scholarly journals Effects of Expansion on Consonant Recognition and Consonant Audibility

2009 ◽  
Vol 20 (02) ◽  
pp. 119-127 ◽  
Author(s):  
Marc Brennan ◽  
Pamela Souza

Background: Hearing aid expansion is intended to reduce the gain for low-level noise. However, expansion can also degrade low-intensity speech. Although it has been suggested that the poorer performance with expansion is due to reduced audibility, this has not been measured directly. Furthermore, previous studies used relatively high expansion kneepoints. Purpose: This study compared the effect of a 30 dB SPL and 50 dB SPL expansion kneepoint on consonant audibility and recognition. Research Design: Eight consonant-vowel syllables were presented at 50, 60, and 71 dB SPL. Recordings near the tympanic membrane were made of each speech token and used to calculate the Aided Audibility Index (AAI). Study Sample: Thirteen subjects with mild to moderate sensorineural hearing loss. Results: Expansion with a high kneepoint resulted in reduced consonant recognition. The AAI correlated significantly with consonant recognition across all conditions and subjects. Conclusion: If consonant recognition is the priority, audibility calculations could be used to determine an optimal expansion kneepoint for a given individual.

2015 ◽  
Vol 26 (01) ◽  
pp. 068-079 ◽  
Author(s):  
Jürgen Kiessling ◽  
Melanie Leifholz ◽  
Steffen Unkel ◽  
Jörn Pons-Kühnemann ◽  
Charlotte Thunberg Jespersen ◽  
...  

Background: In-situ audiometry is a hearing aid feature that enables the measurement of hearing threshold levels through the hearing instrument using the built-in sound generator and the hearing aid receiver. This feature can be used in hearing aid fittings instead of conventional pure-tone audiometry (PTA), particularly in places where no standard audiometric equipment is available. Differences between conventional and in-situ thresholds are described and discussed for some particular hearing aids. No previous investigation has measured and compared these differences for a number of current hearing aid models by various manufacturers across a wide range of hearing losses. Purpose: The purpose of this study was to perform a model-based comparison of conventionally and in-situ measured hearing thresholds. Data were collected for a range of hearing aid devices to study and generalize the effects that may occur under clinical conditions. Research Design: Research design was an experimental and regression study. Study Sample: A total of 30 adults with sensorineural hearing loss served as test persons. They were assigned to three subgroups of 10 subjects with mild (M), moderate to severe (MS), and severe (S) sensorineural hearing loss. Intervention: All 30 test persons underwent both conventional PTA and in-situ audiometry with four hearing aid models by various manufacturers. Data Collection and Analysis: The differences between conventionally and in-situ measured hearing threshold levels were calculated and evaluated by an exploratory data analysis followed by a sophisticated statistical modeling process. Results: At 500 and 1500 Hz, almost all threshold differences (conventional PTA minus in-situ data) were negative, i.e., in the low to mid frequencies, hearing loss was overestimated by most devices relative to PTA. At 4000 Hz, the majority of differences (7 of 12) were positive, i.e., in the frequency range above 1500 Hz, hearing loss was frequently underestimated. As hearing loss increased (M→MS→S), the effect of the underestimation decreased. At 500 and 1500 Hz, Resound devices showed the smallest threshold deviations, followed by Phonak, Starkey, and Oticon instruments. At 4000 Hz, this observed pattern partly disappeared and Starkey and Oticon devices showed a reversed effect with increasing hearing loss (M→MS→S). Because of high standard errors for the estimates, only a few explicit rankings of the devices could be established based on significant threshold differences (5% level). Conclusions: Differences between conventional PTA and in-situ threshold levels may be attributed to (1) frequency, (2) device/hearing loss, and (3) calibration/manufacturer effects. Frequency effects primarily resulting in an overestimation of hearing loss by in-situ audiometry in the low and mid frequencies are mainly due to sound drain-off through vents and leaks. Device/hearing loss effects may be due to leakage as well as boundary effects because in-situ audiometry is confined to a limited measurement range. Finally, different calibration approaches may result in different offset levels between PTA and in-situ audiometry calibration. In some cases, the observed threshold differences of up to 10–15 dB may translate to varied hearing aid fittings for the same user depending on how hearing threshold levels were measured.


