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Many auditory system functions improve under the influence of music. The binaural hearing also plays a critical role in speech-in-noise perception. The present study was done to investigate the effect of music on speech-in-noise perception in binaural and monaural hearing aid users. This study was conducted on 40 unilateral and bilateral hearing aid users aged 25 to 55, including 23 female and 17 male individuals. The Q-SIN test and SSQ questionnaire were used to investigate the effect of music on speech-in-noise perception before and after the treatment. Results of the Q-SIN test showed that music reduced SNR-50 and SNR LOSS, which was more evident in bilateral hearing aid users (p < 0.05). Results of the SSQ questionnaire also indicated that after the 3-month reevaluation, the questionnaire scores increased, and the increase was higher in the bilateral hearing aid users (p < 0.05). Regularly listening to music on a programmed basis improves speech-in-noise perception. Results of the present study showed that bilateral hearing aids had a higher effect on improving speech-in-noise perception than unilateral hearing aids. [ABSTRACT FROM AUTHOR]

Objectives: The ability to localize sound sources is crucial for everyday listening, as it contributes to spatial awareness and the detection of warning signs. Individuals with hearing impairment have poorer localization abilities, which further deteriorate when they are fitted with a hearing aid. Although numerous studies have addressed this phenomenon, there is a lack of systematic evidence. The aim of the current systematic review is to address the following research question, "Do behavioural measures of spatial hearing ability improve with bilateral hearing aid fitting compared to the unaided hearing condition?" Design: A comprehensive search was conducted by two independent authors utilizing electronic databases, using various electronic databases, covering the period of 1965 to 2022. The inclusion and exclusion criteria were formulated using the Population, Intervention, Compression, Outcome, and Study design (PICOS) format, and the certainty of evidence was determined using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) guidelines. Results: The comprehensive search resulted in 2199 studies, 17 studies for qualitative synthesis and 15 studies for quantitative synthesis. The collected data was divided into two groups, namely vertical and horizontal localization. The results of the quantitative analysis indicate that the localization performance was significantly better in the unaided condition for both vertical and horizontal planes. The certainty of our evidence was judged to be moderate, meaning that "we are moderately confident in the effect estimate. The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different". Conclusion: The review findings demonstrate that the bilateral fitting of the hearing aid did not effectively preserve spatial cues, which resulted in poorer localization performance irrespective of the plane of assessment. Review Registration: Prospective Register of Systematic Reviews (PROSPERO); CRD42022358164 IMPLICATIONS FOR REHABILITATION: Hearing aids are a widely used rehabilitative method to compensate for the loss of audibility in individuals with hearing impairment. The current review highlights that, even though hearing aids can enhance audibility, they often fail to preserve spatial cues. This review paper provides a comprehensive summary of the existing literature, focusing on the preservation of spatial cues by hearing aids and the technologies that can enhance localization performance to a certain degree. The findings of the current study encourage both researchers and hearing aid manufacturers to advance their research methods pertaining to the preservation of spatial cues. This advancement has the potential to improve spatial awareness and possibly improve speech perception in the presence of noise in hearing aid users. [ABSTRACT FROM AUTHOR]

ObjectivesMethodsResultsConclusionsThe primary objective was to examine duration of daily cochlear implant (CI) usage at 12 and 24 months post-operatively in single sided deafness (SSD). The secondary objective was to examine factors that could affect CI usage.Retrospective cohort of patients with SSD who received CI from January 2015 to March 2020. CI usage was evaluated at 12 and 24 months. Hearing loss duration, tinnitus scores and signal-to-noise ratio (SNR) were correlated with CI usage at 12 months.Usage data was available for 54 patients at 12 months and 38 patients at 24 months. The mean usage was 8.2 h/day (SD 4.2) at 12 months, 7.0 h/day (SD 5.1) at 24 months. 5 out of 54 (9.3%) and 7 out of 38 patients (18.4%) were non-users at 12 and 24 months post-operatively. An improved mean SNR score from pre-operative 4.4 dB (SD 2.8) to – 0.70 dB (SD 4.2) at 12 months post-operative was positively correlated with CI usage at 12 and 24 months. Hearing loss duration and tinnitus scores were not associated with CI usage.18.4% of our patients were non-users at 24 months. Mean usage at 24 months was 7.0 h/day. Improved hearing in noise at 12 months was correlated with better usage. [ABSTRACT FROM AUTHOR]

The central auditory system encompasses two primary functions: identification and localization. Spatial release from masking (SRM) highlights speech recognition in competing noise and improves the listening experience when a spatial cue is introduced between noise and target speech. This assessment focuses on the integrity of auditory function and holds clinical significance. However, infants or pre-lingual subjects sometimes provide less reliable results. This study investigates the value of cortical auditory evoked potentials (CAEPs) onset and acoustic change complex (ACC) as an objective measurement of SRM. Thirty normal-hearing young adults (11 males) were recruited. We found the spatial separation of signals and noise (±90° symmetrically) resulted in a signal-to-noise ratio (SNR) improvement of 9.00 ± 1.71 dB behaviorally. It significantly enhanced cortical processing at all SNR levels, shortened CAEP latencies, and increased amplitudes, resulting in a greater number of measurable peaks for ACC. SRM showed mild to moderate correlations with the differences between two conditions in CAEP measures. The regression model combining N1′-P2′ amplitude at 5 dB SNR (R2 = 0.26), P1 amplitude at 0 dB SNR (R2 = 0.14), and P1 latency at −5 dB SNR (R2 = 0.15), explained 45.3% of the variance in SRM. Our study demonstrates that introducing spatial cues can improve speech perception and enhance central auditory processing in normal-hearing young adults. CAEPs may contribute to predictions about SRM and hold potential for practical application. NEW & NOTEWORTHY: The neural encoding of spatial release from masking (SRM) can be observed in normal-hearing young adults. Spatial separation between target and masker improves speech perception in noise and enhances central auditory processing. The behavioral results showed mild-to-moderate correlations with electrophysiological measures, with acoustic change complex (ACC) amplitude being a better indicator than onset components. Cortical auditory evoked potentials (CAEPs) may contribute to predictions about spatial release from masking, especially when behavioral tests are less reliable. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to evaluate the efficacy of auditory training (AT) in patients with unilateral hearing loss (UHL) using hearing aids (HAs), comparing traditional methods with a new approach involving a wireless remote microphone. Methods: The study included 96 participants, divided into two groups, with ages ranging from 42 to 64 years, comprising both male and female subjects. A clinical trial including consecutive moderate UHL patients was performed at our institution. For the study group, a Roger Pen was used during AT with patients inside a sound-attenuating cabin. Controls followed conventional sessions. Professional speech and language pathologists performed the rehabilitation. Audiological outcomes were measured, including word recognition at signal-to-noise ratios (SNRs) of 0 dB, +5 dB, and +10 dB, to determine the effectiveness of the training. Measurements also included the Speech, Spatial, and Qualities of Hearing Scale to assess perceived auditory abilities. Results: A total of 46 and 50 UHL patients were randomly included in the study and control groups, respectively. No differences were found in terms of sex, age, presence of tinnitus, duration of hearing loss, pure tone average, and speech-in-noise perception without an HA. Following HA fitting and AT, a notable enhancement in the ability to identify speech in noisy environments was observed in the study group. This improvement was significant at SNRs of +5 and +10. When comparing the ability to identify speech in noise using HAs across both groups, it was observed that hearing capabilities post-wireless AT showed a significant improvement at an SNR of +5. Only the study group had a significant improvement in the total Speech, Spatial, and Qualities of Hearing Scale score after the training. Conclusions: In our group of UHL patients, we found significantly better speech-in-noise perception when HA fitting was followed by wireless AT. Wireless AT may facilitate usage of HAs, leading to binaural hearing in UHL patients. Our findings suggest that future interventions might benefit from incorporating wireless technology in AT programs. [ABSTRACT FROM AUTHOR]

To investigate retrospectively the frequency of usage of bimodal stimulation among cochlear implant (CI) users, as well its clinical benefit relative to unilateral use. All subjects had been monitored with the clinical Minimal Outcome Measurements test battery. 103 adults with bilateral postlingual profound sensorineural hearing loss and unilateral CI use were extracted from the local database. These were divided into two groups: those who only used a CI and those who used bimodal stimulation. The preoperative contralateral residual hearing in the bimodal group was significantly better than that of the CI-only group. In both groups, speech perception in quiet and in noise improved after CI, with no significant difference between postoperative unimodal conditions. For the bimodal group, an additional significant improvement was found for the bimodal condition compared to the unimodal. Given the observed auditory benefit of bimodal stimulation in comparison to unimodal stimulation and given the finding that degree of residual hearing is not correlated with bimodal benefits, it is recommended to encourage CI recipients to continue contralateral HA use after CI. As a result of expanding CI criteria worldwide, the population of bimodal users is expected to grow in the near future. [ABSTRACT FROM AUTHOR]

