Search

The objective of this study was to investigate perception of affective prosody in a group of children diagnosed as having auditory processing disorders (APDs) and compare their performance with tho...

Multi component tympanometry is not widely used in clinics due lack of evidence supporting its usefulness. The present study was undertaken to investigate the efficacy of multicomponent tympanometry for 1000 Hz probe tone in detecting middle ear pathology. Data were collected from 20 ears of 10 participants with no history of middle ear pathology (Group I) and 39 ears of 26 participants (Group II) with history of middle ear infection or ear-pain or blocking sensation. Single component tympanometry for 226 Hz probe tone and Susceptancec and Conductance tympanograms for 1000 Hz probe tone was carried out on all the participants. Results revealed normal tympanogram for both the probe tones for all the participants of Group I. It was observed that 53.84% of the ears could be identified as having middle ear pathology using 226 Hz probe tone whereas the percentage of correct identification increased to 94.87% when 1000 Hz probe tone was used. They are in accordance with the concept that subtle changes in the middle ear which cannot be detected by 226 Hz tympanogram can be identified using 1000 Hz multicomponent tympanogram. These findings highlight the efficiency of 1000 Hz probe tone in detecting mass dominant middle ear pathology.

Background: High frequency (1000 Hz) probe tone holds substantial promise for carrying out acoustic reflexes in neonates and infants. A limited number of studies indicates that acoustic reflex thresholds (ART) also change significantly with age as the newborn hearing system matures. However, there is a need for obtaining more data before using it in a clinical population. The aim was to investigate effect of age of infants on ARTs. Effect of activator signal was also explored. Methods: ARTs were monitored using a 1 kHz probe tone for the 500 Hz, 1 kHz, 2 kHz, and 4 kHz pure tone activators in neonates and infants in the age range of 6 to 8 weeks were analysed.Results: The mean ARTs for neonates were lower compared to infants. Results of repeated measure ANOVA showed that there was a statistically significant age effect. Also, ARTs for high frequency activator signals were significantly higher than the ARTs for low frequency signals.Conclusions: The acoustic reflexes can be elicited for 500, 1000, 2000, and 4000 Hz when monitored using a 1000 Hz probe tone. There is an effect of age and activator signal on the acoustic reflex threshold. The data obtained in the present study can serve as normative for 0-1-week neonates and 6-8-weeks infants.

Introduction: A review of literature on usefulness of Cortical Auditory Evoked Potentials (CAEPS) in verifying the usefulness of hearing aid shows equivocal results and a majority of the studies are carried out in a research laboratory. Objective: The aim of the present investigation was to investigate the usefulness of recording CAEPs for verification of hearing aids in a clinical set up. Material And Methods: CAEPs to stimulus /ma/, /ga/ and /ta/ were recorded from 14 persons with normal hearing and nine persons with mild to moderately severe sensorineural hearing loss. For persons with hearing impairment, the testing was carried out without a hearing aid (unaided) and with a hearing aid (aided) programmed based on NAL NL 1 prescriptive formula. Results: The results revealed that in aided condition, the detectability of CAEP responses was more when compared to unaided condition in persons with hearing impairment. There was a significant difference between the unaided CAEP responses of persons with hearing impair - ment and CAEP responses of persons with normal hearing. However, no such difference was observed between aided CAEPS responses of persons with hearing impairment and those of normal hearing. Conclusions: CAEPs can be reliably recorded in a clinical set up from individuals using hear- ing aids. The detectability of responses increases when a person is wearing hearing aid. CAEPs will be helpful in verification of hearing aids especially in persons with moderately severe to severe hearing loss.

Objective: This study evaluated the cost and outcome of a community-based hearing screening programme in which village health workers (VHWs) screened children in their homes using a two-step DPOAE screening protocol. Children referred in a second screening underwent tele diagnostic ABR testing in a mobile tele-van using satellite connectivity or at local centre using broadband internet at the rural location. Design: Economic analysis was carried out to estimate cost incurred and outcome achieved for hearing screening, follow-up diagnostic assessment and identification of hearing loss. Two-way sensitivity analysis determined the most beneficial cost-outcome. Study sample: 1335 children under 5 years of age underwent screening by VHWs. Results: Nineteen of the 22 children referred completed the tele diagnostic evaluation. Five children were identified with hearing loss. The cost-outcomes were better when using broadband internet for tele-diagnostics. The use of least expensive human resources and equipment yielded the lowest cost per child screened (Rs.1526; $23; €21). When follow-up expenses were thus maximised, the cost per child was reduced considerably for diagnostic hearing assessment (Rs.102,065; $1532; €1368) and for the cost per child identified (Rs.388,237; $5826; €5204). Conclusion: Settings with constrained resources can benefit from a community-based programme integrated with tele diagnostics.

