Test-retest reliability of the urban outdoor situated phoneme (SiP) test.

OBJECTIVE: To introduce the urban outdoor version of the Situated Phoneme (SiP) test and investigate its test-retest reliability. DESIGN: Phonemic discrimination scores in matched-spectrum real-world (MSRW) maskers from an urban outdoor environment were measured using a three-alternative forced choice test paradigm at different phoneme-to-noise ratios (PNR). Each measurement was repeated twice. Test-retest scores for the full 84-trial SiP-test, as well as for four types of contrasting phonemes, were analysed and compared to critical difference scores based on binomial confidence intervals. STUDY SAMPLE: Seventy-two adult native speakers of Swedish (26-83 years) with symmetric hearing threshold levels ranging from normal hearing to severe sensorineural hearing loss. RESULTS: Test-retest scores did not differ significantly for the whole test, or for the subtests analysed. A lower amount of test-retest score difference than expected exceeded the bounds of the corresponding critical difference intervals. CONCLUSIONS: The urban outdoor SiP-test has high test-retest reliability. This information can help audiologists to interpret test scores attained with the urban outdoor SiP-test.

Linguistic Materials and Metrics for the Creation of Well-Controlled Swedish Speech Perception Tests.

Purpose As factors influencing human word perception are important in the construction of speech perception tests used within the speech and hearing sciences, the purposes of this study were as follows: first, to develop algorithms that can be used to calculate different types of word metrics that influence the speed and accuracy of word perception and, second, to create a database in which those word metrics were calculated for a large set of Swedish words. Method Based on a revision of a large Swedish phonetic dictionary, data and algorithms were developed by which various frequency metrics, word length metrics, semantic metrics, neighborhood metrics, phonotactic metrics, and orthographic transparency metrics were calculated for each word in the dictionary. Of the various word metric algorithms used, some were Swedish language reimplementations of previously published algorithms, and some were developed in this study. Results The results of this study have been gathered in a Swedish word metric database called the AFC-list. The AFC-list consists of 816,404 phonetically transcribed Swedish words, all supplied with the word metric data calculated. The full AFC-list has been made publicly available under the Creative Commons Attribution 4.0 International license. Conclusion The results of this study constitute an extensive linguistic resource for the process of selecting test items in new well-controlled speech perception tests in the Swedish language. Supplemental Material https://doi.org/10.23641/asha.8330009.

Loudness and annoyance of disturbing sounds - perception by normal hearing subjects.

OBJECTIVE: Sounds in the daily environment may cause loudness and annoyance. The present study investigated the perception of loudness and annoyance for eight different sounds present in a daily sound environment and at nine different levels varying by ±20 dB around the recorded level. The outcomes were related to tests of participants' auditory and cognitive abilities. DESIGN: The participants undertook auditory and working memory (WM) tests prior to ratings of everyday sounds previously shown to be disturbing for persons with hearing impairment (hearing aid users). STUDY SAMPLE: Twenty-one participants aged between 24 and 71 years, with normal hearing threshold levels. RESULTS: Both perceived loudness and annoyance were primarily driven by the sound level. Sounds emitted from paper were rated as having greater loudness and being more annoying than the other sound sources at the same sound level. Auditory and cognitive abilities did not influence the perception of loudness and annoyance. CONCLUSIONS: Loudness and annoyance ratings were mainly driven by sound level. Expectations of a sound seemed to influence the assessment of loudness and annoyance while auditory performance and WM capacity showed no influence on the ratings.

Cochlear implantation in the elderly.

OBJECTIVES: To analyse complications and outcome of cochlear implant (CI) treatment in seniors receiving CIs during a 10-year period. METHODS: A total of 28 patients, 79 years or older (mean age 81.6 years), were evaluated and compared with a younger group of 76 patients, 20-60 years old (mean age 48.9 years). A retrospective study of the patients' records was performed. Data on per- and post-operative complications, pre- and post-operative speech perception, estimated cognitive skills, and social situation was extracted. A subjective score was assessed and correlated with post-operative performance. RESULTS: No severe per- or post-operative surgical complications were noted. Speech perception improved significantly after surgery (P < 0.001). The younger age group showed better results post-operatively for monosyllabic words (P < 0.01) compared with the older group with no difference seen for bi-syllabic words. In both the groups, there were no significant differences between patients living with or without social support. DISCUSSION: CI surgery for patients 79 years or older was well tolerated. Patients benefited greatly from the device with improved hearing. CI should not be denied older individuals who are otherwise in good health. Non-use in the elderly was associated with post-operative vertigo and tinnitus, severe disease and limited social support.

Cochlear implantation and hearing preservation: Results in 21 consecutively operated patients using the round window approach.

