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Background and Objectives@#The present study aimed to explore meaningful change in the musical performance of cochlear implant (CI) users according to age after receiving music training compared to the other CI users who did not receive any music training and normal hearing (NH) listeners. @*Materials and Methods@#Article search was conducted from five journal databases. In accordance with PICOS criteria, 29 articles and 15 articles were included for the CI and NH groups, respectively. A total of 44 articles consisting of 407 CI users and 486 NH participants were then analyzed. Using the data gathered from pre- and post-training, meta-analysis was applied by the random-effects model, and then piecewise meta-regression was employed. @*Results@#CI users with music training showed better performance than those without the training across all ages. The curve change in musical performance when training showed that the CI users was similar to the general pattern of NH performance, indicating that the CI users gained benefits from music training and developed perceptual ability, even though it was not as high as the level of NH counterparts. @*Conclusions@#This finding supports the benefits of active engagement with music for both CI users and NH listeners, while noting the important role of music as one of the primary aural rehabilitation approaches.
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Background and Objectives@#The digits-in-noise (DIN) test was developed as a simple and time-efficient hearing-in-noise test worldwide. The Korean version of the DIN (K-DIN) test was previously validated for both normal-hearing and hearing-impaired listeners. This study aimed to explore the factors influencing the outcomes of the K-DIN test further by analyzing the threshold (representing detection ability) and slope (representing test difficulty) parameters for the psychometric curve fit. @*Subjects and Methods@#In total, 35 young adults with normal hearing participated in the K-DIN test under the following four experimental conditions: 1) background noise (digit-shaped vs. pink noise); 2) gender of the speaker (male vs. female); 3) ear side (right vs. left); and 4) digit presentation levels (55, 65, 75, and 85 dB). The digits were presented using the method of constant stimuli procedure. Participant responses to the stimulus trials were used to fit a psychometric function, and the threshold and slope parameters were estimated according to pre-determined criteria. The accuracy of fit performance was determined using the root-mean-square error calculation. @*Results@#The listener’s digit detection ability (threshold) was slightly better with pink noise than with digit-shaped noise, with similar test difficulties (slopes) across the digits. Gender and the tested ear side influenced neither the detection ability nor the task difficulty. Additionally, lower presentation levels (55 and 65 dB) elicited better thresholds than the higher presentation levels (75 and 85 dB); however, the test difficulty varied slightly across the presentation levels. @*Conclusions@#The K-DIN test can be influenced by stimulus factors. Continued research is warranted to understand the accuracy and reliability of the test better, especially for its use as a promising clinical measure.
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Background and Objectives@#Although the digit-in-noise (DIN) test is simple and quick, little is known about its key factors. This study explored the considerable components of the DIN test through a systematic review and meta-analysis. @*Materials and Methods@#After six electronic journal databases were screened, 14 studies were selected. For the meta-analysis, standardized mean difference was used to calculate effect sizes and 95% confidence intervals. @*Results@#The overall result of the meta-analysis showed an effect size of 2.224. In a subgroup analysis, the patient’s hearing status was found to have the highest effect size, meaning that the DIN test was significantly sensitive to screen for hearing loss. In terms of the length of the presenting digits, triple digits had lower speech recognition thresholds (SRTs) than single or pairs of digits. Among the types of background noise, speech-spectrum noise provided lower SRTs than multi-talker babbling. Regarding language variance, the DIN test showed better performance in the patient’s native language(s) than in other languages. @*Conclusions@#When uniformly developed and well validated, the DIN test can be a universal tool for hearing screening.
