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To describe clinico-demographical profile for post-lingual hearing loss in the adults undergoing cochlear implantation and their outcomes. A retrospective chart review was conducted including adult patients (> 18 years) with bilateral post-lingual severe to profound hearing loss who underwent cochlear implantation in a tertiary care hospital of north India. The clinico-demographical details were collected and the outcomes of the procedure were assessed in terms of speech intelligibility scores, usage and satisfaction scores. Twenty-one patients were included with a mean age of 38.6 years with 15 males and 6 females. The major cause of deafness was infections followed by ototoxicity. The complication rate was 4.8%. Preoperative SDS was not recordable in any of the patients. The mean postoperative SDS was 74%, with no issue of device malfunction in a mean follow-up of 44 months. Cochlear implantation is a safe surgery with good outcomes in post-lingually deafened adults with the major cause for deafness being infections. [ABSTRACT FROM AUTHOR]

Background: Evaluation of an individual's hearing involves administering a test battery, and these assessments collectively complement each other in defining the degree, type, and configuration of hearing loss. Among the acoustic stimuli used in such tests, speech signals are the most complex and possess significant redundancy. Therefore the use of conventional word lists during routine audiological evaluation may, through redundant information, lead to overestimation of the performance of individuals with high-frequency sloping hearing loss. The Gujarati language, with 56 million native speakers in India, currently has only a conventional speech identification test. The present study aimed at developing and standardizing high-frequency word lists in Gujarati. Material and methods: The study was conducted in three phases. Phase I: development of high-frequency word lists in Gujarati. Phase II: establishment of norms for the developed word lists on 180 normal hearing individuals belonging to different geographic regions of Gujarat. Phase III: Checking the applicability on 25 individuals with high-frequency sloping hearing loss and 25 individuals with flat frequency hearing loss. Results: A Shapiro--Wilks test revealed a normal distribution. One-way ANOVA revealed no significant difference between the scores obtained from the two high-frequency word lists. There was a significant difference in mean speech identification scores (SIS) for individuals with high-frequency sloping hearing loss in which use of conventional word lists gave a mean score of 77% while use of the high-frequency word lists gave a mean score of 53%. Conclusions: Two high-frequency word lists each of 25 words were developed. The word lists were found to be reliable, equally difficult, interchangeable, and effective in detecting communication difficulties due to high-frequency sloping hearing loss. [ABSTRACT FROM AUTHOR]

About 5% of the total population of world has hearing impairment and this is 6.3% in India. The hearing impairment in patients can be corrected by using a hearing aid or cochlear implant (CI) .Hearing aid is a traditional way while CI, which is surgically implanted, is a modern way to correct the hearing impairment. In comparison to hearing aids CI increases speech intelligibility at a greater level. Also speech intelligibility decreases in noise though acceptable in noise-free environments. With the advancement of technology over past decades, it shows increase in speech intelligibility with new emerging speech coding strategies. In this paper the basic speech processing strategies for speech coding and different techniques and algorithms, which aimed to increase the speech intelligibility, are being reviewed. Speech will be analyzed based on some measures like Analysis of Variation (ANOVA), Root Mean Square Error (RMSE) etc. The focus will be on speech perception and intelligibility enhancement. [ABSTRACT FROM AUTHOR]

Backround: Rehabilitation centres for cochlear implant (CI) recipients act as gateways for increasing auditory perception and developing speech and language. In the case of children, such centres must strive not only to get the best outcomes in terms of hearing and speech, but they must also provide satisfaction to both CI recipients and their parents. To gauge the quality of service, we have divided the range of services offered into four areas and have assessed the specific and overall satisfaction levels of parents of CI children towards these services. Material and methods: This was a prospective, randomized, cross-sectional study based on a questionnaire provided to CI users of rehabilitation centers in Tamil Nadu, India. The parents of 100 CI recipients younger than 6 years were asked to fill in a questionnaire using a 5-point rating scale. The education level of the care-taker and the time spent with the child at home were also ascertained, and these factors were correlated with CI performance outcomes (categories of auditory performance, CAP, and speech intelligibility rating, SIR). Results: The overall satisfaction level of the parents was reasonably high (mean=3.9, SD=0.44). There was a positive correlation of satisfaction score with rehabilitation outcomes (r=0.80 for CAP; 0.29 for SIR). The level of education of the parents had no correlation with the outcome either for CAP (r=0.15) or SIR (r=0.07). Time spent by the parents with the CI recipient at home gave r-values of 0.31 for CAP and 0.39 for SIR. Conclusions: The general level of satisfaction of parents towards the services provided by the rehabilitation centres was good. In terms of best CI outcome, the time spent by the parents with their child was more important than the parents' education level. [ABSTRACT FROM AUTHOR]

