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  • 151.
    Stenfelt, Stefan
    Linköping University, Department of Clinical and Experimental Medicine, Technical Audiology. Linköping University, Faculty of Health Sciences.
    The perception of own-voice with hearing aids usage2006In: 28th International Congress of Audiology, Innsbruck, Austria, 2006Conference paper (Refereed)
  • 152.
    Stenfelt, Stefan
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Technical Audiology .
    Towards understanding the specifics of cochlear hearing loss: a modelling approach2008In: International Journal of Audiology, ISSN 1499-2027, E-ISSN 1708-8186, Vol. 47, no suppl 2, p. 10-15Article in journal (Refereed)
    Abstract [en]

    It is well known that two patients suffering from a sensorineural hearing loss with similar audiograms can benefit significantly differently from amplified hearing even if the same settings of the hearing aids are used. The origin of this problem is complex but one part can be caused by the diagnosis itself; all inner-ear hearing losses are assumed similar. Such hypothesis is a simplification that probably leads to suboptimal hearing-aid fitting. For a better understanding of the signal degeneration caused by a cochlear lesion a model layout of the signal transmission in the peripheral hearing organ is presented. This model differentiates between processes in the inner ear caused by the outer hair cells, the inner hair cells, and the endocochlear potential driving the system. The model is intended to predict alteration of the signal caused by different types of cochlear lesions. Ultimately, the model may lead to improved hearing aids and fittings. 

  • 153.
    Stenfelt, Stefan
    Linköping University, Department of Clinical and Experimental Medicine, Technical Audiology. Linköping University, Faculty of Health Sciences.
    Transcranial Attenuation of Bone-Conducted Sound When Stimulation Is at the Mastoid and at the Bone Conduction Hearing Aid Position2012In: Otology and Neurotology, ISSN 1531-7129, E-ISSN 1537-4505, Vol. 33, no 2, p. 105-114Article in journal (Refereed)
    Abstract [en]

    Hypothesis: The transcranial attenuation of bone-conducted (BC) sound depends on the stimulation position and the stimulation frequency. less thanbrgreater than less thanbrgreater thanBackground: Subjective transcranial attenuation of BC sound has previously only been measured at a few audiometric frequencies and with the stimulation at the mastoid. The results reported are on average of 5 to 10 dB with large intersubject variability and inconsistent with results obtained using vibration measurements of the cochlea. less thanbrgreater than less thanbrgreater thanMethods: Pure tone hearing thresholds were measured in 28 unilateral deaf subjects at 31 frequencies between 0.25 and 8 kHz. The stimulation was provided at 4 positions: ipsilateral and contralateral mastoid, and ipsilateral and contralateral position for a bone conduction hearing aid. less thanbrgreater than less thanbrgreater thanResults: With stimulation at the mastoid, the median transcranial attenuation is 3 to 5 dB at frequencies up to 0.5 kHz; between 0.5 and 1.8 kHz, it is close to 0 dB. The attenuation increases at higher frequencies; it is close to 10 dB at 3 to 5 kHz and becomes slightly less at the highest frequencies measured (4 dB at 8 kHz). When measured at the bone conduction hearing aid position, the median transcranial attenuation is 2 to 3 dB lower than at the mastoid. The intersubject variability is large at each frequency (around 40 dB), but there are small differences in general trends of the transcranial attenuation between individuals. less thanbrgreater than less thanbrgreater thanConclusion: The median transcranial attenuation depends on stimulation position and frequency. However, the variability is great, both between individuals and within subjects for adjacent frequencies.

