Direct Acoustic Stimulation at the Lateral Canal: An Alternative Route to the Inner Ear?

by Nicolas Verhaert, Joris Walraevens, Christian Desloovere, Jan Wouters, Jean-Marc Gérard

Severe to profound mixed hearing loss is associated with hearing rehabilitation difficulties. Recently, promising results for speech understanding were obtained with a direct acoustic cochlear implant (DACI). The surgical implantation of a DACI with standard coupling through a stapedotomy can however be regarded as challenging. Therefore, in this experimental study, the feasibility of direct acoustic stimulation was investigated at an anatomically and surgically more accessible inner ear site. DACI stimulation of the intact, blue-lined and opened lateral semicircular canal (LC) was investigated and compared with standard oval window (OW) coupling. Additionally, stapes footplate fixation was induced. Round window (RW) velocity, as a measure of the performance of the device and its coupling efficiency, was determined in fresh-frozen human cadaver heads. Using single point laser Doppler vibrometry, RW velocity could reliably be measured in low and middle frequency range, and equivalent sound pressure level (L_E) output was calculated. Results for the different conditions obtained in five heads were analyzed in subsequent frequency ranges. Comparing the difference in RW membrane velocity showed higher L_E in the LC opened condition [mean: 103 equivalent dB SPL], than in LC intact or blue-lined conditions [63 and 74 equivalent dB SPL, respectively]. No difference was observed between the LC opened and the standard OW condition. Inducing stapes fixation, however, led to a difference in the low frequency range of L_E compared to LC opened. In conclusion, this feasibility study showed promising results for direct acoustic stimulation at this specific anatomically and surgically more accessible inner ear site. Future studies are needed to address the impact of LC stimulation on cochlear micromechanics and on the vestibular system like dizziness and risks of hearing loss.

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Wideband Acoustic Immittance: Normative Study and Test–Retest Reliability of Tympanometric Measurements in Adults

Purpose

The purpose of this study was to present normative data of tympanometric measurements of wideband acoustic immittance and to characterize wideband tympanograms.

Method

Data were collected in 84 young adults with strictly defined normal hearing and middle ear status. Energy absorbance (EA) was measured using clicks for 1/12–octave frequencies (0.236 to 8 kHz), with the ear canal air pressure systematically varied (+200 to −300 daPa). In 40 ears, 7 consecutive trials and a trial of clinical 226-Hz acoustic admittance (Y _a ) tympanometry followed. A cavity test was also conducted.

Results

From the wideband EA tympanogram, several EA spectrums and EA tympanograms were derived. Descriptive statistics were performed, and population parameters were estimated. The immediate test–retest reliability was excellent. Effects of ear canal air pressure on EA were examined comprehensively. Differences in EA between tympanometric and ambient-pressure measurements were significant. Single-frequency EA tympanograms exemplified for half-octave frequencies were contrasted. The bandpass EA tympanogram, 0.236- and 1-kHz EA and Y _a tympanograms, and 226-Hz Y _a tympanogram were compared in 9 variables.

Conclusions

This study established a database of wideband tympanograms in healthy adults. The data analyses will promote our understanding of the middle ear transfer function. These data will serve as a reference for further studies in clinical populations.

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Spontaneous Gesture Production and Lexical Abilities in Children With Specific Language Impairment in a Naming Task

Purpose

The purpose of the study was to investigate the role that cospeech gestures play in lexical production in preschool-age children with expressive specific language impairment (E-SLI).

Method

Fifteen preschoolers with E-SLI and 2 groups of typically developing (TD) children matched for chronological age (n = 15, CATD group) and for language abilities (n = 15, LATD group) completed a picture-naming task. The accuracy of the spoken answers (coded for types of correct and incorrect answers), the modality of expression (spoken and/or gestural), types of gestures, and semantic relationship between gestures and speech produced by children in the different groups were compared.

Results

Children with SLI produced higher rates of phonological simplifications and unintelligible answers than CATD children, but lower rates of semantic errors than LATD children. They did not show a significant preference for spoken answers, as TD children did. Similarly to LATD children, they used gestures at higher rates than CATD, both deictic and representational, and both reinforcing the information conveyed in speech and adding correct information to co-occurring speech.

