In-vivo assessment of osseous versus non-osseous transmission pathways of vibratory stimuli applied to the bone and the dura in humans

Publication date: Available online 28 September 2018

Source: Hearing Research

Author(s): Reto Stump, Ivo Dobrev, Niklaus Krayenbühl, Rudolf Probst, Christof Röösli

Abstract

Background

Bone conduction (BC) is an alternative to air conduction (AC) for stimulation of the inner ear. Stimulation for BC can occur directly on the skull bone, on the skin covering the skull bone, or on soft tissue (i.e., eye, dura). All of these stimuli can elicit otoacoustic emissions (OAE). This study aims to compare OAEs generated by different combinations of stimuli in live humans, including direct stimulation of the intracranial contents via the dura, measured intraoperatively.

Methods

Measurements were performed in five normal-hearing ears of subjects undergoing a neurosurgical intervention with craniotomy in general anesthesia. Distortion product OAEs (DPOAEs) were measured for f₂ at 0.7, 1, 2, 3, 4, and 6 kHz with a constant ratio of the primary frequencies (f₂/f₁) of 1.22. Sound pressure L₁ was held constant at 65 dB SPL, while L₂ was decreased in 10 dB steps from 70 to 30 dB SPL. A DPOAE was considered significant when its level was ≥6 dB above the noise floor. Emissions were generated sequentially with different modes of stimulation: 1) pre-operatively in the awake subject by two air-conducted tones (AC-AC); 2) within the same session preoperatively by one air- and one bone-conducted tone on the skin-covered temporal bone as in audiometry (AC-BC); 3) intra-operatively by one air-conducted tone and one bone-vibrator tone applied directly on the dura (AC-DC). A modified bone vibrator (Bonebridge; MED-EL, Innsbruck, Austria) was used for BC stimulation on the dura or skin-covered mastoid. Its equivalent perceived SPL was calibrated preoperatively for each individual by psychoacoustically comparing the level of a BC tone presented to the temporal region to an AC tone at the same frequency. Simultaneously with the DPOAEs, vibrations at the teeth were measured with an accelerometer attached using a custom-made holder.

Results

It was possible to record DPOAEs for all three stimulation modes. For AC-DC, DPOAEs were not detected above the noise floor below 2 kHz but were detectable at the higher frequencies. The best response was measured at or above 2 kHz with L₂ = 60 dB SPL. The acceleration measured at the teeth for stimulation on the dura was lower than that for stimulation on the bone, especially below 3 kHz.

Conclusion

We demonstrate a proof-of-concept comparison of DPOAEs and teeth acceleration levels elicited by a bone vibrator placed either against the skin-covered temporal bone, as in audiometry, or directly against the dura mater in patients undergoing a craniotomy. It was demonstrated that DPOAEs could be elicited via non-osseous pathways within the skull contents and that the required measurements could be performed intra-operatively.

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In-vivo assessment of osseous versus non-osseous transmission pathways of vibratory stimuli applied to the bone and the dura in humans

Publication date: Available online 28 September 2018

Source: Hearing Research

Author(s): Reto Stump, Ivo Dobrev, Niklaus Krayenbühl, Rudolf Probst, Christof Röösli

Abstract

Background

Bone conduction (BC) is an alternative to air conduction (AC) for stimulation of the inner ear. Stimulation for BC can occur directly on the skull bone, on the skin covering the skull bone, or on soft tissue (i.e., eye, dura). All of these stimuli can elicit otoacoustic emissions (OAE). This study aims to compare OAEs generated by different combinations of stimuli in live humans, including direct stimulation of the intracranial contents via the dura, measured intraoperatively.

Methods

Measurements were performed in five normal-hearing ears of subjects undergoing a neurosurgical intervention with craniotomy in general anesthesia. Distortion product OAEs (DPOAEs) were measured for f₂ at 0.7, 1, 2, 3, 4, and 6 kHz with a constant ratio of the primary frequencies (f₂/f₁) of 1.22. Sound pressure L₁ was held constant at 65 dB SPL, while L₂ was decreased in 10 dB steps from 70 to 30 dB SPL. A DPOAE was considered significant when its level was ≥6 dB above the noise floor. Emissions were generated sequentially with different modes of stimulation: 1) pre-operatively in the awake subject by two air-conducted tones (AC-AC); 2) within the same session preoperatively by one air- and one bone-conducted tone on the skin-covered temporal bone as in audiometry (AC-BC); 3) intra-operatively by one air-conducted tone and one bone-vibrator tone applied directly on the dura (AC-DC). A modified bone vibrator (Bonebridge; MED-EL, Innsbruck, Austria) was used for BC stimulation on the dura or skin-covered mastoid. Its equivalent perceived SPL was calibrated preoperatively for each individual by psychoacoustically comparing the level of a BC tone presented to the temporal region to an AC tone at the same frequency. Simultaneously with the DPOAEs, vibrations at the teeth were measured with an accelerometer attached using a custom-made holder.

Results

It was possible to record DPOAEs for all three stimulation modes. For AC-DC, DPOAEs were not detected above the noise floor below 2 kHz but were detectable at the higher frequencies. The best response was measured at or above 2 kHz with L₂ = 60 dB SPL. The acceleration measured at the teeth for stimulation on the dura was lower than that for stimulation on the bone, especially below 3 kHz.

Conclusion

We demonstrate a proof-of-concept comparison of DPOAEs and teeth acceleration levels elicited by a bone vibrator placed either against the skin-covered temporal bone, as in audiometry, or directly against the dura mater in patients undergoing a craniotomy. It was demonstrated that DPOAEs could be elicited via non-osseous pathways within the skull contents and that the required measurements could be performed intra-operatively.

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In-vivo assessment of osseous versus non-osseous transmission pathways of vibratory stimuli applied to the bone and the dura in humans

Publication date: Available online 28 September 2018

Source: Hearing Research

Author(s): Reto Stump, Ivo Dobrev, Niklaus Krayenbühl, Rudolf Probst, Christof Röösli

Abstract

Background

Bone conduction (BC) is an alternative to air conduction (AC) for stimulation of the inner ear. Stimulation for BC can occur directly on the skull bone, on the skin covering the skull bone, or on soft tissue (i.e., eye, dura). All of these stimuli can elicit otoacoustic emissions (OAE). This study aims to compare OAEs generated by different combinations of stimuli in live humans, including direct stimulation of the intracranial contents via the dura, measured intraoperatively.

Methods

Measurements were performed in five normal-hearing ears of subjects undergoing a neurosurgical intervention with craniotomy in general anesthesia. Distortion product OAEs (DPOAEs) were measured for f₂ at 0.7, 1, 2, 3, 4, and 6 kHz with a constant ratio of the primary frequencies (f₂/f₁) of 1.22. Sound pressure L₁ was held constant at 65 dB SPL, while L₂ was decreased in 10 dB steps from 70 to 30 dB SPL. A DPOAE was considered significant when its level was ≥6 dB above the noise floor. Emissions were generated sequentially with different modes of stimulation: 1) pre-operatively in the awake subject by two air-conducted tones (AC-AC); 2) within the same session preoperatively by one air- and one bone-conducted tone on the skin-covered temporal bone as in audiometry (AC-BC); 3) intra-operatively by one air-conducted tone and one bone-vibrator tone applied directly on the dura (AC-DC). A modified bone vibrator (Bonebridge; MED-EL, Innsbruck, Austria) was used for BC stimulation on the dura or skin-covered mastoid. Its equivalent perceived SPL was calibrated preoperatively for each individual by psychoacoustically comparing the level of a BC tone presented to the temporal region to an AC tone at the same frequency. Simultaneously with the DPOAEs, vibrations at the teeth were measured with an accelerometer attached using a custom-made holder.

Results

It was possible to record DPOAEs for all three stimulation modes. For AC-DC, DPOAEs were not detected above the noise floor below 2 kHz but were detectable at the higher frequencies. The best response was measured at or above 2 kHz with L₂ = 60 dB SPL. The acceleration measured at the teeth for stimulation on the dura was lower than that for stimulation on the bone, especially below 3 kHz.

Conclusion

We demonstrate a proof-of-concept comparison of DPOAEs and teeth acceleration levels elicited by a bone vibrator placed either against the skin-covered temporal bone, as in audiometry, or directly against the dura mater in patients undergoing a craniotomy. It was demonstrated that DPOAEs could be elicited via non-osseous pathways within the skull contents and that the required measurements could be performed intra-operatively.

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In-vivo assessment of osseous versus non-osseous transmission pathways of vibratory stimuli applied to the bone and the dura in humans

Publication date: Available online 28 September 2018

Source: Hearing Research

Author(s): Reto Stump, Ivo Dobrev, Niklaus Krayenbühl, Rudolf Probst, Christof Röösli

Abstract

Background

Bone conduction (BC) is an alternative to air conduction (AC) for stimulation of the inner ear. Stimulation for BC can occur directly on the skull bone, on the skin covering the skull bone, or on soft tissue (i.e., eye, dura). All of these stimuli can elicit otoacoustic emissions (OAE). This study aims to compare OAEs generated by different combinations of stimuli in live humans, including direct stimulation of the intracranial contents via the dura, measured intraoperatively.

