Mandarin Chinese speech recognition by pediatric cochlear implant users

To investigate the outcomes of cochlear implantation in patients with neurofibromatosis type 2 (NF2), and to discuss the current management strategy for NF2 patients. The medical records of NF2 patients who received cochlear implants (CI) at our center between 2012 and 2016 were retrospectively reviewed. Pre-operative hearing status, tumor status, treatment of tumors, and auditory outcomes post-implantation were evaluated. Twelve patients were included in the study. Five were implanted with the tumor in situ; two of them received radiotherapy pre-implantation, and three were implanted without any previous treatment. Four patients were implanted simultaneously with tumor removal. Three patients were implanted as second-stage after failed hearing preservation surgery. The mean pure tone audiometry with the implant was 44 dB (range 25–80 dB) and the mean sentence recognition score (SRS) in a quiet environment without lip reading was 63% (range 0–97%). A poorer objective auditory outcome was identified in one patient who showed no response to electrical promontory stimulation (EPS), but the sound perception was still helpful. In total, 11 of 12 (91%) patients were daily users, and the other patient used the implant as a “sleeper” device due to its interference with contralateral hearing provided by a hearing aid. CI is an effective option in auditory rehabilitation and should be considered primarily for NF2 patients with intact cochlear nerve. EPS might be a predictor for cochlear implant performance. Good contralateral hearing may present a barrier to daily use.

Impact of cochlear implantation on the management strategy of patients with neurofibromatosis type 2

Conclusions: A set of Chinese Mandarin monosyllable test lists with good reliability and sensitivity was established. Objectives. The primary purpose of this study was to evaluate the equivalence of a group of monosyllable lists. Methods: A genetic algorithm was adopted to reorganize the material based on the Phoneme Allocation Table; 10 lists with 25 monosyllabic test items in each were generated. A two-factor design was used for the equivalence evaluation test. A total of 80 normal-hearing and native Mandarin-speaking university students (40 males and 40 females) participated in the trial. Every subject was tested with all 10 lists in sequence at 5 presentation levels (–5, 0, 5, 10, and 15 dB HL). Performance-intensity (P-I) function of each list was fit before P-I curve slope and recognition threshold were calculated. Results: Equivalence evaluation results indicated good psychophysical equivalence between the 10 lists except for list 2. List 9 has a reused item. After the elimination of lists...

Development of a mandarin monosyllable test material with homogenous items (II): lists equivalence evaluation.

Importance The bone-anchored hearing device (BAHD) was not introduced in China until 2010. To our knowledge, this is the first study to assess the efficacy of Chinese Mandarin-speaking patients with bilateral aural atresia. Objective To evaluate the speech recognition of Chinese Mandarin-speaking patients with BAHDs as well as patients’ satisfaction using 2 questionnaires. Design, Setting, and Participants A retrospective case review of 16 patients with bilateral aural atresia conducted at a tertiary referral center. Intervention A BAHD was implanted during auricle reconstruction surgery or after the auricle was rebuilt. A surgical method to combine the BAHD implantation with the second stage of ear reconstruction was introduced. Main Outcomes and Measures Speech audiometry test and mean pure-tone threshold results were compared among patients with unaided hearing and those with BAHDs. Scores from the BAHD user questionnaire and Glasgow Children’s Benefit Inventory (GCBI) were used to measure patients’ satisfaction and subjective health benefit. Results The mean (SD) speech discrimination scores measured in a sound field with a presentation level of 45 dB HL (hearing level) were 6.7% (7.4%) unaided and 86.5% (4.4%) with a BAHD. Scores with a presentation level of 65 dB HL were 56.5% (7.4%) unaided and 90.1% (3.4%) with a BAHD. The speech reception threshold was 60.6 (7.5) dB HL unaided and 24.7 (5.0) dB HL with a BAHD. The mean (SD) pure-tone threshold of the patients was 61.6 (7.8) dB HL unaided and 23.8 (5.9) dB HL with a BAHD. The BAHD application questionnaire demonstrated excellent patient satisfaction. The mean (SD) benefit score of GCBI was 45.6 (14.4). Conclusions and Relevance For aural atresia, the BAHD has been one of the most reliable methods of auditory rehabilitation. It can improve the patient’s word recognition performance and quality of life. The technique of BAHD implantation combined with auricular reconstruction in a 2-stages-in-1 surgery and the modified incision of patients with reconstructed auricle proved to be safe and effective.

