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Interaural time differences are often considered a weak cue for stream segregation. We investigated this claim with headphone-presented pure tones differing in a related form of interaural configuration—interaural phase differences (ΔIPD)—or/and in frequency (ΔF). In experiment 1, sequences comprised 5 × ABA– repetitions (A and B = 80-ms tones, "–" = 160-ms silence), and listeners reported whether integration or segregation was heard. Envelope shape was varied but remained constant across all tones within a trial. Envelopes were either quasi-trapezoidal or had a fast attack and slow release (FA-SR) or vice versa (SA-FR). The FA-SR envelope caused more segregation than SA-FR in a task where only ΔIPD cues were present, but not in a corresponding ΔF-only task. In experiment 2, interstimulus interval (ISI) was varied (0–60 ms) between FA-SR tones. ΔF-based segregation decreased with increasing ISI, whereas ΔIPD-based segregation increased. This suggests that binaural temporal integration may limit segregation at short ISIs. In another task, ΔF and ΔIPD cues were presented alone or in combination. Here, ΔIPD-based segregation was greatly reduced, suggesting ΔIPD-based segregation is highly sensitive to experimental context. Experiments 1–2 demonstrate that ΔIPD can promote segregation in optimized stimuli/tasks. Experiment 3 employed a task requiring integration for good performance. Listeners detected a delay on the final four B tones of an 8 × ABA– sequence. Although performance worsened with increasing ΔF, increasing ΔIPD had only a marginal impact. This suggests that, even in stimuli optimized for ΔIPD-based segregation, listeners remained mostly able to disregard ΔIPD when segregation was detrimental to performance. [ABSTRACT FROM AUTHOR]

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]

The potential of virtual reality (VR) in supporting hearing research and audiological care has long been recognized. While allowing the creation of experimental settings that closely resemble real-life scenarios and potentially leading to more ecologically valid results, VR could also support the current need for automated or remote assessment of auditory processing abilities in clinical settings. Understanding speech in competing noise is the most common complaint of patients with hearing difficulties, and the need to develop tools that can simplify speech-in-noise testing by reducing the time and resources required while improving the ecological validity of current assessment procedures is an area of great research interest. However, the use of VR for speech-in-noise testing has not yet been widely adopted because it is still unclear whether subjects respond to virtual stimuli the same way as they would in real-life settings. Using headphone-based binaural presentation, delivering visuals through head-mounted displays (HMDs), and using unsupervised (self-testing or remote) procedures are some aspects of virtualization that could potentially affect speech-in-noise measures, and the extent of this potential impact remains unclear. Before virtualization can be considered feasible, its effects on behavioral psychoacoustic measures must be understood. Thus, the ability to reproduce results from typical laboratory and clinical settings in VR environments is a major topic of current research. In this study, we sought to answer whether it is possible to reproduce results from a standard speech-in-noise test using state-of-the-art technology and commercially available VR peripherals. To this end, we compared the results of a well-established speech-in-noise test conducted in a conventional loudspeaker-based laboratory setting with those obtained in three different virtual environments. In each environment, we introduced one aspect of virtualization, i.e., virtual audio presentation in the first environment, HMD-based visuals with a visual anchor representing the target speaker in the second, and an alternative feedback- and scoring method allowing unsupervised testing in the last. Our results indicate that the speech-in-noise measures from the loudspeaker-based measurement and those from the virtual scenes were all statistically identical, suggesting that conducting speech-in-noise testing in state-of-the-art VR environments may be feasible even without experimenter supervision. [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]

Objective(s): FDA‐approved indications for cochlear implantation include patients with severe‐to‐profound unilateral hearing loss (UHL) or asymmetric hearing loss (AHL); however, these indications are not covered for Medicare beneficiaries. We assessed the outcomes of cochlear implant (CI) use for older adults with UHL or AHL. Methods: Eighteen older adults (≥65 years of age at surgery) with UHL/AHL participated in a prospective, longitudinal investigation evaluating outcomes of CI use. Speech recognition for the affected ear was evaluated with consonant‐nucleus‐consonant (CNC) words. Spatial hearing was assessed with measures of sound source localization and sentence recognition in noise. The target sentence was presented from the front and the masker was either co‐located with the target (SoNo), presented toward the affected ear (SoNci) or contralateral ear (SoNcontra). Perceived benefit was assessed with the Speech, Spatial, and Qualities of Hearing scale (SSQ) and the Tinnitus Handicap Inventory (THI). Results: Participants experienced significant improvements with CI use for CNC words (mean [SD]; preop: 8% [10%], 1 yr: 51% [22%], 5 yr: 50% [19%]), masked sentence recognition (SoNcontra preop: 5% [6%], 1 yr: 22% [15%], 5 yr: 41% [14%]), and localization (preop: 76° [18°], 1 yr: 40° [11°], 5 yr: 41° [14°]), and reported significant improvements in hearing abilities (SSQ Spatial Hearing preop: 3 [1], 1 yr: 6 [2], 5 yr: 6 [2]) and tinnitus severity (THI preop: 16 [18], 1 yr: 4 [14], 5 yr: 6 [12]). Conclusion: Older adults with UHL/AHL experience significant improvements in speech recognition, spatial hearing, and subjective perceptions (e.g., hearing abilities and tinnitus severity) with a CI as compared to pre‐operative abilities. Level of Evidence: 4 Laryngoscope, 135:352–360, 2025 [ABSTRACT FROM AUTHOR]