Methods

Measurements were performed in five normal-hearing ears of subjects undergoing a neurosurgical intervention with craniotomy in general anesthesia. Distortion product OAEs (DPOAEs) were measured for f₂ at 0.7, 1, 2, 3, 4, and 6 kHz with a constant ratio of the primary frequencies (f₂/f₁) of 1.22. Sound pressure L₁ was held constant at 65 dB SPL, while L₂ was decreased in 10 dB steps from 70 to 30 dB SPL. A DPOAE was considered significant when its level was ≥6 dB above the noise floor. Emissions were generated sequentially with different modes of stimulation: 1) pre-operatively in the awake subject by two air-conducted tones (AC-AC); 2) within the same session preoperatively by one air- and one bone-conducted tone on the skin-covered temporal bone as in audiometry (AC-BC); 3) intra-operatively by one air-conducted tone and one bone-vibrator tone applied directly on the dura (AC-DC). A modified bone vibrator (Bonebridge; MED-EL, Innsbruck, Austria) was used for BC stimulation on the dura or skin-covered mastoid. Its equivalent perceived SPL was calibrated preoperatively for each individual by psychoacoustically comparing the level of a BC tone presented to the temporal region to an AC tone at the same frequency. Simultaneously with the DPOAEs, vibrations at the teeth were measured with an accelerometer attached using a custom-made holder.

Results

It was possible to record DPOAEs for all three stimulation modes. For AC-DC, DPOAEs were not detected above the noise floor below 2 kHz but were detectable at the higher frequencies. The best response was measured at or above 2 kHz with L₂ = 60 dB SPL. The acceleration measured at the teeth for stimulation on the dura was lower than that for stimulation on the bone, especially below 3 kHz.

Conclusion

We demonstrate a proof-of-concept comparison of DPOAEs and teeth acceleration levels elicited by a bone vibrator placed either against the skin-covered temporal bone, as in audiometry, or directly against the dura mater in patients undergoing a craniotomy. It was demonstrated that DPOAEs could be elicited via non-osseous pathways within the skull contents and that the required measurements could be performed intra-operatively.

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Longitudinal analysis of leisure noise exposure among adolescents with special focus on portable listening devices: the OHRKAN cohort study.

Related Articles

Longitudinal analysis of leisure noise exposure among adolescents with special focus on portable listening devices: the OHRKAN cohort study.

Int J Audiol. 2018 Sep 27;:1-9

Authors: Dreher A, Weilnhammer V, Gerstner D, Hendrowarsito L, Twardella D, Reiter C, Perez-Alvarez C, Steffens T, Herr C, Heinze S

Abstract
The aim was to investigate leisure noise exposure and sociodemographic determinants of risky leisure noise exposure over five years in 2148 students visiting grade 9 of any school type in a German city from 2009-2011. Within the OHRKAN cohort study, leisure noise exposure was calculated from literature-retrieved sound pressure levels (SPLs) and self-reported duration of 18 leisure activities at baseline and two follow-ups. Risky exposure was defined as exceeding 85 dB(A) averaged over a 40-h-week. Determinants of risky total leisure noise (TLN) exposure and risky exposure to portable listening devices (PLDs) were investigated using generalised estimating equations (GEEs). Up to 73% of students exceeded noise levels of 85 dB(A) at some timepoint. The noise exposure and importance of different leisure activities changed with increasing age. Risky exposure to TLN and PLDs was associated with lower education, single parent households and being male. Risky PLD exposure was additionally associated with a migrant background. Current prevention measures for leisure noise exposure must be extended to at-risk groups. Besides enhancing campaigns in lower education schools, acoustical insulation in sports halls, noise warnings on tools or in videogames could address especially men. Migrants need education about healthy PLD use in their native language if necessary.

PMID: 30261779 [PubMed - as supplied by publisher]

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Hearing and ear status of Pacific children aged 11 years living in New Zealand: the Pacific Islands families hearing study.

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Hearing and ear status of Pacific children aged 11 years living in New Zealand: the Pacific Islands families hearing study.

Int J Audiol. 2018 Sep 27;:1-10

Authors: Purdy SC, Taylor S, Schluter PJ, Tautolo ES, Iusitini L, Ahmad Z, Sundborn G, Paterson J

Abstract
This study aimed to determine the prevalence of hearing loss and ear problems in Pacific children, and investigate current and past demographic, health and social factors potentially associated with hearing and ear problems. A cross-sectional observational study design nested within a birth cohort was employed. Nine-hundred-twenty Nine-hundred-twenty Pacific children aged 11 years were audiologically assessed. Using average hearing thresholds at 500, 1k and 2k Hz, 162 (18%) right and 197 (21%) left ears had ≥20 dB hearing loss. Hearing loss was mild (20-39 dB) in most cases; 2% of ears had moderate to moderate-severe (40-69 dB) hearing loss. However, only 101 (11%) children had normal peripheral hearing defined by passing hearing threshold, tympanogram and distortion product otoacoustic emission assessments. Those with confirmed middle ear disease at age 2 years had significantly increased odds of a non-Type A tympanogram (adjusted odds ratio: 2.00; 95% confidence interval: 1.56, 2.50) when re-assessed at age 11 years. Hearing loss, abnormal tympanograms, and auditory processing difficulties were present in many Pacific children. Interventions are also urgently needed to mitigate the effect of the longstanding ear disease likely to be present for many Pacific children.

PMID: 30261774 [PubMed - as supplied by publisher]

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Assessing auditory nerve condition by tone decay in deaf subjects with a cochlear implant.

Related Articles

Assessing auditory nerve condition by tone decay in deaf subjects with a cochlear implant.

Int J Audiol. 2018 Sep 27;:1-8

Authors: Wasmann JA, van Eijl RHM, Versnel H, van Zanten GA

Abstract
The condition of the auditory nerve is a factor determining hearing performance of cochlear implant (CI) recipients. Abnormal loudness adaptation is associated with poor auditory nerve survival. We examined which stimulus conditions are suitable for tone decay measurements to differentiate between CI recipients with respect to their speech perception. Tone decay was defined here as occurring when the percept disappears before the stimulus stops. We measured the duration of the percept of a 60-s pulse train. Current levels ranged from below threshold up to maximum acceptable loudness, pulse rates from 250 to 5000 pulses/s, and duty cycles (percentages of time the burst of pulses is on) from 10% to 100%. Ten adult CI recipients were included: seven with good and three with poor speech perception. Largest differences among the subjects were found at 5000 pulses/s and 100% duty cycle. The well performing subjects had a continuous percept of the 60-s stimulus within 3 dB above threshold. Two poorly performing subjects showed abnormal loudness adaptation, that is, no continuous percept even at levels greater than 6 dB above threshold. We conclude that abnormal loudness adaptation can be detected via an electric tone decay test using a high pulse rate and 100% duty cycle.

PMID: 30261773 [PubMed - as supplied by publisher]

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Assessment of speech recognition abilities in quiet and in noise: a comparison between self-administered home testing and testing in the clinic for adult cochlear implant users.

Related Articles

Assessment of speech recognition abilities in quiet and in noise: a comparison between self-administered home testing and testing in the clinic for adult cochlear implant users.

Int J Audiol. 2018 Sep 27;:1-9

Authors: de Graaff F, Huysmans E, Merkus P, Theo Goverts S, Smits C

Abstract
Self speech recognition tests in quiet and noise at home are compared to the standard tests performed in the clinic. Potential effects of stimuli presentation modes (loudspeaker or audio cable) and assessment (clinician or self-assessment at home) on test results were investigated. Speech recognition in quiet was assessed using the standard Dutch test with monosyllabic words. Speech recognition in noise was assessed with the digits-in-noise test. Sixteen experienced CI users (aged between 44 and 83 years) participated. No significant difference was observed in speech recognition in quiet between and presentation modes. Speech recognition in noise was significantly better with the audio cable than with the loudspeaker. There was no significant difference in speech recognition in quiet at 65 dB and in speech recognition in noise between self-assessment at home and testing in the clinic. At 55 dB, speech recognition assessed at home was slightly but significantly better than that assessed in the clinic. The results demonstrate that it is feasible for experienced CI users to perform self-administered speech recognition tests at home. Self-assessment by CI users of speech recognition in quiet and noise within the home environment could serve as an alternative to the tests performed in the clinic.

PMID: 30261772 [PubMed - as supplied by publisher]

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A directional remote-microphone for bimodal cochlear implant recipients.

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A directional remote-microphone for bimodal cochlear implant recipients.

Int J Audiol. 2018 Sep 27;:1-6

Authors: Vroegop JL, Homans NC, Goedegebure A, van der Schroeff MP

Abstract
To evaluate whether speech recognition in noise differs according to whether a wireless remote microphone is connected to just the cochlear implant (CI) or to both the CI and to the hearing aid (HA) in bimodal CI users. The second aim was to evaluate the additional benefit of the directional microphone mode compared with the omnidirectional microphone mode of the wireless microphone. This prospective study measured Speech Recognition Thresholds (SRT) in babble noise in a 'within-subjects repeated measures design' for different listening conditions. Eighteen postlingually deafened adult bimodal CI users. No difference in speech recognition in noise in the bimodal listening condition was found between the wireless microphone connected to the CI only and to both the CI and the HA. An improvement of 4.1 dB was found for switching from the omnidirectional microphone mode to the directional mode in the CI only condition. The use of a wireless microphone improved speech recognition in noise for bimodal CI users. The use of the directional microphone mode led to a substantial additional improvement of speech perception in noise for situations with one target signal.

