scholarly journals Improving Sensitivity of the Digits-in-Noise Test using Antiphasic Stimuli

2019 ◽  
Author(s):  
Karina C. De Sousa ◽  
De Wet Swanepoel ◽  
David R. Moore ◽  
Hermanus Carel Myburgh ◽  
Cas Smits
Keyword(s):  
Hearing Loss ◽  
Repeated Measures ◽  
Regression Line ◽  
Normal Hearing ◽  
Test Duration ◽  
Strongly Correlated ◽  
Operating Characteristics ◽  
Cross Sectional ◽  
Repeated Measures Design ◽  
Noise Test

ABSTRACTObjectiveThe digits-in-noise test (DIN) has become increasingly popular as a consumer-based method to screen for hearing loss. Current versions of all DINs either test ears monaurally or present identical stimuli binaurally (i.e., diotic noise and speech, NoSo). Unfortunately, presentation of identical stimuli to each ear inhibits detection of unilateral sensorineural hearing loss (SNHL), and neither diotic nor monaural presentation sensitively detects conductive hearing loss (CHL). Following an earlier finding of enhanced sensitivity in normally hearing listeners, this study tested the hypothesis that interaural antiphasic digit presentation (NoSπ) would improve sensitivity to hearing loss caused by unilateral or asymmetric SNHL, symmetric SNHL, or CHL.DesignThis cross-sectional study, recruited adults (18-84 years) with various levels of hearing, based on a four-frequency pure tone average (PTA) at 0.5, 1, 2 and 4kHz. The study sample was comprised of listeners with normal hearing (n=41; PTA ≤ 25 dB HL in both ears), symmetric SNHL (n=57; PTA > 25 dB HL), unilateral or asymmetric SNHL (n=24; PTA > 25 dB HL in the poorer ear) and CHL (n=23; PTA > 25 dB HL and PTA air-bone gap ≥ 20 dB HL in the poorer ear). Antiphasic and diotic speech reception thresholds (SRTs) were compared using a repeated-measures design.ResultsAntiphasic DIN was significantly more sensitive to all three forms of hearing loss than the diotic DIN. SRT test-retest reliability was high for all tests (ICC r > 0.89). Area under the receiver operating characteristics (ROC) curve for detection of hearing loss (> 25 dB HL) was higher for antiphasic DIN (0.94) than for diotic DIN (0.77) presentation. After correcting for age, PTA of listeners with normal hearing or symmetric SNHL was more strongly correlated with antiphasic (rpartial[96]=0.69) than diotic (rpartial=0.54) SRTs. Slope of fitted regression lines predicting SRT from PTA was significantly steeper for antiphasic than diotic DIN. For listeners with normal hearing or CHL, antiphasic SRTs were more strongly correlated with PTA (rpartial[62]=0.92) than diotic SRTs (rpartial[62]=0.64). Slope of regression line with PTA was also significantly steeper for antiphasic than diotic DIN. Severity of asymmetric hearing loss (poorer ear PTA) was unrelated to SRT. No effect of self-reported English competence on either antiphasic or diotic DIN among the mixed first-language participants was observedConclusionsAntiphasic digit presentation markedly improved the sensitivity of the DIN test to detect SNHL, either symmetric or asymmetric, while keeping test duration to a minimum by testing binaurally. In addition, the antiphasic DIN was able to detect CHL, a shortcoming of previous monaural or binaurally diotic DIN versions. The antiphasic DIN is thus a powerful tool for population-based screening. This enhanced functionality combined with smartphone delivery could make the antiphasic DIN suitable as a primary screen that is accessible to a large global audience.

The Words-in-Noise Test (WIN), List 3: A Practice List

2012 ◽  
Vol 23 (02) ◽  
pp. 092-096 ◽  
Author(s):  
Richard H. Wilson ◽  
Kelly L. Watts
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Repeated Measures ◽  
Word List ◽  
Normal Hearing ◽  
Sensorineural Hearing ◽  
Practice List ◽  
Repeated Measures Design ◽  
Noise Test ◽  
The Individual