Auditory space has been conceptualized as a matrix of systematically arranged combinations of binaural disparity cues that arise in the superior olivary complex (SOC). The computational code for interaural time and intensity differences utilizes excitatory and inhibitory projections that converge in the inferior colliculus (IC). The challenge is to determine the neural circuits underlying this convergence and to model how the binaural cues encode location. It has been shown that midbrain neurons are largely excited by sound from the contralateral ear and inhibited by sound leading at the ipsilateral ear. In this context, ascending projections from the lateral superior olive (LSO) to the IC have been reported to be ipsilaterally glycinergic and contralaterally glutamatergic. This study used CBA/CaH mice (3-6 months old) and applied unilateral retrograde tracing techniques into the IC in conjunction with immunocytochemical methods with glycine and glutamate transporters (GlyT2 and vGLUT2, respectively) to analyze the projection patterns from the LSO to the IC. Glycinergic and glutamatergic neurons were spatially intermixed within the LSO, and both types projected to the IC. For GlyT2 and vGLUT2 neurons, the average percentage of ipsilaterally and contralaterally projecting cells was similar (ANOVA, p = 0.48). A roughly equal number of GlyT2 and vGLUT2 neurons did not project to the IC. The somatic size and shape of these neurons match the descriptions of LSO principal cells. A minor but distinct population of small (< 40 mm2) neurons that labeled for GlyT2 did not project to the IC; these cells emerge as candidates for inhibitory local circuit neurons. Our findings indicate a symmetric and bilateral projection of glycine and glutamate neurons from the LSO to the IC. The differences between our results and those from previous studies suggest that species and habitat differences have a significant role in mechanisms of binaural processing and highlight the importance of research methods and comparative neuroscience. These data will be important for modeling how excitatory and inhibitory systems converge to create auditory space in the CBA/CaH mouse. [ABSTRACT FROM AUTHOR]

This study investigated sound localization abilities in patients with bilateral conductive and/or mixed hearing loss (BCHL) when listening with either one or two middle ear implants (MEIs). Sound localization was measured by asking patients to point as quickly and accurately as possible with a head-mounted LED in the perceived sound direction. Loudspeakers, positioned around the listener within a range of +73°/−73° in the horizontal plane, were not visible to the patients. Broadband (500 Hz–20 kHz) noise bursts (150 ms), roved over a 20-dB range in 10 dB steps was presented. MEIs stimulate the ipsilateral cochlea only and therefore the localization response was not affected by crosstalk. Sound localization was better with bilateral MEIs compared with the unilateral left and unilateral right conditions. Good sound localization performance was found in the bilaterally aided hearing condition in four patients. In two patients, localization abilities equaled normal hearing performance. Interestingly, in the unaided condition, when both devices were turned off, subjects could still localize the stimuli presented at the highest sound level. Comparison with data of patients implanted bilaterally with bone-conduction devices, demonstrated that localization abilities with MEIs were superior. The measurements demonstrate that patients with BCHL, using remnant binaural cues in the unaided condition, are able to process binaural cues when listening with bilateral MEIs. We conclude that implantation with two MEIs, each stimulating only the ipsilateral cochlea, without crosstalk to the contralateral cochlea, can result in good sound localization abilities, and that this topic needs further investigation. [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]

The potential of virtual reality (VR) in supporting hearing research and audiological care has long been recognized. While allowing the creation of experimental settings that closely resemble real-life scenarios and potentially leading to more ecologically valid results, VR could also support the current need for automated or remote assessment of auditory processing abilities in clinical settings. Understanding speech in competing noise is the most common complaint of patients with hearing difficulties, and the need to develop tools that can simplify speech-in-noise testing by reducing the time and resources required while improving the ecological validity of current assessment procedures is an area of great research interest. However, the use of VR for speech-in-noise testing has not yet been widely adopted because it is still unclear whether subjects respond to virtual stimuli the same way as they would in real-life settings. Using headphone-based binaural presentation, delivering visuals through head-mounted displays (HMDs), and using unsupervised (self-testing or remote) procedures are some aspects of virtualization that could potentially affect speech-in-noise measures, and the extent of this potential impact remains unclear. Before virtualization can be considered feasible, its effects on behavioral psychoacoustic measures must be understood. Thus, the ability to reproduce results from typical laboratory and clinical settings in VR environments is a major topic of current research. In this study, we sought to answer whether it is possible to reproduce results from a standard speech-in-noise test using state-of-the-art technology and commercially available VR peripherals. To this end, we compared the results of a well-established speech-in-noise test conducted in a conventional loudspeaker-based laboratory setting with those obtained in three different virtual environments. In each environment, we introduced one aspect of virtualization, i.e., virtual audio presentation in the first environment, HMD-based visuals with a visual anchor representing the target speaker in the second, and an alternative feedback- and scoring method allowing unsupervised testing in the last. Our results indicate that the speech-in-noise measures from the loudspeaker-based measurement and those from the virtual scenes were all statistically identical, suggesting that conducting speech-in-noise testing in state-of-the-art VR environments may be feasible even without experimenter supervision.

