Analysis of audiological outcomes of children referred from a universal newborn hearing screening program over 9 years in Beijing, China.

Universal newborn hearing screening (UNHS) and audiological diagnosis are crucial for children with congenital hearing loss (HL). The objective of this study was to analyze hearing screening techniques, audiological outcomes and risk factors among children referred from a UNHS program in Beijing. A retrospective analysis was performed in children who were referred to our hospital after failing UNHS during a 9-year period. A series of audiological diagnostic tests were administered to each case, to confirm and determine the type and degree of HL. Risk factors for HL were collected. Of 1839 cases, 53.0% were referred after only transient evoked otoacoustic emission (TEOAE) testing, 46.1% were screened by a combination of TEOAE and automatic auditory brainstem response (AABR) testing, and 1.0% were referred after only AABR testing. HL was confirmed in 55.7% of cases. Ears with screening results that led to referral experienced a more severe degree of HL than those with results that passed. Risk factors for HL were identified in 113 (6.1%) cases. The main risk factors included craniofacial anomalies (2.7%), length of stay in the neonatal intensive care unit longer than 5 days (2.4%) and birth weight less than 1500 g (0.8%). The statistical data showed that age (P < 0.001) and risk factors, including craniofacial anomalies (P < 0.001) and low birth weight (P = 0.048), were associated with the presence of HL. This study suggested that hearing screening plays an important role in the early detection of HL and that children with risk factors should be closely monitored.

Optimized concurrent hearing and genetic screening in Beijing, China: A cross-sectional study.

Concurrent screening has been proven to provide a comprehensive approach for management of congenital deafness and prevention of ototoxicity. The SLC26A4 gene is associated with late-onset hearing loss and is of great clinical concern. For much earlier detection of newborns with deafness-causing mutations in the SLC26A4 gene, the Beijing Municipal Government launched a chip for optimized genetic screening of 15 variants of 4 genes causing deafness based on a chip to screen for 9 variants of 4 genes, and 6 variants of the SLC26A4 gene have now been added. To ascertain the advantage of a screening chip including 15 variants of 4 genes, the trends in concurrent hearing and genetic screening were analyzed in 2019 and 2020. Subjects were 76,460 newborns who underwent concurrent hearing and genetic screening at 24 maternal and child care centers in Beijing from January 2019 to December 2020. Hearing screening was conducted using transiently evoked otoacoustic emissions (TEOAEs), distortion product otoacoustic emissions (DPOAE), or the automated auditory brainstem response (AABR). Dried blood spots were collected for genetic testing and 15 variants of 4 genes, namely GJB2, SLC26A4, mtDNA 12S rRNA, and GJB3, were screened for using a DNA microarray platform. The initial referral rate for hearing screening decreased from 3.60% (1,502/41,690) in 2019 to 3.23% (1,124/34,770) in 2020, and the total referral rate for hearing screening dropped form 0.57% (236/41,690) in 2019 to 0.54% (187/34,770) in 2020, indicating the reduced false positive rate of newborn hearing screening and policies to prevent hearing loss conducted by the Beijing Municipal Government have had a significant effect. Positivity according to genetic screening was similar in 2019 (4.970%, 2,072/41,690) and 2020 (4.863%,1,691/34,770), and the most frequent mutant alleles were c.235 del C in the GJB2 gene, followed by c.919-2 A > G in the SLC26A4 gene, and c.299 del AT in the GJB2 gene. In this cohort study, 71.43% (5/7) of newborns with 2 variants of the SLC26A4 gene were screened for newly added mutations, and 28.57% (2/7) of newborns with 2 variants of the SLC26A4 gene passed hearing screening, suggesting that a screening chip including 15 variants of 4 genes was superior at early detection of hearing loss, and especially in early identification of newborns with deafness-causing mutations in the SLC26A4 gene. These findings have clinical significance.

Diagnostic Accuracy of Mobile Health-Based Audiometry for the Screening of Hearing Loss in Adults: A Systematic Review and Meta-Analysis.

