Ear and Hearing最新文献

{"title":"Cognitive Changes Up to 4 Years After Cochlear Implantation in Older Adults: A Prospective Longitudinal Study Using the RBANS-H.","authors":"Tinne Vandenbroeke, Ellen Andries, Marc J Lammers, Paul Van de Heyning, Anouk Hofkens-Van den Brandt, Olivier Vanderveken, Vincent Van Rompaey, Griet Mertens","doi":"10.1097/AUD.0000000000001583","DOIUrl":"10.1097/AUD.0000000000001583","url":null,"abstract":"<p><strong>Objectives: </strong>Hearing loss is a worldwide health problem that currently affects around 20% of the world's population. Untreated hearing loss can have a significant impact on daily life, it can cause social isolation, loneliness, frustration, and higher anxiety and depression rates. Furthermore, older adults with hearing impairment have a higher risk for accelerated cognitive decline compared with normal-hearing individuals. Previous research indicated a positive effect of cochlear implantation on Health-related Quality of life (HRQoL) and cognitive functioning 1 year after cochlear implantation. The aim of this study was to evaluate the long-term effect of cochlear implantation on cognition and HRQoL in older adults with severe-to-profound hearing loss.</p><p><strong>Design: </strong>All included subjects were 55 years or older with postlingual, bilateral, severe-to-profound hearing loss, and received a unilateral cochlear implant. Cognition was evaluated using the Repeatable Battery for the Assessment of Neuropsychological Status for Hearing Impaired Individuals (RBANS-H), and HRQoL was evaluated using the following five questionnaires: Nijmegen Cochlear Implant Questionnaire (NCIQ); Hearing Implant Sound Quality Index (HISQUI); Speech, Spatial, and Qualities of Hearing Scale (SSQ12); Hospital Anxiety and Depression scale (HADS); and Type D questionnaire (DS14). Individuals were evaluated preoperatively, and annually up to 4 years after CI activation.</p><p><strong>Results: </strong>After cochlear implantation an improvement in hearing, cognition, and HRQoL was observed. When comparing preoperative and 12 months postoperative results a significant improvement was observed in the total RBANS-H score (mean [SD], 92.78 [±15.08] versus 98.35 [±14.18], p < 0.001) and the subdomain scores for \"Immediate Memory\" (94.13 [±18.75] versus 105.39 [±19.98], p = 0.005), \"Attention\" (86.17 [±19.02] versus 91.57 [±15.35], p = 0.048), and \"Delayed memory\" (97.91 [±14.51] versus 103.83 [±14.714], p = 0.017). When comparing preoperative results with 4 years postoperative results, a significant improvement was observed in \"Immediate Memory\" (94.13 [±18.75] versus 101.91 [±16.09], p = 0.020) and a significant decline was observed in \"Visuospatial Memory\" (97.04 [±17.47] versus 87.26 [±13.41], p = 0.013). Compared with the preoperative results, no significant improvement was observed in the total RBANS-H score 4 years after implantation. A significant improvement was observed for the HRQoL questionnaires, that is, NCIQ, HISQUI19, SSQ12, HADS, and DS14, 1 year after cochlear implantation. When comparing preoperative results with 4-year postoperative results, significant improvement was observed for the NCIQ and DS14 social inhibition scores. Long-term results of the SSQ12 and HISQUI19 were lacking.</p><p><strong>Conclusions: </strong>Unilateral cochlear implantation in an adult population with bilateral severe-to-profound sensorineural hearing loss h","PeriodicalId":55172,"journal":{"name":"Ear and Hearing","volume":" ","pages":"361-370"},"PeriodicalIF":2.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11825490/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142127422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Outcomes for Adult Single-Sided Deafness Cochlear Implantees Exceeding the 5% Candidacy Criterion.","authors":"Joshua G W Bernstein, Elicia M Pillion, Anthony M Tolisano","doi":"10.1097/AUD.0000000000001578","DOIUrl":"10.1097/AUD.0000000000001578","url":null,"abstract":"<p><strong>Objectives: </strong>While single-sided deafness cochlear implants (SSD-CIs) have now received regulatory approval in the United States, candidate-ear candidacy criteria (no better than 5% word-recognition score) are stricter than for traditional CI candidates (50 to 60% speech recognition, best-aided condition). SSD implantation in our center began before regulatory approval, using a criterion derived from traditional candidacy: 50% consonant-nucleus-consonant (CNC) word-identification score in the candidate ear. A retrospective analysis investigated whether SSD patients exceeding the 5% CNC criterion nevertheless benefitted from a CI as assessed by spatial-hearing tests (speech understanding in noise [SIN] and localization) and by a patient-reported outcome measure quality-of-life instrument validated for patients with CIs.