Millicent K. Seymour ◽  
Larry Lundy
Keyword(s):  
Cochlear Implantation ◽  
Signal To Noise Ratio ◽  
Percent Correct ◽  
Sentence Recognition ◽  
Speech In Noise ◽  
The Past ◽  
Open Set ◽  
Hearing Aid Use ◽  
Communication Difficulties

An 81-year-old female was referred for cochlear implantation due to difficulty communicating in her daily activities despite the use of appropriate amplification. The poorer ear was unable to tolerate amplification for the past 15 years. The open-set sentence-recognition test score in quiet in her "good" ear was 85 percent correct, indicating that the patient was not a traditional cochlear implant candidate. However, the sentence-recognition score in noise at +10 dB signal-to-noise ratio was 0 percent, demonstrating a significant breakdown in the patient's speech understanding in more difficult listening situations. This speech-in-noise score appeared to correlate with the patient's reported communication difficulties as well as with the communicative breakdowns that were observed clinically. The patient underwent cochlear implantation in the better ear. Cochlear implantation in this nontraditional patient provided objective and subjective benefit over hearing aid use. Una mujer de 81 años de edad fue referida para implante coclear debido a sus dificultades para comunicarse en sus actividades diarias, a pesar del uso de amplificación apropiada. El oído peor había sido incapaz de tolerar la amplificación durante los últimos 15 años. El puntaje de la prueba de reconocimiento de palabras de lista abierta en silencio en su oído "bueno" fue de un 85%, indicando que le paciente no era una candidata tradicional para un implante coclear. Sin embargo, los puntajes de reconocimiento de frases en ruido, a una tasa señal/ruido de ±10 dB fueron de 0%, demostrando un colapso en la comprensión del lenguaje por parte de la paciente en situaciones auditivas más difíciles. Este puntaje de lenguaje en ruido pareció correlacionar con las dificultades reportadas por la paciente, así como con el colapso comunicativo que se observó clínicamente. La paciente fue sometida a una implantación coclear en el mejor oído. El implante coclear en esta paciente no tradicional aportó un beneficio objetivo y subjetivo sobre el uso de auxiliares auditivos.

Paget’s disease and cochlear implantation

2004 ◽  
Vol 118 (10) ◽  
pp. 810-813 ◽  
Author(s):  
A. Bacciu ◽  
E. Pasanisi ◽  
V. Vincenti ◽  
F. Ingegnoli ◽  
M. Guida ◽  
...  
Keyword(s):  
Cochlear Implantation ◽  
Signal To Noise Ratio ◽  
Paget’S Disease ◽  
Paget's Disease ◽  
Postoperative Evaluation ◽  
Sentence Recognition ◽  
Open Set ◽  
Profound Deafness ◽  
History Of ◽  
Nucleus 24

Paget’s disease of bone is a common disorder of unresolved etiology characterized by excessive bone resorption followed by excessive bone formation. If the skull isaffected this may result in hearing loss and eventually develop into profound deafness. To date, no cases of cochlear implantation in patients with Paget’s disease have been reported.The authors present a case of radiographically confirmed Paget’s disease of the skull in a 77-year-old man with a 20-year history of progressive bilateral sensorineural hearing losswho underwent cochlear implantation. A successful insertion of the Nucleus 24 Contour electrodearray was achieved without surgical and postoperative complications. At the 10 months’ postoperative evaluation, the patient had gained useful open-set speech perception. In quiet conditions, his performance scores on the word and sentence recognition tests were 100 and 98 per cent, respectively. In the presence of noise (at +10 dB. signal-to-noise ratio), his performance scores on the word and sentence recognition tests were 96 and 94per cent, respectively.

scholarly journals Masking Release and Modulation Interference in Cochlear Implant and Simulation Listeners

2013 ◽  
Vol 22 (1) ◽  
pp. 135-146 ◽  
Author(s):  
Su-Hyun Jin ◽  
Yingjiu Nie ◽  
Peggy Nelson
Keyword(s):  
Speech Perception ◽  
Cochlear Implants ◽  
Training Programs ◽  
Signal To Noise Ratio ◽  
Spectral Interference ◽  
Signal To Noise ◽  
Sentence Recognition ◽  
Speech In Noise ◽  
Masking Release ◽  
Masking Noise

