[Speech intelligibility in adults after the new coronavirus infection (COVID-19)]. / Razborchivost' rechi u vzroslykh patsientov posle novoi koronavirusnoi infektsii (COVID-19).

OBJECTIVE: The research was aimed to assess speech intelligibility in adults after the new coronavirus infection (COVID-19), state of peripheral and central parts of auditory system and cognitive functions. MATERIAL AND METHODS: 26 people complaining about hearing loss, poor speech intelligibility and/or tinnitus after COVID-19 were examined. All the patients underwent the basic audiological assessment before COVID-19. Extended testing in patients after COVID-19 included: pure tone audiometry, impedancemetry, speech audiometry in quiet and noise (evaluation of monosyllabic words intelligibility and the Russian matrix sentence test RuMatrix), the alternating binaural speech test, the dichotic digits test and the Montreal Cognitive Assessment (MoCA). RESULTS: The most significant deviations from the normative values were obtained in the RuMatrix test and the dichotic digits test that may be due to both central auditory processing disorder and memory impairment. Low MoCA scores were obtained in 62% of patients. CONCLUSION: Deterioration of speech intelligibility after COVID-19 was revealed, both in patients with hearing loss and with normal hearing that corresponded to their complaints. It may be caused by central auditory disorder, memory impairment or cognitive status lesion. The correlation found between the results of the RuMatrix test in noise and the severity of the COVID-19 may indicate the impact of the virus on the auditory cortex.

[Audiological testing in complex geriatric assessment of patients.]

The aim of the study is to evaluate the advantage of including audiological testing in the system of comprehensive geriatric assessment (CGA) of patients. The results of a survey of 988 elderly and senile people (average age 77±7,4 years) are presented, each of whom underwent a CGA and hearing assessment by filling out a questionnaire Hearing Handicap Inventory for the Elderly, Screening version (HHIE-S). All patients were divided into two groups: the first group included 780 inpatient patients undergoing medical and social rehabilitation in different departments of the Saint-Petersburg City Geriatric Center. The second group included 208 outpatient patients, of whom 81 additionally underwent an audiological examination, which included ENT examination and pure tone audiometry to determine the degree of hearing loss. A correlation was revealed between the hearing state and the cognitive status of patients according to the results of the Mini-Mental State Examination (MMSE) questionnaire, as well as the senile asthenia index. The results of the work indicate the need to include the HHIE-S questionnaire in the system of comprehensive geriatric assessment for early detection and correction of hearing loss, and prevention of cognitive disorders.

[Transcranial electrical stimulation of audiology patients of different ages.]

The aim of the study was a comparative analysis of subjective assessments and audiological parameters of patients with hearing loss obtained before and after the course of transcranial electrical stimulation (TES). The study group included 99 patients (45 men and 54 women) with chronic mono- (16%) and bilateral (76%) sensorineural hearing loss (SNHL) aged 20 to 85 years. Groups of young and middle age (20-59 years old) amounted to 37 people; elderly (60-74 years old) - 48 and senile (75-90 years old) - 14 people. The observation included: anamnesis, ENT survey, tone threshold audiometry, impedancemetry, and questioning. All patients underwent a course of 10 TES procedures using the «Transair-7¼ device. The data indicated an improvement in subjective assessments regarding auditory perception in 54%, speech intelligibility in 53%, tinnitus in 24% and general well-being in 36% of patients in the study group. The distribution of hearing thresholds in the region of speech frequencies before and after the course also turned out to be significantly different (p<0,01). At the same time, gender and age-specific features of the effect of TES on hearing and general well-being were revealed, the most pronounced in senile patients who showed minimal positive dynamics. In general, taking into account age restrictions, the results confirm the feasibility of using TES in SNHL, even outside the combined (with audio loading) stimulation.

[Psychoacoustic tests for perceptual assessment of processor fitting in patients with cochlear implants]. / Ispol'zovanie psikhoakusticheskikh testov dlya pertseptivnoi otsenki nastroiki protsessora kokhlearnogo implanta u glukhikh patsientov.

THE AIM OF THE STUDY: Was to study the possibility of using a battery of psychoacoustic tests to assess the tuning of the cochlear implant processor (CI) in deaf patients. METHODOLOGY: The study involved 60 prellingually deaf patients aged 10 to 23 years with oral speech skills. To assess the quality of the CI processor tuning, in addition to traditional methods, a special battery of psychoacoustic tests was used. The first block of tests assessed the perception of the basic characteristics of sound signals (duration, temporal structure, spectrum, timbre) and was used to assess the initial setting. The second block of tests, intended for patients with experience using CI, included tasks to distinguish acoustically similar and dynamically changing signals, etc. RESULTS: At the end of the initial CI setup session, patients with short signal perception problems were identified. Adjusting the frequency of electrical stimulation in patients has increased their ability to distinguish between sounds. During the second tuning session of the CI processor, 6 months later, a group of patients with difficulties in perceiving acoustic information in the low-frequency range was identified - distinguishing melodic intervals, changing the pitch of sounds, highlighting the voice of the target speaker. The «problem¼ patients underwent additional correction of the CI processor setting and the corresponding auditory training, which improved the test performance and subjective perception of sounds. CONCLUSION: The use of psychoacoustic tests expands the possibilities of fine tuning the CI processor, taking into account the individual characteristics of the patient's auditory perception at different stages of CI use, especially in «problem¼ patients.