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Background and Objectives@#Natural and synthetic speech signals effectively stimulate cortical auditory evoked potential (CAEP). This study aimed to select the speech materials for CAEP and identify CAEP waveforms according to gender of speaker (GS) and gender of listener (GL). @*Subjects and Methods@#Two experiments including a comparison of natural and synthetic stimuli and CAEP measurement were performed of 21 young announcers and 40 young adults. Plosive /g/ and /b/ and aspirated plosive /k/ and /p/ were combined to /a/. Six bisyllables–/ga/-/ka/, /ga/-/ba/, /ga/-/pa/, /ka/-/ba/, /ka/-/pa/, and /ba/-/pa/–were formulated as tentative forwarding and backwarding orders. In the natural and synthetic stimulation mode (SM) according to GS, /ka/ and /pa/ were selected through the first experiment used for CAEP measurement. @*Results@#The correction rate differences were largest (74%) at /ka/-/ pa/ and /pa/-/ka/; thus, they were selected as stimulation materals for CAEP measurement. The SM showed shorter latency with P2 and N1-P2 with natural stimulation and N2 with synthetic stimulation. The P2 amplitude was larger with natural stimulation. The SD showed significantly larger amplitude for P2 and N1-P2 with /pa/. The GS showed shorter latency for P2, N2, and N1-P2 and larger amplitude for N2 with female speakers. The GL showed shorter latency for N2 and N1-P2 and larger amplitude for N2 with female listeners. @*Conclusions@#Although several variables showed significance for N2, P2, and N1-P2, P1 and N1 did not show any significance for any variables. N2 and P2 of CAEP seemed affected by endogenous factors.
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It is acknowledged that there is a negative relationship between dementia and auditory function in older adults. This study conducted a systematic review and meta-analysis based on the data of audiologic testings from patients with neurodegenerative diseases in terms of auditory eventrelated potentials and central auditory processing tests, while focusing on Alzheimer’s disease (AD), dementia with Lewy bodies (DLB), and Parkinson’s disease dementia (PDD). A total of 34765 articles were retrieved from the seven electronic databases. After being screened by Participants, Index test, Control, Outcomes, Study design (PICOS) criteria, 129 articles for AD were included and then 72 articles were applied to the meta-analysis. However, five and six ar-ticles were systematically reviewed for the auditory functions of DLB and PDD, respectively,due to a small number of articles. The results of meta-analysis showed a significant difference between patients with AD and age-matched normal subjects, for N200 and P300 latency, P300 amplitude, and the behavioral central auditory processing tests, although there was a high heterogeneity. On the other hand, the systematic review indicated that the results of mismatch negativity test might distinguish auditory performance of DLB patients from that of PDD. Furthermore, for P300 amplitude, anterior to posterior distribution of brain resulted in meaningful difference of auditory function between AD and DLB patients. In sum, current review study suggests that lesion and degree of auditory (dys)function may be different depending on the type of dementia, although future research should be followed.
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Background and Objectives@#This study aimed to investigate the occupational performance of Korean workers with and without hearing loss and analyze the hearing-related difficulties in the working environment. @*Subjects and Methods@#The Amsterdam checklist for hearing and work was used for the analyses and the occupational environments of the Korean workers were investigated. Out of 129 total participants, 86 workers experienced severe to profound hearing loss and 43 had the normal hearing ability. The hearing-impaired workers were recruited from two leading vocational centers and normal-hearing workers were their colleagues. @*Results@#The hearing-impaired workers were found to take fewer sick leaves and exhibited higher rates of permanent job statuses compared to the normal-hearing workers. Workers with hearing loss rarely detected background sound; however, they could perceive reverberation more frequently. They felt more satisfied with their careers than the normal hearing workers as they received social support and needed to put their effort into hearing for most hearing activities. Furthermore, the effort in hearing increased with the increase in job demand, job control, social support, and career satisfaction. The working hours per week increased with the increase in age, education level, job demand, job control, and social support. Different trends were observed in 9 out of 12 variables while comparing the data from the present study with that obtained from the hearing-impaired workers of the Netherlands, indicating a large difference between countries. @*Conclusions@#Although the hearing-impaired Korean workers operate diligently with good job positions, it is necessary to enhance their acoustic environment and provide them social support. Considering the cultural background of the hearing-impaired workers, the development of suitable vocational rehabilitation programs and specific questionnaires is strongly recommended worldwide.
