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Rallapalli V, Schauer J, Souza P. Preference for Combinations of Hearing Aid Signal Processing. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2022; 65:3100-3116. [PMID: 35881878 DOI: 10.1044/2022_jslhr-22-00018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
PURPOSE The purpose of this study was to determine how multiple types of signal processing activated together influence listeners' preferences. METHOD Participants were adults with mild to moderately severe sensorineural hearing loss. Stimuli were spatialized low-context sentences mixed with six-talker babble at 3 and 8 dB signal-to-noise ratios (SNRs). Stimuli were processed with three common hearing aid processing algorithms: wide dynamic range compression (WDRC), frequency compression (FC), and digital noise reduction (DNR). A full-factorial design with two levels for each algorithm (WDRC & DNR: mild versus strong; FC: ON versus OFF; clinically relevant ranges) was evaluated. Preference was measured using a paired-comparison task within a choice-based conjoint analysis framework. Remote data collection methods were used. A signal fidelity metric quantified the acoustic effects across conditions. RESULTS At 3 dB SNR, participants preferred a combination of Slow WDRC and Mild DNR, although the mean preference was small (odds ratio close to 1). At both SNRs when Strong DNR was used, Fast WDRC was preferred over Slow WDRC. This may be related to signal fidelity, which was lower for the combination of Fast WDRC and Mild DNR and higher for the combination of Slow WDRC and either Mild DNR or Strong DNR. There was no effect of FC on preference or signal fidelity. CONCLUSIONS WDRC and DNR together influenced both listeners' preferences and signal fidelity in the investigated listening conditions. On average, the small effect sizes suggest that minor fine-tuning adjustments to hearing aid algorithms may not result in a substantial change in clinical outcomes.
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Affiliation(s)
- Varsha Rallapalli
- Roxelyn and Richard Pepper Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL
| | - Jacob Schauer
- Division of Biostatistics, Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Pamela Souza
- Roxelyn and Richard Pepper Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL
- Knowles Hearing Center, Northwestern University, Evanston, IL
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Qi S, Chen X, Yang J, Wang X, Tian X, Huang H, Rehmann J, Kuehnel V, Guan J, Xu L. Effects of Adaptive Non-linear Frequency Compression in Hearing Aids on Mandarin Speech and Sound-Quality Perception. Front Neurosci 2021; 15:722970. [PMID: 34483833 PMCID: PMC8414550 DOI: 10.3389/fnins.2021.722970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 07/26/2021] [Indexed: 11/29/2022] Open
Abstract
Objective This study was aimed at examining the effects of an adaptive non-linear frequency compression algorithm implemented in hearing aids (i.e., SoundRecover2, or SR2) at different parameter settings and auditory acclimatization on speech and sound-quality perception in native Mandarin-speaking adult listeners with sensorineural hearing loss. Design Data consisted of participants’ unaided and aided hearing thresholds, Mandarin consonant and vowel recognition in quiet, and sentence recognition in noise, as well as sound-quality ratings through five sessions in a 12-week period with three SR2 settings (i.e., SR2 off, SR2 default, and SR2 strong). Study Sample Twenty-nine native Mandarin-speaking adults aged 37–76 years old with symmetric sloping moderate-to-profound sensorineural hearing loss were recruited. They were all fitted bilaterally with Phonak Naida V90-SP BTE hearing aids with hard ear-molds. Results The participants demonstrated a significant improvement of aided hearing in detecting high frequency sounds at 8 kHz. For consonant recognition and overall sound-quality rating, the participants performed significantly better with the SR2 default setting than the other two settings. No significant differences were found in vowel and sentence recognition among the three SR2 settings. Test session was a significant factor that contributed to the participants’ performance in all speech and sound-quality perception tests. Specifically, the participants benefited from a longer duration of hearing aid use. Conclusion Findings from this study suggested possible perceptual benefit from the adaptive non-linear frequency compression algorithm for native Mandarin-speaking adults with moderate-to-profound hearing loss. Periods of acclimatization should be taken for better performance in novel technologies in hearing aids.
