Comparison of performance with hearing aid programmed to NAL-NL1 first-fit and optimized-fit

ABSTRACT Purpose The initial-fit provided by the hearing aid manufacturer's software is generally a display of measurement done in the ear simulators. The need for verification of hearing aid output and gain in the real ear using probe-microphone measurement to match the prescriptive target is highlighted. The objective of the study was to evaluate the difference in real-ear aided response (REAR), real-ear insertion gain (REIG), aided thresholds, articulation index (AI) and word recognition score (WRS) in quiet, with hearing aid programmed to NAL-NL1 first-fit and NAL-NL1 optimized-fit using the probe-microphone technique. Methods In a repeated measure experimental design, 11 participants with a mean age of 41.09 (SD=±9.95) years having moderate and moderately-severe sensorineural hearing loss were tested monaurally in two aided conditions, with a 16-channel hearing aid programmed for manufacturer's NAL-NL1 first-fit and optimized-fit to NAL-NL1 using probe-microphone verification. The REAR, REIG, aided threshold, articulation index and word recognition scores in quiet were obtained for both aided conditions. Results The REAR, REIG, aided threshold, AI and WRS in quiet were significantly better with the NAL-NL1 optimized-fit compared to manufacturer's NAL-NL1 first-fit. Conclusion The optimized-fit yields better audibility and improved word recognition in quiet. This supports best practice guidelines of many professional organizations regarding the use of probe-microphone measurement as the "Gold standard" for verification of hearing aid fitting, thereby providing better satisfaction and quality of life to hearing aid users.

Hipoacusia sensorioneural unilateral: Revisión de los manejos posibles en nuestra realidad nacional / Unilateral sensorineural hearing loss: Review of possible management in our national reality

La hipoacusia unilateral (HUL) definida como la pérdida auditiva de cualquier grado en un solo oído tiene prevalencias en edad escolar de 3% a 6%. La etiología es desconocida en la mayoría de los casos, pero destacan las anormalidades anatómicas severas a diferencia de las hipoacusias bilaterales, lo que le otorga importancia al estudio de imágenes. También se recomienda realizar evaluación oftalmológica. El impacto de la HUL se observa en la localización sonora, reconocimiento del habla, desarrollo del lenguaje, desempeño social y conducta, pero por sobre todo en el rendimiento académico. En este sentido es relevante mencionar que además de existir mayor probabilidad de repitencia de curso, es necesario mayor apoyo educacional individualizado para evitar dicha repitencia o lograr mismo éxito académico que un normoyente. En relación al diagnóstico aún faltan normas o protocolos, siendo éste un desafío en las zonas donde no hay screening universal. Se discute la importancia de las encuestas para realizar evaluaciones y seguimiento en estos casos. Finalmente se abordan las estrategias de intervención disponibles, además de un plan individualizado considerando al niño, su familia y sus expectativas, particularmente se discuten las características o factores a tomar en cuenta en el momento de la adaptación, para así lograr un tratamiento tendiente al éxito.

Unilateral hearing loss (UHL) defined as hearing loss of any degree in only one ear has a school-age prevalence of 3% to 6%. The etiology is unknown in most cases, but severe anatomical abnormalities stand out as opposed to bilateral hearing loss, which gives importance to the study of images. Ophthalmological evaluation is also recommended. The impact of UHL is observed in sound localization, speech recognition, language development, social performance and behavior, but above all in academic performance. In this sense, it is relevant to mention that in addition to having a higher probability of repeating the course, it is necessary to have more individualized educational support to avoid this repetition or achieve the same academic success as a normal listener. Regarding the diagnosis, there are still missing norms or protocols, this being a challenge in areas where there is no universal screening. The importance of surveys to carry out evaluations and follow-up in these cases is discussed. Finally, the available intervention strategies are discussed, in addition to an individualized plan considering the child, his family and his expectations, particularly, the factors to be taken into account at the time of adaptation, in order to achieve a success treatment.

Addressing difficulty in communication while wearing a respirator mask during the COVID-19 pandemic by using a laryngophone

Objective@#To describe the use of a laryngophone to aid in verbal communication when wearing elastomeric respirator masks. @*Methods@#Design: Instrumentation Innovation. Setting: Tertiary Private Training Hospital.@*Participants@#Five volunteers using elastomeric respirator masks rated laryngophone use, afterwhich they individually rated an additional volunteer on speech intelligibility before and after laryngophone use. @*Results@#On a scale of 1-10, the average score of the five volunteers for the laryngophone was 8.8 for ease of use, 8.0 for comfort, and 8.0 for ease of communication. Their average speech intelligibility score for the additional volunteer using the respirator mask alone was 2.0, and for use of the respirator mask with laryngophone was 3.6 on a scale of 1-4. @*Conclusion@#This portable laryngophone speaker may be useful in aiding otolaryngologists and health care providers using elastomeric respirator masks in verbal communication by amplifying speech without needing an external microphone, preventing vocal strain.

