Frequency reallocation based on cochlear place frequencies in cochlear implants: a pilot study

Purpose The aim of this study is to evaluate speech perception outcomes after a frequency reallocation performed through the creation of an anatomically based map obtained with Otoplan®, a tablet-based software that allows the cochlear duct length to be calculated starting from CT images. Methods Ten postlingually deafened patients who underwent cochlear implantation with MED-EL company devices from 2015 to 2019 in the Tertiary referral center University Hospital of Verona have been included in a retrospective study. The postoperative CT scans were evaluated with Otoplan®; the position of the intracochlear electrodes was obtained, an anatomical mapping was carried out and then it was submitted to the patients. All patients underwent pure tonal and speech audiometry before and after the reallocation and the audiological results were processed considering the Speech Recognition Threshold (SRT), the Speech Awareness Threshold (SAT) and the Pure Tone Average (PTA). The differences in the PTA, SAT and SRT values before and after the reallocation were determined. The results were statistically processed using the software Stata with a significance value of α < 0.05. Results The mean values of SRT (61.25 dB versus 51.25 dB) and SAT (49 dB versus 41 dB) were significantly lower (p: 0.02 and p: 0.04, respectively) after the reallocation. No significant difference was found between PTA values (41.5 dB versus 39.25 dB; p: 0.18). Conclusions Our preliminary results demonstrate better speech discrimination and rapid adaptation in implanted postlingually deaf patients after anatomic mapping and subsequent frequency reallocation.

Predicting speech discrimination scores from pure-tone thresholds—A machine learning-based approach using data from 12,697 subjects

Diagnostic tests for hearing impairment not only determines the presence (or absence) of hearing loss, but also evaluates its degree and type, and provides physicians with essential data for future treatment and rehabilitation. Therefore, accurately measuring hearing loss conditions is very important for proper patient understanding and treatment. In current-day practice, to quantify the level of hearing loss, physicians exploit specialized test scores such as the pure-tone audiometry (PTA) thresholds and speech discrimination scores (SDS) as quantitative metrics in examining a patient’s auditory function. However, given that these metrics can be easily affected by various human factors, which includes intentional (or accidental) patient intervention, there are needs to cross validate the accuracy of each metric. By understanding a “normal” relationship between the SDS and PTA, physicians can reveal the need for re-testing, additional testing in different dimensions, and also potential malingering cases. For this purpose, in this work, we propose a prediction model for estimating the SDS of a patient by using PTA thresholds via a Random Forest-based machine learning approach to overcome the limitations of the conventional statistical (or even manual) methods. For designing and evaluating the Random Forest-based prediction model, we collected a large-scale dataset from 12,697 subjects, and report a SDS level prediction accuracy of 95.05% and 96.64% for the left and right ears, respectively. We also present comparisons with other widely-used machine learning algorithms (e.g., Support Vector Machine, Multi-layer Perceptron) to show the effectiveness of our proposed Random Forest-based approach. Results obtained from this study provides implications and potential feasibility in providing a practically-applicable screening tool for identifying patient-intended malingering in hearing loss-related tests.

Attitudes towards migrant workers in South Africa: A critical discourse analysis

Background: The influx of migrants from neighbouring countries has contributed to diversity in South Africa. This has caused on-going clashes between local residents and migrants. This article explores the role of discourse towards enabling a cohesive society. There has been much focus on migrants working in South Africa over the 2020 December festive season as many faced challenges in travelling to their respective countries because of the COVID-19 pandemic. This limelight exposed the underlying discrimination towards migrants in South Africa remain regardless of the South African progressive Constitution that values and respects individuals as well as protecting them from discrimination.Aim: This article adopts threat theory and uses critical discourse analysis to highlight the existing and continued discrimination towards migrant workers. The article exposes the causes of social inequalities, which can assist the government in decision-making towards reducing the inequality gap in service delivery.Setting: Public viewer comments on the news updates on migrants’ travel that were posted on the national news websites over the 2020 festive season were analysed.Methods: Critical Discourse analysis (CDA) was employed as a method of analysis in this article.Results and conclusion: The article intends to add to the existing body of knowledge and to also inform local government towards canvasing agenda that incorporate all human rights and enable a cohesive society by considering the role of discourse as an enabler of the problems experienced in societies. The results show that discourse contributes to negative attitudes, hate speech, discrimination and stereotyping towards migrants in South Africa.

