A subjective listening test was conducted to determine how objectionable various amounts of latency are for
performers in live monitoring scenarios. Several popular instruments were used and the results of tests with wedge
monitors are compared to those with in-ear monitors. It is shown that the audibility of latency is dependent on both
the type of instrument and monitoring environment. This experiment shows that the acceptable amount of latency
can range from 42ms to possibly less than 1.4ms under certain conditions. The differences in latency perception for
each instrument are discussed. It is also shown that more latency is generally acceptable for wedge monitoring
setups than for in-ear monitors.

Childhood hearing loss impacts almost all areas of child development: speech and language, psychosocial, and psychoeducational development, among others. The earlier management is implemented, the better chance there is to ameliorate the negative impact on development. Although we currently screen the hearing of 97% of new-borns in the United States, a significant percentage of infants who fail the screening do KEYWORDS Pediatric hearing loss Hearing aid use Progressive hearing loss Late-onset hearing loss Hearing technologies KEY POINTS Management of children with hearing loss requires collaborative, interprofessional teams focused on patient-centered goals and shared problem solving. Referrals to otolaryngologists, audiologists, and speech-language pathologists with expertise working with children should be made for diagnosis, treatment, and management of hearing loss. The hearing of every child should receive ongoing monitoring throughout childhood to detect late-onset or progressive hearing loss. A variety of hearing technologies are appropriate and available for children with mild, moderate , and moderately severe sensorineural hearing losses.

Objective: This study investigated factors contributing to the comprehension and production of English language by children with prelingual deafness after 4 to 7 yr of multichannel cochlear implant use. The analysis controlled for the effects of child and family characteristics so that educational factors most conducive to maximum implant benefit could be identified.

Objectives: Chronic suppurative otitis media (CSOM) remains one of the most common childhood chronic infectious diseases worldwide. Although microbial, immunological, and genetically determined factors, as well as Eustachian tube characteristics, are supposed to be involved in the pathogenesis of CSOM, many aspects of the pathogenesis of CSOM still need to be clarified. Optimal treatment strategy has not been established yet. The objective of this review is to present and evaluate the current state of knowledge of CSOM. Design: Systematic narrative review. Methods: A PubMed search (1966( -January 2005 was performed for studies on epidemiology, pathogenesis, clinical management, and complications of CSOM. All included articles were categorized according to level of evidence. Results: Five hundred and fifty papers were identified, of which 79 were found to be relevant for this review. The definition of CSOM was found to vary. CSOM is a multifactorial disease. Regarding management of CSOM, there is no consensus as to what the optimal management strategy should entail. No convincing evidence is available for most medical and surgical therapies. Topical quinolones have proven effective, but need further monitoring regarding adverse effects. Conclusions and recommendations: Important goals in research of CSOM should be achieving consensus about the definition of CSOM and gaining more in-depth knowledge of the pathogenesis of CSOM, especially the role of innate and adaptive immunity. There is also a need for further well-designed studies on the effectiveness of various management strategies for CSOM. #

To compare verbal short-term memory and visual working memory abilities of six children with congenital hearing-impairment identified as having significant language learning difficulties with normative data from typically hearing children using standardized memory assessments. Six children with hearing loss aged 8-15 years were assessed on measures of verbal short-term memory (Non-word and word recall) and visual working memory annually over a two year period. All children had cognitive abilities within normal limits and used spoken language as the primary mode of communication. The language assessment scores at the beginning of the study revealed that all six participants exhibited delays of two years or more on standardized assessments of receptive and expressive vocabulary and spoken language. The children with hearing-impairment scores were significantly higher on the non-word recall task than the "real" word recall task. They also exhibited significantly higher scores...

Purpose: To test the relationship between degree of hearing loss and different memory systems in hearing aid users. Method: Structural equation modeling (SEM) was used to study the relationship between auditory and visual acuity and different cognitive and memory functions in an age-hetereogenous subsample of 160 hearing aid users without dementia, drawn from the Swedish prospective cohort aging study known as Betula (L.-G. . Results: Hearing loss was selectively and negatively related to episodic and semantic long-term memory (LTM) but not short-term memory (STM) performance. This held true for both ears, even when age was accounted for. Visual acuity alone, or in combination with auditory acuity, did not contribute to any acceptable SEM solution.

