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PubMed1993

The effect of listeners' experience on the evaluation of intonation contours produced by hearing-impaired children.

This study investigated the effect of the listener's experience on the evaluation of intonation contours produced by hearing-impaired children. Stimuli included imitations of intonation (based on synthetic speech stimuli) produced by hearing-impaired children. Twenty listeners (10 experienced and 10 naive) evaluated the intonation production by means of two evaluation tools: a rating scale and a forced-choice test. No significant differences were found between the two listener groups using the forced-choice test, either for the falling or for the rising contours. However, a significant difference was found between the two listener groups using the rating scale, with regard to both the rising and the falling contours. Thus, the effect of experience decreased when using the forced-choice procedure. This finding supports the use of the forced-choice method for providing a perceptual measure of speech production performance that is independent of the listener's experience.

Acoustic Stimulation↗
PubMed1993

Mismatch negativity in the neurophysiologic/behavioral evaluation of auditory processing deficits: a case study.

The subject of this case report is an 18-year-old woman with grossly abnormal auditory brain stem response (ABR), normal peripheral hearing, and specific behavioral auditory processing deficits. Auditory middle latency responses (MLRs) and cortical potentials N1, P2, and P300 were intact. The mismatch negativity (MMN) was normal in response to certain synthesized speech stimuli and impaired to others--consistent with her behavioral discrimination of these stimuli. Behavioral tests of auditory processing were consistent with auditory brain stem dysfunction. A neuropsychological evaluation revealed normal intellectual and academic performance. The subject was in her first year of college at the time of the evaluation. This case study is important because: (1) Although there have been several reports of absent/abnormal ABR with preserved peripheral hearing and deficits in auditory processing, little is known about the specific nature of the auditory deficits experienced by these individuals. Such information may be valuable to the clinical management of patients with this constellation of findings. (2) Of interest is the information that the mismatch negativity (MMN) cortical event-related potential can bring to the evaluation of patients with auditory processing deficits. The MMN reflects central auditory processing of small acoustic differences and may provide an objective measure of auditory discrimination. (3) From a theorectical standpoint, a patient with neural deficits affecting specific components of the auditory pathway provides insight into the relationship between evoked potentials and physiological mechanisms of auditory processing. How do various components of the auditory pathway contribute to speech discrimination? How might evoked potentials reflect the processes underlying the neural coding of specific features of speech stimuli such as timing and spectral cues?

Achievement↗
PubMed2002

The results in patients implanted with the nucleus double array cochlear implant: pitch discrimination and auditory performance.

OBJECTIVE: In patients with total or surgically inaccessible cochlear obliteration, only a reduced number of active electrodes can be inserted with standard cochlear implants, resulting in below average auditory performance. Therefore, a special implant with two electrode arrays was developed on the basis of the Nucleus 22 cochlear implant, the socalled Double Array. One electrode array with 11 active electrodes is inserted into the basal turn of the cochlea, while the second array with 10 active electrodes is inserted into the second turn. The Double Array is now available on the basis of the more advanced Nucleus 24 with 11 active electrodes on each array and two reference electrodes, one at the case and the second one an additional ball electrode, which is placed under the temporalis muscle. For device description and surgical technique see Lenarz et al. (2001). This paper presents psychophysical data on pitch discrimination and auditory performance of patients implanted with a Double Array on the basis of the Nucleus 22. STUDY DESIGN: A prospective intra-individual study using a Latin square paradigm was performed in six adult patients with obliterated cochlea who received the Nucleus 22 Double Array. After appropriate fitting and loudness balancing, patients were tested either with the basal, the apical or both electrode arrays. Apart from auditory performance tests including numbers and monosyllable word tests, pitch discrimination was determined with a defined procedure. RESULTS: When activating each array alone, auditory performance was better with the basal array than with the apical array. Both arrays together showed marked improvement compared with the basal array, indicating an additional effect of the second array. Pitch discrimination was significantly better for the electrodes in the basal turn than in the second turn, indicating differences in electrical excitation of the auditory nerve fibers. Pitch discrimination was positively correlated with auditory performance data. CONCLUSION: The additional apical array leads to significant improvement in auditory performance in patients with obliterated cochleae by increasing the number of intracochlear electrodes. Despite reduced pitch discrimination, the apical array provides important information for speech recognition. For this reason the Double Array provides a profound advantage for patients with obliterated or surgically inaccessible cochleae.