  • 154.
    Stenfelt, Stefan
    Linköping University, Department of Clinical and Experimental Medicine, Technical Audiology. Linköping University, Faculty of Health Sciences.
    Utvärdering av nya stimuli för klinisk hjärnstamsaudiometri2009In: TeMA Hörsel, Jönköping, Sweden., 2009Conference paper (Refereed)
  • 155.
    Stenfelt, Stefan
    Linköping University, Department of Clinical and Experimental Medicine, Technical Audiology . Linköping University, Faculty of Health Sciences.
    Värt att veta om ASSR2006In: Audio-Nytt, ISSN 0347-6308, Vol. 33, no 3, p. 14-16Article in journal (Other (popular science, discussion, etc.))
  • 156.
    Stenfelt, Stefan
    Linköping University, Department of Clinical and Experimental Medicine, Technical Audiology. Linköping University, Faculty of Health Sciences.
    Wideband absorbance measures2013Conference paper (Refereed)
  • 157.
    Stenfelt, Stefan
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Technical Audiology. Linköping University, Faculty of Health Sciences.
    Asp, Filip
    Karolinska Institutet.
    Harder, Henrik
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Oto-Rhiono-Laryngology and Head & Neck Surgery. Östergötlands Läns Landsting, Reconstruction Centre, Department of ENT - Head and Neck Surgery UHL.
    Hergils, Leif
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Oto-Rhiono-Laryngology and Head & Neck Surgery. Östergötlands Läns Landsting, Reconstruction Centre, Department of ENT - Head and Neck Surgery UHL.
    Karltorp, Eva
    Karolinska Institutet.
    Mäki-Torkko, Elina
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Technical Audiology.
    Klinisk utvärdering av 80 barn med bilaterala cochleaimplantat2009In: TeMA Hörsel, Jönköping, Sweden, 2009Conference paper (Refereed)
  • 158.
    Stenfelt, Stefan
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Technical Audiology . Linköping University, Faculty of Health Sciences.
    Goode, Richard
    Stanford University.
    Bone conducted sound: Physiological and clinical aspects2005In: Otology and Neurotology, ISSN 1531-7129, E-ISSN 1537-4505, Vol. 26, no 6, p. 1245-1261Article in journal (Refereed)
  • 159.
    Stenfelt, Stefan
    et al.
    Chalmers University Technology.
    Goode, RL
    Stanford University .
    Bone-conducted sound: Physiological and clinical aspects2005In: Otology and Neurotology, ISSN 1531-7129, E-ISSN 1537-4505, Vol. 26, no 6, p. 1245-1261Article, review/survey (Refereed)
    Abstract [en]

    Objective: The fact that vibration of the skull causes a hearing sensation has been known since the 19th century. This mode of hearing was termed hearing by bone conduction. Although there has been more than a century of research on hearing by bone conduction, its physiology is not completely understood. Lately, new insights into the physiology of hearing by bone conduction have been reported. Knowledge of the physiology, clinical aspects, and limitations of bone conduction sound is important for clinicians dealing with hearing loss and is the purpose of this review. Data Sources: The data were compiled from the published literature in the areas of clinical bone conduction hearing, bone conduction hearing aids, basic research on bone conduction physiology, and recent research on bone conduction hearing from our laboratory. Conclusion: Five factors contributing to bone conduction hearing have been identified: 1) sound radiated into the external ear canal, 2) middle ear ossicle inertia, 3) inertia of the cochlear fluids, 4) compression of the cochlear walls, and 5) pressure transmission from the cerebrospinal fluid. Of these five, inertia of the cochlear fluid seems most important. E-one conduction sound is believed to reflect the true cochlear function; however, certain conditions such as middle ear diseases can affect bone conduction sensitivity, but less than for air conduction. The bone conduction route can also be used for hearing aids; since the bone conduction route is less efficient than the air conduction route, bone conduction hearing aids are primarily used for hearing losses where, air conduction hearing aids are contraindicated.

  • 160.
    Stenfelt, Stefan
    et al.
    Chalmers .
    Goode, RL
    Stanford University.
    Transmission properties of bone conducted sound: Measurements in cadaver heads2005In: Journal of the Acoustical Society of America, ISSN 0001-4966, E-ISSN 1520-8524, Vol. 118, no 4, p. 2373-2391Article in journal (Refereed)
    Abstract [en]

    In the past, only a few investigations have measured vibration at the cochlea with bone conduction stimulation: dry skulls were used in those investigations. In this paper, the transmission properties of bone conducted sound in human head are presented, measured as the three-dimensional vibration at the cochlear promontory in six intact cadaver heads. The stimulation was provided at 27 positions on the skull surface and two close to the cochlea; mechanical point impedance was measured at all positions. Cochlear promontory vibration levels in the three perpendicular directions were normally within 5 dB. With the stimulation applied on the ipsilateral side, the response decreased, and the accumulated phase increased, with distance between the cochlea and the excitation position. No significant changes were obtained when the excitations were on the contralateral side. In terms of vibration level, the best stimulation position is on the mastoid close to the cochlea; the worst is at the midline of the skull. The transcranial transmission was close to 0 dB for frequencies up to 700 Hz; above it decreased at 12 dB/decade. Wave transmission at the skull-base was found to be nondispersive at frequencies above 2 kHz whereas it altered with frequency at the cranial vault. (c) 2005 Acoustical Society of America.