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.

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]

Auditory space has been conceptualized as a matrix of systematically arranged combinations of binaural disparity cues that arise in the superior olivary complex (SOC). The computational code for interaural time and intensity differences utilizes excitatory and inhibitory projections that converge in the inferior colliculus (IC). The challenge is to determine the neural circuits underlying this convergence and to model how the binaural cues encode location. It has been shown that midbrain neurons are largely excited by sound from the contralateral ear and inhibited by sound leading at the ipsilateral ear. In this context, ascending projections from the lateral superior olive (LSO) to the IC have been reported to be ipsilaterally glycinergic and contralaterally glutamatergic. This study used CBA/CaH mice (3–6 months old) and applied unilateral retrograde tracing techniques into the IC in conjunction with immunocytochemical methods with glycine and glutamate transporters (GlyT2 and vGLUT2, respectively) to analyze the projection patterns from the LSO to the IC. Glycinergic and glutamatergic neurons were spatially intermixed within the LSO, and both types projected to the IC. For GlyT2 and vGLUT2 neurons, the average percentage of ipsilaterally and contralaterally projecting cells was similar (ANOVA, p = 0.48). A roughly equal number of GlyT2 and vGLUT2 neurons did not project to the IC. The somatic size and shape of these neurons match the descriptions of LSO principal cells. A minor but distinct population of small (< 40 μm2) neurons that labeled for GlyT2 did not project to the IC; these cells emerge as candidates for inhibitory local circuit neurons. Our findings indicate a symmetric and bilateral projection of glycine and glutamate neurons from the LSO to the IC. The differences between our results and those from previous studies suggest that species and habitat differences have a significant role in mechanisms of binaural processing and highlight the importance of research methods and comparative neuroscience. These data will be important for modeling how excitatory and inhibitory systems converge to create auditory space in the CBA/CaH mouse.

Bilateral cochlear implants (BiCIs) result in several benefits, including improvements in speech understanding in noise and sound source localization. However, the benefit bilateral implants provide among recipients varies considerably across individuals. Here we consider one of the reasons for this variability: difference in hearing function between the two ears, that is, interaural asymmetry. Thus far, investigations of interaural asymmetry have been highly specialized within various research areas. The goal of this review is to integrate these studies in one place, motivating future research in the area of interaural asymmetry. We first consider bottom-up processing, where binaural cues are represented using excitation-inhibition of signals from the left ear and right ear, varying with the location of the sound in space, and represented by the lateral superior olive in the auditory brainstem. We then consider top-down processing via predictive coding, which assumes that perception stems from expectations based on context and prior sensory experience, represented by cascading series of cortical circuits. An internal, perceptual model is maintained and updated in light of incoming sensory input. Together, we hope that this amalgamation of physiological, behavioral, and modeling studies will help bridge gaps in the field of binaural hearing and promote a clearer understanding of the implications of interaural asymmetry for future research on optimal patient interventions. [ABSTRACT FROM AUTHOR]

Acute ischemic stroke, characterized by a localized reduction in blood flow to specific areas of the brain, has been shown to affect binaural auditory perception. In a previous study conducted during the acute phase of ischemic stroke, two tasks of binaural hearing were performed: binaural tone-in-noise detection, and lateralization of stimuli with interaural time- or level differences. Various lesion-specific, as well as individual, differences in binaural performance between patients in the acute phase of stroke and a control group were demonstrated. For the current study, we re-invited the same group of patients, whereupon a subgroup repeated the experiments during the subacute and chronic phases of stroke. Similar to the initial study, this subgroup consisted of patients with lesions in different locations, including cortical and subcortical areas. At the group level, the results from the tone-in-noise detection experiment remained consistent across the three measurement phases, as did the number of deviations from normal performance in the lateralization task. However, the performance in the lateralization task exhibited variations over time among individual patients. Some patients demonstrated improvements in their lateralization abilities, indicating recovery, whereas others' lateralization performance deteriorated during the later stages of stroke. Notably, our analyses did not reveal consistent patterns for patients with similar lesion locations. These findings suggest that recovery processes are more individual than the acute effects of stroke on binaural perception. Individual impairments in binaural hearing abilities after the acute phase of ischemic stroke have been demonstrated and should therefore also be targeted in rehabilitation programs. [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]