BackgroundDizziness is known to affect the quality of life, irrespective of its underlying pathology. The Dizziness Handicap Inventory (DHI) is a commonly used questionnaire to assess self-perceived handicap among individuals with dizziness. However, the International Classification of Functioning, Disability and Health (ICF), emphasises the assessment of activity limitations and participation restrictions. A recently developed questionnaire, the Vestibular Activities and Participation (VAP), is based on the ICF model and has been found to be a valid and reliable tool. The present study was undertaken to explore which items of DHI relate to vestibular activity limitations and participation restrictions by investigating the correlations between items of DHI and VAP.Material and MethodsThis was a prospective study involving 56 individuals whose primary complaint was dizziness due to vestibular pathology. All had undergone detailed audio-vestibular tests prior to administration of a Marathi translation of the DHI and VAP questionnaires.Results12 of the 25 questions on the DHI showed strong and moderate correlations with the total VAP score (r=0.48–0.68, p0.05). The results indicate that less than half the 25 questions covering the physical, functional, or emotional domains of DHI reflect activity limitations or participation restriction in day-to-day life.ConclusionsThe results indicate that responses to only some of the items of DHI are important when studying activity limitations and participation restrictions of people with dizziness. These particular items may be a better indicator of the effect of dizziness on the quality of life, and hence could be most relevant when reporting post-therapeutic improvement in quality of life.

OBJECTIVE: To investigate the effect of background noise on perception of unprocessed and envelope-enhanced speech in individuals with auditory neuropathy (AN). DESIGN: Open-set speech identification abilities were assessed for unprocessed and envelope-enhanced speech in quiet and at three signal to noise ratios (10, 5, and 0 dB signal to noise ratio) in 15 individuals with AN. RESULTS: Results revealed that speech identification ability was affected more in the presence of noise than in quiet. The participants were classified into two groups, Good Performers and Poor Performers, based on their speech identification scores in quiet. It was observed that the reduction in mean speech identification scores in noise was less for Good Performers when compared with that of Poor Performers. Envelope enhancement of the signal improved speech identification scores in both the groups. The analysis of results also showed that Good Performers showed a significant improvement in all the conditions, whereas Poor Performers showed improvement only in quiet and +10 dB signal to noise ratio. CONCLUSIONS: For individuals with AN, listening in background noise is more difficult than in quiet condition. Envelope enhancement of speech signal improves speech identification scores in quiet and in background noise for individuals with AN. However, the benefit obtained varies depending on the speech identification ability in quiet.

Individuals with auditory neuropathy (AN) often suffer from temporal processing deficits causing speech perception difficulties. In the present study an envelope enhancement scheme that incorporated envelope expansion was used to reduce the effects of temporal deficits. The study involved two experiments. In the first experiment, to simulate the effects of reduced temporal resolution, temporally smeared speech stimuli were presented to listeners with normal hearing. The results revealed that temporal smearing of the speech signal reduced identification scores. With the envelope enhancement of the speech signal prior to being temporally smeared, identification scores improved significantly compared to temporally smeared condition. The second experiment assessed speech perception in twelve individuals with AN, using unprocessed and envelope-enhanced speech signals. The results revealed improvement in speech identification scores for the majority of individuals with AN when the envelope of the speech signal was enhanced. However, envelope enhancement was not able to improve speech identification scores for individuals with AN who had very poor unprocessed speech scores. Overall, the results of the present study suggest that applying envelope enhancement strategies in hearing aids might provide some benefits to many individuals with AN.