https://jamanetwork.com/journals/jamaotolaryngology/articlepdf/1816004/ooi130128.pdf

The Efficacy of Unilateral Bone-Anchored Hearing Devices in Chinese Mandarin-Speaking Patients With Bilateral Aural Atresia

Conclusion. A homogeneity selection could establish a homogenous resource for Chinese Mandarin monosyllabic test lists. Objective: This study aimed to develop a set of succinct and phonemically balanced monosyllabic Mandarin recognition test lists with good item homogeneity, in an effort to meet the need for Chinese Mandarin speech recognition test materials. Methods: In reference to the Chinese phonemes distribution probability, we developed the Phoneme Allocation Table, which decided the occurrence of all consonants, vowels, and semantic tones in each list. A total of 489 monosyllables were selected and organized into 30 lists, with 25 monosyllables in each. A two-factor design was used to screen homogenous items out. Sixty normal-hearing native Mandarin speakers participated in experiment. The performance-intensity (P-I) function curve of each test item was fit by logistic regression. Items were screened out as homogenous ones using the following criteria: 1) regression R value was not <0.9; 2...

Development of a Mandarin monosyllable test material with homogenous items (I): homogeneity selection.

Objective
To edit the sentence list for mandarin speech test materials （MSTM） and to test their equivalence in order to use the list as routine clinical speech tests for evaluation of cochlear implants and hearing aids in different stages of the intervention and rehabilitation. 


Methods
Firstly, two groups of professionals were set up ： one for establishing the principles of the edit, another for experiments. The criteria to guide the selection of spoken sentences were as following：①suitable for everyday speech audiometry, esp. clinically usage;② a normal sampling of everyday spoken sentences in mandarin. Totally, 300 sentences were selected in 30 lists for the experiment. The record cassette was used by a male speaker. The college students （54 persons, 54 ears） with normal hearing participated in the equivalence test. Two statistic methods were used for equivalence analysis. 


Results
Through speech tests and statistic analysis, 2 sets with 29 lists （290 sentences） were selected as our equivalent lists for further evaluation and clinical trial. 


Conclusions
By setting up the strict criteria of selecting sentences, speech test method and statistic analysis, 2 sets of 29 lists （290） sentences were chosen as our speech evaluation materials, but it was necessary for further analysis in different laboratories and clinics. The sentence lists should also get used for hearing impaired subjects, hearing aid users and cochlear implant recipients.


Key words: 
Speech audiometry; Chinese; Mandarin; Equivalence

Edit and evaluation of Mandarin sentence materials for Chinese speech audiometry

Objective
To edit the spondee （disyllable） word lists as a part of mandarin speech test materials （MSTM）. These will be basic speech materials for routine tests in clinics and laboratories. 


Methods
Two groups of professionals （audiologists, Chinese and Mandarin scientists, linguistician and statistician） were set up at first. The editing principles were established after 3 round table meetings. Ten spondee lists, each with 50 words, were edited and recorded into cassettes. All lists were phonemically balanced （3-dimensions： vowels, consonants and Chinese tones）. Seventy-three normal hearing college students were tested. The speech was presented by earphone monaurally. Three statistic methods were used for equivalent analysis. 


Results
Related analysis showed that all lists were much related, except List 5. Cluster analysis showed that all ten lists could be classified as two groups. But Kappa test showed that the lists＇ homogeneity were not well. 


Conclusions
Spondee lists are one of the most routine speech test materials. Their editing, recording and equivalent evaluation are affected by many factors. This also needs multi-discipline cooperation. All lists edited in present study need future modification in recording and testing in order to be used clinically and in research. The phonemic balance should be kept.


