Verification of Hearing Aids by Comparing Real Ear Measurements and Word Recognition Scores

Background and Objectives In this study, we introduce our method of hearing aid (HA) verification using real ear measurement (REM). We verified HAs that have gone through the fitting program using speech mapping REM; we then compared the outcome with word recognition scores (WRS) to evaluate functional gain. Subjects and Method Fifty-six patients of sensorineural hearing loss (81 ears) were enrolled in the study. In REM, if the gap between the target gain of HA and real ear aided response (REAR) was less than 10 dB SPL, fitting was considered successful. In speech audiometry, unaided maximum discrimination score (PB max), unaided WRS at 65 dB HL and aided WRS at 65 dB HL were measured. By comparing PB max and aided WRS at 65 dB HL, patients were sorted into best (n=15), good (n=57), and poorly (n=9) aided groups and analyzed for the successes of fitting. Fitting was deemed unsuccessful if REAR was ≥10 dB SPL lower than the target value of HA.Results The mean aided WRS at 65 dB HL of best, good and poorly aided groups were 85.6%, 77.3%, and 54.2%, respectively. There were statistically significant differences between all groups (p=0.019, 0.001, 0.002). The success rates of HA fitting showed significant differences at 0.5, 0.75, 1, 4 kHz of 55 dB SPL (p=0.023, 0.005, 0.003, 0.014), and at 4 kHz of 65 and 75 dB SPL (p=0.004, 0.001). The high WRS group showed sufficient gain at many frequencies. Conclusion Well fitted HAs can provide sufficient increase in speech intelligibility. Using the speech mapping REM is a great method to verify fitting of HA.

The Development of Categorical Perception of Segments and Suprasegments in Mandarin-Speaking Preschoolers

This study investigated the developmental trajectories of categorical perception (CP) of segments (i.e., stops) and suprasegments (i.e., lexical tones) in an attempt to examine the perceptual development of phonological categories and whether CP of suprasegments develops in parallel with that of segments. Forty-seven Mandarin-speaking monolingual preschoolers aged four to six years old, and fourteen adults completed both identification and discrimination tasks of the Tone 1-2 continuum and the /pa/-/pha/ continuum. Results revealed that children could perceive both lexical tones and aspiration of stops in a categorical manner by age four. The boundary position did not depend on age, with children having similar positions to adults regardless of speech continuum types. The boundary width, on the other hand, reached the adult-like level at age six for lexical tones, but not for stops. In addition, the within-category discrimination score did not differ significantly between children and adults for both continua. The between-category discrimination score improved with age and achieved the adult-like level at age five for lexical tones, but still not for stops even at age six. It suggests that the fine-grained perception of phonological categories is a protracted process, and the improvement and varying timeline of the development of segments and suprasegments are discussed in relation to statistical learning of the regularities of speech sounds in ambient language, ongoing maturation of perceptual systems, the memory mechanism underlying perceptual learning, and the intrinsic nature of speech elements.

Olfactory Function Assessment: Standardization of a New Quantitative Technique for the Indian Population

Aim: Olfactory function assessment is often neglected in clinical settings due to a lack of appropriate cost effective techniques. We therefore aimed to develop a cost effective, reliable and culturally appropriate tool for olfactory function assessment among the Indian population and to compare olfactory functions among 63 healthy controls and 32 idiopathic Parkinson’s disease patients. Materials and Methods: Olfactory stimuli were applied to the nostrils of the participants using an olfactometer. Five different odoriferous substances common to Indian culture were used for the study in three different concentrations: ginger (1%, 2%, 3%), cardamom (0.4%, 2%, 3%), garlic (0.8%, 1.4%, 2%), coffee (1.6%, 2%, 4%), vanilla (2%, 3%, 4%). Olfactory recognition threshold, olfactory identification score and olfactory discrimination score were observed among the control population and Parkinson’s disease population. Results: The olfactory recognition threshold was significantly high among the Parkinson’s disease group compared to controls (Mann Whitney U test, p<0.001). Reliability was tested using the test-retest method among the control group and all olfactory variables in three different concentrations had either r value closer to 1 or 1, which shows an acceptable level of reliability. The correlation was found to be significant (p<0.001). A receiver operating characteristic (ROC) curve drawn for olfactory recognition thresholds at different concentrations for the five odouriferous substances and the area was determined to classify cases and controls (Determined areas: ginger = 0.928, cardamom = 0.955, garlic = 0.921, Coffee = 0.950, vanilla = 0.950). The area under the curve was found to be significant in classifying the cases and the control. Conclusion: The newly developed olfactory assessment tool was found to be reliable and effective in assessing olfactory parameters like recognition threshold, identification score and discrimination score among the Indian population.

The effects of N95 mask and face shield on speech perception among healthcare workers in the coronavirus disease 2019 pandemic scenario

ObjectiveThe current circumstances of the coronavirus disease 2019 pandemic necessitate the use of personal protective equipment in hospitals. N95 masks and face shields are being used as personal protective equipment to protect from aerosol-related spread of infection. Personal protective equipment, however, hampers communication. This study aimed to assess the effect of using an N95 mask and face shield on speech perception among healthcare workers with normal hearing.MethodsTwenty healthcare workers were recruited for the study. Pure tone audiometry was conducted to ensure normal hearing. Speech reception threshold and speech discrimination score were obtained, first without using personal protective equipment and then repeated with the audiologist wearing an N95 mask and face shield.ResultsA statistically significant increase in speech reception threshold (mean of 12.4 dB) and decrease in speech discrimination score (mean of 7 per cent) was found while using the personal protective equipment.ConclusionUse of personal protective equipment significantly impairs speech perception. Alternate communication strategies should be developed for effective communication.