PMID: 30261771 [PubMed - as supplied by publisher]

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Speech intelligibility of virtual humans.

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Speech intelligibility of virtual humans.

Int J Audiol. 2018 Sep 27;:1-9

Authors: Devesse A, Dudek A, van Wieringen A, Wouters J

Abstract
The speech intelligibility benefit of visual speech cues during oral communication is well-established. Therefore, an ecologically valid approach of auditory assessment should include the processing of both auditory and visual speech cues. This study describes the development and evaluation of a virtual human speaker designed to present speech auditory-visually. A male and female virtual human speaker were created and evaluated in two experiments: a visual-only speech reading test of words and sentences and an auditory-visual speech intelligibility sentence test. A group of five hearing, skilled speech reading adults participated in the speech reading test whereas a group of young normal-hearing participants (N = 35) was recruited for the intelligibility test. Skilled speech readers correctly identified 57 to 67% of the words and sentences uttered by the virtual speakers. The presence of the virtual speaker improved the speech intelligibility of sentences in noise by 1.5 to 2 dB. These results demonstrate the potential applicability of virtual humans in future auditory-visual speech assessment paradigms.

PMID: 30261770 [PubMed - as supplied by publisher]

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Prevalence and factors associated with tinnitus: data from adult residents in Guangdong province, South of China.

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Prevalence and factors associated with tinnitus: data from adult residents in Guangdong province, South of China.

Int J Audiol. 2018 Sep 27;:1-8

Authors: Yang H, Cai Y, Guo H, Xiong H, Sun Y, Huang X, Zheng Y

Abstract
There is a lack of national studies on tinnitus in China and data based on a large sample size from multiple areas of the country. A cross-sectional study was carried out in Guangdong province from October 2015 to February 2016. In the study, tinnitus was defined as the presence of ringing, buzzing or other sounds in the ears in the past one year. Fourteen districts in Guangdong Province were selected as the first-level cluster by using the sampling method of probability proportional to size (PPS). Two sub-districts in each first-level cluster were randomly selected as the second-level cluster by PPS method. The sample consisted of 3705 eligible people aged over 18 years old, which were also selected by the PPS methods. The prevalence of tinnitus was 10.4% in Guangdong Province. Age, region, educational background, hearing impairment, ear trauma, otitis media and self-health report were the main risk factors for tinnitus. Tinnitus is a common condition and a large population suffers from tinnitus in Guangdong province, south of China. Greater public awareness and understanding of the associated factors are required for further interventions of prevention and management of tinnitus in China.

PMID: 30261769 [PubMed - as supplied by publisher]

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Rotational vestibular assessment.

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Rotational vestibular assessment.

Int J Audiol. 2018 Sep 27;:1

Authors: Valente LM

PMID: 30261768 [PubMed - as supplied by publisher]

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Hyperacusis and disorders of sound intolerance.

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Hyperacusis and disorders of sound intolerance.

Int J Audiol. 2018 Sep 27;:1

Authors: Whitelaw G

PMID: 30261767 [PubMed - as supplied by publisher]

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Promotion and views on tinnitus self-help within United Kingdom national health service audiology departments.

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Promotion and views on tinnitus self-help within United Kingdom national health service audiology departments.

Int J Audiol. 2018 Sep 27;:1-8

Authors: Smith SN, Broomhead E, Greenwell K, Watts E, Stockdale D, Hoare DJ

Abstract
Self-help has the potential to provide low-cost and effective ways of improving access to psychological support for people with tinnitus. When developing and evaluating resources it is important to consider issues that may influence successful implementation. This Survey explored clinicians' use and views on self-help, and barriers to implementation. An online survey was distributed to 220 UK audiology departments. One-hundred and twenty-four clinicians responded to the survey (91 audiologists, 32 hearing therapists, 1 clinical psychologist), each representing a different tinnitus department. Two-thirds of respondents reported providing or recommending self-help resources. Potential benefits were patient empowerment and providing a means of engaging patients in their care. Almost half of respondents felt that there is insufficient training or guidance for clinicians on using or promoting self-help. Clinicians felt that for patients with low-level tinnitus severity, self-help may reduce the number of audiology appointments required. For patients with more complex needs self-help may be useful to engage with between clinical appointments. Further research is needed to determine effectiveness, who benefits, and by what mechanism, before clinicians can confidently recommend or implement self-help. Clinicians will benefit from formal guidance on promoting and supporting use of self-help for tinnitus.

PMID: 30261766 [PubMed - as supplied by publisher]

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Longitudinal analysis of leisure noise exposure among adolescents with special focus on portable listening devices: the OHRKAN cohort study.

Related Articles

Longitudinal analysis of leisure noise exposure among adolescents with special focus on portable listening devices: the OHRKAN cohort study.

Int J Audiol. 2018 Sep 27;:1-9

Authors: Dreher A, Weilnhammer V, Gerstner D, Hendrowarsito L, Twardella D, Reiter C, Perez-Alvarez C, Steffens T, Herr C, Heinze S

Abstract
The aim was to investigate leisure noise exposure and sociodemographic determinants of risky leisure noise exposure over five years in 2148 students visiting grade 9 of any school type in a German city from 2009-2011. Within the OHRKAN cohort study, leisure noise exposure was calculated from literature-retrieved sound pressure levels (SPLs) and self-reported duration of 18 leisure activities at baseline and two follow-ups. Risky exposure was defined as exceeding 85 dB(A) averaged over a 40-h-week. Determinants of risky total leisure noise (TLN) exposure and risky exposure to portable listening devices (PLDs) were investigated using generalised estimating equations (GEEs). Up to 73% of students exceeded noise levels of 85 dB(A) at some timepoint. The noise exposure and importance of different leisure activities changed with increasing age. Risky exposure to TLN and PLDs was associated with lower education, single parent households and being male. Risky PLD exposure was additionally associated with a migrant background. Current prevention measures for leisure noise exposure must be extended to at-risk groups. Besides enhancing campaigns in lower education schools, acoustical insulation in sports halls, noise warnings on tools or in videogames could address especially men. Migrants need education about healthy PLD use in their native language if necessary.

PMID: 30261779 [PubMed - as supplied by publisher]

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via IFTTT

Hearing and ear status of Pacific children aged 11 years living in New Zealand: the Pacific Islands families hearing study.

Related Articles

Hearing and ear status of Pacific children aged 11 years living in New Zealand: the Pacific Islands families hearing study.

Int J Audiol. 2018 Sep 27;:1-10

Authors: Purdy SC, Taylor S, Schluter PJ, Tautolo ES, Iusitini L, Ahmad Z, Sundborn G, Paterson J

Abstract
This study aimed to determine the prevalence of hearing loss and ear problems in Pacific children, and investigate current and past demographic, health and social factors potentially associated with hearing and ear problems. A cross-sectional observational study design nested within a birth cohort was employed. Nine-hundred-twenty Nine-hundred-twenty Pacific children aged 11 years were audiologically assessed. Using average hearing thresholds at 500, 1k and 2k Hz, 162 (18%) right and 197 (21%) left ears had ≥20 dB hearing loss. Hearing loss was mild (20-39 dB) in most cases; 2% of ears had moderate to moderate-severe (40-69 dB) hearing loss. However, only 101 (11%) children had normal peripheral hearing defined by passing hearing threshold, tympanogram and distortion product otoacoustic emission assessments. Those with confirmed middle ear disease at age 2 years had significantly increased odds of a non-Type A tympanogram (adjusted odds ratio: 2.00; 95% confidence interval: 1.56, 2.50) when re-assessed at age 11 years. Hearing loss, abnormal tympanograms, and auditory processing difficulties were present in many Pacific children. Interventions are also urgently needed to mitigate the effect of the longstanding ear disease likely to be present for many Pacific children.

PMID: 30261774 [PubMed - as supplied by publisher]

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via IFTTT

Assessing auditory nerve condition by tone decay in deaf subjects with a cochlear implant.

Related Articles

Assessing auditory nerve condition by tone decay in deaf subjects with a cochlear implant.

Int J Audiol. 2018 Sep 27;:1-8

Authors: Wasmann JA, van Eijl RHM, Versnel H, van Zanten GA

Abstract
The condition of the auditory nerve is a factor determining hearing performance of cochlear implant (CI) recipients. Abnormal loudness adaptation is associated with poor auditory nerve survival. We examined which stimulus conditions are suitable for tone decay measurements to differentiate between CI recipients with respect to their speech perception. Tone decay was defined here as occurring when the percept disappears before the stimulus stops. We measured the duration of the percept of a 60-s pulse train. Current levels ranged from below threshold up to maximum acceptable loudness, pulse rates from 250 to 5000 pulses/s, and duty cycles (percentages of time the burst of pulses is on) from 10% to 100%. Ten adult CI recipients were included: seven with good and three with poor speech perception. Largest differences among the subjects were found at 5000 pulses/s and 100% duty cycle. The well performing subjects had a continuous percept of the 60-s stimulus within 3 dB above threshold. Two poorly performing subjects showed abnormal loudness adaptation, that is, no continuous percept even at levels greater than 6 dB above threshold. We conclude that abnormal loudness adaptation can be detected via an electric tone decay test using a high pulse rate and 100% duty cycle.

