Ear and Hearing最新文献

{"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":"<p><strong>Objectives: </strong>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).</p><p><strong>Design: </strong>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.</p><p><strong>Results: </strong>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":"<p><strong>Objectives: </strong>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 >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.</p><p><strong>Design: </strong>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.</p><p><strong>Results: </strong>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).</p><p><strong>Conclusions: </strong>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}

{"title":"Effects of Middle Ear Status on Rotary Chair Outcomes in Children.","authors":"Manuel Vicente, Nour El-Hidek, Jessie N Patterson, Gabrielle R Merchant, Kristen L Janky","doi":"10.1097/AUD.0000000000001644","DOIUrl":"https://doi.org/10.1097/AUD.0000000000001644","url":null,"abstract":"<p><strong>Objective: </strong>Middle ear dysfunction is common in young children. There are varying reports on the effects of middle ear dysfunction on the vestibular system; however, it is unknown the extent to which abnormal middle ear function affects vestibular function tests, which could lead to misdiagnosis and improper medical management. Therefore, the purpose of this study is to evaluate how middle ear status affects rotary chair outcomes in young children (6 months to 6 years).</p><p><strong>Design: </strong>Twenty-one children with middle ear dysfunction (mean: 30 months, 11 males) and 36 control children with normal middle ear function (mean: 33 months, 19 males) participated. All participants completed tympanometry, wideband tympanometry, and sinusoidal harmonic acceleration rotary chair testing at 0.01, 0.04, and 0.16 Hz. The primary outcomes were rotary chair gain, phase, and symmetry.</p><p><strong>Results: </strong>For rotary chair gain, there was a significant frequency by group interaction. As expected, gain increased with increases in frequency; however, there were larger gain increases in the middle ear dysfunction group for 0.04 and 0.16 Hz. There was no significant effect of middle ear dysfunction on rotary chair phase or symmetry. Although 6 subjects (29%) had rotary chair phase leads that were greater than 2 SDs from the control mean, there were no significant group-level differences in phase; there was also no effect of severity of middle ear dysfunction on any rotary chair outcomes.</p><p><strong>Conclusions: </strong>Rotary chair in the presence of middle ear dysfunction is valid; however, isolated phase abnormalities can be present that are not explained by severity of middle ear dysfunction. Tympanometry and/or wideband tympanometry is recommended before rotary chair. In the event phase abnormalities are present coupled with abnormal tympanometry and/or wideband tympanometry, rotary chair testing could be repeated once the middle ear normalizes to rule out contributions from middle ear dysfunction.</p>","PeriodicalId":55172,"journal":{"name":"Ear and Hearing","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143416302","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":"A Level-Adjusted Cochlear Frequency-to-Place Map for Estimating Tonotopic Frequency Mismatch With a Cochlear Implant.","authors":"Elad Sagi, Mario A Svirsky","doi":"10.1097/AUD.0000000000001641","DOIUrl":"10.1097/AUD.0000000000001641","url":null,"abstract":"<p><strong>Objectives: </strong>To provide a level-adjusted correction to the current standard relating anatomical cochlear place to characteristic frequency (CF) in humans, and to re-evaluate anatomical frequency mismatch in cochlear implant (CI recipients considering this correction. It is proposed that a level-adjusted place-frequency function may represent a more relevant tonotopic benchmark for CIs in comparison to the current standard.</p><p><strong>Design: </strong>The present analytical study compiled data from 15 previous animal studies that reported isointensity responses from cochlear structures at different stimulation levels. Extracted outcome measures were CFs and centroid-based best frequencies at 70 dB SPL input from 47 specimens spanning a broad range of cochlear locations. A simple relationship was used to transform these measures to human estimates of characteristic and best frequencies, and nonlinear regression was applied to these estimates to determine how the standard human place-frequency function should be adjusted to reflect best frequency rather than CF. The proposed level-adjusted correction was then compared with average place-frequency positions of commonly used CI devices when programmed with clinical settings.