Clinical and diagnostic characteristics of cochleovestibular function in patients of active working age after exposure to stress

Topicality: Long-term and pronounced psychoemotional tension leads to negative changes in the human body. Many aspects of cochleovestibular changes caused by psychoemotional stress are not studied enough to date. Aim: to increase the diagnostic efficiency of auditory and vestibular disorders in patients of active working age after exposure to stress. Materials and methods: 95 patients of active working age with dizziness, which manifested under stress, and 10 persons of control group were studied. The following tests were performed to all patients: survey with the questionnaire "Comprehensive stress assessment", pure tone and speech audiometry, measurement with filtered speech discrimination tests, assessment of the auditory adaptation level, impedancemetry, registration of auditory brainstem responses (ABR), computed static posturography, vestibular testing. Results and discussion: All subjects were divided into three groups according to the results of the survey with the questionnaire "Comprehensive stress assessment": Group 1 included 21 patients with moderate stress, Group 2 included 35 persons with severe stress that could not be compensated and Group 3 included 39 persons under severe stress, moreover 10 of them were on the verge of exhaustion of adaptive capacities. 60 (63.2 %) patients had normal hearing. 24 (25.2 %) subjects had statistically significant (P <0.05) hearing impairment in the high frequency zone compared with the control group, a statistically significant difference in hearing impairment was detected in the entire frequency range in 11 (11.6 %) persons. Central auditory processing disorders were detected in more than half of patients (according to various tests – from 29 (30.5 %) to 49 (51.6 %) persons). Central vestibular syndrome of varying severity was diagnosed in all 95 patients. The most pronounced disorders of balance according to posturography have been reported in patients with severe stress with vision deprivation in the position with closed eyes. Conclusions: An integrated approach allowed to identify and select, besides traditional research methods, supplementary diagnostic measures for optimal assessment of cochleovestibular changes in patients of active working age after exposure to stress, to detect cochleovestibular disorders and differential topical diagnostics of disorders of the central or peripheral portions of the auditory and vestibular analyzers. These included psychological testing, a test battery to determine central auditory processing disorders – hearing adaptation with load, filtered speech discrimination tests, registration of ABR, registration of postural balance using the Wii Balance Board platform, vestibular testing.

Development of ukrainian speech discrimination tests for children (phase of formation of tables with words)

Topicality: The speech audiometry is an essential diagnostic method which allows to fully assess the effectiveness of the cochlear implantation and hearing aids, to identify the central auditory processing disorders among the patients. Ukrainian audiologists have all necessary tools to perform classical speech audiometry and determine speech discrimination in the difficult acoustic conditions in adults. But it should be said that Ukrainian speech tests for children haven’t been developed yet. Aim: to develop and implement the Ukrainian speech discrimination tests for children. To solve the problem of speech audiometry in Ukraine it was decided to develop several speech discrimination tests for children of different ages and needs. At the first stage the authors have formed the groups with Ukrainian words for speech audiometry in children (starting from preschool age) and made a studio recording of the test that should be tested and validated futher. The formed word groups meet with all the requirements for phonetically balanced speech discrimination tests taking into consideration the peculiarities of children’s audiometry. The following principles were adhered in each group: the presence of all Ukrainian vowel phonemes in the stressed syllable and consonants with different frequency; the presence of words with different numbers of syllables; taking into consideration the rhythmic structure of the word (stress place); keeping a constant ratio of vowels and consonants. The article presents the primary (not yet valid) version of the Ukrainian speech discrimination test for children’s audiometry. Studio recording of this test will be tested in children with normal and impaired hearing as well as in users of hearing aids and cochlear implants. Conclusions: For the first time in Ukraine the tables with words have been formed in the native language for the audiometry in children (starting from the preschool age). The studio recording of the speech discrimination test was done with the female voice. Hence the next phase of development of the Ukrainian speech tests for children is planned the sence of which will be to approbate and validate.

Sound Evaluation of Partially Implantable Piezoelectric Middle Ear Implant: Comparative Study of Frequency Responses

Two comparative studies were performed in six subjects using partially implantable middle ear implants (MEI). The sound quality was evaluated by speech discrimination tests and sound evaluation tests. In the first experiment, the performance of the output transducer of the MEI and an ear phone of a conventional hearing aid was compared. The MEI showed better results than the hearing aid in both the speech discrimination tests and sound quality rating. In the second experiment, four kinds of frequency responses for the external component of the MEI were compared. Sound quality evaluation in a wide frequency response with a peak at 4000 Hz were superior to those with the frequency response of the present MEI model. In conclusion, improvement of the external component in the frequency response can provide better performance of the MEI.