AbstractObjectiveDesignStudy sampleResultsConclusionsTo investigate speech recognition in school-age children with early-childhood otitis media (OM) in conditions with noise or speech maskers with or without interaural differences. To also investigate the effects of three otologic history factors.Using headphone presentation, speech recognition thresholds (SRTs) were measured with simple sentences. As maskers, stationary speech-shaped noise (SSN) or two-talker running speech (TTS) were used. The stimuli were presented in a monaural and binaural condition (SSN) or a co-located and spatially separated condition (TTS). Based on the available medical records, overall OM duration, OM onset age, and time since the last OM episode were estimated.6–13-year-olds with a history of recurrent OM (N = 42) or without any ear diseases (N = 20) with normal tympanograms and audiograms at the time of testing.Mixed-model regression analyses that controlled for age showed poorer SRTs for the OM group (Δ-value = 0.84 dB, p = 0.009). These appeared driven by the spatially separated, binaural, and monaural conditions. The OM group showed large inter-individual differences, which were unrelated to the otologic history factors.Early-childhood OM can affect speech recognition in different acoustic conditions. The effects of the otologic history warrant further investigation. [ABSTRACT FROM AUTHOR]

Introduction: Cochlear implants (CIs) can restore binaural hearing in cases of single-sided deafness (SSD). However, studies with a high level of evidence in support of this phenomenon are lacking. The aim of this study is to analyze the effectiveness of CIs using several spatialized speech-in-noise tests and to identify potential predictors of successful surgery. Methods: Ten cases underwent standard CI surgery (MEDEL-Flex24). The speech-in-noise test was used in three different spatial configurations. The noise was presented from the front (N0), toward the CI (NCI), and toward the ear (Near), while the speech was always from the front (S0). For each test, the speech-to-noise ratio at 50% intelligibility (SNR50) was evaluated. Seven different effects were assessed (summation, head shadow [HS], speech released of masking [SRM], and squelch for the CI and for the ear). Results: A significant summation effect of 1.5 dB was observed. Contralateral PTA was positively correlated with S0N0-B and S0NCI-B (CIon and unplugged ear). S0N0-B results were positively correlated with S0N0-CIoff (p < 0.0001) and with S0Near-CIoff results (p = 0.004). A significant positive correlation was found between delay post-activation and HS gain for the CI (p = 0.005). Finally, the HS was negatively correlated with the squelch effect for the ear. Conclusion: CI benefits patients with SSD in noise and can improve the threshold for detecting low-level noise. Contralateral PTA could predict good postoperative results. Simple tests performed preoperatively can predict the likelihood of surgical success in reversing SSD. [ABSTRACT FROM AUTHOR]

Background/Objective: Bilaterally implanted cochlear implant (CI) users do not consistently have access to interaural time differences (ITDs). ITDs are crucial for restoring the ability to localize sounds and understand speech in noisy environments. Lack of access to ITDs is partly due to lack of communication between clinical processors across the ears and partly because processors must use relatively high rates of stimulation to encode envelope information. Speech understanding is best at higher stimulation rates, but sensitivity to ITDs in the timing of pulses is best at low stimulation rates. Methods: We implemented a practical "mixed rate" strategy that encodes ITD information using a low stimulation rate on some channels and speech information using high rates on the remaining channels. The strategy was tested using a bilaterally synchronized research processor, the CCi-MOBILE. Nine bilaterally implanted CI users were tested on speech understanding and were asked to judge the location of a sound based on ITDs encoded using this strategy. Results: Performance was similar in both tasks between the control strategy and the new strategy. Conclusions: We discuss the benefits and drawbacks of the sound coding strategy and provide guidelines for utilizing synchronized processors for developing strategies. [ABSTRACT FROM AUTHOR]

Purpose: The current study was taken up to estimate the prevalence of Single Sided Deafness (SSD) in a tertiary healthcare hospital in Mumbai. Also to determine the acceptance of Contralateral routing of offside signal (CROS) devices by individuals with SSD. Method: A retrospective study design was followed to collect data from September 2020 to September 2022. The data were collected by reviewing the files of the cases diagnosed with Single-Sided Deafness in a tertiary health care hospital in Mumbai. Result: The prevalence of SSD was found to be 24% for the given period. It was observed that 50 out of 4456 took a free trial and 2 bought the device. Conclusion: The poor acceptance and purchase of CROS are attributed to the cost, and missed benefits of true binaural hearing in localization and hearing in noise. These benefits can be achieved by using CI, however, the cost and fear of surgery refrained the participants. Also, participants were observed to learn great use of communication repair strategies. Therefore, it is required to counsel individuals with SSD for CI and provide knowledge about care for the better with regular audiological follow-up. [ABSTRACT FROM AUTHOR]

Brainstem degeneration is a prominent feature of spinocerebellar ataxia type 3 (SCA3), involving structures that execute binaural synchronization with microsecond precision. As a consequence, auditory processing may deteriorate during the course of disease. We tested whether the binaural "Huggins pitch" effect is suitable to study the temporal precision of brainstem functioning in SCA3 mutation carriers. We expected that they would have difficulties perceiving Huggins pitch at high frequencies, and that they would show attenuated neuromagnetic responses to Huggins pitch. The upper limit of Huggins pitch perception was psychoacoustically determined in 18 pre-ataxic and ataxic SCA3 mutation carriers and in 18 age-matched healthy controls. Moreover, the cortical N100 response following Huggins pitch onset was acquired by means of magnetoencephalography (MEG). MEG recordings were analyzed using dipole source modeling and comprised a monaural pitch condition and a no-pitch condition with simple binaural correlation changes. Compared with age-matched controls, ataxic but not pre-ataxic SCA3 mutation carriers had significantly lower frequency limits up to which Huggins pitch could be heard. Listeners with lower frequency limits also showed diminished MEG responses to Huggins pitch, but not in the two control conditions. Huggins pitch is a promising tool to assess brainstem functioning in ataxic SCA3 patients. Future studies should refine the psychophysiological setup to capture possible performance decrements also in pre-ataxic mutation carriers. Longitudinal observations will be needed to prove the potential of the assessment of Huggins pitch as a biomarker to track brainstem functioning during the disease course in SCA3. [ABSTRACT FROM AUTHOR]

The spatial selectivity of hearing to speech signals was studied when the target signal and interference were separated by distance between their sources and the listener. In the work, the hypothesis about the improvement of hearing selectivity due to more intensive activation of the high-frequency binaural mechanism due to the shift of the speaker's voice spectrum occurs in noisy environment towards high frequencies, was tested. The thresholds for detecting the target signal—a two-syllable word uttered by male or female, were evaluated in the two-alternative two-interval forced-choice paradigm in 4 series. Series differed by the type of target signal (normal or Lombard speech) and the location of target source and noise (multi-talker noise) one. The both sources were located at a distance of 1 and 4 m opposite the subject at the level of his head. The detection threshold was defined as the ratio of signal and noise levels at the listener's place (S/N). The threshold for detecting the target signal (male and female speaker voices together) was –11 dB S/N for normal as well as Lombard speech. It did not depend on which of the sources—the target signal or noise, was closer to the listener. In normal speech, the detection thresholds on average differed for male and female voices, but the difference was not significant. In Lombard speech, these thresholds were significantly different: for a male voice, the threshold at a detection level of 0.67 was –10 dB S/N, and for a female voice was –12.5 dB S/N. [ABSTRACT FROM AUTHOR]