Compression introduces distortion in hearing aid processed speech, when compared with linear amplification. Static parameters of compression namely compression ratio, compression threshold, attack time (AT), release time (RT) as well as the number of compression channels of a hearing aid may be the potential sources of compression induced distortion. The role of hearing aid compression parameters on speech perception and sound quality of hearing aids has been investigated in several studies. In some studies, it has been reported that, long ATs/ RTs leads to improvement in intelligibility of speech sounds. However, further research is required to find out the factors responsible for this. The present study therefore, investigated the influence of slow and fast compression time constants on transformation of voice onset time (VOT) in hearing aid processed speech. The objectives of the study were (1) to measure the Attack Time and Release Time of four behind the ear Digital Hearing Aids programmed in fast and slow AT/RT settings and (2) to investigate the effect of slow and fast AT/RT on VOT transformation. Six plosives in CV syllables categorized as:--unvoiced--velar /k/, dental /t/, and bilabial /p/, voiced - velar /g/, dental/d/ and bilabial /b/ produced by an adult (native Kannada) male speaker at a comfortable loudness level were recorded and used as stimulus for the study. AT and RT values of all four hearing aids in slow and fast compression setting were evaluated as per the test procedure specified by American National Standards Institute (ANSI) S3.22 standard. VOT values were measured for the input stimuli and the digitized hearing aid processed speech samples by using speech analysis software and the transformation in VOT was estimated. Results showed a reduction in VOT for voiced and unvoiced plosives at fast compression time constant setting. However, no changes in VOT was noticed at slow AT/RT setting, for unvoiced plosives, but significant difference was observed for voiced plosives. [ABSTRACT FROM AUTHOR]

Various factors such as listeners' familiarity & experience with disordered speech, listener's comprehension, ability to predict and the cues provided by the context are considered to be crucial in the assessment of speech intelligibility in persons with dysarthria. This study addressed the issue of listening competency in normal hearing listeners and its effects on predictability of target words embedded in sentences in naturally degraded speech samples of persons with dysarthria & artificially degraded sample (where distortion was added to the speech of a model speaker). In Experiment 1, thirty normal hearing adults rated the 38 High predictable (HP) and 38 Low predictable (LP) sentences in non degraded and artificially degraded conditions of stimuli produced by a 'model speaker'. In Experiment 2, normal hearing adults rated the intelligibility of the naturally degraded speech samples of 3 persons with dysarthria. Experiment 1 revealed that the mean scores of HP sentences were better & statistically significant compared to LP sentences and the overall combined mean scores of non degraded and artificially degraded stimuli of HP sentences were better compared to the LP sentences. Experiment 2 revealed that the mean scores of HP and LP sentences produced by persons with dysarthria was significantly different. The scores in the HP context of the 'model speaker' (degraded condition) was similar to HP score of the first and third sample of the persons with dysarthria. The LP sentence of the 'model speaker' was similar to the LP score of the third sample of the person with dysarthria. The listening competence amongst the listeners varied across degraded and non degraded HP and LP sentence contexts and the degraded LP sentences were sensitive in evaluating the listening competence of normal listeners' as it was devoid of all the contextual cues for the assessment of speech intelligibility, rendering the task difficult, thus having good potential in tapping the listeners competence. [ABSTRACT FROM AUTHOR]

The paper presents the evaluation of classrooms for young children in India, to assess their acoustical environments. The schools under consideration are located in an educationally advanced locality in India - a district in the southern part of India, namely Kanyakumari. Situated in a tropical climate, the classrooms have open windows and doors with the possibility of noise intrusion from outside. Schools are located in different regions to suit the conditions of education administrators and other factors, and not necessarily the best location for a learning environment. In this study, depending on the location of the schools and their external surroundings, the schools are classified into three categories: a) schools located near roads with heavy traffic (Noisy-sites), b) schools located within Housing sites, c) schools located in zones far from public roads and away from residences (Quiet sites). External and internal noise surveys have been conducted to evaluate the background noise within the classrooms. About 120 classrooms in 25 schools were selected for the study of the acoustic quality within the classrooms, based on measurements. The external noise has a very great influence on the background noise in empty classrooms with open windows. It may not be practicable for schools in tropical climates, where rooms with open windows and doors are realities, to conform to the guidelines of standards such as ANSI S12.60 or BB 93. [ABSTRACT FROM AUTHOR]