Background: The Words-in-Noise Test (WIN) was developed as an instrument to quantify the ability of listeners to understand monosyllabic words in background noise using multitalker babble (Wilson, 2003). The 50% point, which is calculated with the Spearman-Kärber equation (Finney, 1952), is used as the evaluative metric with the WIN materials. Initially, the WIN was designed as a 70-word instrument that presented ten unique words at each of seven signal-to-noise ratios from 24 to 0 dB in 4 dB decrements. Subsequently, the 70-word list was parsed into two 35-word lists that achieved equivalent recognition performances (Wilson and Burks, 2005). This report involves the development of a third list (WIN List 3) that was developed to serve as a practice list to familiarize the participant with listening to words presented in background babble. Purpose: To determine—on young listeners with normal hearing and on older listeners with sensorineural hearing loss—the psychometric properties of the WIN List 3 materials. Research Design: A quasi-experimental, repeated-measures design was used. Study Sample: Twenty-four young adult listeners (M = 21.6 yr) with normal pure-tone thresholds (≤20 dB HL at 250 to 8000 Hz) and 24 older listeners (M = 65.9 yr) with sensorineural hearing loss participated. Data Collection and Analysis: The level of the babble was fixed at 80 dB SPL with the level of the words varied from 104 to 80 dB SPL in 4 dB decrements. Results: For listeners with normal hearing, the 50% points for Lists 1 and 2 were similar (4.3 and 5.1 dB S/N, respectively), both of which were lower than the 50% point for List 3 (7.4 dB S/N). A similar relation was observed with the listeners with hearing loss, 50% points for Lists 1 and 2 of 12.2 and 12.4 dB S/N, respectively, compared to 15.8 dB S/N for List 3. The differences between Lists 1 and 2 and List 3 were significant. The relations among the psychometric functions and the relations among the individual data both reflected these differences. Conclusions: The significant ˜3 dB difference between performances on WIN Lists 1 and 2 and on WIN List 3 by the listeners with normal hearing and the listeners with hearing loss dictates caution with the use of List 3. The use of WIN List 3 should be reserved for ancillary purposes in which equivalent recognition performances are not required, for example, as a practice list or a stand alone measure.

scholarly journals An Automated Speech-in-Noise Test for Remote Testing: Development and Preliminary Evaluation

2020 ◽  
Vol 29 (3S) ◽  
pp. 564-576 ◽  
Author(s):  
Alessia Paglialonga ◽  
Edoardo Maria Polo ◽  
Marco Zanet ◽  
Giulia Rocco ◽  
Toon van Waterschoot ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Test Performance ◽  
Repeated Measures ◽  
Pearson Correlation ◽  
Test Time ◽  
Preliminary Evaluation ◽  
Test Duration ◽  
Adaptive Procedure ◽  
Speech In Noise ◽  
Noise Test

Purpose The aim of this study was to develop and evaluate a novel, automated speech-in-noise test viable for widespread in situ and remote screening. Method Vowel–consonant–vowel sounds in a multiple-choice consonant discrimination task were used. Recordings from a professional male native English speaker were used. A novel adaptive staircase procedure was developed, based on the estimated intelligibility of stimuli rather than on theoretical binomial models. Test performance was assessed in a population of 26 young adults (YAs) with normal hearing and in 72 unscreened adults (UAs), including native and nonnative English listeners. Results The proposed test provided accurate estimates of the speech recognition threshold (SRT) compared to a conventional adaptive procedure. Consistent outcomes were observed in YAs in test/retest and in controlled/uncontrolled conditions and in UAs in native and nonnative listeners. The SRT increased with increasing age, hearing loss, and self-reported hearing handicap in UAs. Test duration was similar in YAs and UAs irrespective of age and hearing loss. The test–retest repeatability of SRTs was high (Pearson correlation coefficient = .84), and the pass/fail outcomes of the test were reliable in repeated measures (Cohen's κ = .8). The test was accurate in identifying ears with pure-tone thresholds > 25 dB HL (accuracy = 0.82). Conclusion This study demonstrated the viability of the proposed test in subjects of varying language in terms of accuracy, reliability, and short test time. Further research is needed to validate the test in a larger population across a wider range of languages and hearing loss and to identify optimal classification criteria for screening purposes.

Hearing Loss and Age-Induced Changes in the Central Auditory System Measured by the P3 Response to Small Changes in Frequency

2017 ◽  
Vol 28 (05) ◽  
pp. 373-384
Author(s):  
Kathy R. Vander Werff ◽  
Kerrie L. Nesbitt
Keyword(s):  
Hearing Loss ◽  
High Frequency ◽  
Repeated Measures ◽  
Cortical Plasticity ◽  
Normal Hearing ◽  
Oddball Paradigm ◽  
Older Individuals ◽  
Repeated Measures Design ◽  
Potential System ◽  
Frequency Changes

