Behavioral and Electrophysiologic Binaural Processing in Persons with Symmetric Hearing Loss

2011 ◽  
Vol 22 (03) ◽  
pp. 181-193 ◽  
Author(s):  
Elizabeth D. Leigh-Paffenroth ◽  
Christina M. Roup ◽  
Colleen M. Noe
Keyword(s):  
Hearing Loss ◽  
Hearing Aids ◽  
Auditory Processing ◽  
Repeated Measures ◽  
Pure Tone ◽  
Binaural Hearing ◽  
Behavioral Tests ◽  
Binaural Processing ◽  
Binaural Interaction ◽  
Noise Test

Background: Binaural hearing improves our ability to understand speech and to localize sounds. Hearing loss can interfere with binaural cues, and despite the success of amplification, ˜25% of people with bilateral hearing loss fit with two hearing aids choose to wear only one (e.g., Brooks and Bulmer, 1981). One explanation is reduced binaural processing, which occurs when the signal presented to one ear interferes with the perception of the signal presented to the other ear (e.g., Jerger et al, 1993). Typical clinical measures, however, are insensitive to binaural processing deficits. Purpose: The purpose of this study was to determine the extent to which behavioral measures of binaural performance were related to electrophysiological measures of binaural processing in subjects with symmetrical pure-tone sensitivity. Research Design: The relationship between middle latency responses (MLRs) and behavioral performance on binaural listening tasks was assessed by Spearman's rho correlation analyses. Separate repeated measures analyses of variance (RMANOVAs) were performed for MLR latency and MLR amplitude. Study Sample: Nineteen subjects were recruited for the present study based on a clinical presentation of symmetrical pure-tone sensitivity with asymmetrical performance on a word-recognition in noise test. This subpopulation of patients included both subjects with and subjects without hearing loss. Data Collection and Analysis: Monaural and binaural auditory processing was measured behaviorally and electrophysiologically in right-handed subjects. The behavioral tests included the Words-in-Noise test (WIN), the dichotic digits test (DDT), and the 500 Hz masking level difference (MLD). Electrophysiologic responses were measured by the binaural interaction component (BIC) of the MLR. The electrophysiological responses were analyzed to examine the effects of peak (Na, Pa, and Nb) and condition (monaural left, monaural right, binaural, and BIC) on MLR amplitude and latency. Results: Significant correlations were found among electrophysiological measures of binaural hearing and behavioral tests of binaural hearing. A strong correlation between the MLD and the binaural Na-Pa amplitude was found (r = .816). Conclusions: The behavioral and electrophysiological measures used in the present study clearly showed evidence of reduced binaural processing in ˜10 of the subjects in the present study who had symmetrical pure-tone sensitivity. These results underscore the importance of understanding binaural auditory processing and how these measures may or may not identify functional auditory problems.

Hearing with Two Ears: Evidence for Cortical Binaural Interaction during Auditory Processing

2015 ◽  
Vol 26 (04) ◽  
pp. 384-392 ◽  
Author(s):  
Yael Henkin ◽  
Yifat Yaar-Soffer ◽  
Lihi Givon ◽  
Minka Hildesheimer
Keyword(s):  
Auditory Processing ◽  
Repeated Measures ◽  
Objective Measure ◽  
Event Related Potentials ◽  
Binaural Hearing ◽  
Listening Condition ◽  
Hearing Sensitivity ◽  
Binaural Processing ◽  
Binaural Interaction ◽  
Related Potentials