[Audiological correlates of age-related manifestations of auditory disorders.]

The aim of the study was a comparative analysis of complaints and audiological findings in patients of the audiological center depending on their age. The results of the examination of 300 firstly consulted patients (random sample) are presented. The group of young patients (19-44 years) included 40 people; middle age (45-59 years) - 62 people; elderly (60-74 years) - 100 people; senile age (75-90 years) - 98 people. The survey included the collection of complaints and anamnesis, ENT checkup, pure tone audiometry, impedancemetry, speech audiometry in headphones to detect the signs of Central Auditory Processing Disorder or in the free sound field to assess the effectiveness of hearing aids. It was found that for early diagnosis of hearing loss and prevention of age-related sensory-cognitive dysfunction, it is advisable to use not only the results of pure tone audiometry, but also the data of speech audiometry, as well as the analysis of subjective complaints. The results of the work indicate the need for hearing screening in the population over 60 years old.

[Age-related issues of the quality of life in hearing impaired patients.]

The aim of the research was to study the quality of life in hearing impaired patients of different age. 100 patients referred to the city audiology centre because of their hearing disorders were examined: 50 patients from 34 to 59 years old and 50 patients from 60 years and older, from which 32 patients were of older age (60 to 74 years old) and 18 of oldest age (75 to 86 years old). A degree of hearing loss was assessed according to results of pure tone audiometry. To study the quality of life all patients filled in the questionnaire MOS SF-36, which evaluates physical and psychological components of health, and the questionnaire HHIA(E)-S, designed specifically for patients with hearing disorders. The HHIA(E)-S scale was found to show high correlation with hearing loss degree in patients younger than 60 years old (R2=0,98 with statistically significant difference, p<0,05), with decreasing correlation in patients from 60 years and older (R2=0,98; no significant difference while assessing various hearing loss degrees). Considerable difficulties in this age group may be explained by the fact, that older and especially oldest patients have a challenge with hearing aids usage (or they are of low efficiency for them) and with assessing theirs difficulties on the questionnaire scales. The HHIA(E)-S scale is useful as a screening tool for early detection of hearing loss, referral of patients to an audiologist and prompt hearing aid fitting.

[Sequential bilateral cochlear implantation with long interval between surgeries in deaf-blind patient]. / Posledovatel'naia bilateral'naia kokhlearnaia implantatsiia s dlitel'nym intervalom mezhdu operatsiiami u slepoglukhogo patsienta.

The efficacy of sequential bilateral cochlear implantation with long interval between surgeries (18 years) was investigated in deaf-blind patient (22 years old man, lost hearing and vision after meningitis at the age 2.5 years). At the age 4 years he got cochlear implant at right ear. His speech skills completely disappeared before the implantation. Auditory-speech rehabilitation with cochlear implant was successful - patient has good auditory, language, speech, cognitive skills. At the age 22 years patient made decision to get cochlear implant at the left ear after breakdown of internal part of cochlear implant at right ear in spite of successful reoperation. After activation of new processor (all electrodes were activated) the patient got daily auditory training with cochlear implant at left ear (Concerto/Opus 2, Medel) on the base of 'auditory' method, in daily life patient uses 2 devices. After 1 month of using cochlear implant at left ear the patient recognized environmental sounds and music instruments, words and sentences in close set tests EARS battery, the score for OLSA test in quiet was 90%, but the perception in noise was complicated. The balance of parameters of fitting for 1-st and 2-nd processors and special auditory training with two cochlear implants provided the development of initial binaural interaction. Perilinqually deaf patients can achieve high effect after sequential bilateral cochlear implantation with long interval between surgeries. The necessary conditions are - preservation of electrical activity of auditory nerve, intensive structured auditory training with new 'ear', patient's motivation of using of cochlear implant at 'new' ear.

[The role of mono- and binaural hearing aid in the rehabilitation of the adult patients presenting with hearing impairment]. / Mono- i binaural'noe slukhoprotezirovanie v reabilitatsii vzroslykh patsientov s tugoukhost'iu.

