摘要:

Objective:The purpose of this study was to examine children's speech recognition abilities for words and sentences presented in background noise when the children used omni-directional and dual-microphone hearing aid technology.Design:Twenty children (ten 4- to 6-yr olds; ten 7- to 11-yr-olds) with bilateral cochlear hearing loss (average four-frequency hearing loss = 57.25 dB HL; range: mild to severe) were included in the study. An adaptive test procedure was used to estimate a signal to noise ratio (SNR) that reduced individual speech recognition ability to 50% in multi-talker background competition. Testing was completed with the child seated in a conventional audiologic test suite. A fixed level of the speech signal was delivered through a loudspeaker located at 0°; noise varying in 2 dB steps was presented at 180°. SNR was estimated for two types of speech materials (closed-set words and sentences). Children wore binaural programmable hearing aids (Phonak PiCS) and were tested in conventional omni-directional and dual-microphone ("Audio Zoom") conditions.Results:Significant effects of microphone condition, speech material type (words and sentences), and age group ("younger" and "older") were revealed by mixed design analysis of variance. Overall, children received a mean advantage of 4.7 dB from listening in the dual-microphone condition. Children's performance was correlated with their chronological age and language age (receptive vocabulary) but not with their degree of hearing loss (except in one condition). Younger children required a more advantageous SNR to achieve the same performance criteria as older children.Conclusions:Under the specific test conditions used in this investigation, dual-microphone hearing aid technology provided a significant listening advantage in background competition over conventional omni-directional microphones for children with mild to severe cochlear hearing loss for both word and sentence test materials.

ISSN:0196-0202    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Objective:The speech-recognition advantages of wide-dynamic range compression (WDRC) hearing aids are believed to be a direct result of improved audibility. The main objective of this study was to compare the relationship between increasing audibility and recognition for compression-amplified versus linearly amplified speech, using a quantitative measure of audibility. A second objective was to explore the adequacy of the Aided Articulation Index(Stelmachowicz, Lewis, Kalberer, & Creutz, 1994)in describing performance with WDRC-amplified speech.Design:Sixteen listeners with mild to severe sensorineural hearing loss were tested on recognition of nonsense syllables that had been digitally processed with linear or WDRC amplification. Speech recognition scores were obtained for three input levels that differed in audibility relative to the listeners' hearing thresholds. An Aided Audibility Index (AAI), ranging from 0.0 (inaudible) to 1.0 (fully audible), was calculated for each listener and condition. This importance-weighted index represents the portion of the speech signal that is available to the listener. The relationship between audibility and recognition was then examined for each type of amplification.Results:At low and moderate input levels, AAI values and corresponding recognition scores were higher for the compression-amplified than for the linearly amplified speech. At high input levels, AAIs and recognition scores were essentially the same for both types of amplification. Recognition scores increased monotonically as a function of the AAI for both linear and WDRC amplifiers. There was no significant difference between the functions for linearly amplified versus compression-amplified speech. In other words, a given increase in audibility resulted in the same increase in recognition for both types of amplification.Conclusions:Increasing the amount of audible speech information plays the same role in recognition for compression-amplified as for linearly amplified speech. This suggests that, at least for the conditions tested here, compression does not introduce detrimental changes to the speech signal that offset the benefits of improved audibility. Accuracy of the compression-amplified AAI can be improved by substituting measured speech ranges for the estimated speech ranges used in the standard AAI calculation. In the absence of measured speech ranges, the standard AAI provides a close approximation.

ISSN:0196-0202    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Objective:To evaluate, in two separate experiments, the effects of intense noise exposures delivered to fetal sheep in utero during a time of rapid auditory development.Design:In the first experiment, auditory brain stem response (ABR) thresholds to clicks and tone bursts were recorded from chronically instrumented fetal sheep in utero before and after exposure of pregnant ewes to intense broadband noise. A single 16 hr exposure was delivered at 113 days gestational age, a time when the ABR is just emerging. Thresholds were compared with an age-matched, nonexposed control group. In the second experiment, fetal sheep at the same gestational age were exposed four times to broadband noise and their cochleae were harvested 20 days later for histological analysis by the use of scanning electron microscopy. Comparisons were made with an age-matched, nonexposed control group.Results:Experiment One: ABR thresholds recorded between 10 to 20 days after the exposure were not as sensitive as thresholds obtained from control fetuses. There was a tendency for thresholds to 0.5 kHz tone bursts to be more affected than thresholds to clicks. Experiment Two: Scanning electron microscopy of the organ of Corti from fetuses exposed to noise from 111 to 114 days gestational age revealed significant damage to inner and outer hair cells in the middle and apical turns of cochleae. Similar hair cell damage was not present in control fetuses.Conclusions:Intense exogenous noise penetrated the uterus of pregnant sheep and resulted in elevations in ABR thresholds 2 to 3 wk after exposure. In fetuses repeatedly exposed to noise, the middle and apical turns of the cochlea showed greater hair cell damage than found at the same locations in control cochlea. The basal turn of the cochlea was not damaged.