The results presented here are based on field measurements carried out in six Catholic churches (Goa, India). Rapid Speech Transmission Index (RASTI) and Subjective Speech Intelligibility (SSI) measurements were made in four different seating zones of a church for three speech source locations (altar, pulpit, high altar), two languages (English, Konkani) and two postures (standing, sitting). The effects of language and postures were not significant. The altar location and the sanctuary of the church were preferable for speech intelligibility. Although the altar location showed better averages than the other speech source locations, the best predictive relationship between RASTI and SSI was the exponential growth of RASTI for the high altar source location with SSI for the English language. [ABSTRACT FROM AUTHOR]

Purpose: In this work, we have determined the long-term average speech spectra (LTASS) and dynamic ranges (DR) of 17 Indian languages. This work is important because LTASS and DR are language-dependent functions used to fit hearing aids, calculate the Speech Intelligibility Index, and recognize speech automatically. Currently, LTASS and DR functions for English are used to fit hearing aids in India. Our work may help improve the performance of hearing aids in the Indian context., Method: Speech samples from native talkers were used as stimuli in this study. Each speech sample was initially cleaned for extraneous sounds and excessively long pauses. Next, LTASS and DR functions for each language were calculated for different frequency bands. Similar analysis was also performed for English for reference purposes. Two-way analysis of variance was also conducted to understand the effects of important parameters on LTASS and DR. Finally, a one-sample t test was conducted to assess the significance of important statistical attributes of our data., Results: We showed that LTASS and DR for Indian languages are 5-10 dB and 11 dB less than those for English. These differences may be due to lesser use rate of high-frequency dominant phonemes and preponderance of vowel-ending words in Indian languages. We also showed that LTASS and DR do not differ significantly across Indian languages. Hence, we propose a common LTASS and DR for Indian languages., Conclusions: We showed that differences in LTASS and DR for Indian languages vis-à-vis English are large and significant. Such differences may be attributed to phonetic and linguistic characteristics of Indian languages.

Objectives: To assess the quality of life (QoL) of prelingually deaf paediatric population after Cochlear implantation (CI), using a bilingual questionnaire and to correlate with rehabilitation scores; to validate the questionnaire and recommend its use in future studies. Methods: This was a questionnaire based cross-sectional study. Parents of 151 paediatric prelingual CI recipients filled the questionnaire using a 5-point rating scale, with a score of 1-5. These scores were correlated with the CAP and SIR scores. Results and discussion: There was a positive correlation of QoL score with rehabilitation outcomes ( r  = 0.4638 and P  ≤ 0.00001 for CAP; r  = 0.3563 and P  ≤ 0.00001 for SIR scores). The maximum scores (≥4.0) were given by parents for integration into educational system (4.86), response to environmental sounds (4.12) and overall parental satisfaction about child's performance (4.09). Minimum scores were given for ability to speak in sentences (2.9) and response to verbal sounds at a distance (3.23). Conclusion: The QoL of these children as assessed by the institutional questionnaire have correlated with the rehabilitation outcomes. These QoL results have a positive impact in counselling for early CI as well as for rehabilitation.

Introduction: Cochlear implantation is a safe surgery for restoration of hearing in profoundly deaf children. Following cochlear implantation, children undergo rehabilitation (or 'habilitation' for those without previous hearing). The device is programmed after the surgery, so that the user can hear sounds through it and through rehabilitation training, the heard sounds are made to understand., Objective: Our study was aimed at analysing the role of satellite habilitation centres following cochlear implantation by analysing the outcomes following habilitation and comparing it with the outcomes of the main centre and correlating it with the percentage of attendance of classes. Our study also aims to compare the attendance of implant patients from outside the geographical area of the main centre before and after starting the satellite centre., Materials and Methods: 1004 profoundly deaf children (6 years and below) who had undergone cochlear implantation and completed 12months of habilitation in our institution from July 2013 to December 2019 were retrospectively analysed. The outcomes of all the centres were assessed by comparing the baseline CAP with CAP scores at 12 months and baseline SIR with SIR scores at 12 months. The outcomes of the main centre and satellite centres were also compared. The outcomes were correlated with percentage of attendance of classes., Observation: The overall attendance in all the centres was between 75 and 80%. Both main and satellite centres showed statistically significant good outcomes and this correlates with percentage of attendance., Conclusion: Satellite centres for habilitation across the state has greatly helped to improve the attendance of these patients and outcomes. Reduced drop-out rates and improved speech language outcomes can be achieved by starting satellite centres for habilitation post cochlear implantation in developing countries like India., (Copyright © 2020. Published by Elsevier B.V.)