PMID: 30261773 [PubMed - as supplied by publisher]

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Assessment of speech recognition abilities in quiet and in noise: a comparison between self-administered home testing and testing in the clinic for adult cochlear implant users.

Related Articles

Assessment of speech recognition abilities in quiet and in noise: a comparison between self-administered home testing and testing in the clinic for adult cochlear implant users.

Int J Audiol. 2018 Sep 27;:1-9

Authors: de Graaff F, Huysmans E, Merkus P, Theo Goverts S, Smits C

Abstract
Self speech recognition tests in quiet and noise at home are compared to the standard tests performed in the clinic. Potential effects of stimuli presentation modes (loudspeaker or audio cable) and assessment (clinician or self-assessment at home) on test results were investigated. Speech recognition in quiet was assessed using the standard Dutch test with monosyllabic words. Speech recognition in noise was assessed with the digits-in-noise test. Sixteen experienced CI users (aged between 44 and 83 years) participated. No significant difference was observed in speech recognition in quiet between and presentation modes. Speech recognition in noise was significantly better with the audio cable than with the loudspeaker. There was no significant difference in speech recognition in quiet at 65 dB and in speech recognition in noise between self-assessment at home and testing in the clinic. At 55 dB, speech recognition assessed at home was slightly but significantly better than that assessed in the clinic. The results demonstrate that it is feasible for experienced CI users to perform self-administered speech recognition tests at home. Self-assessment by CI users of speech recognition in quiet and noise within the home environment could serve as an alternative to the tests performed in the clinic.

PMID: 30261772 [PubMed - as supplied by publisher]

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A directional remote-microphone for bimodal cochlear implant recipients.

Related Articles

A directional remote-microphone for bimodal cochlear implant recipients.

Int J Audiol. 2018 Sep 27;:1-6

Authors: Vroegop JL, Homans NC, Goedegebure A, van der Schroeff MP

Abstract
To evaluate whether speech recognition in noise differs according to whether a wireless remote microphone is connected to just the cochlear implant (CI) or to both the CI and to the hearing aid (HA) in bimodal CI users. The second aim was to evaluate the additional benefit of the directional microphone mode compared with the omnidirectional microphone mode of the wireless microphone. This prospective study measured Speech Recognition Thresholds (SRT) in babble noise in a 'within-subjects repeated measures design' for different listening conditions. Eighteen postlingually deafened adult bimodal CI users. No difference in speech recognition in noise in the bimodal listening condition was found between the wireless microphone connected to the CI only and to both the CI and the HA. An improvement of 4.1 dB was found for switching from the omnidirectional microphone mode to the directional mode in the CI only condition. The use of a wireless microphone improved speech recognition in noise for bimodal CI users. The use of the directional microphone mode led to a substantial additional improvement of speech perception in noise for situations with one target signal.

PMID: 30261771 [PubMed - as supplied by publisher]

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Speech intelligibility of virtual humans.

Related Articles

Speech intelligibility of virtual humans.

Int J Audiol. 2018 Sep 27;:1-9

Authors: Devesse A, Dudek A, van Wieringen A, Wouters J

Abstract
The speech intelligibility benefit of visual speech cues during oral communication is well-established. Therefore, an ecologically valid approach of auditory assessment should include the processing of both auditory and visual speech cues. This study describes the development and evaluation of a virtual human speaker designed to present speech auditory-visually. A male and female virtual human speaker were created and evaluated in two experiments: a visual-only speech reading test of words and sentences and an auditory-visual speech intelligibility sentence test. A group of five hearing, skilled speech reading adults participated in the speech reading test whereas a group of young normal-hearing participants (N = 35) was recruited for the intelligibility test. Skilled speech readers correctly identified 57 to 67% of the words and sentences uttered by the virtual speakers. The presence of the virtual speaker improved the speech intelligibility of sentences in noise by 1.5 to 2 dB. These results demonstrate the potential applicability of virtual humans in future auditory-visual speech assessment paradigms.

PMID: 30261770 [PubMed - as supplied by publisher]

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Prevalence and factors associated with tinnitus: data from adult residents in Guangdong province, South of China.

Related Articles

Prevalence and factors associated with tinnitus: data from adult residents in Guangdong province, South of China.

Int J Audiol. 2018 Sep 27;:1-8

Authors: Yang H, Cai Y, Guo H, Xiong H, Sun Y, Huang X, Zheng Y

Abstract
There is a lack of national studies on tinnitus in China and data based on a large sample size from multiple areas of the country. A cross-sectional study was carried out in Guangdong province from October 2015 to February 2016. In the study, tinnitus was defined as the presence of ringing, buzzing or other sounds in the ears in the past one year. Fourteen districts in Guangdong Province were selected as the first-level cluster by using the sampling method of probability proportional to size (PPS). Two sub-districts in each first-level cluster were randomly selected as the second-level cluster by PPS method. The sample consisted of 3705 eligible people aged over 18 years old, which were also selected by the PPS methods. The prevalence of tinnitus was 10.4% in Guangdong Province. Age, region, educational background, hearing impairment, ear trauma, otitis media and self-health report were the main risk factors for tinnitus. Tinnitus is a common condition and a large population suffers from tinnitus in Guangdong province, south of China. Greater public awareness and understanding of the associated factors are required for further interventions of prevention and management of tinnitus in China.

PMID: 30261769 [PubMed - as supplied by publisher]

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Rotational vestibular assessment.

Related Articles

Rotational vestibular assessment.

Int J Audiol. 2018 Sep 27;:1

Authors: Valente LM

PMID: 30261768 [PubMed - as supplied by publisher]

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Hyperacusis and disorders of sound intolerance.

Related Articles

Hyperacusis and disorders of sound intolerance.

Int J Audiol. 2018 Sep 27;:1

Authors: Whitelaw G

PMID: 30261767 [PubMed - as supplied by publisher]

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Promotion and views on tinnitus self-help within United Kingdom national health service audiology departments.

Related Articles

Promotion and views on tinnitus self-help within United Kingdom national health service audiology departments.

Int J Audiol. 2018 Sep 27;:1-8

Authors: Smith SN, Broomhead E, Greenwell K, Watts E, Stockdale D, Hoare DJ

Abstract
Self-help has the potential to provide low-cost and effective ways of improving access to psychological support for people with tinnitus. When developing and evaluating resources it is important to consider issues that may influence successful implementation. This Survey explored clinicians' use and views on self-help, and barriers to implementation. An online survey was distributed to 220 UK audiology departments. One-hundred and twenty-four clinicians responded to the survey (91 audiologists, 32 hearing therapists, 1 clinical psychologist), each representing a different tinnitus department. Two-thirds of respondents reported providing or recommending self-help resources. Potential benefits were patient empowerment and providing a means of engaging patients in their care. Almost half of respondents felt that there is insufficient training or guidance for clinicians on using or promoting self-help. Clinicians felt that for patients with low-level tinnitus severity, self-help may reduce the number of audiology appointments required. For patients with more complex needs self-help may be useful to engage with between clinical appointments. Further research is needed to determine effectiveness, who benefits, and by what mechanism, before clinicians can confidently recommend or implement self-help. Clinicians will benefit from formal guidance on promoting and supporting use of self-help for tinnitus.

PMID: 30261766 [PubMed - as supplied by publisher]

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Prediction of mild anatomical leg length discrepancy based on gait kinematics and linear regression model

Publication date: Available online 29 September 2018

Source: Gait & Posture

Author(s): Gabriel Zeitoune, Jurandir Nadal, Luiz Alberto Batista, Leonardo Metsavaht, Anna Paula Moraes, Gustavo Leporace

Abstract

Backgound

Leg length discrepancy (LLD) can be related to different pathologies, due to an inadequate distribution of mechanical loads, as well as gait kinematics asymmetries resulted from LLD.

Research question

To validate a model to predict anatomical LLD (ALLD) based on gait kinematics.

Methods

Gait of 39 participants with different lower limb pathologies and mild discrepancy were collected. Pelvic, hip, knee and ankle kinematics were measured with a 3D motion analysis system and ALLD, femur discrepancy (FD) and tibia discrepancy (TD) were measured by a computerized digital radiograph. Three multiple linear regression models were used to identify the ability of kinematic variables to predict ALLD (model 1), FD (model 2) and TD (model 3).

