Sung Hwa Hong

Background: Identifying the temporal and spectral information in sound is important for understanding speech; indeed, a person who has good spectral resolution usually shows good speech recognition performance. The spectral ripple discrimination (SRD) test is often used to behaviorally determine spectral resolution capacity. However, although the SRD test is useful, it is difficult to apply to populations who cannot execute the behavioral task, such as younger children and people with disabilities. In this study, an objective approach using spectral ripple (SR) stimuli to evoke the acoustic change complex (ACC) response was investigated to determine whether it could objectively evaluate the spectral resolution ability of subjects with normal hearing (NH) and those with hearing loss (HL). Method: Ten subjects with NH and eight with HL were enrolled in this study. All subjects completed the behavioral SRD test and the objective SR-ACC test. Additionally, the HL subjects completed speech perception performance tests while wearing hearing aids. Results: In the SRD test, the average thresholds were 6.48 and 1.52 ripples per octave (RPO) for the NH and HL groups, respectively, while in the SR-ACC test, they were 4.90 and 1.35 RPO, respectively. There was a significant difference in the average thresholds between the two groups for the SRD (p < 0.001) and the SR-ACC (p < 0.001) tests. A significant positive correlation was observed between the SRD and SR-ACC tests (ρ = 0.829, p < 0.001). In the HL group, there was a statistically significant relationship between speech recognition performance in noisy conditions and the SR-ACC threshold (ρ = 0.911, p < 0.001 in Sentence score of Korean Speech Audiometry (KSA)). Conclusions: The results supported the feasibility of the SR-ACC test to objectively evaluate auditory spectral resolution in individuals with HL. This test has potential for use in individuals with HL who are unable to complete the behavioral task associated with the SRD test; therefore, it is proposed as a more inclusive alternative to the SRD test.

Background and Objectives: Wireless streaming technology (WT), designed to transmit sounds directly from a mobile phone to hearing aids, was developed to enhance the signal-to-noise ratio. However, the advantages of WT during phone use and the specific demographic that can fully benefit from this technology has not been thoroughly evaluated. We aimed to investigate the benefits and identify predictive factors associated with bilateral wireless streaming among hearing aid users.Subjects and Methods: Eighteen adults with symmetrical, bilateral hearing loss participated in the study. To assess the benefits of wireless streaming during phone use, researchers assessed sentence/word recognition and listening effort in two scenarios: a noisy background with WT turned “OFF” or “ON.” Listening effort was evaluated through self-reported measurements. Cognitive function was also assessed using the Montreal Cognitive Assessment (MoCA) score.Results: Participant mean age was 57.3 years (range 27-70), and the mean MoCA score was 27.0 (23-30). The activation of WT demonstrated a significant improvement in the sentence/word recognition test and reduced listening effort. The MoCA score showed a significant correlation with WT (ρ=0.59, p=0.01), suggesting a positive association between cognitive function and the benefits of WT.Conclusions: Bilateral wireless streaming may enhance sentence/word recognition and reduce listening effort during phone use in hearing aid users, with these benefits potentially linked to cognitive function.

Background and Objectives: The temporal structure of sound, characterized by regular patterns, plays a crucial role in optimizing the processing of auditory information. The meter, representing a well-organized sequence of evenly spaced beats in music, exhibits a hierarchical arrangement, with stronger beats occupying higher metrical positions. Moreover, the meter has been shown to influence behavioral and neural processing, particularly the N1, P2, and mismatch negativity components. However, the role of the P1 component in the context of metrical hierarchy remains unexplored. This study aimed to investigate the effects of metrical hierarchy on the P1 component and compare the responses between musicians and non-musicians.Subjects and Methods: Thirty participants (15 musicians and 15 non-musicians) were enrolled in the study. Auditory stimuli consisted of a synthesized speech syllable presented together with a repeating series of four tones, establishing a quadruple meter. Electrophysiological recordings were performed to measure the P1 component. Results: The results revealed that metrical position had a significant effect on P1 amplitude, with the strongest beat showing the lowest amplitude. This contrasts with previous findings, in which enhanced P1 responses were typically observed at on-the-beat positions. The reduced P1 response on the strong beat can be interpreted within the framework of predictive coding and temporal prediction, where a higher predictability of pitch changes at the strong beat leads to a reduction in the P1 response. Furthermore, higher P1 amplitudes were observed in musicians compared to non-musicians, suggesting that musicians have enhanced sensory processing. Conclusions: This study demonstrates the effects of metrical hierarchy on the P1 component, thereby enriching our understanding of auditory processing. The results suggest that predictive coding and temporal prediction play important roles in shaping sensory processing. Further, they suggest that musical training may enhance P1 responses.

