Tinnitus Suppression Effect of Hearing Aids in Patients With High-frequency Hearing Loss: A Randomized Double-blind Controlled Trial.

INTRODUCTION: Hearing aids (HAs) with frequency lowering have been used for high-frequency hearing loss (HFHL), but their effects on tinnitus relief have not been studied extensively. This randomized double-blind trial was performed to investigate and compare tinnitus suppression effects of conventional type HAs and frequency-lowering HAs in patients with HFHL. METHODS: A total of 114 patients were randomized into three groups: conventional HA using wide dynamic range compression, HA with frequency translation, and HA with linear frequency transposition. Participants wore HAs for 3 months and then discontinued their use. The final evaluation was performed at 3 months after cessation of wearing HA (6 mo after the initial visit). The Tinnitus Handicap Inventory (THI) score and additional variables, such as matched tinnitus loudness and visual analog scale scores of subjectively perceived tinnitus loudness, daily awareness, and annoyance, were measured at the initial visit and at 3- and 6-month follow-ups. RESULTS: THI score and most of the additional outcomes were significantly improved at 3 and 6 months (3 mo after HA removal) compared with their initial values in all three groups. The incidence rates of patients with improvements in the THI score by 20% or more were 71.0, 72.7, and 74.3% at 3 months, and 54.8, 51.6, and 59.4% at 6 months for the three groups, respectively. There were no significant differences in primary or additional variables between hearing aid types at either 3 or 6 months. CONCLUSION: This is a consolidated standards of reporting trials-guided study providing direct evidence for tinnitus suppression effects of HA alone, without accompanying counseling or any other treatments, which lasted for at least 3 months after patients stopped using HAs. HAs effectively suppressed tinnitus in patients with HFHL regardless of the amplification strategy type.

Potential Benefits of an Integrated Electric-Acoustic Sound Processor with Children: A Preliminary Report.

BACKGROUND: A number of published studies have demonstrated the benefits of electric-acoustic stimulation (EAS) over conventional electric stimulation for adults with functional low-frequency acoustic hearing and severe-to-profound high-frequency hearing loss. These benefits potentially include better speech recognition in quiet and in noise, better localization, improvements in sound quality, better music appreciation and aptitude, and better pitch recognition. There is, however, a paucity of published reports describing the potential benefits and limitations of EAS for children with functional low-frequency acoustic hearing and severe-to-profound high-frequency hearing loss. PURPOSE: The objective of this study was to explore the potential benefits of EAS for children. RESEARCH DESIGN: A repeated measures design was used to evaluate performance differences obtained with EAS stimulation versus acoustic- and electric-only stimulation. STUDY SAMPLE: Seven users of Cochlear Nucleus Hybrid, Nucleus 24 Freedom, CI512, and CI422 implants were included in the study. DATA COLLECTION AND ANALYSIS: Sentence recognition (assayed using the pediatric version of the AzBio sentence recognition test) was evaluated in quiet and at three fixed signal-to-noise ratios (SNR) (0, +5, and +10 dB). Functional hearing performance was also evaluated with the use of questionnaires, including the comparative version of the Speech, Spatial, and Qualities, the Listening Inventory for Education Revised, and the Children's Home Inventory for Listening Difficulties. RESULTS: Speech recognition in noise was typically better with EAS compared to participants' performance with acoustic- and electric-only stimulation, particularly when evaluated at the less favorable SNR. Additionally, in real-world situations, children generally preferred to use EAS compared to electric-only stimulation. Also, the participants' classroom teachers observed better hearing performance in the classroom with the use of EAS. CONCLUSIONS: Use of EAS provided better speech recognition in quiet and in noise when compared to performance obtained with use of acoustic- and electric-only stimulation, and children responded favorably to the use of EAS implemented in an integrated sound processor for real-world use.

Health-related quality of life and mental distress in patients with partial deafness: preliminary findings.