The objective of the present study was to compare the effectiveness of mono- and binaural hearing aids in the rehabilitation of the adult patients of different age presenting with chronic symmetric hearing loss (CSHL). A total of 263 subjects at the age from 50 to 88 years complaining of moderate to severe (grade I-IV) chronic symmetric hearing impairment were available for the examination. Following the ENT examination with the application of pure tone audiometry and impedancometry, the participants of the study were supplied with the individually fitted digital behind-the-ear hearing instruments and underwent speech audiometry in the free sound field. The intelligibility of polysyllabic words in the calm and noisy environment was evaluated. A significant deterioration of the intelligibility was documented both under the quiet and noisy conditions. Its severity increased with the patients' age and the degree of hearing impairment. The comparison of the results of speech audiometry in the patients using either a single or two hearing aids gave evidence that binaural hearing aids were more efficient than monoaural ones in 86% of the patients. Re-examination of the same patients one year after the completion of the first study has demonstrated that 59% of them became permanent users of the hearing aids with 47% of them making regular use of simultaneously two hearing aids. It is concluded that speech audiometry in the free sound field can be recommended as a highly informative method that allows to substantiate the reasonable choice between the mono- and binaural hearing aids for the adult patients presenting with hearing impairment.

[Age related aspects of cochlear implantation.]

The objective of this study was to assess the long-term results of cochlear implantation in terms of age-related changes. 67 patients of different age with chronic bilateral severe sensorineural hearing loss and deafness with experience of use of cochlear implants (CI) for at least 5 years were tested. The 1st group included young patients (25,5±7,9 years), the 2nd group - middle-aged (51,4±5,4 years), the 3rd group - elderly patients (67±5,6 years). The examination, which conducted before and after the planned replacement of the speech processor, included: pure tone and speech audiometry in the free field, subjective assessment of satisfaction with CI, assessment of the state of speech function and psychological testing using the Montreal Cognitive Assessment and Mini-Mental State Examination. The increase in speech intelligibility in silence and in a background noise after the replacement of speech processors was revealed. The expediency of cochlear implantation in geriatric practice to maintain the mental and social status of elderly people, prevention of dementia, improving the quality of their lives in the conditions of increasing the age-related risks of sensory and cognitive dysfunction was shown.

[The effectiveness of hearing aids in elderly people].

The analysis of factors which influence on the hearing aid efficacy in elderly with presbycusis is presented in the article. 125 patients from 60 to 90 years old with moderate to severe hearing loss, hearing aid users, were examined. The audiology examination included standard methods as well as tests evaluating central auditory pathways processing. According to the results of speech audiometry in free field low efficacy of hearing aid is revealed in 21 % patients. The main factor that decreases hearing aid benefit is the presence of central auditory processing disorders, the additional one is poor technical characteristics of a hearing aid. To increase hearing aid benefit in elderly the correction of central auditory processing disorders, rational hearing aid fitting according to individual features of auditory system and help in adaptation to hearing aid using are required.

[Speech intelligibility in elderly hearing impaired people].

The results of studying the features of auditory perception of speech stimuli in aged patients with hearing loss are presented in the article. 145 patients with moderate to severe sensorineural hearing loss from 52 to 90 years old underwent the tonal threshold audiometry and the tests battery to evaluate central auditory pathways functioning: the gap detection test, frequency difference limens, masking level difference, dichotic digits test. After analyzing speech discrimination scores of monosyllable words in quiet and in noise significantly worse results of all listeners in comparison with listeners with normal hearing are revealed; the deterioration of speech discrimination scores depending on age is noted. The impairment of speech discrimination is maximal when the speech stimuli are presented in background noise. Direct correlation between the deterioration of speech discrimination and the degree of hearing loss, it's duration, the presence of central auditory pathways dysfunction was ascertained.

[EFFECT OF HYPOXIA ON THE CHARACTERISTICS OF HUMAN AUDITORY PERCEPTION].

The effect of normobaric hypoxic hypoxia (single and interval training) on the characteristics of human hearing was investigated. The hearing thresholds (tonal audiograms), reaction time of subjects in psychophysical experiments (pause detection, perception of rhythm and target words), and short-term auditory memory were measured before and after hypoxia. The obtained data revealed improvement of the auditory sensitivity and characteristics of working memory, and increasing of response speed. It was demonstrated that interval hypoxic training had positive effect on the processes of auditory perception.

[Principles of temporal processing of spectral information during vowel perception]. / Printsipy vremennói obrabotki spektral'noi informatsii pri vospriiatii glasnykh.

Pairs of "one-formant pulses" with 10 ms onset-to-onset interval and highly different F values for the first and the second pulse (LH and HL pairs) were used in vowel identification experiment. Response distributions corresponding to these stimuli and to "stationary" two-formant and one-formant pulse pairs were compared to calculate the phonetic distance between stimuli. The results are in favour of low-pass filtering of excitation pattern with sampling at the stimulus offset.