To examine spoken language outcomes in children undergoing bilateral cochlear implantation compared with matched peers undergoing unilateral implantation.

The use of in situ measurements of hearing protectors' (HPD's) attenuation following the microphone in real ear (MIRE) protocol is increasing. The attenuation is hereby calculated from the difference in sound levels outside the ear and inside the ear canal behind the HPD. Custom-made earplugs have been designed with an inner bore that allows inserting a miniature microphone. A thorough understanding of the difference, henceforth called transfer function, between the sound pressure of interest at the eardrum and the one measured at the inner bore of the HPD is indispensable for optimizing the MIRE technique and extending its field of application. This issue was addressed by measurements on a head-and-torso-simulator and finite difference time domain numerical simulations of the outer ear canal occluded by an earplug. Both approaches are in good agreement and reveal a clear distinction between the sound pressure at the MIRE microphone and at eardrum, but the measured transfer functions appear to be stable and reproducible. Moreover, the most striking features of the transfer functions can be traced down to the geometrical and morphological characteristics of the earplug and ear canal.

SNR-NR provides a significant benefit in noise. Recipients were easily converted from Nucleus(®) 5 to Nucleus(®) 6 requiring little or no sound quality adjustment period. The Nucleus(®) 6 SCAN program was well accepted by the majority of recipients for use during their daily life.

Speech recognition with hearing protectors 1 AbstractThe perceived negative influence of standard hearing protectors on communication is a common argument for not wearing them. Thus, 'augmented' protectors have been developed to improve speech intelligibility. Nevertheless, their actual benefit remains a point of concern.In this paper, speech perception with active earplugs is compared to standard custom-made earplugs. The two types of active protectors included amplify the incoming sound respectively with a fixed level or to a user selected fraction of the maximum safe level. For the latter type, minimal and maximal amplification are selected. To compare speech intelligibility, 20 different speech-in-noise fragments are presented to 60 normal-hearing subjects and speech recognition is scored. The background noise is selected from realistic industrial noise samples with different intensity, frequency and temporal characteristics. Statistical analyses suggest that the protectors' performance strongly depends on the noise condition. The active protectors with minimal amplification outclass the others for the most difficult and the easiest situations, but they also limit binaural listening. In other conditions, the passive protectors clearly surpass their active counterparts. Subsequently, test fragments are analyzed acoustically to clarify the results. This provides useful information for developing prototypes, but also indicates that tests with human subjects remain essential.

IMPORTANCE Pediatric single-sided deafness (SSD) can seriously affect development, causing impaired spatial hearing skills, speech-language delays, and academic underachievement. Early cochlear implantation likely improves hearing-related outcomes, but its association with language development remains unclear.OBJECTIVE To investigate whether early cochlear implantation is associated with language outcomes for children with prelingual SSD. DESIGN, SETTING, AND PARTICIPANTSThe Cochlear Implant for Children and One Deaf Ear study was initiated in 2015 and recruited participants at 4 academic hospitals in Flanders, Belgium, through 2019. This cohort study included 3 groups of children aged 2 to 5 years: children with SSD and a cochlear implant, children with SSD without a cochlear implant, and a control group with normal hearing. Language and hearing skills were assessed 1 to 2 times per year until the age of 10 years.Study completion rates were high (82%). Data analysis was performed from October to December 2020. EXPOSURE Unilateral cochlear implant. MAIN OUTCOMES AND MEASURESLongitudinal vocabulary, grammar, and receptive language scores. The implanted group was hypothesized to outperform the nonimplanted group on all language tests. RESULTS During the recruitment period, 47 children with prelingual SSD without additional disabilities were identified at the participating hospitals. Fifteen of the 34 children with an intact auditory nerve received a cochlear implant (44%, convenience sample). Sixteen of the remaining children were enrolled in the SSD control group (50%). Data from 61 children (mean [SD] age at the time of enrollment, 2.08 [1.34] years; 26 girls [42%]) were included in the analysis: 15 children with SSD and a cochlear implant, 16 children with SSD without a cochlear implant, and 30 children with normal hearing. Children with SSD and a cochlear implant performed in line with their peers with normal hearing with regard to grammar. In contrast, children with SSD without a cochlear implant had worse grammar scores than the group with implants (−0.76; 95% CI, −0.31 to −1.21; P = .004) and the group with normal hearing (−0.53; 95% CI, −0.91 to −0.15; P = .02). The 3 groups had similar vocabulary and receptive language abilities. CONCLUSIONS AND RELEVANCE These findings suggest that early cochlear implantation is associated with normal grammar development in young children with prelingual SSD. Although further follow-up will reveal the long-term outcomes of the cochlear implant for other skills, the (continued) Key Points Question Is early cochlear implantation associated with language development in children with prelingual single-sided deafness (SSD)? Findings In this longitudinal cohort study of 61 children, children with SSD with a cochlear implant achieved significantly better scores for grammar than children with SSD without an implant (difference in score, 0.76), similar to scores for children with bilateral normal hearing. Vocabulary and receptive language scores did not differ for the 3 groups. Me...