Purpose To examine the effects of temporal and spectral interference of masking noise on sentence recognition for listeners with cochlear implants (CI) and normal-hearing persons listening to vocoded signals that simulate signals processed through a CI (NH-Sim). Method NH-Sim and CI listeners participated in the experiments using speech and noise that were processed by bandpass filters. Depending on the experimental condition, the spectra of the maskers relative to that of speech were set to be completely embedded with, partially overlapping, or completely separate from, the speech. The maskers were either steady or amplitude modulated and were presented at +10 dB signal-to-noise ratio. Results NH-Sim listeners experienced progressively more masking as the masker became more spectrally overlapping with speech, whereas CI listeners experienced masking even when the masker was spectrally remote from the speech signal. Both the NH-Sim and CI listeners experienced significant modulation interference when noise was modulated at a syllabic rate (4 Hz), suggesting that listeners may experience both modulation interference and masking release. Thus, modulated noise has mixed and counteracting effects on speech perception. Conclusion When the NH-Sim and CI listeners with poor spectral resolution were tested using syllabic-like rates of modulated noise, they tended to integrate or confuse the noise with the speech, causing an increase in speech errors. Optional training programs might be useful for CI listeners who show more difficulty understanding speech in noise.

scholarly journals List Equivalency of PRESTO for the Evaluation of Speech Recognition

2015 ◽  
Vol 26 (06) ◽  
pp. 582-594 ◽  
Author(s):  
Kathleen F. Faulkner ◽  
Terrin N. Tamati ◽  
Jaimie L. Gilbert ◽  
David B. Pisoni
Keyword(s):  
Speech Recognition ◽  
Undergraduate Students ◽  
Signal To Noise Ratio ◽  
Spoken Word Recognition ◽  
Recognition Task ◽  
Clinical Test ◽  
English Sentence ◽  
Sentence Recognition ◽  
Open Set ◽  
Regional Dialect

Background: There is a pressing clinical need for the development of ecologically valid and robust assessment measures of speech recognition. Perceptually Robust English Sentence Test Open-set (PRESTO) is a new high-variability sentence recognition test that is sensitive to individual differences and was designed for use with several different clinical populations. PRESTO differs from other sentence recognition tests because the target sentences differ in talker, gender, and regional dialect. Increasing interest in using PRESTO as a clinical test of spoken word recognition dictates the need to establish equivalence across test lists. Purpose: The purpose of this study was to establish list equivalency of PRESTO for clinical use. Research Design: PRESTO sentence lists were presented to three groups of normal-hearing listeners in noise (multitalker babble [MTB] at 0 dB signal-to-noise ratio) or under eight-channel cochlear implant simulation (CI-Sim). Study Sample: Ninety-one young native speakers of English who were undergraduate students from the Indiana University community participated in this study. Data Collection and Analysis: Participants completed a sentence recognition task using different PRESTO sentence lists. They listened to sentences presented over headphones and typed in the words they heard on a computer. Keyword scoring was completed offline. Equivalency for sentence lists was determined based on the list intelligibility (mean keyword accuracy for each list compared with all other lists) and listener consistency (the relation between mean keyword accuracy on each list for each listener). Results: Based on measures of list equivalency and listener consistency, ten PRESTO lists were found to be equivalent in the MTB condition, nine lists were equivalent in the CI-Sim condition, and six PRESTO lists were equivalent in both conditions. Conclusions: PRESTO is a valuable addition to the clinical toolbox for assessing sentence recognition across different populations. Because the test condition influenced the overall intelligibility of lists, researchers and clinicians should take the presentation conditions into consideration when selecting the best PRESTO lists for their research or clinical protocols.

scholarly journals Children's Perception of Speech Produced in a Two-Talker Background

2014 ◽  
Vol 57 (1) ◽  
pp. 327-337 ◽  
Author(s):  
Mallory Baker ◽  
Emily Buss ◽  
Adam Jacks ◽  
Crystal Taylor ◽  
Lori J. Leibold
Keyword(s):  
Speech Perception ◽  
Word Recognition ◽  
Repeated Measures ◽  
Signal To Noise Ratio ◽  
Age Groups ◽  
Recognition Task ◽  
Monosyllabic Word ◽  
Repeated Measures Design ◽  
Speech In Noise ◽  
Open Set

Purpose This study evaluated the degree to which children benefit from the acoustic modifications made by talkers when they produce speech in noise. Method A repeated measures design compared the speech perception performance of children (5–11 years) and adults in a 2-talker masker. Target speech was produced in a 2-talker background or in quiet. In Experiment 1, recognition with the 2 target sets was assessed using an adaptive spondee identification procedure. In Experiment 2, the benefit of speech produced in a 2-talker background was assessed using an open-set, monosyllabic word recognition task at a fixed signal-to-noise ratio (SNR). Results Children performed more poorly than adults, regardless of whether the target speech was produced in quiet or in a 2-talker background. A small improvement in the SNR required to identify spondees was observed for both children and adults using speech produced in a 2-talker background (Experiment 1). Similarly, average open-set word recognition scores were 11 percentage points higher for both age groups using speech produced in a 2-talker background compared with quiet (Experiment 2). Conclusion The results indicate that children can use the acoustic modifications of speech produced in a 2-talker background to improve masked speech perception, as previously demonstrated for adults.