Results

Difference between peak knee and hip flexion of the long and short lower limb was selected by models 1 (p < 0.001) and 2 (p < 0.001). Hip adduction was selected as a predictor only by model 1 (p = 0.05). Peak pelvic obliquity and ankle dorsiflexion were not selected by any model and model 3 did not retain any dependent variable (p > 0.05). Regression models predicted mild ALLD with moderate accuracy based on hip and knee kinematics during gait, but not ankle strategies. Excessive hip flexion of the longer limb possibly occurs to reduce the limb to equalize the LLD, and discrepancies of the femur and tibia affects gait cycle in a different way.

Significance

This study showed that kinematic variables during gait could be used as a screening tool to identify patients with ALLD, reducing unnecessary x-ray exposure and assisting rehabilitation programs.

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Validation of the stabilometer balance test: Bridging the gap between clinical and research based balance control assessments for stroke patients

Publication date: Available online 29 September 2018

Source: Gait & Posture

Author(s): Rafaël Brouwer, Elmar Kal, John van der Kamp, Han Houdijk

Abstract

Background

A pronounced discrepancy exists between balance assessments for stroke survivors that are used for clinical purposes and those used for research. Clinical assessments like the Berg Balance Scale generally have stronger ecological validity, whereas research-based assessments like posturography are generally more reliable and precise. We developed a stabilometer balance test (SBT) that aims to couple measurement reliability and precision to clinical meaningfulness by means of a personalized and adaptive test procedure.

Research question

To examine the validity, reliability, and measurement error of the stabilometer balance test in inpatient stroke patients.

Methods

In this cross-sectional study, inpatient stroke patients (FAC > 2) were tested on a stabilometer with adjustable resistance to mediolateral movement. A modified staircase procedure was used to adapt task difficulty (i.e., rotational stiffness) on a trial-by-trial basis. The main outcome was the threshold stiffness at which a patient could just stay balanced. Threshold stiffness was correlated with the Berg Balance Scale and posturography measurements to determine concurrent validity (N = 86). Test-retest reliability (N = 23) was analyzed with the Intraclass Correlation Coefficient (ICC). Floor and ceiling effects were assessed. The minimal detectable change was determined at individual and group level.

Results

Threshold rotational stiffness moderately correlated with the Berg Balance Scale (r=-0.559, p < 0.001), and the absolute path length of the center of pressure during posturography (r=0.348, p = 0.006). Test-retest reliability was good to excellent (ICC=0.869; 95%CI=0.696-0.944). There were no floor or ceiling effects. The minimal detectable change was sufficiently small to detect relevant changes in balance control both on individual and group level.

Relevance

The SBT is both a valid and reliable balance assessment in stroke patients. It is at least as precise as current clinically preferred measures and does not suffer from ceiling effects. Therefore, it is suitable for use in clinical practice as well as research.

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Prediction of mild anatomical leg length discrepancy based on gait kinematics and linear regression model

Publication date: Available online 29 September 2018

Source: Gait & Posture

Author(s): Gabriel Zeitoune, Jurandir Nadal, Luiz Alberto Batista, Leonardo Metsavaht, Anna Paula Moraes, Gustavo Leporace

Abstract

Backgound

Leg length discrepancy (LLD) can be related to different pathologies, due to an inadequate distribution of mechanical loads, as well as gait kinematics asymmetries resulted from LLD.

Research question

To validate a model to predict anatomical LLD (ALLD) based on gait kinematics.

Methods

Gait of 39 participants with different lower limb pathologies and mild discrepancy were collected. Pelvic, hip, knee and ankle kinematics were measured with a 3D motion analysis system and ALLD, femur discrepancy (FD) and tibia discrepancy (TD) were measured by a computerized digital radiograph. Three multiple linear regression models were used to identify the ability of kinematic variables to predict ALLD (model 1), FD (model 2) and TD (model 3).

Results

Difference between peak knee and hip flexion of the long and short lower limb was selected by models 1 (p < 0.001) and 2 (p < 0.001). Hip adduction was selected as a predictor only by model 1 (p = 0.05). Peak pelvic obliquity and ankle dorsiflexion were not selected by any model and model 3 did not retain any dependent variable (p > 0.05). Regression models predicted mild ALLD with moderate accuracy based on hip and knee kinematics during gait, but not ankle strategies. Excessive hip flexion of the longer limb possibly occurs to reduce the limb to equalize the LLD, and discrepancies of the femur and tibia affects gait cycle in a different way.

Significance

This study showed that kinematic variables during gait could be used as a screening tool to identify patients with ALLD, reducing unnecessary x-ray exposure and assisting rehabilitation programs.

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Validation of the stabilometer balance test: Bridging the gap between clinical and research based balance control assessments for stroke patients

Publication date: Available online 29 September 2018

Source: Gait & Posture

Author(s): Rafaël Brouwer, Elmar Kal, John van der Kamp, Han Houdijk

Abstract

Background

A pronounced discrepancy exists between balance assessments for stroke survivors that are used for clinical purposes and those used for research. Clinical assessments like the Berg Balance Scale generally have stronger ecological validity, whereas research-based assessments like posturography are generally more reliable and precise. We developed a stabilometer balance test (SBT) that aims to couple measurement reliability and precision to clinical meaningfulness by means of a personalized and adaptive test procedure.

Research question

To examine the validity, reliability, and measurement error of the stabilometer balance test in inpatient stroke patients.

Methods

In this cross-sectional study, inpatient stroke patients (FAC > 2) were tested on a stabilometer with adjustable resistance to mediolateral movement. A modified staircase procedure was used to adapt task difficulty (i.e., rotational stiffness) on a trial-by-trial basis. The main outcome was the threshold stiffness at which a patient could just stay balanced. Threshold stiffness was correlated with the Berg Balance Scale and posturography measurements to determine concurrent validity (N = 86). Test-retest reliability (N = 23) was analyzed with the Intraclass Correlation Coefficient (ICC). Floor and ceiling effects were assessed. The minimal detectable change was determined at individual and group level.

Results

Threshold rotational stiffness moderately correlated with the Berg Balance Scale (r=-0.559, p < 0.001), and the absolute path length of the center of pressure during posturography (r=0.348, p = 0.006). Test-retest reliability was good to excellent (ICC=0.869; 95%CI=0.696-0.944). There were no floor or ceiling effects. The minimal detectable change was sufficiently small to detect relevant changes in balance control both on individual and group level.

Relevance

The SBT is both a valid and reliable balance assessment in stroke patients. It is at least as precise as current clinically preferred measures and does not suffer from ceiling effects. Therefore, it is suitable for use in clinical practice as well as research.

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Interaural Time Difference Perception with a Cochlear Implant and a Normal Ear.

Related Articles

Interaural Time Difference Perception with a Cochlear Implant and a Normal Ear.

J Assoc Res Otolaryngol. 2018 Sep 27;:

Authors: Francart T, Wiebe K, Wesarg T

Abstract
Currently there is a growing population of cochlear-implant (CI) users with (near) normal hearing in the non-implanted ear. This configuration is often called SSD (single-sided deafness) CI. The goal of the CI is often to improve spatial perception, so the question raises to what extent SSD CI listeners are sensitive to interaural time differences (ITDs). In a controlled lab setup, sensitivity to ITDs was investigated in 11 SSD CI listeners. The stimuli were 100-pps pulse trains on the CI side and band-limited click trains on the acoustic side. After determining level balance and the delay needed to achieve synchronous stimulation of the two ears, the just noticeable difference in ITD was measured using an adaptive procedure. Seven out of 11 listeners were sensitive to ITDs, with a median just noticeable difference of 438 μs. Out of the four listeners who were not sensitive to ITD, one listener reported binaural fusion, and three listeners reported no binaural fusion. To enable ITD sensitivity, a frequency-dependent delay of the electrical stimulus was required to synchronize the electric and acoustic signals at the level of the auditory nerve. Using subjective fusion measures and refined by ITD sensitivity, it was possible to match a CI electrode to an acoustic frequency range. This shows the feasibility of these measures for the allocation of acoustic frequency ranges to electrodes when fitting a CI to a subject with (near) normal hearing in the contralateral ear.

PMID: 30264229 [PubMed - as supplied by publisher]

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Interaural Time Difference Perception with a Cochlear Implant and a Normal Ear.

Related Articles

Interaural Time Difference Perception with a Cochlear Implant and a Normal Ear.

J Assoc Res Otolaryngol. 2018 Sep 27;:

Authors: Francart T, Wiebe K, Wesarg T

Abstract
Currently there is a growing population of cochlear-implant (CI) users with (near) normal hearing in the non-implanted ear. This configuration is often called SSD (single-sided deafness) CI. The goal of the CI is often to improve spatial perception, so the question raises to what extent SSD CI listeners are sensitive to interaural time differences (ITDs). In a controlled lab setup, sensitivity to ITDs was investigated in 11 SSD CI listeners. The stimuli were 100-pps pulse trains on the CI side and band-limited click trains on the acoustic side. After determining level balance and the delay needed to achieve synchronous stimulation of the two ears, the just noticeable difference in ITD was measured using an adaptive procedure. Seven out of 11 listeners were sensitive to ITDs, with a median just noticeable difference of 438 μs. Out of the four listeners who were not sensitive to ITD, one listener reported binaural fusion, and three listeners reported no binaural fusion. To enable ITD sensitivity, a frequency-dependent delay of the electrical stimulus was required to synchronize the electric and acoustic signals at the level of the auditory nerve. Using subjective fusion measures and refined by ITD sensitivity, it was possible to match a CI electrode to an acoustic frequency range. This shows the feasibility of these measures for the allocation of acoustic frequency ranges to electrodes when fitting a CI to a subject with (near) normal hearing in the contralateral ear.