Background: Hearing loss is one of the most prevalent chronic health conditions. Traditional pure tone audiometry (PTA) is the gold standard for hearing loss screening, but is not widely available outside specialized clinical centers. Mobile health (mHealth)-based audiometry could improve access and cost-effectiveness, but its diagnostic accuracy varies widely between studies. Therefore, we aimed to evaluate the diagnostic accuracy of mHealth-based audiometry for hearing loss screening in adults compared with traditional PTA. Methods: Ten English and Chinese databases were searched from inception until April 30, 2022. Two researchers independently selected studies, extracted data, and appraised methodological quality. The bivariate random-effects model was adopted to estimate the pooled sensitivity and specificity for each common threshold (i.e., the threshold to define mild or moderate hearing loss). The hierarchical summary receiver operating characteristic model was used to assess the area under the receiver operating characteristic curve (AUC) across all thresholds. Results: Twenty cohort studies were included. Only one study (n = 109) used the mHealth-based speech recognition test (SRT) as the index test. Nineteen studies (n = 1,656) used mHealth-based PTA as the index test, and all of them were included in the meta-analysis. For detecting mild hearing loss, the pooled sensitivity and specificity were 0.91 (95% confidence interval [CI] 0.80-0.96) and 0.90 (95% CI 0.82-0.94), respectively. For detecting moderate hearing loss, the pooled sensitivity and specificity were 0.94 (95% CI 0.87-0.98) and 0.87 (95% CI 0.79-0.93), respectively. For all PTA thresholds, the AUC was 0.96 (95% CI 0.40-1.00). Conclusions: mHealth-based audiometry provided good diagnostic accuracy for screening both mild and moderate hearing loss in adults. Given its high diagnostic accuracy, accessibility, convenience, and cost-effectiveness, it shows enormous potential for hearing loss screening, particularly in primary care sites, low-income regions, and settings with in-person visit limitations. Further work should evaluate the diagnostic accuracy of the mHealth-based SRT tests.

A Cross-Language Comparison of Sentence Recognition Using American English and Mandarin Chinese HINT and AzBio Sentences.

OBJECTIVES: The aim of this study was to perform a cross-language comparison of two commonly used sentence-recognition materials (i.e., Hearing in Noise Test [HINT] and AzBio) in American English (AE) and Mandarin Chinese (MC). DESIGNS: Sixty normal-hearing, native English-speaking and 60 normal-hearing, native Chinese-speaking young adults were recruited to participate in three experiments. In each experiment, the subjects were tested in their native language. In experiments I and II, noise and tone vocoders were used to process the HINT and AzBio sentences, respectively. The number of channels varied from 1 to 9, with an envelope cutoff frequency of 160 Hz. In experiment III, the AE AzBio and the MC HINT sentences were tested in speech-shaped noise at various signal to noise ratios (i.e., -20, -15, -10, -5, and 0 dB). The performance-intensity functions of sentence recognition using the two sets of sentence materials were compared. RESULTS: Results of experiments I and II using vocoder processing indicated that the AE and MC versions of HINT and AzBio sentences differed in level of difficulty. The AE version yielded higher recognition performance than the MC version for both HINT and AzBio sentences. The type of vocoder processing (i.e., tone and noise vocoders) produced little differences in sentence-recognition performance in both languages. Incidentally, the AE AzBio sentences and the MC HINT sentences had similar recognition performance under vocoder processing. Such similarity was further confirmed under noise conditions in experiment III, where the performance-intensity functions of the two sets of sentences were closely matched. CONCLUSIONS: The HINT and AzBio sentence materials developed in AE and MC differ in level of difficulty. The AE AzBio and the MC HINT sentence materials are similar in level of difficulty. In cross-language comparative research, the MC HINT and the AE AzBio sentences should be chosen for the respective language as the target sentence-recognition test materials.

[Analysis of hearing screening results in adult health check-up population].