Background: Recent behavioral studies have suggested that individuals with sloping audiograms exhibit localized improvements in frequency discrimination in the frequency region near the drop in hearing. Auditory-evoked potentials may provide evidence of such cortical plasticity and reorganization of frequency maps. Purpose: The objective of this study was to evaluate electrophysiological evidence of cortical plasticity related to cortical frequency representation and discrimination abilities in older individuals with high-frequency sensorineural hearing loss (SNHL). It was hypothesized that the P3 response in this group would show evidence of physiological reorganization of frequency maps and enhanced neural representation at the edge of their high-frequency loss due to their restricted SNHL. Research Design: The P3 auditory event-related potential in response to small frequency changes was recorded in a repeated measures design using an oddball paradigm that presented upward and downward frequency changes of 2%, 5%, and 20% to three groups of listeners. Study Sample: P3 recordings from a group of seven older individuals with a restricted sloping hearing loss >1000 or 2000 Hz was compared to two control groups of younger (n = 7) and older (n = 7) individuals with normal hearing/borderline normal hearing through 4000 Hz. Data Collection and Analysis: The auditory P3 was recorded using an oddball paradigm (80%/20%) with the standard tone at the highest frequency of normal hearing in the hearing-impaired participants, also known as the edge frequency (EF). EFs were either 1000 or 2000 Hz for all participants. The target tones represented upward and downward frequency changes of 2%, 5%, and 20% from the standard tones of either 1000 or 2000 Hz. Waveforms were recorded using a two-channel clinical-evoked potential system. Latency and amplitude of the P300 peak were analyzed across groups for the three frequency conditions using repeated measures analysis of variance. Results: The results of this study suggest that the P3 response can be elicited by frequency changes as small as 2–5%. P3 responses at the EF of hearing loss were present and larger in amplitude for more participants with a sloping hearing loss compared to age-matched normal-hearing peers tested at the same frequencies. As a result, the older participants with sloping hearing losses had P3 responses more similar to the younger normal-hearing participants than their age-matched peers with normal hearing. Conclusions: These preliminary results partially support the idea of enhanced cortical representation of frequency at the EF of localized SNHL in older adults that is not purely due to age.

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.

The Revised Speech Perception in Noise Test (R-SPIN) in a Multiple Signal-to-Noise Ratio Paradigm

2012 ◽  
Vol 23 (08) ◽  
pp. 590-605 ◽  
Author(s):  
Richard H. Wilson ◽  
Rachel McArdle ◽  
Kelly L. Watts ◽  
Sherri L. Smith
Keyword(s):  
Hearing Loss ◽  
Speech Perception ◽  
Repeated Measures ◽  
Signal To Noise Ratio ◽  
Normal Hearing ◽  
Signal To Noise ◽  
Speech Perception In Noise ◽  
Noise Test ◽  
Noise Ratio ◽  
Better Than

Background: The Revised Speech Perception in Noise Test (R-SPIN; Bilger, 1984b) is composed of 200 target words distributed as the last words in 200 low-predictability (LP) and 200 high-predictability (HP) sentences. Four list pairs, each consisting of two 50-sentence lists, were constructed with the target word in a LP and HP sentence. Traditionally the R-SPIN is presented at a signal-to-noise ratio (SNR, S/N) of 8 dB with the listener task to repeat the last word in the sentence. Purpose: The purpose was to determine the practicality of altering the R-SPIN format from a single SNR paradigm into a multiple SNR paradigm from which the 50% points for the HP and LP sentences can be calculated. Research Design: Three repeated measures experiments were conducted. Study Sample: Forty listeners with normal hearing and 184 older listeners with pure-tone hearing loss participated in the sequence of experiments. Data Collection and Analysis: The R-SPIN sentences were edited digitally (1) to maintain the temporal relation between the sentences and babble, (2) to establish the SNRs, and (3) to mix the speech and noise signals to obtain SNRs between –1 and 23 dB. All materials were recorded on CD and were presented through an earphone with the responses recorded and analyzed at the token level. For reference purposes the Words-in-Noise Test (WIN) was included in the first experiment. Results: In Experiment 1, recognition performances by listeners with normal hearing were better than performances by listeners with hearing loss. For both groups, performances on the HP materials were better than performances on the LP materials. Performances on the LP materials and on the WIN were similar. Performances at 8 dB S/N were the same with the traditional fixed level presentation and the descending presentation level paradigms. The results from Experiment 2 demonstrated that the four list pairs of R-SPIN materials produced good first approximation psychometric functions over the –4 to 23 dB S/N range, but there were irregularities. The data from Experiment 2 were used in Experiment 3 to guide the selection of the words to be used at the various SNRs that would provide homogeneous performances at each SNR and would produce systematic psychometric functions. In Experiment 3, the 50% points were in good agreement for the LP and HP conditions within both groups of listeners. The psychometric functions for List Pairs 1 and 2, 3 and 4, and 5 and 6 had similar characteristics and maintained reasonable separations between the HP and LP functions, whereas the HP and LP functions for List Pair 7 and 8 bisected one another at the lower SNRs. Conclusions: This study indicates that the R-SPIN can be configured into a multiple SNR paradigm. A more in-depth study with the R-SPIN materials is needed to develop lists that are systematic and reasonably equivalent for use on listeners with hearing loss. The approach should be based on the psychometric characteristics of the 200 HP and 200 LP sentences with the current R-SPIN lists discarded. Of importance is maintaining the synchrony between the sentences and their accompanying babble.