</p><p><strong>Results: </strong>The present study showed that the best frequency at 70 dB SPL (BF70) tends to shift away from CF. The amount of shift was statistically significant (signed-rank test z = 5.143, p < 0.001), but the amount and direction of shift depended on cochlear location. At cochlear locations up to 600° from the base, BF70 shifted downward in frequency relative to CF by about 4 semitones on average. Beyond 600° from the base, BF70 shifted upward in frequency relative to CF by about 6 semitones on average. In terms of spread (90% prediction interval), the amount of shift between CF and BF70 varied from relatively no shift to nearly an octave of shift. With the new level-adjusted place-frequency function, the amount of anatomical frequency mismatch for devices programmed with standard-of-care settings is less extreme than originally thought and may be nonexistent for all but the most apical electrodes.</p><p><strong>Conclusions: </strong>The present study validates the current standard for relating cochlear place to CF, and introduces a level-adjusted correction for how best frequency shifts away from CF at moderately loud stimulation levels. This correction may represent a more relevant tonotopic reference for CIs. To the extent that it does, its implementation may potentially enhance perceptual accommodation and speech understanding in CI users, thereby improving CI outcomes and contributing to advancements in the programming and clinical management of CIs.</p>","PeriodicalId":55172,"journal":{"name":"Ear and Hearing","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143392578","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":"Self-Fitting Hearing Aids: Effects of Starting Response and Field Experience.","authors":"Arthur Boothroyd, Dhiman Sengupta, Shaelyn Painter, Elena Shur, Harinath Garudadri, Carol Mackersie","doi":"10.1097/AUD.0000000000001642","DOIUrl":"https://doi.org/10.1097/AUD.0000000000001642","url":null,"abstract":"<p><strong>Objectives: </strong>To determine the effects of changing from a prescribed to a generic starting response on self-fitting outcome and behavior before and after a brief field experience.</p><p><strong>Method: </strong>Twenty adult hearing-aid users with mild-to-moderate hearing loss used a smartphone interface to adjust level and spectral tilt of the output of a wearable master hearing aid while listening to prerecorded speech, presented at 65 dB SPL, in quiet. A prescribed starting response was based on the participant's own audiogram. A generic starting response was based on an audiogram for a typical mild-to-moderate hearing loss and was the same for all participants. Initial self-fittings from the two starting responses took place in the lab. After a brief field experience, involving conversation, self-hearing, and ambient noise, with readjustment as needed, self-fittings from the two starting responses were repeated in the lab. Starting responses, self-fitted responses, and adjustment steps were logged in the master hearing aid for subsequent evaluation of real-ear output spectra and for assessment of self-fitting behavior.</p><p><strong>Results: </strong>Neither starting response nor field experience had a significant effect on mean self-fitted output in the lab (p = 0.506 and 0.149, respectively). However, the SD of individual starting-response effects on high-frequency self-fitted output fell by around 50% after the field experience (p = 0.006). The effect of starting response on self-fitting behavior was limited to number of adjustment steps, which was higher for the generic start (p = 0.014). The effect of field experience on self-fitting behavior was limited to a 50% reduction in self-fitting time (p < 0.001). This reduction was attributable mainly to less time spent listening after each adjustment step (p = 0.019).</p><p><strong>Conclusions: </strong>The findings support the conclusion that, for a population with mild-to-moderate hearing loss, a generic starting response can be a viable option for over-the-counter self-fitting hearing aids. They highlight, however, the need for practice and experience with novel self-fitting hearing aids and the fact that self-fitting may not be suitable for all.</p>","PeriodicalId":55172,"journal":{"name":"Ear and Hearing","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143392580","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":"Enhancing Speech Perception in Noise Through Home-Based Competing Talker Training.","authors":"Mira Van Wilderode, Nathan Van Humbeeck, Ralf T Krampe, Astrid van Wieringen","doi":"10.1097/AUD.0000000000001631","DOIUrl":"https://doi.org/10.1097/AUD.0000000000001631","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to evaluate the effectiveness of a competing talker training paradigm (2TT-Flemish). The primary objectives were the assessment of on-task learning and the transfer to untrained tasks.