</p><p><strong>Design: </strong>A retrospective chart review assessed the clinical experience of a single CI center. Subjects consisted of 27 adult CI recipients with SSD (N = 21) or asymmetric hearing loss (AHL; N = 6) implanted since September 2019 with at least 3 months of postoperative follow-up. Patients with revision surgery or simultaneous labyrinthectomy and CI surgery were excluded from the sample. Subjects were divided into 2 groups based on preoperative CNC scores measured under best-aided conditions with a behind-the-ear hearing aid in the sound field at 0.9 m from a front loudspeaker, and the better ear masked using an insert earphone with 45 dB HL speech-weighted noise. The \"MEETS\" group had preoperative CNC word scores <5%; the \"EXCEEDS\" group had scores >5%. The clinical protocol also included intelligibility tests using AzBio sentences in the same test conditions as CNC; binaural spatial testing (broadband-noise sound localization, and matrix-sentence speech-reception thresholds in spatially separated noise) using a custom-built 7-speaker array; and the CI Quality of Life (CIQOL) instrument. To evaluate CI benefit, preoperative unaided performance was compared with postoperative binaural (acoustic ear + CI ear) performance at a clinic visit closest to 6 months postsurgery.</p><p><strong>Results: </strong>Of 27 SSD-CI recipients, 11 subjects exceeded the 5% preoperative CNC candidacy criterion. Both the MEETS and EXCEEDS groups improved significantly on all 5 primary study outcome measures (CI-alone CNC and AzBio, binaural SIN and sound localization, and CIQOL). The only statistically significant differences observed between the MEETS and EXCEEDS groups were that preoperative CNC and AzBio scores were significantly higher for the EXCEEDS group, as expected given that the groups were defined based on preoperative speech-perception scores in quiet. There were no statistically significant differences between the MEETS and EXCEEDS groups in postoperative scores in any test or in the magnitude of the improvement from preoperative to postoperative assessment.</p><p><strong>Conclusions: </strong>SSD- and A","PeriodicalId":55172,"journal":{"name":"Ear and Hearing","volume":" ","pages":"336-346"},"PeriodicalIF":2.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142683383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding the Process of Integration in Binaural Cochlear Implant Configurations.","authors":"John B Muegge, Bob McMurray","doi":"10.1097/AUD.0000000000001629","DOIUrl":"https://doi.org/10.1097/AUD.0000000000001629","url":null,"abstract":"<p><strong>Objectives: </strong>Cochlear implant (CI) users with access to hearing in both ears (binaural configurations) tend to perform better in speech perception tasks than users with a single-hearing ear alone. This benefit derives from several sources, but one central contributor may be that binaural hearing allows listeners to integrate content across ears. A substantial literature demonstrates that binaural integration differs between CI users and normal hearing controls. However, there are still questions about the underlying process of this integration. Here, we test both normal-hearing listeners and CI users to examine this process.</p><p><strong>Design: </strong>Twenty-three CI users (7 bimodal, 7 bilateral, and 9 single sided deafness CI users) and 28 age-matched normal-hearing listeners completed a dichotic listening task, in which first and second formants from one of four vowels were played to each ear in various configurations: with both formants heard diotically, with one formant heard diotically, or with one formant heard in one ear and the second formant heard in the other (dichotically). Each formant heard alone should provide minimal information for identifying the vowel. Thus, listeners must successfully integrate information from both ears if they are to show good performance in the dichotic condition.</p><p><strong>Results: </strong>Normal-hearing listeners showed no noticeable difference in performance when formants were heard diotically or dichotically. CI users showed significantly reduced performance in the dichotic condition relative to when formants were heard diotically. A deeper examination of individual participants suggests that CI users show important variation in their integration process.</p><p><strong>Conclusions: </strong>Using a dichotic listening task we provide evidence that while normal-hearing listeners successfully integrate content dichotically, CI users show remarkable differences in how they approach integration. This opens further questions regarding the circumstances in which listeners display different integration profiles and has implications for understanding variation in real-world performance outcomes.