Objective: The objective was to assess the degradation of speech sound quality produced by frequency compression for listeners with extensive high-frequency dead regions (DRs). Design: Quality ratings were obtained using values of the starting frequency (Sf) of the frequency compression both below and above the estimated edge frequency, fe, of each DR. Thus, the value of Sf often fell below the lowest value currently used in clinical practice. Several compression ratios were used for each value of Sf. Stimuli were sentences processed via a prototype hearing aid based on Phonak Exélia Art P. Study sample: Five participants (eight ears) with extensive high-frequency DRs were tested. Results: Reductions of sound-quality produced by frequency compression were small to moderate. Ratings decreased significantly with decreasing Sf and increasing CR. The mean ratings were lowest for the lowest Sf and highest CR. Ratings varied across participants, with one participant rating frequency compression lower than no frequency compression even when Sf was above fe. Conclusions: Frequency compression degraded sound quality somewhat for this small group of participants with extensive high-frequency DRs. The degradation was greater for lower values of Sf relative to fe, and for greater values of CR. Results varied across participants.

The recommended management for children with otitis media with effusion (OME) is ‘watchful waiting’ before considering grommet surgery. During this time speech and language, listening skills, quality of life, social skills, and outcomes of education can be jeopardized. Air-conduction (AC) hearing aids are problematic due to fluctuating AC hearing loss. Bone-conduction (BC) hearing is stable, but BC hearing aids can be uncomfortable. Both types of hearing aids are costly. Given the high prevalence of OME and the transitory nature of the accompanying hearing loss, cost-effective solutions are needed. The leisure industry has developed relatively inexpensive, comfortable, high-quality BC headsets for transmission of speech or music. This study assessed whether these headsets, paired with a remote microphone, improve speech discrimination for children with OME. Nineteen children aged 3 to 6 years receiving recommended management in the United Kingdom for children with OME participated. Word-discrimination thresholds were measured in a sound-treated room in quiet and with 65 dB(A) speech-shaped noise, with and without a headset. The median threshold in quiet ( N = 17) was 39 dB(A) (range: 23–59) without a headset and 23 dB(A) (range: 9–35) with a headset ( Z = −3.519, p < .001). The median threshold in noise ( N = 19) was 59 dB(A) (range: 50–63) without a headset and 45 dB(A) (range: 32–50) with a headset (Z = −3.825, p < .001). Thus, the use of a BC headset paired with a remote microphone significantly improved speech discrimination in quiet and in noise for children with OME.

The objective was to determine the effects of a frequency-lowering algorithm (frequency composition, Fcomp) on consonant identification, word-final /s, z/ detection, the intelligibility of sentences in noise, and subjective benefit, for people with high-frequency hearing loss, including people with dead regions (DRs) in the cochlea. A single-blind randomized crossover design was used. Performance with Bernafon Acriva 9 hearing aids was compared with Fcomp off and Fcomp on. Participants wore the hearing aids in each condition in a counterbalanced order. Data were collected after at least 8 weeks of experience with a condition. Outcome measures were audibility, scores from the speech perception tests, and scores from a questionnaire comparing self-perceived hearing ability with Fcomp off and Fcomp on. Ten adults with mild to severe high-frequency hearing loss (seven with extensive DRs, one with patchy or restricted DRs, and two with no DR) were tested. Fcomp improved the audibility of high-frequency sounds for 6 out of 10 participants. There was no overall effect of Fcomp on consonant identification, but the pattern of consonant confusions varied across conditions and participants. For word-final /s, z/ detection, performance was significantly better with Fcomp on than with Fcomp off. Questionnaire scores showed no differences between conditions. In summary, Fcomp improved word-final /s, z/ detection. No benefit was found for the other measures.

§Guy's and St. Thomas' NHS Foundation Trust, London; and jjOticon Medical, UK Objectives: To investigate the combined effect of changing pulse shape and grounding configuration to manage facial nerve stimulation (FNS) in cochlear implant (CI) recipients. Patients: Three adult CI recipients with severe FNS were offered a replacement implant when standard stimulation strategies and programming adjustments did not resolve symptoms. Our hypothesis was that the facial nerve was less likely to be activated when using anodic pulses with ''mixed-mode'' intra-cochlear and extra-cochlear current return. Intervention: All patients were reimplanted with an implant that uses a pseudo-monophasic anodic pulse shape, with mixed-mode grounding (stimulus mixed-mode anodic)-the Neuro Zti CI (Oticon Medical). This device also allows measurements of neural function and loudness with monopolar, symmetric biphasic pulses (stimulus MB), the clinical standard used by most CIs as a comparison. Main Outcome Measures: The combined effect of pulse shape and grounding configuration on FNS was monitored during surgery. Following CI activation, FNS symptoms and performance with the Neuro Zti implant were compared with outcomes before reimplantation. Results: FNS could only be recorded using stimulus MB for all patients. In clinical use, all patients reported reduced FNS and showed an improvement in Bamford-Kowal-Bench sentences recognition compared with immediately before reimplantation. Bamford-Kowal-Bench scores with a male speaker were lower compared with measurements taken before the onset of severe FNS for patients 1 and 2. Conclusions: In patients where CI auditory performance was severely limited by FNS, charge-balanced pseudo-monophasic stimulation mode with a mixed-mode grounding configuration limited FNS and improved loudness percept compared with standard biphasic stimulation with monopolar grounding.