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Affiliation(s)
- Shuang Qi
- Beijing Tongren Hospital, Capital Medical University, Beijing, China.,Key Laboratory of Otolaryngology-Head and Neck Surgery, Beijing Institute of Otolaryngology, Capital Medical University, Ministry of Education, Beijing, China
| | - Xueqing Chen
- Beijing Tongren Hospital, Capital Medical University, Beijing, China.,Key Laboratory of Otolaryngology-Head and Neck Surgery, Beijing Institute of Otolaryngology, Capital Medical University, Ministry of Education, Beijing, China
| | - Jing Yang
- Department of Communication Sciences and Disorders, University of Wisconsin-Milwaukee, Milwaukee, WI, United States
| | - Xianhui Wang
- Division of Communication Sciences and Disorders, Ohio University, Athens, OH, United States
| | | | | | | | | | | | - Li Xu
- Division of Communication Sciences and Disorders, Ohio University, Athens, OH, United States
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Bruno R, Freni F, Portelli D, Alberti G, Gazia F, Meduri A, Galletti F, Galletti B. Frequency-lowering processing to improve speech-in-noise intelligibility in patients with age-related hearing loss. Eur Arch Otorhinolaryngol 2020; 278:3697-3706. [PMID: 33083865 DOI: 10.1007/s00405-020-06431-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 10/08/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVE Modern hearing aids use various signal-processing strategies to improve speech intelligibility. In this manuscript, we studied the linear frequency transposition (LFT), a frequency-lowering algorithm, in patients with age-related hearing loss. Frequency-lowering algorithms transpose high-frequency sounds to a lower-frequency band. The study aimed to assess whether LFT could be used as a tool to improve speech intelligibility in patients with a better high-frequency preservation. METHODS The study population consisted of 77 patients (age average 74.8 ± 12.4) wearing hearing aids with an open or tulip coupling system with age-related hearing loss. The unaided air conduction pure tone average (PTA) at 500, 1000, 2000 Hz was 43.5 ± 14.3 dB; the unaided word recognition score (WRS) average was 53.7 ± 12.5%. We compared WRS in all patients with the hearing aid turned on, in "quiet" and using a "pink" and "babble" masking noise. Three hearing aid settings were tested in each acoustic conditions: no transposition (NT), high transposition (HT), and low transposition (LT). "High" and "low" refer to the "start frequency"; all sounds above the start frequency are transposed in a lower-frequency band. When the start frequency was suggested by the fitting software, we called the condition "high transposition"; when the start frequency was set at the lowest possible value provided by the fitting software, we called the condition "low transposition". The quality of the voice was also assessed asking the patient to give a score from 1 to 10, where 10 was the maximum listening comfort [quality of voice score (QVS)]. RESULTS Collected data were compared for each condition (NT, HT, LT, in quiet, pink noise and babble noise) and no statistically significant differences were found in WRS and QVS (quiet WRS p = 0.07, pink noise WRS p = 0.18, babble noise WRS p = 0.11, QVS p = 0.91). We selected 33 patients with a better WRS in babble noise using transposition (high and low). In this group, the age was significantly lower than patients who did not use transposition (p = 0.01). CONCLUSION Linear frequency transposition is not useful to improve speech-in-noise intelligibility in patients with age-related hearing loss. Despite that no statistically significant differences were found, younger people could get advantages from the LFT when babble noise disturbs the listening of speech. The use of FL algorithm as a way to improve speech intelligibility in noisy environments should be always considered.
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Affiliation(s)
- Rocco Bruno
- Department of Adult and Development Age Human Pathology "Gaetano Barresi", Unit of Otorhinolaryngology, University of Messina, Via Consolare Valeria 1, 98125, Messina, ME, Italy
| | - Francesco Freni
- Department of Adult and Development Age Human Pathology "Gaetano Barresi", Unit of Otorhinolaryngology, University of Messina, Via Consolare Valeria 1, 98125, Messina, ME, Italy
| | - Daniele Portelli
- Department of Adult and Development Age Human Pathology "Gaetano Barresi", Unit of Otorhinolaryngology, University of Messina, Via Consolare Valeria 1, 98125, Messina, ME, Italy
| | - Giuseppe Alberti
- Department of Adult and Development Age Human Pathology "Gaetano Barresi", Unit of Otorhinolaryngology, University of Messina, Via Consolare Valeria 1, 98125, Messina, ME, Italy
| | - Francesco Gazia
- Department of Adult and Development Age Human Pathology "Gaetano Barresi", Unit of Otorhinolaryngology, University of Messina, Via Consolare Valeria 1, 98125, Messina, ME, Italy.
| | - Alessandro Meduri
- Department of Scienze biomediche, odontoiatriche e delle immagini morfologiche e funzionali, Unit of Ophthalmology, University of Messina, Messina, Italy
| | - Francesco Galletti
- Department of Adult and Development Age Human Pathology "Gaetano Barresi", Unit of Otorhinolaryngology, University of Messina, Via Consolare Valeria 1, 98125, Messina, ME, Italy
| | - Bruno Galletti
- Department of Adult and Development Age Human Pathology "Gaetano Barresi", Unit of Otorhinolaryngology, University of Messina, Via Consolare Valeria 1, 98125, Messina, ME, Italy
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Turton L, Souza P, Thibodeau L, Hickson L, Gifford R, Bird J, Stropahl M, Gailey L, Fulton B, Scarinci N, Ekberg K, Timmer B. Guidelines for Best Practice in the Audiological Management of Adults with Severe and Profound Hearing Loss. Semin Hear 2020; 41:141-246. [PMID: 33364673 PMCID: PMC7744249 DOI: 10.1055/s-0040-1714744] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Individuals with severe to profound hearing loss are likely to present with complex listening needs that require evidence-based solutions. This document is intended to inform the practice of hearing care professionals who are involved in the audiological management of adults with a severe to profound degree of hearing loss and will highlight the special considerations and practices required to optimize outcomes for these individuals.