PMID: 30264229 [PubMed - as supplied by publisher]

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Longitudinal analysis of leisure noise exposure among adolescents with special focus on portable listening devices: the OHRKAN cohort study.

Related Articles

Longitudinal analysis of leisure noise exposure among adolescents with special focus on portable listening devices: the OHRKAN cohort study.

Int J Audiol. 2018 Sep 27;:1-9

Authors: Dreher A, Weilnhammer V, Gerstner D, Hendrowarsito L, Twardella D, Reiter C, Perez-Alvarez C, Steffens T, Herr C, Heinze S

Abstract
The aim was to investigate leisure noise exposure and sociodemographic determinants of risky leisure noise exposure over five years in 2148 students visiting grade 9 of any school type in a German city from 2009-2011. Within the OHRKAN cohort study, leisure noise exposure was calculated from literature-retrieved sound pressure levels (SPLs) and self-reported duration of 18 leisure activities at baseline and two follow-ups. Risky exposure was defined as exceeding 85 dB(A) averaged over a 40-h-week. Determinants of risky total leisure noise (TLN) exposure and risky exposure to portable listening devices (PLDs) were investigated using generalised estimating equations (GEEs). Up to 73% of students exceeded noise levels of 85 dB(A) at some timepoint. The noise exposure and importance of different leisure activities changed with increasing age. Risky exposure to TLN and PLDs was associated with lower education, single parent households and being male. Risky PLD exposure was additionally associated with a migrant background. Current prevention measures for leisure noise exposure must be extended to at-risk groups. Besides enhancing campaigns in lower education schools, acoustical insulation in sports halls, noise warnings on tools or in videogames could address especially men. Migrants need education about healthy PLD use in their native language if necessary.

PMID: 30261779 [PubMed - as supplied by publisher]

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Hearing and ear status of Pacific children aged 11 years living in New Zealand: the Pacific Islands families hearing study.

Related Articles

Hearing and ear status of Pacific children aged 11 years living in New Zealand: the Pacific Islands families hearing study.

Int J Audiol. 2018 Sep 27;:1-10

Authors: Purdy SC, Taylor S, Schluter PJ, Tautolo ES, Iusitini L, Ahmad Z, Sundborn G, Paterson J

Abstract
This study aimed to determine the prevalence of hearing loss and ear problems in Pacific children, and investigate current and past demographic, health and social factors potentially associated with hearing and ear problems. A cross-sectional observational study design nested within a birth cohort was employed. Nine-hundred-twenty Nine-hundred-twenty Pacific children aged 11 years were audiologically assessed. Using average hearing thresholds at 500, 1k and 2k Hz, 162 (18%) right and 197 (21%) left ears had ≥20 dB hearing loss. Hearing loss was mild (20-39 dB) in most cases; 2% of ears had moderate to moderate-severe (40-69 dB) hearing loss. However, only 101 (11%) children had normal peripheral hearing defined by passing hearing threshold, tympanogram and distortion product otoacoustic emission assessments. Those with confirmed middle ear disease at age 2 years had significantly increased odds of a non-Type A tympanogram (adjusted odds ratio: 2.00; 95% confidence interval: 1.56, 2.50) when re-assessed at age 11 years. Hearing loss, abnormal tympanograms, and auditory processing difficulties were present in many Pacific children. Interventions are also urgently needed to mitigate the effect of the longstanding ear disease likely to be present for many Pacific children.

PMID: 30261774 [PubMed - as supplied by publisher]

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Assessing auditory nerve condition by tone decay in deaf subjects with a cochlear implant.

Related Articles

Assessing auditory nerve condition by tone decay in deaf subjects with a cochlear implant.

Int J Audiol. 2018 Sep 27;:1-8

Authors: Wasmann JA, van Eijl RHM, Versnel H, van Zanten GA

Abstract
The condition of the auditory nerve is a factor determining hearing performance of cochlear implant (CI) recipients. Abnormal loudness adaptation is associated with poor auditory nerve survival. We examined which stimulus conditions are suitable for tone decay measurements to differentiate between CI recipients with respect to their speech perception. Tone decay was defined here as occurring when the percept disappears before the stimulus stops. We measured the duration of the percept of a 60-s pulse train. Current levels ranged from below threshold up to maximum acceptable loudness, pulse rates from 250 to 5000 pulses/s, and duty cycles (percentages of time the burst of pulses is on) from 10% to 100%. Ten adult CI recipients were included: seven with good and three with poor speech perception. Largest differences among the subjects were found at 5000 pulses/s and 100% duty cycle. The well performing subjects had a continuous percept of the 60-s stimulus within 3 dB above threshold. Two poorly performing subjects showed abnormal loudness adaptation, that is, no continuous percept even at levels greater than 6 dB above threshold. We conclude that abnormal loudness adaptation can be detected via an electric tone decay test using a high pulse rate and 100% duty cycle.

PMID: 30261773 [PubMed - as supplied by publisher]

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Assessment of speech recognition abilities in quiet and in noise: a comparison between self-administered home testing and testing in the clinic for adult cochlear implant users.

Related Articles

Assessment of speech recognition abilities in quiet and in noise: a comparison between self-administered home testing and testing in the clinic for adult cochlear implant users.

Int J Audiol. 2018 Sep 27;:1-9

Authors: de Graaff F, Huysmans E, Merkus P, Theo Goverts S, Smits C

Abstract
Self speech recognition tests in quiet and noise at home are compared to the standard tests performed in the clinic. Potential effects of stimuli presentation modes (loudspeaker or audio cable) and assessment (clinician or self-assessment at home) on test results were investigated. Speech recognition in quiet was assessed using the standard Dutch test with monosyllabic words. Speech recognition in noise was assessed with the digits-in-noise test. Sixteen experienced CI users (aged between 44 and 83 years) participated. No significant difference was observed in speech recognition in quiet between and presentation modes. Speech recognition in noise was significantly better with the audio cable than with the loudspeaker. There was no significant difference in speech recognition in quiet at 65 dB and in speech recognition in noise between self-assessment at home and testing in the clinic. At 55 dB, speech recognition assessed at home was slightly but significantly better than that assessed in the clinic. The results demonstrate that it is feasible for experienced CI users to perform self-administered speech recognition tests at home. Self-assessment by CI users of speech recognition in quiet and noise within the home environment could serve as an alternative to the tests performed in the clinic.

PMID: 30261772 [PubMed - as supplied by publisher]

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A directional remote-microphone for bimodal cochlear implant recipients.

Related Articles

A directional remote-microphone for bimodal cochlear implant recipients.

Int J Audiol. 2018 Sep 27;:1-6

Authors: Vroegop JL, Homans NC, Goedegebure A, van der Schroeff MP

Abstract
To evaluate whether speech recognition in noise differs according to whether a wireless remote microphone is connected to just the cochlear implant (CI) or to both the CI and to the hearing aid (HA) in bimodal CI users. The second aim was to evaluate the additional benefit of the directional microphone mode compared with the omnidirectional microphone mode of the wireless microphone. This prospective study measured Speech Recognition Thresholds (SRT) in babble noise in a 'within-subjects repeated measures design' for different listening conditions. Eighteen postlingually deafened adult bimodal CI users. No difference in speech recognition in noise in the bimodal listening condition was found between the wireless microphone connected to the CI only and to both the CI and the HA. An improvement of 4.1 dB was found for switching from the omnidirectional microphone mode to the directional mode in the CI only condition. The use of a wireless microphone improved speech recognition in noise for bimodal CI users. The use of the directional microphone mode led to a substantial additional improvement of speech perception in noise for situations with one target signal.

PMID: 30261771 [PubMed - as supplied by publisher]

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Speech intelligibility of virtual humans.

Related Articles

Speech intelligibility of virtual humans.

Int J Audiol. 2018 Sep 27;:1-9

Authors: Devesse A, Dudek A, van Wieringen A, Wouters J

Abstract
The speech intelligibility benefit of visual speech cues during oral communication is well-established. Therefore, an ecologically valid approach of auditory assessment should include the processing of both auditory and visual speech cues. This study describes the development and evaluation of a virtual human speaker designed to present speech auditory-visually. A male and female virtual human speaker were created and evaluated in two experiments: a visual-only speech reading test of words and sentences and an auditory-visual speech intelligibility sentence test. A group of five hearing, skilled speech reading adults participated in the speech reading test whereas a group of young normal-hearing participants (N = 35) was recruited for the intelligibility test. Skilled speech readers correctly identified 57 to 67% of the words and sentences uttered by the virtual speakers. The presence of the virtual speaker improved the speech intelligibility of sentences in noise by 1.5 to 2 dB. These results demonstrate the potential applicability of virtual humans in future auditory-visual speech assessment paradigms.