</p>","PeriodicalId":55172,"journal":{"name":"Ear and Hearing","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143525337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Electrocochleography Latency: Correlation With Electrode Position During Cochlear Implantation.","authors":"Raphael R Andonie, Wilhelm Wimmer, Reto A Wildhaber, Georgios Mantokoudis, Marco Caversaccio, Stefan Weder","doi":"10.1097/AUD.0000000000001652","DOIUrl":"https://doi.org/10.1097/AUD.0000000000001652","url":null,"abstract":"<p><strong>Objectives: </strong>Cochlear implant (CI) candidates increasingly exhibit some degree of residual hearing, which should be preserved despite the implantation. Today, cochlear health is monitored during CI surgery by tracking the cochlear microphonic (CM) amplitude from intracochlear electrocochleography (ECochG) measurements. However, recent studies indicate that the insertion depth of the measuring electrode must be considered to accurately interpret these signals. The acoustic path from the cochlear base to the apex induces excitation delays in deeper regions, which should be reflected in the CM measurements. In this study, we analyzed the potential of cochlear microphonic latency (CML) as an objective method for continuously tracking CI electrode position during cochlear implantation. In addition, we examined whether CML can be associated with residual hearing.</p><p><strong>Design: </strong>We recorded intraoperative pure-tone ECochG at maximum stimulation levels from 30 CI patients to derive CML. During CI electrode insertion, ECochG was continuously recorded at the 2 stimulation frequencies of 0.5 and 0.75 kHz. After complete insertion, ECochG was measured on all evenly numbered electrodes at frequencies of 0.25, 0.5, 0.75, and 1 kHz. The electrode locations (i.e., linear insertion depth) were identified by postoperative computed tomography (CT) scans. The location of the measuring electrode during the insertion period was then calculated backward, assuming a constant insertion speed. Finally, we used a linear regression model to relate CML to linear insertion depth. In addition, we evaluated the relationship between CML and preoperative residual hearing.</p><p><strong>Results: </strong>CML is significantly correlated to the linear insertion depth (p < 0.001) during and after electrode insertion (with restrictions on 0.25 kHz stimulus, presumably since the characteristic 0.25 kHz region is not within reach of the used CI electrode arrays). Despite high inter-individual variability, our results align with documented delays in the basilar membrane observed in other studies. However, we could not identify a significant association between CML and residual hearing.</p><p><strong>Conclusions: </strong>Our study demonstrates that objectively extracted CML encodes the intracochlear electrode location in CI patients but is not directly linked to residual hearing. Consequently, CML has the potential to enhance intraoperative ECochG analysis by providing real-time tracking of electrode position. To better understand the inter-individual variations in CML, future studies with larger patient cohorts are needed.</p>","PeriodicalId":55172,"journal":{"name":"Ear and Hearing","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143506118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship Between Auditory Distraction and Emotional Dimensionality for Non-Speech Sounds.","authors":"Shae D Morgan, Erin M Picou, Elizabeth D Young, Samantha J Gustafson","doi":"10.1097/AUD.0000000000001643","DOIUrl":"https://doi.org/10.1097/AUD.0000000000001643","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;If task-irrelevant sounds are present when someone is actively listening to speech, the irrelevant sounds can cause distraction, reducing word recognition performance and increasing listening effort. In some previous investigations into auditory distraction, the task-irrelevant stimuli were non-speech sounds (e.g., laughter, animal sounds, music), which are known to elicit a variety of emotional responses. Variations in the emotional response to a task-irrelevant sound could influence the distraction effect. The goal of this study was to examine the relationship between the arousal (exciting versus calming) or valence (positive versus negative) of task-irrelevant auditory stimuli and auditory distraction. Using non-speech sounds that have been used previously in a distraction task, we sought to determine whether stimulus characteristics of arousal or valence affected word recognition or verbal response times (which serve as a measure of behavioral listening effort). We anticipated that the perceived arousal and valence of task-irrelevant stimuli would be related to distraction from target stimuli.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design: &lt;/strong&gt;In an online listening task, 19 young adult listeners rated the valence and arousal of non-speech sounds, which previously served as task-irrelevant stimuli in studies of auditory distraction. Word recognition and verbal response time data from these previous studies were reanalyzed using the present data to evaluate the effect of valence or arousal stimulus category on the distraction effect in quiet and in noise. In addition, correlation analyses were conducted between ratings of valence, ratings of arousal, word recognition performance, and verbal response times.