Sound and postural control during stance tasks in abnormal subjective haptic vertical.

BACKGROUND: Patients with vestibular impairment often suffer from postural instability. This could be compensated by other sensory systems such as the auditory system. OBJECTIVE: The aim of this study was to investigate whether auditory input improves postural stability in patients with abnormal subjective haptic vertical (SHV). METHODS: Participants (n = 13) with normal hearing and vision, but abnormal SHV participated. Participants performed standing on firm ground and foam support (eyes open/closed) and Tandem Romberg test (eyes closed) in quiet (reference), noise and with plugged ears. All tasks were conducted in a soundproofed and reverberant room. Postural stability was recorded close to the body's center of gravity. Reference conditions were compared with a control group. RESULTS: In only two tasks sway increased significantly when noise was presented during challenging tasks in the soundproofed room. Sway of the reference conditions did not differ significantly between control and study group. CONCLUSIONS: This study shows no influence of applied auditory stimulation on posture in participants with abnormal SHV in a reverberant room, but an adverse effect on balance during difficult tasks in the soundproofed room. Noise possibly masked auditory information that was helpful in improving posture in the quiet condition. Futhermore, noise might have distracted participants from maintaining balance.

Influence of Auditory Information on Postural Control During Different Gait Tasks in the Elderly.

BACKGROUND: Hearing loss is frequently associated with reduced postural control. This is possibly not only related to simultaneous pathophysiological changes within the hearing and vestibular system. The auditory input itself could provide helpful information for maintaining postural control. Previous studies of our group already showed that continuous or interrupted white noise can significantly improve postural control during gait conditions in young healthy individuals. The present study aimed at investigating if those effects are also active in the elderly. METHODS: Elderly volunteers (mean age 67 years) without any history of disorders to influence gait performance successfully completed 5 walking tasks under 4 different acoustic conditions. Angular sway velocity was measured close to the center of gravity with the Vertiguard® system. RESULTS: Significant changes in body sway velocity were found in 4 of 5 investigated tasks. Only "walking with turning head in rhythm" was not associated with any change in the acoustic input. The sway increased by 8.9% during "walking with open eyes" in the pitch direction and by 11.5% during "tandem walking" in the roll direction if ear protection was applied. The sway was reduced by 9.1% during "walking over barriers" in the pitch direction and by 16.7% in the roll direction during "walking with closed eyes" if a stationary source of continuous white noise was presented. CONCLUSION: The data of the present study indicate that auditory information could significantly alter postural control during walking in the elderly. Continuous white noise seems to be helpful for maintaining balance in different walking tasks.

Digital Live Imaging of Intraoperative Electrocochleography - First Description of Feasibility and Hearing Preservation During Cochlear Implantation.

INTRODUCTION: Intraoperative electrocochleography (ECochG) during cochlear implantation is a promising tool to preserve residual hearing. However, the time gap between insertion of the electrode and acoustic feedback from the audiologist to the surgeon can cause delay and subsequently irreparable damage to cochlear structures. In this feasibility study, for the first time, real-time visualization of intraoperative ECochG via digital microscope display directly to the surgeon was successfully performed in four patients. MATERIALS AND METHODS: Four patients with residual hearing underwent cochlear implantation. Intraoperative electrocochleography responses were collected and direct visualization during the time of electrode insertion into the surgeon's field of view in the binoculars using augmented real-time digital imaging was realized. The time of electrode insertion was recorded. Hearing preservation was determined by testing postoperative changes in behavioral thresholds. RESULTS: Digital live visualization of intraoperative ECochG using image augmentation in a digital microscope was successfully performed in all cases and enabled direct adaptation of the surgeon's insertion behavior. Mean time of electrode insertion was 129.8 seconds. Postoperative behavioral thresholds were comparable to preoperative taken thresholds. Preservation of residual hearing in the low frequency range was possible. DISCUSSION: This study is the first to describe digital visualization of intraoperative electrocochleography as a new method enabling the surgeon to directly react to changes in amplitude of the cochlea microphonics. Our results show that augmentation of the intraoperative live imaging with electrical potentials could add to hearing preservation during cochlear implantation.

A static sound source can improve postural stability during walking.

