Showing papers in "British Journal of Audiology in 1988"
TL;DR: A model of the structure of the handicap has been outlined illustrating how spontaneous adjustments can be in themselves sources of disadvantages.
Abstract: Hearing difficulties among noise-exposed workers were investigated by means of an interview. A group of 61 workers from a metal product plant had their hearing tested; 66% had abnormal hearing according to their age. Interviews on hearing problems and on their consequences were conducted at home with the spouses. The interviews were recorded and transcribed, and then treated according to a procedure that combines phenomenological and content analysis. The results were classified into hearing disabilities, disadvantages and adjustments. Listening and communication problems result in extra efforts, anxiety and stress, changes in social activities, isolation in groups and a negative self-image. These problems also affect others, especially the spouse, who take an active part in the spontaneous adjustment to disabilities. A model of the structure of the handicap has been outlined illustrating how spontaneous adjustments can be in themselves sources of disadvantages. Implications for rehabilitation services ar...
171 citations
TL;DR: Four different systems for implementing AGC are compared, and each of them is compared with unaided listening and with linear amplification, with best results overall obtained using the mark II aid.
Abstract: Hearing impairment of cochlear origin is usually associated with loudness recruitment. As a consequence, the dynamic range between threshold and the highest comfortable level is smaller than normal. To ensure that low-level sounds can be heard, while avoiding discomfort at high levels, a hearing aid with automatic gain control (AGC) is required. This paper compares four different systems for implementing AGC, and compares each of them with unaided listening and with linear amplification. The systems were evaluated by measuring thresholds for understanding speech in quiet and in five types of background sound: speech-shaped noise, 12-talker babble, cafeteria noise, traffic noise and a single competing speaker. The first system used a new dual-action AGC (called dual front-end AGC) operating on the whole speech signal. A slow-acting control voltage (recovery time 5 s) held the average level of speech at the output constant, regardless of the input level. In response to sudden intense transients, a fast-acting control voltage (recovery time 150 ms) reduced the gain rapidly and then returned the gain to the value set by the slow-acting component. In the second system, referred to as the mark II aid, the output of the dual front-end AGC was split into two frequency bands, and fast-acting (syllabic) compression was applied in the high-frequency band only. The bands were then recombined. The third system resembled the mark II aid except that fast-acting compression was applied in both bands. The fourth system resembled the 2-channel aid evaluated in previous trials (Moore, 1987). It was similar to the third system, but had only single-action front-end AGC with a recovery time of 400 ms. Six subjects with moderate sensorineural hearing loss accompanied by recruitment were used. Best results overall were obtained using the mark II aid. Speech reception thresholds (SRTs) in noise were, on average, 4 dB better than for linear amplification and 2.4 dB lower than for the previous 2-channel aid. There was a significant advantage of having fast-acting AGC in the high-frequency band, but no advantage of having AGC in the low-frequency band.
90 citations
TL;DR: St striking uniformity in the form of the distributions is revealed among apparently discordant data from different studies, showing that the adventitious hearing loss, or so-called 'pathological overlay', is essentially equivalent to accelerated ageing.
Abstract: Thresholds of hearing as a function of age and sex for screened, or 'otologically normal', persons have been standardised (ISO 7029) on the basis of a study by Robinson and Sutton (1978). For purposes such as the evaluation of hearing loss due to noise exposure in industrial populations, it is not generally realistic to compare the hearing thresholds to an age-matched 'otologically normal' baseline, since the difference will include adventitious hearing loss as well as the noise-related components. This paper presents typical data for an unscreened population, in a companion form to ISO 7029. The results are derived from a critical analysis of published material and are shown to converge closely to ISO 7029 at the extremity of the distributions. Striking uniformity in the form of the distributions is revealed among apparently discordant data from different studies, showing that the adventitious hearing loss, or so-called 'pathological overlay', is essentially equivalent to accelerated ageing.
73 citations
TL;DR: Behavioural therapy was given to reduce discomfort and annoyance associated with severe tinnitus in 75 consecutive patients, indicating strong overall positive effects of treatment, as well as other positive side-effects on complaints such as tension headaches, dizziness, muscle tension and sleep disturbances.
