[Application of new speech intelligibility tests in silence for the assessment of acquired hearing losses]. / Der Einsatz neuer Testverfahren zur Erfassung des Sprachverstehens in Ruhe bei der Begutachtung erworbener Schwerhörigkeiten.

BACKGROUND: Previous studies comparing the Freiburg speech tests (FST) currently used in Germany to assess the severity of hearing loss with two modern speech intelligibility tests [the Göttingen sentence test (GöSa) and the monosyllabic rhyme test devised by von Wallenberg and Kollmeier (WaKo)] have indicated that a replacement of the old procedure would be possible. The current study investigates the consequences of the modern test procedures for the estimation of reduction in earning capacity resulting from hearing loss, and considers the optimal presentation levels for the WaKo test. METHODS: The FST, GöSa, and WaKo speech intelligibility tests were performed on 29 volunteers with a hearing impairment. All tests were conducted in silence. The presentation levels for the Freiburg monosyllabic test were 60, 80, and for some participants also 100 dB SPL. The WaKo test was carried out once at 45, 65, and 85 dB SPL (a reduction of 15 dB relative to the FST) and again at 40, 60 and 80 dB SPL (reduction of 20 dB relative to the FST). RESULTS: A consideration across all presentation levels revealed that the best correlation match between the two monosyllabic tests was achieved at a 20-dB reduction in presentation level for the WaKo test relative to the FST. On average, the application of modern procedures and the different options for level reduction had only a minor effect on the quantitative assessment of reduction in earning capacity.

[Hearing loss determination and assessment of the reduction in earning capacity taking speech discrimination tests in noise into account]. / Hörverlustbestimmung und MdE-Abschätzung unter Einbezug von Sprachverständlichkeitsmessungen im Störgeräusch.

BACKGROUND: In Germany the guideline for the hearing loss quantification and the resulting assessment of the reduction in earning capacity is the Königsteiner Merkblatt (KM). The quantification depends on the results of the tone and speech audiogram in silence. However, speech discrimination tests in noise may provide additional information about the impairment of the ENT patients. Especially, the impairment of persons with a slight hearing loss, characterized by high-frequency hearing loss, in noisy environment can not be indicated by the measurement in silence, which is proposed in the KM. METHODS UND PATIENTS: The Göttingen sentence test in noise was applied as a supplement to the routine ENT procedures of the medical estimate in 135 test persons. Based on these measurement results a table for the percentage hearing loss in noise is defined. Furthermore, an integration of the hearing loss in noise in the assessment of the reduction in earning capacity is proposed in addition to the hearing loss in silence. RESULTS: Using the newly introduced hearing loss for speech in noise, a suitable assessment for persons with a slight hearing loss is achieved. By integrating it into the assessment procedure additionally to the hearing loss in silence, the hearing impairment of all patients can be rated depending on their speech test results in silence and in noise. In comparison to the results obtained by the KM, the new procedure does not lead to higher values for the proposed reduction in earning capacity in general, but instead seems to be equally suitable for all groups of patients.

[Indication for and verification of hearing aid benefit using modern methods of speech audiometry in German]. / Hörgeräteindikation und -überprüfung nach modernen Verfahren der Sprachaudiometrie im Deutschen.

The current guidelines for hearing aid supply in Germany employ the often criticised Freiburg monosyllabic speech test (FBE) in quiet. This test can be replaced with the monosyllabic rhyme test by von Wallenberg and Kollmeier (WaKo) in quiet and by the measurement of a speech reception threshold in an interfering noise at a moderate level (45 dB SPL) using either the Göttingen or the Oldenburg sentence test (criterion: 2 dB improvement in SNR, "signal-to-noise ratio"). This procedure was investigated in a group of 38 participants with a sensorineural hearing impairment (mild, moderate or severe hearing loss) and 11 volunteers with normal hearing. On average, comparable indications were achieved. Participants with a mild hearing loss and a selective problem with listening in interfering noise were assessed more fairly.

[Comparison of the Göttingen sentence test and the monosyllabic rhyme test by von Wallenberg and Kollmeier with the Freiburg speech test : Investigation in a clinically representative group of listeners]. / Vergleich des Göttinger Satztests und des Einsilber-Reimtests nach von Wallenberg und Kollmeier mit dem Freiburger Sprachtest : Untersuchung bei einem klinisch repräsentativen Probandenkollektiv.

BACKGROUND: In a previous study [12] we compared the Freiburg speech test (number test and monosyllabic test) with the Göttingen sentence test and the monosyllabic rhyme test developed by von Wallenberg and Kollmeier. For a small group of participants we were able to demonstrate that the often criticized Freiburg speech test could be replaced by more modern test procedures. In the current study we verified this for a larger and more heterogeneous group of participants. METHOD: A total of 145 participants with hearing impairments were tested with the Freiburg speech test and the modern procedures. Both monosyllabic tests were carried out at three different presentation levels. Based on the findings of the previous study the monosyllabic rhyme test was performed in each case with a presentation level reduced by 15 dB relative to the Freiburg monosyllabic test levels. RESULTS: The feasibility to replace both parts of the Freiburg speech test by more modern test procedures could be confirmed. The comparison of both monosyllabic tests showed that a reduction in the presentation level by 20 dB for the monosyllabic rhyme test would be most appropriate to achieve on average the same results with both procedures.

[Comparison of different speech intelligibility tests in German language (Freiburg speech test vs. Göttingen sentence test and monosyllabic rhyme test)]. / Untersuchung zur Vergleichbarkeit des Freiburger Sprachtests mit dem Göttinger Satztest und dem Einsilber-Reimtest nach von Wallenberg und Kollmeier.

BACKGROUND: For assessing a noise-induced hearing loss, the Freiburg speech test (Freiburger Sprachtest) is traditionally used to examine speech recognition in silence. However, for many years this test has been shown to have serious shortcomings. Various modern procedures in German language are available as alternatives. METHODS: The aim of the current study was to compare the Freiburg number test (FBZ) with the Göttingen sentence test (GöSa) and the Freiburg monosyllabic test (FBE) with the monosyllabic rhyme test developed by von Wallenberg and Kollmeier (WaKo), all applied in silence. Overall, 31 participants with various degrees of hearing loss were tested in this study. Speech intelligibility was determined with both monosyllabic tests at presentation levels of 60 and 80 dB SPL and for some listeners also at 100 dB SPL. The maximum intelligibility was also determined. In addition, for the combination FBZ and FBE and for the combination FBZ and WaKo, the percentage of hearing loss based on speech audiometry was calculated. RESULTS: The results show that both of the modern speech tests can be used as an alternative to the Freiburg speech test. Altogether the monosyllabic rhyme test leads to higher speech intelligibility than the Freiburg monosyllabic test. Therefore, a reduction of the presentation level by 15 dB is recommended if it is intended to retain the existing tables for calculating the percentage of hearing loss. Reducing the presentation level also has the advantage that measurements at 100 dB SPL are not required anymore. A level of 100 dB SPL is assessed as unpleasant by many listeners.