</p><p><strong>Design: </strong>A total of 60 participants (54-84 years, mean age = 69.4) with speech-in-noise problems participated in the study. The study used a randomized controlled design with three groups: an immediate training group, a delayed training group, and an active control group. The immediate training group trained from the very beginning, while delayed training started after 4 weeks. The active control group listened to audiobooks for the first 4 weeks. All participants underwent 4 weeks of competing talker training. Outcome measures included speech perception in noise, analytical tasks (modulation detection and phoneme perception in noise), and inhibitory control. In addition, a listening-posture dual task assessed whether training freed up cognitive resources for a concurrently performed task. Finally, we assessed whether training induced self-reported benefits regarding hearing, listening effort, communication strategies, emotional consequences, knowledge, and acceptance of hearing loss. Outcome measures were assessed every 4 weeks over a 12-week period. The present study aimed to investigate the effectiveness of competing talker training in a stratified randomized controlled trial.</p><p><strong>Results: </strong>Overall compliance to the training was good and increased with age. We observed on-task improvements during the 4 weeks of training in all groups. Results showed generalization toward speech-in-noise perception, persisting for at least 4 weeks after the end of training. No transfer toward more analytical tasks or inhibitory control was observed. Initial dual-task costs in postural control were reliably reduced after competing talker training suggesting a link between improved listening skills and cognitive resource allocation in multitask settings. Our results show that listeners report better knowledge about their hearing after training.</p><p><strong>Conclusions: </strong>After training with the 2TT-Flemish, results showed on-task improvements and generalization toward speech-in-noise. Improvements did not generalize toward basic analytical tasks. Results suggest that competing talker training enables listeners to free up cognitive resources, which can be used for another concurrent task.</p>","PeriodicalId":55172,"journal":{"name":"Ear and Hearing","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143384155","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":"Language Complexities for Deaf and Hard of Hearing Individuals in Their Pursuit of a Career in Science, Technology, Engineering, Mathematics, and Medicine: Perspectives From an LSL/ASL User.","authors":"Henry J Adler","doi":"10.1097/AUD.0000000000001637","DOIUrl":"https://doi.org/10.1097/AUD.0000000000001637","url":null,"abstract":"<p><p>A research scientist with 35 years of experience in the field of hearing research, the author writes that his own experiences have provided a perspective that may be valuable for both future d/Deaf and Hard of Hearing (D/HH) individuals and their peers with typical hearing in their pursuit of a career in Science, Technology, Engineering, Mathematics, and Medicine (STEMM). The author first describes the role of Hearing Inclusive-Association for Research in Otolaryngology in enhancing inclusivity and accessibility for D/HH scientists in the field of Hearing Research. Second, the challenges faced by D/HH scientists arise from the difficulties of working with peers with typical hearing, resulting in less inclusivity and accessibility for the D/HH scientists. The next section deals with solutions to these challenges, including American Sign Language interpreters, websites that give advice on inclusivity and accessibility, and technological advances such as assistive listening devices and smartphones with a capacity for auto captioning. The solutions, however, are fraught with issues such as limited budgets and misperception. Fourth, the author argues that the experiences necessary for a career in STEMM may require a higher-than-expected degree of collaboration with peers with typical hearing outside the laboratory. Finally, studies on successful D/HH scientists in STEMM fields should include experiences of obtaining successful research funding.</p>","PeriodicalId":55172,"journal":{"name":"Ear and Hearing","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143191084","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 the Predictive Strength of Better-Ear Four-Frequency Pure-Tone Average With the Addition of the Tinnitus and Hearing Survey-Hearing Subscale.","authors":"Gregory M Ellis, Rebecca Bieber, Alyssa Davidson, LaGuinn Sherlock, Michele Spencer, Douglas Brungart","doi":"10.1097/AUD.0000000000001633","DOIUrl":"https://doi.org/10.1097/AUD.0000000000001633","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;The objective of this project was to quantify the relative efficacy of a four-frequency pure-tone average in the better ear (PTA4), the Hearing subscale of the Tinnitus and Hearing Survey (THS-H), and a combination of the two in predicting speech-in-noise performance, hearing aid recommendation, and hearing aid use among United States service members (SMs).