This paper presents an overview of modern methods used for studies of the ability to localize sound sources by distance. Monaural and binaural localization cues are considered. The role of binaural hearing in estimating the distance to a sound source is discussed in detail. Localizing cues are shown to have roles in absolute and relative estimation of distance. The advantages and limitations of various experimental approaches to creating virtual sound images are considered. A separate section discusses approaches to the formation of moving sound images. Overall data are given on results of assessments of auditory resolution by distance as obtained using different methods for stationary and moving sound sources. The review includes the results of the authors' own research and a description of promising experimental and applied approaches to the development of this area. [ABSTRACT FROM AUTHOR]

Objective: To assess the perceived benefit of cochlear implant (CI) use for children with unilateral hearing loss (UHL) and evaluate whether perceived abilities are associated with performance on measures of speech recognition and spatial hearing. Method: Nineteen children with moderate‐to‐profound UHL underwent cochlear implantation. The Speech Spatial and Qualities of Hearing Questionnaire modified for children (SSQ‐C) were completed by parental proxy pre‐operatively and at 3, 6, 9, 12, 18, and 24 months post‐activation. Linear mixed models evaluated perceived benefits over the study period. Pearson correlations assessed the association between subjective report and performance on measures of word recognition with the CI alone and spatial hearing (speech recognition in spatially‐separated noise and sound source localization) in the combined condition (CI plus contralateral ear). Results: For the SSQ‐C, parents reported significant improvements with CI use as compared to pre‐operative perceptions (p < 0.001); improved perceptions were either maintained or continued to improve over the 2‐year post‐activation period. Perceived benefit did not significantly correlate with word recognition with the CI alone or spatial hearing outcomes in the combined condition. Conclusion: Families of children with UHL observed benefits of CI use early after cochlear implantation that was maintained with long‐term device use. Responses to subjective measures may broaden our understanding of the experiences of pediatric CI users with UHL in addition to outcomes on typical measures of CI performance. Level of Evidence: 3 Laryngoscope, 134:919–925, 2024 [ABSTRACT FROM AUTHOR]

Introduction: Subjects with mild to moderate hearing loss today often receive hearing aids (HA) with open-fitting (OF). In OF, direct sound reaches the eardrums with minimal damping. Due to the required processing delay in digital HA, the amplified HA sound follows some milliseconds later. This process occurs in both ears symmetrically in bilateral HA provision and is likely to have no or minor detrimental effect on binaural hearing. However, the delayed and amplified sound are only present in one ear in cases of unilateral hearing loss provided with one HA. This processing alters interaural timing differences in the resulting ear signals. Methods: In the present study, an experiment with normal-hearing subjects to investigate speech intelligibility in noise with direct and delayed sound was performed to mimic unilateral and bilateral HA provision with OF. Results: The outcomes reveal that these delays affect speech reception thresholds (SRT) in the unilateral OF simulation when presenting speech and noise from different spatial directions. A significant decrease in the median SRT from -18.1 to -14.7 dB SNR is observed when typical HA processing delays are applied. On the other hand, SRT was independent of the delay between direct and delayed sound in the bilateral OF simulation. Discussion: The significant effect emphasizes the development of rapid processing algorithms for unilateral HA provision. [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]

The binaural masking level difference (BMLD) is a psychoacoustic method to determine binaural interaction and central auditory processes. The BMLD is the difference in hearing thresholds in homophasic and antiphasic conditions. The duration, phase and frequency of the stimuli can affect the BMLD. The main aim of the study is to evaluate the BMLD for stimuli of different durations and frequencies which could also be used in future electrophysiological studies. To this end we developed a GUI to present different frequency signals of variable duration and determine the BMLD. Three different durations and five different frequencies are explored. The results of the study confirm that the hearing threshold for the antiphasic condition is lower than the hearing threshold for the homophasic condition and that differences are significant for signals of 18ms and 48ms duration. Future objective binaural processing studies will be based on 18ms and 48ms stimuli with the same frequencies as used in the current study.

Acute ischemic stroke, characterized by a localized reduction in blood flow to specific areas of the brain, has been shown to affect binaural auditory perception. In a previous study conducted during the acute phase of ischemic stroke, two tasks of binaural hearing were performed: binaural tone-in-noise detection, and lateralization of stimuli with interaural time- or level differences. Various lesion-specific, as well as individual, differences in binaural performance between patients in the acute phase of stroke and a control group were demonstrated. For the current study, we re-invited the same group of patients, whereupon a subgroup repeated the experiments during the subacute and chronic phases of stroke. Similar to the initial study, this subgroup consisted of patients with lesions in different locations, including cortical and subcortical areas. At the group level, the results from the tone-in-noise detection experiment remained consistent across the three measurement phases, as did the number of deviations from normal performance in the lateralization task. However, the performance in the lateralization task exhibited variations over time among individual patients. Some patients demonstrated improvements in their lateralization abilities, indicating recovery, whereas others’ lateralization performance deteriorated during the later stages of stroke. Notably, our analyses did not reveal consistent patterns for patients with similar lesion locations. These findings suggest that recovery processes are more individual than the acute effects of stroke on binaural perception. Individual impairments in binaural hearing abilities after the acute phase of ischemic stroke have been demonstrated and should therefore also be targeted in rehabilitation programs.