A Comparison of Recognition Performances in Speech-Spectrum Noise by Listeners with Normal Hearing on PB-50, CID W-22, NU–6, W-1 Spondaic Words, and Monosyllabic Digits Spoken by the Same Speaker

2008 ◽  
Vol 19 (06) ◽  
pp. 496-506 ◽  
Author(s):  
Richard H. Wilson ◽  
Rachel McArdle ◽  
Heidi Roberts
Keyword(s):  
Word Recognition ◽  
Repeated Measures ◽  
Recognition Performance ◽  
Normal Hearing ◽  
Psychometric Characteristics ◽  
Monosyllabic Word ◽  
Repeated Measures Design ◽  
Word Lists ◽  
Monosyllabic Words ◽  
Speech Spectrum

Background: So that portions of the classic Miller, Heise, and Lichten (1951) study could be replicated, new recorded versions of the words and digits were made because none of the three common monosyllabic word lists (PAL PB-50, CID W-22, and NU–6) contained the 9 monosyllabic digits (1–10, excluding 7) that were used by Miller et al. It is well established that different psychometric characteristics have been observed for different lists and even for the same materials spoken by different speakers. The decision was made to record four lists of each of the three monosyllabic word sets, the monosyllabic digits not included in the three sets of word lists, and the CID W-1 spondaic words. A professional female speaker with a General American dialect recorded the materials during four recording sessions within a 2-week interval. The recording order of the 582 words was random. Purpose: To determine—on listeners with normal hearing—the psychometric properties of the five speech materials presented in speech-spectrum noise. Research Design: A quasi-experimental, repeated-measures design was used. Study Sample: Twenty-four young adult listeners (M = 23 years) with normal pure-tone thresholds (≤20-dB HL at 250 to 8000 Hz) participated. The participants were university students who were unfamiliar with the test materials. Data Collection and Analysis: The 582 words were presented at four signal-to-noise ratios (SNRs; −7-, −2-, 3-, and 8-dB) in speech-spectrum noise fixed at 72-dB SPL. Although the main metric of interest was the 50% point on the function for each word established with the Spearman-Kärber equation (Finney, 1952), the percentage correct on each word at each SNR was evaluated. The psychometric characteristics of the PB-50, CID W-22, and NU–6 monosyllabic word lists were compared with one another, with the CID W-1 spondaic words, and with the 9 monosyllabic digits. Results: Recognition performance on the four lists within each of the three monosyllabic word materials were equivalent, ±0.4 dB. Likewise, word-recognition performance on the PB-50, W-22, and NU–6 word lists were equivalent, ±0.2 dB. The mean recognition performance at the 50% point with the 36 W-1 spondaic words was ˜6.2 dB lower than the 50% point with the monosyllabic words. Recognition performance on the monosyllabic digits was 1–2 dB better than mean performance on the monosyllabic words. Conclusions: Word-recognition performances on the three sets of materials (PB-50, CID W-22, and NU–6) were equivalent, as were the performances on the four lists that make up each of the three materials. Phonetic/phonemic balance does not appear to be an important consideration in the compilation of word-recognition lists used to evaluate the ability of listeners to understand speech.A companion paper examines the acoustic, phonetic/phonological, and lexical variables that may predict the relative ease or difficulty for which these monosyllable words were recognized in noise (McArdle and Wilson, this issue).

scholarly journals Effectiveness Of Transient Evoked Otoacoustic Emission (TEOAE) Test For Neonatal Auditory Screening