Avaliação do Naída CI Q70 e estratégia UltraZoom para o reconhecimento de fala em situações reverberantes e com ruído competitivo / Assessment of the benefits of the Naída CI Q70 and its Ultrazoom strategy for speech recognition in reverberating and noisy listening conditions

RESUMO Objetivo identificar a contribuição do microfone omnidirecional (T-Mic) e microfone direcional adaptativo (UltraZoom) do processador de som Naída CIQ70 para o reconhecimento da fala no ruído e em ambiente reverberante. Identificar a contribuição do processador de som Naída CIQ70 para usuários do processador Harmony. Métodos participaram do estudo sete adultos com implante coclear unilateral, usuários do processador de som Harmony. O reconhecimento de sentenças foi avaliado em silêncio, em sala reverberante (RT60 de 553 ms) e ruído de 42,7 dBA (Leq), com os processadores Harmony e Naída CIQ70. A contribuição do microfone direcional UltraZoom foi avaliada no ruído. As sentenças gravadas foram apresentadas a 0° azimute. O ruído (babble noise) foi apresentado a + 5 dB SNR, a 90° azimute. Os participantes avaliaram subjetivamente a clareza do som e a dificuldade de escutar nas várias condições do teste. Resultados a média do reconhecimento de sentenças no silêncio com reverberação foi de 38,5% com o Harmony e 66,5% com o Naída CIQ70. A pontuação média de reconhecimento de sentenças no ruído foi de 40,5% com o Naída CIQ70, sem UltraZoom, e de 64,5% com UltraZoom. Nas classificações subjetivas de clareza do som e facilidade de escuta no ruído, nenhuma diferença foi identificada entre as condições de teste. Conclusão para usuários experientes do processador de som Harmony, a compreensão da fala em silêncio em uma sala reverbente foi significativamente melhor com o Naída CIQ70. O uso de uma tecnologia de microfone direcional adaptativa (UltraZoom) contribuiu para o reconhecimento de fala no ruído.

Abstract Purpose 1) To measure speech understanding in noise with the Naída Q70 in the omnidirectional microphone mode (T-Mic) and adaptive directional microphone mode (UltraZoom) in reverberating acoustics and noisy conditions. 2) To measure improvement in speech understanding with use of the Advanced Bionics (AB) Naída Q70 sound processor for existing Harmony users. Methods Seven adult unilateral cochlear implant (CI) recipients, who were experienced users of the Harmony sound processor, participated in the study. Sentence recognition was evaluated in quiet in a reverberating room, with Harmony and Naída CI Q70 processors. Effectiveness of Naída CI Q70's UltraZoom directional microphone was evaluated in noise. Target stimuli were recorded Portuguese sentences presented from 0° azimuth. Twenty-talker babble was presented at +5dB SNR from ±90° azimuth. In addition to sentence recognition, the participants also rated the clarity of sound and difficulty of listening in the various test conditions. In order to evaluate the outcomes under more realistic acoustic conditions, tests were conducted in a non-sound treated reverberant room (RT60 of 553 ms and noise floor of 42.7 dBA (Leq). Results The average sentence recognition in quiet in the reverberant non-sound treated room was 38.5% with the Harmony and 66.5% with Naída CI Q70. The average sentence recognition score in noise was 40.5% with Naída CI Q70 without UltraZoom and 64.5% with UltraZoom. For subjective ratings of sound clarity and listening ease in noise no difference were identified between the test conditions. Conclusion For experienced users of the Harmony sound processor, speech understanding in quiet in a reverberating room was significantly improved with the Naída CI Q70. The use of an adaptive directional microphone technology (UltraZoom) enhanced speech perception in noise.

The use of remote microphone systems in unilateral hearing loss: a preliminary study among Brazilian children and teenagers

Abstract Due to the large number of individuals with Unilateral Hearing Loss (UHL) and the recommendation to use hearing assistive devices, studies are required to define possibilities of intervention for this population. Objective: To evaluate the performance of the Remote Microphone System (RMS) in children with UHL. Methodology: Prospective clinical study with a convenience sample. Eleven children (mean age of 9.2 years) with severe and profound sensorineural UHL, hearing aid users and enrolled in regular schools participated in the study. They were evaluated using the Hearing in Noise Test (HINT), the Classroom Participation Questionnaire (CPQ), and the Sustained Auditory Attention Ability Test (SAAAT) with RMS. Results: HINT results were analyzed using variance to three criteria of repeated measures, which revealed differences between intervention, position, and time factors and significant interaction between these three factors. The comparative analysis of the results from CPQ showed significant differences in the statistical t-test (p=<0.001) for all subscales. The analysis of variance at two repeated measures criteria used in the study of SAAAT revealed a difference between intervention and time, and both interacted significantly. Conclusion: The RMS associated with a hearing aid was effective for individuals with UHL.