IntroductionSubjects with mild to moderate hearing loss today often receive hearing aids (HA) with open-fitting (OF). In OF, direct sound reaches the eardrums with minimal damping. Due to the required processing delay in digital HA, the amplified HA sound follows some milliseconds later. This process occurs in both ears symmetrically in bilateral HA provision and is likely to have no or minor detrimental effect on binaural hearing. However, the delayed and amplified sound are only present in one ear in cases of unilateral hearing loss provided with one HA. This processing alters interaural timing differences in the resulting ear signals.MethodsIn the present study, an experiment with normal-hearing subjects to investigate speech intelligibility in noise with direct and delayed sound was performed to mimic unilateral and bilateral HA provision with OF.ResultsThe outcomes reveal that these delays affect speech reception thresholds (SRT) in the unilateral OF simulation when presenting speech and noise from different spatial directions. A significant decrease in the median SRT from –18.1 to –14.7 dB SNR is observed when typical HA processing delays are applied. On the other hand, SRT was independent of the delay between direct and delayed sound in the bilateral OF simulation.DiscussionThe significant effect emphasizes the development of rapid processing algorithms for unilateral HA provision.

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]

So far, binaural summation for speech stimuli has been less evaluated in the literature, without the head shadow effect and spatial release from masking. Moreover, the right ear advantage has been shown mostly in the dichotic listening situation, but with conflicting results in the monaural/binaural listening condition. Therefore, the present study aimed to evaluate binaural hearing advantage utilizing only binaural summation without other factors and to evaluate the right ear advantage in the monaural listening situation. Thirty-seven participants with normal hearing in the range of 0.125–20 kHz participated current study. Evaluation of speech perception in noise (SPIN) performances were conducted by Matrix test. Participants assessed in three different conditions including the right ear condition, the left ear condition and the binaural condition. Test order of the ears was counterbalanced and noises presented ipsilateral for monaural conditions. The lowest signal-to-noise ratio (SNR) values needed for understanding speech in noise were statistically significantly lower in binaural listening conditions compared to monaural listening conditions. In monaural listening conditions, the SNR value needed to understand speech in noise in the right ear was statistically significantly lower than in the left ear. The results showed that the rehabilitation/habilitation of hearing-impairment patient should consider binaural amplification options to improve SPIN. In case of the symmetric hearing loss with the encountering compulsory situations which bring about the necessity to use only one ear, then right ear preference for amplification devices can provide better SPIN performance. [ABSTRACT FROM AUTHOR]

Lateralized sounds can orient visual attention, with benefits for audio-visual processing. Here, we asked to what extent perturbed auditory spatial cues—resulting from cochlear implants (CI) or unilateral hearing loss (uHL)—allow this automatic mechanism of information selection from the audio-visual environment. We used a classic paradigm from experimental psychology (capture of visual attention with sounds) to probe the integrity of audio-visual attentional orienting in 60 adults with hearing loss: bilateral CI users (N = 20), unilateral CI users (N = 20), and individuals with uHL (N = 20). For comparison, we also included a group of normal-hearing (NH, N = 20) participants, tested in binaural and monaural listening conditions (i.e., with one ear plugged). All participants also completed a sound localization task to assess spatial hearing skills. Comparable audio-visual orienting was observed in bilateral CI, uHL, and binaural NH participants. By contrast, audio-visual orienting was, on average, absent in unilateral CI users and reduced in NH listening with one ear plugged. Spatial hearing skills were better in bilateral CI, uHL, and binaural NH participants than in unilateral CI users and monaurally plugged NH listeners. In unilateral CI users, spatial hearing skills correlated with audio-visual-orienting abilities. These novel results show that audio-visual-attention orienting can be preserved in bilateral CI users and in uHL patients to a greater extent than unilateral CI users. This highlights the importance of assessing the impact of hearing loss beyond auditory difficulties alone: to capture to what extent it may enable or impede typical interactions with the multisensory environment. [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]

Information regarding sound-source spatial location provides several speech-perception benefits, including auditory spatial cues for perceptual talker separation and localization cues to face the talker to obtain visual speech information. These benefits have typically been examined separately. A real-time processing algorithm for sound-localization degradation (LocDeg) was used to investigate how spatial-hearing benefits interact in a multitalker environment. Normal-hearing adults performed auditory-only and auditory-visual sentence recognition with target speech and maskers presented from loudspeakers at −90°, −36°, 36°, or 90° azimuths. For auditory-visual conditions, one target and three masking talker videos (always spatially separated) were rendered virtually in rectangular windows at these locations on a head-mounted display. Auditory-only conditions presented blank windows at these locations. Auditory target speech (always spatially aligned with the target video) was presented in co-located speech-shaped noise (experiment 1) or with three co-located or spatially separated auditory interfering talkers corresponding to the masker videos (experiment 2). In the co-located conditions, the LocDeg algorithm did not affect auditory-only performance but reduced target orientation accuracy, reducing auditory-visual benefit. In the multitalker environment, two spatial-hearing benefits were observed: perceptually separating competing speech based on auditory spatial differences and orienting to the target talker to obtain visual speech cues. These two benefits were additive, and both were diminished by the LocDeg algorithm. Although visual cues always improved performance when the target was accurately localized, there was no strong evidence that they provided additional assistance in perceptually separating co-located competing speech. These results highlight the importance of sound localization in everyday communication. [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]