Abstract: Behavioural therapy was given to reduce discomfort and annoyance associated with severe tinnitus in 75 consecutive patients. Treatment was conducted within the routine clinical management. It included information and discussion about tinnitus, behavioural analysis and relaxation training combined with various cognitive strategies. The method of treatment was thus a form of coping technique. Self-recordings showed significant reductions of 'discomfort from tinnitus' as well as significant elevations in 'general mood' over a 3-month follow-up period. Interview findings indicated strong overall positive effects of treatment, as well as other positive side-effects on complaints such as tension headaches, dizziness, muscle tension and sleep disturbances. Implications for the clinical management of tinnitus sufferers are discussed.
57 citations
TL;DR: In this article, drug-induced ototoxicity was investigated in the context of audiology and audiology, and the results showed that drugs can cause ototoxic effects in audiology patients.
Abstract: (1988). Drug-induced ototoxicity. British Journal of Audiology: Vol. 22, No. 3, pp. 195-210.
48 citations
TL;DR: The results of the investigation confirmed the superiority of binaural v. monaural hearing and the parameters concerned with educational, social and employment achievement did not support the existence of any significant difference between binaurally and monaurally hearing subjects.
Abstract: The recent audiological literature has put forward the hypothesis that children with unilateral hearing loss (UHL) show delays in educational achievement and academic progress and some behavioural difficulties. This motivated us to investigate the long-term effects of monaural auditory deprivation in a group of adults who had suffered from UHL since childhood. A group of subjects, ranging in age from 30 to 55 years, suffering from sensorineural UHL since early childhood, has been examined for psychosocial and psychoacoustical effects and statistically compared with a control group matched for age and sex. We prepared a questionnaire directed to provide some objective and subjective indices of psychosocial disability and handicap. Some questions were directed towards specific aspects of auditory function; others assessed the degree of education and the type of working performed. The results of the investigation confirmed the superiority of binaural v. monaural hearing. This was clearly demonstrated in psycho-acoustical performance in sound localisation, speech recognition in noise, together with the appreciation of music. On the other hand, the parameters concerned with educational, social and employment achievement did not support the existence of any significant difference between binaurally and monaurally hearing subjects. The data obtained in the present study thus do not support the existence of non-auditory, long-term effects of monaural hearing loss.
45 citations
TL;DR: The level of stimulus required to obtain a recordable emission was found to be correlated with the psycho-acoustical threshold of the click stimuli but not to a high enough level to make this a useful measure of hearing loss.
Abstract: Click-evoked oto-acoustic emissions have been recorded in 18 normal subjects and 19 hearing-impaired subjects taken from an ENT outpatient clinic. An emission could be recorded in all but 1 ear of those subjects where the psychoacoustic threshold to the click stimulus was 13 dB nHL or lower. No emission could be recorded in all subjects where this threshold was 18 dB nHL or higher. The level of stimulus required to obtain a recordable emission was found to be correlated with the psycho-acoustical threshold of the click stimuli but not to a high enough level to make this a useful measure of hearing loss.
43 citations
TL;DR: It is concluded that binaural amplification should be attempted in all bilateral, severely hearing-impaired subjects and about 80% will accept this and be able to demonstrate benefit in an audiovisual task.
Abstract: The relative benefits of binaural as opposed to monaural hearing aids were assessed by the use of a diotically presented, audiovisual speech-in-noise task in a group of bilateral, severely hearing-impaired individuals.Significantly greater benefit was gained from binaural amplification, irrespective of hearing level and degree of asymmetry. The benefit was considered to be due to central summation. It is concluded that binaural amplification should be attempted in all bilateral, severely hearing-impaired subjects. About 80% will accept this and be able to demonstrate benefit in an audiovisual task.
42 citations
TL;DR: A figure of 9% was found for prevalence, but arguments are put forward to show that this is probably a minimum figure and that most studies are likely to under-estimate the number of children with progressive sensorineural hearing loss.