Background: Integration of information presented to the two ears has been shown to manifest in binaural interaction components (BICs) that occur along the ascending auditory pathways. In humans, BICs have been studied predominantly at the brainstem and thalamocortical levels; however, understanding of higher cortically driven mechanisms of binaural hearing is limited. Purpose: To explore whether BICs are evident in auditory event-related potentials (AERPs) during the advanced perceptual and postperceptual stages of cortical processing. Research Design: The AERPs N1, P3, and a late negative component (LNC) were recorded from multiple site electrodes while participants performed an oddball discrimination task that consisted of natural speech syllables (/ka/ vs. /ta/) that differed by place-of-articulation. Participants were instructed to respond to the target stimulus (/ta/) while performing the task in three listening conditions: monaural right, monaural left, and binaural. Study Sample: Fifteen (21–32 yr) young adults (6 females) with normal hearing sensitivity. Data Collection and Analysis: By subtracting the response to target stimuli elicited in the binaural condition from the sum of responses elicited in the monaural right and left conditions, the BIC waveform was derived and the latencies and amplitudes of the components were measured. The maximal interaction was calculated by dividing BIC amplitude by the summed right and left response amplitudes. In addition, the latencies and amplitudes of the AERPs to target stimuli elicited in the monaural right, monaural left, and binaural listening conditions were measured and subjected to analysis of variance with repeated measures testing the effect of listening condition and laterality. Results: Three consecutive BICs were identified at a mean latency of 129, 406, and 554 msec, and were labeled N1-BIC, P3-BIC, and LNC-BIC, respectively. Maximal interaction increased significantly with progression of auditory processing from perceptual to postperceptual stages and amounted to 51%, 55%, and 75% of the sum of monaural responses for N1-BIC, P3-BIC, and LNC-BIC, respectively. Binaural interaction manifested in a decrease of the binaural response compared to the sum of monaural responses. Furthermore, listening condition affected P3 latency only, whereas laterality effects manifested in enhanced N1 amplitudes at the left (T3) vs. right (T4) scalp electrode and in a greater left–right amplitude difference in the right compared to left listening condition. Conclusions: The current AERP data provides evidence for the occurrence of cortical BICs during perceptual and postperceptual stages, presumably reflecting ongoing integration of information presented to the two ears at the final stages of auditory processing. Increasing binaural interaction with the progression of the auditory processing sequence (N1 to LNC) may support the notion that cortical BICs reflect inherited interactions from preceding stages of upstream processing together with discrete cortical neural activity involved in binaural processing. Clinically, an objective measure of cortical binaural processing has the potential of becoming an appealing neural correlate of binaural behavioral performance.

Otologics Fully Implantable Hearing Device Phase II Results

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P57-P57
Author(s):  
Drew M Horlbeck ◽  
Herman A Jenkins ◽  
Ben J Balough ◽  
Michael E Hoffer
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Phase Ii ◽  
Hearing Aids ◽  
Repeated Measures ◽  
Pure Tone ◽  
Sound Field ◽  
Sensorineural Hearing ◽  
Significant Difference ◽  
Hearing Device

Objective The efficacy of the Otologics Fully Implantable Hearing Device (MET) was assessed in adult patients with bilateral moderate to severe sensorineural hearing loss. Methods Surgical insertion of this totally implanted system was identical to the Phase I study. A repeated-measures within-subjects design assessed aided sound field thresholds and speech performances with the subject's own, appropriately fit, walk-in hearing aid(s) and the Otologics Fully Implantable Hearing Device. Results Six- and 12-month Phase II data will be presented. Ten patients were implanted and activated as part Phase II clinical trial. Three patients were lost to long term follow-up due to two coil failures and one ossicular abnormality preventing proper device placement. No significant differences between preoperative (AC = 59 dB, BC = 55 dB) and postoperative (AC = 61 dB, BC = 54 dB) unaided pure tone averages were noted (p < 0.05). Pure tone average implant aided thresholds (41 dB) were equivalent to that of walk-in-aided (37 dB) condition with no significant difference (p < 0.05) between patients’ walk-in-aided individual frequency thresholds and implant-aided thresholds. Word recognition scores and hearing in noise scores were similar between the walk-in-aided and for the implant-aided condition. Patient benefit scales will be presented at all end points. Conclusions Results of the Otologics MET Fully Implantable Hearing Device Phase II trial provide evidence that this fully implantable device is a viable alternative to currently available hearing aids in patients with sensorineural hearing loss.

Are Two Ears Not Better Than One?