Acoustic Stimulation↗
PubMed2004

Pitch ranking with deeply inserted electrode arrays.

OBJECTIVE: Electrode pitch ranking was assessed as a function of cochlear region, electrode spacing, and stimulation rate in eight subjects implanted with the MED-EL COMBI 40+ implant. The MED-EL COMBI 40+ electrode array allows deep insertion of the electrode up to the apex of the cochlea and provides a wide electrode spacing of 2.4 mm. DESIGN: The pitch of a reference electrode was compared with the pitch of two apical and two basal probe electrodes using a two-alternative forced-choice procedure. The reference electrodes were placed in the apical region, in the middle region, and in the basal region of the cochlea. Each condition was tested at pulse rates of 1515 pps, 500 pps, and 250 pps. RESULTS: Electrode pitch ranking did not depend on electrode spacing, the position of the reference electrode in the cochlea, or stimulation rate. CONCLUSIONS: These results indicate that a spacing of 2.4 mm seems sufficient to allow good electrode pitch ranking performance for the average user and that electrode pitch ranking is similar in the apical, middle, and basal region of the cochlea, irrespective of the stimulation rate. Most importantly, the results of this study indicate that residual neural structures in the apical region of the cochlea are sensitive to pitch changes provided by different places of electrical stimulation.

Adult↗
PubMed1994

Magnetoencephalographic studies of auditory system function.

Magnetoencephalography (MEG) has provided a noninvasive method of demonstrating physiological processes underlying fundamental aspects of auditory system function. MEG technology offers a key advantage over evoked potentials, that being a relatively unimpeded view of structures underlying auditory evoked responses in which cortical sources predominate. Investigators conducting auditory evoked field investigations have demonstrated tonotopicity, amplitopicity, and periodicity pitch representation in the auditory cortex. This article provides a description of MEG, various auditory evoked fields that have been reported, the psychophysics associated with auditory evoked field component N1m, and some clinical applications of this technology.

Auditory Cortex↗
PubMed1995

Auditory evoked magnetic fields to tones and pseudowords in healthy children and adults.

Neuromagnetic responses to tones and pseudowords were measured with a 24-channel magnetometer in nine adults and in 23 children, the latter aged 0.3-15 years. Both stimulus types elicited substantially similar responses in all subjects. At 0.9-s interstimulus interval (ISI), the adult response was a stable P1m-N1m-P2m-N2m sequence peaking at 50, 100, 200, and 250 ms, respectively. A biphasic P1m-N1,2m response with peaks at 100 and 260 ms occurred in children up to 12 years of age. At longer ISIs (1.2-2.4 s), an adult-type N1m response appeared in most children. N1m amplitude suppression at short ISIs was stronger in children than in adults and may reflect a longer refractory period of the N1 generator neurons during early childhood than later in life. Peak latencies of P1m, N1m, and N2m decreased with age, most rapidly < 7 years of age. All deflections originated in nearby cortical areas within the posterior sylvian fissure, and may serve as functional landmarks for that anatomic area.

Adolescent↗
PubMed1998

Assessment of functional cerebral laterality for language using magnetoencephalography.