BACKGROUND: During walking, postural stability is controlled by visual, vestibular and proprioceptive input. The auditory system uses acoustic input to localize sound sources. For some static balance conditions, the auditory influence on posture was already proven. Little is known about the impact of auditory inputs on balance in dynamic conditions. OBJECTIVE: This study is aimed at investigating postural stability of walking tasks in silence and sound on condition to better understand the impact of auditory input on balance in movement. METHODS: Thirty participants performed: walking (eyes open), tandem steps, walking with turning head and walking over barriers. During each task, acoustic condition changed between silence and presented noise through an earth-fixed loudspeaker located at the end of the walking distance. Body sway velocity was recorded close to the body's center of gravity. RESULTS: A decreased body sway velocity was significant for walking (eyes open), tandem steps and walking over barriers when noise was presented. Those auditory stimuli did not affect sway velocity while walking with turning head. The posture has probably improved due to the localization ability when walking with the head facing forward, while the localization ability was impaired when turning the head. CONCLUSIONS: The localization ability of a fixed sound source through the auditory system has a significant but limited impact on posture while walking.

Auditory influence on postural control during stance tasks in different acoustic conditions.

BACKGROUND: Postural stability might be influenced by auditory input as humans utilize spatiotemporal information to localise sound sources. Earlier studies investigated the acoustic influence on posture but unfortunately experimental setup, room acoustics and conditions of participants varied widely. OBJECTIVE: This study aimed at recording body sway velocity under clearly defined acoustic conditions in a homogenous group of young healthy participants. METHODS: Thirty participants performed five stance tasks (standing eyes open/closed, standing on a foam support eyes open/closed, Tandem Romberg test eyes closed) under four acoustic conditions (in quiet, with a loudspeaker presenting continuous/interrupted noise, with ear protectors) in two different rooms (long/short reverberation time). Body sway velocity was determined close to body's centre of gravity. RESULTS: Postural stability decreased significantly when continuous noise was applied and increased significantly when interrupted noise was presented in the reverberant room. The usage of ear protectors increased body sway velocity compared to quietness in both rooms. CONCLUSIONS: An impaired auditory input by plugging/acoustic masking reduced postural control. Interrupted noise seems to provide a continuously repeated feedback about the postural position in a reverberant room. Hence, the effect of hearing on posture highly depends on the structure of the auditory signal, the sensorimotor condition and the acoustic environment.

Benefit of directional microphones for unilateral, bilateral and bimodal cochlear implant users.

OBJECTIVE: To compare the standard T-Mic setting to UltraZoom and StereoZoom in 10 unilateral cochlear implant (CI) users, 10 bimodal device users and 10 bilateral CI users as well as a normal hearing (NH) reference group (n = 10). METHOD: Speech reception thresholds were measured using the Oldenburg sentence test in noise. Speech was presented from the front at 0°, noise was presented from five loudspeakers spaced at ±60°, ±120°, 180° (setup A) or from four loudspeakers in the front hemisphere at ±30°, ±60° and one at 180° (setup B). RESULTS: There was a significant advantage for UltraZoom and StereoZoom for all groups in both setups. The largest advantage was for StereoZoom in the bilateral group (setup A, 5.2 dB, P < 0.001 and B, 3.4 dB, P < 0.001) There was a significant advantage for StereoZoom over UltraZoom in the bimodal group (setup A, P < 0.01 and B, P < 0.05) and in the bilateral group (P < 0.01, setup B only). The bilateral group performed as well as the normally hearing group in both setups and the bimodal group performed as well in setup A. There was a significant benefit of 1.8 dB for ClearVoice over UltraZoom alone for the unilateral group. CONCLUSIONS: UltraZoom and StereoZoom provided a clinically and statistically significant benefit over the T-Mic condition. The largest gain was shown for StereoZoom in the bimodal and bilateral groups. The use of StereoZoom enabled the bilateral group to perform as well as the normally hearing group in both the challenging speaker setups. However, real life environments might provide an even greater challenge than the conditions tested here.

Use of high-rate envelope speech cues and their perceptually relevant dynamic range for the hearing impaired.

The ability of hearing-impaired (HI) listeners to use high-rate envelope information in a competing-talker situation was assessed. In experiment 1, signals were tone vocoded and the cutoff frequency (f(c)) of the envelope extraction filter was either 50 Hz (E filter) or 200 Hz (P filter). The channels for which the P or E filter was used were varied. Intelligibility was higher with the P filter regardless of whether it was used for low or high center frequencies. Performance was best when the P filter was used for all channels. Experiment 2 explored the dynamic range over which HI listeners made use of high-rate cues. In each channel of a vocoder, the envelope extracted using f(c) = 16 Hz was replaced by the envelope extracted using f(c) = 300 Hz, either at the peaks or valleys, with a parametrically varied "switching threshold." For a target-to-background ratio of +5 dB, changes in speech intelligibility occurred mainly when the switching threshold was between -8 and +8 dB relative to the channel root-mean-square level. This range is similar in width to, but about 3 dB higher in absolute level than, that found for normal-hearing listeners, despite the reduced dynamic range of the HI listeners.