Introduction: Paediatric Auditory Brainstem Implantation (ABI) is indicated for children with congenital cochlear aplasia, absent/hypoplastic vestibulocochlear nerve, for whom cochlear implantation is not possible. Knowledge of the anatomical landmarks and variants in anatomy of the brainstem is vital for ABI surgery., Method: Study was done at Auditory implant centre in Madras ENT research foundation, which includes 24 children who had undergone ABI surgery and are being followed up for 1 year, post operatively. Aims were to study the anatomical variants and the outcomes of ABI implantation. To determine if different anatomical variants effect placement of ABI electrode. To assess the patient outcomes by Categories of auditory Performance (CAP) scores and Speech Intelligibility Ratings (SIR) scores., Results: All the candidates showed gradual improvement in audiological and verbal outcomes after the ABI. The mean CAP and SIR scores after 6 months of AVHT were 2.07 and 1.37 respectively. After 1 year of auditory verbal rehabilitation therapy CAP was 3.42 and SIR was 2.33. Flocculus of the cerebellum can be of different grades. Though, there was difficulty in insertion of the electrode in subjects with anatomical variants, the outcomes were comparable with other subjects., Conclusion: ABI surgery involves frequent anatomical variations surrounding the lateral recess which makes the positioning of the auditory prosthesis difficult. Variants during the surgery can make the placement of ABI electrodes difficult, but promising results were seen all the implantees., (Copyright © 2018 Elsevier Masson SAS. All rights reserved.)

Purpose: This study investigated the relative outcomes of segmental and prosodic training of nonnative speakers of American English., Method: The study used a single-subject, alternating treatments, multiple baseline design with replication across participants and counterbalanced for order effect. Participants were 4 adult male native Hindi speakers proficient in English. Two participants received ABABCACA (A = baseline/withdrawal, B = segmental training, C = prosody training), and 2 participants received ACACBABA, with a minimum of 5 sessions per phase. Segmental accuracy and prosodic accuracy were probed at each session, as were perception of accentedness and ease of understanding., Results: Visual assessment of data and effect size calculation demonstrated that segmental and prosody training resulted in increased accuracy of pronunciation and prosody patterns, respectively, and those improvements appeared to be maintained over the short term. Listeners perceived lesser accent and easier understanding as a result of the combination of segmental and prosody training. The findings are uncertain with respect to the relative contribution of segmental and prosody training, and they may be speaker dependent, but the data do suggest that both components are important., Conclusion: Accent management, consisting of both segmental and prosody training, yielded positive outcomes. Further research with native language speakers of other languages is important to verify and expand on these findings.

Objective: Early palate repair is recommended to minimize the development of disordered speech. We studied the speech outcome of late palate repair in 131 patients. The success of late palate repair is questioned because of the persistence of learned, compensatory misarticulations that are difficult to correct in spite of the establishment of correct palatal anatomy and a competent velopharyngeal mechanism. The objective of this study is to highlight the speech results following late primary repair of the palate., Settings and Design: Retrospective analysis of speech outcomes in 131 patients with cleft lip and palate who underwent primary palate repair after the age of 10 years between November 2000 and December 2004. None of the patients had received supervised institution-based speech therapy. However, all patients were counseled and oriented and demonstrated the correct place and manner of articulation for the phonemes misarticulated by them. Preoperative and 6- to 12-month postoperative speech samples were assessed within the parameters of articulation, hypernasality, nasal air emission, and speech intelligibility., Outcome: The analysis indicated improvement in all speech parameters leading to an overall improvement in postoperative intelligibility for most patients., Conclusion: Although definite improvement occurs in all parameters of speech following late primary palate repair, residual speech problems persist in most patients, requiring further evaluation and appropriate treatment.

This prospective study analyzes the feasibility, oncologic safety and functional utility of Pearson's near-total laryngectomy with tracheopharyngeal shunt (NTL-TPSS). The procedure was found to give gratifying locoregional control in 30 consecutive advanced T3 and selected T4 tumors involving the larynx (n = 11) and hypopharynx (n = 19) and managed at Kidwai Memorial Institute of Oncology, Bangalore, India. The oncologic "safety" of this technique was established in following examinations, ranging from 18 to 44 months (median, 22.2 months). A locoregional control rate of 74% was obtained. Lung-powered "shunt" speech was acquired with ease in periods ranging from 7 days in speakers deemed "excellent" (15/29) to 20 days in those deemed "satisfactory" (8/29). Except for a single case experiencing temporary aspiration of liquids, patients did not have any swallowing difficulties following removal of nasogastric tubes. The period of hospitalization averaged 22.6 days. The complication rate was 33%, with one patient death (3.3%) occurring. The dynamics of the TPSS were analyzed in selected "speakers" and "non-speakers", using transcutaneous needle electromyography. Analysis of data supports the possibility of dynamic speech modulation. However, the favored anatomic location and design renders the shunts aspiration-proof rather than demonstrating any active sphincteric action.