Of 200 patients with perceptive hearing loss seen at our outpatient clinic for digital hearing aid (DHA) dispensation from October 2000 to May 2003, 95 agreed to take a course on DHA dispensation, 20 declined to undertake fitting for different reasons, and 10 patients stopped during fitting due to psychological and physical problems. DHAs were not indicated in 75 cases. Of the 95 taking the course, 67 suffered from binaural hearing loss and 40 agreed to wear DHAs binaurally (59.7%). The most frequently dispensed DHA was a complete-in-canal (CIC) type (42%). A behind-the-ear type was dispensed in 31% and a common canal type suffered in the remaining 27%. In aided ears, 47 and mild hearing loss, 72 moderate hearing loss, 11 severe or profound hearing loss. Using DHAs, significantly improved speech perception in speech presentation within 30 to 50dB in those with mild hearing loss, and within 40 to 60dB in those with moderate hearing loss. The mean functional gain was greatest at a frequency of 1-4kHz, compared to other frequencies. Individual counseling is vital to successfully dispensing DHAs.
We studied the relationship of stressful life events occurring due to hearing loss, perceived stress, and mental health in older adults with hearing loss. Subjects were 235 people with clinically diagnosed presbycusis who had consulted hospital or hearing-aid center audiologists in Wakayama Prefecture. An interview was conducted by audiologists with a questionnaire including subjects' demographics, degree of hearing loss, hearing aid use, frequency of stressful life events, perceived stress, and mental health. The structural equation modeling results demonstrated that subjects' gender, age, and degree of hearing loss were significantly related to stressful life events. Stressful life events were further related indirectly to mental health via perceived stress. Direct effect of stressful life events on mental health was not significant. These results suggest that it is possible to avoid mental health disturbances due to hearing loss by early preventive intervention to alleviate the effects of stressful events and moderate the effects of stress appraisal on mental health.
We studied 49 cases of nonorganic hearing loss seen in the last 19 years at Yamagata University Hospital. More women (71%) were affected than men (29%). We found that the incidence peaked at from 6 to 11 years of age. In most cases, pure tone audiography showed moderate, flat sensorineural hearing loss. ABR and AMFR were useful in diagnosing nonorganic hearing loss, and Bekesy audiography was used for screening nonorganic hearing loss. We divided subjects into a screening group (SG) consisting of cases found by audiography in a school hearing test and a patient group (PG) consisting of those visiting our clinic reporting hearing problems.The SG accounted for 25 (51%) of 49 cases and the PG for 23 (47%). No significant difference was seen hearing impairment prognosis between groups. In the SG, 72% either reported or were conscious of hearing impairment. Psychological problems related to hearing loss were found both groups. Based upon these results, we concluded that SG should be followed up as carefully as PG.
We report on 8 infants —2 boys and 6 girls—, referred in neonatal hearing screening between January 2000 and December 2001. They were 0 to 6 months old at the first visit. Hearing thresholds were diagnosed by conditioned orientation reflex (COR) and auditory brain stem response (ABR), which showed that 2 of the 8 had profound by impaired hearing, 2 moderate by impaired hearing, 3 mild by impaired or almost normal hearing, and 1 suspected unilateral profound by impaired hearing. The 4 diagnosed with profound or moderate hearing impairment averaged 13 months old (10 to 17 months). We found that 1 referred only for unilateral hearing impairment based on automated ABR actually had profound bilateral hearing impairment. Two more who proved to have almost normal hearing were suspected of early moderate hearing impairment based on both COR and ABR thresholds. We concluded that neonatal hearing screening was effective in detecting congenital hearing impairment. Because development of the auditory pathway may improve hearing at several months of age, however, careful follow-up is recommended. This study did not consider possible technical error in neonatal hearing screening by obstetricians, so we suggested that referred infants have their hearing thresholds examined at specialized institutions.
Acoustic characteristics of onomatopoeic expression in 242 patients with unilateral and 1type of tinnitus were analyzed using Hayashi's quantification theory III. Three axes, corresponding to subjective volume, tonality, and pitch of tinnitus, were obtained. The acoustic characteristics of the Japanese onomatopoeic expressions “kiin” and “jiin” differed in subjective tonality. Cluster analysis, applied to evaluate similarities among onomatopoeic expressions of tinnitus, showed that the onomatopoeias of “miin” and “siin, ” “pii” and “buun, ” “uuu” and “waan, ” and “zaa” and “shaa” had similar acoustic characteristics. These results may be useful in comparing change in acoustic characteristics of the onomatopoeic expression of tinnitus before and after medical treatment.
Cogan's syndrome involves the association of abrupt or intermittent worsening of auditory and vestibular function and nonsyphilic interstitial keratitis, or in patients with “atypical” Cogan's syndrome, various inflammatory eye disease. We report a case of a 44-year-old man who suffered from sensorineural hearing loss, tinnitus, vertigo, headache, conjunctivitis and inflammation of the extraocular muscles. Audiometric tests such as short increment sensitivity index (SISI), distortion product of otoacoustic emissions (DPOAE), electrocochleogram (ECochG), and auditory brainstem response (ABRs) indicated cochlear deafness. Although no abnomal findings were found in serological immune function, including assay for immunoglobulin, complement, and specific autoantibody, his sensorineural hearing loss was responsive to steroid administration. The pathological mechanism of steroid-responsive sensorineural hearing loss is not yet understood, although autoimmune reactions against the inner ear may play a possible role.
We prolonged the consonant portion using digital speech processing and studied effects on the degree of speech discrimination in Japanese. A speech discrimination test was conducted on patients with moderate sensorineural hearing loss using a test language table with phonetic processing. For this test, (1) a single-syllable table (19 words) and (2) a continuously spoken three-syllable nonsense table (10 words) were prepared. The table in (1) was prepared by combining processing to prolong the consonant portion two-fold and no processing. The table in (2) was prepared by combing 40-m consonant extension processing and no processing plus compression amplification processing and no processing. The indicated sound pressure was 25dB at the subject's air conduction threshold of 1, 000Hz. The consonant double extension of the single syllable improved the discrimination of voiced consonants. The 40-ms consonant extension in the continuously spoken three-syllable table had little effect on discrimination because of the short processing time and the major improvement in discrimination by intonation clusters.
We studied pediatric ability to identify prosodic information. Subjects were 38 children aged 4 to 8 years and 6 adults who underwent pitch identification tests using word accent (“ame (candy)” and “ame (rain)”) and sentence intonation (statement and question). Materials were 6 synthetic speech stimuli, changing the F0 between 2 accent types. Conditions of time expansion and pitch increase were added to the test. Subjects were instructed to identify the pitch accent and choose between 2 pictures of test materials. One hearing-impaired child received same pitch identification test to apply to the test. We found that (1) The ability to identify pitch accent in children developed at 4 to 8 years old. (2) Children identified word accent earlier than sentence intonation. (3) The identification of pitch accent was improved more by increasing word pitch than by time expansion. (4) The pitch identification test is applicable to hearing-impaired children.