Bluetooth Coupling in Hearing Aids: Effect on Audiovisual Speech Recognition and Quality Rating of Compressed Speech in Older Individuals with Sloping Hearing Loss

Abstract Introduction Older individuals often report that they find it difficulty in enjoying watching television since they find it hard to follow the rapid intensity variations, and voice changes from scene to scene. Objective The present study investigated the effect of coupling the hearing aid with the television via Bluetooth on audiovisual speech recognition and quality rating of compressed speech in older individuals with hearing loss. Method Twenty participants in the age range of 60 to 75 years who had moderate to moderately severe sloping sensorineural hearing loss were bilaterally fitted with digital receiver in the canal hearing aids. The hearing aid was coupled with a television via Bluetooth using a streamer. The video recorded stimuli were presented at 65 dB SPL at normal rate, 35% compression and 45% compression conditions. Speech recognition scores and quality ratings were obtained for each condition with and without the Bluetooth streamer connected to the hearing aids. Results Speech recognition scores were significantly better with Bluetooth coupling compared with conventional hearing aid use at 40% compressed speech rate. The quality was also rated higher in almost all parameters across speech rates when Bluetooth was used. Conclusions The improved clarity and nullification of room reverberation offered by Bluetooth coupling can potentially compensate for the age-related temporal processing deficit contributing to ease of listening.

Determining attributed factors of hearing handicap in individuals with auditory sensory and neural pathology

Abstract Introduction: There is a modest relationship between speech perception skills and perceived hearing handicap in individuals with hearing loss. In this study, an attempt is made at linking psychoacoustic results and speech perception skills to understand the subjective handicap and quality of life. Objective: To investigate how speech perception in noise (signal to noise ratio-50), difference limen frequency, temporal modulation transfer function, hearing handicap inventory for adults, and quality of life in auditory neuropathy spectrum disorder differs from sensorineural hearing loss. Further we attempt to discern attributed factors of hearing handicap in auditory neuropathy spectrum disorder and sensorineural hearing loss. Methods: A cross-sectional study with comparative and correlational research designs were utilized. Eighty-four participants were grouped into sensorineural hearing loss (n = 49), and auditory neuropathy spectrum disorder (n = 35) was sub-grouped into mild, moderately severe, and severe. We evaluated signal to noise ratio-50, difference limen frequency, and temporal modulation transfer function. In addition, hearing handicap inventory for adults, and quality of life questionnaires were administered. Results: Mild auditory neuropathy spectrum disorder showed impairment in speech perception and discriminating frequency, which were similar to the severe sensory neural hearing loss. Temporal resolution impairment in auditory neuropathy spectrum disorder mild was significantly higher than in each sub-groups of sensorineural hearing loss. The severity of the hearing handicap in was similar to severe sensorineural hearing loss, quality of life was equally affected in sensorineural hearing loss and auditory neuropathy spectrum disorder. In sensorineural hearing loss, signal to noise ratio-50 was positively related, and quality of life was negatively related to hearing handicap. In auditory neuropathy spectrum disorder, no contributory factors were related to hearing handicap. Conclusion: Mild auditory neural pathology demonstrates impairment in speech recognition and psychoacoustic skills similar to severe cochlear pathology. In sensorineural hearing loss, hearing handicap is predicted from quality of life and speech perception, but none of the contributory factors predicted hearing handicap in auditory neuropathy spectrum disorder.

Representation of amplified speech at cortical level in good and poor hearing aid performers / Representação da fala amplificada ao nível cortical em bons e maus usuários de aparelhos auditivos