There is a discrepancy between the hearing test results in patients with single-sided deafness (SSD) and their reported outcome measures. This is probably due to the presence of two elements in everyday situations: noise and head movements. We developed a stereo-audiometric test in noise with free head movements to evaluate movements and auditory performance in monaural and binaural conditions in normal hearing volunteers with one occluded ear. Tests were performed in the binaural condition (BIN), with the left ear (LEO) or the right ear occluded (REO). The signal was emitted by one of the seven speakers, placed every 30° in a semicircle, and the noise (cocktail party) by all speakers. Subjects turned their head freely to obtain the most comfortable listening position, then repeated 10 sentences in this position. In monaural conditions, the sums of rotations (head rotations for an optimal hearing position in degrees, random signal azimuth, 1 to 15 signal ad lib signal presentations) were higher (LEO 255 ± 212°, REO 308 ± 208° versus BIN 74 ± 76, p < 0.001, ANOVA) than those in the BIN condition and the discrimination score (out of 10) was lower than that in the BIN condition (LEO 5 ± 1, REO 7 ± 1 versus BIN 8 ± 1, respectively p < 0.001 and p < 0.05 ANOVA). In the monaural condition, total rotation and discrimination in noise were negatively correlated with difficulty (Pearson r = −0.68, p < 0.01 and −0.51, p < 0.05, respectively). Subjects' behaviors were different in optimizing their hearing in noise via head rotation. The evaluation of head movements seems to be a significant parameter in predicting the difficulty of monaural hearing in noisy environments. [ABSTRACT FROM AUTHOR]

Background: To assess and compare binaural benefits and subjective satisfaction of active bone conduction implant (BCI) in patients with bilateral conductive or mixed hearing loss fitted with bilateral BCI and patients with monaural conductive hearing loss fitted with monaural BCI. Methods: ITA Matrix test was performed both on patients affected by bilateral conductive or mixed hearing loss fitted with monaural bone conduction hearing implant (Bonebridge, Med-El) before and after implantation of contralateral bone conduction hearing implant and on patients with monaural conductive or mixed hearing loss before and after implantation of monaural BCI. The Abbreviated Profile of Hearing Aid Benefit (APHAB) questionnaire was administered to both groups of subjects and the results were compared with each other. Results: Patients of group 1 reported a difference of 4.66 dB in the summation setting compared to 0.79 dB of group 2 (p < 0.05). In the squelch setting, group 1 showed a difference of 2.42 dB compared to 1.53 dB of group 2 (p = 0.85). In the head shadow setting, patients of group 1 reported a difference of 7.5 dB, compared to 4.61 dB of group 2 (p = 0.34). As for the APHAB questionnaire, group 1 reported a mean global score difference of 11.10% while group 2 showed a difference of −4.00%. Conclusions: Bilateral BCI in patients affected by bilateral conductive or mixed hearing loss might show more advantages in terms of sound localisation, speech perception in noise and subjective satisfaction if compared to unilateral BCI fitting in patients affected by unilateral conductive hearing impairment. This may be explained by the different individual transcranial attenuation of each subject, which might lead to different outcomes in terms of binaural hearing achievement. On the other hand, patients with unilateral conductive or mixed hearing loss fitted with monaural BCI achieved good results in terms of binaural hearing and for this reason, there is no absolute contraindication to implantation in those patients. [ABSTRACT FROM AUTHOR]

Purpose: Inter-aural insertion depth difference (IEDD) in bilateral cochlear implant (BiCI) with continuous interleaved sampling (CIS) processing is known to reduce the recognition of speech in noise and spatial release from masking (SRM). However, the independent channel selection in the 'n-of-m' sound coding strategy might have a different effect on speech recognition and SRM when compared to the effects of IEDD in CIS-based findings. This study aimed to investigate the effect of bilateral 'n-of-m' processing strategy and interaural electrode insertion depth difference on speech recognition in noise and SRM under conditions that simulated bilateral cochlear implant listening. Methods: Five young adults with normal hearing sensitivity participated in the study. The target sentences were spatially filtered to originate from 0° and the masker was spatially filtered at 0°, 15°, 37.5°, and 90° using the Oldenburg head-related transfer function database for behind the ear microphone. A 22-channel sine wave vocoder processing based on 'n-of-m' processing was applied to the spatialized target-masker mixture, in each ear. The perceptual experiment involved a test of speech recognition in noise under one co-located condition (target and masker at 0°) and three spatially separated conditions (target at 0°, masker at 15°, 37.5°, or 90° to the right ear). Results: The results were analyzed using a three-way repeated measure analysis of variance (ANOVA). The effect of interaural insertion depth difference (F (2,8) = 3.145, p = 0.098, ɳ2 = 0.007) and spatial separation between target and masker (F (3,12) = 1.239, p = 0.339, ɳ2 = 0.004) on speech recognition in noise was not significant. Conclusions: Speech recognition in noise and SRM were not affected by IEDD ≤ 3 mm. Bilateral 'n-of-m' processing resulted in reduced speech recognition in noise and SRM. [ABSTRACT FROM AUTHOR]

Introduction: The study aimed to investigate binaural cues in the rehabilitation of unilateral occluded ears with a bone conduction hearing aid. Methods: The study sample consisted of 40 adult volunteers with normal hearing. Unilateral pseudo-conductive hearing loss was induced by inserting an earplug into the external auditory canal (EAC) and silicone material in the concha for ear impression. The adaptive speech-in-noise test (Italian Matrix test) was performed in three spatial orientations to assess binaural cues (summation, squelch, and head shadow effects). All evaluations were performed in the normal condition, after EAC occlusion, and after application of an adhesive bone conduction hearing aid. Binaural contrast differences were calculated in the three conditions. Results: In the EAC occlusion condition, there was a significant increase in the signal-to-noise ratio (SNR) in both the S0N0 (2.4 dB) and the S90N−90 (7.7 dB) settings, and a slight albeit significant increase in the S0N90 setting (1.35 dB). After fitting the BC hearing aid, there was a reduction of −1.8 dB SNR (p < 0.001) in the S0N0 setting and −2 dB (p = 0.003) in the S90N−90 setting. There was no improvement in the SNR (p = 0.405) in evaluation of the squelch effect (S0N90). These data were corroborated by a better binaural contrast due to a reduction in the summation effect in the monaural occlusion condition and a subsequent reduction in binaural contrast after fitting the hearing aid due to an increase in the summation effect (−2.5 dB vs. 0.3 dB; p < 0.001). Conclusions: Application of a bone conduction hearing aid in unilateral pseudo-conductive hearing loss strengthens speech recognition of noise by improving the summation effect and impeding the shadow effect of the head; however, there appears to be no improvement in speech perception in noise due to spatial release from masking. [ABSTRACT FROM AUTHOR]

Dichotic pitches such as the Huggins pitch (HP) and the binaural edge pitch (BEP) are perceptual illusions whereby binaural noise that exhibits abrupt changes in interaural phase differences (IPDs) across frequency creates a tonelike pitch percept when presented to both ears, even though it does not produce a pitch when presented monaurally. At the perceptual and cortical levels, dichotic pitches behave as if an actual tone had been presented to the ears, yet investigations of neural correlates of dichotic pitch in single-unit responses at subcortical levels are lacking. We tested for cues to HP and BEP in the responses of binaural neurons in the auditory midbrain of anesthetized cats by varying the expected pitch frequency around each neuron's best frequency (BF). Neuronal firing rates showed specific features (peaks, troughs, or edges) when the pitch frequency crossed the BF, and the type of feature was consistent with a well-established model of binaural processing comprising frequency tuning, internal delays, and firing rates sensitive to interaural correlation. A Jeffress-like neural population model in which the behavior of individual neurons was governed by the cross-correlation model and the neurons were independently distributed along BF and best IPD predicted trends in human psychophysical HP detection but only when the model incorporated physiological BF and best IPD distributions. These results demonstrate the existence of a rate-place code for HP and BEP in the auditory midbrain and provide a firm physiological basis for models of dichotic pitches. NEW & NOTEWORTHY Dichotic pitches are perceptual illusions created centrally through binaural interactions that offer an opportunity to test theories of pitch and binaural hearing. Here we show that binaural neurons in auditory midbrain encode the frequency of two salient types of dichotic pitches via specific features in the pattern of firing rates along the tonotopic axis. This is the first combined single-unit and modeling study of responses of auditory neurons to stimuli evoking a dichotic pitch. [ABSTRACT FROM AUTHOR]

