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To investigate hearing and the take rate of crushed cartilage grafts in tympanoplasty. In this double-blinded, randomised, controlled trial, 46 patients with tympanic membrane perforation were enrolled. A conchal cartilage graft was used for reconstruction in both intervention and control groups. In the intervention group, crushed cartilage was used. The success rate and hearing results were ascertained every four months over a one-year follow-up period. A total of 36 patients - 20 in the intervention group and 16 in the control group - completed one year of follow up. There were no statistically significant differences between the two groups in mean air-bone gap, bone conduction threshold, speech discrimination score or speech reception threshold. The reduction in living cells after crushed cartilage tympanoplasty may decrease the rigidity and the volume of the graft, but may not necessarily improve the hearing results.

Studies point to low help-seeking after a failed hearing screening. This research forum article presents the research protocol for a randomized controlled trial of motivational interviewing via the Internet to promote help-seeking in people who have failed an online hearing screening. Adults who fail a Swedish online hearing screening, including a speech-in-noise recognition test, will be randomized to either an intervention group (participating in motivational interviewing) or an active control group (reading a book on history of hearing aids). Both of the conditions will be delivered via the Internet. The primary outcome is experience with seeking health care and using hearing aids 9 months after the intervention. Secondary outcomes are changes in before and after measures of self-reported hearing difficulties, anxiety, depression, and quality of life. Stages of change and self-efficacy in hearing help-seeking are measured immediately after intervention and at a 9-month follow-up for the purpose of mediation analysis. The results of this randomized controlled trial may help bridge the gap between hearing screening and successful hearing rehabilitation. Although no large instantaneous benefits are expected, a slow change toward healthy behaviors—seeking health care and using hearing aids—would shed light on how to use the Internet to assist people with hearing impairment.

To evaluate the advancements in speech intelligibility testing over the recent decades, with a particular emphasis on the development of audiovisual speech in noise tests that incorporate both auditory and visual modalities for the measurement of speech recognition thresholds. A scoping review was conducted systematically to examine the existing literature on speech intelligibility testing methods. Following comprehensive screening process, studies were selected for detailed analysis, focusing on audiovisual integration and potential for remote or automated administration within studies methodologies. The review encompassed 11 scholarly articles that investigated diverse approaches to speech intelligibility testing. The analysis revealed variability in the accuracy and reliability of speech intelligibility testing methods. Although certain methods demonstrated efficacy in incorporating audiovisual cues, none of the reviewed studies included provisions for remote administration, thereby necessitating the presence of a clinician for test execution. This limitation underscores the imperative for further research development of remote testing methodologies that leverage audiovisual technologies to assess speech in noise. The findings of this review underscore the critical need for advancement in speech intelligibility testing methodologies particularly integrating audiovisual components and enabling remote administration. The development in this domain holds significant potential to enhance the assessment and implementation of assistive technologies for individuals with hearing impairments.

Speech-in-noise (SiN) perception is a critical aspect of natural listening, deficits in which are a major contributor to the hearing handicap in cochlear hearing loss. Studies suggest that SiN perception correlates with cognitive skills, particularly phonological working memory: the ability to hold and manipulate phonemes or words in mind. We consider here the idea that SiN perception is linked to a more general ability to hold sound objects in mind, auditory working memory, irrespective of whether the objects are speech sounds. This process might help combine foreground elements, like speech, over seconds to aid their separation from the background of an auditory scene. We investigated the relationship between auditory working memory precision and SiN thresholds in listeners with normal hearing. We used a novel paradigm that tests auditory working memory for non-speech sounds that vary in frequency and amplitude modulation (AM) rate. The paradigm yields measures of precision in frequency and AM domains, based on the distribution of participants’ estimates of the target. Across participants, frequency precision correlated significantly with SiN thresholds. Frequency precision also correlated with the number of years of musical training. Measures of phonological working memory did not correlate with SiN detection ability. Our results demonstrate a specific relationship between working memory for frequency and SiN. We suggest that working memory for frequency facilitates the identification and tracking of foreground objects like speech during natural listening. Working memory performance for frequency also correlated with years of musical instrument experience suggesting that the former is potentially modifiable.