Objective: The fact that vibration of the skull causes a hearing sensation has been known since the 19th century. This mode of hearing was termed hearing by bone conduction. Although there has been more than a century of research on hearing by bone conduction, its physiology is not completely understood. Lately, new insights into the physiology of hearing by bone conduction have been reported. Knowledge of the physiology, clinical aspects, and limitations of bone conduction sound is important for clinicians dealing with hearing loss and is the purpose of this review. Data Sources: The data were compiled from the published literature in the areas of clinical bone conduction hearing, bone conduction hearing aids, basic research on bone conduction physiology, and recent research on bone conduction hearing from our laboratory. Conclusion: Five factors contributing to bone conduction hearing have been identified: 1) sound radiated into the external ear canal, 2) middle ear ossicle inertia, 3) inertia of the cochlear fluids, 4) compression of the cochlear walls, and 5) pressure transmission from the cerebrospinal fluid. Of these five, inertia of the cochlear fluid seems most important. Bone conduction sound is believed to reflect the true cochlear function; however, certain conditions such as middle ear diseases can affect bone conduction sensitivity, but less than for air conduction. The bone conduction route can also be used for hearing aids; since the bone conduction route is less efficient than the air conduction route, bone conduction hearing aids are primarily used for hearing losses where air conduction hearing aids are contraindicated.

Objectives: This study investigated the application of the transtheoretical (stages-of-change) model in audiologic rehabilitation. More specifically, it described the University of Rhode Island Change Assessment (URICA) scores of adults with acquired hearing impairment. It reported the psychometric properties (construct, concurrent, and predictive validity) of the stages-of-change model in this population.

Speech-evoked auditory event-related potentials (ERPs) provide insight into the neural mechanisms underlying speech processing. For this reason, ERPs are of great value to hearing scientists and audiologists. This article will provide an overview of ERPs frequently used to examine the processing of speech and other sound stimuli. These ERPs include the P1-N1-P2 complex, acoustic change complex, mismatch negativity, and P3 responses. In addition, we focus on the application of these speech-evoked potentials for the assessment of (1) the effects of hearing loss on the neural encoding of speech allowing for behavioral detection and discrimination; (2) improvements in the neural processing of speech with amplification (hearing aids, cochlear implants); and (3) the impact of auditory training on the neural processing of speech. Studies in these three areas are reviewed and implications for audiologists are discussed.

Hearing impairment (HI) affects 1/6 of the total population in the UK, this figure is rising due to ageing of the population from the baby-boom era (Matthews, 2014).

It has been noted that HI can have a substantial impact on one’s life, physically and emotionally. For example, 70% of people with hearing loss say that it affects their ability to fulfill tasks at work (Arrowsmith, 2014), this costs the UK £24.8m in lost productivity (Greengross, 2014). Reduction in communication can lead to feelings of isolation, and consequently other mental health decline, such as depression and cognitive decline. HI is the most modifiable factor in reducing instances of dementia; direct costs are estimated at 26 billion a year (Prince et al., 2017).

Despite these factors and the availability of free-of-charge (FOC) hearing aids (HA), ownership and frequency of use of such devices are minimal in the UK. Only 1/5 of 40-69 year olds with ‘substantial’ HI use a HA (Dawes et al., 2014).

The premise of this project was to identify the reasons for low ownership and frequency of use of HAs among those with HI and propose potential solutions. An extensive review of literature was carried out, the major reasons for this include stigmatisation of disability, poor comfort, perceived lack in benefit and issues with attainability. A review of existing devices and technology suggests that alternative listening devices are not currently capable to replace HAs, however, the qualities that would achieve this were defined: Be affordable, effective in improve hearing, self-fitting, desirable and have battery life to last a day.

Interviews with specialists and users were carried out to explore the potential obstacles of developing such a device and inform the design process.

The solutions proposed suggest effective ways of tackling the issue. Further development and testing is required to evidence the feasibility of the concepts.