Speech token detection and discrimination in individual infants using functional near-infrared spectroscopy

Speech detection and discrimination ability are important measures of hearing ability that may inform crucial audiological intervention decisions for individuals with a hearing impairment. However, behavioral assessment of speech discrimination can be difficult and inaccurate in infants, prompting the need for an objective measure of speech detection and discrimination ability. In this study, the authors used functional near-infrared spectroscopy (fNIRS) as the objective measure. Twenty-three infants, 2 to 10 months of age participated, all of whom had passed newborn hearing screening or diagnostic audiology testing. They were presented with speech tokens at a comfortable listening level in a natural sleep state using a habituation/dishabituation paradigm. The authors hypothesized that fNIRS responses to speech token detection as well as speech token contrast discrimination could be measured in individual infants. The authors found significant fNIRS responses to speech detection in 87% of tested infants (false positive rate 0%), as well as to speech discrimination in 35% of tested infants (false positive rate 9%). The results show initial promise for the use of fNIRS as an objective clinical tool for measuring infant speech detection and discrimination ability; the authors highlight the further optimizations of test procedures and analysis techniques that would be required to improve accuracy and reliability to levels needed for clinical decision-making.

İşitme cihazı kullanıcısı bebeklerin görsel pekiştirmeli konuşmayı ayırt etme yöntemi ile değerlendirilmesi: Olgu serisi

Evaluation of babies with hearing aids using visual reinforced ınfant speech discrimination method: A case series Speech perception measurements are an important part of the audiology test battery. It is important to investigate hearing loss in the early period and to evaluate the auditory pathway in terms of speech perception for appropriate amplification. Due to the level of language development in infants, it is not possible to objectively evaluate speech perception skills with the speech test battery used in adults. It is necessary to use a test battery that gives objective results for the measurement of speech perception in infants. Visual Reinforcement Infant Speech Discrimination (VRISD) method is the most commonly used test technique to evaluate speech discrimination skills in infants. The aim of this study is to evaluate the speech discrimination skills of 3 babies aged 6-18 months, who are hearing aid users, with the VRISD test method. In the VRISD test protocol used in this study, test stimuli were created by matching /a/ with /i/ and /ba/ with /da/ speech stimuli. These stimulus pairs are arranged as one target sound and the other background sound, and they are presented at 70 dB via loudspeaker by creating a repeating sound sequence. Animated video that attracts the attention of the baby was used as visual reinforcement. Speech discrimination skills of 3 babies with bilateral hearing aids were evaluated with the VRISD test, and the results of the cases are presented. As a result of the study, speech discrimination skills of babies with hearing aids will be evaluated with the VRISD test method. These results contribute to habilitation and amplification programming. Keywords: Hearing aid, speech perception, pediatric audiology

Homing in on HATE: Critical Discourse Studies of Hate Speech, Discrimination and Inequality in the Digital Age Edited by G. Balirano and B. Hughes (2020)

Homing in on HATE: Critical Discourse Studies of Hate Speech, Discrimination and Inequality in the Digital Age Edited by G. Balirano and B. Hughes (2020) Napoli, Italy: Paolo Loffredo Editore srl, 267 pp.

Electrode array design determines scalar position, dislocation rate and angle and postoperative speech perception

Purpose The aim of this study is to examine the scalar dislocation rate in straight and perimodiolar electrode arrays in relation to cochlear morphology. Furthermore, we aim to analyze the specific dislocation point of electrode arrays depending on their design and shape and to correlate these results to postoperative speech perception. Methods We conducted a comparative analysis of patients (ears: n = 495) implanted between 2013 and 2018 with inserted perimodiolar or straight electrode arrays from Cochlear™ or MED-EL. CBCT (cone beam computed tomography) was used to determine electrode array position (scalar insertion, intra-cochlear dislocation, point of dislocation and angular insertion depth). Furthermore, cochlear morphology was measured. The postoperative speech discrimination was compared regarding electrode array dislocation, primary scalar insertion and angular insertion depth. Results The electrode array with the highest rate of primary SV insertions was the CA; the electrode array with the highest rate of dislocations out of ST was the FlexSoft. We did not find significantly higher dislocation rates in cochleostomy-inserted arrays. The angle of dislocation was electrode array design-specific. A multivariate nonparametric analysis revealed that the dislocation of the electrode array has no significant influence on postoperative speech perception. Nevertheless, increasing angular insertion depth significantly reduced postoperative speech perception for monosyllables. Conclusion This study demonstrates the significant influence of electrode array design on scalar location, dislocation and the angle of dislocation itself. Straight and perimodiolar electrode arrays differ from each other regarding both the rate and place of dislocation. Insertion via cochleostomy does not lead to increased dislocation rates in any of the included electrode arrays. Furthermore, speech perception is significantly negatively influenced by angular insertion depth.

