BACKGROUND AND OBJECTIVES: Sound localization in subjects with normal hearing is done by recognition of interaural difference of time, intensity and phase of sound source. Individuals with unilateral hearing losses, deprived of the binaural cues, are expected to have difficulty in localizing sound. The purpose of the research is to investigate the sound localizing ability in subjects with unilateral hearing losses to localize sound in horizontal plane by comparing with normal control group, and to know the effects of age, gender, stimulus type and hearing level. MATERIALS: Two groups of subjects participated in this study. The first group consisted of 60 normal hearing adults, in each age groups of 10 subjects, ranging from teens to sixties. The second group consisted of 50 subjects with unilateral hearing losses. METHODS: Sound localization ability was assessed by means of an array of eight loudspeakers positioned at the azimuth of 45 degrees each in the horizontal plane at a distance of 100 cm from the subject. The stimuli consisted of speech noise, narrow band noise centered at 500 Hz and 4000 Hz, pure tone of 500 Hz and 4000 Hz at the level of 45 dB HL for 5 seconds. RESULTS: 1) Speech noise was the most easily detected stimulus (p<0.001). 2) The age and gender did not affect significantly to the ability to localize sound (p>0.05). 3) The localization errors for speech noise increased significantly as hearing threshold increased in patients with unilateral hearing losses (p<0.001). CONCLUSION: The results suggest that speech noise is the most easily detected stimulus in directional discrimination test and that the ability of sound localization is degraded as hearing threshold is increased for patients with unilateral hearing losses.
Adolescent ; Adult ; Cues ; Discrimination (Psychology) ; Hearing Loss* ; Hearing Loss, Unilateral* ; Hearing* ; Humans ; Noise ; Sound Localization*

OBJECTIVE: To analyze social-psychological causes of acute exacerbation or re-decompensation of chronic tinnitus and provide theoretical basis for controlling and preventing tinnitus exacerbation and re-decompensation. METHOD: Systemic audiological tests and tinnitus handicap inventory were performed on 136 chronic tinnitus patients with acuteexacerbation or re-decompensation. For the patients with new hearing loss, a further investigation of living conditions and assessment of social support rating scale were utilized. The patients with relatively definite causes were treated accordingly. RESULT: (1) There were 89 patients complained of new changes of hearing, all of whom could tell the definite time point of tinnitus exacerbation, and 5 of them felt the exacerbation of hearing loss meanwhile. (2) Forty-two patients encountered adverse events on life or working, and tinnitus exacerbation occurred within several weeks to 3 months afterwards. Most of these patients could not tell the definite time point of tinnitus exacerbation or re-decompensation. Five cases of tinnitus exacerbation didn't tell any adverse events on life or working, but showed mood disorders, and the anti-anxiety treatment was effective to them. (3) Forty-seven cases without new hearing loss scored significantly lower in SSRS than healthy adults. CONCLUSION Emerging hearing loss is the main cause of acute exacerbation of chronic tinnitus. To find it in time and give effective treatment can save newly presented hearing loss, cure or relieve tinnitus. Adverse events in life(or working) and short of social support is another important cause of acute exacerbation of chronic tinnitus or decompensation recurrence, which suggests that social-psychological factors besides of hearing loss should be concerned in diagnosis and treatment of tinnitus.
Adult ; Disease Progression ; Hearing Loss ; Humans ; Social Support ; Tinnitus ; psychology

OBJECTIVE: The aim of this study was to predetermine the discrimination standard point of distortion product otoacoustic emission(DPOAE) amplitudes, which discriminates the degree of the mild noise-induced hearing loss, and to estimate the accuracy and predictability of the discrimination standard point of DPOAE amplitudes. Therefore we were able to determine the usability of the DPOAE test in screening exam for mild noise-induced hearing loss. METHODS: This study was analyzed 50 high frequency-impaired ears(from 25dB HL to 40dB HL at 4000Hz for which the response of DPOAE was not disappeared) and 81 normal ears through the correlation test between the amplitudes of DPOAE test and the threshold of the pure-tone audiometry test. RESULT: The discrimination between >or=25dB and hearing threshold with -1dB SPL value of DP amplitude at 4000Hz produced a sensitivity result of 89.7%, specificity of 90.2% and predictability of 90.0%. CONCLUSION: DPOAE test is considered as a more efficient early prevention method against noise-induced hearing loss if this test is conducted as part of the special medical checkup of industrial workers exposed to noise.
Audiometry, Pure-Tone ; Discrimination (Psychology) ; Ear ; Hearing Loss* ; Hearing Loss, Noise-Induced* ; Hearing* ; Mass Screening ; Noise ; Sensitivity and Specificity