2012 ◽  
Vol 23 (03) ◽  
pp. 171-181 ◽  
Author(s):  
Rachel A. McArdle ◽  
Mead Killion ◽  
Monica A. Mennite ◽  
Theresa H. Chisolm
Keyword(s):  
Hearing Loss ◽  
Speech Recognition ◽  
Hearing Aids ◽  
Repeated Measures ◽  
Signal To Noise Ratio ◽  
Hearing Aid ◽  
Binaural Hearing ◽  
Analysis Experiment ◽  
Insert Earphones ◽  
Speech Recognition In Noise

Background: The decision to fit one or two hearing aids in individuals with binaural hearing loss has been debated for years. Although some 78% of U.S. hearing aid fittings are binaural (Kochkin , 2010), Walden and Walden (2005) presented data showing that 82% (23 of 28 patients) of their sample obtained significantly better speech recognition in noise scores when wearing one hearing aid as opposed to two. Purpose: To conduct two new experiments to fuel the monaural/binaural debate. The first experiment was a replication of Walden and Walden (2005), whereas the second experiment examined the use of binaural cues to improve speech recognition in noise. Research Design: A repeated measures experimental design. Study Sample: Twenty veterans (aged 59–85 yr), with mild to moderately severe binaurally symmetrical hearing loss who wore binaural hearing aids were recruited from the Audiology Department at the Bay Pines VA Healthcare System. Data Collection and Analysis: Experiment 1 followed the procedures of the Walden and Walden study, where signal-to-noise ratio (SNR) loss was measured using the Quick Speech-in-Noise (QuickSIN) test on participants who were aided with their current hearing aids. Signal and noise were presented in the sound booth at 0° azimuth under five test conditions: (1) right ear aided, (2) left ear aided, (3) both ears aided, (4) right ear aided, left ear plugged, and (5) unaided. The opposite ear in (1) and (2) was left open. In Experiment 2, binaural Knowles Electronics Manikin for Acoustic Research (KEMAR) manikin recordings made in Lou Malnati's pizza restaurant during a busy period provided a typical real-world noise, while prerecorded target sentences were presented through a small loudspeaker located in front of the KEMAR manikin. Subjects listened to the resulting binaural recordings through insert earphones under the following four conditions: (1) binaural, (2) diotic, (3) monaural left, and (4) monaural right. Results: Results of repeated measures ANOVAs demonstrated that the best speech recognition in noise performance was obtained by most participants with both ears aided in Experiment 1 and in the binaural condition in Experiment 2. Conclusions: In both experiments, only 20% of our subjects did better in noise with a single ear, roughly similar to the earlier Jerger et al (1993) finding that 8–10% of elderly hearing aid users preferred one hearing aid.

Assessment of expressive vocabulary outcomes in hearing-impaired children with hearing aids: do bilaterally hearing-impaired children catch up?

2006 ◽  
Vol 120 (8) ◽  
pp. 619-626 ◽  
Author(s):  
C Kiese-Himmel ◽  
M Reeh
Keyword(s):  
Hearing Loss ◽  
Hearing Aids ◽  
Repeated Measures ◽  
Binaural Hearing ◽  
Normal Hearing ◽  
Hearing Impaired ◽  
Expressive Vocabulary ◽  
Clinical Tool ◽  
Impaired Children ◽  
Hearing Impaired Children