  • 161.
    Stenfelt, Stefan
    et al.
    Chalmers.
    Hato, N
    Stanford University.
    Goode, RL
    Stanford University.
    Fluid volume displacement at the oval and round windows with air and bone conduction stimulation2004In: Journal of the Acoustical Society of America, ISSN 0001-4966, E-ISSN 1520-8524, Vol. 115, no 2, p. 797-812Article in journal (Refereed)
    Abstract [en]

    The fluids in the cochlea are normally considered incompressible, and the fluid volume displacement of the oval window (OW) and the round window (RW) should be equal and of opposite phase. However, other channels, such as the cochlear and vestibular aqueducts, may affect the fluid flow. To test if the OW and RW fluid flows are equal and of opposite phase, the volume displacement was assessed by multiple point measurement at the windows with a laser Doppler vibrometer. This was done during air conduction (AC) stimulation in seven fresh human temporal bones, and with bone conduction (BC) stimulation in-eight temporal bones and one human cadaver head. With AC stimulation, the average volume displacement of the two windows is within 3 dB, and the phase difference is close to 180degrees for the frequency range 0.1 to 10 kHz. With BC stimulation, the average volume displacement difference between the two windows is greater: below 2 kHz, the volume displacement at the RW is 5 to 15 dB greater than at the OW and above 2 kHz more fluid is displaced at the OW. With BC stimulation, lesions at the OW caused only minor changes of the fluid flow at the RW.

  • 162.
    Stenfelt, Stefan
    et al.
    Chalmers University of Technology.
    Hato, N
    Stanford.
    Goode, RL
    Stanford.
    Round window membrane motion with air conduction and bone conduction stimulation2004In: Hearing Research, ISSN 0378-5955, E-ISSN 1878-5891, Vol. 198, no 02-Jan, p. 10-24Article in journal (Refereed)
    Abstract [en]

    The vibration patterns of the round window (RW) membrane in human cadaver temporal bone specimens were assessed by measurements of the velocity of reflective targets placed on the RW membrane with an approximate spacing of 0.2 mm. The velocity was measured in the frequency range 0.1-10 kHz by a laser Doppler vibrometer in four specimens with air conduction (AC) stimulation and in four specimens with bone conduction (BC) stimulation. The response pattern was investigated by analyzing the velocity response of all targets on the RW membrane, by making iso-amplitude and iso-phase contour plots of the membrane surface, and by creating animations of the surface vibration at several frequencies. Similar response pattern was found with AC and BC stimulations. At frequencies below 1.5 kHz, the RW membrane vibrates nearly as a whole in an in-and-out motion and above 1.5 kHz, the membrane moves primarily in two sections that vibrate with approximately 180degrees difference. Indication of some traveling wave motion of the RW membrane at those frequencies was also found. At higher frequencies, above 3 kHz, the membrane motion is complex with a mixture of modal and traveling wave motion. An increase of the stimulation level did not alter the vibration pattern; it only gave an increase of the RW membrane vibration amplitude corresponding to the increase in stimulation. When the mode of stimulation at the oval window was altered, by the insertion of a 0.6 mm piston, the vibration pattern of the RW membrane changed.

  • 163.
    Stenfelt, Stefan
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Technical Audiology . Linköping University, Faculty of Health Sciences.
    Hato, Naohito
    Stanford University.
    Goode, Richard
    Stanford University.
    Factors contributing to bone conduction: The middle ear2002In: Journal of the Acoustical Society of America, ISSN 0001-4966, E-ISSN 1520-8524, Vol. 111, no 2, p. 947-959Article in journal (Refereed)
  • 164.
    Stenfelt, Stefan
    et al.
    Chalmers University Technology.
    Håkansson, B
    Chalmers University of Technology.
    Jönsson, R
    Chalmers University of Technology.
    Granström, G
    Chalmers University of Technology.
    A bone-anchored hearing aid for patients with pure sensorineural hearing impairment: A pilot study2000In: Scandinavian Audiology, ISSN 0105-0397, E-ISSN 1940-2872, Vol. 29, no 3, p. 175-185Article in journal (Refereed)
    Abstract [en]