Objective:To obtain incidence of hearing loss and the influence factors in adult health check-up population, and to provide supporting information for the prevention of hearing loss. Method:Hearing Handicap Inventory for the Adult-screening（HHIA-S）, electro-otoscopy and pure tone test were used to evaluate subjects'hearing health condition. SPSS 25.0 software was used to perform one-way ANOVA on the results. Result:①HHIA-S questionnaire results: 3704 subjects completed the questionnaire, 29 subjects（0.8%） were reported hearing difficulties in daily life. ②Hearing screening results: 1264 subjects failed to pass the hearing screening, including 936 male and 328 female subjects. 33.5% subjects with noramlself-rated hearing failed to pass the hearing screening test, and all the patients with abnormal self-rated hearing did not pass the hearing screening.③The passing rate of hearing screening was significantly affected by gender, age, BMI, blood pressure and plasma glucose. The passing rate of hearing screening was higher in female than that in male, in younger than that in elder, in subjects with normal blood pressure, plasma glucose and BMI than those with abnormal above conditions. Conclusion:Aging, abnormal blood pressure, fasting plasma glucose and BMI may have potential risks on hearing health. Therefore, it is of practical significance to carry out hearing screening in adult population. For those adults with abnormal indexes, they should pay close attention to their hearing condition status and monitor their hearing regularly.

The development of auditory performance and speech perception in CI children after long-period follow up.

PURPOSE: The main purpose of the current study was to assess the development of auditory and speech perception and the effects of the age at implantation in CI children after long-period follow up. MATERIALS AND METHODS: Five hundred and forty-four young children participated in this study (339 males and 205 females). The age at implantation ranged from 6 months to 36 months. All subjects were prelingually bilateral profound sensorineural hearing loss. They were divided into 3 groups according to the implant ages: group 1 (age at implantation < 12 months, n = 109); group 2 (12 months < age at implantation < 24 months, n = 284); and group 3 (24 months < age at implantation < 36 months, n = 151). The categorical auditory performance (CAP) was used to assess auditory abilities and the speech intelligibility rating (SIR) was used to assess the speech intelligibility of these CI children. The tests were administered at pre-surgery and 1, 3, 6, 12, 24, 36, 48- and 60-months post-surgery. RESULTS: All the subjects demonstrated improvements of auditory abilities and speech intelligibility after CI surgery. The auditory ability developed quickly in 12 months after implantation. However, the speech intelligibility scores show rapid improvement within 24 months post implantation. Significant difference was found between group 1 and group 3, group 2 and group 3 before 12 months post-implantation for CAP and SIR. The three groups of children showed similar development pattern for their auditory abilities and speech intelligibility. CONCLUSION: The results of this study suggested dramatic and continuous improvement of the auditory and speech abilities post implantation in these CI children. Furthermore, the age at implantation played a considerably smaller role in the improvement of hearing and speech abilities. However, earlier implantation still benefits the language development.

Speech development after cochlear implantation in infants with isolated large vestibular aqueduct syndrome.

Background: Few studies on speech performance of children after cochlear implantation (CI) described isolated large vestibular aqueduct syndrome (LVAS). Objective: To investigate speech developmental trajectories of infants with LVAS after CI, and to compare with those who have structurally normal inner ears. Materials and methods: 1112 infants with congenital severe to profound hearing loss participated in this study. 150 infants in group A were diagnosed with LVAS, 962 infants in group B with structurally normal inner ear. The speech performance was assessed via the Meaningful Use of Speech Scale (MUSS). The evaluations were performed pre-implant, 1, 3, 6, 9, 12, 24, 36, 48 and 60 months after CI. Results: The mean scores of the MUSS improved over a 5-year period after implantation in both groups A and B. The LVAS group presented similar speech developmental trajectory to the non-LVAS group at each assessment interval, except pre-operation. There were significant differences in mean scores between vocalizing behavior and oral communication skills, clarification skills of infants in both two groups. Conclusions and significance: Speech performance of infants with LVAS developed rapidly after CI and was similar to infants with structurally normal inner ear. For infants with isolated LVAS, CI had a significant effect and should be recommended as a therapeutic option.

Long-term follow-up of auditory performance and speech perception and effects of age on cochlear implantation in children with pre-lingual deafness.