Background: Hearing loss limits communication and social activity, and hearing aids (HAs) are an efficient rehabilitative option for improving oral communication and speech comprehension, as well as the psychosocial comfort of people with hearing loss. To overcome this problem, over-the-counter amplification devices including personal sound amplification products and wearable augmented reality devices (WARDs) have been introduced. Objective: This study aimed to evaluate the clinical effectiveness of WARDs for patients with mild to moderate hearing loss. Methods: A total of 40 patients (18 men and 22 women) with mild to moderate hearing loss were enrolled prospectively in this study. All participants were instructed to wear a WARD, Galaxy Buds Pro (Samsung Electronics), at least 4 hours a day for 2 weeks, for amplifying ambient sounds. Questionnaires including the Korean version of the abbreviated profile of hearing aid benefit (K-APHAB) and the Korean adaptation of the international outcome inventory for hearing aids (K-IOI-HA) were used to assess personal satisfaction in all participants. Audiologic tests, including sound field audiometry, sound field word recognition score (WRS), and the Korean version of hearing in noise test (K-HINT), were administered to 14 of 40 patients. The tests were performed under two conditions: unaided and aided with WARDs. Results: The mean age of the participants was 55.4 (SD 10.7) years. After 2 weeks of the field trial, participants demonstrated a benefit of WARDs on the K-APHAB. Scores of 3 subscales of ease of communication, reverberation, and background noise were improved significantly (P<.001). However, scores regarding aversiveness were worse under the aided condition (P<.001). K-IOI-HA findings indicated high user satisfaction after the 2-week field trial. On audiologic evaluation, the K-HINT did not show significant differences between unaided and aided conditions (P=.97). However, the hearing threshold on sound field audiometry (P=.001) and the WRS (P=.002) showed significant improvements under the aided condition. Conclusions: WARDs can be beneficial for patients with mild to moderate hearing loss as a cost-effective alternative to conventional hearing aids.

Objectives. This study was conducted to evaluate the user satisfaction, efficacy, and safety of round window (RW) vibroplasty using the Vibrant Soundbridge (VSB) in patients with persistent mixed hearing loss after mastoidectomy.Methods. The study included 27 patients (mean age, 58.7 years; age range, 28–76 years; 11 men and 16 women) with mixed hearing loss after mastoidectomy from 15 tertiary referral centers in Korea. The VSB was implanted at the RW. The Korean translation of the Abbreviated Profile of Hearing Aid Benefit (APHAB) questionnaire and the Korean version of the International Outcome Inventory for Hearing Aids (K-IOI-HA) questionnaire were used to evaluate user satisfaction as the primary outcome. The secondary outcome measures were audiological test results and complication rates.Results. The mean scores for ease of communication (61.3% to 29.7% to 30.2%), reverberation (62.1% to 43.1% to 37.4%), and background noise (63.3% to 37.7% to 34.3%) subscales of the APHAB questionnaire significantly decreased after VSB surgery. The mean K-IOI-HA scores at 3 and 6 months after surgery were significantly higher than the mean preoperative score (18.6 to 27.2 to 28.1). The postoperative VSB-aided thresholds were significantly lower than the preoperative unaided and hearing aid (HA)-aided thresholds. There was no significant difference between preoperative unaided, preoperative HA-aided, and postoperative VSB-aided maximum phonetically balanced word-recognition scores. None of the 27 patients experienced a change in postoperative bone conduction pure tone average. One patient developed temporary facial palsy and two developed surgical wound infections.Conclusion. RW vibroplasty resulted in improved satisfaction and audiological test results in patients with mixed hearing loss after mastoidectomy, and the complication rate was tolerable.

[This corrects the article DOI: 10.2196/26976.].

UNSTRUCTURED It has been noted in the literature that there is a gap between clinical assessment and real-world performance. Real-world conversations entail visual and audio information, yet there are not any audiological assessment tools that include visual information. Virtual reality (VR) technology has been applied to various areas, including audiology. However, the use of VR in speech-in-noise perception has not yet been investigated. The purpose of this study was to investigate the impact of virtual space (VS) on speech performance and its feasibility to be used as a speech test instrument. We hypothesized that individuals’ ability to recognize speech would improve when visual cues were provided. A total of 30 individuals with normal hearing and 25 individuals with hearing loss completed pure-tone audiometry and the Korean version of the Hearing in Noise Test (K-HINT) under three conditions—conventional K-HINT (cK-HINT), VS on PC (VSPC), and VS head-mounted display (VSHMD)—at –10 dB, –5 dB, 0 dB, and +5 dB signal-to-noise ratios (SNRs). Participants listened to target speech and repeated it back to the tester for all conditions. Hearing aid users in the hearing loss group completed testing under unaided and aided conditions. A questionnaire was administered after testing to gather subjective opinions on the headset, the VSHMD condition, and test preference. Provision of visual information had a significant impact on speech performance between the normal hearing and hearing impaired groups. The Mann-Whitney U test showed statistical significance (P<.05) between the two groups under all test conditions. Hearing aid use led to better integration of audio and visual cues. Statistical significance through the Mann-Whitney U test was observed for –5 dB (P=.04) and 0 dB (P=.02) SNRs under the cK-HINT condition, as well as for –10 dB (P=.007) and 0 dB (P=.04) SNRs under the VSPC condition, between hearing aid and non–hearing aid users. Participants reported positive responses across almost all items on the questionnaire except for the weight of the headset. Participants preferred a test method with visual imagery, but found the headset to be heavy. Findings are in line with previous literature that showed that visual cues were beneficial for communication. This is the first study to include hearing aid users with a more naturalistic stimulus and a relatively simple test environment, suggesting the feasibility of VR audiological testing in clinical practice.