Background. The aim of this study was to investigate the individual effects of envelope enhancement and high-pass filtering (500 Hz) on word identification scores in quiet for individuals with Auditory Neuropathy. Method. Twelve individuals with Auditory Neuropathy (six males and six females) with ages ranging from 12 to 40 years participated in the study. Word identification was assessed using bi-syllabic words in each of three speech processing conditions: unprocessed, envelope-enhanced, and high-pass filtered. All signal processing was carried out using MATLAB-7. Results. Word identification scores showed a mean improvement of 18% with envelope enhanced versus unprocessed speech. No significant improvement was observed with high-pass filtered versus unprocessed speech. Conclusion. These results suggest that the compression/expansion signal processing strategy enhances speech identification scores—at least for mild and moderately impaired individuals with AN. In contrast, simple high-pass filtering (i.e., eliminating the low-frequency content of the signal) does not improve speech perception in quiet for individuals with Auditory Neuropathy.

Objectives To investigate the ability to identify consonant-vowel (CV) stimuli by individuals with auditory neuropathy (AN) when the envelope of the speech signal is enhanced by 15 dB for different modulation bandwidths (3 to 10 Hz; 3 to 20 Hz; 3 to 30 Hz; 3 to 60 Hz). Design Eight individuals with auditory neuropathy whose pure-tone thresholds ranged from 30 to 70 dB HL participated in the present study. Speech material consisted of five lists of CV, one unprocessed and four with envelope enhancement. The magnitude of envelope enhancement was 15 dB and the bandwidths used were 3 to 10 Hz, 3 to 20 Hz, 3 to 30 Hz, and 3 to 60 Hz. Results Speech identification scores improved when the envelope of the speech was enhanced. The improvement was greater for the broader bandwidth (3 to 30 Hz) conditions when compared with the smaller bandwidth (3 to 10 Hz and 3 to 20 Hz) conditions. In the unprocessed condition, manner of articulation was transmitted better than voicing and place of articulation. In the envelope-enhanced conditions, cues for manner and place of articulation were transmitted better than voicing. Conclusions Envelope enhancement using digital techniques improves speech perception by individuals with auditory neuropathy, and it may be a viable option for the rehabilitation of these individuals. However, the magnitude of envelope enhancement of speech required for maximal improvement of speech perception is yet to be determined.

Background Present study investigated the relationship between speech identification scores in quiet and parameters of cortical potentials (latency of P1, N1, and P2; and amplitude of N1/P2) in individuals with auditory neuropathy. Methods Ten individuals with auditory neuropathy (five males and five females) and ten individuals with normal hearing in the age range of 12 to 39 yr participated in the study. Speech identification ability was assessed for bi-syllabic words and cortical potentials were recorded for click stimuli. Results Results revealed that in individuals with auditory neuropathy, speech identification scores were significantly poorer than that of individuals with normal hearing. Individuals with auditory neuropathy were further classified into two groups, Good Performers and Poor Performers based on their speech identification scores. It was observed that the mean amplitude of N1/P2 of Poor Performers was significantly lower than that of Good Performers and those with normal hearing. There was no significant effect of group on the latency of the peaks. Speech identification scores showed a good correlation with the amplitude of cortical potentials (N1/P2 complex) but did not show a significant correlation with the latency of cortical potentials. Conclusion Results of the present study suggests that measuring the cortical potentials may offer a means for predicting perceptual skills in individuals with auditory neuropathy.

Objectives: To evaluate the effect of contralateral acoustic stimuli on speech identification scores and to correlate this effect to contralateral suppression of evoked otoacoustic emission. Design: Ten normal-hearing children with good academic performance participated in the study. Speech identification scores were measured in quiet and with different ipsilateral signal to noise ratios in two conditions, with and without contralateral acoustic stimuli. Transient evoked otoacoustic emissions were recorded for 70 dB SPL clicks with and without contralateral acoustic stimuli. Results: Findings revealed that contralateral acoustic stimuli enhanced speech perception when ipsilateral signal to noise ratios was +10 dB and +15 dB. This enhancement had significant positive correlation with contralateral suppression of OAE. Conclusions: The results of the present study support the hypothesis that medial olivocochlear bundle might aid in speech perception in noise, thereby suggesting a possible role of cochlear efferent fibers in hearing. The psychoacoustic measures can be used to evaluate the efferent auditory pathways, where it is not possible to record otoacoustic emissions.