The purpose of the study was to examine the feasibility of using magnetoencephalography (MEG), a noninvasive functional brain imaging technique, to assess cerebral laterality for language. The magnetic flux normal to the scalp surface was measured with a whole-head neuromagnetometer while subjects (n = 16) were engaged in a word-matching and a tone-matching task. The effect of hemisphere and task on the number of satisfactory equivalent current dipole (ECD) solutions obtained during the late portion of the responses to the word and tone stimuli was examined. An interhemispheric ECD laterality index was also computed. Satisfactory ECD solutions were localized in perisylvian cortices during both tasks. A greater number of ECDs was found in the left hemisphere in 14 (87%) of 16 of the subjects in the word-matching task, a proportion that approaches the reported incidence of left-hemisphere dominance among right-handers. A similar proportion of subjects also showed a clear asymmetry in the number of ECDs favoring the left hemisphere in the language task as compared to the nonlanguage task. These findings suggest that MEG is a promising tool for laterality assessment. Magnetoencephalography-based functional asymmetry data are currently being compared against invasive presurgical procedures (i.e., intracarotid amobarbital procedure).

Adult↗
PubMed2002

Electrophysiologic signs of attention versus distraction in a binaural listening task.

Effects of active versus passive listening on the N1 and P2 components of the late auditory evoked potential were examined in 20 young adults following instructions to ignore and later to attend to different trains of frequent and deviant tones presented to one or both ears. To distinguish monaural from binaural neural refractory or recovery effects, monaural test runs were used to control for differences in stimulus-onset asynchronies (SOAs) between monaural and binaural runs. As expected, selective attention and monaural neuronal refractory effects were found. When attending the tones, listeners exhibited significantly larger P2, but not N1, amplitudes. During test runs with shorter monaural SOAs, listeners exhibited smaller N1 and P2 amplitudes than they did with longer SOAs. However, whether attending or nonattending, P2 amplitudes were smaller during binaural than monaural test runs, which suggests the possible existence of some form of "binaural" neuronal refractory or recovery effect. However, the absence of this binaural effect with the N1 component would suggest that binaural refractoriness, if it exists, involves different physiologic processes than monaural refractoriness.

Acoustic Stimulation↗
PubMed2003

Does repeated hyperbaric exposure to 4 atmosphere absolute cause hearing impairment? Study in Guinea pigs and clinical incidences.

HYPOTHESIS: Direct pressure applied on the inner ear cannot induce hearing loss. BACKGROUND: Three possible causes have been described in the literature for inner ear permanent lesions during scuba diving: pressure imbalance between the middle ear and the external ear, appearance of microbubbles in the internal ear, and direct effect of pressure on the inner ear. We seek to determine whether this last factor can be involved. METHODS: We submitted two groups of guinea pigs previously implanted with an electrode in the round window to a protocol of air diving in a hyperbaric chamber. Eardrums of animals in one of the two groups had been perforated beforehand. Twenty dives were practiced over 4 weeks. We chose dive parameters consistent with common sport diving: maximal pressure of 4 atmosphere absolute and duration of 30 minutes. Auditory threshold and cochlear spontaneous activity were recorded at regular intervals. Furthermore, we recorded spontaneous cochlear activity in Heliox 400-m and 600-m dives to determine whether our conclusions hold for "extreme" diving. RESULTS: In the group with perforated eardrums, no variation of those parameters were recorded, even in extreme diving. Important variations were noticed in the other group. CONCLUSIONS: Pressure applied directly on the inner ear during diving does not disturb cochlear activity.

Animals↗
PubMed2005

Underwater hearing and sound localization with and without an air interface.