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Background and Objectives@#The purpose of the present study was to validate the performance and diagnostic efficacy of the Korean digits-in-noise (K-DIN) test in comparison to the Korean speech perception-in-noise (K-SPIN) test, which is the representative speech-in-noise test in clinical practice. @*Subjects and Methods@#Twenty-seven subjects (15 normal-hearing and 12 hearing-impaired listeners) participated. The recorded Korean 0-9 digits were used to form quasirandom digit triplets; 50 target digit triplets were presented at the most comfortable level of each subject while presenting speech-shaped background noise at various levels of signal-to-noise ratios (-12.5, -10, -5, or +5 dB). Subjects were then instructed to listen to both target and noise masker unilaterally and bilaterally through a headphone. K-SPIN test was also conducted using the same procedure as the K-DIN. After calculating their percent correct responses, K-DIN and K-SPIN results were compared using a Pearson-correlation test. @*Results@#Results showed a statistically significant correlation between K-DIN and K-SPIN in all hearing conditions (left: r=0.814, p<0.001; right: r=0.788, p<0.001; bilateral: r=0.727, p<0.001). Moreover, the K-DIN test achieved better testing efficacy, shorter average listening time (5 min vs. 30 min), and easier performance of task according to participants’ qualitative reports than the K-SPIN test. @*Conclusions@#In this study, the Korean version of digit triplet test was validated in both normal-hearing and hearing-impaired listeners. The findings suggest that the K-DIN test can be used as a simple and time-efficient hearing-in-noise test in audiology clinics in Korea.
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This study aimed to evaluate the efficacy of music training on the improvement of musical perception among hearing-impaired listeners using a systematic review and meta-analysis. Article search was conducted from five databases, Scopus, ScienceDirect, Web of Knowledge, CINAHL, and PubMed. A total of 186 participants from 10 studies investigating the music training effects on individuals fitted with hearing assistive devices and outcome measurements were included. The meta-analysis showed standardized mean difference as a measure of the effect size, in musical improvement between the preand post-training. Although the funnel plot yielded an asymmetrical graph, the Egger’s regression showed no significant publication bias. Interestingly, subgroup analysis showed that the training effect was greater in children than in adults. With a necessity of longer training period to significantly improve their musical perception, cochlear implant only users had better effect compared to bi-modal users with both cochlear implant and hearing aids. However, the difference in the training effect between the users with and without previous musical experience was nonsignificant. The present study concludes that auditory music training brings hearing-impaired listeners into better musical perception while informing that training effects differ depending on age, duration of the training, and the type of hearing device used.
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Background and Objectives@#In distracting listening conditions, individuals need to pay extra attention to selectively listen to the target sounds. To investigate the amount of listening effort required in reverberating and noisy backgrounds, a semantic mismatch was examined. @*Subjects and Methods@#Electroencephalography was performed in 18 voluntary healthy participants using a 64-channel system to obtain N400 latencies. They were asked to listen to sounds and see letters in 2 reverberated×2 noisy paradigms (i.e., Q-0 ms, Q-2000 ms, 3 dB-0 ms, and 3 dB-2000 ms). With auditory-visual pairings, the participants were required to answer whether the auditory primes and letter targets did or did not match. @*Results@#Q-0 ms revealed the shortest N400 latency, whereas the latency was significantly increased at 3 dB-2000 ms. Further, Q-2000 ms showed approximately a 47 ms delayed latency compared to 3 dB-0 ms. Interestingly, the presence of reverberation significantly increased N400 latencies. Under the distracting conditions, both noise and reverberation involved stronger frontal activation. @*Conclusions@#The current distracting listening conditions could interrupt the semantic mismatch processing in the brain. The presence of reverberation, specifically a 2000 ms delay, necessitates additional mental effort, as evidenced in the delayed N400 latency and the involvement of the frontal sources in this study.