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design: &lt;/strong&gt;A two-analysis retrospective study was performed. The first analysis examined the degree to which better-ear PTA4 alone, THS-H alone, and better-ear PTA4 in conjunction with THS-H predicted performance on a speech-in-noise test, the modified rhyme test. Three binomial mixed-effects models were fitted using better-ear PTA4 alone, THS-H alone, and both measures as primary predictors of interest. Age and sex were included as covariates in all models. The models were compared to one another using Chi-square goodness-of-fit tests and the best-fitting model was examined. Data from 5988 SMs were analyzed in the first analysis. The second analysis examined the degree to which better-ear PTA4 alone, THS-H alone, and better-ear PTA4 in conjunction with THS-H predicted two hearing aid-related outcomes: recommendation for hearing aids by a clinician and hearing aid use. Three receiver operating characteristic curves were fit for each question for better-ear PTA4 alone, THS-H alone, and better-ear PTA4 + THS-H. The area under the curve was bootstrapped to generate confidence intervals to compare the three measures. Data from 8001 SMs were analyzed in the second analysis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;In the first analysis, all three models explained more variance than chance; however, the better-ear PTA4 + THS-H model was a significantly better fit than either the better-ear PTA4 alone or the THS-H alone models. Significant main effects of better-ear PTA4 and THS-H indicated that proportion correct decreased as better-ear PTA4 and THS-H increased. A significant interaction was observed such that proportion correct decreased more rapidly if both better-ear PTA4 and THS-H were increasing in tandem. In the second analysis, better-ear PTA4 + THS-H showed good predictive discrimination of a prior hearing aid recommendation. For predicting hearing aid use, better-ear PTA4 was the only predictor with an area under the curve bootstrapped confidence interval that overlapped 0.50, indicating better-ear PTA4 alone is a chance predictor for hearing aid use. Both THS-H alone and better-ear PTA4 + THS-H predicted hearing aid use better than chance, but had poor discrimination overall.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Adding the THS-H to the better-ear PTA4 improves predictions of speech intelligibility in noise, has good predictive strength for hearing aid recommendations, and predicts hearing aid use better than chance. This study provides evidence for using surveys in conjunction with objective data when evaluating hearing ability and recommending int","PeriodicalId":55172,"journal":{"name":"Ear and Hearing","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143069877","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":"Machine-Learning Predictions of Cochlear Implant Functional Outcomes: A Systematic Review.","authors":"Jonathan T Mo, Davis S Chong, Cynthia Sun, Nikita Mohapatra, Nicole T Jiam","doi":"10.1097/AUD.0000000000001638","DOIUrl":"https://doi.org/10.1097/AUD.0000000000001638","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;Cochlear implant (CI) user functional outcomes are challenging to predict because of the variability in individual anatomy, neural health, CI device characteristics, and linguistic and listening experience. Machine learning (ML) techniques are uniquely poised for this predictive challenge because they can analyze nonlinear interactions using large amounts of multidimensional data. The objective of this article is to systematically review the literature regarding ML models that predict functional CI outcomes, defined as sound perception and production. We analyze the potential strengths and weaknesses of various ML models, identify important features for favorable outcomes, and suggest potential future directions of ML applications for CI-related clinical and research purposes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design: &lt;/strong&gt;We conducted a systematic literature search with Web of Science, Scopus, MEDLINE, EMBASE, CENTRAL, and CINAHL from the date of inception through September 2024. We included studies with ML models predicting a CI functional outcome, defined as those pertaining to sound perception and production, and excluded simulation studies and those involving patients without CIs. Using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we extracted participant population, CI characteristics, ML model, and performance data. Sixteen studies examining 5058 pediatric and adult CI users (range: 4 to 2489) were included from an initial 1442 publications.