ISSN:0196-0202    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Objective:1) To determine whether the N1-P2 acoustic change complex is elicited by a change of periodicity in the middle of an ongoing stimulus, in the absence of changes of spectral envelope or rms intensity. 2) To compare the N1-P2 acoustic change complex with the mismatch negativity elicited by the same stimuli in terms of amplitude and signal to noise ratio.Design:The signals used in this study were a tonal complex and a band of noise having the same spectral envelope and rms intensity. For elicitation of the acoustic change complex, the signals were concatenated to produce two stimuli that changed in the middle (noise-tone, tone-noise). Two control stimuli were created by concatenating two copies of the noise and two copies of the tone (noise-only, tone-only). The stimuli were presented using an onset-to-onset interstimulus interval of 3 sec. For elicitation of the mismatch negativity, the tonal complex and noise band stimuli were presented using an oddball paradigm (deviant probability = 0.14) with an onset-to-onset interstimulus interval of 600 msec. The stimuli were presented via headphones at 80 dB SPL to 10 adults with normal hearing. Subjects watched a silent video during testing.Results:The responses to the noise-only and tone-only stimuli showed a clear N1-P2 complex to the onset of stimulation followed by a sustained potential that continued until the offset of stimulation. The noise-tone and tone-noise stimuli elicited an additional N1-P2 acoustic change complex in response to the change in periodicity occurring in the middle. The acoustic change complex was larger for the tone-noise stimulus than for the noise-tone stimulus. A clear mismatch negativity was elicited by both the noise band and tonal complex stimuli. In contrast to the acoustic change complex, there was no significant difference in amplitude across the two stimuli. The acoustic change complex was a more sensitive index of peripheral discrimination capacity than the mismatch negativity, primarily because its average amplitude was 2.5 times as large.Conclusions:These findings indicate that both the acoustic change complex and the mismatch negativity are sensitive indexes of the neural processing of changes in periodicity, though the acoustic change complex has an advantage in terms of amplitude. The results support the possible utility of the acoustic change complex as a clinical tool in the assessment of peripheral speech perception capacity.

ISSN:0196-0202    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Objective:This study outlines a series of experiments using the neural response telemetry (NRT) system of the Nucleus CI24M cochlear implant to measure the electrically evoked compound action potential (EAP). The goal of this investigation was to develop a protocol that allows successful recording of the EAP in a majority of CI24M cochlear implant users.Design:Twenty-six postlingually deafened adults participated in this study. A series of experiments were conducted that allowed us to examine how manipulation of stimulation and recording parameters may affect the morphology of the EAP recorded using the Nucleus NRT system.Results:Results of this study show consistent responses on at least some electrodes from all subjects. Cross-subject and cross electrode variations in both the growth of the response and the temporal refractory properties of the response were observed. The range of stimulus and recording parameters that can be used to record the EAP with the Nucleus NRT system is described.Conclusions:Using the protocol outlined in this study, it is possible to reliably record EAP responses from most subjects and for most electrodes in Nucleus CI24M cochlear implant users. These responses are robust and recording these responses does not require that the subject sleep or remain still. Based on these results, a specific protocol is proposed for measurement of the EAP using the NRT system of the CI24M cochlear implant. Potential clinical implications of these results are discussed.