The aim of the study was to evaluate mental distress and health-related quality of life in patients with bilateral partial deafness (high-frequency sensorineural hearing loss) before cochlear implantation, with respect to their audiological performance and time of onset of the hearing impairment. Thirty-one patients and 31 normal-hearing individuals were administered the Beck Depression Inventory (BDI), the State-Trait-Anxiety-Inventory (STAI) and the World Health Organization Quality of Life-BREF questionnaire (WHOQOL-BREF). Patients also completed the Nijmegen-Cochlear-Implant-Questionnaire (NCIQ), a tool for evaluation of quality of life related to hearing loss. Patients revealed increased depressive and anxiety symptoms, as well as decreased health-related quality of life (psychological health, physical health), in comparison with their healthy counterparts (t tests, p < 0.05). Furthermore, a General Linear Model demonstrated in patients with a prelingual onset of hearing loss enhanced self-evaluated social interactions and activity (NCIQ), when their outcomes were contrasted with those obtained in individuals with postlingual partial deafness (p < 0.05). The study failed to show any effect of collateral tinnitus. Patients not using hearing aids had better audiological performance and, therefore, better sound perception and speech production, as measured with NCIQ. There was no effect of hearing aid use with respect to mental distress. Additional statistically significant correlations seen in patients included those between a steeper slope hearing loss configuration (averaged pure-tone thresholds at 1 and 2 kHz with subtracted threshold at 0.5 kHz) and better audiometric speech detection, between audiometric thresholds and the subjectively rated sound perception (NCIQ), as well as left-ear audiometric word recognition scores and the subjectively perceived ability to recognize advanced sounds (NCIQ). In addition, a longer duration of postlingual deafness, as well as a younger age at the onset were both related to worse speech detection thresholds. The results of the study provide evidence that successful rehabilitation in patients with partial deafness might have to go beyond the standard speech therapy. Enhancement of the regular diagnostic assessment with additional psychological tools is highly recommended. Further investigation is required as to the role of functional residual hearing, hearing aid use and tinnitus, in relation to future outcomes of cochlear implantation.

A Patient-Centered, Provider-Facilitated Approach to the Refinement of Nonlinear Frequency Compression Parameters Based on Subjective Preference Ratings of Amplified Sound Quality.

PURPOSE: To evaluate sound quality preferences of participants wearing hearing aids with different strengths of nonlinear frequency compression (NFC) processing versus no NFC processing. Two analysis methods, one without and one with a qualifier as to the magnitude of preferences, were compared for their percent agreement to differentiate a small difference in perceived sound quality as a result of applied NFC processing. RESEARCH DESIGN: A single-blind design was used with participants unaware of the presence or strength of NFC processing (independent variable). The National Acoustic Laboratories-Nonlinear 2 (NAL-NL2) prescription of amplification was chosen because audibility is intentionally not prescribed in the presence of larger sensorineural hearing loss thresholds. A lack of prescribed audibility, when present, was deemed an objective qualifier for NFC. NFC is known to improve the input bandwidth available to listeners when high-frequency audibility is not otherwise available and increasing strengths of NFC were examined. Experimental condition 3 (EC3) was stronger than the manufacturer default (EC2). More aggressive strengths (e.g., EC4 and EC5), however, were expected to include excessive distortion and even reduce the output bandwidth that had been prescribed as audible by NAL-NL2 (EC1). STUDY SAMPLE: A total of 14 male Veterans with severe high-frequency sensorineural hearing loss. DATA COLLECTION AND ANALYSIS: Participant sound quality preference ratings (dependent variable) without a qualifier as to the magnitude of preference were analyzed based on binomial probability theory, as is traditional with paired comparison data. The ratings with a qualifier as to the magnitude of preference were analyzed based on the nonparametric statistic of the Wilcoxon signed rank test. RESULTS: The binomial probability analysis method identified a sound quality preference as well as the nonparametric probability test method. As the strength of NFC increased, more participants preferred the EC with less NFC. Fourteen of 14 participants showed equal preference between EC1 and EC2 perhaps, in part, because EC2 showed no objective improvement in audibility for six of the 14 participants (42%). Thirteen of the 14 participants showed no preference between NAL-NL2 and EC3, but all participants had an objective improvement in audibility. With more NFC than EC3, more and more participants preferred the other EC with less NFC in the paired comparison. CONCLUSIONS: By referencing the recommended sensation levels of amplitude compression (e.g., NAL-NL2) in the ear canal of hearing aid wearers, the targeting of NFC parameters can likely be optimized with respect to improvements in effective audibility that may contribute to speech recognition without adversely impacting sound quality. After targeting of NFC parameters, providers can facilitate decisions about the use of NFC parameters (strengths of processing) via sound quality preference judgments using paired comparisons.