Objective: To evaluate expressive vocabulary growth in hearing-impaired preschool children wearing hearing aids.Design: Prospective analysis of the outcomes of children included in the 1994 German ‘Goettinger Hoer-Sprachregister’ (GHR) series, using a repeated-measures paradigm in six- to nine-month intervals (t1–t3).Subjects: Twenty-seven children (aged 2.0–4.4 years) with bilateral sensorineural hearing loss (with averages at frequencies of 0.5, 1, 2 and 4 kHz of >20 to >90 dB in the better ear) from the 1994 GHR series. The children were diagnosed at a mean age of 31.4 months (standard deviation (SD) 10.6 months) and fitted with a binaural hearing aid at a mean age of 32.3 months (SD 10.5 months). Nonverbal intelligence was average (five missing data entries). Standardized, age-appropriate picture naming tests (the ‘Sprachentwicklungstest für 2-jährige Kinder’, the Kaufman Assessment Battery for Children subtest vocabulary, and the ‘Aktiver Wortschatztest für drei- bis sechsjährige Kinder’) were carried out at three time points and results compared with data from children with normal hearing. The test raw scores were converted to T scores (mean = 50; SD = 10).Results: On average, the children scored far below the normative population at t1 (mean = 28.9; SD = 11.3) and slowly improved as they got older (at t3, mean = 34.1; SD = 16.1; p = 0.010). Children with mild or moderate hearing loss improved most notably (mean difference t1–t3; p = 0.001), except for one child of deaf parents. Two of the five mildly hearing-impaired children and two of the eleven moderately hearing-impaired children caught up with their normal hearing peers with regards to expressive vocabulary. Such expressive vocabulary achievements were not seen in any children with >70 dB hearing loss or in six of the eleven children (55 per cent) with a 40–70 dB hearing loss, despite receiving adequate personal amplification.Conclusion: Testing expressive vocabulary size is a useful clinical tool in assessing linguistic lexical outcome.

scholarly journals Auditory rehabilitation in adults: results of a training program

Revista CEFAC ◽  
2019 ◽  
Vol 21 (5) ◽  
Author(s):  
Cristiane Bueno Sales ◽  
Luciana Macedo de Resende ◽  
Carlos Faria Santos Amaral
Keyword(s):  
Hearing Loss ◽  
Hearing Aids ◽  
Auditory Processing ◽  
Auditory Training ◽  
Functional Improvement ◽  
Moderate Degree ◽  
Behavioral Tests ◽  
Level Difference ◽  
Significant Difference ◽  
Masking Level Difference

ABSTRACT Objective: to describe the findings of the auditory processing behavioral tests in patients with hearing loss before and after hearing aid fitting associated with auditory training. Methods: a descriptive analytical study that compared the findings of the auditory processing evaluation in 22 patients, from 19 to 62 years old, with mild or moderate sensorineural hearing loss. Tests used: Sound localization; Masking Level Difference; Alternate Disyllables Dichotic Listening Test; Melodic Frequency Pattern Test, Melodic Duration Pattern Test; Gaps in Noise; Speech in Noise Test. After the first tests, the patients were fitted with hearing aids and underwent eight auditory training sessions. The tests were retaken after a two-month period. Results: there was a predominance of females and a moderate degree hearing loss. In the comparison of the initial and final assessment situations, a statistically significant difference (p <0.05) was seen in all conditions studied, except for the Gaps in Noise and Masking Level Difference tests. Conclusion: the results have proven that the auditory training performed in adult users of hearing aids brought about significant improvements on the auditory processing skills, thus, modifying their auditory behavior. The improvement of the results of the auditory processing behavioral tests in the initial and final situations reflects the hearing functional improvement achieved.

scholarly journals Unilateral Conductive Hearing Loss Disrupts the Developmental Refinement of Binaural Processing in the Rat Primary Auditory Cortex

2021 ◽  
Vol 15 ◽  
Author(s):  
Jing Liu ◽  
Xinyi Huang ◽  
Jiping Zhang
Keyword(s):  
Hearing Loss ◽  
Auditory Cortex ◽  
Conductive Hearing Loss ◽  
Spatial Perception ◽  
Primary Auditory Cortex ◽  
Binaural Hearing ◽  
Adult Rats ◽  
Binaural Processing ◽  
Binaural Interaction ◽  
Conductive Hearing