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Because the psychophysical symptoms of hearing loss and dementia in the elderly are very similar, untrained healthcare professionals in dementia facilities can easily overlook a severity of hearing loss in their patients. The present study identifies their knowledge, attitudes, and practices (KAP) on hearing loss using a survey whether they may help hearing problem of the patients with dementia. A total of 29 health-care professionals responded to the KAP survey. Also, 2 family members participated. The results showed that most of the nurses and caregivers in elderly medical welfare facilities who worked with dementia patients did not have knowledge of their hearing loss. Even the facility managers did not know how to conduct hearing tests for their patients although they did recognize that some of their patients had a hearing loss. Eventually, actual practice was not possible at this moment by the professionals. However, our respondents did have a positive attitude toward screening for hearing loss and help their patients with dementia wear hearing aids if a clinical guideline was provided. We suggest to develop clear and precise clinical guidelines of the hearing screening test for the dementia patients due to the interrelationship between dementia and hearing loss. When these guidelines apply to elderly residents in a medical welfare facility, early diagnosis and treatment of their sensory loss will help alleviate their dementia as well.
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Auditory scene analysis is defined as a listener’s ability to segregate a meaningful message from meaningless background noise in a listening environment. To gain better understanding of auditory perception in terms of message integration and segregation ability among concurrent signals, we aimed to systematically review the size of auditory scenes among individuals. A total of seven electronic databases were searched from 2000 to the present with related key terms. Using our inclusion criteria, 4,507 articles were classified according to four sequential steps–identification, screening, eligibility, included. Following study selection, the quality of four included articles was evaluated using the CAMARADES checklist. In general, studies concluded that the size of auditory scene increased as the number of sound sources increased; however, when the number of sources was five or higher, the listener’s auditory scene analysis reached its maximum capability. Unfortunately, the score of study quality was not determined to be very high, and the number of articles used to calculate mean effect size and statistical significance was insufficient to draw significant conclusions. We suggest that study design and materials that consider realistic listening environments should be used in further studies to deep understand the nature of auditory scene analysis within various groups.
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The present study aimed to compare thresholds of directbone-conduction (BC direct) with those of behaviorally measured BC pure-tone audiometry(PTA) and objectively measured BC auditory brainstem response (ABR) to confirm the clinicalfeasibility of their relationships. Subjects and Methods: Young adults with normal hearingparticipated in the study to determine the thresholds from three measurements at four testingfrequencies. In the BC direct, the vibrator of a bone-anchored hearing aid softband wasplaced on the right mastoid of each subject. In both PTA and ABR, a B71 bone oscillatorwas placed on the subject’s right mastoid. While the subject’s thresholds of BC direct andBC PTA were determined with a clinically routine 5-dB step procedure, BC ABR was conductedto determine the individual’s hearing sensitivity by a peak V of the waveform usingtone-burst and click stimuli. Results: The BC direct showed a different pattern between lowand high frequencies. Precisely, its thresholds were 13.25 and 12.25 dB HL at 0.5 and 1kHz, respectively, but 19 and 19.75 dB HL at 2 and 4 kHz, respectively. A significant positivecorrelation existed between BC direct and PTA at 1 kHz, which was also correlated withABR. Conclusions: Based on the current data, the thresholds of BC direct were similar toBC PTA at low frequencies and BC ABR at high frequencies. The thresholds of BC directmight be predictable at approximately 5 dB higher (or lower) than that in PTA, although alarge data set is required for standardization. J Audiol Otol 2020;24(2):85-90
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Objectives@#. To determine the appropriate anatomical borders of implantation on the temporal bone in a cadaver study, and to develop a simplified surgical technique for Baha Attract implantation through a small incision along the hairline using anatomical evidence and a navigation system. @*Methods@#. In a cadaver study, 20 human adult dry skulls were used to find flat areas of the temporal bone for Baha Attract magnet implantation. Four borders of the “optimal surgical site” were defined: Asterion line, occipitomastoid suture line, sigmoid sinus line, and digastric groove line. In three patients, we implanted the Baha Attract according to the newly developed surgical procedure and validated the feasibility of this technique with a navigation system. @*Results@#. We identified the appropriate position of the implant on the temporal bone, suggesting a simplified surgical technique for Baha Attract with a small incision. We determined the spot of implantation, and the implants were inserted through a small surgical incision (<2.5 cm) under local anesthesia; the procedure lasted approximately 30 minutes. @*Conclusion@#. The optimal surgical site of the temporal bone is a safe and easily accessible location for implantation of the Baha Attract.