Hearing preservation and clinical outcome of 32 consecutive electric acoustic stimulation (EAS) surgeries.

CONCLUSIONS: Our results indicated that electric acoustic stimulation (EAS) is beneficial for Japanese-speaking patients, including those with less residual hearing at lower frequencies. Comparable outcomes for the patients with less residual hearing indicated that current audiological criteria for EAS could be expanded. Successful hearing preservation results, together with the progressive nature of loss of residual hearing in these patients, mean that minimally invasive full insertion of medium/long electrodes in cochlear implantation (CI) surgery is a desirable solution. The minimally invasive concepts that have been obtained through EAS surgery are, in fact, crucial for all CI patients. OBJECTIVES: This study was conducted to evaluate hearing preservation results and speech discrimination outcomes of hearing preservation surgeries using medium/long electrodes. METHODS: A total of 32 consecutive minimally invasive hearing preservation CIs (using a round window approach with deep insertion of a flexible electrode) were performed in 30 Japanese patients (two were bilateral cases), including patients with less residual hearing. Hearing preservation rates as well as speech discrimination/perception scores were investigated on a multicenter basis. RESULTS: Postoperative evaluation after full insertion of the flexible electrodes (24 mm, 31.5 mm) showed that residual hearing was well preserved in all 32 ears. In all patients, speech discrimination and perception scores were improved postoperatively.

[Clinical analysis of sudden deafness after radiotherapy and chemotherapy in nasopharyngeal carcinoma patients].

OBJECTIVE: To investigate the clinical features and therapeutic effects of sudden deafness after radiotherapy combined with chemotherapy in nasopharyngeal carcinoma patients. METHOD: Clinical data of 42 nasopharyngeal carcinoma patients suffered from sudden deafness after radiotherapy combined with chemotherapy were analyzed retrospectively. Among the 42 patients, 2 showed moderate deafness, 4 presented excessive deafness, 30 suffered from severe deafness, and 6 exhibited profound deafness. The audiogram pattern of 33 patients met with the type of high tone frequencies hearing loss, and that of the rest 9 cases showed hearing loss at all frequencies. All patients received medical therapy combined with hyperbaric oxygen therapy. RESULT: Of all the cases with hearing loss, 2 were cured, 2 showed excellent recovery, 9 came out partial recovery, and 29 showed no response to the treatment. The total effective rate was 30.95%. For the accompanied symptoms, none of the 30 cases of tinnitus were relieved, 3 out of 10 cases of aural fullness were cured, and the 5 cases of dizziness or vertigo were all improved. CONCLUSION: The sudden deafness after radiotherapy combined with chemotherapy in patients with nasopharyngeal carcinoma is closely related to radiotherapy. The hearing loss is serious, and the therapeutic effects are not satisfactory.

An initial-fit comparison of two generic hearing aid prescriptive methods (NAL-NL2 and CAM2) to individuals having mild to moderately severe high-frequency hearing loss.