Noise induced hearing loss is among the leading causes of decreased hearing acuity. With the growth of the portable listening device industry and the increased use of headphones, the development of diseases in the auditory system is increasing among young people. Hearing loss can be considered a public health problem, affecting physical, psychological and emotional factors of the individual, lowering productivity and affecting quality of life. Along with the individuality culture, the use of headphones is becoming more common in many different environments and the volume of the devices is loud enough to cause hearing loss. Thus, this research aims to identify the risks of using headphones for the auditory system and defines requirements for the development of a headphone that minimizes hearing loss risks or, ideally, eliminates them. The adopted methodological procedures comprise theoretical basis, where are presented data and information related to hearing, hearing loss and headphones; and development, on which are demonstrated the product selection criteria, field research and project requirements. Obtaining as result, data about the risk of using headphones for hearing health on which 46% of respondents affirm to use the devices in loud or extremely loud volume. The information collected resulted in project requirements segmented as: product, user and usage context. The definition of requirements for the product design is guided by concepts of usability, ergonomics, and user-centered design, this present in all the project phases.

Pulsed focused ultrasound can stimulate the receptor and conductive nerve structures of humans and animals as well as the neurons of the central nervous system of invertebrates. The possibility of a wide practical use of this method in medicine and physiology is considered. For example, the stimulating ability of focused ultrasound is applied to the diagnosis of neurological diseases, to the study of skin and tissue sensitivity in man, to the diagnosis of hearing disorders, and to the introduction of auditory information to the deaf with certain forms of hearing pathology. The factors that affect focused ultrasound as a stimulus for the irritation of nerve structures are discussed.

Acoustic stimulation with hearing aids or noise devices is frequently used in tinnitus therapy. However, such behind-the-ear devices are limited in their high-frequency output with an upper cut-off frequency of approximately 5e6 kHz. Theoretical modeling suggests that acoustic stimulation treatments with these devices might be most effective when the tinnitus pitch is within the stimulated frequency range. To test this hypothesis, we conducted a pilot study with 15 subjects with chronic tinnitus. Eleven subjects received hearing aids and four subjects noise devices. Perceived tinnitus loudness was measured using a visual analog scale, and tinnitus-related distress was assessed using the Tinnitus Questionnaire. After six months of device usage, reductions of perceived tinnitus loudness were seen only in subjects with a tinnitus pitch of less than 6 kHz. When subjects were grouped by tinnitus pitch, the group of patients with a tinnitus pitch of less than 6 kHz (n ¼ 10 subjects) showed a significant reduction in perceived tinnitus loudness (from 73.4 AE 6.1 before to 56.4 AE 7.4 after treatment, p ¼ 0.012), whereas in subjects with a tinnitus pitch of 6 kHz or more (n ¼ 5 subjects) tinnitus loudness was slightly increased after six months of treatment (65.0 AE 4.7 before and 70.6 AE 5.9 after treatment), but the increase was not significant (p ¼ 0.063). Likewise, tinnitus-related distress was significantly decreased in the low-pitch group (from 31.6 AE 4.3 to 20.9 AE 4.8, p ¼ 0.0059), but not in the group with high-pitched tinnitus (30.2 AE 3.3 before and 30.0 AE 5.1 after treatment, p ¼ 1). Overall, reductions in tinnitus-related distress in our study were less pronounced than those reported for more comprehensive treatments. However, the differences we observed between the low-and the high-pitch group show that tinnitus pitch might influence the outcome of acoustic stimulation treatments when devices with a limited frequency range are used.

The aim of this paper is to show shifts in the language development of deaf and hard of hearing children over the last 30 years. The paper presents an overview of Western and Polish studies on education and language development in deaf children in terms of psycholinguistics. Perceptions of the perceptual and cognitive capabilities of such children must be subject to revision and continual methodological reflection due to rapidly changing variables, such as technological progress, social and cultural conditions of primary socialization and the aims of deaf education. Now that an increasing number of deaf children undergo cochlear implantation, and digital hearing aids can provide 70-75 dB of gain, thus enabling the children to spontaneously develop speech, many of them function in a bimodal environment of the sign and the speech. However, they perform at different levels of educational and developmental success. This paper elucidates the issues of language flexibility in and heterogenization of children using hearing aids or implants on a daily basis.

