High-Frequency Gain and Maximum Output Effects on Speech Recognition in Bone-Conduction Hearing Devices: Blinded Study.

INTRODUCTION: Bone-conduction hearing device (BCHD) uses natural sound transmission through bone and soft tissue, directly to the cochlea, via an external processor that captures and processes sound, which is converted into mechanical vibrations. Key parameters, as maximum power output (MPO) and broader frequency range (FR), must be considered when indicating a BCHD because they can be decisive for speech recognition, especially under listening challenge conditions. OBJECTIVES: Compare hearing performance and speech recognition in noise of two sound processors (SPs), with different features of MPO and FR, among BCHD users. MATERIALS AND METHODS: This single-blinded, comparative, observational study evaluated 21 individuals Baha 4 system users with conductive or mixed hearing impairment. The free-field audiometry and speech recognition results were blindly collected under the following conditions: unaided, with Baha 5, and with Baha 6 Max SP. RESULTS: In free-field audiometry, significant differences were observed between the SP at 0.25, 3, 4, 6, and 8 kHz, with Baha 6 Max outperforming Baha 5. The Baha 6 Max provided significantly better speech recognition than Baha 5 under all the speech in noise conditions evaluated. Separating the transcutaneous from the percutaneous users, Baha 6 Max Attract SP provided the best results and significantly lowered the free-field thresholds than Baha 5 Attract. The Baha 6 Max also significantly improved speech recognition in noise, among both Attract and Connect users. CONCLUSION: The present study revealed that the greater MPO and broader FR of the Baha 6 Max device helped increase high-frequency gain and improved speech recognition in BCHD-experimented users.

Novel cochlear implant assessment tool: Comparative analysis of children and adults.

Objectives: To analyse the results of children and adults with cochlear implants (CIs) in pure tone audiometry (PTA) and speech perception tests. Tests were performed in two ways: using loudspeakers in the sound booth (SB) and with direct audio input (DAI) employing the Cochlear Latin America BOX (CLABOX). Methods: Fifty individuals (33 adults and 17 children) participated in the study, including children aged between 8 and 13 years; of these, 15 users had bilateral CIs, 35 had unilateral CIs, and all had severe to profound bilateral sensorineural hearing loss. All participants were evaluated in the SB with loudspeakers and the CLABOX with DAI. The following evaluations were conducted: PTA, speech recognition tests with the hearing in noise test (HINT). Results: The results for PTA and HINT conducted in SB and with CLABOX presented no significant difference between children and adults. Conclusion: The CLABOX tool presents a new possible method to evaluate PTA and speech recognition tests in adults and children, with results comparable to the conventional evaluation in the SB.

Comparison of Speech Recognition in Cochlear Implant Users with Different Speech Processors.

BACKGROUND: Speech recognition in noisy environments is a challenge for both cochlear implant (CI) users and device manufacturers. CI manufacturers have been investing in technological innovations for processors and researching strategies to improve signal processing and signal design for better aesthetic acceptance and everyday use. PURPOSE: This study aimed to compare speech recognition in CI users using off-the-ear (OTE) and behind-the-ear (BTE) processors. DESIGN: A cross-sectional study was conducted with 51 CI recipients, all users of the BTE Nucleus 5 (CP810) sound processor. Speech perception performances were compared in quiet and noisy conditions using the BTE sound processor Nucleus 5 (N5) and OTE sound processor Kanso. Each participant was tested with the Brazilian-Portuguese version of the hearing in noise test using each sound processor in a randomized order. Three test conditions were analyzed with both sound processors: (i) speech level fixed at 65 decibel sound pressure level in a quiet, (ii) speech and noise at fixed levels, and (iii) adaptive speech levels with a fixed noise level. To determine the relative performance of OTE with respect to BTE, paired comparison analyses were performed. RESULTS: The paired t-tests showed no significant difference between the N5 and Kanso in quiet conditions. In all noise conditions, the performance of the OTE (Kanso) sound processor was superior to that of the BTE (N5), regardless of the order in which they were used. With the speech and noise at fixed levels, a significant mean 8.1 percentage point difference was seen between Kanso (78.10%) and N5 (70.7%) in the sentence scores. CONCLUSION: CI users had a lower signal-to-noise ratio and a higher percentage of sentence recognition with the OTE processor than with the BTE processor.