    This pilot study assesses the potential benefits of an optimized bone-anchored hearing aid (BAHA) for patients with a mild to moderate purl sensorineural high frequency hearing impairment. The evaluation was conducted with eight first-time hearing aid users by means of psyche-acoustic sound field measurements and a questionnaire on subjective experience; all of the patients benefited from the BAHA. On average, the eight patients showed improvement in PTA threshold of 3.4 dB and in speech intelligibility in noise of 14%. Seven of the subjects, also fitted with present standard air conduction hearing aids (ACHA) found the ACHA thresholds to be improved more than the BAHA ones. In speech tests, the ACHA was only slightly better; these patients chose between their different hearing aids according to the sound environment. Although the BAHA was preferred for wearing and sound comfort, it cannot be used as the sole aid for patients with pure sensorineural impairment.

  • 165.
    Stenfelt, Stefan
    et al.
    Chalmers University Technology.
    Håkansson, B
    Chalmers University Technology.
    Tjellström, A
    Sahlgrenska University Hospital.
    Vibration characteristics of bone conducted sound in vitro2000In: Journal of the Acoustical Society of America, ISSN 0001-4966, E-ISSN 1520-8524, Vol. 107, no 1, p. 422-431Article in journal (Refereed)
    Abstract [en]

    A dry skull added with damping material was used to investigate the vibratory pattern of bone conducted sound. Three orthogonal vibration responses of the cochleae were measured, by means of miniature accelerometers, in the frequency range 0.1-10 kHz. The exciter was attached to the temporal, parietal, and frontal bones, one at the time. In the transmission response to the ipsilateral; cochlea, a profound low frequency antiresonance (attenuation) was found, verified psycho-acoustically, and shown to yield a distinct lateralization effect. It was also shown that, for the ipsilateral side, the direction of excitation coincides with that of maximum response. At the contralateral cochlea, no such dominating response direction was found for frequencies above the first skull resonance. An overall higher response level was achieved, for the total energy transmission in general and specifically for the direction of excitation, at the ipsilateral cochlea when the transducer was attached to the excitation point closest to the cochlea. The transranial attenuation was found to be frequency dependent, with values from -5 to 10 dB for the energy transmission and -30 to 40 dB for measurements in a single direction, with a tendency toward higher attenuation at the higher frequencies.

  • 166.
    Stenfelt, Stefan
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Technical Audiology. Linköping University, Faculty of Health Sciences.
    Håkansson, Bo
    Chalmers.
    A bone conduction implant – measurements in a human cadaver2008In: International Congress of Audiology, Hong Kong, 2008Conference paper (Refereed)
  • 167.
    Stenfelt, Stefan
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Technical Audiology . Linköping University, Faculty of Health Sciences.
    Håkansson, Bo
    Chalmers.
    Air versus bone conduction: An equal loudness investigation2002In: Hearing Research, ISSN 0378-5955, E-ISSN 1878-5891, Vol. 167, no 1-2, p. 1-12Article in journal (Refereed)
  • 168.
    Stenfelt, Stefan
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Technical Audiology. Linköping University, Faculty of Health Sciences.
    Håkansson, Bo
    Chalmers.
    An implantable hearing aid using bone conduction transmission2006In: 28th International Congress of Audiology, Innsbruck, Austria, 2006Conference paper (Refereed)
  • 169.
    Stenfelt, Stefan
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Technical Audiology . Linköping University, Faculty of Health Sciences.
    Jacobs, Reinhilde
    Catholic University Leuven.
    Olmarker, K
    Göteborg University.
    Rydevik, Björn
    Göteborg Universitet.
    Brånemark, Per-Ingvar
    Applied Biotechnology.
    A Technique for Determination of Vibrotactile Force Threshold Levels in Patients with Orthopaedic Osseointegrated Implants1998In: Osseoperception / [ed] R. Jacobs, Leuven: Catholic University of Leuven , 1998, p. 105-123Chapter in book (Other academic)
  • 170.
    Stenfelt, Stefan
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Technical Audiology. Linköping University, Faculty of Health Sciences.
    Janssen, Thomas
    Technische Universität München.
    Schirkonyer, Volker
    Technische Universität München.
    Grandori, Ferdinando
    Instituto di Ingengeria Biomedica Milano.
    e-Health technologies for adult hearing screening2011In: Audiology Research, ISSN 2039-4349, Vol. 1, p. 55-57Article in journal (Refereed)
    Abstract [en]