Introduction: Cochlear implantation is an effective treatment for children with deafness. Although the binaural effect of bilateral cochlear implantation on sound localization and speech perception in noisy environments has been demonstrated, the outcome and performance predictors of the second cochlear implant (CI2) remain uncertain for patients receiving sequential implantation. This study evaluated the hearing performance between the first cochlear implant (CI1), CI2, and bilateral cochlear implants (CI1+2) among children with sequential bilateral cochlear implantation.Methods: This single-center retrospective study enrolled 14 children and adolescents aged 8-18 years who underwent sequential bilateral cochlear implantation with a mean interimplant interval of 8.2 years. The Mandarin Lexical Neighborhood Test (M-LNT), the Mandarin Hearing in Noise Test (M-HINT), and the Comprehensive Cochlear Implant Questionnaire (CCIQ) scores of participants were evaluated. Mann-Whitney U tests and Spearman correlation analysis were performed to analyze factors associated with CI2 performance.Results: In the 1-year follow-up period after CI2 implantation, although the M-LNT mean score for CI2 was significantly lower than that for CI1, the M-LNT scores for CI2 and CI1+2 improved significantly over time. In a noisy environment, CI1+2 significantly outperformed CI1 in the M-HINT. The M-LNT score for CI2 was significantly associated with preoperative bimodal fitting, residual hearing of the second implanted ear, and CI2 daily-usage time. Specific to CI2, the CCIQ showed improvement 1 year after CI2 implantation.Conclusion: CI2 improved the hearing performance and quality of life of recipients with longer interimplant intervals, especially in noisy environments, and its efficacy was associated with preoperative bimodal fitting and regular daily use. [ABSTRACT FROM AUTHOR]

The study aimed to develop a consensus classification system for the reporting of sound localization testing results, especially in the field of cochlear implantation. Against the background of an overview of the wide variations present in localization testing procedures and reporting metrics, a novel classification system was proposed to report localization errors according to the widely accepted International Classification of Functioning, Disability and Health (ICF) framework. The obtained HEARRING_LOC_ICF scale includes the ICF graded scale: 0 (no impairment), 1 (mild impairment), 2 (moderate impairment), 3 (severe impairment), and 4 (complete impairment). Improvement of comparability of localization results across institutes, localization testing setups, and listeners was demonstrated by applying the classification system retrospectively to data obtained from cohorts of normal-hearing and cochlear implant listeners at our institutes. The application of our classification system will help to facilitate multi-center studies, as well as allowing better meta-analyses of data, resulting in improved evidence-based practice in the field. [ABSTRACT FROM AUTHOR]

Introduction: Our purpose was to investigate binaural integration for spectrally degraded speech in normal-hearing (NH) subjects, single-sided deafness (SSD) cochlear implant (CI) recipients, and bilateral deaf bilateral CI recipients. Methods: We tested ten adult subjects in each group with a modified version of the binaural fusion test according to Matzker. Speech recognition was assessed for monotic listening with the better-hearing ear or CI, monotic listening with the poorer-hearing ear or CI, and dichotic listening. We employed two presentation modes: (1) low pass (LP)-filtered speech to the better ear or CI and high pass (HP)-filtered speech to the poorer ear or CI, and (2) LP-filtered speech to the poorer ear or CI and HP-filtered speech to the better ear or CI. Five magnitudes of LP and HP filtering, i.e., spectral degradation, for each presentation mode were applied yielding two spectrally overlapping and three nonoverlapping presentation conditions. Sentences from the Oldenburg Children's sentence test were applied to assess speech recognition. Results: NH subjects, SSD CI recipients, and bilateral CI recipients were able to understand spectrally degraded speech under both monotic and dichotic listening conditions for both the presentation modes. Speech performance decreased with the increasing loss of spectral information in all the three subject groups. In the NH subjects, speech recognition scores significantly improved for dichotic compared with each monotic listening type under two spectrally nonoverlapping conditions. The SSD CI subjects showed a significant improvement in speech scores for dichotic listening compared with monotic listening with the NH ear under one nonoverlapping condition, i.e., a dichotic benefit in speech recognition with CI. We saw a dichotic benefit in the bilateral CI recipients who achieved significantly better speech scores for dichotic compared with monotic listening with the better CI in three nonoverlapping conditions. Conclusions: All the three groups (NH subjects, SSD CI recipients, and BiCI recipients) showed binaural integration for the side-separated presentation of spectrally degraded speech. Use of strictly side-separated dichotic stimulus presentation avoided the possible occurrence of physical effects such as the head shadow effect and therefore, confirmed the binaural benefit attributable to central binaural processing. [ABSTRACT FROM AUTHOR]

Introduction: Cochlear implant (CI) recipients with normal hearing (NH) in the contralateral ear experience a significant improvement in sound source localization when listening with the CI in combination with their NH-ear (CI + NH) as compared to with the NH-ear alone. The improvement in localization is primarily due to sensitivity to interaural level differences (ILDs). Sensitivity to interaural timing differences (ITDs) may be limited by auditory aging, frequency-to-place mismatches, the signal coding strategy, and duration of CI use. The present report assessed the sensitivity of ILD and ITD cues in CI + NH listeners who were recipients of long electrode arrays that provide minimal frequency-to-place mismatches and were mapped with a coding strategy that presents fine structure cues on apical channels. Methods: Sensitivity to ILDs and ITDs for localization was assessed using broadband noise (BBN), as well as high-pass (HP) and low-pass (LP) filtered noise for adult CI + NH listeners. Stimuli were 200-ms noise bursts presented from 11 speakers spaced evenly over an 180° arc. Performance was quantified in root-mean-squared error and response patterns were analyzed to evaluate the consistency, accuracy, and side bias of the responses. Fifteen listeners completed the task at the 2-year post-activation visit; seven listeners repeated the task at a later annual visit. Results: Performance at the 2-year visit was best with the BBN and HP stimuli and poorer with the LP stimulus. Responses to the BBN and HP stimuli were significantly correlated, consistent with the idea that CI + NH listeners primarily use ILD cues for localization. For the LP stimulus, some listeners responded consistently and accurately and with limited side bias, which may indicate sensitivity to ITD cues. Two of the 7 listeners who repeated the task at a later annual visit experienced a significant improvement in performance with the LP stimulus, which may indicate that sensitivity to ITD cues may improve with long-term CI use. Conclusions: CI recipients with a NH-ear primarily use ILD cues for sound source localization, though some may use ITD cues as well. Sensitivity to ITD cues may improve with long-term CI listening experience. [ABSTRACT FROM AUTHOR]

Background and Aim: Difficulty in perception of speech in noise is one of the main complaints of hearing-impaired people. Due to profound hearing loss in cochlear implant (CI) users, they need higher signal-to-noise ratio for a better perception. Bimodal fitting is a preferred way for CI users because it prevents auditory nerve degeneration, is a complement of frequency range at the opposite ear, an is less invasive to provide binaural hearing. Acceptable noise level (ANL), as a reliable test to assess noise tolerance, has not yet been used in comparing children with bimodal hearing and CI. This study aimed to determine whether bimodal fitting can help CI children tolerate more noise. Methods: This descriptive-analytical study was conducted on 13 children with unilateral CI and bimodal hearing. Audiometry test was performed at aided and non-aided conditions. Then, their noise tolerance was assessed by the Persian version of ANL test. Results: Bimodal hearing resulted in statistically significant increase in ANL. The mean of ANL at unilateral CI and bimodal hearing conditions were 6.15±2.90 and 4.77±1.70, respectively. Conclusion: Bimodal fitting lead to more noise tolerance in unilateral CI children due to the combination of binaural summation and binaural release from masking. [ABSTRACT FROM AUTHOR]

Background and Aim: The masking level difference (MLD) test is a behavioral test that assesses binaural interactions and central auditory processing. This study aims to design a binaural MLD (BMLD) test application using tonal and Speech Stimuli in Persian. Methods: In the first stage, the BMLD test application was designed in MATLAB software. Then, the spondaic words were recorded and added to the sound processing panel of the application. In the next stage, the MLD of tonal and speech stimuli was measured on 20 subjects aged 18-25 years. To examine the test-retest reliability of the application, all steps were repeated after one week. Results: The MLD values for tonal and speech stimuli under the SoNo-SpNo condition were significantly different from those under the SoNo-SoNp condition (p<0.05). These values for tonal and speech stimuli were 10.50 and 6.12 dB under the SoNo-SpNo condition, and 6.85 and 4.43 under the SoNo-SoNp condition. There was no significant difference in the MLD values between males and females. The intraclass correlation coefficient value for different phase conditions was more than 0.8, indicating the high reliability of the BMLD test application for tonal and speech stimuli in Persian (p<0.05). Conclusion: The designed BMLD test application using tonal and speech stimuli in Persian has similar results compared to the conventional methods of MLD test for other languages, therefore, this application can be used in audiology clinics in Iran to perform the MLD test. [ABSTRACT FROM AUTHOR]