BACKGROUND: The development of auditory and speech perception ability of children with hearing loss is affected by many factors after they undergo cochlear implantation (CI). Age at CI (CI age) appears to play an important role among these factors. This study aimed to evaluate the development of auditory and speech perception ability and explore the impact of CI age on children with pre-lingual deafness present before 3 years of age. METHODS: Two hundred and seventy-eight children with pre-lingual deafness (176 boys and 102 girls) were included in this study, and the CI age ranged from 6 to 36 months (mean age, 19 months). Categorical auditory performance (CAP) was assessed to evaluate auditory ability, and the speech intelligibility rating was used to evaluate speech intelligibility. The evaluations were performed before CI and 1, 3, 6, 12, 18, 24, 36, 48, and 60 months after CI. RESULTS: The auditory ability of the pre-lingually hearing-impaired children showed the fastest development within 6 months after CI (k = 0.524, t = 30.992, P < 0.05); then, the progress started to decelerate (k = 0.14, t = 3.704, P < 0.05) and entered a plateau at the 24th month (k = 0.03, t = 1.908, P < 0.05). Speech intelligibility showed the fastest improvement between the 12th and 24th months after CI (k = 0.138, t = 5.365, P < 0.05); then, the progress started to decelerate (k = 0.026, t = 1.465, P < 0.05) and entered a plateau at the 48th month (k = 0.012, t = 1.542, P < 0.05). The CI age had no statistical significant effect on the auditory and speech abilities starting at 2 years after CI (P > 0.05). The optimal cutoff age for CI was 15 months. CONCLUSIONS: Within 5 years after CI, the auditory and speech ability of young hearing-impaired children continuously improved, although speech development lagged behind that of hearing. An earlier CI age is recommended; the optimal cutoff age for CI is at 15 months.

Speech development in young children with Mondini dysplasia who had undergone cochlear implantation.

OBJECTIVE: The purpose of this study was to investigate the development of speech skills in young children with Mondini dysplasia and age-matched deaf children with radiologically normal inner ears over a period of 5 years after cochlear implantation (CI). METHODS: In total, 700 congenitally severely to profoundly deaf children (281 girls and 419 boys) participated in this study. All of the participants had undergone unilateral CI surgery before 36 months of age. The participants were categorized into two groups based on the absence or presence of Mondini dysplasia in the implanted ear, as assessed via high-resolution, thin-slice computerized tomography or magnetic resonance imaging: group A comprised 592 children with radiologically normal inner ears and group B comprised 108 children with Mondini dysplasia. The Meaningful Use of Speech Scale (MUSS) and Speech Intelligibility Rating (SIR) were used to evaluate the speech performance of all young children at various time points: pre-surgery and at 1, 3, 6, 12, 24, 36, 48, and 60 months after switch-on programming. RESULTS: The mean scores of SIR and MUSS in children from both group A and group B showed significant improvements over time. No significant differences were found in the mean scores of SIR between the two groups at any time interval during the 5-year follow-up. The mean score of MUSS was significantly different between group A and group B at 12, 24, and 36 months after implantation, whereas no obvious differences were noted pre-surgery, and at 1, 3, 6, 48, and 60 months post-operation. CONCLUSIONS: Young children with Mondini dysplasia develop their speech skills at a fast rate and achieve similar speech acquisition compared to age-matched children with radiologically normal inner ears 5 years post-operation. Therefore, CI is an effective intervention method for young children with Mondini dysplasia.

Categorical perception of lexical tones in native Mandarin-speaking listeners with sensorineural hearing loss.

BACKGROUND: Categorical perception (CP) of lexical tones was examined in normal hearing (NH) people, but it was unclear whether lexical tones can be perceived categorically in sensorineural hearing loss (SNHL) people. OBJECTIVES: To explore the characteristic of lexical tone perception in native Mandarin speakers with SNHL. MATERIALS AND METHODS: Three types of continuum (Tone1/Tone2, Tone1/Tone4 and Tone2/Tone3) were constructed and each of them includes 15 stimuli which were resynthesized by applying the pitch-synchronous overlap and add (PSOLA) method implemented in Praat to the same Mandarin syllable, /a/, with a high-level tone produced by a female speaker. Forty native Mandarin NH speakers and 23 native Mandarin speakers with mild to moderate SNHL were recruited. A two alternative-forced-choice identification task was used to acquire the tonal perceptual data. RESULTS: All tone perception curves owns the characteristic of CP in SNHL subjects. All tone perception curves were S-shape in SNHL subjects same as those in NH subjects. No significant difference of each continuum was observed between SNHL and NH. CONCLUSIONS: CP of lexical tone perception could be observed in native Mandarin speakers with mild to moderate SNHL. The slight damage in the peripheral auditory system did not change characteristic of lexical tone perception.