BACKGROUND: Johnson and Dillon (2011) provided a model-based comparison of current generic hearing aid prescriptive methods for adults with hearing loss based on the attributes of speech intelligibility, loudness, and bandwidth. PURPOSE: This study compared the National Acoustic Laboratories-Non-linear 2 (NAL-NL2) and Cambridge Method for Loudness Equalization 2-High-Frequency (CAM2) prescriptive methods using adult participants with less high-frequency hearing loss than Johnson and Dillon (2011). Of study interest was quantification of prescribed audibility, speech intelligibility, and loudness. The preferences of participants for either NAL-NL2 or CAM2 and preferred deviations from prescribed settings are also reported. RESEARCH DESIGN: Using a single-blind, counter-balanced, randomized design, preference judgments for the prescriptive methods with regard to sound quality of speech and music stimuli were obtained. Preferred gain adjustments from the prescription within the 4-10 kHz frequency range were also obtained from each participant. Speech intelligibility and loudness model calculations were completed on the prescribed and adjusted amplification. STUDY SAMPLE: Fourteen male Veterans, whose average age was 65 yr and whose hearing sensitivity averaged normal to borderline normal through 1000 Hz sloping to a moderately severe sensorineural loss, served as participants. DATA COLLECTION AND ANALYSIS: Following a brief listening time (~10 min), typical of an initial fitting visit, the participants made paired comparison of sound quality between the NAL-NL2 and CAM2 prescriptive settings. Participants were also asked to modify each prescription in the range of 4-10 kHz using an overall gain control and make subsequent comparisons of sound quality preference between prescriptive and adjusted settings. Participant preferences were examined with respect to quantitative analysis of loudness modeling, speech intelligibility modeling, and measured high-frequency bandwidth audibility. RESULTS: Consistent with the lack of difference in predicted speech intelligibility between the two prescriptions, sound quality preferences on the basis of clarity were split across participants while some participants did not have a discernable preference. Considering sound quality judgments of pleasantness, the majority of participants preferred the sound quality of the NAL-NL2 (8 of 14) prescription instead of the CAM2 prescription (2 of 14). Four of the 14 participants showed no preference on the basis of pleasantness for either prescription. Individual subject preferences were supported by loudness modeling that indicated NAL-NL2 was the softer of the two prescriptions and CAM2 was the louder. CAM2 did provide more audibility to the higher frequencies (5-8 kHz) than NAL-NL2. Participants turned the 4-10 kHz gain recommendation of CAM2 lower, on average, by a significant amount of 4 dB when making adjustments while no significant adjustment was made to the initial NAL-NL2 recommendation. CONCLUSIONS: NAL-NL2 prescribed gains were more often preferred at the initial fitting by the majority of participating veterans. For those patients with preference for a louder fitting than NAL-NL2, CAM2 is a good alternative. When the participant adjustment from the prescription between 4 and 10 kHz exceeded 4 dB from either NAL-NL2 (2 of 14) or CAM2 (11 of 14), the participants demonstrated a later preference for that adjustment 69% of the time. These findings are viewed as limited evidence that some individuals may have a preference for high-frequency gain that differs from the starting prescription.

[Peripheral vestibular syndrome intricated pathogenic issues. A case report]. / Sindromul vestibular--aspecte patogenice intricate. Prezentare de caz.

BACKGROUND: Ménière's syndrome appears to be the final common pathway of the mechanisms the inner ear responds to almost any injury. Although the autoimmune disease seems to play a major role, exposure to intense noise can also be a trigger in the appearance and/or aggravation of the disease. MATERIAL AND METHODS: The case of 41 years old musician with a history of ankylosing spondylitis, diagnosed with Ménière's syndrome 5 years ago, is presented. Recently the symptoms became more polymorphic, revealing the association between benign paroxysmal positional vertigo (BPPV), Ménière's syndrome and high frequency hearing loss in an autoimmune background. Besides general, neurological and ENT examination, the diagnostic workup comprised of tonal audiogram, brain stem auditory evoked potentials, computerized dynamic posturography and videonistagmography. RESULTS: The final diagnosis was acute noise trauma, Ménière's syndrome, left horizontal semicircular canal BPPV, bilateral sensorineural sudden aggravated hearing loss in high frequencies (above 9 kHz) and allegedly autoimmune inner ear disease. Treatment with an association of corticosteroids, vasodilators and vitamins combined with Vannucchi's maneuver were followed by a significant relief of the symptoms. CONCLUSION: Although no causal relationship was found between acoustic trauma and increased endolymphatic pressure, both literature data and the case presented show that intense and prolonged noise exposure may aggravate peripheral vestibular syndrome.