Binaural hearing is critically important for the perception of sound spatial locations. The primary auditory cortex (AI) has been demonstrated to be necessary for sound localization. However, after hearing onset, how the processing of binaural cues by AI neurons develops, and how the binaural processing of AI neurons is affected by reversible unilateral conductive hearing loss (RUCHL), are not fully elucidated. Here, we determined the binaural processing of AI neurons in four groups of rats: postnatal day (P) 14–18 rats, P19–30 rats, P57–70 adult rats, and RUCHL rats (P57–70) with RUCHL during P14–30. We recorded the responses of AI neurons to both monaural and binaural stimuli with variations in interaural level differences (ILDs) and average binaural levels. We found that the monaural response types, the binaural interaction types, and the distributions of the best ILDs of AI neurons in P14–18 rats are already adult-like. However, after hearing onset, there exist developmental refinements in the binaural processing of AI neurons, which are exhibited by the increase in the degree of binaural interaction, and the increase in the sensitivity and selectivity to ILDs. RUCHL during early hearing development affects monaural response types, decreases the degree of binaural interactions, and decreases both the selectivity and sensitivity to ILDs of AI neurons in adulthood. These new evidences help us to understand the refinements and plasticity in the binaural processing of AI neurons during hearing development, and might enhance our understanding in the neuronal mechanism of developmental changes in auditory spatial perception.

Evaluation of the Benefits of Binaural Hearing on the Telephone for Children with Hearing Loss

2015 ◽  
Vol 26 (01) ◽  
pp. 093-100 ◽  
Author(s):  
Jace Wolfe ◽  
Erin Schafer ◽  
Emily Mills ◽  
Andrew John ◽  
Mary Hudson ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Speech Recognition ◽  
Hearing Aids ◽  
Repeated Measures ◽  
Signal To Noise Ratio ◽  
Binaural Hearing ◽  
Monosyllabic Word ◽  
Cross Sectional ◽  
Repeated Measures Design ◽  
Children With Hearing Loss

Background: There is a paucity of published studies examining how children with hearing loss understand speech over the telephone. Previous studies on adults with hearing aids have suggested that adults with bilateral hearing aids experience significant difficulty recognizing speech on the telephone when listening with one ear, but the provision of telephone input to both ears substantially improved speech understanding. Purpose: The objectives of this study were to measure speech recognition in quiet and in noise for a group of older children with hearing loss over the telephone and to evaluate the effects of binaural hearing (e.g., DuoPhone) on speech recognition over the telephone. Research Design: A cross-sectional, repeated-measures design was used in this study. Study Sample: A total of 14 children, ages 6–14 yr, participated in the study. Participants were obtained using convenience sampling from a nonprofit clinic population. Intervention: Speech recognition in quiet and in noise with binaural versus monaural telephone input was compared in pediatric participants. Data Collection and Analysis: Monosyllabic word recognition was assessed in quiet and classroom noise set at 50 dBA in conditions with monaural and binaural (DuoPhone) telephone input. Results: The children’s speech recognition in quiet and in noise was significantly better with binaural telephone input relative to monaural telephone input. Conclusions: To obtain optimal performance on the telephone, the following considerations may apply: (1) use of amplification with binaural streaming capabilities (e.g., DuoPhone), (2) counseling of family and children on how to best use the telephone, (3) provision of telecoil with microphone attenuation for improved signal-to-noise ratio, and (4) use of probe tube measures to verify the appropriateness of the telephone programs.

AUDIOLOGICAL CORRELATES OF AGE-RELATED MANIFESTATIONS OF AUDITORY DISORDERS

2020 ◽  
pp. 549-554
Author(s):  
Л. Е. Голованова ◽  
Е. А. Огородникова ◽  
Н. С. Белокурова ◽  
Е. С. Лаптева ◽  
М. Ю. Бобошко
Keyword(s):  
Hearing Aids ◽  
Auditory Processing ◽  
Pure Tone ◽  
Young Patients ◽  
Pure Tone Audiometry ◽  
Sound Field ◽  
Speech Audiometry ◽  
Central Auditory Processing ◽  
Central Auditory Processing Disorder ◽  
Age Related