Words in noise audiometry in adult subjects with normal hearing

Background: Patients with hearing disturbance will generally undergo pure tone audiometry andspeech audiometry in a quiet room, but those examinations cannot evaluate the ability to understand speech in daily environment with a noisy background. Words in noise test will provide valuable informationregarding patient’s hearing problem in noise. Purpose: To evaluate the hearing threshold using wordsin noise test in adults with normal hearing. Method: This cross-sectional study was conducted in CiptoMangunkusumo Hospital from January to April 2017. All subjects who fulfilled the inclusion and exclusioncriteria underwent pure tone audiometry, speech audiometry, and words in noise test. Results: A total of71 individuals with normal hearing were recruited for this study. Words in noise test showed the medianvalue of 67 dB and 100 dB for Speech Recognition Threshold (SRT) 50% and Speech DiscriminationScore (SDS) 100%, respectively. The SRT 50% and SDS 100% were significantly higher in the age group40–60 years compared to the age group 18–39 years. There was also a statistically significant differencebetween males and females at SRT 50% assessed by words in noise audiometry. Conclusion: Wordsin noise test showed a statistically significant difference in SRT 50% and SDS 100% between two agegroups, but no difference was found between genders. The result of this study can be used as a referencefor SRT and SDS values of speech audiometry test in noise.Keywords: words in noise, speech audiometry, speech recognition threshold, speech discrimination score ABSTRAKLatar belakang: Pasien dengan gangguan pendengaran umumnya menjalani pemeriksaanaudiometri nada murni dan audiometri tutur di ruangan yang sunyi, tetapi pemeriksaan ini tidakdapat menggambarkan kemampuan pemahaman wicara di lingkungan sehari-hari yang ramai. Testutur dalam bising dapat mengevaluasi masalah pendengaran pasien dalam keadaan bising. Tujuan:Untuk mengevaluasi ambang pendengaran menggunakan tes tutur dalam bising pada orang dewasadengan pendengaran normal. Metode: Penelitian potong lintang ini dilakukan di Rumah Sakit CiptoMangunkusumo dari Januari hingga April 2017. Semua subjek yang memenuhi kriteria inklusi daneksklusi menjalani pemeriksaan audiometri nada murni, audiometri tutur, dan tes tutur dalam bising.Hasil: Sebanyak 71 orang dengan pendengaran normal diikutsertakan dalam penelitian ini. Tes tuturdalam bising menunjukkan nilai median masing-masing 67 dB dan 100 dB pada Speech RecognitionThreshold (SRT) 50% dan Speech Discrimination Score (SDS) 100%. SRT 50% dan SDS 100% secarasignifikan lebih tinggi pada kelompok usia 40–60 tahun dibandingkan dengan kelompok usia 18–39 tahun. Hasil pemeriksaan tes tutur dalam bising menunjukkan perbedaan yang signifikan antara laki-laki dan wanita pada nilai SRT 50%. Kesimpulan: Tes tutur dalam bising menunjukkan perbedaan yang bermakna secara statistik pada SRT 50% dan SDS 100% antara dua kelompok umur, tetapi tidak ada perbedaan signifikan diantara jenis kelamin. Hasil penelitian ini dapat digunakan sebagai acuan untuk nilai SRT dan SDS pada pemeriksaan audiometri tutur dalam bising.

Systematic Review of Hearing Preservation in Observed Vestibular Schwannoma

Objective This is a systematic review of the literature on the spontaneous course of hearing in patients observed with a vestibular schwannoma. Included studies are appraised using the Grading of Recommendations Assessment, Development and Evaluation system. Design PubMed, Embase, Medline, Cochrane library, and CINAHL (Cumulative Index to Nursing and Allied Health Literature) were searched for literature on hearing in patients observed with a vestibular schwannoma. Participants Of 217 evaluated papers, 15 were included, representing a total of 2,142 patients. Main Outcome Measures Hearing according to the AAO-HNS (American Academy of Otorhinolaryngology- Head and Neck Surgery) classification system. Weighted average of the proportion of patients preserving good hearing (>70% discrimination score and pure tone audiometry [PTA] < 30dB) and serviceable hearing (>50% discrimination score and PTA < 50dB) was determined. Results Fifty percent of patients presenting with good hearing at diagnosis had preserved this after a mean of 5 years of observation, whereas serviceable hearing was preserved in 54%. Patients with normal discrimination at diagnosis preserve their hearing very well. Very few studies exist on long-term hearing preservation. Conclusions After 5 years of observation, around half of patients will have preserved good or serviceable hearing. Patients with normal discrimination at diagnosis are more likely to preserve good hearing.

Measuring individual identity information in animal signals: Overview and performance of available identity metrics

Identity signals have been studied for over 50 years but there is no consensus as to how to quantify individuality. While there are a variety of different metrics to quantify individual identity, or individuality, these methods remain un-validated and the relationships between them unclear.We contrasted three univariate and four multivariate metrics (and their different computational variants) and evaluated their performance on simulated and empirical datasets.Of the metrics examined, Beecher’s information statistic (HS) was the best one and could easily and reliably be converted into the commonly used discrimination score (and vice versa) after accounting for the number of individuals and calls per individual in a given dataset. Although Beecher’s information statistic is not entirely independent of sampling parameters, this problem can be removed by reducing the number of parameters or by increasing the number of individuals.Because it is easily calculated, has superior performance, can be used to describe single variables or signal as a whole, and because it tells us the maximum number of individuals that can be discriminated given a set of measurements, we recommend that individuality should be quantified using Beecher’s information statistic.