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Studies predicted heterogeneous outcome measures pertaining to sound production (5 studies), sound perception (12 studies), and language (2 studies). ML models use a variety of prediction features, including demographic, audiological, imaging, and subjective measures. Some studies highlighted predictors beyond traditional CI audiometric outcomes, such as anatomical and imaging characteristics (e.g., vestibulocochlear nerve area, brain regions unaffected by auditory deprivation), health system factors (e.g., wait time to referral), and patient-reported measures (e.g., dizziness and tinnitus questionnaires). Used ML models were tree-based, kernel-based, instance-based, probabilistic, or neural networks, with validation and test methods most commonly being k-fold cross-validation and train-test split. Various statistical measures were used to evaluate model performance, however, for studies reporting accuracy, the best-performing models for each study ranged from 71.0% to 98.83%.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;ML models demonstrate high predictive performance and illuminate factors that contribute to CI user functional outcomes. While many models showed favorable evaluation statistics, the majority were not adequately reported with regard to dataset characteristics, model creation, and validation. Furthermore, the extent of overfitting in these models is unclear and will likely result in poor generalization to new data.","PeriodicalId":55172,"journal":{"name":"Ear and Hearing","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143061483","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":"Evaluating a Hearing Loop Implementation for Live Orchestral Music.","authors":"Sean McWeeny, Laurel J Trainor, Steve Armstrong, Dan Bosnyak, Hany Tawfik, Ian C Bruce","doi":"10.1097/AUD.0000000000001626","DOIUrl":"https://doi.org/10.1097/AUD.0000000000001626","url":null,"abstract":"<p><strong>Objectives: </strong>Live music creates a sense of connectedness in older adults, which can help alleviate the social isolation frequently associated with hearing loss and aging. However, most hearing-aid (HA) users are dissatisfied with the sound quality of live music and rate sound quality as important to them. Assistive listening systems are frequently independent of a user's HAs and fall short in tailoring to each individual's hearing loss. The present study thus tested whether the use of a hearing loop would improve sound quality during an orchestral concert.</p><p><strong>Design: </strong>Participants with symmetrical moderate-to-severe hearing loss were assigned to use Sonova-provided HAs with a telecoil (n = 20) or their own HAs (n = 8) without a telecoil during a performance by the Hamilton Philharmonic Orchestra. We changed loop input to use one of three feeds every 5 minutes: a mix of microphones from the hall's standard assistive feed on the first balcony (house condition), a mix of microphones located on the stage (stage condition), or no input to the loop (no feed). After each 5-minute interval, we collected sound quality and naturalness ratings for the previous 5 minutes.</p><p><strong>Results: </strong>Sound quality and naturalness ratings were highly related (rRM = 0.81), though each provided unique insight. Repeated measures analysis of variance found significant differences among the loop feed conditions for sound quality and naturalness, with the no feed condition significantly outperforming the house condition on sound quality [t(18) = -3.73, adj. p = 0.005] and naturalness [t(18) = -4.15, adj. p = 0.002]. Mixed effects models allowed us to retain the richness of a repeated observation dataset and provided point estimates of the overall quality and naturalness among conditions; however, assumption violations of normality and homoskedasticity prevented further interpretation.</p><p><strong>Conclusions: </strong>Though HA-integrated assistive listening systems are a promising option for improving live music for people with hearing loss, a hearing loop does not seem to be crucial for orchestral music. Future directions include improving lyric understanding for music with vocals and customizing user experience via Bluetooth Low Energy Audio systems.</p>","PeriodicalId":55172,"journal":{"name":"Ear and Hearing","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048626","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}