Identifying the causes underlying a person’s hearing impairment is challenging. It requires linking the results of listening tests to possible pathologies of the highly non-linear auditory system. This process is further aggravated by restrictions in measurement time, especially in clinical settings. A central but difficult goal is thus, to maximize the diagnostic information that is collectable within a given time frame. This study demonstrates the practical applicability of the model-based experiment-steering procedure introduced in Herrmann and Dietz (2021, Acta Acustica, 5:51). The approach chooses the stimuli that are presented and estimates the model parameters best predicting the subject’s performance using a maximum-likelihood method. The same binaural tone-in-noise detection task was conducted using two measurement procedures: A standard adaptive staircase procedure and the model-based selection procedure based on an existing model. The model-steered procedure reached the same accuracy of model parameter estimation in on average only 42% of the time that was required with the standard adaptive procedure. Difficulties regarding the choice of a reliable model and reasonable discretization steps of its parameters are discussed. Although the physiological causes of an individual’s results cannot directly be inferred using this procedure, a characterization in terms of functional parameters is possible.

Bone conduction hearing aids are designed to help individuals with conductive hearing loss. However, a common challenge in the use of these devices is the presence of "crosstalk," where sound intended for one ear is received by the opposite ear by bone conduction. In this study, we aimed to address this issue by investigating the potential of canceling crosstalk at an accelerometer on the mastoid. Surprisingly, the cancellation was still noticeable despite being designed to occur at the mastoid. Our test results with normal-hearing individuals showed that their hearing thresholds improved with crosstalk cancellation compared to when crosstalk was not canceled. These results demonstrate the potential for enhancing bone conduction hearing aids using crosstalk cancellation technology. [ABSTRACT FROM AUTHOR]

In a natural acoustic environment, a preceding sound can suppress the perception of a succeeding sound which can lead to auditory phenomena such as forward masking and the precedence effect. The degree of suppression is dependent on the relationship between the sounds in sound quality, timing, and location. Correlates of such phenomena exist in sound-elicited activities of neurons in hearing-related brain structures. The present study recorded responses to pairs of leading-trailing sounds from ensembles of neurons in the rat's inferior colliculus. Results indicated that a leading sound produced a suppressive aftereffect on the response to a trailing sound when the two sounds were colocalized at the ear contralateral to the site of recording (i.e., the ear that drives excitatory inputs to the inferior colliculus). The degree of suppression was reduced when the time gap between the two sounds was increased or when the leading sound was relocated to an azimuth at or close to the ipsilateral ear. Local blockage of the type-A g-aminobutyric acid receptor partially reduced the suppressive aftereffect when a leading sound was at the contralateral ear but not at the ipsilateral ear. Local blockage of the glycine receptor partially reduced the suppressive aftereffect regardless of the location of the leading sound. Results suggest that a soundelicited suppressive aftereffect in the inferior colliculus is partly dependent on local interaction between excitatory and inhibitory inputs which likely involves those from brainstem structures such as the superior paraolivary nucleus. These results are important for understanding neural mechanisms underlying hearing in a multiple-sound environment. [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]

Studies in a bottlenose dolphin Tursiops truncatus measured the time of release of short-latency auditory evoked potentials (auditory brainstem responses, ABR) from forward masking during contact sound stimulation with short tonal bursts both when the sources of the conditioning and test signals were positioned on one side of the head (unilateral stimulation) and when the sources were positioned on different sides of the head (bilateral stimulation). In both variants of stimulation, significant suppression of the testing ABR was observed at interstimulus delays of less than 1 msec, with almost complete recovery of the test response (release from masking) at delays of about 5 msec. These results suggest that effects of forward masking develop predominantly in binaural auditory structures, where the afferent inputs from the two cochleas interact. [ABSTRACT FROM AUTHOR]

Speech information in the better ear interferes with the poorer ear in patients with bilateral cochlear implants (BiCIs) who have large asymmetries in speech intelligibility between ears. The goal of the present study was to assess how each ear impacts, and whether one dominates, speech perception using simulated CI processing in older and younger normal-hearing (ONH and YNH) listeners. Dynamic range (DR) was manipulated symmetrically or asymmetrically across spectral bands in a vocoder. We hypothesized that if abnormal integration of speech information occurs with asymmetrical speech understanding, listeners would demonstrate an atypical preference in accuracy when reporting speech presented to the better ear and fusion of speech between the ears (i.e., an increased number of one-word responses when two words were presented). Results from three speech conditions showed that: (1) When the same word was presented to both ears, speech identification accuracy decreased if one or both ears decreased in DR, but listeners usually reported hearing one word. (2) When two words with different vowels were presented to both ears, speech identification accuracy and percentage of two-word responses decreased consistently as DR decreased in one or both ears. (3) When two rhyming words (e.g., bed and led) previously shown to phonologically fuse between ears (e.g., bled) were presented, listeners instead demonstrated interference as DR decreased. The word responded in (2) and (3) came from the right (symmetric) or better (asymmetric) ear, especially in (3) and for ONH listeners in (2). These results suggest that the ear with poorer dynamic range is down-weighted by the auditory system, resulting in abnormal fusion and interference, especially for older listeners. [ABSTRACT FROM AUTHOR]

