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Neuro-rehabilitation Approach for Sudden Sensorineural Hearing Loss
Published on: January 25, 2016
Understanding excessive SNR loss in hearing-impaired listeners
Ken W Grant1, Therese C Walden
1Audiology and Speech Center, Scientific and Clinical Studies Section, Walter Reed National Military Medical Center, Bethesda, MD 20889-5600, USA. kenneth.w.grant@health.mil
Journal of the American Academy of Audiology
|May 3, 2013
Summary
Traditional hearing tests are poor predictors of speech understanding in noise for hearing-impaired individuals. Suprathreshold measures, especially when combined with age, better predict speech-in-noise difficulties, highlighting the need for advanced audiological assessments.
Area of Science:
- Audiology and Speech-Language Pathology
- Neuroscience
- Gerontology
Background:
- Traditional audiometric measures inadequately predict speech understanding in noise for hearing-impaired (HI) individuals.
- Suprathreshold auditory function measures, such as noise tolerance and frequency/temporal resolution, are more indicative of amplification success and hearing distortion.
- Integrating audibility and suprathreshold distortion measures offers a comprehensive understanding of HI individuals' speech deficits in noisy environments.
Purpose of the Study:
- To investigate the relationship between speech recognition in noise and various auditory functions (frequency selectivity, temporal acuity, modulation masking release, informational masking) in adults with sensorineural hearing loss.
- To determine if peripheral distortion of suprathreshold sounds contributes to variable outcomes in speech-in-noise perception for individuals with sensorineural hearing loss.
Main Methods:
- A correlational study involving 27 sensorineural hearing loss patients and 4 normal-hearing adults.
- Data collection included speech recognition tests (Hearing-in-Noise Test [HINT] and Quick Speech-in-Noise test [QSIN]), frequency selectivity, and temporal acuity measures in a sound-attenuated booth.
- Statistical analyses included correlation, step-wise multiple linear regression, and repeated analysis of variance.
Main Results:
- Signal-to-noise ratio (SNR) loss was only partially predictable by audibility measures like the Speech Intelligibility Index (SII).
- The SII accounted for 71% of SNR loss variance with HINT but only 49% with QSIN.
- Listener age and suprathreshold measures significantly improved QSIN's prediction of SNR loss to nearly 71% variance explained.
Conclusions:
- The Quick Speech-in-Noise test (QSIN) is a better clinical indicator of suprathreshold deficits impacting speech-in-noise understanding compared to the Hearing-in-Noise Test (HINT).
- Aging, spectral resolution, and temporal resolution enhance the prediction of SNR loss measured by QSIN.
- A significant portion of individual differences in SNR loss remains unexplained, suggesting the need for additional measures of suprathreshold acuity or cognitive function.
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