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The presence of task-irrelevant stimuli affected word recognition performance. This effect was observed generally in quiet and for stimuli rated as exciting (in noise) or calming (in quiet). The presence of task-irrelevant stimuli also affected reaction times. Background noise increased verbal response times by approximately 35 msec. In addition, all task-irrelevant stimuli, regardless of valence or arousal category, increased verbal response times by more than 200 msec relative to the condition with no task-irrelevant stimuli. Valenced stimuli caused the largest distraction effect on response times; there was no difference in the distraction effect on verbal response times based on the stimulus arousal category. Correlation analyses between valence ratings and dependent variables (word recognition and reaction time) revealed that, in quiet, there was a weak, but statistically significant, relationship between valence ratings (absolute deviation from neutral) and word recognition scores; the more valenced a stimulus, the more distracting it was in terms of word recognition performance. This significant relationship between valence and word recognition was not evident when participants completed the","PeriodicalId":55172,"journal":{"name":"Ear and Hearing","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143506156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"To Ear and Hearing Reviewers: Thank You.","authors":"Ruth Y Litovsky","doi":"10.1097/AUD.0000000000001647","DOIUrl":"https://doi.org/10.1097/AUD.0000000000001647","url":null,"abstract":"","PeriodicalId":55172,"journal":{"name":"Ear and Hearing","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143506164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Speech and Non-Speech Auditory Task Performance by Non-Native English Speakers.","authors":"Bridget McNamara, Douglas S Brungart, Rebecca E Bieber, Ian Phillips, Alyssa J Davidson, Sandra Gordon-Salant","doi":"10.1097/AUD.0000000000001648","DOIUrl":"https://doi.org/10.1097/AUD.0000000000001648","url":null,"abstract":"<p><strong>Objectives: </strong>The goal of this study was to determine if performance on speech and non-speech clinical measures of auditory perception differs between two groups of adults: self-identified native speakers of English and non-native speakers of English who speak Spanish as a first language. The overall objective was to establish whether auditory perception tests developed for native English speakers are appropriate for bilingual Spanish-speaking adults who self-identify as non-native speakers of English. A secondary objective was to determine whether relative performance on English- and Spanish-language versions of a closed-set speech perception in noise task could accurately predict native-like performance on a battery of English language-dependent tests of auditory perception.</p><p><strong>Design: </strong>Participants were young, normal-hearing adults who self-identified as either native speakers of American English (n = 50) or as non-native speakers of American English (NNE; n = 25) who spoke Spanish as their first language. Participants completed a battery of perceptual tests, including speech tests (e.g., Quick Speech-in-Noise, time-compressed reverberant Quick Speech-in-Noise, etc.) and non-speech tests (Gaps in Noise, Frequency Pattern test, Duration Pattern test, Masking Level Difference). The English version of the Oldenburg Sentence test (OLSA) was administered to both groups; NNE participants also completed the Spanish version of the OLSA.</p><p><strong>Results: </strong>Analyses indicate that the native speakers of the American English group performed significantly better than the NNE group on all speech-based tests and on the two pattern recognition tests. There was no difference between groups on the remaining non-speech tests. For the NNE group, a difference of more than 2 SD on group-normalized scores for the English and Spanish OLSA accurately predicted poorer than normal performance on two or more tests of auditory perception with a language-dependent component either in the instructions or the stimuli.</p><p><strong>Conclusions: </strong>The results indicate that a number of English-based tests designed to assess auditory perception may be inappropriate for some Spanish-English bilingual adults. That is, some bilingual adults may perform worse than expected on tests that involve perceiving spoken English, in part because of linguistic differences, and not because of unusually poor auditory perception. The results also support the use of preliminary speech-in-noise screening tests in each of a bilingual patient's languages to establish if auditory perception tests in English are appropriate for a given individual. If a non-native English speaker's screening performance is worse in English than in the native language, one suggested strategy is to select auditory perceptual tests that are impacted minimally or not at all by linguistic differences.