HYPOTHESIS: Underwater hearing acuity and sound localization are improved by the presence of an air interface around the pinnae and inside the external ear canals. BACKGROUND: Hearing threshold and the ability to localize sound sources are reduced underwater. The resonance frequency of the external ear is lowered when the external ear canal is filled with water, and the impedance-matching ability of the middle ear is significantly reduced due to elevation of the ambient pressure, the water-mass load on the tympanic membrane, and the addition of a fluid-air interface during submersion. Sound lateralization on land is largely explained by the mechanisms of interaural intensity differences and interaural temporal or phase differences. During submersion, these differences are largely lost due to the increase in underwater sound velocity and cancellation of the head's acoustic shadow effect because of the similarity between the impedance of the skull and the surrounding water. METHODS: Ten scuba divers wearing a regular opaque face mask or an opaque ProEar 2000 (Safe Dive, Ltd., Hofit, Israel) mask that enables the presence of air at ambient pressure in and around the ear made a dive to a depth of 3 m in the open sea. Four underwater speakers arranged on the horizontal plane at 90-degree intervals and at a distance of 5 m from the diver were used for testing pure-tone hearing thresholds (PTHT), the reception threshold for the recorded sound of a rubber-boat engine, and sound localization. For sound localization, the sound of the rubber boat's engine was randomly delivered by one speaker at a time at 40 dB HL above the recorded sound of a rubber-boat engine, and the diver was asked to point to the sound source. The azimuth was measured by the diver's companion using a navigation board. RESULTS: Underwater PTHT with both masks were significantly higher for frequencies of 250 to 6000 Hz when compared with the thresholds on land (p <0.0001). No differences were found in the PTHT or the reception threshold for the recorded sound of a rubber-boat engine for dry or wet ear conditions. There was no difference in the sound localization error between the regular mask and the ProEar 2000 mask. CONCLUSIONS: The presence of air around the pinna and inside the external ear canal did not improve underwater hearing sensitivity or sound localization. These results support the argument that bone conduction plays the main role in underwater hearing.

Acoustic Impedance Tests↗
PubMed2005

The effects of mass loading the ossicles with a floating mass transducer on middle ear transfer function.

HYPOTHESIS: The aim of this study was to measure the mass loading effect of an active middle-ear implant (the Vibrant Soundbridge) in cadaver temporal bones. BACKGROUND: Implantable middle ear hearing devices such as Vibrant Soundbridge have been used as an alternative to conventional hearing aids for the rehabilitation of sensorineural hearing loss. Other than the obvious disadvantage of requiring implantation middle ear surgery, it also applies a direct weight on the ossicular chain which, in turn, may have an impact on residual hearing. Previous studies have shown that applying a mass directly on the ossicular chain has a damping effect on its response to sound. However, little has been done to investigate the magnitude and the frequency characteristics of the mass loading effect in devices such as the Vibrant Soundbridge. METHODS: Five fresh cadaver temporal bones were used. The stapes displacement was measured using laser Doppler vibrometry before and after the placement of a Vibrant Soundbridge floating mass transducer. The effects of mass and attachment site were compared with the unloaded response. Measurements were obtained at frequencies between 0.1 and 10 kHz and at acoustic input levels of 100 dB sound pressure level. Each temporal bone acted as its own control. RESULTS: Placement of the floating mass transducer caused a reduction of the stapes displacement. There were variations between the bones. The change of the stapes displacement varied from 0 dB to 28 dB. The effect was more prominent at frequencies above 1,000 Hz. Placing the floating mass transducer close to the incudostapedial joint reduced the mass loading effect. CONCLUSION: The floating mass transducer produces a measurable reduction of the stapes displacement in the temporal bone model. The effect is more prominent at high frequencies.

Acoustic Stimulation↗
PubMed2003

Adaptation by a cochlear-implant patient to upward shifts in the frequency representation of speech.

The purpose of this project was to assess the degree to which a patient, after 1 wk of experience, could adapt to 3.2-mm and 6.8-mm basal shifts in the representation of speech. Only small deficits in performance were found after practice after the 3.2-mm shift. After practice after the 6.9-mm shift, scores on tests that emphasized amplitude envelope cues returned to baseline levels. Scores on vowel and sentence tests that emphasized frequency-based cues remained poor. Scores for "place," however, showed some recovery. Vowel recognition may be the limiting factor in recognizing basally shifted speech.