2010 ◽  
Vol 2 (2) ◽  
pp. 143-149
Author(s):  
Ashutosh G Pusalkar

Abstract Till about 15 years ago, the only choice of hearing improvement for moderate sensorineural hearing loss with severe speech discrimination defect was a hearing aid. It was only after Mr. Geoff Ball, an electronic engineer who was suffering from a similar defect, started thinking of an alternative to the conventional hearing aid that the Vibrant Soundbridge came into existence, and with the passage of time the indications for the use of the same have increased.


2017 ◽  
Author(s):  
Joanna Nkyekyer ◽  
Denny Meyer ◽  
Peter J Blamey ◽  
Andrew Pipingas ◽  
Sunil Bhar

BACKGROUND Sensorineural hearing loss is the most common sensory deficit among older adults. Some of the psychosocial consequences of this condition include difficulty in understanding speech, depression, and social isolation. Studies have shown that older adults with hearing loss show some age-related cognitive decline. Hearing aids have been proven as successful interventions to alleviate sensorineural hearing loss. In addition to hearing aid use, the positive effects of auditory training—formal listening activities designed to optimize speech perception—are now being documented among adults with hearing loss who use hearing aids, especially new hearing aid users. Auditory training has also been shown to produce prolonged cognitive performance improvements. However, there is still little evidence to support the benefits of simultaneous hearing aid use and individualized face-to-face auditory training on cognitive performance in adults with hearing loss. OBJECTIVE This study will investigate whether using hearing aids for the first time will improve the impact of individualized face-to-face auditory training on cognition, depression, and social interaction for adults with sensorineural hearing loss. The rationale for this study is based on the hypothesis that, in adults with sensorineural hearing loss, using hearing aids for the first time in combination with individualized face-to-face auditory training will be more effective for improving cognition, depressive symptoms, and social interaction rather than auditory training on its own. METHODS This is a crossover trial targeting 40 men and women between 50 and 90 years of age with either mild or moderate symmetric sensorineural hearing loss. Consented, willing participants will be recruited from either an independent living accommodation or via a community database to undergo a 6-month intensive face-to-face auditory training program (active control). Participants will be assigned in random order to receive hearing aid (intervention) for either the first 3 or last 3 months of the 6-month auditory training program. Each participant will be tested at baseline, 3, and 6 months using a neuropsychological battery of computer-based cognitive assessments, together with a depression symptom instrument and a social interaction measure. The primary outcome will be cognitive performance with regard to spatial working memory. Secondary outcome measures include other cognition performance measures, depressive symptoms, social interaction, and hearing satisfaction. RESULTS Data analysis is currently under way and the first results are expected to be submitted for publication in June 2018. CONCLUSIONS Results from the study will inform strategies for aural rehabilitation, hearing aid delivery, and future hearing loss intervention trials. CLINICALTRIAL ClinicalTrials.gov NCT03112850; https://clinicaltrials.gov/ct2/show/NCT03112850 (Archived by WebCite at http://www.webcitation.org/6xz12fD0B).


2017 ◽  
Vol 28 (10) ◽  
pp. 941-949 ◽  
Author(s):  
Charles E. Bishop ◽  
Elgenaid Hamadain ◽  
Jason A. Galster ◽  
Mary Frances Johnson ◽  
Christopher Spankovich ◽  
...  