Abstract: Examination was made of the records of school-aged children with a bilateral sensorineural hearing loss who were seen for audiological assessment in the period 1984 to 1986. These records formed the basis of an investigation, reported in this paper, into the prevalence of progressive sensorineural hearing loss, the causes of hearing impairment in these children, the ages at which deterioriation occurs and the patterns of progression in terms of audiogram shape and symmetry. A figure of 9% was found for prevalence, but arguments are put forward to show that this is probably a minimum figure and that most studies are likely to under-estimate the number of children with progressive sensorineural hearing loss. There is a tendency for the deterioration to be greater in the better ear. The implications of this when assessing the role of hearing aids in causing deterioration is discussed.
37 citations
TL;DR: In this article, the hearing level of 133 railway workers who also hunted for sport was evaluated and compared with that of 82 non-hunters colleagues, both groups were affected by hearing loss, mostly involving the highfrequency range.
Abstract: The hearing level of 133 railway workers who also hunted for sport was evaluated and compared with that of 82 non-hunting colleagues. Both groups were affected by hearing loss, mostly involving the high-frequency range. Hunters were found to differ from non-hunters by having significantly worse hearing threshold in the ear contralateral to the shoulder supporting the firearm. The interaural threshold difference at 4 kHz was related to the number of rounds fired and exposure duration, thus providing an estimate of the adverse effect of gunfire noise to which the hunters had been exposed.
34 citations
TL;DR: An attempt is made in this pilot study to construct short word lists which are equal in phonemic distribution in Cantonese.
Abstract: Cantonese is the common Chinese dialect spoken by the citizens in Hong Kong It is difficult to construct a material for speech audiometry in the Chinese language in view of 3 facts: (1) all words are monosyllabic, (2) the language is tonal and (3) there are many homophones Since well-documented Cantonese speech audiometry is not available, an attempt is made in this pilot study to construct short word lists which are equal in phonemic distribution
TL;DR: This study reports the findings in 35 normal children, finding the incidence of spontaneous and positional nystagmus was higher than in adults and the normal limits for these tests are defined.
Abstract: The use of electronystagmography (ENG) is well established in the diagnosis of imbalance in adults It is now recognised that children with vertigo merit similar investigation Experience in our own department has shown that children tolerate the ENG test procedure providing a few minor adjustments are made to the methodology In a previous study, it was shown that normal adult data cannot be used in the interpretation of ENG tracing in children This study reports the findings in 35 normal children The incidence of spontaneous and positional nystagmus was higher than in adults The vestibulo-ocular reflex to rotational and caloric tests is also different, and the normal limits for these tests are defined
TL;DR: A system which consists of a stimulator/amplifier unit for recording the ABR controlled by a standard Master Series BBC Microcomputer is described which fulfils the requirements of routine screening of hearing in infants.
Abstract: Routine screening of hearing using the auditory brainstem response (ABR) in infants, such as neonates in the special care baby unit, requires a system which is quick, user-friendly and gives a simple outcome. A system which consists of a stimulator/amplifier unit for recording the ABR controlled by a standard Master Series BBC Microcomputer is described which fulfils these requirements. The test procedure is highly automated, and a pass or refer decision for the screen on each ear is given by a machine-scoring algorithm which detects the ABR waveform.
Journal Article•
TL;DR: The middle latency response (MLR) using wide band-pass filters shows marked changes in amplitude, latency and configuration in sleep, and the components with latencies greater than 20 ms show the greatest variability.
Abstract: The middle latency response (MLR) using wide band-pass filters shows marked changes in amplitude, latency and configuration in sleep. The components with latencies greater than 20 ms show the greatest variability. There is a significant increase in Pa latency in stages 2 and stages 3/4, and in some cases a disappearance of the Nb component with the development of a broad positivity of latency intermediate to Pa and Pb which dominates the response. The responses in REM are of similar latency and configuration as in wakefulness but of reduced amplitude. The 40 Hz response is markedly reduced in amplitude in all sleep stages reflecting a decrease in the contribution of the middle latency components to this composite response. This appears to arise through a loss of 40 Hz periodicity in slow wave sleep and an increase in the slow 10 Hz component. In REM sleep, there is an overall reduction in amplitude. Much of the reported variability of the MLR in the literature arises from the widely differing band-pass fi...