Research of front-end speech enhancement and beamforming algorithm based on dual microphoneforcochlear implant / 生物医学工程学杂志

Speech enhancement methods based on microphone array adopt many microphones to record speech signal simultaneously. As spatial information is increased, these methods can increase speech recognition for cochlear implant in noisy environment. Due to the size limitation, the number of microphones used in the cochlear implant cannot be too large, which limits the design of microphone array beamforming. To balance the size limitation of cochlear implant and the spatial orientation information of the signal acquisition, we propose a speech enhancement and beamforming algorithm based on dual thin uni-directional / omni-directional microphone pairs (TP) in this paper. Each TP microphone contains two sound tubes for signal acquisition, which increase the overall spatial orientation information. In this paper, we discuss the beamforming characteristics with different gain vectors and the influence of the inter-microphone distance on beamforming, which provides valuable theoretical analysis and engineering parameters for the application of dual microphone speech enhancement technology in cochlear implants.

Research progress of microphone array based front-end speech enhancement technology for cochlear implant / 生物医学工程学杂志

Microphone array based methods are gradually applied in the front-end speech enhancement and speech recognition improvement for cochlear implant in recent years. By placing several microphones in different locations in space, this method can collect multi-channel signals containing a lot of spatial position and orientation information. Microphone array can also yield specific beamforming mode to enhance desired signal and suppress ambient noise, which is particularly suitable to be applied in face-to-face conversation for cochlear implant users. And its application value has attracted more and more attention from researchers. In this paper, we describe the principle of microphone array method, analyze the microphone array based speech enhancement technologies in present literature, and further present the technical difficulties and development trend.

Individual Fit Testing of Hearing Protection Devices Based on Microphone in Real Ear

BACKGROUND: Labeled noise reduction (NR) data presented by manufacturers are considered one of the main challenging issues for occupational experts in employing hearing protection devices (HPDs). This study aimed to determine the actual NR data of typical HPDs using the objective fit testing method with a microphone in real ear (MIRE) method. METHODS: Five available commercially earmuff protectors were investigated in 30 workers exposed to reference noise source according to the standard method, ISO 11904-1. Personal attenuation rating (PAR) of the earmuffs was measured based on the MIRE method using a noise dosimeter (SVANTEK, model SV 102). RESULTS: The results showed that means of PAR of the earmuffs are from 49% to 86% of the nominal NR rating. The PAR values of earmuffs when a typical eyewear was worn differed statistically (p 0.05). CONCLUSION: This study could provide local individual fit data. Ergonomic aspects of the earmuffs and different levels of users experience and awareness can be considered the main factors affecting individual fitting compared with the laboratory condition for acquiring the labeled NR data. Based on the obtained fit testing results, the field application of MIRE can be employed for complementary studies in real workstations while workers perform their regular work duties.

Advantages of Binaural Amplification to Acceptable Noise Level of Directional Hearing Aid Users

OBJECTIVES: The goal of the present study was to examine whether Acceptable Noise Levels (ANLs) would be lower (greater acceptance of noise) in binaural listening than in monaural listening condition and also whether meaningfulness of background speech noise would affect ANLs for directional microphone hearing aid users. In addition, any relationships between the individual binaural benefits on ANLs and the individuals' demographic information were investigated. METHODS: Fourteen hearing aid users (mean age, 64 years) participated for experimental testing. For the ANL calculation, listeners' most comfortable listening levels and background noise level were measured. Using Korean ANL material, ANLs of all participants were evaluated under monaural and binaural amplification with a counterbalanced order. The ANLs were also compared across five types of competing speech noises, consisting of 1- through 8-talker background speech maskers. Seven young normal-hearing listeners (mean age, 27 years) participated for the same measurements as a pilot testing. RESULTS: The results demonstrated that directional hearing aid users accepted more noise (lower ANLs) with binaural amplification than with monaural amplification, regardless of the type of competing speech. When the background speech noise became more meaningful, hearing-impaired listeners accepted less amount of noise (higher ANLs), revealing that ANL is dependent on the intelligibility of the competing speech. The individuals' binaural advantages in ANLs were significantly greater for the listeners with longer experience of hearing aids, yet not related to their age or hearing thresholds. CONCLUSION: Binaural directional microphone processing allowed hearing aid users to accept a greater amount of background noise, which may in turn improve listeners' hearing aid success. Informational masking substantially influenced background noise acceptance. Given a significant association between ANLs and duration of hearing aid usage, ANL measurement can be useful for clinical counseling of binaural hearing aid candidates or unsuccessful users.