</p>","PeriodicalId":55172,"journal":{"name":"Ear and Hearing","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143470006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring N400 Predictability Effects During Sustained Speech Comprehension: From Listening-Related Fatigue to Speech Enhancement Evaluation.","authors":"Cheng-Hung Hsin, Chia-Ying Lee, Yu Tsao","doi":"10.1097/AUD.0000000000001635","DOIUrl":"https://doi.org/10.1097/AUD.0000000000001635","url":null,"abstract":"<p><strong>Objectives: </strong>This study investigated the predictability effect on the N400 as an objective measure of listening-related fatigue during speech comprehension by: (1) examining how its characteristics (amplitude, latency, and topographic distribution) changed over time under clear versus noisy conditions to assess its utility as a marker for listening-related fatigue, and (2) evaluating whether these N400 parameters could assess the effectiveness of speech enhancement (SE) systems.</p><p><strong>Design: </strong>Two event-related potential experiments were conducted on 140 young adults (aged 20 to 30) assigned to four age-matched groups. Using a between-subjects design for listening conditions, participants comprehended spoken sentences ending in high- or low-predictability words while their brain activity was recorded using electroencephalography. Experiment 1 compared the predictability effect on the N400 in clear and noise-masked conditions, while experiment 2 examined this effect under two enhanced conditions (denoised using the transformer- and minimum mean square error-based SE models). Electroencephalography data were divided into two blocks to analyze the changes in the predictability effect on the N400 over time, including amplitude, latency, and topographic distributions.</p><p><strong>Results: </strong>Experiment 1 compared N400 effects across blocks under different clarity conditions. Clear speech in block 2 elicited a more anteriorly distributed N400 effect without reduction or delay compared with block 1. Noisy speech in block 2 showed a reduced, delayed, and posteriorly distributed effect compared with block 1. Experiment 2 examined N400 effects during enhanced speech processing. Transformer-enhanced speech in block 1 demonstrated significantly increased N400 effect amplitude compared to noisy speech. However, both enhancement methods showed delayed N400 effects in block 2.</p><p><strong>Conclusions: </strong>This study suggests that temporal changes in the N400 predictability effect might serve as objective markers of sustained speech processing under different clarity conditions. During clear speech comprehension, listeners appear to maintain efficient semantic processing through additional resource recruitment over time, while noisy speech leads to reduced processing efficiency. When applied to enhanced speech, these N400 patterns reveal both the immediate benefits of SE for semantic processing and potential limitations in supporting sustained listening. These findings demonstrate the potential utility of the N400 predictability effect for understanding sustained listening demands and evaluating SE effectiveness.</p>","PeriodicalId":55172,"journal":{"name":"Ear and Hearing","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143451072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Relationship Between Spatial Release From Masking and Listening Effort Among Cochlear Implant Users With Single-Sided Deafness.","authors":"Lukas Suveg, Tanvi Thakkar, Emily Burg, Shelly P Godar, Daniel Lee, Ruth Y Litovsky","doi":"10.1097/AUD.0000000000001611","DOIUrl":"https://doi.org/10.1097/AUD.0000000000001611","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;To examine speech intelligibility and listening effort in a group of patients with single-sided deafness (SSD) who received a cochlear implant (CI). There is limited knowledge on how effectively SSD-CI users can integrate electric and acoustic inputs to obtain spatial hearing benefits that are important for navigating everyday noisy environments. The present study examined speech intelligibility in quiet and noise simultaneously with measuring listening effort using pupillometry in individuals with SSD before, and 1 year after, CI activation. The study was designed to examine whether spatial separation between target and interfering speech leads to improved speech understanding (spatial release from masking [SRM]), and is associated with a decreased effort (spatial release from listening effort [SRE]) measured with pupil dilation (PPD).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design: &lt;/strong&gt;Eight listeners with adult-onset SSD participated in two visits: (1) pre-CI and (2) post-CI (1 year after activation). Target speech consisted of Electrical and Electronics Engineers sentences and masker speech consisted of AzBio sentences. Outcomes were measured in three target-masker configurations with the target fixed at 0° azimuth: (1) quiet, (2) co-located target/maskers, and (3) spatially separated (±90° azimuth) target/maskers. Listening effort was quantified as change in peak proportional PPD on the task relative to baseline dilation. Participants were tested in three listening modes: acoustic-only, CI-only, and SSD-CI (both ears). At visit 1, the acoustic-only mode was tested in all three target-masker configurations. At visit 2, the acoustic-only and CI-only modes were tested in quiet, and the SSD-CI listening mode was tested in all three target-masker configurations.