ISSN:0196-0202    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Objective:Speech and other environmental sounds must be compressed to accommodate the small electric dynamic range in cochlear implant listeners. The objective of this paper is to study whether and how amplitude compression and dynamic range reduction affect phoneme recognition in quiet and in noise for cochlear implant listeners.Design:Four implant listeners using the Nucleus-22 SPEAK speech processor participated in this study. The amount of compression was varied by manipulating the Q-value in the SPEAK processor. The size of the dynamic range was systematically reduced by increasing the threshold level and decreasing the comfortable level in the processor. Both female- and male-talker vowel and consonant materials were used to evaluate speech recognition performance in quite and in noise. Speech-spectrum-shaped noise was mixed with the speech signal and presented continuously to the speech processor through a direct electric connection. Signal to noise ratios were changed over a 30 to 40 dB range, within which phoneme recognition increased from chance to asymptotic performance. Phoneme recognition scores were obtained as the number of active electrodes was reduced from 20 to 10 to 4. For purposes of comparison, phoneme recognition data also were collected in four normal-hearing listeners under comparable laboratory conditions.Results:In both quiet and noise, the amount of amplitude compression did not significantly affect phoneme recognition. The reduction of dynamic range marginally affected phoneme recognition in quiet, but significantly degraded phoneme recognition in noise. Generally, the 20- and 10-electrode processors produced similar performance, whereas the 4-electrode processor produced significantly poorer performance. Compared with normal-hearing listeners, cochlear-implant listeners required higher signal to noise ratios to achieve comparable recognition performance and produced significantly lower recognition scores at the same signal to noise ratios.Conclusions:The amount of amplitude compression does not significantly affect phoneme recognition, whereas reducing dynamic range significantly lowers phoneme recognition, particularly in noise and for vowels. Because the SPEAK processor extracts mostly spectral peaks, the present conclusions may not be applied to other types of processors extracting temporal envelope cues. The present results also suggest that more than four electrodes are required to optimize speech recognition in multiple-talker and noise conditions. A significant performance gap in speech recognition still remains between cochlear implant and normal-hearing listeners at the same signal to noise ratios. Improved cochlear implant designs and fitting procedures are required to narrow and, hopefully, close this performance gap.

ISSN:0196-0202    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Objective:Transient evoked otoacoustic emissions (TEOAEs) were measured in children with normal hearing and in children with hearing loss to investigate the characteristics of TEOAEs as they relate to overall amplitude and amplitude spectra of evoking stimuli, and to audiometric status.Design:Three parameters of response measure (signal to noise ratio, amplitude and reproducibility) were assessed to determine accuracy of identification of varying degrees of hearing loss for broadband clicks, frequency-specific click bands and tone bursts. Forty-four children (66 ears) between 4 and 13 yr of age were evaluated for participation in the study. Fifty-nine ears with intact tympanic membranes were included in the final analyses: 14 ears with normal hearing and 45 ears with hearing loss.Results:Children with normal hearing had robust responses that displayed nonlinear growth functions for broadband clicks and for tone bursts. Children with hearing loss had responses that decreased rapidly with decreasing stimulus level, if emissions were present at all. Data were analyzed using clinical decision analysis and receiver operator characteristic curves. Broadband clicks presented at 80 and 86 dB peSPL identified a hearing loss ≥30 dB HL with a high degree of accuracy. Click responses filtered into octave bands centered at 500 and 1000 Hz did not improved classification of hearing loss, in fact, the 500 Hz band was particularly inaccurate. Results for click responses filtered into half-octave bands centered at 2000 and 4000 Hz were comparable with those for the broadband click, although the 2000 Hz band was superior for identification of hearing loss ≥20 dB HL for an 80 dB peSPL click, and ≥30 dB HL for an 86 dB peSPL click. Results for tone bursts centered at 500, 1000, 2000 and 4000 Hz, presented at 80 dB peSPL, were similar to results of the filtered click bands. Accuracy for identifying hearing loss increased with increasing center frequency. The 2000 and 4000 Hz tone bursts provided the best separation between normal-hearing and hearing-impaired ears, with 4000 Hz being slightly better.Conclusions:Data from this study suggest that TEOAEs in children can separate ears with normal hearing from those with hearing loss using a variety of stimulus and response conditions. Moreover, by using multiple stimulus levels it may be possible to distinguish between mild and moderate hearing losses.

ISSN:0196-0202    

出版商:OVID    

年代:1999

数据来源: OVID

ISSN:0196-0202    

出版商:OVID    

年代:1999

数据来源: OVID

ISSN:0196-0202    

出版商:OVID    

年代:1999

数据来源: OVID