Conclusions

These findings support the hypotheses that children with SLI rely on gestures for scaffolding their speech and do not have a clear preference for the spoken modality, as TD children do, and have implications for educational and clinical practice.

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Wideband Acoustic Immittance: Normative Study and Test–Retest Reliability of Tympanometric Measurements in Adults

Purpose

The purpose of this study was to present normative data of tympanometric measurements of wideband acoustic immittance and to characterize wideband tympanograms.

Method

Data were collected in 84 young adults with strictly defined normal hearing and middle ear status. Energy absorbance (EA) was measured using clicks for 1/12–octave frequencies (0.236 to 8 kHz), with the ear canal air pressure systematically varied (+200 to −300 daPa). In 40 ears, 7 consecutive trials and a trial of clinical 226-Hz acoustic admittance (Y _a ) tympanometry followed. A cavity test was also conducted.

Results

From the wideband EA tympanogram, several EA spectrums and EA tympanograms were derived. Descriptive statistics were performed, and population parameters were estimated. The immediate test–retest reliability was excellent. Effects of ear canal air pressure on EA were examined comprehensively. Differences in EA between tympanometric and ambient-pressure measurements were significant. Single-frequency EA tympanograms exemplified for half-octave frequencies were contrasted. The bandpass EA tympanogram, 0.236- and 1-kHz EA and Y _a tympanograms, and 226-Hz Y _a tympanogram were compared in 9 variables.

Conclusions

This study established a database of wideband tympanograms in healthy adults. The data analyses will promote our understanding of the middle ear transfer function. These data will serve as a reference for further studies in clinical populations.

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Spontaneous Gesture Production and Lexical Abilities in Children With Specific Language Impairment in a Naming Task

Purpose

The purpose of the study was to investigate the role that cospeech gestures play in lexical production in preschool-age children with expressive specific language impairment (E-SLI).

Method

Fifteen preschoolers with E-SLI and 2 groups of typically developing (TD) children matched for chronological age (n = 15, CATD group) and for language abilities (n = 15, LATD group) completed a picture-naming task. The accuracy of the spoken answers (coded for types of correct and incorrect answers), the modality of expression (spoken and/or gestural), types of gestures, and semantic relationship between gestures and speech produced by children in the different groups were compared.

Results

Children with SLI produced higher rates of phonological simplifications and unintelligible answers than CATD children, but lower rates of semantic errors than LATD children. They did not show a significant preference for spoken answers, as TD children did. Similarly to LATD children, they used gestures at higher rates than CATD, both deictic and representational, and both reinforcing the information conveyed in speech and adding correct information to co-occurring speech.

Conclusions

These findings support the hypotheses that children with SLI rely on gestures for scaffolding their speech and do not have a clear preference for the spoken modality, as TD children do, and have implications for educational and clinical practice.

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Wideband Acoustic Immittance: Normative Study and Test–Retest Reliability of Tympanometric Measurements in Adults

Purpose

The purpose of this study was to present normative data of tympanometric measurements of wideband acoustic immittance and to characterize wideband tympanograms.

Method

Data were collected in 84 young adults with strictly defined normal hearing and middle ear status. Energy absorbance (EA) was measured using clicks for 1/12–octave frequencies (0.236 to 8 kHz), with the ear canal air pressure systematically varied (+200 to −300 daPa). In 40 ears, 7 consecutive trials and a trial of clinical 226-Hz acoustic admittance (Y _a ) tympanometry followed. A cavity test was also conducted.

Results

From the wideband EA tympanogram, several EA spectrums and EA tympanograms were derived. Descriptive statistics were performed, and population parameters were estimated. The immediate test–retest reliability was excellent. Effects of ear canal air pressure on EA were examined comprehensively. Differences in EA between tympanometric and ambient-pressure measurements were significant. Single-frequency EA tympanograms exemplified for half-octave frequencies were contrasted. The bandpass EA tympanogram, 0.236- and 1-kHz EA and Y _a tympanograms, and 226-Hz Y _a tympanogram were compared in 9 variables.

Conclusions

This study established a database of wideband tympanograms in healthy adults. The data analyses will promote our understanding of the middle ear transfer function. These data will serve as a reference for further studies in clinical populations.