    The development of hearing diagnosis methods and hearing screeningmethods are not isolated phenomena: they are intimately relatedto changes in the cultural background and to advances in fields of medicineand engineering. In the recent years, there has been a rapid evolutionin the development of fast, easy and reliable techniques for lowcosthearing screening initiatives. Since adults and elderly people typicallyexperience a reduced hearing ability in challenging listening situations[e.g., in background noise, in reverberation, or with competingspeech (Pichora‑Fuller & Souza, 2003)], these newly developedscreening tests mainly rely on the recognition of speech stimuli innoise, so that the real experienced listening difficulties can be effectivelytargeted (Killion & Niquette, 2000). New tests based on therecognition of speech in noise are being developed on portable, battery-operated devices (see, for example, Paglialonga et al., 2011), ordistributed diffusely using information and communication technologies.The evolutions of e-Health and telemedicine have shifted focusfrom patients coming to the hearing clinic for hearing health evaluationtowards the possibility of evaluating the hearing status remotelyat home. So far, two ways of distributing the hearing test have primarilybeen used: ordinary telephone networks (excluding mobile networks)and the internet. When using the telephone network for hearingscreening, the predominantly test is a speech-in-noise test oftenreferred to as the digit triplet test where the subjects hearing status isevaluated as the speech-to-noise threshold for spoken digits. This testis today available in some ten countries in Europe, North America andAustralia. The use of internet as testing platform allows several differenttypes of hearing assessment tests such as questionnaires, differenttypes of speech in noise tests, temporal gap detection, sound localization(minimum audible angle), and spectral (un)masking tests.Also, the use of the internet allows audiovisual presentations as wellas visual interaction and cues in the tests for a more ecologicalapproach. Even if several new and novel approaches for hearingassessment using the internet are surfacing, the validated tests arebased on questionnaires or speech-in-noise. Although the internetallows for a broader flora of pure auditory and audiovisual tests forhearing health assessment, calibration problems such as timinguncertainty, output levels and modes of presentation (speakers or earphones)limits the usability at present.

  • 171.
    Stenfelt, Stefan
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Technical Audiology . Linköping University, Faculty of Health Sciences.
    Janssen, Thomas
    Technische Universitaet Muenchen.
    Schirkonyer, Volker
    Technische Universitaet Muenchen.
    Grandori, Ferdinando
    Istituto di Ingegneria Biomedica, Italy.
    New technologies for adult hearing screening2010Conference paper (Refereed)
  • 172.
    Stenfelt, Stefan
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences.
    Lunner, Thomas
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research. Eriksholm Research Centre, Oticon A/S, Helsingor, Denmark.
    Ng, Elaine
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences.
    Lidestam, Björn
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
    Zekveld, Adriana
    Linköping University, The Swedish Institute for Disability Research. Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. VU University Medical Center, Amsterdam, Netherlands.
    Sörqvist, Patrik
    Linköping University, The Swedish Institute for Disability Research. Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. University of Gävle, Gävle, Sweden.
    Lyxell, Björn
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research.
    Träff, Ulf
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
    Yumba, Wycliffe
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences.
    Classon, Elisabet
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Linköping University, The Swedish Institute for Disability Research.
    Hällgren, Mathias
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences.
    Larsby, Birgitta
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Linköping University, The Swedish Institute for Disability Research.
    Signoret, Carine
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research.
    Pichora-Fuller, Kathleen
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research. University of Toronto, Toronto, Canada.
    Rudner, Mary
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research.
    Danielsson, Henrik
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research.
    Rönnberg, Jerker
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research.
    Auditory, signal processing, and cognitive factors  influencing  speech  perception  in  persons with hearing loss fitted with hearing aids – the N200 study2016Conference paper (Other academic)
    Abstract [en]

    Objective: The aim of the current study was to assess aided speech-in-noise outcomes and relate those measures to auditory sensitivity and processing, different types of cognitive processing abilities, and signal processing in hearing aids.

