Evaluation of the Recovery of Idiopathic Sudden Sensorineural Hearing Loss Based on Estimated Hearing Disorders.

Various prognostic factors for idiopathic sudden sensorineural hearing loss (SSNHL) have been reported. Hearing loss directly derived from idiopathic SSNHL is important for understanding underlying pathogenesis and outcomes. We assessed the usefulness of evaluating hearing loss and recovery of idiopathic SSNHL on the basis of estimated hearing loss. The study included 115 patients whose characteristics and outcomes of hearing loss were investigated. The effects of vertigo/dizziness and age on hearing thresholds before/after treatment, nonaffected ear threshold, estimated hearing loss, improvement of hearing loss, and estimated remaining hearing loss were investigated. Vertigo/dizziness was a significant prognostic factor for hearing. In vertigo/dizziness patients, significantly more severe hearing loss and poorer improvement of hearing loss were observed above 500 Hz and below 1000 Hz, respectively. Severe hearing disorder remained at all frequencies. Conversely, post-treatment thresholds were significantly higher in the older population (≥65 years), although no differences in pretreatment thresholds were observed between the younger (≤64 years) and older populations. However, on the basis of nonaffected ear thresholds, previously existing hearing loss could have influenced the outcome. Thus, comparison of hearing outcomes between affected and nonaffected ears is essential for understanding hearing loss and outcomes in idiopathic SSNHL cases with existing hearing disorder.

Speech recognition scores in bilateral and unilateral atretic ears.

OBJECTIVE: Congenital aural atresia causes severe conductive hearing loss disturbing auditory development. The differences in speech recognition were investigated between bilateral and unilateral aural atresia. DESIGN: The maximum speech recognition scores (SRSs) were compared between patients with bilateral and unilateral aural atresia. In patients with unilateral aural atresia, the maximum SRSs were compared between the atretic and unaffected ears. Furthermore, the correct response rates for test material monosyllables were compared with those of patients with sensorineural hearing loss (SNHL), which had been previously obtained. STUDY SAMPLE: Twenty-four patients with aural atresia (8 bilateral, and 16 unilateral) participated. RESULTS: The maximum SRS in unilateral atretic ears (median: 72%) was significantly lower than that in unaffected ears (median: 89%) (p < 0.05) and in bilateral atretic ears (median: 91%) (p < 0.05). Patients with aural atresia had relatively high correct response rates for monosyllables with low correct response rates by patients with SNHL. Conversely, incorrect responses were obtained for several words for which high correct-response rates were attained by patients with SNHL. CONCLUSIONS: Poor unilateral atretic-ear development may induce low speech recognition, and the mechanisms underlying speech-recognition reduction differ from those in SNHL.

Benefits of Cartilage Conduction Hearing Aids for Speech Perception in Unilateral Aural Atresia.

Severe conductive hearing loss due to unilateral aural atresia leads to auditory and developmental disorders, such as difficulty in hearing in challenging situations. Bone conduction devices compensate for the disability but unfortunately have several disadvantages. The aim of this study was to evaluate the benefits of cartilage conduction (CC) hearing aids for speech perception in unilateral aural atresia. Eleven patients with unilateral aural atresia were included. Each participant used a CC hearing aid in the atretic ear. Speech recognition scores in the binaural hearing condition were obtained at low speech levels to evaluate the contribution of aided atretic ears to speech perception. Speech recognition scores were also obtained with and without presentation of noise. These assessments were compared between the unaided and aided atretic ear conditions. Speech recognition scores at low speech levels were significantly improved under the aided atretic ear condition (p < 0.05). A CC hearing aid in the unilateral atretic ear did not significantly improve the speech recognition score in a symmetrical noise presentation condition. The binaural hearing benefits of CC hearing aids in unilateral aural atresia were predominantly considered a diotic summation. Other benefits of binaural hearing remain to be investigated.

Effect of fixation place on airborne sound in cartilage conduction.

When a transducer is placed on aural cartilage, relatively loud sound becomes audible in a conduction form termed cartilage conduction (CC). Previous studies have revealed the acoustical differences between CC and conventional air or bone conduction. This study elucidates the working principle of CC through measurements of threshold shifts by water injection into the ear canal under various fixation place conditions. Seven volunteers with normal hearing participated. A lightweight transducer was fixed for three CC conductions (on the tragus, antitragus, and intertragal incisure), and two non-CC conditions (on the pre-tragus and mastoid). Thresholds were measured at 500, 1000, and 2000 Hz in the 0%-, 40%-, and 80%-water injection conditions. Results for the three CC conditions revealed unique features different from those for the non-CC conditions. For the CC conditions, the thresholds increased by the 40%-water injection at all frequencies. However, with additional water injection (80%-water injection), the thresholds decreased at 500 and 1000 Hz; in particular, dramatically at 500 Hz. The results suggest that a direct vibration of the aural cartilage is important to obtaining the significant contribution of airborne sound to hearing above 1000 Hz. Fixation place results in no significant difference in acoustic features among CC conditions.

Autocorrelation factors and intelligibility of Japanese monosyllables in individuals with sensorineural hearing loss.

Some Japanese monosyllables contain consonants that are not easily discernible for individuals with sensorineural hearing loss. However, the acoustic features that make these monosyllables difficult to discern have not been clearly identified. Here, this study used the autocorrelation function (ACF), which can capture temporal features of signals, to clarify the factors influencing speech intelligibility. For each monosyllable, five factors extracted from the ACF [Φ(0): total energy; τ1 and ϕ1: delay time and amplitude of the maximum peak; τe: effective duration; Wϕ(0): spectral centroid], voice onset time, speech intelligibility index, and loudness level were compared with the percentage of correctly perceived articulations (144 ears) obtained by 50 Japanese vowel and consonant-vowel monosyllables produced by one female speaker. Results showed that median effective duration [(τe)med] was strongly correlated with the percentage of correctly perceived articulations of the consonants (r = 0.87, p < 0.01). (τe)med values were computed by running ACFs with the time lag at which the magnitude of the logarithmic-ACF envelope had decayed to -10 dB. Effective duration is a measure of temporal pattern persistence, i.e., the duration over which the waveform maintains a stable pattern. The authors postulate that low recognition ability is related to degraded perception of temporal fluctuation patterns.