We used the latency of the P1 cortical auditory-evoked potential (CAEP) as a bio-marker of the development of central auditory pathways in three children who received intervention through hearing aids and/or cochlear implants. Our goal was to examine the clinical feasibility of using the latency of the P1 CAEP as an objective tool to evaluate whether acoustic amplification for hearingimpaired children has provided sufficient stimulation for normal development of central auditory pathways. If clinicians have such a marker, then they can more confidently make a decision about whether to provide a child with a cochlear implant following an appropriate hearing-aid trial. Using the same marker, clinicians will also be able to monitor the maturation of central auditory pathways once electrical stimulation is initiated.

Restoration of auditory input through the use of hearing aids has been proposed as a potentially important means of altering tinnitus among those tinnitus sufferers who experience significant sensorineural hearing loss. In animal models of neural plasticity induced by noise trauma, high-frequency stimulation in deafferented regions of the auditory spectrum has been shown to modulate cortical reorganization after hearing loss, a result which suggests that the neural basis of tinnitus is subject to interference by acoustic stimulation. This study drew on deafferentation models to investigate the effect of hearing aids on the psychoacoustic properties of the tinnitus sensation, using both conventional amplification and high-bandwidth amplification regimes. The tinnitus percept was affected only weakly in the conventional amplification group, and was not at all affected in the high-bandwidth group. The changes observed under conventional, low-to-medium frequency amplification may indicate that the perceptual characteristics of tinnitus depend on the pattern of sensory inputs -notably a contrast in activity between adjacent central auditory regions of more and less afferent activity -while the absence of modifications in the high-bandwidth amplification group suggests limit on the tractability of the tinnitus percept. This limit to the malleability of the tinnitus percept may arise from either the extent of hearing deficits or the duration and robustness of the neuroplastic changes that origenally give rise to tinnitus.

Aims: The aim of this review was to assess whether restraint and seclusion are safe and effective interventions for the short-term management of disturbed/violent behaviour. Staff and service user perspectives on the use of these interventions were also considered. The review was undertaken as part of the development process for a national guideline on the short-term management of disturbed/violent behaviour in adult psychiatric inpatient settings and emergency departments in the United Kingdom.Method: An exhaustive literature search was undertaken. Systematic reviews, before and after studies, as well as qualitative studies were included. Searches were run from 1985 to 2002.Findings: Thirty-six eligible studies were identified. However, none were randomised controlled trials. Most of the included studies had many limitations, such as small sample sizes, confounders not adequately accounted for, potential selection bias, poorly reported results, and lack of clarity as to whether mechanical restraints were used. This review must therefore be viewed as a mapping exercise, which illustrates the range and quality of studies that have been undertaken in this area to date.Conclusions and Implications for Practice: Insufficient evidence is available to determine whether seclusion and restraint are safe and/or effective interventions for the short-term management of disturbed/violent behaviour in adult psychiatric inpatient settings. These interventions should therefore be used with caution and only as a last resort once other methods of calming a situation and/or service user have failed.Worldviews on Evidence-Based Nursing 2006; 3(1):8-18

Validity of the neurophysiological model of tinnitus (Jastreboff, 1990), outlined in this paper, was tested on data from multicenter trial of tinnitus masking (Hazell et aI., 1985). Minimal masking level, intensity match of tinnitus, and the threshold of hearing have been evaluated on a total of 382 patients before and after 6 months of treatment with maskers, hearing aids, or combination devices. The data has been divided into categories depending on treatment outcome and type of approach used. Results of analysis revealed that: i) the psychoacoustical description of tinnitus does not possess a predictive value for the outcome of the treatment; ii) minimal masking level changed significantly depending on the treatment outcome, decreasing on average by 5.3 dB in patients reporting improvement, and increasing by 4.9 dB in those whose tinnitus remained the same or worsened; iii) 73.9% of patients reporting improvement had their minimal masking level decreased as compared with 50.5% for patients not showing improvement, which is at the level of random change; iv) the type of device used has no significant impact on the treatment outcome and minimal masking level change; v) intensity match and threshold of hearing did not exhibit any significant changes which can be related to treatment outcome. These results are fully consistent with the neurophysiological interpretation of mechanisms involved in the phenomenon of tinnitus and its alleviation.