Целью исследования был сравнительный анализ жалоб и аудиологических показателей у пациентов сурдологического центра в зависимости от возраста. Представлены результаты обследования 300 первичных пациентов (случайная выборка), обратившихся к сурдологу-оториноларингологу в течение 1 мес. В группу молодых пациентов (19-44 года) вошли 40 человек; в группу среднего возраста (45- 59 лет) - 62 человека; в группу пожилых (60-74 года) - 100 человек; в группу старческого возраста (75-90 лет) - 98 человек. Обследование включало сбор жалоб и анамнеза, ЛОР-осмотр, тональную пороговую аудиометрию, импедансометрию, речевую аудиометрию в наушниках для выявления признаков центральных слуховых расстройств или в свободном звуковом поле для оценки эффективности слухопротезирования. Установлено, что для ранней диагностики тугоухости и профилактики возрастных сенсорнокогнитивных дисфункций целесообразно использовать не только результаты тональной пороговой аудиометрии, но и данные речевой аудиометрии, а также анализ субъективных жалоб. Результаты работы свидетельствуют о необходимости организации скрининга состояния слуха в рамках диспансеризации населения старше 60 лет. The aim of the study was a comparative analysis of complaints and audiological findings in patients of the audiological center depending on their age. The results of the examination of 300 fi rstly consulted patients (random sample) are presented. The group of young patients (19-44 years) included 40 people; middle age (45-59 years) - 62 people; elderly (60-74 years) - 100 people; senile age (75-90 years) - 98 people. The survey included the collection of complaints and anamnesis, ENT checkup, pure tone audiometry, impedancemetry, speech audiometry in headphones to detect the signs of Central Auditory Processing Disorder or in the free sound field to assess the effectiveness of hearing aids. It was found that for early diagnosis of hearing loss and prevention of age-related sensory-cognitive dysfunction, it is advisable to use not only the results of pure tone audiometry, but also the data of speech audiometry, as well as the analysis of subjective complaints. The results of the work indicate the need for hearing screening in the population over 60 years old.

scholarly journals Pure-tone audiometry without bone-conduction thresholds: using the digits-in-noise test to detect conductive hearing loss

2020 ◽  
Vol 59 (10) ◽  
pp. 801-808 ◽  
Author(s):  
Karina C. De Sousa ◽  
Cas Smits ◽  
David R. Moore ◽  
Hermanus Carel Myburgh ◽  
De Wet Swanepoel
Keyword(s):  
Hearing Loss ◽  
Pure Tone ◽  
Conductive Hearing Loss ◽  
Bone Conduction ◽  
Pure Tone Audiometry ◽  
Noise Test ◽  
Conductive Hearing

The Effects of Changes in Head Angle on Auditory and Visual Input for Omnidirectional and Directional Microphone Hearing Aids

2003 ◽  
Vol 12 (1) ◽  
pp. 41-51 ◽  
Author(s):  
Paula Henry ◽  
Todd Ricketts
Keyword(s):  
Hearing Loss ◽  
Speech Recognition ◽  
Hearing Aids ◽  
Visual Cues ◽  
Signal To Noise Ratio ◽  
Hearing Aid ◽  
Recognition Performance ◽  
Binaural Hearing ◽  
Increase Signal Intensity ◽  
Visual Mode

Improving the signal-to-noise ratio (SNR) for individuals with hearing loss who are listening to speech in noise provides an obvious benefit. Although binaural hearing provides the greatest advantage over monaural hearing in noise, some individuals with symmetrical hearing loss choose to wear only one hearing aid. The present study tested the hypothesis that individuals with symmetrical hearing loss fit with one hearing aid would demonstrate improved speech recognition in background noise with increases in head turn. Fourteen individuals were fit monaurally with a Starkey Gemini in-the-ear (ITE) hearing aid with directional and omnidirectional microphone modes. Speech recognition performance in noise was tested using the audiovisual version of the Connected Speech Test (CST v.3). The test was administered in auditory-only conditions as well as with the addition of visual cues for each of three head angles: 0°, 20°, and 40°. Results indicated improvement in speech recognition performance with changes in head angle for the auditory-only presentation mode at the 20° and 40° head angles when compared to 0°. Improvement in speech recognition performance for the auditory + visual mode was noted for the 20° head angle when compared to 0°. Additionally, a decrement in speech recognition performance for the auditory + visual mode was noted for the 40° head angle when compared to 0°. These results support a speech recognition advantage for listeners fit with one ITE hearing aid listening in a close listener-to-speaker distance when they turn their head slightly in order to increase signal intensity.

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