    Material and method: Participants were 200 hearing-aid wearers, with a mean age of 60.8 years, 43% females, with average hearing thresholds in the better ear of 37.4 dB HL. Tests of auditory functions were hearing thresholds, DPOAEs, tests of fine structure processing, IHC dead regions, spectro-temporal modulation, and speech recognition in quiet (PB words). Tests of cognitive processing function were tests of phonological skills, working memory, executive functions and inference making abilities, and general cognitive tests (e.g., tests of cognitive decline and IQ). The outcome test variables were the Hagerman sentences with 50 and 80% speech recognition levels, using two different noises (stationary speech weighted noise and 4-talker babble), and three types of signal processing (linear gain, fast acting compression, and linear gain plus a non-ideal binary mask). Another sentence test included typical and atypical sentences with contextual cues that were tested both audio-visually and in an auditory mode only. Moreover, HINT and SSQ were administrated.

    Analysis: Factor analyses were performed separate for the auditory, cognitive, and outcome tests.

    Results: The auditory tests resulted in two factors labeled SENSITIVITY and TEMPORAL FINE STRUCTURE, the cognitive tests in one factor (COGNITION), and the outcome tests in the two factors termed NO CONTEXT and CONTEXT that relates to the level of context in the different outcome tests. When age was partialled out, COGNITION was moderately correlated with the TEMPORAL FINE STRUCTURE and NO CONTEXT factors but only weakly correlated with the CONTEXT factor. SENSITIVITY correlated weakly with TEMPORAL FINE STRUCTURE and CONTEXT, and moderately with NO CONTEXT, while TEMPORAL FINE STRUCTURE showed weak correlation with CONTEXT and moderate correlation with NO CONTEXT. CONTEXT and NO CONTEXT had a  moderate correlation. Moreover, the overall results of the Hagerman sentences showed 0.9 dB worse SNR with fast acting compression compared with linear gain and 5.5 dB better SNR with linear  gain and noise reduction compared with only linear gain.

    Conclusions: For hearing aid wearers, the ability to recognize speech in noise is associated with both sensory and cognitive processing abilities when the speech materials have low internal context. These associations are less prominent when the speech material has contextual cues.

  • 173.
    Stenfelt, Stefan
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Technical Audiology. Linköping University, Faculty of Health Sciences.
    Puria, Sunil
    Stanford University.
    Consider bone-conducted human hearing2010In: The Use of Vibrations in Communication: properties, mechanisms and function across Taxa / [ed] C. O'Connell-Rodwell, Research Signpost , 2010, p. 142-162Chapter in book (Other academic)
    Abstract [en]

    This volume is a collection of chapters representing the depth and breadth of research that underlies the understanding of the complexity and diversity of vibrational communication in the animal kingdom. The chapters, organized by taxa, are all contributed by specialists in their respective fields. Peggy Hill, whose recent book Vibrational Communication in Animals helped set the stage for this volume, has supplied a useful and unifying introduction. The initial three chapters on invertebrates review the remarkable array of mechanisms employed by crustaceans, spiders and insects to generate and detect vibrations. These chapters address the subtleties of the social contexts in which vibration is used in communication, prey detection and avoidance. Also explored is the influence of the ecology of these organisms on vibration transmission and detection as well as the significance of habitat selection in assuring optimal vibration transmission. The next five chapters include a review of what is known about vibration generation, propagation and detection in amphibians and snakes as well as in small and large mammals, including humans. They present in detail the anatomy of the various ear (and jaw) structures that process vibrations, tracing the development of the ear from the simpler frog and snake ear to the more derived mammalian ear that incorporates three bones from the jaw. The treatment of the opercularis of the frog, progressing to the jawbones of snakes, then to the hypertrophied middle ear bones found in small rodents and elephants illustrates the depth of the research that has contributed to our understanding in this field. Topics such as vibration production and detection in the particular context of the sender and receiver are reviewed, as well as other anatomic variants relevant to the generation and detection of vibrations, wave architecture and transmission properties of the substrate. The phenomenon of bone conduction adds a separate pathway for detection through the skeleton in mammals, with pressure waves generated by substrate-borne vibrations oscillating the middle-ear bones in the same way as airborne vibrations, which are then processed in the auditory cortex, although having arrived via this alternative pathway. The penultimate chapter provides a summary of field recording methods that should prove useful for investigators new to this field. It should also be helpful to researchers wishing to compare vibration recording techniques applicable to different species or to learn more about equipment and options for recording vibration transmission properties in different media and soil types. The final chapter presents an overview of what is known about the ability of the largest land mammal, the elephant, to detect and interpret vibrations.