Adaptation, Physiological↗
PubMed2004

Effects of speech processing strategy on Chinese tone recognition by nucleus-24 cochlear implant users.

OBJECTIVE: To evaluate the effects of speech processing strategy on Chinese tone recognition by Nucleus-24 cochlear implant users. METHODS: Recognition of Chinese tones was measured with the spectral peak (SPEAK), advanced combination encoders (ACE), and continuous interleaved sampling (CIS) strategies in nine Nucleus-24 cochlear implant users. Recognition of Chinese sentences was also measured with the ACE strategy (1200 pulse-per-sec on each electrode). As the stimulation rate in the SPEAK processor is fixed at 250 pulses per sec per electrode (ppspe), only one stimulation rate was tested with the SPEAK processor. Three stimulation rates (900, 1200, and 1800 ppspe) were tested in the ACE processing conditions. Four stimulation rates (1200, 1800, 2400, and 3600 ppspe) were tested in the CIS processing conditions. Because the number of stimulating electrodes determines the stimulation rate in CIS processors, the number of electrodes was reduced from 12 to 8 to 6 to 4 to achieve stimulation rates of 1200, 1800, 2400, to 3600 pps. RESULTS: Results showed that mean Chinese tone recognition scores with the ACE and CIS strategies were significantly higher than those with the SPEAK strategy. For the ACE strategy, there was no significant difference in performance among the various stimulation rates (for the ACE processing conditions, the stimulation rate was varied while keeping the number of stimulating electrodes constant). For the CIS strategy, there was no significant difference among the various stimulation rates and electrode configurations (for the CIS processing conditions, the stimulation rate was varied by changing the number of stimulating electrodes). There was also a significant correlation between Chinese tone recognition and the recognition of everyday sentences. CONCLUSIONS: The latest-generation speech processing strategies were able to provide cochlear implant users with considerable amounts of tonal information. However, Chinese tone recognition was significantly affected by the choice in speech processing strategy. Relatively higher stimulation rates (>900 ppspe) may improve Chinese tone recognition. Furthermore, it may be necessary to develop speech processing strategies to specifically improve tone recognition, which is critical for understanding tonal languages.

Adult↗
PubMed2006

Determination of the potential benefit of time-frequency gain manipulation.

OBJECTIVE: The purpose of this study was to determine the maximum benefit provided by a time-frequency gain-manipulation algorithm for noise-reduction (NR) based on an ideal detector of speech energy. The amount of detected energy necessary to show benefit using this type of NR algorithm was examined, as well as the necessary speed and frequency resolution of the gain manipulation. DESIGN: NR was performed using time-frequency gain manipulation, wherein the gains of individual frequency bands depended on the absence or presence of speech energy within each band. Three different experiments were performed: (1) NR using ideal detectors, (2) NR with nonideal detectors, and (3) NR with ideal detectors and different processing speeds and frequency resolutions. All experiments were performed using the Hearing-in-Noise test (HINT). A total of 6 listeners with normal hearing and 14 listeners with hearing loss were tested. RESULTS: HINT thresholds improved for all listeners with NR based on the ideal detectors used in Experiment I. The nonideal detectors of Experiment II required detection of at least 90% of the speech energy before an improvement was seen in HINT thresholds. The results of Experiment III demonstrated that relatively high temporal resolution (<100 msec) was required by the NR algorithm to improve HINT thresholds. CONCLUSIONS: The results indicated that a single-microphone NR system based on time-frequency gain manipulation improved the HINT thresholds of listeners. However, to obtain benefit in speech intelligibility, the detectors used in such a strategy were required to detect an unrealistically high percentage of the speech energy and to perform the gain manipulations on a fast temporal basis.

Acoustic Stimulation↗
PubMed2006

Repeatability of high-frequency distortion-product otoacoustic emissions in normal-hearing adults.