Purpose The aim of the study was to develop the German Hearing in Noise Test (HINT) with female speaker by fulfilling the recommendations by International Collegium of Rehabilitative Audiology (ICRA) for using a female speaker to create new multilingual speech tests and to determine norms and to compare these norms with German male speech tests—the male speakers HINT and the Oldenburg Sentence Test (OLSA). Methods The HINT with a female speaker consists of the same speech material as the male speaking HINT. After recording the speech material, 10 normal hearing subjects were included to determine the performance–intensity function (PI function). 24 subjects were part of the measurements to determine the norms and compare them with the norms of male HINT and OLSA. Comparably, adaptive, open-set methods under headphones (HINT) and sound field (OLSA) were used. Results Acoustic phonetic analysis demonstrated significant difference in mean fundamental frequency, its range and mean speaking rate between both HINT speakers. The calculated norms by three of the tested four conditions of the HINT with a female speaker are not significantly different from the norms with a male speaker. No significant effect of the speaker’s gender of the first HINT measurement and no significant correlation between the threshold results of the HINT and the OLSA were determined. Conclusions The Norms for German HINT with a female speaker are comparable to the norms of the HINT with a male speaker. The speech intelligibility score of the HINT does not depend on the speakers’ gender despite significant difference of acoustic–phonetic parameters between the female and male HINT speaker’s voice. Instead, the speech intelligibility rating must be seen as a function of the used speech material.

Speech-recognition tests are widely used in both clinical and research audiology. The purpose of this study was the development of a novel speech-recognition test that combines concepts of different speech-recognition tests to reduce training effects and allows for a large set of speech material. The new test consists of four different words per trial in a meaningful construct with a fixed structure, the so-called phrases. Various free databases were used to select the words and to determine their frequency. Highly frequent nouns were grouped into thematic categories and combined with related adjectives and infinitives. After discarding inappropriate and unnatural combinations, and eliminating duplications of (sub-)phrases, a total number of 772 phrases remained. Subsequently, the phrases were synthesized using a text-to-speech system. The synthesis significantly reduces the effort compared to recordings with a real speaker. After excluding outliers, measured speech-recognition scores for the phrases with 31 normal-hearing participants at fixed signal-to-noise ratios (SNR) revealed speech-recognition thresholds (SRT) for each phrase varying up to 4 dB. The median SRT was −9.1 dB SNR and thus comparable to existing sentence tests. The psychometric function's slope of 15 percentage points per dB is also comparable and enables efficient use in audiology. Summarizing, the principle of creating speech material in a modular system has many potential applications.

Previous studies have demonstrated the feasibility of estimating the speech reception threshold (SRT) based on electroencephalography (EEG), termed SRTneuro, in younger normal-hearing (YNH) participants. This method may support speech perception in hearing-aid users through continuous adaptation of noise-reduction algorithms. The prevalence of hearing impairment and thereby hearing-aid use increases with age. The SRTneuro estimation is based on envelope reconstruction accuracy, which has also been shown to increase with age, possibly due to excitatory/inhibitory imbalance or recruitment of additional cortical regions. This could affect the estimated SRTneuro. This study investigated the age-related changes in the temporal response function (TRF) and the feasibility of SRTneuro estimation across age. Twenty YNH and 22 older normal-hearing (ONH) participants listened to audiobook excerpts at various signal-to-noise ratios (SNRs) while EEG was recorded using 66 scalp electrodes and 12 in-ear-EEG electrodes. A linear decoder reconstructed the speech envelope, and the Pearson's correlation was calculated between the reconstructed and speech-stimulus envelopes. A sigmoid function was fitted to the reconstruction-accuracy-versus-SNR data points, and the midpoint was used as the estimated SRTneuro. The results show that the SRTneuro can be estimated with similar precision in both age groups, whether using all scalp electrodes or only those in and around the ear. This consistency across age groups was observed despite physiological differences, with the ONH participants showing higher reconstruction accuracies and greater TRF amplitudes. Overall, these findings demonstrate the robustness of the SRTneuro method in older individuals and highlight its potential for applications in age-related hearing loss and hearing-aid technology.