BACKGROUND Hearing loss limits communication and social activity, and hearing aids (HAs) are an efficient rehabilitative option for improving oral communication and speech comprehension, as well as the psychosocial comfort of people with hearing loss. To overcome this problem, over-the-counter amplification devices including personal sound amplification products and wearable augmented reality devices (WARDs) have been introduced. OBJECTIVE This study aimed to evaluate the clinical effectiveness of WARDs for patients with mild to moderate hearing loss. METHODS A total of 40 patients (18 men and 22 women) with mild to moderate hearing loss were enrolled prospectively in this study. All participants were instructed to wear a WARD, Galaxy Buds Pro (Samsung Electronics), at least 4 hours a day for 2 weeks, for amplifying ambient sounds. Questionnaires including the Korean version of the abbreviated profile of hearing aid benefit (K-APHAB) and the Korean adaptation of the international outcome inventory for hearing aids (K-IOI-HA) were used to assess personal satisfaction in all participants. Audiologic tests, including sound field audiometry, sound field word recognition score (WRS), and the Korean version of hearing in noise test (K-HINT), were administered to 14 of 40 patients. The tests were performed under two conditions: unaided and aided with WARDs. RESULTS The mean age of the participants was 55.4 (SD 10.7) years. After 2 weeks of the field trial, participants demonstrated a benefit of WARDs on the K-APHAB. Scores of 3 subscales of ease of communication, reverberation, and background noise were improved significantly (P<.001). However, scores regarding aversiveness were worse under the aided condition (P<.001). K-IOI-HA findings indicated high user satisfaction after the 2-week field trial. On audiologic evaluation, the K-HINT did not show significant differences between unaided and aided conditions (P=.97). However, the hearing threshold on sound field audiometry (P=.001) and the WRS (P=.002) showed significant improvements under the aided condition. CONCLUSIONS WARDs can be beneficial for patients with mild to moderate hearing loss as a cost-effective alternative to conventional hearing aids.

Background: It has been noted in the literature that there is a gap between clinical assessment and real-world performance. Real-world conversations entail visual and audio information, yet there are not any audiological assessment tools that include visual information. Virtual reality (VR) technology has been applied to various areas, including audiology. However, the use of VR in speech-in-noise perception has not yet been investigated. Objective: The purpose of this study was to investigate the impact of virtual space (VS) on speech performance and its feasibility to be used as a speech test instrument. We hypothesized that individuals’ ability to recognize speech would improve when visual cues were provided. Methods: A total of 30 individuals with normal hearing and 25 individuals with hearing loss completed pure-tone audiometry and the Korean version of the Hearing in Noise Test (K-HINT) under three conditions—conventional K-HINT (cK-HINT), VS on PC (VSPC), and VS head-mounted display (VSHMD)—at –10 dB, –5 dB, 0 dB, and +5 dB signal-to-noise ratios (SNRs). Participants listened to target speech and repeated it back to the tester for all conditions. Hearing aid users in the hearing loss group completed testing under unaided and aided conditions. A questionnaire was administered after testing to gather subjective opinions on the headset, the VSHMD condition, and test preference. Results: Provision of visual information had a significant impact on speech performance between the normal hearing and hearing impaired groups. The Mann-Whitney U test showed statistical significance (P<.05) between the two groups under all test conditions. Hearing aid use led to better integration of audio and visual cues. Statistical significance through the Mann-Whitney U test was observed for –5 dB (P=.04) and 0 dB (P=.02) SNRs under the cK-HINT condition, as well as for –10 dB (P=.007) and 0 dB (P=.04) SNRs under the VSPC condition, between hearing aid and non–hearing aid users. Participants reported positive responses across almost all items on the questionnaire except for the weight of the headset. Participants preferred a test method with visual imagery, but found the headset to be heavy. Conclusions: Findings are in line with previous literature that showed that visual cues were beneficial for communication. This is the first study to include hearing aid users with a more naturalistic stimulus and a relatively simple test environment, suggesting the feasibility of VR audiological testing in clinical practice.