Key words: 
Audiometry, speech; Cochlear implantation; Linguistics; Vocabulary; Rehabilitation of speech and language disorders

Development and equivalence evaluation of spondee lists of mandarin speech test materials

Objective To find a good speech material in audiology routine tests and cochlear implant evaluation, the monosyllable lists which were a part of mandarin speech test materials (MSTM) were edited and recorded. The equivalence test was done for all the lists. Methods The professional group was set up at first, which composed of specialists of Chinese, mandarin teaching, linguistics and statistics. The principles of word selection were established according to the coherence with international speech test materials and mandarin. Ten Monosyllable lists, each of which has 50 mandarin words according to phonemic balance and criteria of speech audiometry, were edited. The balance was 3-dimension: vowels, consonants and four Chinese tones. One cassette was recorded by a male speaker (radiobroadcaster). The 72 normal hearing subjects were tested monaurally with ten monosyllable lists and the materials were presented by the earphone. The equivalence evaluation was done at the level of about 50% correct scores. Results Statistic analysis shows that 7 lists were equivalent in difficulty. They were ready for future research and clinical trial. Conclusions The mandarin monosyllable lists were edited in terms of international standard and Chinese 3-dimension phonemic balance. Seven of them met the demands for research and clinical application.

Development and equivalence evaluation of monosyllable lists of mandarin speech test materials

Objective To evaluate the equivalence of difficulty of disyllabic Mandarin Speech Test Materials (MSTM) in order to facilitate wider use of speech audiometry in Chinese audiology clinics. Method The Mandarin disyllabic materials, including 10 lists with 50 words in each, have been recorded and converted digitally into CD format. Sixty-five subjects (the age-range 18-25 years) with normal hearing who speak Mandarin well in their daily lives participated in this study. Five of them joined the pilot study, which aimed to identify a presentation level which would be used into the formal test. The other sixty subjects participated in the formal speech perception test. The results were analyzed statistically with Statistical Package for the Social Sciences Software Version 11.0 (SPSS 11.0). Result Nine of the 10 lists were found to have equal difficulty with application of the ANOVA and SNK-Q statistical methods. Conclusion Nine lists of 50 words of these Mandarin disyllabic materials can be considered to have equal difficulty and could be used in a clinical setting.

Equivalence analysis of disyllabic Mandarin speech test materials

OBJECTIVE To provide a clinical reference by comparing the conventional 226 Hz tympanometry with 1000 Hz tympanometry in two groups of young children with otitis media effusion evidenced by CT scan. METHOD One hundred and seventy-seven young children (226 ears), from 1 to 60 months, with otitis media effusion were involved in this study. They were divided into six groups by age: 0-6 months group, 6-12 months group, 12-18 months group, 18-24 months group, 24-36 months group, 36-60 months group. They were tested with tympanometry of 2 probe-tones of 226 and 1 000 Hz. Type A tympanogram was defined as a normal middle ear function in 226 Hz and single-or double-peak in 1 000 Hz tympanometry. One hundred and fifty-eight normal young children (266 ears) were selected as control group. The results were analysed with Chi square test. Receiver operator characteristic (ROC) analysis was performed to evaluate the two methods. RESULT In the young children with otitis media effusion, the detection rate of 226 Hz tympanogram in six groups was 21.1%, 35.2%, 46.9%, 42%, 62.5% and 68% respectively, while 94.7%, 98.1%, 96.9%, 91.2%, 95.8% and 88% respectively in 1 000 Hz tympanogram. In the young children with normal middle ear function, the detection rate of 226 Hz tympanogram in six groups was 95.1%, 88.6%, 85.1%, 93.3%, 88.5% and 93.5%, while 87.8%, 94.3%, 89.4%, 95.6%, 94.2% and 97.8% respectively in 1 000 Hz tympanogram. The detection rate was significantly different between 226 and 1 000 Hz tympanogram in the young children under 36-month old. CONCLUSION A single-or double-peak 1000 Hz tympanometric patterns as normal criteria was a simple way to evaluate young children s' middle ear function. 1 000 Hz tympanometry should be given priority to the children within 36-month old in detection middle ear function,the 226 and 1 000 Hz tympanometry should be done at the same time within 36-60 months old.

Chen Ji

Papers

Edit and evaluation of Mandarin sentence materials for Chinese speech audiometry

Development and equivalence evaluation of spondee lists of mandarin speech test materials

Development and equivalence evaluation of monosyllable lists of mandarin speech test materials

Equivalence analysis of disyllabic Mandarin speech test materials

A comparison of 226 Hz and 1 000 Hz tympanometry in diagnosis of infants otitis media effusion