In a natural acoustic environment, a preceding sound can suppress the perception of a succeeding sound which can lead to auditory phenomena such as forward masking and the precedence effect. The degree of suppression is dependent on the relationship between the sounds in sound quality, timing, and location. Correlates of such phenomena exist in sound-elicited activities of neurons in hearing-related brain structures. The present study recorded responses to pairs of leading-trailing sounds from ensembles of neurons in the rat’s inferior colliculus. Results indicated that a leading sound produced a suppressive aftereffect on the response to a trailing sound when the two sounds were colocalized at the ear contralateral to the site of recording (i.e., the ear that drives excitatory inputs to the inferior colliculus). The degree of suppression was reduced when the time gap between the two sounds was increased or when the leading sound was relocated to an azimuth at or close to the ipsilateral ear. Local blockage of the type-A γ-aminobutyric acid receptor partially reduced the suppressive aftereffect when a leading sound was at the contralateral ear but not at the ipsilateral ear. Local blockage of the glycine receptor partially reduced the suppressive aftereffect regardless of the location of the leading sound. Results suggest that a sound-elicited suppressive aftereffect in the inferior colliculus is partly dependent on local interaction between excitatory and inhibitory inputs which likely involves those from brainstem structures such as the superior paraolivary nucleus. These results are important for understanding neural mechanisms underlying hearing in a multiple-sound environment.

Spatial processing is a major cognitive function of hearing. Sound source localization is an intuitive evaluation of spatial hearing. Current evidence of the effect of tinnitus on sound source localization remains limited. The present study aimed to investigate whether tinnitus affects the ability to localize sound in participants with normal hearing and whether the effect is related to the type of stimulus. Overall, 40 participants with tinnitus and another 40 control participants without tinnitus were evaluated. The sound source discrimination tasks were performed on the horizontal plane. Pure tone (PT, with single frequency) and monosyllable (MS, with spectrum information) were used as stimuli. The root-mean-square error (RMSE) score was calculated as the mean target response difference. When the stimuli were PTs, the RMSE scores of the control and tinnitus group were 11.77 ± 2.57° and 13.97 ± 4.18°, respectively. The control group performed significantly better than did the tinnitus group (t = 2.841, p = 0.006). When the stimuli were MS, the RMSE scores of the control and tinnitus groups were 7.12 ± 2.29° and 7.90 ± 2.33°, respectively. There was no significant difference between the two groups (t = 1.501, p = 0.137). Neither the effect of unilateral or bilateral tinnitus (PT: t = 0.763, p = 0.450; MS: t = 1.760, p = 0.086) nor the effect of tinnitus side (left/right, PT: t = 0.389, p = 0.703; MS: t = 1.407, p = 0.179) on sound localization ability were determined. The sound source localization ability gradually deteriorated with an increase in age (PT: r2 = 0.153, p < 0.001; MS: r2 = 0.516, p = 0.043). In conclusion, tinnitus interfered with the ability to localize PTs, but the ability to localize MS was not affected. Therefore, the interference of tinnitus in localizing sound sources is related to the type of stimulus.

Speech information in the better ear interferes with the poorer ear in patients with bilateral cochlear implants (BiCIs) who have large asymmetries in speech intelligibility between ears. The goal of the present study was to assess how each ear impacts, and whether one dominates, speech perception using simulated CI processing in older and younger normal-hearing (ONH and YNH) listeners. Dynamic range (DR) was manipulated symmetrically or asymmetrically across spectral bands in a vocoder. We hypothesized that if abnormal integration of speech information occurs with asymmetrical speech understanding, listeners would demonstrate an atypical preference in accuracy when reporting speech presented to the better ear and fusion of speech between the ears (i.e., an increased number of one-word responses when two words were presented). Results from three speech conditions showed that: (1) When the same word was presented to both ears, speech identification accuracy decreased if one or both ears decreased in DR, but listeners usually reported hearing one word. (2) When two words with different vowels were presented to both ears, speech identification accuracy and percentage of two-word responses decreased consistently as DR decreased in one or both ears. (3) When two rhyming words (e.g., bed and led) previously shown to phonologically fuse between ears (e.g., bled) were presented, listeners instead demonstrated interference as DR decreased. The word responded in (2) and (3) came from the right (symmetric) or better (asymmetric) ear, especially in (3) and for ONH listeners in (2). These results suggest that the ear with poorer dynamic range is downweighted by the auditory system, resulting in abnormal fusion and interference, especially for older listeners.