OBJECTIVES: This study was performed to investigate the effectiveness of the questionnaire. METHODS: Workers'health examination records, work environment record, and questionnaires of selected industries as samples were analysed using logistic regression analysis and discrimination analysis Results'Cases of bearing impairment (Dl+C) as dependent variables, and age, work duration and level of environmental noise as independent variables were selected for multiple unconditional logistic regression analysis. Odds ratio was 4.04 in hearing difficulty, 2.78 in tlnnitus and 1.08 in age. In the second analysis Noise induced hearing loss is selected as dependent variable. The OR in hearing difficulty was 3.67(95 % C.1. : 1.61 8.61), and was 1.09(95 % C.1. : 1.05-1.14) in age. Conditionnal multlple logistic regression analysis was performed. In hearing impairment as dependent variable, the OR of age was 1.02(95 % C.1. : 1.00-1.04) and other variables were not significant. However, NIHL as dependent, the OR of hearing difficulty was 4.57(95 % C.1. : 1.43-14.67). According to multiple logistic regression adopting each items of questionnaire as dependent variable, the only item of hearing difficulty showed significant difference with hearing ability. The discrimination analysis was performed with the class variable of hearing impairment, and discrimination variables of age, work duration, and environment noise level. The sensitivity of 59 %, and specificity of 88 %, and average error count of 23 % were obtained. When the numbers of items answered in questionnaire were assumed as the parameter of judgement for noise induced hearing loss (NIHL), the highest sensitivity and specificity were 33.5% and 49.0% in cases of more than two items answered. CONCLUSIONS: The development of items that is simple and discriminative mainly consisted of chronic and specific diseases related items is needed. Computerization for newly developed items might be needed to establish effective surveillance system for NIHL in the future.
Discrimination (Psychology) ; Hearing Loss* ; Hearing* ; Logistic Models ; Mass Screening* ; Noise* ; Odds Ratio ; Questionnaires* ; Sensitivity and Specificity

BACKGROUND AND OBJECTIVES: Various speech perception tests have been developed for children with hearing loss (HL) in Korea, although they are not standardized yet. This study aims to examine the actual condition of speech perception tests for children with HL in Korea. SUBJECTS AND METHOD: Survey questionnaires and speech perception tests for children with HL were collected from 24 cochlear implant (CI) centers between March and July 2009. The speech perception tests were classified according to target ages, speech stimulus levels, and response formats. We interviewed speech therapists who had developed monosyllabic word (MW) tests, and gathered source materials, considerations, and limitations of the MW tests. We also analyzed vocabulary familiarity and phonetic balancing of words in the most commonly used MW tests. RESULTS: Thirty-eight kinds of speech perception tests for children with HL were collected from 24 CI centers. Among these tests, open-set MW tests and sentence tests were used in all centers. Speech therapists responsible for developing MW tests had selected words from textbooks, storybooks, and spontaneous speech data to secure vocabulary familiarity and phonetic balancing within each list. Four commonly used MW tests revealed that vocabulary familiarity was compatible with commonly used MW in preschoolers and demonstrated a similar trend in phoneme frequencies. CONCLUSION: The results of this study showed that current speech perception tests for children with HL should be verified, revised, and standardized in an experimental setting.
Child ; Cochlear Implants ; Hearing ; Hearing Loss ; Humans ; Korea ; Surveys and Questionnaires ; Recognition (Psychology) ; Speech Perception ; Vocabulary

OBJECTIVE: To evaluate the effects of hearing aids combined with psychological counseling on subjective tinnitus. METHOD: One hundred and fifty four tinnitus patients with deafness were randomly divided into two groups: 84 cases in study group, receiving hearing aids combined with psychological counseling therapy; 70 cases in control group, receiving counseling therapy only. Two groups were assessed at 3, 6 and 12 months after the beginning of the therapy. In study group, 6 cases were bilaterally aided and 78 cases were unilaterally aided. The 78 cases are divided into three subgroups: Group A (moderate hearing loss), Group B (moderate to severe hearing loss), and Group C(severe hearing loss) according to the severity of hearing loss. RESULT: At 3, 6 and 12 months after the beginning of the therapy ,the effective rates in study group are 26.19%, 63.10% and 72.62% respectively and the effective rates in control group are 8.57%, 18.57% and 25.71% respectively. There are statistically significant differences between the effective rates of the two groups after 3,6 and 12 months since the therapy started (P < 0.01). The tinnitus improvement of Group A is the most, and that of Group C is the least. The effective rate of Group A is higher than groups B and C with statistically significant differences (P < 0.0167). The effective rate of Group B is higher than Group C while with no statistically significant difference(P > 0.05). CONCLUSION Hearing aids can not only improve hearing but also help with the treatment of tinnitus. Hearing aids combined with psychological counseling treatment is an ideal method for dealing with tinnitus in patients with deafness.
Aged ; Counseling ; Female ; Hearing Aids ; Hearing Loss ; psychology ; therapy ; Humans ; Male ; Middle Aged ; Tinnitus ; psychology ; therapy ; Treatment Outcome