PMID: 30261770 [PubMed - as supplied by publisher]

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Prevalence and factors associated with tinnitus: data from adult residents in Guangdong province, South of China.

Related Articles

Prevalence and factors associated with tinnitus: data from adult residents in Guangdong province, South of China.

Int J Audiol. 2018 Sep 27;:1-8

Authors: Yang H, Cai Y, Guo H, Xiong H, Sun Y, Huang X, Zheng Y

Abstract
There is a lack of national studies on tinnitus in China and data based on a large sample size from multiple areas of the country. A cross-sectional study was carried out in Guangdong province from October 2015 to February 2016. In the study, tinnitus was defined as the presence of ringing, buzzing or other sounds in the ears in the past one year. Fourteen districts in Guangdong Province were selected as the first-level cluster by using the sampling method of probability proportional to size (PPS). Two sub-districts in each first-level cluster were randomly selected as the second-level cluster by PPS method. The sample consisted of 3705 eligible people aged over 18 years old, which were also selected by the PPS methods. The prevalence of tinnitus was 10.4% in Guangdong Province. Age, region, educational background, hearing impairment, ear trauma, otitis media and self-health report were the main risk factors for tinnitus. Tinnitus is a common condition and a large population suffers from tinnitus in Guangdong province, south of China. Greater public awareness and understanding of the associated factors are required for further interventions of prevention and management of tinnitus in China.

PMID: 30261769 [PubMed - as supplied by publisher]

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Rotational vestibular assessment.

Related Articles

Rotational vestibular assessment.

Int J Audiol. 2018 Sep 27;:1

Authors: Valente LM

PMID: 30261768 [PubMed - as supplied by publisher]

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via IFTTT

Hyperacusis and disorders of sound intolerance.

Related Articles

Hyperacusis and disorders of sound intolerance.

Int J Audiol. 2018 Sep 27;:1

Authors: Whitelaw G

PMID: 30261767 [PubMed - as supplied by publisher]

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Promotion and views on tinnitus self-help within United Kingdom national health service audiology departments.

Related Articles

Promotion and views on tinnitus self-help within United Kingdom national health service audiology departments.

Int J Audiol. 2018 Sep 27;:1-8

Authors: Smith SN, Broomhead E, Greenwell K, Watts E, Stockdale D, Hoare DJ

Abstract
Self-help has the potential to provide low-cost and effective ways of improving access to psychological support for people with tinnitus. When developing and evaluating resources it is important to consider issues that may influence successful implementation. This Survey explored clinicians' use and views on self-help, and barriers to implementation. An online survey was distributed to 220 UK audiology departments. One-hundred and twenty-four clinicians responded to the survey (91 audiologists, 32 hearing therapists, 1 clinical psychologist), each representing a different tinnitus department. Two-thirds of respondents reported providing or recommending self-help resources. Potential benefits were patient empowerment and providing a means of engaging patients in their care. Almost half of respondents felt that there is insufficient training or guidance for clinicians on using or promoting self-help. Clinicians felt that for patients with low-level tinnitus severity, self-help may reduce the number of audiology appointments required. For patients with more complex needs self-help may be useful to engage with between clinical appointments. Further research is needed to determine effectiveness, who benefits, and by what mechanism, before clinicians can confidently recommend or implement self-help. Clinicians will benefit from formal guidance on promoting and supporting use of self-help for tinnitus.

PMID: 30261766 [PubMed - as supplied by publisher]

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Longitudinal analysis of leisure noise exposure among adolescents with special focus on portable listening devices: the OHRKAN cohort study.

Related Articles

Longitudinal analysis of leisure noise exposure among adolescents with special focus on portable listening devices: the OHRKAN cohort study.

Int J Audiol. 2018 Sep 27;:1-9

Authors: Dreher A, Weilnhammer V, Gerstner D, Hendrowarsito L, Twardella D, Reiter C, Perez-Alvarez C, Steffens T, Herr C, Heinze S

Abstract
The aim was to investigate leisure noise exposure and sociodemographic determinants of risky leisure noise exposure over five years in 2148 students visiting grade 9 of any school type in a German city from 2009-2011. Within the OHRKAN cohort study, leisure noise exposure was calculated from literature-retrieved sound pressure levels (SPLs) and self-reported duration of 18 leisure activities at baseline and two follow-ups. Risky exposure was defined as exceeding 85 dB(A) averaged over a 40-h-week. Determinants of risky total leisure noise (TLN) exposure and risky exposure to portable listening devices (PLDs) were investigated using generalised estimating equations (GEEs). Up to 73% of students exceeded noise levels of 85 dB(A) at some timepoint. The noise exposure and importance of different leisure activities changed with increasing age. Risky exposure to TLN and PLDs was associated with lower education, single parent households and being male. Risky PLD exposure was additionally associated with a migrant background. Current prevention measures for leisure noise exposure must be extended to at-risk groups. Besides enhancing campaigns in lower education schools, acoustical insulation in sports halls, noise warnings on tools or in videogames could address especially men. Migrants need education about healthy PLD use in their native language if necessary.

PMID: 30261779 [PubMed - as supplied by publisher]

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Hearing and ear status of Pacific children aged 11 years living in New Zealand: the Pacific Islands families hearing study.

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Hearing and ear status of Pacific children aged 11 years living in New Zealand: the Pacific Islands families hearing study.

Int J Audiol. 2018 Sep 27;:1-10

Authors: Purdy SC, Taylor S, Schluter PJ, Tautolo ES, Iusitini L, Ahmad Z, Sundborn G, Paterson J

Abstract
This study aimed to determine the prevalence of hearing loss and ear problems in Pacific children, and investigate current and past demographic, health and social factors potentially associated with hearing and ear problems. A cross-sectional observational study design nested within a birth cohort was employed. Nine-hundred-twenty Nine-hundred-twenty Pacific children aged 11 years were audiologically assessed. Using average hearing thresholds at 500, 1k and 2k Hz, 162 (18%) right and 197 (21%) left ears had ≥20 dB hearing loss. Hearing loss was mild (20-39 dB) in most cases; 2% of ears had moderate to moderate-severe (40-69 dB) hearing loss. However, only 101 (11%) children had normal peripheral hearing defined by passing hearing threshold, tympanogram and distortion product otoacoustic emission assessments. Those with confirmed middle ear disease at age 2 years had significantly increased odds of a non-Type A tympanogram (adjusted odds ratio: 2.00; 95% confidence interval: 1.56, 2.50) when re-assessed at age 11 years. Hearing loss, abnormal tympanograms, and auditory processing difficulties were present in many Pacific children. Interventions are also urgently needed to mitigate the effect of the longstanding ear disease likely to be present for many Pacific children.

PMID: 30261774 [PubMed - as supplied by publisher]

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Assessing auditory nerve condition by tone decay in deaf subjects with a cochlear implant.

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Assessing auditory nerve condition by tone decay in deaf subjects with a cochlear implant.

Int J Audiol. 2018 Sep 27;:1-8

Authors: Wasmann JA, van Eijl RHM, Versnel H, van Zanten GA

Abstract
The condition of the auditory nerve is a factor determining hearing performance of cochlear implant (CI) recipients. Abnormal loudness adaptation is associated with poor auditory nerve survival. We examined which stimulus conditions are suitable for tone decay measurements to differentiate between CI recipients with respect to their speech perception. Tone decay was defined here as occurring when the percept disappears before the stimulus stops. We measured the duration of the percept of a 60-s pulse train. Current levels ranged from below threshold up to maximum acceptable loudness, pulse rates from 250 to 5000 pulses/s, and duty cycles (percentages of time the burst of pulses is on) from 10% to 100%. Ten adult CI recipients were included: seven with good and three with poor speech perception. Largest differences among the subjects were found at 5000 pulses/s and 100% duty cycle. The well performing subjects had a continuous percept of the 60-s stimulus within 3 dB above threshold. Two poorly performing subjects showed abnormal loudness adaptation, that is, no continuous percept even at levels greater than 6 dB above threshold. We conclude that abnormal loudness adaptation can be detected via an electric tone decay test using a high pulse rate and 100% duty cycle.

PMID: 30261773 [PubMed - as supplied by publisher]

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Assessment of speech recognition abilities in quiet and in noise: a comparison between self-administered home testing and testing in the clinic for adult cochlear implant users.

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Assessment of speech recognition abilities in quiet and in noise: a comparison between self-administered home testing and testing in the clinic for adult cochlear implant users.

Int J Audiol. 2018 Sep 27;:1-9

Authors: de Graaff F, Huysmans E, Merkus P, Theo Goverts S, Smits C

Abstract
Self speech recognition tests in quiet and noise at home are compared to the standard tests performed in the clinic. Potential effects of stimuli presentation modes (loudspeaker or audio cable) and assessment (clinician or self-assessment at home) on test results were investigated. Speech recognition in quiet was assessed using the standard Dutch test with monosyllabic words. Speech recognition in noise was assessed with the digits-in-noise test. Sixteen experienced CI users (aged between 44 and 83 years) participated. No significant difference was observed in speech recognition in quiet between and presentation modes. Speech recognition in noise was significantly better with the audio cable than with the loudspeaker. There was no significant difference in speech recognition in quiet at 65 dB and in speech recognition in noise between self-assessment at home and testing in the clinic. At 55 dB, speech recognition assessed at home was slightly but significantly better than that assessed in the clinic. The results demonstrate that it is feasible for experienced CI users to perform self-administered speech recognition tests at home. Self-assessment by CI users of speech recognition in quiet and noise within the home environment could serve as an alternative to the tests performed in the clinic.