The aim of our study is to compare the outcomes in unilateral and bilateral cochlear implants in pediatric age and also between simultaneous and sequential cochlear implant surgery. This retrospective study was carried out with 83 children aged between 12 months to 2.5 years which included 41 children with bilateral Cochlear implants and 42 with unilateral implants. Out of these 41 children, 21 were simultaneous and 20 were sequential cochlear implant. All the children were operated at civil hospital Gandhinagar, Gujarat, India. CAP, SIR, localization, traffic noise and speech in noise scores were assessed at regular intervals over the period of 4 years. Also the drug administration time, surgical time, operating room time were assessed for simultaneous and sequential cochlear implant surgery. Children with bilateral simultaneous implants fared significantly better with CAP, SIR, localization, speech noise and traffic noise scores than sequential bilateral implants and unilateral implants with a significant difference of means t tests between the two groups. Simultaneous cochlear implant surgery is associated with reduced surgical time, operating room time, it shortens the total in patient stay. There is less of drug administration and bilateral ones are stimulated simultaneously. Bilateral cochlear implants perform better with respect to auditory perception skills and spontaneous speech when compared with unilateral implants, but simultaneous surgery is better and safe option for pediatric cochlear implantation. [ABSTRACT FROM AUTHOR]

• The frequency following response (FFR) can measure binaural neural synchrony. • FFR bilateral advantage = larger amplitudes to bilateral than unilateral input. • Children with bilateral hearing loss showed reduced FFR bilateral advantage. • Many children with hearing loss have reduced sensitivity to interaural timing cues. • Reduced binaural neural synchrony is associated with reduced binaural hearing. In prior work using non-speech stimuli, children with hearing loss show impaired perception of binaural cues and no significant change in cortical responses to bilateral versus unilateral stimulation. Aims of the present study were to: 1) identify bilateral responses to envelope and spectral components of a speech syllable using the frequency-following response (FFR), 2) determine if abnormalities in the bilateral FFR occur in children with hearing loss, and 3) assess functional consequences of abnormal bilateral FFR responses on perception of binaural timing cues. A single-syllable speech stimulus (/dα/) was presented to each ear individually and bilaterally. Participants were 9 children with normal hearing (M Age = 12.1 ± 2.5 years) and 6 children with bilateral hearing loss who were experienced bilateral hearing aid users (M Age = 14.0 ± 2.6 years). FFR temporal and spectral peak amplitudes were compared between listening conditions and groups using linear mixed model regression analyses. Behavioral sensitivity to binaural cues were measured by lateralization responses as coming from the right or left side of the head. Both temporal and spectral peaks in FFR responses increased in amplitude in the bilateral compared to unilateral listening conditions in children with normal hearing. These measures of "bilateral advantage" were reduced in the group of children with bilateral hearing loss and associated with decreased sensitivity to interaural timing differences. This study is the first to show that bilateral responses in both temporal and spectral domains can be measured in children using the FFR and is altered in children with hearing loss with consequences to binaural hearing. [ABSTRACT FROM AUTHOR]

Purpose: To investigate sound localization in patients bilaterally fitted with bone conduction devices (BCDs). Additionally, clinically applicable methods to improve localization accuracy were explored. Methods: Fifteen adults with bilaterally fitted percutaneous BCDs were included. At baseline, sound localization, (un)aided pure-tone thresholds, device use, speech, spatial and qualities of hearing scale (SSQ) and York hearing-related quality of life (YHRQL) questionnaire were measured. Settings to optimize sound localizing were added to the BCDs. At 1 month, sound localization was assessed again and localization was practiced with a series of sounds with visual feedback. At 3 months¸ localization performance, device use and questionnaire scores were determined again. Results: At baseline, one patient with congenital hearing loss demonstrated near excellent localization performance and four other patients (three with congenital hearing loss) localized sounds (quite) accurately. Seven patients with acquired hearing loss were able to lateralize sounds, i.e. identify whether sounds were coming from the left or right side, but could not localize sounds accurately. Three patients (one with congenital hearing loss) could not even lateralize sounds correctly. SSQ scores were significantly higher at 3 months. Localization performance, device use and YHRQL scores were not significantly different between visits. Conclusion: In this study, the majority of experienced bilateral BCD users could lateralize sounds and one third was able to localize sounds (quite) accurately. The localization performance was robust and stable over time. Although SSQ scores were increased at the last visit, optimizing device settings and a short practice session did not improve sound localization. [ABSTRACT FROM AUTHOR]

Correlated sounds presented to two ears are perceived as compact and centrally lateralized, whereas decorrelation between ears leads to intracranial image widening. Though most listeners have fine resolution for perceptual changes in interaural correlation (IAC), some investigators have reported large variability in IAC thresholds, and some normal-hearing listeners even exhibit seemingly debilitating IAC thresholds. It is unknown whether or not this variability across individuals and outlier manifestations are a product of task difficulty, poor training, or a neural deficit in the binaural auditory system. The purpose of this study was first to identify listeners with normal and abnormal IAC resolution, second to evaluate the neural responses elicited by IAC changes, and third to use a well-established model of binaural processing to determine a potential explanation for observed individual variability. Nineteen subjects were enrolled in the study, eight of whom were identified as poor performers in the IACthreshold task. Global scalp responses (N1 and P2 amplitudes of an auditory change complex) in the individuals with poor IAC behavioral thresholds were significantly smaller than for listeners with better IAC resolution. Source-localized evoked responses confirmed this group effect in multiple subdivisions of the auditory cortex, including Heschl's gyrus, planum temporale, and the temporal sulcus. In combination with binaural modeling results, this study provides objective electrophysiological evidence of a binaural processing deficit linked to internal noise, that corresponds to very poor IAC thresholds in listeners that otherwise have normal audiometric profiles and lack spatial hearing complaints. [ABSTRACT FROM AUTHOR]

The paper examines the little-known experiments in audition performed by the prominent experimental physiologist Jan Purkyně in Prague in the 1850s. Purkyně's original research on spatial hearing and auditory attention is studied against the backdrop of the nineteenth century research on binaural audition and the nascent field of psychophysics. The article revolves around an acoustic research instrument of Purkyně's own making, the opistophone, in which hearing became both an object of investigation and an instrument of scientific inquiry. It argues that Purkyně's understanding of auditory attention, which combined acoustic stimulation, physiological conditions, and sensory training, preceded a similar approach to hearing in psychophysical debates in the second half of the nineteenth century. Purkyně was the first scholar to experimentally investigate intracranial sounds, which he studied in his experiments with the inmates of the Prague Institute of Deaf-Mutes. This research on intracranial hearing was part of Purkyně's study of so-called organic subjectivity, in which subjective hearing experience was interpreted as the result of the interaction between individual perception and objective acoustic phenomena. [ABSTRACT FROM AUTHOR]

Sound localization in daily life is one of the important functions of binaural hearing. Bilateral bone conduction devices (BCDs), middle ear implants, and cartilage conduction hearing aids have been often applied for patients with conductive hearing loss (CHL) or mixed hearing loss, for example, resulting from bilateral microtia and aural atresia. In this review, factors affecting the accuracy of sound localization with bilateral BCDs, middle ear implants, and cartilage conduction hearing aids were classified into four categories: (1) types of device, (2) experimental conditions, (3) participants, and (4) pathways from the stimulus sound to both cochleae. Recent studies within the past 10 years on sound localization and lateralization by BCDs, middle ear implants, and cartilage conduction hearing aids were discussed. Most studies showed benefits for sound localization or lateralization with bilateral devices. However, the judgment accuracy was generally lower than that for normal hearing, and the localization errors tended to be larger than for normal hearing. Moreover, it should be noted that the degree of accuracy in sound localization by bilateral BCDs varied considerably among patients. Further research on sound localization is necessary to analyze the complicated mechanism of bone conduction, including suprathreshold air conduction with bilateral devices. [ABSTRACT FROM AUTHOR]