  • 174.
    Stenfelt, Stefan
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Technical Audiology . Linköping University, Faculty of Health Sciences.
    Puria, Sunil
    Stanford University.
    Hato, Naohito
    Stanford University.
    Goode, Richard
    Stanford university.
    Basilar membrane and osseous spiral lamina motion in human cadavers with air and bone conduction stimuli2004In: Hearing Research, ISSN 0378-5955, E-ISSN 1878-5891, Vol. 198, no 1-2, p. 10-24Article in journal (Refereed)
  • 175.
    Stenfelt, Stefan PY
    et al.
    Chalmers University of Technology.
    Håkansson, Bo EV
    Chalmers University of Technology.
    A miniaturized artificial mastoid using a skull simulator1998In: Scandinavian Audiology, ISSN 0105-0397, E-ISSN 1940-2872, Vol. 27, no 2, p. 67-76Article in journal (Refereed)
    Abstract [en]

    A miniaturized artificial mastoid of size and weight that allow calibration and measurement of bone conduction hearing aids in a conventional audiometric soundproof box has been developed. Its level of mechanical impedance corresponds to the standard IEC 373 (1990) within the frequency range 250 Hz to 8 kHz. The miniaturized artificial mastoid consists of three parts: coupler, skull simulator (TU-1000), and an external electrical correction filter. The soupier is a highly damped mass-spring system designed to give the miniaturized artificial mastoid mechanical impedance in accordance with the standard IEC 373 (1990). It was found that the miniaturized artificial mastoid yielded results that are in correspondence with results obtained with the Bruel and Kjaer type 4930 artificial mastoid for frequencies above 350 Hz. Thus, at these frequencies, the miniaturized artificial mastoid can be used for audiometer calibration as well as measurement of bone conduction hearing aids.

  • 176.
    Stenfelt, Stefan PY
    et al.
    Chalmers University Technology.
    Håkansson, Bo EV
    Chalmers University Technology.
    Sensitivity to bone-conducted sound: excitation of the mastoid vs the teeth1999In: Scandinavian Audiology, ISSN 0105-0397, E-ISSN 1940-2872, Vol. 28, no 3, p. 190-198Article in journal (Refereed)
    Abstract [en]

    The sensitivity of nine subjects to bone-conducted sound was measured at three positions: osseointegrated percutaneous titanium implants in the temporal bone, the skin-covered mastoid and the teeth. Voltage levels supplied to a bone-anchored hearing aid (BAHA) transducer and to an Oticon bone-transducer were measured and the thresholds obtained at the three positions were compared. Using the mechanical impedance of the teeth, the parameters of a first order model for the vibration transmission through the teeth was calculated. Also, the equivalent force thresholds were calculated from the voltage threshold levels. The sensitivity to bone-conducted sound, for both voltage and force thresholds, conformed fairly well at the three positions for frequencies below 1 kHz; however, above 1 M-Iz, bone-conducted sound applied at the titanium implant becomes mole sensitive than at the two other positions investigated. It was concluded that the teeth can be used for the application of bone-conducted sound, in particular for pre-operative assessment of a BAHA and to facilitate service and quality control of such a hearing device.

  • 177.
    Stenfelt, Stefan
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Technical Audiology. Linköping University, Faculty of Health Sciences.
    Reinfeldt, Sabine
    Chalmers.
    A model of own-voice perception with hearing aid usage2006In: 4th joint meeting of the Acoustical Societies of America and Japan, Honolulu, Hawaii, 2006Conference paper (Refereed)
  • 178.
    Stenfelt, Stefan
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Technical Audiology.
    Reinfeldt, sabine
    A model of the occlusion effect with bone-conducted stimulation2007In: International Journal of Audiology, ISSN 1499-2027, E-ISSN 1708-8186, Vol. 46, no 10, p. 595-608Article in journal (Refereed)
    Abstract [en]