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Background and Objectives@#Recently, researchers have been interested in auditory brainstem response (ABR) under noisy condition for better diagnosis of the hidden hearing loss. However, there is no normative data conducted from a simple noise condition for the clinical setting yet. The purpose of the present study was to compare the data of ABR under quiet condition with those under noisy conditions and to confirm the feasibility of these data in the clinic.Subjects and Method A total of 104 young listeners with normal hearing (53 female and 51 male) participated. After completing the hearing screening tests, they were given the ABR measure with 75 dB nHL click stimulus under quiet condition, and with a level of 85 dB nHL white noise via a speaker. Absolute latencies and amplitudes of the waves were statistically compared against test condition and gender. @*Results@#There was a significant difference of the latency and amplitude between the quiet and noisy conditions. Under the noise, the absolute latencies of the waves I-V were delayed, and their amplitudes were smaller compared to the quiet condition. Such patterns were revealed in both female and male subjects. However, the females had shorter latencies and larger amplitudes than the male participants regardless of noise. @*Conclusion@#We confirmed stable ABR data using simple white noise setting. In the following study, patients with various pathologies should be applied for the ABR under noisy condition and have their data standardized according to sensitivity and specificity.
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BACKGROUND AND OBJECTIVES: Many studies have reported no benefit of sound localization, but improved speech understanding in noise after treating patients with single-sided deafness (SSD). Furthermore, their performances provided a large individual difference. The present study aimed to measure the ability of speech perception and gap detection in noise for the SSD patients to better understand their hearing nature.
Subject(s)
Humans , Young Adult , Deafness , Hearing , Hearing Loss , Hearing Loss, Conductive , Individuality , Noise , Plastics , Sample Size , Signal-To-Noise Ratio , Silver Sulfadiazine , Sound Localization , Speech PerceptionABSTRACT
With a high sound quality stimulated by the electrical device and a large inclusion in medical insurance, the number of cochlear implant recipients has been rapidly increased in Korea. Today, it is not surprising that early implanted young children with congenital deafness show a similar performance to their normal hearing peers in speech perception. However, the cochlear implant users still have a trouble to enjoy music. This review study aims to introduce briefly about acoustic components that required to perceive the music and understand a relationship between cochlear implantation and temporal fine structure. For the pediatric implant users who have less experience on acoustical sound features but are much familiar with the electrically stimulated sound, perceiving the music seems to be challengeable due to the lack of temporal fine resolution related to pitch and timbre among various components of music. Four representative test batteries for evaluating the recipients' ability of the music perception were mentioned and effective auditory music trainings were discussed with analysis of related investigations. Unlike hearing aids users who usually depend on fitting algorism for better music quality, the cochlear implant users need systematic training to improve their music perception ability. In conclusion, advancement of speech processing technology which can provide accurate information about the temporal fine structure of incoming music to the recipients needs to be developed. Also, a practical application of music training should be recommended as a part of auditory training for the cochlear implant users.
Subject(s)
Child , Humans , Acoustics , Cochlear Implantation , Cochlear Implants , Deafness , Hearing , Hearing Aids , Insurance , Korea , Music , Perception , Pitch Perception , Speech PerceptionABSTRACT
Since noise-induced hearing loss (NIHL) is one of prevalent issues in the occupational settings, hearing protection device (HPD) has been widely used to reduce noise exposure levels and to prevent developing NIHL. This review study aimed to introduce several types of the HPD in terms of current trends, its variety and functions, and application. Including a brief history of the HPD, we explain its two types, i.e., passive and active functions, in the first part of main body. The passive HPD has a flat attenuation across the overall frequency range, whereas the active HPD effectively preserves communication components such as meaningful speech with low intensity stimuli while filtering out the high levels of noise. In the second part of the main body, we discuss some negative issues of hearing functions when users are wearing the HPD. In detail, the active HPD does not much degrade the hearing performance for speech detection/recognition and sound source localization compared to the passive HPD. Rather, reduced sound (or music) quality is improved with active one in general. In the final part, we mention that although various applications in the special fields such as factory, mining, army, airplane, and music have been demonstrated, the usage and awareness of HPD in occupational aspect may not follow its fast technological development. Furthermore, most people do not know about either importance or use method of HPD in the non-occupational setting. For these reasons, we conclude that hearing professionals have to access the latest trends of the HPD and to increase their knowledge on it, and thus they should provide the best HPD prescription for the public as well as employees who have to protect their ears from hazard noise impacts.