CONCLUSION: Prevalent hearing conservation may be achieved after round window (RW) cochlear implantation using soft and flexible electrode arrays if variations of RW anatomy, topography, and facial nerve position are considered. The most favorable electrode insertion depth remains to be established. OBJECTIVES: We assessed the incidence of cochlear function after cochlear implant (CI) electrode insertion through the RW in our first 21 consecutively operated patients aimed at hearing conservation. METHODS: Eleven patients had a preoperative low frequency hearing suitable for electro-acoustic stimulation. Hearing was preserved in an additional nine patients at their request with the intention to use full frequency CI stimulation. Anatomic variations of the RW were carefully considered using our temporal bone collection of micro-dissected ears. Electrode extension was assessed on X-ray by measuring the insertion angle of the first electrode and intra-cochlear length and correlated with audiometric data. RESULTS: There was no incidence of total loss of residual hearing in any of the patients. A slight deterioration of low frequency thresholds occurred in some patients. Mean hearing loss at 125-500 Hz was 14.4 dB at 1 month following surgery and 15.6 dB after 1 year. Insertion angle (300-540°) and depth (17.5-28.5 mm) were not statistically correlated to hearing loss.

High frequency hearing following stapes surgery.

CONCLUSION: Our results indicate that a pre-existing sensorineural hearing loss (SNHL) is not a potential risk factor for further hearing loss in stapes surgery. OBJECTIVE: The study evaluated whether pre-existing SNHL in otosclerosis constitutes a risk factor for further hearing loss in stapedotomy. METHODS: Preoperative and postoperative audiometric evaluation including air (AC) and bone conduction (BC) hearing levels were assessed together with collection of surgical records from 338 consecutively operated cases for primary otosclerosis using a database. Patients were operated by the same surgeon between 2000 and 2006. In all, 291 patients were operated on 1 side and 47 patients were operated on both sides. Ages ranged from 16 to 76 years. Stapedotomy was performed in all cases except five (stapedectomy). Cases were separated into four different groups based on preoperative AC hearing levels at 4, 6, and 8 kHz: group I, <30 dB HL; group II, 30-50 dB HL; group III, 51-70 dB HL; group IV, >70 dB HL). RESULTS: Hearing deterioration at 4, 6, and 8 kHz (>10 dB) was observed in 6.5% of all cases. Patients with normal preoperative hearing were found to be more prone to further SNHL 4, 6, and 8 kHz (range 13-25 dB) at surgery, while patients in group IV, with preoperative SNHL impairment, remained unaffected.

Surgical treatment of paediatric cholesteatoma: long-term follow up in comparison with adults.

OBJECTIVE: This study was designed to analyse long-term results after surgery of acquired (ACH) and congenital cholesteatoma (CCH) of the middle ear in children and compare these with adults. METHODS: Computer-based analysis of consecutively operated paediatric patients for ACH and CCH in a tertiary referral centre was made in 57 cases under the age of 12 operated 1983-2004 by three surgeons using identical technique. A canal wall down and total reconstruction procedure (TRP) with obliteration of the mastoid cavity, canal wall reconstruction, ossiculoplasty with consistent use of autologous bone and an "aeration enhancement procedure" (AEP) with silicon sheet in selected cases were used. Pre- and post-operative PTA (0.5-3 kHz) and pure-tone average air-bone gap (PTA-ABG) together with surgical parameters were assessed 1, 3 and 6 years following surgery. RESULTS: Results showed stable hearing over 6 years with low incidence of persistent and recurrent disease comparable with results from adult patients. In nearly half of the cases, silastic sheeting was used. In 21 cases, stapes was eroded. Bone conduction thresholds levels remained unaffected 6 years after surgery. No deaf ears, postoperative facial dysfunction or other lesions related to surgery were observed. Six years after surgery every evaluated ear was found to be water-resistant and infection -free. CONCLUSION: Our results suggest that one-stage eradication of ACH and CCH in children using total reconstruction procedure (TRP) provide long-term improvement or preservation of hearing, with a low incidence of persistent or recurrent disease. No difference in surgical outcome between children and adults was found.

Successful and unsuccessful users of bilateral amplification: differences and similarities in binaural performance.

Bilateral amplification seems to be the best solution for bilaterally hearing-impaired persons. Nevertheless, some individuals are unsuccessful with this strategy. The goals of the present study were to develop tests to improve the diagnostic test battery before rehabilitation of hearing-impaired persons with bilateral or unilateral amplification, and to evaluate the tests with normally-hearing subjects and with two groups of hearing-impaired persons. The latter two groups contained 11 successful and 11 unsuccessful users of bilateral amplification respectively. Hearing thresholds, speech recognition in noise, signal analysis ability, binaural abilities, and dichotic tests were used in the investigation. The subjects answered a questionnaire and hearing aid gain curves were measured. The results for the two groups were similar for peripheral hearing functions and binaural performance. The unilateral amplification group showed significantly worse results in speech-in-noise and dichotic tests. Spatial aspects within the questionnaire were correlated to amplification preference. We therefore suggest the inclusion of speech-in-noise, dichotic tests, and questions on spatial orientation into the diagnostic scheme before rehabilitation with hearing aids.