A Follow-Up Study on Music and Lexical Tone Perception in Adult Mandarin-Speaking Cochlear Implant Users.

OBJECTIVE: The aim was to evaluate the development of music and lexical tone perception in Mandarin-speaking adult cochlear implant (CI) users over a period of 1 year. STUDY DESIGN: Prospective patient series. SETTING: Tertiary hospital and research institute. PATIENTS: Twenty five adult CI users, with ages ranging from 19 to 75 years old, participated in a year-long follow-up evaluation. There were also 40 normal hearing adult subjects who participated as a control group to provide the normal value range. INTERVENTIONS: Musical sounds in cochlear implants (Mu.S.I.C.) test battery was undertaken to evaluate music perception ability. Mandarin Tone Identification in Noise Test (M-TINT) was used to assess lexical tone recognition. The tests for CI users were completed at 1, 3, 6, and 12 months after the CI switch-on. MAIN OUTCOMES MEASURES: Quantitative and statistical analysis of their results from music and tone perception tests. RESULTS: The performance of music perception and tone recognition both demonstrated an overall improvement in outcomes during the entire 1-year follow-up process. The increasing trends were obvious in the early period especially in the first 6 months after switch-on. There was a significant improvement in the melody discrimination (p < 0.01), timbre identification (p < 0.001), tone recognition in quiet (p < 0.0001), and in noise (p < 0.0001). CONCLUSIONS: Adult Mandarin-speaking CI users show an increasingly improved performance on music and tone perception during the 1-year follow-up. The improvement was the most prominent in the first 6 months of CI use. It is essential to strengthen the rehabilitation training within the first 6 months.

Relative contributions of acoustic temporal fine structure and envelope cues for lexical tone perception in noise.

Previous studies have shown that lexical tone perception in quiet relies on the acoustic temporal fine structure (TFS) but not on the envelope (E) cues. The contributions of TFS to speech recognition in noise are under debate. In the present study, Mandarin tone tokens were mixed with speech-shaped noise (SSN) or two-talker babble (TTB) at five signal-to-noise ratios (SNRs; -18 to +6 dB). The TFS and E were then extracted from each of the 30 bands using Hilbert transform. Twenty-five combinations of TFS and E from the sound mixtures of the same tone tokens at various SNRs were created. Twenty normal-hearing, native-Mandarin-speaking listeners participated in the tone-recognition test. Results showed that tone-recognition performance improved as the SNRs in either TFS or E increased. The masking effects on tone perception for the TTB were weaker than those for the SSN. For both types of masker, the perceptual weights of TFS and E in tone perception in noise was nearly equivalent, with E playing a slightly greater role than TFS. Thus, the relative contributions of TFS and E cues to lexical tone perception in noise or in competing-talker maskers differ from those in quiet and those to speech perception of non-tonal languages.

Speech recognition outcomes in Mandarin-speaking cochlear implant users with fine structure processing.

CONCLUSION: Mandarin-speaking adults can use the Fine Structure Processing (FSP) coding strategy as well as the Continuous Interleaved Sampling (CIS+) coding strategy. No loss in performance was observed after switch-over. Tone identification improves over time with the FSP coding strategy, which is of benefit to tonal-language users. After some time, fine structure was preferred. OBJECTIVE: This study aimed to determine speech perception, tone perception, and the subjective preferences of Mandarin-speaking adults who received the FSP coding strategy, at upgrade from the CIS + coding strategy. METHODS: Thirteen Mandarin-speaking subjects were tested at switch-over from CIS + to the FSP coding strategy ∼1-month after switch-over, 2-months after switch-over, and 3-months after switch-over with the Mandarin Hearing in Noise Test (M-HINT), the Mandarin Tone Identification in Noise Test (M-TINT), and a visual analogue scale assessing Sound and Speech Assessment (SSA). RESULTS: There were no significant differences in the M-HINT between presentation levels (62 dB SPL vs 65 dB SPL), over time, nor when compared to the CIS + coding strategy. Tone perception improved significantly over time with the FSP coding strategy. Subjects rated the FSP coding strategy with the OPUS 2 as significantly more 'full' and 'rich' than with the CIS + coding strategy after 3-months.