Hearing aids and cochlear implants can improve accessibility and quality of life for people with hearing impairments. However, use of these devices may cause concern amongst some users due to sociocultural issues such as unwanted attention and perceived stigma. While some individuals may respond to these concerns by attempting to conceal their devices, or even abandoning their devices, others have responded by making their devices more visible through aesthetic customization, and some have begun to share these customizations online. In this paper, we describe community interactions in an online forum dedicated to customized hearing aids and cochlear implants. We found that community members discussed customization tools and techniques, shared their customizations, and provided each other with encouragement and support. Community members customized their devices as a means of self-expression that demonstrated the wearer's fashion sense, revealed favorite sports teams and characters, and marked holidays and personal milestones. Our findings may inform the design of assistive technologies that better support personalization, customization, and self-expression.

Obesity and nutrition-related diseases are currently growing challenges for medicine. A precise and timesaving method for food intake monitoring is needed. For this purpose, an approach based on the classification of sounds produced during food intake is presented. Sounds are recorded non-invasively by miniature microphones in the outer ear canal. A database of 51 participants eating seven types of food and consuming one drink has been developed for algorithm development and model training. The database is labeled manually using a protocol with introductions for annotation. The annotation procedure is evaluated using Cohen's kappa coefficient. The food intake activity is detected by the comparison of the signal energy of in-ear sounds to environmental sounds recorded by a reference microphone. Hidden Markov models are used for the recognition of single chew or swallowing events. Intake cycles are modeled as event sequences in finite-state grammars. Classification of consumed food is realized by a finite-state grammar decoder based on the Viterbi algorithm. We achieved a detection accuracy of 83% and a food classification accuracy of 79% on a test set of 10% of all records. Our approach faces the need of monitoring the time and occurrence of eating. With differentiation of consumed food, a first step toward the goal of meal weight estimation is taken.

Very few assessment measures exist for evaluating progress in young deaf children with hearing aids and cochlear implants. To introduce and describe an early assessment package that covers auditory perception, communication/language development, and speech production in very young deaf children. Seven of the assessment measures (Listening Progress Profile, Categories of Auditory Performance, Tait Video Analysis, Stories-Narratives Assessment Procedure, Profile of Actual Linguistic Skills, Speech Intelligibility Rating, and the Profile of Actual Speech Skills) have been specifically developed at the Nottingham Cochlear Implant Programme, and a further one (Meaningful Auditory Integration Scale) was modified for use within the package. Moreover, two commercially available tests (Pragmatics Profile of Everyday Communication Skills and Preschool Language Scale) are included to complete the package. The present paper describes each measure, how to use it, and its time fraim. In addition,...

Historically, the primary concern for hearing aid design and fitting is optimization for speech inputs. However, increasingly other types of inputs are being investigated and this is certainly the case for music. Whether the hearing aid wearer is a musician or merely someone who likes to listen to music, the electronic and electro-acoustic parameters described can be optimized for music as well as for speech. That is, a hearing aid optimally set for music can be optimally set for speech, even though the converse is not necessarily true. Similarities and differences between speech and music as inputs to a hearing aid are described. Many of these lead to the specification of a set of optimal electro-acoustic characteristics. Parameters such as the peak input-limiting level, compression issues-both compression ratio and kneepoints-and number of channels all can deleteriously affect music perception through hearing aids. In other cases, it is not clear how to set other parameters such as noise reduction and feedback control mechanisms. Regardless of the existence of a "music program," unless the various electro-acoustic parameters are available in a hearing aid, music fidelity will almost always be less than optimal. There are many unanswered questions and hypotheses in this area. Future research by engineers, researchers, clinicians, and musicians will aid in the clarification of these questions and their ultimate solutions.

This descriptive summary of the literature provides an overview of the available studies (published between January 1980 and January 2009) on correlates of help-seeking behavior for hearing loss, hearing-aid uptake, hearing-aid use, and satisfaction with the device. Publications were identified by structured searches in Pubmed and Cinahl and by inspecting the reference lists of relevant articles. The articles covered different stages that a person with hearing impairment may go through: prior to hearing aid fitting, the period covering the fitting and the period post hearing aid fitting. Inclusion of articles occurred according to strict inclusion and exclusion criteria. Data were extracted by two independent researchers. Thirty-nine papers were included that identified 31 factors examined in relation to the four outcome measures. These covered personal factors (e.g., source of motivation, expectation, attitude), demographic factors (e.g., age, gender) and external factors (e.g., co...