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Spontaneous Gesture Production and Lexical Abilities in Children With Specific Language Impairment in a Naming Task

Purpose

The purpose of the study was to investigate the role that cospeech gestures play in lexical production in preschool-age children with expressive specific language impairment (E-SLI).

Method

Fifteen preschoolers with E-SLI and 2 groups of typically developing (TD) children matched for chronological age (n = 15, CATD group) and for language abilities (n = 15, LATD group) completed a picture-naming task. The accuracy of the spoken answers (coded for types of correct and incorrect answers), the modality of expression (spoken and/or gestural), types of gestures, and semantic relationship between gestures and speech produced by children in the different groups were compared.

Results

Children with SLI produced higher rates of phonological simplifications and unintelligible answers than CATD children, but lower rates of semantic errors than LATD children. They did not show a significant preference for spoken answers, as TD children did. Similarly to LATD children, they used gestures at higher rates than CATD, both deictic and representational, and both reinforcing the information conveyed in speech and adding correct information to co-occurring speech.

Conclusions

These findings support the hypotheses that children with SLI rely on gestures for scaffolding their speech and do not have a clear preference for the spoken modality, as TD children do, and have implications for educational and clinical practice.

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Direct Acoustic Stimulation at the Lateral Canal: An Alternative Route to the Inner Ear?

by Nicolas Verhaert, Joris Walraevens, Christian Desloovere, Jan Wouters, Jean-Marc Gérard

Severe to profound mixed hearing loss is associated with hearing rehabilitation difficulties. Recently, promising results for speech understanding were obtained with a direct acoustic cochlear implant (DACI). The surgical implantation of a DACI with standard coupling through a stapedotomy can however be regarded as challenging. Therefore, in this experimental study, the feasibility of direct acoustic stimulation was investigated at an anatomically and surgically more accessible inner ear site. DACI stimulation of the intact, blue-lined and opened lateral semicircular canal (LC) was investigated and compared with standard oval window (OW) coupling. Additionally, stapes footplate fixation was induced. Round window (RW) velocity, as a measure of the performance of the device and its coupling efficiency, was determined in fresh-frozen human cadaver heads. Using single point laser Doppler vibrometry, RW velocity could reliably be measured in low and middle frequency range, and equivalent sound pressure level (L_E) output was calculated. Results for the different conditions obtained in five heads were analyzed in subsequent frequency ranges. Comparing the difference in RW membrane velocity showed higher L_E in the LC opened condition [mean: 103 equivalent dB SPL], than in LC intact or blue-lined conditions [63 and 74 equivalent dB SPL, respectively]. No difference was observed between the LC opened and the standard OW condition. Inducing stapes fixation, however, led to a difference in the low frequency range of L_E compared to LC opened. In conclusion, this feasibility study showed promising results for direct acoustic stimulation at this specific anatomically and surgically more accessible inner ear site. Future studies are needed to address the impact of LC stimulation on cochlear micromechanics and on the vestibular system like dizziness and risks of hearing loss.

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What Is the Prevalence of Tinnitus?—Part Two

Recently, we reviewed a study that examined the prevalence of tinnitus worldwide (McCormack et al., 2016). At the end of July, another group of investigators (Bhatt et al., 2016) published a study whose aim was to explore the prevalence of tinnitus in the United States, as well as how it is treated. Specifically, these authors were interested in current reports and clinical practice patterns before the release of clinical practice guidelines for adults with “bothersome and persistent” tinnitus (Tunkel et al. , 2014).

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Researchers identify part of the brain that compensates for hearing loss in older adults

Researchers have pinpointed the specific part of the brain that older adults rely on to differentiate speech sounds in background noise, which could revolutionize the treatment of hearing loss.

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Researchers identify part of the brain that compensates for hearing loss in older adults

Researchers have pinpointed the specific part of the brain that older adults rely on to differentiate speech sounds in background noise, which could revolutionize the treatment of hearing loss.

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Researchers identify part of the brain that compensates for hearing loss in older adults

Researchers have pinpointed the specific part of the brain that older adults rely on to differentiate speech sounds in background noise, which could revolutionize the treatment of hearing loss.

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