2018 ◽  
Vol 08 (02) ◽  
pp. 77-81
Author(s):  
Shanila Feroz ◽  
Iqbal Hussain Udaipurwala ◽  
Danish Muhammad Khan ◽  
Fatima Iqbal Hussain
Keyword(s):  
Hearing Loss ◽  
Predictive Value ◽  
False Negative ◽  
Otoacoustic Emission ◽  
Normal Hearing ◽  
Speech Development ◽  
True Negative ◽  
Cross Sectional ◽  
Transient Evoked Otoacoustic Emission

Objective: The purpose of this study is to assess the efficacy of Transient Evoked Otoacoustic Emission (TEOAE) as screening test for auditory function in neonates. Study Design: A cross-sectional study Place and Duration of Study: This study was conducted at United Medical and Dental College, Creek General Hospital, Karachi, from July 2106 to May 2017. A total number of 120 newborn babies were screened for hearing loss before discharge from hospital but 20 were lost for follow up and 100 cases were included in this study. Method: TEOAE was done in all neonates born during this period at 3rd day after birth. Those who were found to have hearing loss, TEOAE was repeated at the end of 1st week and again in 6th week after birth. BERA was done in those cases who showed hearing loss on TEOAE on all three occasions. All the 100 cases were followed up regularly for more than one year for appearance of any sign or symptom related with hearing loss or speech development failure. Result: Out of 100 cases included in this study, 96 were found to have no hearing loss on TEOAE and 1 on BERA test. Remaining three cases were found to have hearing loss on both TEOAE and BERA test. True negative cases where no hearing loss was found on TEOAE and subsequent follow up were 96. True positive cases were 3 where hearing loss was found on TEOAE and BERA and also on subsequent follow-up. False positive case was 1, where hearing loss was detected on TEOAE but BERA showed normal hearing and subsequent follow-up also showed normal hearing and false negative result was not detected in any case. Sensitivity of TEOAE was found to be 100%, specificity is 98.9%, accuracy is 99%, positive predictive value is 75% and negative predictive value is 100% in this study. Conclusion: TEOAE was found to be a cost-effective and practicable method of recognizing congenital hearing loss. It should be done in all newborns as routine screening for hearing loss

N1-P2 Recordings to Gaps in Broadband Noise

2013 ◽  
Vol 24 (01) ◽  
pp. 037-045 ◽  
Author(s):  
Shannon B. Palmer ◽  
Frank E. Musiek
Keyword(s):  
Temporal Resolution ◽  
Repeated Measures ◽  
Evoked Potential ◽  
Detection Threshold ◽  
Normal Hearing ◽  
Broadband Noise ◽  
Gap Detection ◽  
Electrophysiological Response ◽  
Repeated Measures Design ◽  
Waveform Amplitude

Background: Normal temporal processing is important for the perception of speech in quiet and in difficult listening situations. Temporal resolution is commonly measured using a behavioral gap detection task, where the patient or subject must participate in the evaluation process. This is difficult to achieve with subjects who cannot reliably complete a behavioral test. However, recent research has investigated the use of evoked potential measures to evaluate gap detection. Purpose: The purpose of the current study was to record N1-P2 responses to gaps in broadband noise in normal hearing young adults. Comparisons were made of the N1 and P2 latencies, amplitudes, and morphology to different length gaps in noise in an effort to quantify the changing responses of the brain to these stimuli. It was the goal of this study to show that electrophysiological recordings can be used to evaluate temporal resolution and measure the influence of short and long gaps on the N1-P2 waveform. Research Design: This study used a repeated-measures design. All subjects completed a behavioral gap detection procedure to establish their behavioral gap detection threshold (BGDT). N1-P2 waveforms were recorded to the gap in a broadband noise. Gap durations were 20 msec, 2 msec above their BGDT, and 2 msec. These durations were chosen to represent a suprathreshold gap, a near-threshold gap, and a subthreshold gap. Study Sample: Fifteen normal-hearing young adult females were evaluated. Subjects were recruited from the local university community. Data Collection and Analysis: Latencies and amplitudes for N1 and P2 were compared across gap durations for all subjects using a repeated-measures analysis of variance. A qualitative description of responses was also included. Results: Most subjects did not display an N1-P2 response to a 2 msec gap, but all subjects had present clear evoked potential responses to 20 msec and 2+ msec gaps. Decreasing gap duration toward threshold resulted in decreasing waveform amplitude. However, N1 and P2 latencies remained stable as gap duration changed. Conclusions: N1-P2 waveforms can be elicited by gaps in noise in young normal-hearing adults. The responses are present as low as 2 msec above behavioral gap detection thresholds (BGDT). Gaps that are below BGDT do not generally evoke an electrophysiological response. These findings indicate that when a waveform is present, the gap duration is likely above their BGDT. Waveform amplitude is also a good index of gap detection, since amplitude decreases with decreasing gap duration. Future studies in this area will focus on various age groups and individuals with auditory disorders.