Reconhecimento de fala no ruído em sujeitos com audição normal e queixa de zumbido / Speech recognition in noise in individuals with normal hearing and tinnitus

RESUMO Introdução O desempenho auditivo para sons supraliminares pode estar comprometido, mesmo quando o audiograma é normal. Pacientes com zumbido sem perda auditiva queixam-se frequentemente de dificuldades de compreensão de fala, principalmente em ambientes ruidosos. Objetivo Investigar o desempenho em testes de fala com ruído, em indivíduos com limiares audiométricos normais, com e sem queixa de zumbido. Métodos Foram avaliados 20 sujeitos adultos, com idade entre 18 e 45 anos, com audição dentro dos padrões de normalidade, que apresentavam, ou não, o sintoma de zumbido, divididos em grupo zumbido e grupo controle. Foram pesquisados os limiares de reconhecimento de sentenças no ruído, por meio do teste Listas de Sentenças em Português. Resultados O grupo zumbido apresentou pior desempenho para os dois ruídos utilizados, porém, com diferença estatística somente na utilização do ruído speech-noise. Conclusão O desempenho de sujeitos com audição normal e queixa de zumbido, no reconhecimento de fala na presença de ruído competitivo, foi pior que em indivíduos sem o sintoma, principalmente na etapa com o ruído speech-noise.

ABSTRACT Introduction Auditory performance for suprathreshold sounds may be compromised even when the audiogram is normal. Patients with tinnitus but without hearing loss often complain of speech recognition difficulties, especially in noisy environments. Purpose To investigate the performance in noise tests in individuals with normal hearing thresholds with and without tinnitus. Methods Twenty adult individuals were evaluated, aged between 18 and 45 years, with hearing within normal limits, presenting or not with tinnitus symptoms, divided into two groups, the tinnitus group and the control group. The SRTN (sentence recognition threshold in noise) were surveyed with the LSP test (list of sentences in Portuguese). Results The tinnitus group had the worst performance for the two noises used, but with a statistically significant difference only when using “speech-noise”. Conclusion We found that the performance of individuals with normal hearing and tinnitus in speech recognition in the presence of background noise is poorer than in patients without the symptom mainly in step obtained with speech-shaped noise.

Otoacoustic emissions in newborns with mild and moderate perinatal hypoxia. / Emissões otoacústicas em recém-nascidos com hipóxia perinatal leve e moderada.

Introduction Severe neonatal hypoxia (as evidenced by the Apgar value) is currently considered the only risk for hearing loss. Hypoxia is one of the most common causes of injury and cell death. The deprivation of oxygen in mild or moderate cases of hypoxia, although smaller, occurs and could cause damage to the auditory system. Objective To investigate the amplitude of otoacoustic emissions in neonates at term with mild to moderate hypoxia and no risk for hearing loss. Methods We evaluated 37 newborns, divided into two groups: a control group of 25 newborns without hypoxia and a study group of 12 newborns with mild to moderate hypoxia. TEOAE and DPOAE were investigated in both groups. Results The differences between groups were statistically significant in the amplitude of DPOAE at the frequencies of 1000, 2800, 4000 and 6000 Hz. In TEOAE, statistically significant differences were found in all tested frequency bands. OAE of the study group were lower than those in the control group. Conclusion Although the occurrence of mild and moderate neonatal hypoxia is not considered a risk factor for hearing loss, deprivation of minimum oxygen during neonatal hypoxia seems to interfere in the functioning of the outer hair cells and, consequently, alter the response level of otoacoustic emissions. Thus, hese children need longitudinal follow-up in order to identify the possible impact of these results on language acquisition and future academic performance.

Emissões otoacústicas em recém-nascidos com hipóxia perinatal leve e moderada / Otoacoustic emissions in newborns with mild and moderate perinatal hypoxia