[The review of categorization features of tone perception].

Categorical perception (CP) is the unique phenomenon that gradually morphed physical feature in a stimulus continuum tends to be perceived as discrete representations. CP has been evidenced in several modalities in the sensor perception. The first study of CP of phonetic perception was performed in 1957. However, the early CP studies focused on segmental features. The first study of CP of pitch contours was performed until 1976. This article will review the results of previous studies focus on the categorical perception applies to the lexical tone perception.

[The effect of improving the physical and mental health on different rehabilitation programs for post-linguistic cochlear implantees].

OBJECTIVE: To evaluate the physical and mental health status of post-linguistic cochlear implantees, and then to explore the effectiveness on of different rehabilitation programs. METHOD: Mandarin hearing in noise test (MHINT), personal report of communication apprehension (PRCA-24) and Nijmegen cochlear implant questionnaire (NCIQ) were used to measure the hearing ability, mental health degree and the health related life quality in 36 post-linguistic cochlear implant users, respectively. The improvement of subjects' physical and mental health levels was compared with among different rehabilitation programs, including family training program, auditory habilitation program and psychological intervention program. RESULT: (1) Family training program only can improve the subject's hearing ability (P < 0.05), but failed to ease the communication apprehension; ((2) Auditory habilitation program can both significantly improve the subjects' hearing ability (P < 0.01) and ease the fear of talking face to face (P < 0.01); (3) Psychological intervention program can significantly increase the auditory abilities (P < 0.01), reduce the communication apprehension (P < 0.01) and improve the quality of life. CONCLUSION: Post-linguistic cochlear implantees had obvious mental symptoms. It was very important to design an effective rehabilitation program to improvement the living quality of hearing loss people.

[The analysis of correlative factors on mental health of post-linguistic hearing loss adults].

OBJECTIVE: To evaluate the mental health level of the post-linguistic deafen adult, to analyze factors affecting the mental health level. METHOD: Fifty-two adult patients with severe to extremely severe post-linguistic hearing loss were randomly selected to participate the study. A self-reporting questionnaire drew up by researchers was used to collect sociological data of the participants. The self-rating anxiety scale (SAS), self-rating depression scale (SDS) and personal report of communication apprehension (PRCA-24) were used to measure the mental health degree of 52 post-linguistic hearing loss adults. To analyze related factors affecting the mental health in post-linguistic deafen adult. RESULT: (1) Majority of post-linguistic deafen adult have mental symptoms, including 24 subjects (46.15%) with anxiety feeling, 18 subjects (34.61%) with depression feeling and 45 subjects (86.54%) with communication apprehension. (2) Gander, with/without tinnitus, duration of hearing loss, education background and family support had significant correlation with the mental health level of subjects. Higher incident rate of mental symptoms were found in male (OR = 2.246), with tinnitus (OR = 0.536), short duration (OR = 1.397, 1.530), high education background (OR = 0.323) and poor family support (OR = 1.724). CONCLUSION: The mental health of the post-linguistic deafen adult was worse than that of the normal people, pathological feature and sociological factors were significantly correlated to the psychological evaluation. It is very important to pay attention on mental health and to give effective counseling of hearing loss people.

[The review of newborn hearing screening program in neonatal intensive care unit].

The incidence of hearing impairment in neonatal intensive care unit (NICU) was much higher than that of well-baby nursery. The incidence of the former was 2%-4%, whereas that of the latter was 0.1%-0.3%. Furthermore, the incidence of auditory neuropathy spectrum disorder, progressive and delayed hearing loss was also higher than those of other infants. Therefore, the newborn hearing screening program in NICU has become an important part of pediatric audiology. In this paper, we reviewed the previous studies and suggested the special procedure of hearing screening and following-up which based on the physiological and pathological characteristics of NICU in order to detect hearing impaired as early as possible.

[Development of Mandarin tonal identification in noise test materials].