Comparing Recognition of Distorted Speech Using an Equivalent Signal-to-Noise Ratio Index

1995 ◽  
Vol 38 (3) ◽  
pp. 706-713 ◽  
Author(s):  
Sandra Gordon-Salant ◽  
Peter J. Fitzgibbons
Keyword(s):  
Hearing Loss ◽  
Speech Recognition ◽  
Signal To Noise Ratio ◽  
Recognition Performance ◽  
Percent Correct ◽  
Time Compression ◽  
Speech In Noise ◽  
Speech Distortion ◽  
Different Types ◽  
Young Subjects

An index of equivalent performance in noise was developed to compare recognition in different forms of speech distortion. Speech-recognition performance of young and elderly listeners with and without hearing loss was evaluated for undistorted speech presented in quiet and noise, and for speech distorted by four time-compression ratios and by four reverberation times. The data obtained in noise on young subjects with normal hearing served to generate a normalized regression equation, which was used to convert percent-correct performance in different distortion conditions to equivalent performance for undistorted speech at a particular S/N ratio. Comparisons of the equivalent S/N ratios obtained in the various conditions allowed rank-ordering of speech recognition performance in different types of degradation. The data also show that age and hearing loss affect recognition of speech degraded by reverberation or time compression. However, age effects are evident primarily in the most severe distortion conditions. Recognition of undistorted speech in noise was affected by hearing loss but not by age. These findings support a hypothesis that stipulates that increased age produces a reduction in the functional S/N ratio.

Effect of Competition, Signal-to-Noise Ratio, Race, and Sex on Southern American English Dialect Talkers’ Sentence Recognition

2020 ◽  
Author(s):  
Andrew Stuart ◽  
Yolanda F. Holt ◽  
Alyssa N. Kerls ◽  
Madeline R. Smith
Keyword(s):  
African American ◽  
Speech Perception ◽  
Signal To Noise Ratio ◽  
American English ◽  
Broadband Noise ◽  
Signal To Noise ◽  
English Sentence ◽  
Sentence Recognition ◽  
Open Set ◽  
Noise Ratio

Background: Although numerous studies have examined regional and racial–ethnic labeling of talkeridentity, few have evaluated speech perception skills of listeners from the southern United States.Purpose: The objective of the study was to examine the effect of competition, signal-to-noise ratio(SNR), race, and sex on sentence recognition performance in talkers from the Southern American Englishdialect region.Research Design: A four-factor mixed-measures design was used.Study Sample: Forty-eight normal-hearing young African American and White adults participated.Data Collection and Analyses: The Perceptually Robust English Sentence Test Open-set was used inquiet and in continuous and interrupted noise and multitalker babble at SNRs of -10, -5, 0, and 5 dB.Results: Significant main effects of competition (p < 0.001) and SNR (p < 0.001) and a competition bySNR interaction were found (p < 0.001). Performance improved with increasing SNRs. Performance wasalso greater in the interrupted broadband noise at poorer SNRs, relative to the other competitors. Multitalkerbabble performance was significantly poorer than the continuous noise at the poorer SNRs. Therewas no effect of race or sex on performance in quiet or competition.Conclusions: Although African American English and White American English talkers living in the samegeographic region demonstrate differences in speech production, their speech perception in noise doesnot appear to differ under the conditions examined in this study.

Bilateral cochlear implantation in a patient with petrous bone cholesteatoma in the only hearing ear: case report

2011 ◽  
Vol 125 (12) ◽  
pp. 1272-1274 ◽  
Author(s):  
S T Husseini ◽  
M Guida ◽  
M Negri ◽  
M Falcioni
Keyword(s):  
Case Report ◽  
Cochlear Implantation ◽  
English Language ◽  
Internal Auditory Canal ◽  
Petrous Bone ◽  
Successful Outcome ◽  
Sentence Recognition ◽  
Open Set ◽  
History Of ◽  
Petrous Bone Cholesteatoma

AbstractObjective:We report a case of successful cochlear implantation in a patient with petrous bone cholesteatoma in the only hearing ear.Case report:A 63-year-old man presented with a four-year history of right-sided, progressive hearing loss in his only hearing ear. Computed tomography and magnetic resonance imaging revealed a right supralabyrinthine petrous bone cholesteatoma, with erosion of the superior semicircular canal and the roof of the internal auditory canal. Due to the high risk of post-operative right-sided deafness, we decided first to perform left cochlear implantation. Five months later, the patient had a 40 per cent score for open-set two-syllable word recognition and an 85 per cent score for sentence recognition. Given these good performances, we decided to eradicate the cholesteatoma via a translabyrinthine approach, with insertion of a second cochlear implant, as a single-stage procedure. A successful outcome was achieved.Conclusion:Cochlear implantation can be an effective method of hearing rehabilitation in patients with petrous bone cholesteatoma, following total eradication of disease, if the cochlea remains intact. To our best knowledge, this is the first English language report of cochlear implantation in a patient with petrous bone cholesteatoma.