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Speech intelligibility scores in quiet were at the ceiling for the acoustic-only mode at both visits, and in the SSD-CI listening mode at visit 2. In quiet, at visit 2, speech intelligibility scores were significantly worse in the CI-only listening modes than in all other listening modes. Comparing SSD-CI listening at visit 2 with pre-CI acoustic-only listening at visit 1, speech intelligibility scores for co-located and spatially separated configurations showed a trend toward improvement (higher scores) that was not significant. However, speech intelligibility was significantly higher in the separated compared with the co-located configuration in acoustic-only and SSD-CI listening modes, indicating SRM. PPD evoked by speech presented in quiet was significantly higher with CI-only listening at visit 2 compared with acoustic-only listening at visit 1. However, there were no significant differences between co-located and spatially separated configurations on PPD, likely due to the variability among this small group of participants. There was a negative correlation between SRM and SRE, indicating that improved speech intelligibility with spatial sep","PeriodicalId":55172,"journal":{"name":"Ear and Hearing","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143451074","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving Real-Time Feedback During Cochlear Implantation: The Auditory Nerve Neurophonic/Cochlear Microphonic Ratio.","authors":"Christofer Bester, Stephen John O'Leary, Frédéric Venail, Andreas Büchner, Tiago Rocha Félix, Wai Kong Lai, Carlos Boccio, Baishakhi Choudhury, Viral Tejani, Emmanuel Mylanus, Marielle Sicard, Thomas Lenarz, Catherine Birman, Frederico Di Lella, J Thomas Roland, Bruce Gantz, Kerrie Plant, Ruth English, Remo Arts, Andy Beynon","doi":"10.1097/AUD.0000000000001613","DOIUrl":"10.1097/AUD.0000000000001613","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;Real-time monitoring of cochlear function to predict the loss of residual hearing after cochlear implantation is now possible. Current approaches monitor the cochlear microphonic (CM) during implantation from the electrode at the tip of the implant. A drop in CM response of &gt;30% is associated with poorer hearing outcomes. However, there is prior evidence that CM amplitude can fluctuate in a manner unrelated to hearing trauma, leading to false positives. By monitoring another cochlear response, the auditory nerve neurophonic (ANN), a differentiation between CM drops that result in reduced cochlear output from false positives may be possible. The hypothesis tested in the present work was that ANN/CM ratios measured during a CM drop will increase during drops not associated with postoperative hearing loss.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design: &lt;/strong&gt;Twenty-eight adult participants with known CM drops during implantation were taken from a larger data set. This contains adult cochlear implant candidates scheduled to receive a Cochlear Nucleus cochlear implant with either the slim-straight or slim-modiolar electrode array with preoperative audiometric low-frequency average thresholds of ≤80 dB HL at 500, 750, and 1000 Hz in the ear to be implanted. Patients were recruited from eight international implant sites. Pure-tone audiometry was measured postoperatively and 4 to 6 weeks after implantation. Electrocochleography was measured during and immediately after the implantation of the array in response to a 500-Hz, 6-msec pure-tone pip at 110 dB HL.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The ANN/CM ratio rose during CM drops in 19 of these patients and decreased in 9. At the follow-up timepoint, patients with a decreasing ANN/CM ratio had a median hearing loss of 29.0 dB, significantly worse than the group with increasing ratio at 13.3 dB ( p = 0.004). Considering only the change in ANN amplitude during a CM drop led to smaller groups (ANN drop during CM drop N = 17, ANN increasing during CM drop N = 6) due to 5 patients having undetectable ANN during the CM drop. Using the ANN alone also led to as poorer prediction of hearing preservation, with median hearing preservation in the ANN increasing group of 12.9 dB, significantly better than the ANN decreasing group of 25 dB ( p = 0.02). The group with a decreasing ANN/CM ratio had maximum CM amplitude immediately after insertion lower than the maximum amplitude reached during insertion (mean maximum postinsertion amplitude of 98% of during-insertion amplitude). In comparison, the ANN/CM ratio increasing group tended to have a larger CM amplitude immediately after insertion (mean maximum CM amplitude postinsertion of 164% of the maximum during-insertion amplitude).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;These data show that the ANN/CM ratio is a measure that can differentiate between patients with CM drops that lead to a loss of residual hearing and those that do not. The ANN/CM ratio is easily measu","PeriodicalId":55172,"journal":{"name":"Ear and Hearing","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142959007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}