Background: Unilateral sensorineural hearing loss (USNHL) can have a negative impact on functions associated with the advantages of balanced, binaural hearing. Although single-sided deafness, which is a complete loss of audibility in one ear, has gained increased interest in the published research, there is a gap in the literature concerning hearing aid outcomes for individuals with residual, or otherwise “aidable,” hearing in the affected ear. Purpose: To assess hearing aid outcomes for a group of individuals with USNHL with residual, aidable function. Research Design: A quasi-experimental study of hearing aid outcomes with paired comparisons made between unaided and aided test conditions. Study Sample: A convenience sample of twenty-two individuals with USNHL, with sufficient residual hearing in the affected ear as to receive audibility from use of a hearing aid, were recruited into the study from September 2011 to August 2012. Intervention: Each participant was fit with a digital behind-the-ear hearing aid coupled to a custom ear mold. Data Collection and Analysis: Assessments were performed at baseline (unaided) and after a three-month field trial (aided) with primary outcomes involving objective measures in sound field yielding signal-to-noise ratio loss (SNR Loss) via the Quick Speech-in-Noise Test and word recognition scores (WRS) via the Northwestern University Auditory Test, No. 6. Outcomes also involved the administration of two well-established subjective benefit questionnaires: The Abbreviated Profile of Hearing Aid Benefit (APHAB) and the 49-item Speech, Spatial, and Qualities of Hearing Scale (SSQ49). Results: As a group, participants showed significantly improved median SNR Loss thresholds when aided in a test condition that included spatial separation of speech and noise, with speech stimuli directed toward the worse ear and noise stimuli directed toward the better ear (diff. = −4.5; p < 0.001). Hearing aid use had a small, though statistically significant, negative impact on median SNR Loss thresholds, when speech and noise stimuli originated from the same 0° azimuth (diff. = 1.0; p = 0.018). This was also evidenced by the median WRS in sound field (diff. = −6.0; p = 0.006), which was lowered from 98% in the unaided state to 92% in the aided state. Results from the SSQ49 showed statistically significant improvement on all subsection means when participants were aided (p < 0.05), whereas results from the APHAB were generally found to be unremarkable between unaided and aided conditions as benefit was essentially equal to the 50th percentile of the normative data. At the close of the study, it was observed that only slightly more than half of all participants chose to continue use of a hearing aid after their participation. Conclusions: We observed that hearing aid use by individuals with USNHL can improve the SNR Loss associated with the interference of background noise, especially in situations when there is spatial separation of the stimuli and speech is directed toward the affected ear. In addition, hearing aid use by these individuals can provide subjective benefit, as evidenced by the APHAB and SSQ49 subjective benefit questionnaires.


1994 ◽  
Vol 3 (2) ◽  
pp. 71-77 ◽  
Author(s):  
James J. Dempsey ◽  
Mark Ross

A large number of personal amplifiers have recently become available commercially. These devices have not been classified as hearing aids by the FDA and are therefore not subject to the FDA rules and regulations governing the sales of hearing aid devices. In this investigation, several of these personal amplifiers were evaluated to determine potential benefits and problems for each device. The devices were evaluated electroacoustically and, also, subjectively by a group of adults with sensorineural hearing loss. The results of the electroacoustic evaluation revealed very sharply peaked frequency responses. The subjective evaluations revealed tremendous variability, with some preferences for power and low-frequency amplification. Clinical implications of these results and suggestions for further research are provided.


2004 ◽  
Vol 15 (09) ◽  
pp. 605-615 ◽  
Author(s):  
Thomas F. Muller ◽  
Frances P. Harris ◽  
John C. Ellison

Eighteen experienced hearing aid users with mild to moderate sensorineural hearing loss were fit with a digital hearing instrument. An adaptive procedure was used to determine their preferred gain setting for continuous speech under six conditions. Release time (RT) was set to 40, 160, or 640 msec. A prerecorded speech stimulus was presented in quiet or in the presence of multitalker babble (10 dB signal-to-babble ratio); all other compression variables were fixed. Real-ear data obtained with settings for each condition suggest that RT did not affect gain preference; however, subjects preferred higher gain in the presence of the multitalker babble. The RMS amplitudes of 30 phonemic units were calculated using ear canal recordings of the speech stimulus for each subject in each condition. Altering RT resulted primarily in decreased amplitude with increased RT, but this effect was not predictable across listeners or conditions.


2012 ◽  
Vol 23 (04) ◽  
pp. 241-248
Author(s):  
Steven P. Smith ◽  
Simon Milov ◽  
Joel A. Goebel

This case study summarizes findings in an adult male, aged 57, who presented to the Adult Audiology Clinic with aural atresia in the right ear resulting in a conductive hearing loss and a sudden sensorineural hearing loss in the left ear. Treatment options included reconstruction surgery in the right ear, bone anchored hearing aid in the right ear to overcome the conductive hearing loss, bone anchored hearing aid in the left ear for single sided deafness, and intratympanic steroid injections in the left ear to salvage hearing.This case study highlights that when a patient is educated on all available options the patient is then able to make a decision comfortable to him and to help improve his hearing.


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