Stroke-induced lesions at different locations in the brain can affect various aspects of binaural hearing, including spatial perception. Previous studies found impairments in binaural hearing, especially in patients with temporal lobe tumors or lesions, but also resulting from lesions all along the auditory pathway from brainstem nuclei up to the auditory cortex. Currently, structural magnetic resonance imaging (MRI) is used in the clinical treatment routine of stroke patients. In combination with structural imaging, an analysis of binaural hearing enables a better understanding of hearing-related signaling pathways and of clinical disorders of binaural processing after a stroke. However, little data are currently available on binaural hearing in stroke patients, particularly for the acute phase of stroke. Here, we sought to address this gap in an exploratory study of patients in the acute phase of ischemic stroke. We conducted psychoacoustic measurements using two tasks of binaural hearing: binaural tone-in-noise detection, and lateralization of stimuli with interaural time- or level differences. The location of the stroke lesion was established by previously acquired MRI data. An additional general assessment included three-frequency audiometry, cognitive assessments, and depression screening. Fifty-five patients participated in the experiments, on average 5 days after their stroke onset. Patients whose lesions were in different locations were tested, including lesions in brainstem areas, basal ganglia, thalamus, temporal lobe, and other cortical and subcortical areas. Lateralization impairments were found in most patients with lesions within the auditory pathway. Lesioned areas at brainstem levels led to distortions of lateralization in both hemifields, thalamus lesions were correlated with a shift of the whole auditory space, whereas some cortical lesions predominantly affected the lateralization of stimuli contralateral to the lesion and resulted in more variable responses. Lateralization performance was also found to be affected by lesions of the right, but not the left, basal ganglia, as well as by lesions in non-auditory cortical areas. In general, altered lateralization was common in the stroke group. In contrast, deficits in tone-in-noise detection were relatively scarce in our sample of lesion patients, although a significant number of patients with multiple lesion sites were not able to complete the task. [ABSTRACT FROM AUTHOR]

Speech recognition in rooms requires the temporal integration of reflections which arrive with a certain delay after the direct sound. It is commonly assumed that there is a certain temporal window of about 50–100 ms, during which reflections can be integrated with the direct sound, while later reflections are detrimental to speech intelligibility. This concept was challenged in a recent study by employing binaural room impulse responses (RIRs) with systematically varied interaural phase differences (IPDs) and amplitude of the direct sound and a variable number of reflections delayed by up to 200 ms. When amplitude or IPD favored late RIR components, normal-hearing (NH) listeners appeared to be capable of focusing on these components rather than on the precedent direct sound, which contrasted with the common concept of considering early RIR components as useful and late components as detrimental. The present study investigated speech intelligibility in the same conditions in hearing-impaired (HI) listeners. The data indicate that HI listeners were generally less able to "ignore" the direct sound than NH listeners, when the most useful information was confined to late RIR components. Some HI listeners showed a remarkable inability to integrate across multiple reflections and to optimally "shift" their temporal integration window, which was quite dissimilar to NH listeners. This effect was most pronounced in conditions requiring spatial and temporal integration and could provide new challenges for individual prediction models of binaural speech intelligibility. [ABSTRACT FROM AUTHOR]

Introduction: Bilateral cochlear implants (BiCIs) can facilitate improved speech intelligibility in noise and sound localization abilities compared to a unilateral implant in individuals with bilateral severe to profound hearing loss. Still, many individuals with BiCIs do not benefit from binaural hearing to the same extent that normal hearing (NH) listeners do. For example, binaural redundancy, a speech intelligibility benefit derived from having access to duplicate copies of a signal, is highly variable among BiCI users. Additionally, patients with hearing loss commonly report elevated listening effort compared to NH listeners. There is some evidence to suggest that BiCIs may reduce listening effort compared to a unilateral CI, but the limited existing literature has not shown this consistently. Critically, no studies to date have investigated this question using pupillometry to quantify listening effort, where large pupil sizes indicate high effort and small pupil sizes indicate low effort. Thus, the present study aimed to build on existing literature by investigating the potential benefits of BiCIs for both speech intelligibility and listening effort. Methods: Twelve BiCI adults were tested in three listening conditions: Better Ear, Poorer Ear, and Bilateral. Stimuli were IEEE sentences presented from a loudspeaker at 0° azimuth in quiet. Participants were asked to repeat back the sentences, and responses were scored by an experimenter while changes in pupil dilation were measured. Results: On average, participants demonstrated similar speech intelligibility in the Better Ear and Bilateral conditions, and significantly worse speech intelligibility in the Poorer Ear condition. Despite similar speech intelligibility in the Better Ear and Bilateral conditions, pupil dilation was significantly larger in the Bilateral condition. Discussion: These results suggest that the BiCI users tested in this study did not demonstrate binaural redundancy in quiet. The large interaural speech asymmetries demonstrated by participants may have precluded them from obtaining binaural redundancy, as shown by the inverse relationship between the two variables. Further, participants did not obtain a release from effort when listening with two ears versus their better ear only. Instead, results indicate that bilateral listening elicited increased effort compared to better ear listening, which may be due to poor integration of asymmetric inputs. [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]