A new non-invasive adhesive bone conduction hearing device (ABCD) has been proposed as an alternative solution for reversible bilateral conductive hearing loss in recurrent or long-lasting forms of otitis media with effusion (OME) in children that cannot undergo surgical treatment. Our aim was to assess the effectiveness of ABCD in children with OME. Twelve normal-hearing Italianspeaking volunteers, in whom a conductive hearing loss was simulated, participated in the study. The free-field average hearing threshold was determined and, to evaluate binaural hearing skills, loudness summation and the squelch effect were assessed. Five conditions were tested: (1) unaided without earplugs, (2) unaided with bilateral earplugs, (3) aided right ear with bilateral earplugs, (4) aided left ear with bilateral earplugs, and (5) bilateral aid with bilateral earplugs. Post-hoc analysis showed a significant statistical difference between plugged, unplugged, and each aided condition. The main results were a better loudness summation and a substantial improvement of the squelch effect in the bilaterally aided. Our results suggest that ABCD is a valid treatment for patients with conductive hearing loss that cannot undergo bone conduction implant surgery. It is also important to consider bilateral aids in order to deal with situations in which binaural hearing is fundamental. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this retrospective study was to investigate the outcome and critical age of cochlear implantation in congenital single-sided deafness (SSD). Methods: 11 children with congenital SSD were implanted with a cochlear implant (CI). Auditory performance was measured through the results of speech discrimination, subjective assessment by the Categories of auditory performance (CAP) score, the Speech, Spatial and Qualities scale questionnaire (SSQ) and the German version of the IOI-HA [Internationales Inventar zur Evaluation von Hörgeräten (IIEH, version for CI)]. Results: Long-term follow-up [median: 3 years and 5 months (3;5 years)] revealed that nine children use their CI (> 8 h/day) and two became nonusers. In children aged below 3;2 years at surgery, there was a substantial long-term increase in speech discrimination and subjective benefit. Children over 4;4 years of age at CI surgery improved partially in audiological/subjective measurements. Among children above 5 years, the SSQ score did not improve despite further slight improvement in speech discrimination long-term. Conclusion: Our data suggest a critical age for CI surgery below 3 years in children with congenital SSD for successful hearing rehabilitation. It is mandatory to identify children with SSD as early as bilaterally deaf children. [ABSTRACT FROM AUTHOR]

Objective: A review of published data regarding binaural hearing after treatment of congenital unilateral conductive hearing loss (UCHL) due to aural atresia. Treatment options concern atresia surgery (reconstructive surgery), application of a bone conduction device (BCD), or application of a middle ear implant (MEI). Data Sources: Database PubMed was searched for articles published in English and German between January 1, 1994, and January 1, 2019. Study Selection: The initial search identified 52 studies, of which 9 met the inclusion criteria. Data Synthesis: Comparison of studies was based on a structured review. Meta-analysis was not feasible because of the heterogeneity of outcome measures, the limited number of relevant papers (9), and diverse types of treatment (5). Conclusions: Treatment of UCHL results in bilateral hearing instead of binaural hearing. The large intersubject variability in benefit of treatment is unexplained with a clear improvement in the minority of listeners and a limited improvement or binaural interference in most listeners after atresia repair or amplification with a BCD or MEI. [ABSTRACT FROM AUTHOR]

Directionality is the only hearing aid technology — in addition to amplification — proven to help hearing aid users hear better in noise. Hearing aid directionality has been documented to improve speech intelligibility in multiple laboratory studies. In contrast, real-world studies have shown a disconnect between the potential of the technology and what hearing aid users experience in their daily life. This article describes the real-world studies that inspired ReSound to take a different approach to applying directional microphone technology. This approach is based on the idea that hearing aid directionality can leverage natural binaural hearing and inherent listening strategies. The directional strategy includes three listening modes that will be explained. These are the Spatial Cue Preservation mode, the Binaural Listening mode, and the Speech Intelligibility mode. The strategy and the advantages it provides in terms of sound quality, spatial hearing, and improved signal-to-noise ratio with maintained awareness of surroundings are explained. [ABSTRACT FROM AUTHOR]

The cochlear implant (CI) as a treatment option for single-sided deafness (SSD) started with a clinical study looking in to the influence of cochlear implantation with a MED-EL device on incapacitating unilateral tinnitus in SSD. The study began in 2003 and was conducted by P. Van de Heyning and his team in Antwerp, Belgium. The first CI in SSD without tinnitus in Germany was implanted by J. Mueller and R. Jacob in Koblenz in 2005. Translational research activities took place since then to evaluate the CI as a treatment option for SSD not only in adults but also in children. They assessed the hearing performance of SSD patients implanted with CI, importance of long electrode arrays in SSD patients, degree of acceptance of CI by SSD children, importance of early CI implantation in SSD children in developing language skills, music enjoyment by hearing with two ears and evidence on spiral ganglion cell body distribution. In 2013, MED-EL was the first CI manufacturer to receive the CE mark for the indication of SSD and asymmetric hearing loss (AHL) in adults and children. In 2019, MED-EL was the first CI manufacturer to get its CI device approved for patients over the age of five with SSD and AHL, by the FDA in the USA. This article covers the milestones of translational research from the first concept to the widespread clinical use of CI in SSD. [ABSTRACT FROM AUTHOR]

Binaural hearing has certain benefits while listening in noisy environments. It provides the listeners with access to time, level and spectral differences between sound signals, perceived by the two ears. However, single sided deaf (SSD) or unilateral cochlear implant (CI) users cannot experience these binaural benefits due to the acoustic input coming from a single ear. The translational research on bilateral CIs started in the year 1998, initiated by J. M€uller and J. Helms from W€urzburg, Germany in association with MED-EL. Since then, several clinical studies were conducted by different research groups from across the world either independently or in collaboration with MED-EL. As a result, the bilateral CI has become the standard of care in many countries along with reimbursement by the health care systems. Recent data shows that children particularly, are given high priority for the bilateral CI implantation, most often performed simultaneously in a single surgery, as the binaural hearing has a positive effect on their language development. This article covers the milestones of translational research from the first concept to the widespread clinical use of bilateral CI. [ABSTRACT FROM AUTHOR]

Objectives: To describe the treatment choice in a cohort of subjects with single‐sided deafness (SSD) and asymmetric hearing loss (AHL). To assess the reliability of the treatment trials. Design: In this national, multicentre, prospective study, the choice of subjects was made after two consecutive trials of Contralateral Routing Of the Signal (CROS) hearing aids and a Bone Conduction Device (BCD) on a headband. Subjects could proceed with one of these two options, opt for cochlear implantation or decline all treatments. Setting: Seven tertiary university hospitals. Participants: One hundred fifty‐five subjects with SSD or AHL fulfilling the candidacy criteria for cochlear implantation, with or without associated tinnitus. Main outcome measures: After the two trials, the number of subjects choosing each option was described. Repeated assessments of both generic and auditory‐specific quality of life were conducted, as well as hearing assessments (speech recognition in noise and horizontal localization). Results: CROS was chosen by 75 subjects, followed by cochlear implantation (n = 51), BCD (n = 18) and abstention (n = 11). Patients who opted for cochlear implantation had a poorer quality of life (P =.03). The improvement of quality of life indices after each trial was significantly associated with the final treatment choice (P =.008 for generic indices, P =.002 for auditory‐specific indices). The follow‐up showed that this improvement had been overestimated in the CROS group, with a long‐term retention rate of 52.5%. Conclusions: More than one third of SSD/AHL subjects are unsatisfied after CROS and BCD trials. Repeated quality of life assessments help counselling the patient for his/her treatment choice. [ABSTRACT FROM AUTHOR]

Humans make use of small differences in the timing of sounds at the two ears—interaural time differences (ITDs)—to locate their sources. Despite extensive investigation, however, the neural representation of ITDs in the human brain is contentious, particularly the range of ITDs explicitly represented by dedicated neural detectors. Here, using magneto- and electro-encephalography (MEG and EEG), we demonstrate evidence of a sparse neural representation of ITDs in the human cortex. The magnitude of cortical activity to sounds presented via insert earphones oscillated as a function of increasing ITD—within and beyond auditory cortical regions—and listeners rated the perceptual quality of these sounds according to the same oscillating pattern. This pattern was accurately described by a population of model neurons with preferred ITDs constrained to the narrow, sound-frequency-dependent range evident in other mammalian species. When scaled for head size, the distribution of ITD detectors in the human cortex is remarkably like that recorded in vivo from the cortex of rhesus monkeys, another large primate that uses ITDs for source localization. The data solve a long-standing issue concerning the neural representation of ITDs in humans and suggest a representation that scales for head size and sound frequency in an optimal manner. • Neural representation of ITD in human cortex is sparse and sound-frequency dependent • Cortical activation to ITD is correlated with spatial perceptual qualities • Scaled for head size, humans and macaques show a common cortical representation of ITD • Our findings suggest a common representation of ITDs across mammalian cortex The neural representation of interaural time differences (ITDs) in humans is contentious. Undurraga et al. show that cortical and behavioral measures of ITD are best explained by a sparse representation of neural detectors. Humans and macaques show a similar cortical pattern of activity, suggesting a common representation of ITDs in primates. [ABSTRACT FROM AUTHOR]

