Contribution of spectral pinna cues for sound localization in children with congenital unilateral conductive hearing loss after hearing rehabilitation

Vogt, Katharina; Wasmann, Jan-Willem A.; Opstal, A. John Van; Snik, A.F.M.; Agterberg, Martijn J.H.

doi:10.1016/j.heares.2019.107847

Cited by 13 publications

(6 citation statements)

References 29 publications

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“…Another hypothesis for good directional hearing in patients with UCHL is that some of them may rely on monaural cues to achieve good sound localization performance. Vogt et al (2020) confirmed that patients with congenital UCHL rely on monaural spectral cues to detect highfrequency sound sources by comparing localization accuracy with and without covering the normal hearing ear pinna. Van Wanrooij and Van Opstal ( 2004) evaluated nine listeners with chronic unilateral hearing loss through a group of broadband sound stimuli fixed at 60 dB, and the results indicated a strong reliance on the ambiguous HSE in familiar acoustic environments.…”

Section: Sound Localization Performance Of Children With Unilateral M...mentioning

confidence: 60%

“…In contrast, other studies have suggested that congenital UCHL cannot benefit from BCDs in terms of horizontal spatial hearing abilities (Kunst et al, 2008;Weiss et al, 2017). They maintained that listeners with congenital UCHL might have adapted to their hearing impairment as they learned to rely on the spectral shape cues and ambiguous monaural head shadow effect (HSE) cues, which had developed during the long-term unilateral hearing deprivation (Van Wanrooij and Van Opstal, 2004;Vogt et al, 2020). When aided with a BCD, such listening cues might be distorted sharply, thus jeopardizing the original directional hearing.…”

Section: Introductionmentioning

confidence: 99%

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Characteristics of sound localization in children with unilateral microtia and atresia and predictors of localization improvement when using a bone conduction device

et al. 2022

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This study aimed to determine the characteristics of sound localization in children with unilateral microtia and atresia (UMA) and the influence of a non-surgical bone conduction device (BCD). Hearing benefits were evaluated by the word recognition score (WRS), speech reception threshold, the international outcome inventory for hearing aids (IOI-HA), and the Speech, Spatial, and Qualities of Hearing Test for Parent (SSQ-P). Sound localization was measured using broadband noise stimuli randomly played from seven loudspeakers at different stimulus levels [65, 70, and 75 dB sound pressure levels (SPLs)]. The average unaided WRS and speech-to-noise ratio (SNR) for UMA patients was 18.27 ± 14.63 % and −5 ± 1.18 dB SPL, and the average aided WRS and SNR conspicuously changed to 85.45 ± 7.38 % and −7.73 ± 1.42 dB SPL, respectively. The mean IOI-HA score was 4.57 ± 0.73. Compared to the unaided condition, the mean SSQ-P score in each domain improved from 7.08 ± 2.5, 4.86 ± 2.27, and 6.59 ± 1.4 to 8.72 ± 0.95, 7.61 ± 1.52, and 8.55 ± 1.09, respectively. In the sound localization test, some children with UMA were able to detect sound sources quite well and the sound localization abilities did not deteriorate with the non-surgical BCD. Our study concludes that for children with UMA, the non-surgical BCD provided a definite benefit on speech recognition and high satisfaction without deteriorating their sound localization abilities. It is an efficient and safe solution for the early hearing intervention of these patients.

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Section: Sound Localization Performance Of Children With Unilateral M...mentioning

confidence: 60%

Section: Introductionmentioning

confidence: 99%

Characteristics of sound localization in children with unilateral microtia and atresia and predictors of localization improvement when using a bone conduction device

et al. 2022

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“…It was postulated that some listeners with congenital conductive UHL have adapted to their UHL and learned to rely on the spectral shape cues and monaural head shadow effect cues ( 36 ). In summary, how BCD stimulation affects spatial hearing abilities and the predictive factors that may affect the degree of the benefit provided by BCDs remains unknown.…”

Section: Introductionmentioning

confidence: 99%

Characterisation of the treatment provided for children with unilateral hearing loss

Patel,

Hoare,

Willis

et al. 2023

Front. Pediatr.