Subject(s)
Aircraft , Ear , Hearing Loss, Noise-Induced , Hearing , Methods , Mining , Music , Noise , Prescriptions , Public HealthABSTRACT
With a high sound quality stimulated by the electrical device and a large inclusion in medical insurance, the number of cochlear implant recipients has been rapidly increased in Korea. Today, it is not surprising that early implanted young children with congenital deafness show a similar performance to their normal hearing peers in speech perception. However, the cochlear implant users still have a trouble to enjoy music. This review study aims to introduce briefly about acoustic components that required to perceive the music and understand a relationship between cochlear implantation and temporal fine structure. For the pediatric implant users who have less experience on acoustical sound features but are much familiar with the electrically stimulated sound, perceiving the music seems to be challengeable due to the lack of temporal fine resolution related to pitch and timbre among various components of music. Four representative test batteries for evaluating the recipients' ability of the music perception were mentioned and effective auditory music trainings were discussed with analysis of related investigations. Unlike hearing aids users who usually depend on fitting algorism for better music quality, the cochlear implant users need systematic training to improve their music perception ability. In conclusion, advancement of speech processing technology which can provide accurate information about the temporal fine structure of incoming music to the recipients needs to be developed. Also, a practical application of music training should be recommended as a part of auditory training for the cochlear implant users.
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It is acknowledged that implantable bone conduction hearing aids such as a bone anchored hearing aid provide benefit and satisfaction to patients with unilateral hearing loss in terms of sound localization and speech perception under noise circumstances. This review paper introduces current models of the implantable bone conduction hearing aids, their candidacy, brief surgical procedures, and general audiological examinations. A table summary was used for nine published research papers which have very similar results by three points, i.e., no change in ability of sound localization, better performance of Hearing-In-Noise Test, and improved satisfaction of sound quality using questionnaires after the implantation. Unfortunately, systematic fitting strategy for users of the implantable bone conduction hearing aids has not been either studied or developed yet. Futhermore, there is no scientific based approach of reason why the implantation has no benefit in sound localization but still provides better performance for speech perception in noise. In conclusion, specific and effective fitting strategy of the current implantable bone conduction hearing aids should be developed and also support effect of the implantation with sensitivity and specificity for both clinicians and patients while accompanying their advanced technology.
Subject(s)
Humans , Bone Conduction , Hearing Aids , Hearing Loss, Unilateral , Noise , Sensitivity and Specificity , Sound Localization , Speech Perception , Suture AnchorsABSTRACT
It is acknowledged that implantable bone conduction hearing aids such as a bone anchored hearing aid provide benefit and satisfaction to patients with unilateral hearing loss in terms of sound localization and speech perception under noise circumstances. This review paper introduces current models of the implantable bone conduction hearing aids, their candidacy, brief surgical procedures, and general audiological examinations. A table summary was used for nine published research papers which have very similar results by three points, i.e., no change in ability of sound localization, better performance of Hearing-In-Noise Test, and improved satisfaction of sound quality using questionnaires after the implantation. Unfortunately, systematic fitting strategy for users of the implantable bone conduction hearing aids has not been either studied or developed yet. Futhermore, there is no scientific based approach of reason why the implantation has no benefit in sound localization but still provides better performance for speech perception in noise. In conclusion, specific and effective fitting strategy of the current implantable bone conduction hearing aids should be developed and also support effect of the implantation with sensitivity and specificity for both clinicians and patients while accompanying their advanced technology.