OBJECTIVES: Distortion-product otoacoustic emissions (DPOAEs) are repeatable over time at lower frequencies ( 8 kHz) for DPOAE level measurements. The average DPOAE level differences-between-trials for the higher and lower frequencies for the four different stimulus level conditions was 5.15 (SD = 4.40 dB) and 2.80 (SD = 2.70 dB) dB, respectively. Individual subject analysis revealed that high-frequency DPOAE levels varied no more than 10 dB for 87.5 and 83.1% of young adult subjects for the 70/55 and 60/50 dB SPL stimulus level conditions, respectively. For low frequencies, repeated DPOAE level variations were within +/-10 dB for 98.4 and 96% of young adult subjects for the 70/55 and 60/50 dB SPL stimulus level conditions, respectively. For DPOAE group delay, greater variability was noted at lower frequencies (<or=8 kHz) and at 10 kHz. The average group-delay differences-between-trials for the higher (10 to 16 kHz) and lower (<or=8 kHz) frequencies was 0.22 (SD = 0.20 msec) and 0.28 (SD = 0.24 msec) msec, respectively. Individual subject analysis revealed that DPOAE group-delay values varied no more than 0.70 msec for the majority of young adult subjects (96.5 and 93.5% at high and low frequencies, respectively). CONCLUSIONS: Even though the DPOAE level data obtained at frequencies greater than 8 kHz were more variable than at low frequencies, the higher frequencies were found to be repeatable for both paradigms tested. These results encourage the exploration of high-frequency DPOAE measures to be used as an objective test for monitoring ototoxicity in humans. Testing subjects receiving ototoxic therapies is a necessary step in determining if monitoring high-frequency DPOAEs will successfully predict ototoxic effects.

Acoustic Stimulation↗
PubMed2005

Preservation of hearing in cochlear implant surgery: advantages of combined electrical and acoustical speech processing.

OBJECTIVES/HYPOTHESIS: This study documents the importance of preserving residual low-frequency acoustic hearing as those with more residual hearing are selected for cochlear implantation. Surgical strategies used for hearing preservation with a short hybrid cochlear implant are outlined. The benefits of preserved residual low-frequency hearing, improved word understanding in noise, and music appreciation are described. STUDY DESIGN: Multicenter, prospective, single-subject design. METHODS: Records were reviewed of 21 individuals participating in an Food and Drug Administration (FDA) feasibility clinical trial who have received an Iowa/Nucleus 10 mm electrode. A second group of subjects receiving implants at the University of Iowa that have used the 10 mm device between 2 years and 6 months were also reviewed. Outcome measures included standardized tests of monosyllabic word understanding, spondees in noise, and common melody recognition. RESULTS: Low-frequency hearing was maintained in all individuals immediately postoperative. One subject lost hearing at 2.5 months postoperative after a viral infection. The group has averaged a loss of -9 dB low-frequency acoustic hearing between 125 and 1,000 Hz. Monosyllabic word understanding scores at 6 months for a group being followed for an FDA clinical trial using the implant plus hearing aids was 69% correct. For the long-term group receiving implants at Iowa, monosyllabic word understanding in those who have used the device between 6 months and 2 years is 79%. Other important findings include improved recognition of speech in noise (9 dB improvement) as compared with standard cochlear implant recipients who were matched for speech recognition in quiet and near normal recognition of common melodies. CONCLUSION: The surgical strategies outlined have been successful in preservation of low-frequency hearing in 96% of individuals. Combined electrical and acoustical speech processing has enabled this group of volunteers to gain improved word understanding as compared with their preoperative hearing with bilateral hearing aids and a group of individuals receiving a standard cochlear implant with similar experience with their device. The improvement of speech in noise and melody recognition is attributed to the ability to distinguish fine pitch differences as the result of preserved residual low-frequency acoustic hearing. Preservation of low-frequency acoustic hearing is important for improving speech in noise and music appreciation for the hearing impaired, both of which are important in real-life situations.

Audiometry, Pure-Tone↗