Instant improvement in monaural spatial hearing abilities through cognitive feedback

Arras, Tine; Snapp, Hillary; Sangen, Anouk; Snels, Chantal; Kuntz, I; Theunen, Tinne; Kheirkhah, Kiana; Zarowski, Andrzej; Wesarg, Thomas; Wieringen, Astrid Van; Agterberg, Martijn J.H.

doi:10.1007/s00221-022-06333-7

Cited by 5 publications

(3 citation statements)

References 70 publications

(98 reference statements)

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“…A recent study in children with congenital conductive UHL showed that they may rely on monaural spectral cues for horizontal sound localisation ( 35 ). Context of listening cues can also be important for sound localisation and would be interesting to investigate ( 80 ).…”

Section: Discussionmentioning

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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Section: Discussionmentioning

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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“…Thus, for the former the E rms of chance responses could range from 32 deg to 63 deg, while for our study it ranges between 48 deg and 73 deg. Second, top-down cognitive factors and strategies (e.g., influenced by instruction, task, speaker layout and (in)visibility) may introduce significant experimental differences ( Arras et al, 2022 ). Third, sounds of different frequency content, duration, and power spectra have been used (speech vs broadband white noise vs narrowband sounds).…”

Section: Discussionmentioning

confidence: 99%

Hearing Asymmetry Biases Spatial Hearing in Bimodal Cochlear-Implant Users Despite Bilateral Low-Frequency Hearing Preservation

Sharma

Mens²,

Snik

et al. 2023

Trends in Hearing

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Many cochlear implant users with binaural residual (acoustic) hearing benefit from combining electric and acoustic stimulation (EAS) in the implanted ear with acoustic amplification in the other. These bimodal EAS listeners can potentially use low-frequency binaural cues to localize sounds. However, their hearing is generally asymmetric for mid- and high-frequency sounds, perturbing or even abolishing binaural cues. Here, we investigated the effect of a frequency-dependent binaural asymmetry in hearing thresholds on sound localization by seven bimodal EAS listeners. Frequency dependence was probed by presenting sounds with power in low-, mid-, high-, or mid-to-high-frequency bands. Frequency-dependent hearing asymmetry was present in the bimodal EAS listening condition (when using both devices) but was also induced by independently switching devices on or off. Using both devices, hearing was near symmetric for low frequencies, asymmetric for mid frequencies with better hearing thresholds in the implanted ear, and monaural for high frequencies with no hearing in the non-implanted ear. Results show that sound-localization performance was poor in general. Typically, localization was strongly biased toward the better hearing ear. We observed that hearing asymmetry was a good predictor for these biases. Notably, even when hearing was symmetric a preferential bias toward the ear using the hearing aid was revealed. We discuss how frequency dependence of any hearing asymmetry may lead to binaural cues that are spatially inconsistent as the spectrum of a sound changes. We speculate that this inconsistency may prevent accurate sound-localization even after long-term exposure to the hearing asymmetry.

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“…Also, stimuli have included broadband noise ( Dillon et al 2017b ), high-pass/low-pass filtered stimuli ( Dorman et al 2015 ; Mertens et al 2016 ; Dirks et al 2019 ), words ( Firszt et al 2012a , b ), and sentences ( Arndt et al 2011 ). It is important to note that the results may be influenced by the methodological approach, such as whether leveling roving of the stimulus is used to limit the sole use of level cues ( Middlebrooks & Green 1991 ; Wightman & Kistler 1997 ; Arras et al 2022 ). Taken together, investigation is needed for clinically feasible test configurations that can assess sound source localization within the typical clinical setup and an optimal test battery.…”

Section: Audiologic Assessmentmentioning

confidence: 99%

American Cochlear Implant Alliance Task Force Guidelines for Clinical Assessment and Management of Adult Cochlear Implantation for Single-Sided Deafness

et al. 2022

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The indications for cochlear implantation have expanded to include individuals with profound sensorineural hearing loss in the impaired ear and normal hearing (NH) in the contralateral ear, known as single-sided deafness (SSD). There are additional considerations for the clinical assessment and management of adult cochlear implant candidates and recipients with SSD as compared to conventional cochlear implant candidates with bilateral moderate to profound sensorineural hearing loss. The present report reviews the current evidence relevant to the assessment and management of adults with SSD. A systematic review was also conducted on published studies that investigated outcomes of cochlear implant use on measures of speech recognition in quiet and noise, sound source localization, tinnitus perception, and quality of life for this patient population. Expert consensus and systematic review of the current literature were combined to provide guidance for the clinical assessment and management of adults with SSD.

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Instant improvement in monaural spatial hearing abilities through cognitive feedback

Cited by 5 publications

References 70 publications

Characterisation of the treatment provided for children with unilateral hearing loss

Characterisation of the treatment provided for children with unilateral hearing loss

Hearing Asymmetry Biases Spatial Hearing in Bimodal Cochlear-Implant Users Despite Bilateral Low-Frequency Hearing Preservation

American Cochlear Implant Alliance Task Force Guidelines for Clinical Assessment and Management of Adult Cochlear Implantation for Single-Sided Deafness

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