Abstract Introduction: Hearing aid users reject their own hearing aid because of annoyance with background noise. The reason for dissatisfaction is located anywhere from the hearing aid microphone to the integrity of neurons along the auditory pathway. In this preview, the output of hearing aid was recorded at the level of ear canal and at auditory cortex in good and poor hearing aid users, who were classified using acceptable noise level. Objective: To study the representation of amplified speech in good and poor hearing aid performers. Methods: A total of 60 participants (age ranged 15-65 years) with moderate bilateral sensorineural hearing impairment grouped into good (n = 35) and poor (n = 25) hearing aid performers. Gap detection test and aided SNR 50 were administered. In addition, ear canal acoustic measures and cortical auditory evoked potentials were recorded in unaided and aided conditions at 65 dB SPL. Results: Hearing aid minimally alters temporal contrast of speech reflected in envelope difference index. Although having similar temporal impairment, acoustic characteristics of amplified speech sounds and SNR 50 scores from both groups, the aided cortical auditory evoked potentials surprisingly showed significant earlier latencies and higher amplitudes in good performers than poor performers. In addition, good and poor performers classified based on annoyance level was predicted by latencies of 2N1 and 2P2 components of acoustic change complex. Further, a follow-up revealed hearing aid use has relation with acceptance towards noise. Conclusion: Participants who are willing to accept noise from those who are not willing to accept noise have subtle physiological changes evident at the auditory cortex, which supports the hearing aid usage.

Resumo Introdução: Usuários de aparelhos auditivos rejeitam seu próprio aparelho pelo incômodo relacionado ao ruído de fundo. O motivo da insatisfação varia desde o microfone do aparelho auditivo até a integridade dos neurônios ao longo da via auditiva. Nesta análise prévia, a saída da prótese auditiva foi registrada no nível do meato auditivo externo e no córtex auditivo em bons e maus usuários de prótese auditiva, que foram classificados com um nível de ruído aceitável. Objetivo: Estudar a representação da fala amplificada em bons e maus usuários de aparelhos auditivos. Método: Foram examinados 60 participantes (de 15 a 65 anos) com deficiência auditiva neurossensorial bilateral moderada divididos em bons (n = 35) e maus (n = 25) usuários de aparelhos auditivos. Teste de detecção de gap e SNR 50 assistido foi administrado. Além disso, as medidas acústicas do meato externo e os potenciais evocados auditivos corticais foram registrados em condições não assistida e assistida a 65 dB NPS. Resultados: O aparelho auditivo altera minimamente o contraste temporal da fala, refletido no envelope difference index. Embora tenham uma deficiência temporal similar, as características acústicas de sons de fala amplificados e escores do SNR 50 de ambos os grupos, os potenciais evocados auditivos corticais assistidos surpreendentemente demonstraram latências iniciais significativas e maiores amplitudes em bons do que em maus usuários. Além disso, os bons em comparação com os maus usuários, classificados com base no nível de incômodo, foram previstos pelas latências dos componentes 2N1 e 2P2 do complexo de alteração acústica. Além disso, os resultados do seguimento revelaram que o uso de aparelhos auditivos têm relação com a aceitação do ruído. Conclusão: Os participantes dispostos a aceitar o ruído, quando comparados com aqueles que não estão dispostos a aceitá-lo, apresentam evidência de sutis alterações fisiológicas no córtex auditivo, que apoiam o uso da prótese auditiva.

The Effect of Digital Noise Reduction on Annoyance and Speech Perception in Low and High Acceptable Noise Level Groups

Introduction: Studies have reported that although speech perception in noise was unaltered with and without digital noise reduction (DNR), the annoyance toward noise measured by acceptable noise level (ANL) was significantly improved by DNR with the range between 2.5 and 4.5 dB. It is unclear whether a similar improvement would be observed in those individuals who have an ANL ≥ 14 dB (predictive of poor hearing aid user) often rejects their aid because of annoyance toward noise. Objectives: (a) To determine the effect of activation of DNR on the improvement in the aided ANL from low- and high-ANL groups; and (b) to predict the change in ANL when DNR was activated. Method: Ten bilateral mild to severe sloping sensorineural hearing loss (SNHL) participants in each of the low- and high-ANL groups were involved. These participants were bilaterally fitted with receiver in canal (RIC) hearing aids (Oticon, Smorum, Egedal, Denmark) with a DNR processor. Both SNR-50% (Signal to noise ratio (in dB) required to achieve 50 % speech recognition) and ANL were assessed in DNR-on and DNR-off listening conditions. Results: Digital noise reduction has no effect on SNR-50 in each group. The annoyance level was significantly reduced in the DNR-on than DNR-off condition in the low-ANL group. In the high-ANL group, a strong negative correlation was observed between the ANL in DNR off and a change in ANL after DNR was employed in the hearing aid (benefit). The benefit of DNR on annoyance can be effectively predicted by baseline-aided ANL by linear regression. Conclusion: Digital noise reduction reduced the annoyance level in the high-ANL group, and the amount of improvement was related to the baseline-aided ANL value (AU)