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The microphone in real ear (MIRE) protocol allows the assessment of hearing protector's (HPD) attenuation in situ by measuring the difference between the sound pressure outside and inside the ear canal behind the HPD. Custom-made earplugs have been designed with an inner bore to insert the MIRE probe containing two microphones, the reference microphone measuring the sound pressure outside and the measurement microphone registering the sound pressure behind the HPD. Previous research on a head and torso simulator reveals a distinct difference, henceforth called transfer function, between the sound pressure at the MIRE measurement microphone and the sound pressure of interest at the eardrum. In the current study, similar measurements are carried out on humans with an extra microphone to measure the sound pressure at the eardrum. The resulting transfer functions confirm the global frequency dependency found earlier, but also show substantial variability between the ears with respect to the exact frequency and amplitude of the transfer functions' extrema. In addition, finite-difference time-domain numerical models of an ear canal with earplug are developed for each individual ear by including its specific geometrical parameters. This approach leads to a good resemblance between the simulations and their corresponding measurements.

BackgroundCochlear implants (CIs) are considered an effective treatment for severe-to-profound sensorineural hearing loss. However, speech perception outcomes are highly variable among adult CI recipients. Top-down neurocognitive factors have been hypothesized to contribute to this variation that is currently only partly explained by biological and audiological factors. Studies investigating this, use varying methods and observe varying outcomes, and their relevance has yet to be evaluated in a review. Gathering and structuring this evidence in this scoping review provides a clear overview of where this research line currently stands, with the aim of guiding future research.ObjectiveTo understand to which extent different neurocognitive factors influence speech perception in adult CI users with a postlingual onset of hearing loss, by systematically reviewing the literature.MethodsA systematic scoping review was performed according to the PRISMA guidelines. Studies investigating the influence of one or more neurocognitive factors on speech perception post-implantation were included. Word and sentence perception in quiet and noise were included as speech perception outcome metrics and six key neurocognitive domains, as defined by the DSM-5, were covered during the literature search (Protocol in open science registries: 10.17605/OSF.IO/Z3G7W of searches in June 2020, April 2022).ResultsFrom 5,668 retrieved articles, 54 articles were included and grouped into three categories using different measures to relate to speech perception outcomes: (1) Nineteen studies investigating brain activation, (2) Thirty-one investigating performance on cognitive tests, and (3) Eighteen investigating linguistic skills.ConclusionThe use of cognitive functions, recruiting the frontal cortex, the use of visual cues, recruiting the occipital cortex, and the temporal cortex still available for language processing, are beneficial for adult CI users. Cognitive assessments indicate that performance on non-verbal intelligence tasks positively correlated with speech perception outcomes. Performance on auditory or visual working memory, learning, memory and vocabulary tasks were unrelated to speech perception outcomes and performance on the Stroop task not to word perception in quiet. However, there are still many uncertainties regarding the explanation of inconsistent results between papers and more comprehensive studies are needed e.g., including different assessment times, or combining neuroimaging and behavioral measures.Systematic review registrationhttps://doi.org/10.17605/OSF.IO/Z3G7W.