Purpose The Oldenburg Sentence Test (OLSA) is a German matrix test designed to determine speech recognition thresholds (SRT). It is widely used for hearing-aids and cochlear implant fitting, but an age-adjusted standard is still lacking. In addition, knowing that the ability to concentrate is an important factor in OLSA performance, we hypothesized that OLSA performance would depend on the time of day it was administered. The aim of this study was to propose an age standardization for the OLSA and to determine its diurnal performance. Methods The Gutenberg Health Study is an ongoing population-based study and designed as a single-centre observational, prospective cohort study. Participants were interviewed about common otologic symptoms and tested with pure-tone audiometry and OLSA. Two groups—subjects with and without hearing loss—were established. The OLSA was performed in two runs. The SRT was evaluated for each participant. Results were characterized by age in 5-year cohorts, gender and speech recognition threshold (SRT). A time stamp with an hourly interval was also implemented. Results The mean OLSA SRT was − 6.9 ± 1.0 dB (group 1 male) and − 7.1 ± 0.8 dB (group 1 female) showing an inverse relationship with age in the whole cohort, whereas a linear increase was observed in those without hearing loss. OLSA-SRT values increased more in males than in females with increasing age. No statistical significance was found for the diurnal performance. Conclusions A study with 2900 evaluable Oldenburg Sentence Tests is a novelty and representative for the population of Mainz and its surroundings. We postulate an age- and gender-standardized scale for the evaluation of the OLSA. In fact, with an intergroup standard deviation (of about 1.5 dB) compared to the age dependence of 0.7 dB/10 years, this age normalization should be considered as clinically relevant.

Background The development of a Digit Triplet Test in the Swahili language is an essential step towards providing accurate hearing assessment for Swahili-speaking populations. Objectives This study aimed to develop a Digit Triplet Test in Swahili through a two-part procedure consisting of an optimisation phase and an evaluation phase using normal hearing participants. Method A total of 34 subjects participated in the study. During the optimisation phase, a psychometric intelligibility function was determined for each recorded digit, allowing for volume adjustments to standardise the threshold across all digits. This resulted in a lower threshold and a steeper psychometric function for both the triplets and the test lists. Using the optimised speech material, four test lists were created, each containing 27 triplets composed of digits between 1 and 9. The finalised material was then evaluated. Results In the final version, the mean Speech Reception Threshold (SRT) for the participants was −8.9 ± 0.6 dB Signal-to-Noise Ratio (SNR), and the mean slope was 24.7 ± 3.5%/dB using triplet scoring. Conclusion The psychometric function for normal listeners shows a steep slope with little variation between subjects and across test lists. Contribution The test results are comparable to those of Digit Triplet Tests developed in other languages, indicating the effectiveness and reliability of the Swahili Digit Triplet Test for hearing assessments.

Many tinnitus patients report difficulties understanding speech in noise or competing talkers, despite having “normal” hearing in terms of audiometric thresholds. The interference caused by tinnitus is more likely central in origin. Release from informational masking (more central in origin) produced by competing speech may further illuminate central interference due to tinnitus. In the present study, masked speech understanding was measured in normal hearing listeners with or without tinnitus. Speech recognition thresholds were measured for target speech in the presence of multi-talker babble or competing speech. For competing speech, speech recognition thresholds were measured for different cue conditions (i.e., with and without target-masker sex differences and/or with and without spatial cues). The present data suggest that tinnitus negatively affected masked speech recognition even in individuals with no measurable hearing loss. Tinnitus severity appeared to especially limit listeners’ ability to segregate competing speech using talker sex differences. The data suggest that increased informational masking via lexical interference may tax tinnitus patients’ central auditory processing resources.