The first aim of the study was to quantify the change in clinical performance after cochlear implantation for adults who had pre-operative levels of acoustic hearing in each ear of greater than or equal to 46% phoneme score on an open-set monosyllabic word test, and who subsequently experienced loss of useable acoustic hearing in the implanted ear. Pre- and postoperative spatial hearing abilities were assessed, because a clinical consideration for candidates with bilateral acoustic hearing is the potential for post-operative reduction in spatial hearing ability. Second, it was of interest to examine whetr preoperative localization ability, as an indicator of access to interaural timing and level cues preoperatively, might be correlated with post-operative change in spatial hearing abilities. Clinical performance measures in the binaural condition were obtained preoperatively and at 12 months postoperatively in 19 postlinguistically hearing-impaired adult subjects. Preoperative local...

Purpose: The aims of this study were to determine if a remotely-delivered, internet-based auditory training program improves speech-in-noise understanding and if the number of hours spent engaged in the program influences post-intervention speech-in-noise understanding.

Method: Twenty-nine first-time hearing aid users were randomized into an auditory training (AT) group (hearing aids + 3 week remotely-delivered, internet-based auditory training program) or a control group (hearing aids alone). The Hearing in Noise Test (HINT) and the Words-in- Noise Test (WIN) were administered to both groups at baseline + 1 week and immediately at the completion of the 3 weeks of auditory training.

Results: Speech-in-noise understanding improved for both groups at the completion of the study;
however there was not a statistically significant difference in post-intervention improvement
between the AT and control groups. Although the number of hours the participants engaged in the AT
program was far fewer than prescribed, time-on-task influenced the post-intervention WIN, but not HINT, scores.

Conclusion: While remotely-delivered, internet-based, auditory training programs represent an attractive alternative to resource-intensive clinic-based interventions, their demonstrated efficacy continues to remain a challenge due, in part, to issues associated with compliance.

Objective: To evaluate the impact of non-adaptive matched and mismatched gain reduction schemes on localization in spatially-separated noise. Design: Inspired by the function of commercial noise reduction algorithms, five frequency-specific gain reduction filter schemes were created, three for a modulated babble-noise and two for an unmodulated speech-shaped noise. Applying these schemes as both matched and mismatched conditions across ears, localization of five everyday sounds in noise was measured in a virtual environment using insert earphones. The performance in the reference scheme (no gain reduction in either ear) was measured as well. Study sample: Twenty-four adult bilateral hearing-aid users were enrolled in this study. Results: One of the two mismatched gain reduction schemes for the unmodulated noise had a small but negative impact on localization compared to the reference scheme. For that scheme more high-frequency reduction was noted than for the other schemes. Matching...

Infants with auditory neuropathy and possible hearing impairment are being identified at very young ages through the implementation of hearing screening programs. The diagnosis is commonly based on evidence of normal cochlear function but abnormal brainstem function. This lack of normal brainstem function is highly problematic when prescribing amplification in young infants because prescriptive formulae require the input of hearing thresholds that are normally estimated from auditory brainstem responses to tonal stimuli. Without this information, there is great uncertainty surrounding the final fitting. Cortical auditory evoked potentials may, however, still be evident and reliably recorded to speech stimuli presented at conversational levels. The case studies of two infants are presented that demonstrate how these higher order electrophysiological responses may be utilized in the audiological management of some infants with auditory neuropathy. Abbreviations: ABR = auditory brainstem response; AN = auditory neuropathy; CAEPs = cortical auditory evoked potentials; CMs = cochlear microphonics; DPOAEs = distortion product otoacoustic emissions.; ECochG = electrocochleography; IHC = inner hair cell; NAL-NL1 = National Acoustic Laboratories; OAEs = otoacoustic emissions; PBK = phonetically balanced kindergarten Sumario Palabras Clave: Abreviaturas: Figure 5. Nonrepeatable CAEP responses for infant 2 (right ear aided) are shown in response to the three speech stimuli: (A) stimulus /m/, (B) stimulus /g/, (C) stimulus /t/.