Categorical Perception of Chinese Lexical Tones by Late Second Language Learners With High Proficiency: Behavioral and Electrophysiological Measures

Purpose Although acquisition of Chinese lexical tones by second language (L2) learners has been intensively investigated, very few studies focused on categorical perception (CP) of lexical tones by highly proficient L2 learners. This study was designed to address this issue with behavioral and electrophysiological measures. Method Behavioral identification and auditory event-related potential (ERP) components for speech discrimination, including mismatch negativity (MMN), N2b, and P3b, were measured in 23 native Korean speakers who were highly proficient late L2 learners of Chinese. For the ERP measures, both passive and active listening tasks were administered to examine the automatic and attention-controlled discriminative responses to within- and across-category differences for carefully chosen stimuli from a lexical tone continuum. Results The behavioral task revealed native-like identification function of the tonal continuum. Correspondingly, the active oddball task demonstrated larger P3b amplitudes for the across-category than within-category deviants in the left recording site, indicating clear CP of lexical tones in the attentive condition. By contrast, similar MMN responses in the right recording site were elicited by both the across- and within-category deviants, indicating the absence of CP effect with automatic phonological processing of lexical tones at the pre-attentive stage even in L2 learners with high Chinese proficiency. Conclusion Although behavioral data showed clear evidence of categorical perception of lexical tones in proficient L2 learners, ERP measures from passive and active listening tasks demonstrated fine-grained sensitivity in terms of response polarity, latency, and laterality in revealing different aspects of auditory versus linguistic processing associated with speech decoding by means of largely implicit native language acquisition versus effortful explicit L2 learning.

Effectiveness of Channel-Free Hearing Aid and Noise Desensitisation Training in Auditory Neuropathy Spectrum Disorder - Single Case Study

Auditory Neuropathy Spectrum Disorder is a rare condition wherein neural transmission through the VIIIth nerve and auditory brainstem is disrupted with intact peripheral hearing. Most frequently reported symptoms by individuals suffering from such conditions include impaired speech discrimination especially in presence of background noise. The aim of this single case study is to emphasize the effectiveness of channel-free technology as a rehabilitative option and to demonstrate the improvement in speech perception in noise with noise desensitisation training. A 24-year-old male patient reported to the National Institute of Speech and Hearing with the complaint of poor speech comprehension. The audiological profile revealed, bilateral moderate sensorineural hearing loss in pure tone audiometry with poor speech discrimination scores, bilateral ‘A’ type tympanogram with absent acoustic reflexes, good signal to noise ratio in otoacoustic emissions, and absent Auditory Brainstem Response at 95 dBnHL bilaterally suggestive of auditory neuropathy spectrum disorder in both the ears. As a part of rehabilitation, hearing aids with multiple channels and channel-free technology were tried and better speech discrimination scores were obtained with channel-free technology. In order to address poor speech discrimination in presence of noise, noise desensitisation training was given at different Signal to Noise Ratio with channel-free hearing aids and was found to be effective in improving the speech discrimination scores especially in adverse listening conditions. Key words: Auditory neuropathy spectrum disorder, Channel free hearing aid, Noise desensitisation.

Audiometric Characteristics of Presbycusis: A Hospital-Based Study

Background: Presbycusis is related to degenerative changes of aging resulting from deficient cochlear microcirculation. It is characterized by bilateral, symmetrical, sensorineural hearing loss (SNHL) in which recruitment and speech discrimination is affected in the absence of noise exposure. The objective of this study was to analyze the pure tone audiogram characteristics in Presbycusis. Methods: This descriptive study recruited n=192 cases of presbycusis of both genders, aged 50 to 80 years with convenience sampling technique. The study was conducted at Yusra General Hospital and the National Institute of Rehabilitation Medicine, Islamabad from1st July 2017 to 30th September 2017. Pure tone audiometry was used to collect audiometric data. SPSS-24 was used for data analysis. Chi-square and Pearson’s correlation were used to determine association between variables with p < 0.05 taken as significant. Results: Pure tone audiometry revealed 58 (30.2%) right and 65 (33.9%) left ears with high frequency gently sloping audiogram, while the second commonest configuration being high frequency steeply sloping curve in 51(26.6%) right and 52(27.1%) left ears. There was a significant correlation between the configuration of the audiogram and age with p=0.000, while no significant correlation with gender (p=0.71). The majority,77 (40.10%) right and 71(36.98%) of left ears had moderately severe hearing loss, while severe hearing loss was second commonest with 60(31.25%) right and 70(36.46%) left ears affected. The severity of hearing loss had a significant (P=0.000) positive correlation with age but no significant relationship with gender. Conclusion: High frequency gently sloping audiogram was the commonest configuration followed by high frequency steeply sloping curve. Moderately severe hearing loss was most commonly seen followed by severe hearing loss.