Cochlear implant (CI) users with a prelingual onset of hearing loss show poor sensitivity to interaural time differences (ITDs), an important cue for sound localization and speech reception in noise. Similarly, neural ITD sensitivity in the inferior colliculus (IC) of neonatally-deafened animals is degraded compared with animals deafened as adults. Here, we show that chronic bilateral CI stimulation during development can partly reverse the effect of early-onset deafness on ITD sensitivity. The prevalence of ITD sensitive neurons was restored to the level of adult-deaf (AD) rabbits in the early-deaf rabbits of both sexes that received chronic stimulation and behavioral training with wearable bilateral sound processors during development. We also found a partial improvement in neural ITD sensitivity in the early-deaf and stimulated rabbits compared with unstimulated rabbits. In contrast, chronic CI stimulation did not improve temporal coding in early-deaf rabbits. The present study is the first report showing functional restoration of ITD sensitivity with CI stimulation in single neurons and highlights the importance of auditory experience during development on the maturation of binaural circuitry. [ABSTRACT FROM AUTHOR]

The cochlear implant (CI) as a treatment option for single-sided deafness (SSD) started with a clinical study looking in to the influence of cochlear implantation with a MED-EL device on incapacitating unilateral tinnitus in SSD. The study began in 2003 and was conducted by P. Van de Heyning and his team in Antwerp, Belgium. The first CI in SSD without tinnitus in Germany was implanted by J. Mueller and R. Jacob in Koblenz in 2005. Translational research activities took place since then to evaluate the CI as a treatment option for SSD not only in adults but also in children. They assessed the hearing performance of SSD patients implanted with CI, importance of long electrode arrays in SSD patients, degree of acceptance of CI by SSD children, importance of early CI implantation in SSD children in developing language skills, music enjoyment by hearing with two ears and evidence on spiral ganglion cell body distribution. In 2013, MED-EL was the first CI manufacturer to receive the CE mark for the indication of SSD and asymmetric hearing loss (AHL) in adults and children. In 2019, MED-EL was the first CI manufacturer to get its CI device approved for patients over the age of five with SSD and AHL, by the FDA in the USA. This article covers the milestones of translational research from the first concept to the widespread clinical use of CI in SSD. [ABSTRACT FROM AUTHOR]

Binaural hearing has certain benefits while listening in noisy environments. It provides the listeners with access to time, level and spectral differences between sound signals, perceived by the two ears. However, single sided deaf (SSD) or unilateral cochlear implant (CI) users cannot experience these binaural benefits due to the acoustic input coming from a single ear. The translational research on bilateral CIs started in the year 1998, initiated by J. Müller and J. Helms from Würzburg, Germany in association with MED-EL. Since then, several clinical studies were conducted by different research groups from across the world either independently or in collaboration with MED-EL. As a result, the bilateral CI has become the standard of care in many countries along with reimbursement by the health care systems. Recent data shows that children particularly, are given high priority for the bilateral CI implantation, most often performed simultaneously in a single surgery, as the binaural hearing has a positive effect on their language development. This article covers the milestones of translational research from the first concept to the widespread clinical use of bilateral CI. [ABSTRACT FROM AUTHOR]

Neurons in the medial superior olive (MSO) detect 10 ms differences in the arrival times of a sound at the two ears. Such acuity requires exquisitely precise integration of binaural synaptic inputs. There is substantial understanding of how neuronal phase locking of afferent MSO structures, and MSO membrane biophysics subserve such high precision. However, we still lack insight into how the entirety of excitatory inputs is integrated along the MSO dendrite under sound stimulation. To understand how the dendrite integrates excitatory inputs as a whole, we combined anatomic quantifications of the afferent innervation in gerbils of both sexes with computational modeling of a single cell. We present anatomic data from confocal and transmission electron microscopy showing that single afferent fibers follow a single dendrite mostly up to the soma and contact it at multiple (median 4) synaptic sites, each containing multiple independent active zones (the overall density of active zones is estimated as 1.375 per lm²). Thus, any presynaptic action potential may elicit temporally highly coordinated synaptic vesicle release at tens of active zones, thereby achieving secure transmission. Computer simulations suggest that such an anatomic arrangement boosts the amplitude and sharpens the time course of excitatory postsynaptic potentials by reducing current sinks and more efficiently recruiting subthreshold potassium channels. Both effects improve binaural coincidence detection compared with single large synapses at the soma. Our anatomic data further allow for estimation of a lower bound of 7 and an upper bound of 70 excitatory fibers per dendrite. [ABSTRACT FROM AUTHOR]

Objective: Binaural hearing is facilitated by neural interactions in the auditory pathway. Ageing results in impairment of localisation and listening in noisy situations without any significant hearing loss. The present study focused on comparing the binaural encoding of a speech stimulus at the subcortical level in middle-aged versus younger adults, based on speech-evoked auditory brainstem responses. Methods: Thirty participants (15 young adults and 15 middle-aged adults) with normal hearing sensitivity (less than 15 dB HL) participated in the study. The speech-evoked auditory brainstem response was recorded monaurally and binaurally with a 40-ms /da/ stimulus. Fast Fourier transform analysis was utilised. Results: An independent sample t-test revealed a significant difference between the two groups in fundamental frequency (F0) amplitude recorded with binaural stimulation. Conclusion: The present study suggested that ageing results in degradation of F0 encoding, which is essential for the perception of speech in noise. [ABSTRACT FROM AUTHOR]

Background and Aim: Spatial hearing plays an important role in listening in complex hearing situations, including contributing to localization, lateralization, spatial release from masking, distance estimation from a sound source, and perceiving a signal in noise. Questionnaires are useful tools for assessing spatial processing disorder in adults. Given the high prevalence of this disorder in children and that the extent of children's ability in completing questionnaires is not clear, this study aimed to evaluate the response validity of children to the Persian translation of the child version of the Speech, Spatial and Quality of Hearing Scale (PSSQ-Ch). Methods: The child version of the SSQ was translated into Persian and cross-culturally adapted. The final version was administered to 150 children (6 to 12 years of age) with normal hearing. The children's response validity was evaluated qualitatively and the percentage of valid responses calculated for each of 7 age groups. Results: Across the three sections, the percentage of valid responses for children under age 10 was minimum 44.4% and maximum 83.3%, and the mode was around 60%. There was no child in the under-10 age group who answered all questions validly. The response validity of children aged 10 or more was higher with a minimum of 93.3%, a maximum of 100% and mode of 100%. Conclusion: Children = 10 years can reliably respond to the PSSQ-Ch. The response validity of children below 10 years is low; therefore, this questionnaire cannot be used as a self-assessment questionnaire in children below age 10. [ABSTRACT FROM AUTHOR]

Background Speech recognition in complex multisource environments is challenging, particularly for listeners with hearing loss. One source of difficulty is the reduced ability of listeners with hearing loss to benefit from spatial separation of the target and masker, an effect called spatial release from masking (SRM). Despite the prevalence of complex multisource environments in everyday life, SRM is not routinely evaluated in the audiology clinic. Purpose The purpose of this study was to demonstrate the feasibility of assessing SRM in adults using widely available tests of speech-in-speech recognition that can be conducted using standard clinical equipment. Research Design Participants were 22 young adults with normal hearing. The task was masked sentence recognition, using each of five clinically available corpora with speech maskers. The target always sounded like it originated from directly in front of the listener, and the masker either sounded like it originated fromthe front (colocated with the target) or from the side (separated from the target). In the real spatial manipulation conditions, source locationwasmanipulated by routing the target andmasker to either a single speaker or to two speakers: one directly in front of the participant, and onemounted in an adjacent corner, 90° to the right. In the perceived spatial separation conditions, the target andmasker were presented fromboth speakers with delays thatmade themsoundas if theywere either colocated or separated. Results With real spatial manipulations, the mean SRM ranged from 7.1 to 11.4 dB, depending on the speech corpus. With perceived spatialmanipulations, the mean SRM ranged from1.8 to 3.1 dB. Whereas real separation improves the signal-to-noise ratio in the ear contralateral to the masker, SRM in the perceived spatial separation conditions is based solely on interaural timing cues. Conclusions The finding of robust SRMwithwidely available speech corpora supports the feasibility of measuring this important aspect of hearing in the audiology clinic. The finding of a small but significant SRM in the perceived spatial separation conditions suggests that modified materials could be used to evaluate the use of interaural timing cues specifically. [ABSTRACT FROM AUTHOR]

