RESUMEN
Extended-wear hearing aids (EWHAs) are small broadband analog amplification devices placed deeply enough in the ear canal to preserve most of the cues in the head-related transfer function. However, little is known about how EWHAs affect localization accuracy for normal hearing threshold (NHT) listeners. In this study, eight NHT participants were fitted with EWHAs and localized broadband sounds of different durations (250 ms and 4 s) and stimulus intensities (40, 50, 60, 70, and 80 dBA) in a spherical speaker array. When the EWHAs were in the active mode, localization accuracy was only slightly degraded relative to open-ear performance. However, when the EWHAs were turned off, localization performance was substantially degraded even at the highest stimulus intensities. An electro-acoustical evaluation of the EWHAs showed minimal effects of dynamic range compression on the signals and good preservation of the signal pattern for vertical polar sound localization. Between-study comparisons suggest that EWHA active mode localization accuracy is favorable compared to conventional active earplugs, and EWHA passive mode localization accuracy is comparable to conventional passive earplugs. These results suggest that the deep-insertion analog design of the EWHA is generally better at preserving localization accuracy of NHT listeners than conventional earplug devices.
Asunto(s)
Umbral Auditivo , Audífonos , Localización de Sonidos , Humanos , Adulto , Masculino , Femenino , Adulto Joven , Estimulación Acústica/métodos , Señales (Psicología) , Diseño de EquipoRESUMEN
OBJECTIVE: Sampling distortion product otoacoustic emissions (DPOAEs) at multiple f2/f1 ratios and f2 frequency values produces a DPOAE "map." This study examined the efficacy of DPOAE mapping compared with pure tone audiometry and standard DPOAEs for detecting noise effects in subjects exposed to loud sound. DESIGN: A map significance score was developed as a single measure of map change. Significance scores were evaluated before and after exposure to: loud music (LM), controlled noise (CN), and firing range noise (FR) in three separate sets of subjects. Scores were compared to audiometry and standard DPOAE results in the LM study. STUDY SAMPLE: The LM and CN exposure studies involved 22, and 20 healthy young subjects respectively with normal hearing. Eight Marines were studied before and after FR exposure. RESULTS: After LM exposure, audiometry showed significant changes at 1, 2, 4, and 6 kHz. Standard DPOAE measures were also significantly different at several frequencies. Map significance scores detected changes more effectively and showed the distribution of DPOAE alterations. CONCLUSIONS: Map significance scores detected changes after noise exposure more reliably than audiometry and standard DPOAEs. Additionally, maps showed a diffuse response to sound exposure perhaps explaining why individual DP-grams appear less sensitive.
Asunto(s)
Música , Emisiones Otoacústicas Espontáneas , Audiometría de Tonos Puros/métodos , Umbral Auditivo/fisiología , Humanos , Ruido/efectos adversos , Emisiones Otoacústicas Espontáneas/fisiologíaRESUMEN
The extended-wear hearing aid (EWHA) is a hearing assistive device that combines a low-power analog amplification circuit with a soft biocompatible foam plug that allows it to remain in the ear canal for several months at a time without replacement. EWHAs fit snugly in the ear canal and are not vented and so produce insertion losses comparable to a passive earplug when inserted into the ear canal with the active circuitry turned off. However, EWHAs are not marketed as hearing protection devices, and other than a general warning to users that the device will have impaired auditory awareness when the device is inserted in the "off" mode, relatively little has been reported about the attenuation characteristics of EWHAs. In this study, commercially-available EWHAs were evaluated using the ANSI standard procedures for measuring hearing protector attenuation in impulse noise [ANSI (2010). S1242-2010, Methods for the Measurement of Insertion Loss of Hearing Protective Devices in Continuous or Impulsive Noise Using Microphone-In-Real-Ear or Acoustic Text Fixture Procedures (American National Standards Institute, New York)] and in continuous noise [ANSI (2006). S12.6, Methods for Measuring the Real-Ear Attenuation of Hearing Protectors (American National Standards Institute, New York)]. Attenuation values were also measured in double and triple protection conditions that combined EWHAs with traditional earplugs and earmuffs. The results show that properly-fit EWHAs can provide passive attenuation comparable to conventional passive earplugs, which may make it possible to use them to provide persistent protection from intermittent noise sources.
Asunto(s)
Audífonos , Pérdida Auditiva Provocada por Ruido , Umbral Auditivo , Dispositivos de Protección de los Oídos , Pérdida Auditiva Provocada por Ruido/etiología , Pérdida Auditiva Provocada por Ruido/prevención & control , Humanos , Ruido/efectos adversosRESUMEN
Purpose A growing body of evidence suggests that military service members and military veterans are at risk for deficits in central auditory processing. Risk factors include exposure to blast, neurotrauma, hazardous noise, and ototoxicants. We overview these risk factors and comorbidities, address implications for clinical assessment and care of central auditory processing deficits in service members and veterans, and specify knowledge gaps that warrant research. Method We reviewed the literature to identify studies of risk factors, assessment, and care of central auditory processing deficits in service members and veterans. We also assessed the current state of the science for knowledge gaps that warrant additional study. This literature review describes key findings relating to military risk factors and clinical considerations for the assessment and care of those exposed. Conclusions Central auditory processing deficits are associated with exposure to known military risk factors. Research is needed to characterize mechanisms, sources of variance, and differential diagnosis in this population. Existing best practices do not explicitly consider confounds faced by military personnel. Assessment and rehabilitation strategies that account for these challenges are needed. Finally, investment is critical to ensure that Veterans Affairs and Department of Defense clinical staff are informed, trained, and equipped to implement effective patient care.
Asunto(s)
Percepción Auditiva , Trastornos del Desarrollo del Lenguaje , Personal Militar , Veteranos , Humanos , Ruido , Estados Unidos/epidemiologíaRESUMEN
OBJECTIVE: Information is summarized from the overall body of published literature regarding ototoxic chemicals encountered outside of clinical exposures, largely in occupational settings. While summarizing the most common non-pharmaceutical ototoxins, this review provides clinically relevant information and recommendations such that hearing health professionals may adopt a more comprehensive and appropriate diagnostic case history, test battery, documentation scheme, and education delivery. METHODS: Solvents, metals, and asphyxiants literature was reviewed using PubMed, national and international agency websites, and communications with known ototoxicity experts. RESULTS: Initial intentions to summarize the existing programs for occupational ototoxicity monitoring fell short when it was discovered that such programs have not yet formalized across the major oversight agencies in the United States. Instead, recommended guidance documents and fact sheets, which highlight existing occupational exposure limits and suggest monitoring and education are discussed. CONCLUSIONS: While evidence in humans is limited, potentially ototoxic substances are worthy of improved surveillance and further research to understand their ototoxic mechanisms, effects, and possible mitigation strategies. A triad approach of monitoring, protecting, and educating is recommended for effective prevention of hearing loss: the Department of Defense Hearing Center of Excellence's Comprehensive Hearing Health Program model employs such an approach.