PMID: 30261772 [PubMed - as supplied by publisher]

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A directional remote-microphone for bimodal cochlear implant recipients.

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A directional remote-microphone for bimodal cochlear implant recipients.

Int J Audiol. 2018 Sep 27;:1-6

Authors: Vroegop JL, Homans NC, Goedegebure A, van der Schroeff MP

Abstract
To evaluate whether speech recognition in noise differs according to whether a wireless remote microphone is connected to just the cochlear implant (CI) or to both the CI and to the hearing aid (HA) in bimodal CI users. The second aim was to evaluate the additional benefit of the directional microphone mode compared with the omnidirectional microphone mode of the wireless microphone. This prospective study measured Speech Recognition Thresholds (SRT) in babble noise in a 'within-subjects repeated measures design' for different listening conditions. Eighteen postlingually deafened adult bimodal CI users. No difference in speech recognition in noise in the bimodal listening condition was found between the wireless microphone connected to the CI only and to both the CI and the HA. An improvement of 4.1 dB was found for switching from the omnidirectional microphone mode to the directional mode in the CI only condition. The use of a wireless microphone improved speech recognition in noise for bimodal CI users. The use of the directional microphone mode led to a substantial additional improvement of speech perception in noise for situations with one target signal.

PMID: 30261771 [PubMed - as supplied by publisher]

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Speech intelligibility of virtual humans.

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Speech intelligibility of virtual humans.

Int J Audiol. 2018 Sep 27;:1-9

Authors: Devesse A, Dudek A, van Wieringen A, Wouters J

Abstract
The speech intelligibility benefit of visual speech cues during oral communication is well-established. Therefore, an ecologically valid approach of auditory assessment should include the processing of both auditory and visual speech cues. This study describes the development and evaluation of a virtual human speaker designed to present speech auditory-visually. A male and female virtual human speaker were created and evaluated in two experiments: a visual-only speech reading test of words and sentences and an auditory-visual speech intelligibility sentence test. A group of five hearing, skilled speech reading adults participated in the speech reading test whereas a group of young normal-hearing participants (N = 35) was recruited for the intelligibility test. Skilled speech readers correctly identified 57 to 67% of the words and sentences uttered by the virtual speakers. The presence of the virtual speaker improved the speech intelligibility of sentences in noise by 1.5 to 2 dB. These results demonstrate the potential applicability of virtual humans in future auditory-visual speech assessment paradigms.

PMID: 30261770 [PubMed - as supplied by publisher]

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Prevalence and factors associated with tinnitus: data from adult residents in Guangdong province, South of China.

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Prevalence and factors associated with tinnitus: data from adult residents in Guangdong province, South of China.

Int J Audiol. 2018 Sep 27;:1-8

Authors: Yang H, Cai Y, Guo H, Xiong H, Sun Y, Huang X, Zheng Y

Abstract
There is a lack of national studies on tinnitus in China and data based on a large sample size from multiple areas of the country. A cross-sectional study was carried out in Guangdong province from October 2015 to February 2016. In the study, tinnitus was defined as the presence of ringing, buzzing or other sounds in the ears in the past one year. Fourteen districts in Guangdong Province were selected as the first-level cluster by using the sampling method of probability proportional to size (PPS). Two sub-districts in each first-level cluster were randomly selected as the second-level cluster by PPS method. The sample consisted of 3705 eligible people aged over 18 years old, which were also selected by the PPS methods. The prevalence of tinnitus was 10.4% in Guangdong Province. Age, region, educational background, hearing impairment, ear trauma, otitis media and self-health report were the main risk factors for tinnitus. Tinnitus is a common condition and a large population suffers from tinnitus in Guangdong province, south of China. Greater public awareness and understanding of the associated factors are required for further interventions of prevention and management of tinnitus in China.

PMID: 30261769 [PubMed - as supplied by publisher]

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Rotational vestibular assessment.

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Rotational vestibular assessment.

Int J Audiol. 2018 Sep 27;:1

Authors: Valente LM

PMID: 30261768 [PubMed - as supplied by publisher]

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Hyperacusis and disorders of sound intolerance.

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Hyperacusis and disorders of sound intolerance.

Int J Audiol. 2018 Sep 27;:1

Authors: Whitelaw G

PMID: 30261767 [PubMed - as supplied by publisher]

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Promotion and views on tinnitus self-help within United Kingdom national health service audiology departments.

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Promotion and views on tinnitus self-help within United Kingdom national health service audiology departments.

Int J Audiol. 2018 Sep 27;:1-8

Authors: Smith SN, Broomhead E, Greenwell K, Watts E, Stockdale D, Hoare DJ

Abstract
Self-help has the potential to provide low-cost and effective ways of improving access to psychological support for people with tinnitus. When developing and evaluating resources it is important to consider issues that may influence successful implementation. This Survey explored clinicians' use and views on self-help, and barriers to implementation. An online survey was distributed to 220 UK audiology departments. One-hundred and twenty-four clinicians responded to the survey (91 audiologists, 32 hearing therapists, 1 clinical psychologist), each representing a different tinnitus department. Two-thirds of respondents reported providing or recommending self-help resources. Potential benefits were patient empowerment and providing a means of engaging patients in their care. Almost half of respondents felt that there is insufficient training or guidance for clinicians on using or promoting self-help. Clinicians felt that for patients with low-level tinnitus severity, self-help may reduce the number of audiology appointments required. For patients with more complex needs self-help may be useful to engage with between clinical appointments. Further research is needed to determine effectiveness, who benefits, and by what mechanism, before clinicians can confidently recommend or implement self-help. Clinicians will benefit from formal guidance on promoting and supporting use of self-help for tinnitus.

PMID: 30261766 [PubMed - as supplied by publisher]

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New Canal Hearing Aids Market Report

HTF Market Intelligence has released the World Canal Hearing Aids Market study on the devices’ market size, industry status and forecast, competition landscape and growth opportunity to 2023. The market study is segmented by key regions that are accelerating the marketization, and includes key players such as William Demant, Sonova, Sivantos, GN Hearing, ReSound, Starkey, and Widex, It also categorizes the international canal hearing aid market by companies, region, type, and end-use industry. The full report is available at http://bit.ly/2NCE52E.

Published: 9/28/2018 2:30:00 PM

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New Hearing Loss and Cognitive Impairment Study Seeks Volunteers

​A new study investigating age-related hearing loss in people with mild cognitive impairment or Alzheimer's disease and related dementia at the University of Massachusetts Amherst is recruiting volunteers. The two-part study is looking for participants 55 and older for laboratory-based experiments and older adults in the Programs of All-Inclusive Care for the Elderly (PACE) for a field study. The laboratory arm of the study will test the ability of older adults with and without early-stage cognitive impairment or dementia to understand speech in difficult listening environments, such as in the presence of white noise or other people talking. The field part of the study will be conducted at PACE centers in Springfield, West Springfield, and Worcester where older adults receive all-inclusive health care. Researchers will investigate whether people with age-related hearing loss have more negative health outcomes, such as more falls and more hospitalizations. The overall goal of the study is to identify techniques and tools to improve these individuals' ability to engage with family, caregivers, and friends and enhance their quality of life. 

Published: 9/28/2018 12:43:00 PM

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New Canal Hearing Aids Market Report

HTF Market Intelligence has released the World Canal Hearing Aids Market study on the devices’ market size, industry status and forecast, competition landscape and growth opportunity to 2023. The market study is segmented by key regions that are accelerating the marketization, and includes key players such as William Demant, Sonova, Sivantos, GN Hearing, ReSound, Starkey, and Widex, It also categorizes the international canal hearing aid market by companies, region, type, and end-use industry. The full report is available at http://bit.ly/2NCE52E.

Published: 9/28/2018 2:30:00 PM

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New Hearing Loss and Cognitive Impairment Study Seeks Volunteers

​A new study investigating age-related hearing loss in people with mild cognitive impairment or Alzheimer's disease and related dementia at the University of Massachusetts Amherst is recruiting volunteers. The two-part study is looking for participants 55 and older for laboratory-based experiments and older adults in the Programs of All-Inclusive Care for the Elderly (PACE) for a field study. The laboratory arm of the study will test the ability of older adults with and without early-stage cognitive impairment or dementia to understand speech in difficult listening environments, such as in the presence of white noise or other people talking. The field part of the study will be conducted at PACE centers in Springfield, West Springfield, and Worcester where older adults receive all-inclusive health care. Researchers will investigate whether people with age-related hearing loss have more negative health outcomes, such as more falls and more hospitalizations. The overall goal of the study is to identify techniques and tools to improve these individuals' ability to engage with family, caregivers, and friends and enhance their quality of life. 

Published: 9/28/2018 12:43:00 PM

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