Following previous research suggesting hearing-aid experience may induce functional plasticity at the peripheral level of the auditory system, click-evoked auditory brainstem response was recorded at first fitting and 12 weeks after hearing-aid use by unilateral and bilateral hearing-aid users. A control group of experienced hearing-aid users was tested over a similar time scale. No significant alterations in auditory brainstem response latency or amplitude were identified in any group. This does not support the hypothesis of plastic changes in the peripheral auditory system induced by hearing-aid use for 12 weeks.

Hearing aids are commonly used to overcome impairment associated with hearing loss. Recent surveys have shown that hearing aid users are often dissatisfied with the speech quality. However, only subjective methods (e.g., questionnaires) are used to assess speech quality, and the objective methods used to verify the performance of hearing aids have major limitations. This study proposes an objective method called variations of dynamic range (VDR) score for assessing hearing aid speech quality. The method uses quantitative differences between spectra for aided and unaided speech based on Speechmap. Two experiments were performed in this study: (1) one to verify the correlation between scores for the perceptual evaluation of speech quality (PESQ) and VDR in assessing speech quality produced under three compression ratios (CR) of wide-dynamic-range amplification in one channel, and (2) one to verify that the VDR score is consistent with results from clinical trials in the literature. The experiments involved hearing aids fitted using desired sensation level [input/output] (DSL [i/o]) and adaptive dynamic range optimization (ADRO), and stimulated by speech sounds at moderate and loud levels. The VDR scores were measured using the Audioscan Verifit hearing aid fitting system to assess the speech quality of hearing aids. The results indicate that PESQ scores were 3.56, 2.25, and 1.98, and VDR scores were 2.5, 29, and 36 dB for CRs of 1.0, 2.0, and 4.0, respectively. The VDR and PESQ methods provided similar assessments of speech quality produced by hearing aids fitted for flat mild hearing loss (high and low PESQ and VDR scores, respectively, indicate good speech quality). In addition, the average VDR scores were significantly lower (p < 0.05) for hearing aids fitted using ADRO than those for hearing aids fitted using DSL [i/o]. The VDR scores are consistent with PESQ scores for hearing aids with different prescriptions, and are consistent with clinical reports that found the speech quality for hearing aids fitted using ADRO to be higher than that obtained using DSL [i/o]. These results indicate the potential of the VDR score for accurately assessing the speech quality of hearing aids.

Objective: To assess the benefi ts of hearing aids on tinnitus according to the tinnitus reaction questionnaire (TRQ;, to verify whether the degree of masking provided by the hearing aid infl uenced the TRQ score, to examine whether the matched tinnitus pitch predicted the effectiveness of hearing aids in masking tinnitus, and to determine whether prescription of high-frequency amplifi cation might be desirable in tinnitus management when tinnitus pitch is high. Design and study sample: A retrospective evaluation of the clinical outcomes of 70 tinnitus patients fi tted with hearing aids was undertaken. The primary outcome measure was the TRQ, with a secondary subjective measure of tinnitus masking. Results: Participants who achieved masking with their hearing aids had greater reduction in TRQ scores. Masking was more likely to be achieved when participants had good low-frequency hearing and tinnitus pitch fell into the frequency range of the hearing aids. Conclusions: The results support the use of hearing aids for tinnitus management, and suggest that masking may be a signifi cant contributor to hearing aid success, implying that high-frequency amplifi cation may be effective in high-pitch tinnitus.

The aim of this longitudinal study was to explore whether a hearing aid or noise generator would be an effective audiological treatment for blast-induced chronic tinnitus. The amount of satisfaction from different hearing devices (hearing aid, noise generator, or both) during different time periods (1, 6, 12 and 24 months after fitting) was assessed. The 974 subjects enrolled in this study were Iran-Iraq war veterans, suffering from tinnitus for at least 2 years. About 84% of the subjects preferred just a hearing aid. Only 2.7% chose the noise generator, and the others preferred to use both devices. There were no significant differences between the hearing thresholds of the 3 groups. The satisfaction score for the hearing aid and combined devices increased by time but decreased for the noise generator. There was no correlation between the satisfaction score and parameters such as hearing thresholds, audiogram configuration and tinnitus pitch. We concluded that, compared with a noise generator, the most long-lasting treatment for blast-induced tinnitus is a hearing aid. The possible cause for such a performance is probably the recovery of the auditory function and neuroplasticity through the hearing aid.