scholarly journals The Relationship between Severity of Hearing Loss and Subjective Tinnitus Loudness among Patients Seen in a Specialist Tinnitus and Hyperacusis Therapy Clinic in UK

2019 ◽  
Vol 30 (08) ◽  
pp. 712-719 ◽  
Author(s):  
Hashir Aazh ◽  
Richard Salvi
Keyword(s):  
Hearing Loss ◽  
Regression Model ◽  
Pure Tone ◽  
Cross Sectional Study ◽  
Emotional Disturbances ◽  
Self Report ◽  
Strongly Correlated ◽  
Cross Sectional ◽  
The Impact ◽  
The Relationship

AbstractHearing loss is often associated with the phantom sound of tinnitus. However, the degree of the association between severity of hearing loss and tinnitus loudness taking into account the impact of other variables (e.g., emotional disturbances) is not fully understood. This is an important question for audiologists who are specialized in tinnitus rehabilitation as patients often ask whether the loudness of their tinnitus will increase if their hearing gets worse.To explore the relationship between tinnitus loudness and pure tone hearing thresholds.This was a retrospective cross-sectional study.445 consecutive patients who attended a Tinnitus and Hyperacusis Therapy Specialist Clinic in UK were included.The results of audiological tests and self-report questionnaires were gathered retrospectively from the records of the patients. Multiple-regression analysis was used to assess the relationship between tinnitus loudness, hearing loss and other variables.The regression model showed a significant relationship between the pure tone average (PTA) at the frequencies 0.25, 0.5, 1, 2, and 4 kHz of the better ear and the tinnitus loudness as measured via visual analogue scale (VAS), r (regression coefficient) = 0.022 (p < 0.001). Other variables significantly associated with tinnitus loudness were tinnitus annoyance (r = 0.49, p < 0.001) and the effect of tinnitus on life (r = 0.09, p = 0.006). The regression model explained 52% of the variance of tinnitus loudness.Although increased tinnitus loudness was associated with worse PTA, the relationship was very weak. Tinnitus annoyance and impact of tinnitus on life were more strongly correlated with tinnitus loudness than PTA.

An Electrophysiological Measure of Binaural Hearing in Noise

2008 ◽  
Vol 19 (06) ◽  
pp. 481-495 ◽  
Author(s):  
Jeffrey Weihing ◽  
Frank E. Musiek
Keyword(s):  
Noise Level ◽  
Repeated Measures ◽  
Otoacoustic Emissions ◽  
Pure Tone Audiometry ◽  
Binaural Hearing ◽  
Normal Hearing ◽  
Noise Levels ◽  
Repeated Measures Design ◽  
Brainstem Response ◽  
Different Levels

Background: A common complaint of patients with (central) auditory processing disorder is difficulty understanding speech in noise. Because binaural hearing improves speech understanding in compromised listening situations, quantifying this ability in different levels of noise may yield a measure with high clinical utility. Purpose: To examine binaural enhancement (BE) and binaural interaction (BI) in different levels of noise for the auditory brainstem response (ABR) and middle latency response (MLR) in a normal hearing population. Research Design: An experimental study in which subjects were exposed to a repeated measures design. Study Sample: Fifteen normal hearing female adults served as subjects. Normal hearing was assessed by pure-tone audiometry and otoacoustic emissions. Intervention: All subjects were exposed to 0, 20, and 35 dB effective masking (EM) of white noise during monotic and diotic click stimulation. Data Collection and Analysis: ABR and MLR responses were simultaneously acquired. Peak amplitudes and latencies were recorded and compared across conditions using a repeated measures analysis of variance (ANOVA). Results: For BE, ABR results showed enhancement at 0 and 20 dB EM, but not at 35 dB EM. The MLR showed BE at all noise levels, but the degree of BE decreased with increasing noise level. For BI, both the ABR and MLR showed BI at all noise levels. However, the degree of BI again decreased with increasing noise level for the MLR. Conclusions: The results demonstrate the ability to measure BE simultaneously in the ABR and MLR in up to 20 dB of EM noise and BI in up to 35 dB EM of noise. Results also suggest that ABR neural generators may respond to noise differently than MLR generators.

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