Preliminary results of a novel enhancement method for high-frequency hearing loss.

In this study, a software program was developed for high-frequency hearing loss subjects that includes a detailed audiogram and novel enhancement methods. The software performs enhancements of the audibility of high-frequency sounds according to the subject's detailed 31-point audiogram. This provides subject-specific gains in the entire frequency spectrum, and especially for high frequencies, of sounds. Amplification, compression, and transposition are the three main processing methods used to obtain the desired enhancements for the subjects. For low frequencies, only the amplification method was used according to the dB value of the input. For mid and high frequencies, the compression and transposition methods were used together. To obtain the preliminary results of the study, 10 subjects were enrolled in a detailed audiogram study for five weeks. In the study, environmental, music, and speech sounds were used. While the perceptual mean performances of the subjects were in the range of 25.33-63.77% in the first week, those values increased to 68.75-95.75% in the fifth week. In particular, all noisy and speech sounds were more significantly identified and understood by the subjects with the enhancement method (from 25.33% to 87.5% and from 42.33% to 90.5%, respectively). Three subjects had dropped out at the end of the study and small number of participants are the limitations of this study; however, as a preliminary result, some ideas can be inferred from the results for a smaller set of subjects obtained in the five weeks of the study. Thus, the reliability of the study needs to be tested with more subjects and a comparison with their own hearing aids should be conducted.

Effects of electrical stimulation on the acoustically evoked auditory-nerve response in guinea pigs with a high-frequency hearing loss.

Criteria for cochlear implantation keep expanding and people with substantial residual low-frequency hearing are considered candidates for implantation nowadays. Therefore, electro-acoustical stimulation in the same ear (EAS) is receiving increasing interest. We have investigated the effects of intracochlear electrical stimulation on acoustically evoked auditory-nerve activity, using a forward masking paradigm. The stimulation electrode was placed in the basal turn of the cochlea. Compound action potential (CAP) recordings were performed in guinea pigs with severe high-frequency hearing loss and in normal-hearing control animals. In normal-hearing animals, electrical stimulation generally suppressed CAPs, especially at high acoustic frequencies (8 and 16 kHz) and low sound levels. At low frequencies (0.5 and 1 kHz), suppression was observed only at high sound levels. In animals with a high-frequency hearing loss, suppression of CAPs at low frequencies was substantially less compared to control animals, even at high current levels and temporal overlap of acoustic and electric stimuli. Hence, effects of electrical stimulation substantially differed between normal-hearing animals and animals with a high-frequency hearing loss. These findings stress the need for a proper animal model when investigating EAS. We conclude that in case of high-frequency loss, the basal part of the cochlea can be stimulated electrically with little effect on responses to low-frequency acoustic stimuli.

Partial deafness cochlear implantation (PDCI) and electric-acoustic stimulation (EAS).

The purposes of this paper are to (1) review briefly the experience to date with combined EAS for patients with some residual, low-frequency hearing; and (2) describe the further results that have been obtained with this combination for patients with higher levels of residual hearing at low frequencies, termed 'PDCI'. In broad terms, PDCI and combined EAS have produced large improvements in the speech reception abilities of the treated patients, compared with preoperative scores or with postoperative scores for electric stimulation only or acoustic stimulation only. The benefits have been especially large for recognition of speech presented in competition with interfering sounds such as speech-spectrum noise. Although PDCI and combined EAS have been established as highly effective procedures, questions remain about optimal combinations of electric and acoustic stimuli; the ideal depth of insertion for the electrode array; whether the ideal depth may vary from patient to patient; and whether the reliability of hearing preservation in an implanted cochlea can be increased beyond the present high levels. The answers to these questions could lead to even better treatments for persons with little or no hearing at high frequencies and at least some remaining hearing at low frequencies.

