Aims: To evaluate the effect of a cochlear implant (CI) on quality of life (QoL), quality of hearing (QoH), and working performance in patients with single-sided deafness (SSD). Methods: Using specific questionnaires, we measured QoL, QoH, and working performance in 7 SSD patients scheduled for CI surgery of the affected ear. Sound localization and speech perception in noise were also assessed. All questionnaires and tests were performed before the CI surgery and at 6 and 12 months after CI activation. Results: The QoL, QoH, sound localization, and speech perception in noise had improved statistically significantly after CI surgery. Communication with co-workers became easier, and the patients were less fatigued after the working day. Conclusions: CI clearly improves QoL, QoH, and working performance in patients with SSD.
The effect of sound incidence angle on loudness was investigated using real sound sources positioned in an anechoic chamber. Eight normal-hearing listeners produced loudness matches between a frontal reference location and seven sources placed at other directions, both in the horizontal and median planes. Matches were obtained via a two-interval, adaptive forced-choice (2AFC) procedure for three center frequencies (0.4, 1, and 5 kHz) and two overall levels (45 and 65 dB SPL). The results showed that loudness is not constant over sound incidence angles, with directional sensitivity varying over a range of up to 10 dB, exhibiting considerable frequency dependence, but only minor effects of overall level. The pattern of results varied substantially between subjects, but was largely accounted for by variations in individual head-related transfer functions. Modeling of binaural loudness based on the at-ear signals favored a sound-power summation model, according to which the maximum binaural gain is only 3 dB, over competing models based on larger gains, or on the summation of monaural loudness indices.
Despite a high level of sound exposure and a fairly large selection of earplugs available, musicians have often been reported to use personal hearing protectors only seldom. For better hearing conservation, it is important to identify and eliminate the causes for the low motivation to use hearing protection. We explored the usage rate of custom-molded musician's earplugs (ER-15) among 15 symphony orchestra musicians with a questionnaire, and measured the attenuation properties of their earplugs with a Real-Ear Attenuation at Threshold (REAT) procedure in a sound field. Earplug use was found to be low, and the musicians reported that earplugs hampered listening to their own and their colleagues' playing; earplugs affected either timbre or dynamics, or both. Additionally, several reasons related to discomfort of use were itemized, but the musicians who consistently used their earplugs did so in spite of problems with use. The REAT values obtained in sound field were relatively close to the manufacturer's nominal specifications, being 13.7 dB, on average. In the frequency range studied (0.125-8 kHz), individual variation in REAT was, however, up to 15 dB across the measured frequencies. Fluctuation in attenuation might be related to low use of hearing protectors, and REAT measured at fixed center frequencies may be too robust a method to uncover it. We therefore tested 10 additional subjects to find out whether a sweeping signal used in Bιkιsy audiometry would bring more detailed information on earplug attenuation. Mean attenuation was found to be somewhat closer to the nominal attenuation of the ER-9 and ER-15 earplugs up to about 1 kHz, whereas REAT measurements in sound field revealed more even attenuation at frequencies between 1 and 6 kHz. No significant association was found between earplug attenuation properties and earplug use. It was concluded that support and determination to get accustomed to hearing protector use are important factors in hearing conservation.
Bilateral CIs increased patients' working performance and their work-related stress and fatigue decreased. Communication with co-workers was easier and patients were more active in their working environment. Sequential bilateral cochlear implantation improved QoL, QoH, sound localization, and speech perception in noise statistically significantly.
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