OBJECTIVE: The aim of this study was to develop comprehensive test material for Mandarin tone identification in noise (M-TINT) based on the linguistic characteristics in Chinese. METHODS: In keeping with both the reliability and efficiency in clinical practice, a primary list consisted of 320 words(80 syllables in four tones each) was designed according to the following principles: shortness of the lists, word familiarity and with a meaning in all four tones. The digital sound file was recorded by a male speaker and a female speaker (both of them are radio broadcaster). RESULTS: The tonal identification material database, which included 288 items (72 loudness-balanced syllables in all 4 Mandarin tones) was established by digital filler and balanced for equal loudness. The complete material was recorded in two CDs in a male version and a female version. The speaker-specific masking noises were generated by filtering Gaussian white noise to the speaker's long-term average speech spectrum (LTASS) and by scaling the masking noises to the same RMS amplitudes, as those of the speech, in order to acquire the effective sound masking. The speaker-specific masking noises could be able or disable during the word presentation. The sound pressure level could be selected concerning on the test setting. CONCLUSIONS: The mandarin tonal identification materials were designed by both the tonal acoustic properties and the psychophysics characteristic of adults. It is an useful speech test in clinical work and research, and can potentially be used as the basic list for other tonal language identification test in the future.

Characterization of spontaneous otoacoustic emissions in full-term newborns.

OBJECTIVE: To analyze the characteristics of spontaneous otoacoustic emissions (SOAEs) in full-term newborns. METHODS: A total of 236 ears from 147 randomly selected full-term Chinese neonates (82 females and 65 males), who had passed the initial newborn hearing screening, were assessed for SOAEs using the Capella OAE equipment (Madsen, Denmark). The test was performed in a sound booth. RESULTS: (1) The overall prevalence of SOAE was 56.77% of the ears. The prevalence of SOAEs was significantly higher in females (69.23%) than in males (41.51%, p<0.01), as well as in the right ears (64.17%) than in the left ears (49.14%, p<0.05). (2) The overall mean level of SOAE was 11.78±8.36dB SPL, with no significant differences between males (11.73±8.25dB SPL) and females (11.81±8.43dB SPL) or between the left (11.97±8.56dB SPL) and the right ears (11.65±8.22dB SPL). (3) The 25th and 75th percentiles of SOAE frequencies were 2.31 and 4.36kHz in females and 1.93 and 3.94kHz in males, which were statistically significantly different (p<0.01). In contrast, the SOAE frequency was not significantly different between ears (2.22-4.18kHz in the left ears and 2.17-4.14kHz in right ears). (4) The overall mean number of SOAEs was 3.70±2.75, with no significant differences in females (3.62±2.70) and males (3.86±2.87) or in right (3.70±2.55) and left ears (3.70±3.02). CONCLUSIONS: The prevalence rate of SOAE is significantly higher in females than in males and in the right ears than in the left ears in Chinese newborns. The frequencies of the SOAEs in newborns appeared to be higher than those reported in normal-hearing adults in the literature.

[Effects of temporal fine structure stimulation on Mandarin identification in cochlear implant users].

OBJECTIVE: To assess the contribution of the temporal fine structure cues on speech recognition, especially tone perception of cochlear implant users whose native language is Mandarin Chinese. METHODS: Twelve Mandarin speaking users of the MED-EL COMBI 40+ cochlear implants with the standard COMBI 40+ electrode array participated in the study. The subjects were followed up and studied using the longitudinal method for six weeks to compare the difference in speech identification results between fine structure processing (FSP) and continuous interleaved sampler (CIS). The test battery comprised two objective speech tests, including tone identification in quiet as well as a sentence recognition task in quiet and noise. RESULTS: The scores of acute speech test: after replacing FSP strategy, the acute tone test results were similar to that of daily used CIS strategy(male version t = 0.791, P = 0.446;female version t = 0.679, P = 0.511), but the scores of MHINT were decreased significantly (t = -4.365, P = 0.001). The scores of long-lasting speech test were as follows the scores of tone identification test were sharply increased after subjects used the new coding strategy for six weeks continuously(male version t = 3.023, P = 0.018;female version t = 3.883, P = 0.003) and the MHIN results were similar to that of daily used CIS strategy(t = 1.475, P = 0.173). CONCLUSION: The extraction of temporal fine structure cues supplemented in speech processing strategy of cochlear implant benefits the improvements in tone perception and the understanding of speech in cochlear implant recipients, which can further promotes their quality of life.