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BackgroundChildren with permanent unilateral hearing loss (UHL) are an understudied population, with limited data to inform the guidelines on clinical management. There is a funding gap in healthcare provision for the children with UHL in the United Kingdom, where genetic screening, support services, and devices are not consistently provided or fully funded in all areas. They are a disparate population with regard to aetiology and their degree of hearing loss, and hence their device choice and use. Despite having one “good ear”, some children with UHL can have similar outcomes, socially, behaviourally, and academically, to children with bilateral hearing loss, highlighting the importance of understanding this population. In this longitudinal cohort study, we aimed to characterise the management of the children with UHL and the gaps in the support services that are provided for the children in Nottingham, United Kingdom.MethodsA cohort study was conducted collecting longitudinal data over 17 years (2002–2019) for 63 children with permanent congenital confirmed UHL in a large tertiary regional referral centre for hearing loss in Nottingham, United Kingdom. The cases of UHL include permanent congenital, conductive, mixed, or sensorineural hearing loss, and the degree of hearing loss ranges from mild to profound. The data were taken from their diagnostic auditory brainstem responses and their two most recent hearing assessments. Descriptors were recorded of the devices trialled and used and the diagnoses including aetiology of UHL, age of first fit, degree of hearing loss, when and which type of device was used, why a device was not used, the support services provided, concerns raised, and who raised them.ResultsMost children (45/63; 71%) trialled a device, and the remaining 18 children had no device trial on record. Most children (20/45; 44%) trialled a bone-conduction device, followed by contralateral routing of signal aid (15/45; 33%) and conventional hearing aids (9/45; 20%). Most children (36/45; 80%) who had a device indicated that they wore their device “all day” or every day in school. Few children (8/45; 18%) reported that they wore their device rarely, and the reasons for this included bullying (3/8), feedback from the device (2/8), and discomfort from the device (2/8). Only one child reported that the device was not helping with their hearing. The age that the children were first fitted with their hearing device varied a median of 2.5 years for hearing aids and bone-conduction devices and 7 years for a contralateral routing of signal aid. The length of time that the children had the device also varied widely (median of 26 months, range 3–135 months); the children had their bone-conduction hearing aid for the longest period of time (median of 32.5 months). There was a significant trend where more recent device fittings were happening for children at a younger age. Fifty-one children were referred by the paediatric audiologist to a support service, 72.5% (37/51) were subsequently followed up by the referred service with no issue, whilst the remaining 27.5% (14/51) encountered an issue leading to an unsuccessful provision of support. Overall, most children (65%, 41/63) had no reported concerns, and 28.5% (18/63) of the children went on to have a documented concern at some point during their audiological care: five with hearing aid difficulties, five with speech issues, four with no improvement in hearing, three facing self-image or bullying issues, and one case of a child struggling to interact socially with friends. Three of these children had not trialled a device. We documented every concern reported from the parents, clinicians, teachers of the deaf, and from the children themselves. Where concerns were raised, more than half (58.6%, 10/18) were by schools and teachers, the remaining four concerns were raised by the family, and further four concerns were raised by the children themselves.ConclusionTo discover what management will most benefit which children with permanent UHL, we first must characterise their treatment, their concerns, and the support services available for them. Despite the children with UHL being a highly disparate population—in terms of their aetiology, their device use, the degree of hearing loss, and the age at which they trial a device—the majority report they use their device mostly in school. In lieu of available data and in consideration of the devices that are available to them, it could be useful to support families and clinicians in understanding the devices which are most used and where they are used. Considering the reasons for cessation of regular device use counselling and support services would be vital to support the children with UHL.

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“…It is known that some individuals localize fairly good in the monaural unaided setting and thus will not benefit as much from BCD ( 6 , 8 , 9 ). A possible explanation for the high inter-individual variability in benefit from a BCD is that some individuals with congenital UAA learn to use monaural spectral cues for localization in the horizontal plane ( 10 ). The age at which the child is fitted with the BCD has also been suggested as a factor influencing the benefit from amplification ( 11 , 12 ).…”

Section: Introductionmentioning

confidence: 99%

A pilot study on spatial hearing in children with congenital unilateral aural atresia

Josefsson Dahlgren,

Engmér Berglin,

Hultcrantz

et al. 2023

Front. Pediatr.

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Despite normal hearing in one ear, individuals with congenital unilateral aural atresia may perceive difficulties in everyday listening conditions typically containing multiple sound sources. While previous work shows that intervention with bone conduction devices may aid spatial hearing for some children, testing conditions are often arranged to maximize any benefit and are not very similar to daily life. The benefit from amplification on spatial tasks has been found to vary between individuals, for reasons not entirely clear. This study has sought to expand on the limited knowledge on how children with unilateral aural atresia recognize speech masked by competing speech, and how horizontal sound localization accuracy is affected by the degree of unilateral hearing loss and by amplification using unilateral bone conduction devices when fitted before 3 years of age. In a within-subject, repeated measures design, including 11 children (mean age = 7.9 years), bone conduction hearing device (BCD) amplification did not negatively affect horizontal sound localization accuracy. The effect on speech recognition scores showed greater inter-individual variability. No benefit from amplification on a group level was found. There was no association between age at fitting and the benefit of the BCD. For children with poor unaided sound localization accuracy, there was a greater BCD benefit. Unaided localization accuracy increased as a function of decreasing hearing thresholds in the atretic ear. While it is possible that low sound levels in the atretic ear provided access to interaural localization cues for the children with the lowest hearing thresholds, the association has to be further investigated in a larger sample of children.

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Contribution of spectral pinna cues for sound localization in children with congenital unilateral conductive hearing loss after hearing rehabilitation

Cited by 13 publications

References 29 publications

Characteristics of sound localization in children with unilateral microtia and atresia and predictors of localization improvement when using a bone conduction device

Characteristics of sound localization in children with unilateral microtia and atresia and predictors of localization improvement when using a bone conduction device

Characterisation of the treatment provided for children with unilateral hearing loss

A pilot study on spatial hearing in children with congenital unilateral aural atresia

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