The Influence of Different Channel Adaptive Directional Microphone Setups on the Spoken Language Understandability / 听力学及言语疾病杂志

Objective To compare the effects of speech recognition scores in young normal hearing adults using single-channel adaptive microphone and multi-channel microphone paradigm.Methods 30 normal hearing young adults,15 females and 15 males with a total of 60 ears were fitted binaurally with Diva 9(single-channel adaptive directional microphone mode)and Inteo 9(multi-channel adaptive directional microphone mode).The speech recognition scores were compared as a function of different signal to noise ratios in a diffuse environment.Results The SNR of L50 of single-channel adaptive directional microphone mode was 0.63 dB and that of multi-channel adaptive directional microphone mode was-4.63 dB.There was significant difference between the two microphone setups.Conclusion Multi-channel adaptive directional microphone mode can improve the speech recognition score in noise.

Development of Acquisition of Korotkoff's Sound Signal Device / 医疗卫生装备

Objective To design a device sampling Korotkoff's sound signal and acquiring blood pressure based on Korotkoff theory.Methods The author sampled Korotkoff's sound signal via microphone,and then according the cuff pressure corresponding to signal appearance and disappearance,the author acquired SBP and DBP.At last,the author validated the creditability by contrasting with the results of auscultatory method.Results The difference of SBP and DBP is near nonexistence,the blood pressure data using this device is creditable.Conclusion The blood pressure can be measured using this device,and it can be used to further study the auto-measurement of blood pressure base on Korotkoff's sound theory.

Advantages of Frequency Specific Tri-microphone Binaural Wireless Hearing Aid Technology / 听力学及言语疾病杂志

Objective To examine adult speech recognition for words presented in different background noise when the adults used 4-band tri-microphone and traditional tri-microphone hearing aid technology,and to examine the ability of sound location when using wireless remote control.Methods A total 40(female 29,male 11) subjects with moderate to severe bilateral sensorineural hearing loss were encountered in this test,and were divided into two groups(group A and group B).With binaural fitting ACURIS P(frequency specific tri-microphone adaptive mode) and Triano 3 P(Tri-microphone adaptive mode),the patients were tested with speech recognition in two sound field through PB test and the accurateness of sound localization were investigated through questionnaire.Results Significant differences were found between the mean L50(the S/N at which 50% of running speech is correctly understood) obtained from group A versus group B in Tri-microphone adaptive directional condition in multiple sound fields(P

Comparison of Speech Perception Performance of BTE Hearing Aids With Different Directional Microphones / 听力学及言语疾病杂志

Objective To compare the speech perception performance of BTE hearing aids with different directional microphones. Methods 20 adults with sensorineural hearing loss participated in the research. Two digital hearing aids were programmed for adaptive directional, fixed directional, and omni-directional microphone patterns. The multi-talker noise was presented in three conditions: 180?,?90?, and 360?. Each subject was tested in nine listening conditions (three microphone patterns and three noise presentations) by using modified Hearing In Noise Test. SNR was obtained in each testing condition. Results Under each noise presentation, the sequence of microphone patterns that obtained SNR from low to high was: adaptive directional, fixed directional, and omni-directional. Conclusion Adaptive directional microphone worked best when the noise source was changing or the noise was coming not only from behind but also from other directions; fixed directional microphone could be employed when the noise came from the rear; omni-directional microphone was suitable for hearing in quiet.

Experimental Observation of Spontaneous Otoacoustic Emissions and Cochlear Microphone Potential in Guinea Pigs / 听力学及言语疾病杂志

The spontaneous otoacoustic emissions(SOAEs) and spontaneous cochlear microphone potential (SCM) were observed in 8 guinea pigs from 168 normal guinea pigs. Second and third harmonics of SOAE had been observed in three animals. The distortion product otoacoustic emissions(2f1-f2) were created with an external tone as f2 and the SOAE as f 1 in 6 animals , SOAE were suppressed by contralateral broadband noise stimulation and enhanced by strychnine . The suppression tuning curve was similar to the two tone suppression. The results indicate that SOAE and SCM are spontaneous electromotile vibration of outer hair cells. The model of spontaneous vibration and characteristic of audiology is the same as that of hearing of external tone and it can be modulated by efferent system.

Design of heart sound processing analog circuit based on the electret capacitor microphone / 医疗卫生装备

This paper designs a heart sound processing analog circuit, in which the amplification circuit, the filter circuit and the lifting of electrical level circuit are involved. It also gives a safety design problem analysis using an electret capacitor microphone to pick-up the heart sound signals. It is proved that the circuit is reliable and effective.