Effects of Fundamental Frequency Contours on Sentence Recognition in Mandarin-Speaking Children With Cochlear Implants

2020 ◽  
Vol 63 (11) ◽  
pp. 3855-3864
Author(s):  
Wanting Huang ◽  
Lena L. N. Wong ◽  
Fei Chen ◽  
Haihong Liu ◽  
Wei Liang
Keyword(s):  
Cochlear Implants ◽  
Fundamental Frequency ◽  
Signal To Noise Ratio ◽  
Lexical Tone ◽  
Signal To Noise ◽  
Sentence Recognition ◽  
Test Conditions ◽  
Age Appropriate ◽  
F0 Contour ◽  
Appropriate Sentences

Purpose Fundamental frequency (F0) is the primary acoustic cue for lexical tone perception in tonal languages but is processed in a limited way in cochlear implant (CI) systems. The aim of this study was to evaluate the importance of F0 contours in sentence recognition in Mandarin-speaking children with CIs and find out whether it is similar to/different from that in age-matched normal-hearing (NH) peers. Method Age-appropriate sentences, with F0 contours manipulated to be either natural or flattened, were randomly presented to preschool children with CIs and their age-matched peers with NH under three test conditions: in quiet, in white noise, and with competing sentences at 0 dB signal-to-noise ratio. Results The neutralization of F0 contours resulted in a significant reduction in sentence recognition. While this was seen only in noise conditions among NH children, it was observed throughout all test conditions among children with CIs. Moreover, the F0 contour-induced accuracy reduction ratios (i.e., the reduction in sentence recognition resulting from the neutralization of F0 contours compared to the normal F0 condition) were significantly greater in children with CIs than in NH children in all test conditions. Conclusions F0 contours play a major role in sentence recognition in both quiet and noise among pediatric implantees, and the contribution of the F0 contour is even more salient than that in age-matched NH children. These results also suggest that there may be differences between children with CIs and NH children in how F0 contours are processed.

From hard to soft: theory and Neolithic studies in Scotland

2011 ◽  
Vol 33 (1-2) ◽  
pp. 7-19
Author(s):  
Kenneth Brophy
Keyword(s):  
The Past

The Scottish Theoretical Archaeology Group (STAG) conference organisers expressed some doubts about how far theory has changed, and impacted, archaeological establishment and academia in Scotland. In this paper, I will argue that Scotland is certainly not isolated in a theoretical sense, although in the past, Scottish archaeology could be accused of being theoretically conservative, or at least dependent on ideas and models developed elsewhere. A case-study looking at Neolithic studies will be used to illustrate that despite some recent critical historiographies of the study of the period in Scotland, archaeologists in Scotland and those working with Scottish material have been theoretically innovative and in step with wider paradigm changes. The study of the Neolithic in Scotland, it could be argued, has been shaped by theory more than the study of any other period; we are not isolated, but rather part of wider networks of discourse.

THE URBAN MIGRANT FUTURE DESIRE: A STUDY OF REVERSE MIGRATION IN MALAYSIA

2017 ◽  
Vol 3 (2) ◽  
pp. 177
Author(s):  
Nur Huzeima Mohd Hussain ◽  
Hugh Byrd ◽  
Nur Azfahani Ahmad
Keyword(s):  
Oil And Gas ◽  
Industrial Society ◽  
Peak Oil ◽  
Population Mobility ◽  
Reverse Migration ◽  
The Past ◽  
Urban Migrants ◽  
Urban Migrant ◽  
Oil Crisis

Globalisation combined with resources of oil and gas has led to an industrial society in Malaysia.  For the past 30 years, rapid urban growth has shifted from 73% rural to 73% urban population. However, the peak oil crisis and economic issues are threatening the growth of urbanisation and influencing the trends of population mobility. This paper documents the beginnings of a reverse migration (urban-to-rural) in Malaysia.  The method adopted case study that involves questionnaires with the urban migrants to establish the desires, definite intentions and reasons for future migration. Based on this data, it predicts a trend and rate of reverse migration in Malaysia. 

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