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Affiliation(s)
- Laura Turton
- Department of Audiology, South Warwickshire NHS Foundation Trust, Warwick, United Kingdom
| | - Pamela Souza
- Communication Sciences and Disorders and Knowles Hearing Center, Northwestern University, Evanston, Illinois
| | - Linda Thibodeau
- University of Texas at Dallas, Callier Center for Communication Disorders, Dallas, Texas
| | - Louise Hickson
- School of Health and Rehabilitation Sciences, The University of Queensland, Australia
| | - René Gifford
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Judith Bird
- Cambridge University Hospital NHS Foundation Trust, United Kingdom
| | - Maren Stropahl
- Department of Science and Technology, Sonova AG, Stäfa, Switzerland
| | | | | | - Nerina Scarinci
- School of Health and Rehabilitation Sciences, The University of Queensland, Australia
| | - Katie Ekberg
- School of Health and Rehabilitation Sciences, The University of Queensland, Australia
| | - Barbra Timmer
- School of Health and Rehabilitation Sciences, The University of Queensland, Australia
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Polanik MD, Trakimas DR, Castillo‐Bustamante M, Cheng JT, Kozin ED, Remenschneider AK. Do high-frequency air-bone gaps persist after ossiculoplasty? Laryngoscope Investig Otolaryngol 2020; 5:734-742. [PMID: 32864446 PMCID: PMC7444777 DOI: 10.1002/lio2.418] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 04/29/2020] [Accepted: 05/26/2020] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVES Conventional reporting of postoperative hearing outcomes utilizes a pure-tone averaged air-bone gap (ABG) that is biased toward low frequencies. Consequently, a high-frequency ABG after otologic surgery may go unnoticed. In this study, we evaluate changes in low- and high-frequency ABG following ossiculoplasty. STUDY DESIGN Retrospective review. SUBJECTS AND SETTING Consecutive series of patients who underwent ossiculoplasty at a single tertiary care center. Patients with pre- and postoperative audiograms were included. METHODS Low-frequency ABG was calculated as the mean ABG at 250, 500, and 1000 Hz. High-frequency ABG was calculated at 4 kHz. Pre- and postoperative ABGs were compared. RESULTS Thirty-seven consecutive patients were included. Mean age at surgery was 38 years (range, 7-77 years). Reconstruction materials included: cartilage (N = 4), hydroxyapatite cement (N = 5), and partial or total ossicular replacement prostheses (N = 20 and N = 8, respectively). Postoperatively, the mean low-frequency ABG improved by 11.9 ± 15.1 dB (P < .0001) and the mean high-frequency ABG improved by 5.9 ± 16.0 dB (P = .030). Low-frequency ABG closure was significantly larger than high-frequency ABG closure (P = .007). Mean postoperative persistent high-frequency ABG was 22.0 ± 13.8 dB. CONCLUSION In this series, ossiculoplasty improved ABG across all frequencies, but greater improvements were observed at low frequencies when compared to high frequency. Current reporting standards may not identify persistent high-frequency ABG. Additional study of the mechanisms of high-frequency sound conduction in reconstructed middle ears is needed to improve high-frequency hearing outcomes in ossiculoplasty. LEVEL OF EVIDENCE Level 4.
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Affiliation(s)
- Marc D. Polanik
- Eaton‐Peabody LaboratoriesMassachusetts Eye and Ear InfirmaryBostonMassachusettsUSA
- Department of OtolaryngologyUMass Memorial Medical CenterWorcesterMassachusettsUSA
- University of Massachusetts Medical SchoolWorcesterMassachusettsUSA
| | - Danielle R. Trakimas
- Department of Otolaryngology‐Head & Neck SurgeryJohns Hopkins School of MedicineBaltimoreMarylandUSA
| | | | - Jeffrey T. Cheng
- Eaton‐Peabody LaboratoriesMassachusetts Eye and Ear InfirmaryBostonMassachusettsUSA
- Department of Otolaryngology‐Head & Neck SurgeryHarvard Medical SchoolBostonMassachusettsUSA
| | - Elliott D. Kozin
- Eaton‐Peabody LaboratoriesMassachusetts Eye and Ear InfirmaryBostonMassachusettsUSA
- Department of Otolaryngology‐Head & Neck SurgeryHarvard Medical SchoolBostonMassachusettsUSA
| | - Aaron K. Remenschneider
- Eaton‐Peabody LaboratoriesMassachusetts Eye and Ear InfirmaryBostonMassachusettsUSA
- Department of OtolaryngologyUMass Memorial Medical CenterWorcesterMassachusettsUSA
- University of Massachusetts Medical SchoolWorcesterMassachusettsUSA
- Department of Otolaryngology‐Head & Neck SurgeryHarvard Medical SchoolBostonMassachusettsUSA
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