TL;DR: Benefits of hearing aids were studied in a group of 169 patients using an open-ended self-report approach and the overall pattern of benefits was qualitatively similar to the pattern of complaints reported by candidates for hearing aids.
Abstract: Benefits of hearing aids were studied in a group of 169 patients using an open-ended self-report approach. The overall pattern of benefits was qualitatively similar to the pattern of complaints reported by candidates for hearing aids (Golabek et al., 1988). The response pattern was related to the age and work of the hearing aid users, to the level of the hearing loss in the better ear and to the amount of use of the hearing aid.
TL;DR: It is suggested that elderly patients with dry ears and a normal tympanogram could be fitted with a hearing aid without specialist otological examination.
Abstract: One hundred and fourteen adults with hearing loss, but without otorrhoea, were studied with the aim of establishing whether tympanometry could be used as a screening test to identify potentially treatable aural pathology. Tympanometry was compared with independent otoscopy. No middle ear pathology likely to be of significance in an elderly person was found in ears with a normal tympanogram. All ears with significant pathology gave an abnormal tympanogram, and in addition there was a false positive rate of 6.8%. We suggest that elderly patients with dry ears and a normal tympanogram could be fitted with a hearing aid without specialist otological examination.
TL;DR: The revised FSPHAU cannot supplant trial use of amplification, as client success was not predicted based upon responses offered prior to aid use and in the absence of reliability, discussion of validity becomes moot.
Abstract: Test-retest reliability and criterion validity of an extensively revised version of the feasibility scale for predicting hearing aid use (FSPHAU) was examined. Twenty-two older adults presenting with symmetrical mild to moderate sensory hearing loss completed the revised FSPHAU (pencil and paper) on two occasions prior to hearing aid fitting. The hearing handicap inventory for the elderly was administered during the fitting session and again six months following aid fitting. Test-retest reliability of the revised FSPHAU is not adequate, as revealed by a significant change in the distribution of scores between administrations. From a clinical standpoint, however, true change in an individual's scores was seen in only 4 subjects. In the absence of reliability, discussion of validity becomes moot. The revised FSPHAU cannot supplant trial use of amplification, as client success was not predicted based upon responses offered prior to aid use.
TL;DR: The results question the concept of phonemic regression as a concomitant of ageing by finding the young group's speech discrimination was significantly better in the closed-set condition then in the open- set condition.
Abstract: This investigation sought to determine whether the pattern of performance differed between young and elderly normally hearing adults on a closed v. open-set discrimination task. The California Consonant Test was administered at 32 dB SL (re: SRT) to 20 young and 20 elderly normally hearing subjects under two conditions: one which required subjects to mark their response on a multiple choice answer form; and a second which required subjects to provide a one-word written response on a blank answer form. The only significant difference occurred within the young group between conditions (closed-set, open-set). The young group's speech discrimination was significantly better in the closed-set condition then in the open-set condition. No other differences were significant. The results question the concept of phonemic regression as a concomitant of ageing.
TL;DR: A statistical test of auditory brainstem responses (ABR) for detecting auditory thresholds is presented and the synchrony measure (SM) which represents the degree of reproducibility for group averages was used to calculate the selected Fourier components of the group averages from phase variance.
Abstract: Using the method of Fridman and his colleagues, a statistical test of auditory brainstem responses (ABR) for detecting auditory thresholds is presented. The synchrony measure (SM) which represents the degTee of Teproducibility for group averages was used to calculate the selected Fourier components of the group averages from phase variance. The sensitivity of the test was demonstrated on 35 normal ABRs with 60 and 45 dB SL stimulus intensity and in the absence of stimulus from the ipsilateral recordings. The SM of all cases of normal ABRs at 60 and 45 dB SL exceeded those in the absence of stimulation. The same procedure was applied to 16 ears with cochlear hearing loss with (4 ears) and without (10 ears) recruitment and 2 ears with relatively normal hearing threshold (less than 30 dB HL). Seven out of 10 ears without recruitment had the SM value at 60 dB SL stimulus intensity significantly lower than those of normal ABRs.
TL;DR: An audiovisual test, using BKB sentences in noise, has been developed to assess hearing disability, unaided and aided with a hearing aid(s), in severely hearing-impaired individuals.