Encoding of speech sounds at auditory brainstem level in good and poor hearing aid performers / Codificação dos sons da fala no nível do tronco encefálico auditivo em bons e maususuários de aparelhos auditivos

Abstract Introduction: Hearing aids are prescribed to alleviate loss of audibility. It has been reported that about 31% of hearing aid users reject their own hearing aid because of annoyance towards background noise. The reason for dissatisfaction can be located anywhere from the hearing aid microphone till the integrity of neurons along the auditory pathway. Objectives: To measure spectra from the output of hearing aid at the ear canal level and frequency following response recorded at the auditory brainstem from individuals with hearing impairment. Methods: A total of sixty participants having moderate sensorineural hearing impairment with age range from 15 to 65 years were involved. Each participant was classified as either Good or Poor Hearing aid Performers based on acceptable noise level measure. Stimuli /da/ and /si/ were presented through loudspeaker at 65 dB SPL. At the ear canal, the spectra were measured in the unaided and aided conditions. At auditory brainstem, frequency following response were recorded to the same stimuli from the participants. Results: Spectrum measured in each condition at ear canal was same in good hearing aid performers and poor hearing aid performers. At brainstem level, better F0 encoding; F0 and F1 energies were significantly higher in good hearing aid performers than in poor hearing aid performers. Though the hearing aid spectra were almost same between good hearing aid performers and poor hearing aid performers, subtle physiological variations exist at the auditory brainstem. Conclusion: The result of the present study suggests that neural encoding of speech sound at the brainstem level might be mediated distinctly in good hearing aid performers from that of poor hearing aid performers. Thus, it can be inferred that subtle physiological changes are evident at the auditory brainstem in a person who is willing to accept noise from those who are not willing to accept noise.

Resumo Introdução: Os aparelhos auditivos são prescritos para aliviar a perda de audibilidade. Tem sido relatado que 31% dos usuários rejeitam seu aparelho auditivo devido ao desconforto com o ruído de fundo. A razão para a insatisfação pode estar situada em qualquer local desde o microfone do aparelho auditivo até a integridade de neurônios ao longo da via auditiva. Objetivos: Medir espectros desde a saída do aparelho auditivo no nível do meato acústico externo e frequência de resposta (FFR) registrada no tronco encefálico de indivíduos com deficiência auditiva. Método: Foram selecionados 60 participantes com deficiência auditiva neurossensorial moderada, de 15 a 65 anos. Cada participante foi classificado como usuário bom ou mau de prótese auditiva (GHP ou PHP) com base na medida de nível de ruído aceitável (ANL). Estímulos/da/e/si/foram apresentados em alto-falante a 65 dB SPL. No meato acústico externo, os espectros foram medidos nas condições sem aparelho e com aparelho. No tronco encefálico auditivo, FFR foram registradas para os mesmos estímulos dos participantes. Resultados: Os espectros medidos em cada condição no meato acústico externo foram os mesmos em GHP e PHP. No nível do tronco cerebral, melhor codificação F0; energias de F0 e F1 foram significativamente maiores em GHP do que em PHP. Embora os espectros do aparelho auditivo fossem quase os mesmos entre GHP e PHP, existem variações fisiológicas sutis no tronco encefálico auditivo. Conclusão: O resultado do presente estudo sugere que a codificação neural do som da fala no nível do tronco encefálico pode ser mediada distintamente em GHP em comparação com PHP. Assim, pode-se inferir que mudanças fisiológicas sutis são evidentes no tronco encefálico em uma pessoa que está disposta a aceitar o ruído em comparação com aqueles que não estão dispostos a aceitar o ruído.