• The specialized sound localization system of the barn owl has provided knowledge and theories towards fundamental brain mechanisms and coding schemes underlying optimal sound localization. • The barn owl system is an excellent model system to test mathematical computations and theories underlying sound localization. • Mechanisms described in the barn owl has provided a rich foundation for comparative investigations into conserved mechanisms across species. The barn owl, a nocturnal raptor with remarkably efficient prey-capturing abilities, has been one of the initial animal models used for research of brain mechanisms underlying sound localization. Some seminal findings made from their specialized sound localizing auditory system include discoveries of a midbrain map of auditory space, mechanisms towards spatial cue detection underlying sound-driven orienting behavior, and circuit level changes supporting development and experience-dependent plasticity. These findings have explained properties of vital hearing functions and inspired theories in spatial hearing that extend across diverse animal species, thereby cementing the barn owl's legacy as a powerful experimental system for elucidating fundamental brain mechanisms. This concise review will provide an overview of the insights from which the barn owl model system has exemplified the strength of investigating diversity and similarity of brain mechanisms across species. First, we discuss some of the key findings in the specialized system of the barn owl that elucidated brain mechanisms toward detection of auditory cues for spatial hearing. Then we examine how the barn owl has validated mathematical computations and theories underlying optimal hearing across species. And lastly, we conclude with how the barn owl has advanced investigations toward developmental and experience dependent plasticity in sound localization, as well as avenues for future research investigations towards bridging commonalities across species. Analogous to the informative power of Astrophysics for understanding nature through diverse exploration of planets, stars, and galaxies across the universe, miscellaneous research across different animal species pursues broad understanding of natural brain mechanisms and behavior. [ABSTRACT FROM AUTHOR]

Background and Aim: Dichotic listening disorders occur secondary to interhemispheric transfer dysfunction. Central processing tests such as staggered spondaic words (SSW) and dichotic digits test (DDT) are recommended for the evaluation of dichotic listening in patients with multiple sclerosis (MS). The present study aimed to evaluate dichotic listening in subjects with MS by SSW and DDT. Methods: This cross-sectional study was conducted on 45 patients with MS, including 20 males (mean ± SD age: 35.95 ± 5.73 y) and 25 females (mean ± SD age: 37.40 ± 6.1 y) and their data were collected by the Persian version of SSW (P-SSW) and DDT. The results compared to 45 normal subjects age- and gendermatched as the control group. Results: In patients with MS, P-SSW quantitative and qualitative errors (except for Sm2 and reversals), errors were significantly more than the control group (p = 0.001). Right and left ear scores in DDT for the patients with MS were significantly lower, and right ear advantage was significantly higher than that in the control group (p = 0.001). The results also showed a significant correlation between the test of PSSW and DDT in the left ear. Conclusion: The present study showed that patients with MS have lower performance in dichotic listening and binaural processing than normal peers. Identification of binaural processing deficit in patients with MS may lead to early rehabilitation and improving their function by facilitating auditory processing. [ABSTRACT FROM AUTHOR]

The auditory brain stem response (ABR) is an evoked potential that indexes a cascade of neural events elicited by sound. In the present study we evaluated the influence of sound frequency on a derived component of the ABR known as the binaural interaction component (BIC). Specifically, we evaluated the effect of acoustic interaural (between-ear) frequency mismatch on BIC amplitude. Goals were to 1) increase basic understanding of sound features that influence this long-studied auditory potential and 2) gain insight about the persistence of the BIC with interaural electrode mismatch in human users of bilateral cochlear implants, presently a limitation on the prospective utility of the BIC in audiological settings. Data were collected in an animal model that is audiometrically similar to humans, the chinchilla (Chinchilla lanigera; 6 females). Frequency disparities and amplitudes of acoustic stimuli were varied over broad ranges, and associated variation of BIC amplitude was quantified. Subsequently, responses were simulated with the use of established models of the brain stem pathway thought to underlie the BIC. Collectively, the data demonstrate that at high sound intensities (≥85 dB SPL), the acoustically elicited BIC persisted with interaurally disparate stimulation (click frequencies ≥1.5 octaves apart). However, sharper tuning emerged at moderate sound intensities (65 dB SPL), with the largest BIC occurring for stimulus frequencies within ~0.8 octaves, equivalent to ±1 mm in cochlear place. Such responses were consistent with simulated responses of the presumed brain stem generator of the BIC, the lateral superior olive. The data suggest that leveraging focused electrical stimulation strategies could improve BIC-based bilateral cochlear implant fitting outcomes. NEW & NOTEWORTHY Traditional hearing tests evaluate each ear independently. Diagnosis and treatment of binaural hearing dysfunction remains a basic challenge for hearing clinicians. We demonstrate in an animal model that the prospective utility of a noninvasive electrophysiological signature of binaural function, the binaural interaction component (BIC), depends strongly on the intensity of auditory stimulation. Data suggest that more informative BIC measurements could be obtained with clinical protocols leveraging stimuli restricted in effective bandwidth. [ABSTRACT FROM AUTHOR]

When two tones with slightly different frequencies are dichotically presented, binaural beats (BBs) are experienced. BBs resulting from the cycling change in interaural phase difference elicit electroencephalographic responses. Because they repeat at short periods, allowing poor recovery of the cortical responses, these steady-state responses have small amplitudes, and their various wave components intermingle and might mask each other. Using single-cycle BBs separated by relatively long inter-onset intervals would be a solution, but introducing a transient interaural frequency shift requires response subtraction which may not be acceptable for non-additive brain responses. The proposed stimulation method employs transient and monaurally subthreshold frequency shifts in opposite directions in the two ears to produce single-cycle BBs of a 250 Hz tone. These shifts are perceived as distinct BBs when presented dichotically, but remain subthreshold when presented monotically. Therefore, no frequency-shift response is elicited, and the specific BB response is obtained with no need for waveform subtraction. We recorded from 19 normal hearing participants the event-related potentials (ERPs) to single-cycle BBs and also to temporary diotic amplitude modulation (AM) with matched perceptual salience. The ERPs to single-cycle BBs presented at 2 s inter-onset intervals had N1-P2 responses with up to seven times larger amplitudes than the conventional steady-state BB responses in the literature. Significant differences were found between the scalp potential distributions of the N1 responses to BB and AM stimuli, suggesting that the cortical sites, where envelope-based level processing and temporal fine structure-based spatial processing of the stimulus take place, are not totally overlapped. [ABSTRACT FROM AUTHOR]

An experiment was performed with 10 young normal-hearing listeners that attempted to determine if envelope modulations affected binaural processing in bandlimited pulse trains. Listeners detected an interaurally out-of-phase carrier pulse train in the presence of different amplitude modulations. The peaks of the pulses were constant (called "flat" or F), followed envelope modulations from an interaurally correlated 50-Hz bandwidth noise (called CM), or followed modulations from an interaurally uncorrelated noise (called UM). The pulse rate was varied from 50 to 500 pulses per second (pps) and the center frequency (CF) was 4 or 8 kHz. It was hypothesized that CM would cause no change or an increase in performance compared to F; UM would cause a decrease because of the blurring of the binaural detection cue. There was a small but significant decrease from F to CM (inconsistent with the hypothesis) and a further decrease from CM to UM (consistent with the hypothesis). Critically, there was a significant envelope by rate interaction caused by a decrease from F to CM for the 200–300 pps rates. The data can be explained by a subject-based factor, where some listeners experienced interaural envelope decorrelation when the sound was encoded by the auditory system that reduced performance when the modulations were present. Since the decrease in performance between F and CM conditions was small, it seems that most young normal-hearing listeners have very similar encoding of modulated stimuli across the ears. This type of task, when further optimized, may be able to assess if hearing-impaired populations experience interaural decorrelation from encoding modulated stimuli and therefore could help better understand the limited spatial hearing in populations like cochlear-implant users. • Modulated stimuli can cause decreases in binaural performance in listeners with normal hearing. • Most audiometrically normal-hearing listeners show small amounts of interaural asymmetry, but some show more. • There is no effect of center frequency on binaural performance if the stimuli have a constant spatial bandwidth and constant sensation level. [ABSTRACT FROM AUTHOR]