RESUMO Introdução Atualmente, somente a hipóxia neonatal grave (evidenciada pelo valor do Apgar) é considerada risco para a deficiência auditiva. A hipóxia é uma das causas mais comuns de lesão e morte celular. Nos casos de hipóxia leve ou moderada, embora menor, a privação da oxigenação está presente e, dessa forma, algum dano ao sistema auditivo pode ocorrer. Objetivo Investigar as amplitudes das emissões otoacústicas em recém-nascidos a termo sem risco para deficiência auditiva que apresentaram hipóxia leve ou moderada. Métodos Foram selecionados 37 recém-nascidos de ambos os sexos, divididos em dois grupos: 25 do grupo controle, formado por recém-nascidos sem hipóxia, e 12 do grupo estudo, formado por recém-nascidos com hipóxia leve ou moderada. Resultados Foram pesquisadas as EOAT e EOAPD em ambos os grupos e comparados os seus resultados. Nas EOAPD foram encontradas diferenças estatísticas entre as amplitudes nas frequências 1.000, 2.800, 4.000 e 6.000 Hz. Nas EOAT foram encontradas diferenças estatísticas nas bandas de frequência de 1.000, 1.400, 2.000, 2.800 e 4.000 Hz, sendo as EOA do grupo estudo menores que as do grupo controle. Conclusão Embora a ocorrência de hipóxia neonatal leve e moderada não seja considerada risco para perda auditiva, a mínima privação do oxigênio durante o momento de hipóxia neonatal parece interferir no funcionamento das células ciliadas externas e, consequentemente, no nível de respostas das emissões otoacústicas. Dessa forma, faz-se necessário o acompanhamento longitudinal desses lactentes, a fim de identificar o possível impacto desses resultados na aquisição de linguagem e, futuramente, no desempenho escolar.

ABSTRACT Introduction Severe neonatal hypoxia (as evidenced by the Apgar value) is currently considered the only risk for hearing loss. Hypoxia is one of the most common causes of injury and cell death. The deprivation of oxygen in mild or moderate cases of hypoxia, although smaller, occurs and could cause damage to the auditory system. Objective To investigate the amplitude of otoacoustic emissions in neonates at term with mild to moderate hypoxia and no risk for hearing loss. Methods We evaluated 37 newborns, divided into two groups: a control group of 25 newborns without hypoxia and a study group of 12 newborns with mild to moderate hypoxia. TEOAE and DPOAE were investigated in both groups. Results The differences between groups were statistically significant in the amplitude of DPOAE at the frequencies of 1000, 2800, 4000 and 6000 Hz. In TEOAE, statistically significant differences were found in all tested frequency bands. OAE of the study group were lower than those in the control group. Conclusion Although the occurrence of mild and moderate neonatal hypoxia is not considered a risk factor for hearing loss, deprivation of minimum oxygen during neonatal hypoxia seems to interfere in the functioning of the outer hair cells and, consequently, alter the response level of otoacoustic emissions. Thus, hese children need longitudinal follow-up in order to identify the possible impact of these results on language acquisition and future academic performance.

Psychoacoustic analyses of cochlear mechanisms in tinnitus patients with normal auditory thresholds.

OBJECTIVE: Tinnitus is often related to auditory dysfunction. We hypothesised that, among individuals with normal auditory thresholds, the mechanism of frequency selectivity might differ between subjects with and without tinnitus. Our objective was to identify any differences between normal-hearing individuals with tinnitus and those without in terms of psychophysical tuning curves (PTCs) and threshold-equalising noise (TEN) test results. DESIGN: We determined PTCs and performed the TEN test. STUDY SAMPLE: We evaluated 57 individuals, 16 with bilateral tinnitus (tinnitus-group) and 41 without tinnitus (control-group). RESULTS: We found significant differences between tinnitus and control groups regarding the following: 2 kHz PTCs obtained in noise at 6 and 8 kHz; 4 kHz PTCs obtained in noise at 2 and 8 kHz; and 6 and 8 kHz PTCs obtained in noise at 2 and 3 kHz. The TEN test revealed differences between groups in terms of auditory thresholds, which were significantly higher in the tinnitus group. In addition, none of the individuals in the tinnitus group were found to have dead regions in the cochlea. CONCLUSIONS: Despite having normal auditory thresholds, individuals with tinnitus have auditory patterns that differ significantly from those seen in individuals without tinnitus, such differences being suggestive of cochlear impairment.

Adaptação de aparelho de amplificação sonora individual: relações entre a auto-percepção do handcap auditivo e a avaliação da percepção de fala / Acclimatization to hearing aids: relatioship between self assessment of hearing handcap and speech perception

Descreve e analisa como medidas de auto-percepção do handcap auditivo e da percepção dos sons da fala modificam-se ao longo do processo inicial de indicação de aparelho de amplificação sonora individual