Between one and three of every 1,000 neonates have sensorineural hearing loss (SNHL). It is of utmost importance to minimize the duration of auditory deprivation between the onset of bilateral deafness and intervention using hearing devices such as hearing aids and cochlear implants for achieving the best speech percpetion ability. To fit amplification accurately for children with SNHL, hearing thresholds for frequencies in the range of human communication should be evaluated. However, infants and young children are difficult to test using conventional behavioral tests, and hearing thresholds of them can be predicted using auditory brainstem response (ABR) and auditory steady-state response (ASSR). ABR is best evoked by applying a click stimulus, which allows an estimate over a broad range of high frequencies. ABR elicited by tone burst stimulus provides frequency-specific audiometric information. However, it can be difficult to record and observe at near-threshold levels, especially at lower frequencies. ABR thresholds for click and tone burst stimuli are highly correlated with behavioral thresholds, and often give an idea of the shape of an audiogram. ASSR is an auditory evoked potential, elicited with modulated tones. It provides frequency-specific hearing thresholds across the audiometric frequencies, which are well correlated with behavioral thresholds. However, the accuracy of threshold prediction decreases directly with the decrease of degree of hearing loss, and hearing thresholds cannot be predicted for auditory neuropathy. ASSR is most useful for estimating auditory thresholds for patients with no evidence of auditory neuropathy by the click ABR and OAEs, and who have an ABR only at high intensities or no ABR at a maximum stimulus level. Even if hearing thresholds are predicted through ABR and ASSR, behavioral testing including behavioral observation audiometry, visual reinforcement audiometry, or play audiometry should be employed repeatedly to verify the predicted thresholds, becasue the thresholds of ABR and ASSR are not true measure of hearing acuity but just responses generated at the brainstem.
Audiometry ; Auditory Threshold ; Brain Stem ; Child ; Cochlear Implants ; Deafness ; Evoked Potentials, Auditory ; Evoked Potentials, Auditory, Brain Stem ; Hearing ; Hearing Aids ; Hearing Loss ; Hearing Loss, Central ; Hearing Loss, Sensorineural ; Humans ; Infant ; Infant, Newborn ; Reinforcement (Psychology)

Postoperative vertigo after tympanomastoidectomy can be attributed to several causes such as inner ear damage due to excessive ossicle handling, labyrinthitis, BPPV resulting from vibration of drilling, iatrogenic lateral semicircular canal damage, and perilymphtic fistula. Differential diagnosis is critical for the proper management and prognosis of accompanied sensorineural hearing loss, but it may be difficult in some cases. Especially it is quite difficult to distinguish between the serous and suppurative labyrinthitis. In this article we present a case with simultaneous serous labyrinthitis and BPPV. The patient developed whirling vertigo and hearing loss on the 5th day after tympanomastoidectomy. After conservative treatment with steroid and antibiotics, his hearing recovered to preoperative level. We retrospectively reviewed the pitfalls to make a correct diagnosis in this patient and the serial change in nystagmus during the treatment period. The usefullness of the rotation chair test to predict the prognosis of sensorineural hearing loss in labyrinthitis was also discussed.
Anti-Bacterial Agents ; Diagnosis, Differential ; Ear, Inner ; Fistula ; Handling (Psychology) ; Hearing ; Hearing Loss ; Hearing Loss, Sensorineural ; Humans ; Labyrinthitis ; Mandrillus ; Prognosis ; Retrospective Studies ; Semicircular Canals ; Vertigo ; Vibration

BACKGROUND AND OBJECTIVES: To standard test method of Korean speech audiometry, we developed an audio compact disk, the KsoM-07 (Korean Society of Otolaryngolgy, Monosyllabic, 2007) word lists and evaluated them for clinical usage. SUBJECTS AND METHOD: The monitored live voice (MLV) of a female talker was digitally recorded with a Beltone audiometer and the GoldWave program. The calibration for each word was done by calculating the root-mean-square (RMS) at the moving time of 300 ms using MATLAB(R) (7.0 version, The MathWorks, Inc. Natick, Massachusetts, USA) and the GoldWave (v 5.25 GoldWave Inc. St. John's, NL, Canada) program. The discrimination score was measured in 20 normal subjects to obtain psychometric function curve of each word and to compare the homogeneity of two lists. The first verification methods for new speech materials were done by comparing the discrimination scores of the flat type and the descending types at 150 sensorineural hearing loss with similar pure tone threshold. RESULTS: 44% of MLV recording was above +/-3 dB deviation and had to be recalibrated. Two lists showed equal difficulty or homogeneity in normal subjects. Discrimination scores were statistically different among the groups with respect to hearing level and the slope of audiogram. CONCLUSION: KsoM-07 word lists were relatively homogeneous and showed differences between the descending type and the flat type of hearing loss. Therefore, KsoM-07 word lists can be useful in evaluating the impairment found in the descending type of sensorineural hearing loss as well as in serving as a new speech test material for Korean monosyllabic words.
Audiometry, Speech ; Calibration ; Compact Disks ; Discrimination (Psychology) ; Female ; Hearing ; Hearing Loss ; Hearing Loss, Sensorineural ; Humans ; Massachusetts ; Psychometrics ; Speech Discrimination Tests ; Speech Intelligibility ; Voice

Adolescent ; Adult ; Female ; Hearing Loss, Sudden ; etiology ; psychology ; Humans ; Male ; Middle Aged ; Young Adult