[An overview of the studies on combined electric and acoustic stimulation of auditory system].

This paper discusses the technology of combined electric and acoustic stimulation (EAS) of the auditory system, which is a new therapy for the patients suffering from severe to profound high- and mid-frequency hearing loss but still having their low-frequency hearing. EAS uses hearing aid and cochlear implant technology together in the same ear. The hearing aid acoustically amplifies at low-frequencies, while the cochlear implant electrically stimulates at mid- and high-frequencies. The inner ear processes acoustic and electric stimuli simultaneously. This technique can provide substantial benefit in speech understanding for individuals with severe high-frequency hearing loss and can maintain their residual lower-frequency acoustic hearing. The study of EAS would significantly enhance the conventional cochlear implant therapy and benefit the patients afflicted with severe to profound hearing loss.

Effects of neonatal partial deafness and chronic intracochlear electrical stimulation on auditory and electrical response characteristics in primary auditory cortex.

The use of cochlear implants in patients with severe hearing losses but residual low-frequency hearing raises questions concerning the effects of chronic intracochlear electrical stimulation (ICES) on cortical responses to auditory and electrical stimuli. We investigated these questions by studying responses to tonal and electrical stimuli in primary auditory cortex (AI) of two groups of neonatally deafened cats with residual high-threshold, low-frequency hearing. One group were implanted with a multi-channel intracochlear electrode at 8 weeks of age, and received chronic ICES for up to 9 months before cortical recording. Cats in the other group were implanted immediately prior to cortical recording as adults. In all cats in both groups, multi-neuron responses throughout the rostro-caudal extent of AI had low characteristic frequencies (CFs), in the frequency range of the residual hearing, and high-thresholds. Threshold and minimum latency at CF did not differ between the groups, but in the chronic ICES animals there was a higher proportion of electrically but not acoustically excited recording sites. Electrical response thresholds were higher and latencies shorter in the chronically stimulated animals. Thus, chronic implantation and ICES affected the extent of AI that could be activated by acoustic stimuli and resulted in changes in electrical response characteristics.

Evaluation of nonlinear frequency compression: clinical outcomes.

This study evaluated prototype multichannel nonlinear frequency compression (NFC) signal processing on listeners with high-frequency hearing loss. This signal processor applies NFC above a cut-off frequency. The participants were hearing-impaired adults (13) and children (11) with sloping, high-frequency hearing loss. Multiple outcome measures were repeated using a modified withdrawal design. These included speech sound detection, speech recognition, and self-reported preference measures. Group level results provide evidence of significant improvement of consonant and plural recognition when NFC was enabled. Vowel recognition did not change significantly. Analysis of individual results allowed for exploration of individual factors contributing to benefit received from NFC processing. Findings suggest that NFC processing can improve high frequency speech detection and speech recognition ability for adult and child listeners. Variability in individual outcomes related to factors such as degree and configuration of hearing loss, age of participant, and type of outcome measure.

Evaluation of a frequency transposition algorithm using wearable hearing aids.

Transposition of acoustic information from higher to lower frequencies may help people with severe or profound high-frequency hearing loss, especially when a 'dead region' is present. Previously, we (Robinson et al, 2007 ) evaluated the benefit of an FFT-based transposition algorithm in a laboratory study. Although results were promising, we hypothesized that further training and exposure would be needed to gain the full benefit. This was tested here by implementing the algorithm in wearable digital hearing aids. Five subjects with high-frequency dead regions used the aids for five weeks. Performance on the transposing and control conditions was compared objectively using speech tests (vowel-consonant-vowel, 's' detection, and speech in noise) and subjectively using questionnaires. Overall, the results showed no benefit with the transposition even after experience. Subjective preference was generally for the control condition.

[New potentialities of the hearing aids: the frequential transposition in high frequencies sensorineural hearing losses]. / Nouvelles potentialités des appareils auditifs: transposition en fréquence dans la surdité de perception avec amputation des aiguës.