Abstract: An audiovisual test, using BKB sentences in noise, has been developed to assess hearing disability, unaided and aided with a hearing aid(s), in severely hearing-impaired individuals. After a single practice list, no significant further increases in performance were detected. The test is reproducible within and between test sessions.
TL;DR: The present method has been developed to simplify and speed up the interpretation of the recordings by means of an enhancement of the response peaks, to make the computation time compatible with the use of low-cost microcomputers.
Abstract: The aim of this paper is to propose a method of data processing for the analysis of evoked potentials, in particular for auditory brainstem responses. The present method has been developed to simplify and speed up the interpretation of the recordings by means of an enhancement of the response peaks. Even for experienced observers, identification of the response waves and subsequent latency measurements may sometimes constitute a difficult task, due to the presence of residual noise or to interference between the temporal waveforms of adjacent peaks and troughs. The method is implemented with a digital non-causal (zero-phase shift) filter, based on the convolution with a finite impulse response, to make the computation time compatible with the use of low-cost microcomputers. The performance is shown to be very good in several examples.
TL;DR: It is argued from a theoretical standpoint that, if appropriate coupler/real ear correction factors are used, coupler estimates of real ear gain can be of comparable accuracy to functional estimates, and experimental evidence from a study carried out is used to show that this is true.
Abstract: Selection of a hearing aid frequency response is often initially based on coupler-measured performance, but is subsequently confirmed by functional measurement of real ear gain. It is usually assumed that functional gain measurement is necessary as confirmation because coupler measures do not take individual differences into account. This paper first argues from a theoretical standpoint that, if appropriate coupler/real ear correction factors are used, coupler estimates of real ear gain can be of comparable accuracy to functional estimates. It then uses experimental evidence from a study carried out by the author to show that, because of the variability in functional measurements of gain, suitably corrected coupler estimates of real ear gain can be more accurate than their functional counterparts.
TL;DR: Results indicated that the TAM aided the detection but not recognition of environmental sounds and Lip-reading was not improved, and there was a worrying trend toward the use of an elevated voice pitch with changes in voice quality including increased occurrence of creaky voice.
Abstract: Two women with a total acquired hearing loss who had previously derived no benefit from hearing aids were fitted with the tactile acoustic monitor (TAM) (Summers et al., 1981). Speech perceptual and productive abilities were assessed using a variety of tests prior to TAM fitting, at the time of fitting and after one month of daily use but without detailed training. Self-report and questionnaire data were also obtained. Results indicated that the TAM aided the detection but not recognition of environmental sounds. Lip-reading was not improved, and there was a worrying trend toward the use of an elevated voice pitch with changes in voice quality including increased occurrence of creaky voice.
TL;DR: The use of pre-gelled disposable electrodes in auditory brainstem response audiometry (ABR) is described, this test being employed as part of a screening procedure for acoustic neuroma.
Abstract: Since the first applications of auditory evoked potentials to neuro-otological diagnosis and objective audiometry, many advances have been made in electrode technology, including the development of disposable electrodes. This paper describes the use of pre-gelled disposable electrodes in auditory brainstem response audiometry (ABR), this test being employed as part of a screening procedure for acoustic neuroma. Factors of patient safety, clinical time and cost are discussed. The use of disposable electrodes is considered a beneficial advance in the ABR test technique.
TL;DR: The effects of sensory intake and rejection tasks on auditory fatigue were examined in 14 male subjects, and poorer post-exposure auditory thresholds and larger Q10 tip values were seen when the task required counting of interruptions in the noise.
Abstract: The effects of sensory intake and rejection tasks on auditory fatigue were examined in 14 male subjects. Auditory thresholds, psychophysical tuning curves and physiological measures of cardiovascular function were obtained before, during, and following a 7 min 110 dB SPL white noise exposure. Acceleration of heart rate was observed under the sensory rejection (mental arithmetic) condition, and poorer post-exposure auditory thresholds and larger Q10 tip values (measured during late post-exposure intervals) were seen when the task required counting of interruptions in the noise. However, Q10 tip values obtained 1 to 2 min post-exposure, when cochlear effects are maximal, failed to confirm a significant difference as a function of task.