OBJECTIVES: Hearing aids are becoming very complex instruments with amplification combining numerous signal processing. Digital equipment allows a transposition of acute frequencies towards lower frequencies. The goal of this study is to extend the possibilities of this transposition based on results obtained on 8 patients. MATERIAL AND METHODS: With these new systems, the frequential transposition involves tiny artifacts but the relation of frequency between the various components of the original signal is preserved. The transposition must be done only in the frequencies which are necessary and must as selective as possible. The structure of the original sound must be preserved which implies a certain flexibility and specificity to guarantee the individual needs of the patient. These complex adjustments are assisted by a linear transposition algorithm; Audibility Extender (Widex). This system was used to fit 8 patients presenting a significant acute frequency loss. RESULTS: The improvement is evident on the level of perception of sounds of the environment and consonant recognition. The improvement is significant as well on the tonal sensitivity as on the threshold of vocal intelligibility with a conservation of the percentage of speech discrimination for monosyllabic words. CONCLUSION: The frequential transposition is an alternative to cochlear implants in certain indications and has its place alongside hybrid implants. The indications are reserved to patients presenting dead cochlear zones in the acute frequencies. The algorithm with its various adjustments allows an adaptation preserving the characteristics of the transposed sounds. The adaptation to such a system of hearing amplification requires an adaptation, and rehabilitation is essential in all the cases.

High-frequency amplification and sound quality in listeners with normal through moderate hearing loss.

PURPOSE: One factor that has been shown to greatly affect sound quality is audible bandwidth. Provision of gain for frequencies above 4-6 kHz has not generally been supported for groups of hearing aid wearers. The purpose of this study was to determine if preference for bandwidth extension in hearing aid processed sounds was related to the magnitude of hearing loss in individual listeners. METHOD: Ten participants with normal hearing and 20 participants with mild-to-moderate hearing loss completed the study. Signals were processed using hearing aid-style compression algorithms and filtered using two cutoff frequencies, 5.5 and 9 kHz, which were selected to represent bandwidths that are achievable in modern hearing aids. Round-robin paired comparisons based on the criteria of preferred sound quality were made for 2 different monaurally presented brief sound segments, including music and a movie. RESULTS: Results revealed that preference for either the wider or narrower bandwidth (9- or 5.5-kHz cutoff frequency, respectively) was correlated with the slope of hearing loss from 4 to 12 kHz, with steep threshold slopes associated with preference for narrower bandwidths. CONCLUSION: Consistent preference for wider bandwidth is present in some listeners with mild-to-moderate hearing loss.

Use of linear frequency transposition in simulated hearing loss.

PURPOSE: To demonstrate the usability of new acoustic cues provided by a commercial hearing aid using linear frequency transposition. The importance of auditory training in realizing the benefit was evaluated. RESEARCH DESIGN: Quasi-experimental study design. All subjects were tested both with conventional amplification and with linear frequency transposition before and after directed training. STUDY SAMPLE: A total of nine normal hearing participants with simulated high frequency hearing loss at and above 1600 Hz participated in the study. All subjects were native English speakers ranging in age from 18 to 24 years. INTERVENTION: Identification of voiceless phonemes in CV, VC, and CVC context processed with and without linear frequency transposition was evaluated. Identification test was carried out four times. Between test trials, participants completed 15 minutes of self-paced training using transposed stimuli. RESULTS: Prior to any training, transposition did not improve phoneme identification scores. Training of 30 minutes improved the overall identification scores of the transposed stimuli over the nontransposed stimuli by 14.4%. CONCLUSIONS: The results demonstrated that frequency transposition produces acoustic cues that normal hearing listeners with a simulated hearing loss at and above 1600 Hz may be trained to utilize.

Age-related hearing loss.

Age-related hearing loss or presbycusis is hearing loss that progressively worsens with age. With the expected increase in the number of elderly in the United States, the problem is anticipated to be increasingly common, and the impact widely felt in coming years. This article discusses the causes and mechanisms of this type of hearing loss and current research that may lead to new treatments.