    An acoustical model using simplified ear anatomy was designed to predict the ear-canal sound pressure occlusion effect in humans. These predictions were compared perceptually as well as with ear-canal sound pressure occlusion effect measurements using a foam earplug with shallow insertion, a foam earplug with deep insertion into the bony part of the ear canal, and a circumaural earmuff. There was good resemblance between model predictions and ear-canal sound pressure measurements. It was also found that all occlusion positions, even deep ear-canal occlusion, produced noticeable occlusion effects. With the bone-conduction transducer at the forehead, the perceived occlusion effect was close to that obtained from ear-canal sound pressure data in the 0.3 to 2 kHz frequency range, when the stimulation was at the mastoid the difference between the perceived and measured ear-canal sound pressure occlusion effect was around 10 dB at frequencies below 1 kHz. Further, the occlusion effect was obtained in two clinical settings: with supra-aural earphones (TDH39), and insert earphones (CIR22). Although both transducers produced occlusion effects, insert earphones produced a greater effect than surpa-aural earphones at the low frequencies. © 2007 British Society of Audiology, International Society of Audiology, and Nordic Audiological Society.

  • 179.
    Stenfelt, Stefan
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Technical Audiology. Linköping University, Faculty of Health Sciences.
    Rönnberg, Jerker
    Linköping University, The Swedish Institute for Disability Research. Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences.
    Swedish matrix speech-in-noise test (Hagerman test) in normal hearing subject: psychometric function and relation to working memory2011Conference paper (Other academic)
  • 180.
    Stenfelt, Stefan
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Technical Audiology . Linköping University, Faculty of Health Sciences.
    Rönnberg, Jerker
    Linköping University, The Swedish Institute for Disability Research. Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences.
    The Signal-Cognition interface: interactions between degraded auditory signals and cognitive processes.2009In: Scandinavian journal of psychology, ISSN 1467-9450, Vol. 50, no 5, p. 385-393Article in journal (Refereed)
    Abstract [en]

    A hearing loss leads to problems with speech perception; this is exacerbated when competing noise is present. The speech signal is recognized by the cognitive system of the listener; noise and distortion tax the cognitive system when interpreting it. The auditory system must interact with the cognitive system for optimal signal decoding. This article discusses this interaction between the signal and cognitive system based on two models: an auditory model describing signal transmission and degeneration due to a hearing loss and a cognitive model for Ease of Language Understanding. The signal distortion depends on the specifics of the hearing impairment and thus differently distorted signals can affect the cognitive system in different ways. Consequently, the severity of a hearing loss may not only depend on the lesion itself but also on the cognitive recourses required to interpret the signal.

  • 181.
    Stenfelt, Stefan
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Technical Audiology . Linköping University, Faculty of Health Sciences.
    Wild, Tim
    Stanford University.
    Hato, Naohito
    Stanford University.
    Goode, Richard
    Stanford University.
    Factors contributing to bone conduction: The outer ear2003In: Journal of the Acoustical Society of America, ISSN 0001-4966, E-ISSN 1520-8524, Vol. 113, no 2, p. 902-913Article in journal (Refereed)
  • 182.
    Stenfelt, Stefan
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Technical Audiology. Linköping University, Faculty of Health Sciences.
    Zeitooni, Mehrnaz
    Linköping University, Department of Clinical and Experimental Medicine, Technical Audiology. Linköping University, Faculty of Health Sciences.
    Binaural Hearing Ability in Normal Hearing Subjects When Stimulation is by Bone Conduction2012Conference paper (Refereed)
  • 183.
    Stenfelt, Stefan
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Technical Audiology. Linköping University, Faculty of Health Sciences.
    Zeitooni, Mehrnaz
    Linköping University, Department of Clinical and Experimental Medicine, Technical Audiology. Linköping University, Faculty of Health Sciences.
    Binaural hearing ability with mastoid applied bilateral bone conduction stimulation in normal hearing subjects2013In: Journal of the Acoustical Society of America, ISSN 0001-4966, E-ISSN 1520-8524, Vol. 134, no 1, p. 481-493Article in journal (Refereed)
    Abstract [en]

    The ability to use binaural cues when stimulation was by bilaterally applied bone conduction (BC) transducers was investigated in 20 normal hearing participants. The results with BC stimulation were compared with normal air conduction (AC) stimulation through earphones. The binaural hearing ability was tested by spatial release from masking, binaural intelligibility level difference (BILD), binaural masking level difference (BMLD) using chirp stimulation, and test of the precedence effect. In all tests, the participants revealed a benefit of bilateral BC stimulation indicating use of binaural cues. In the speech based tests, the binaural benefit for BC stimulation was approximately half that with AC stimulation. For the BC BMLD test with chirp stimulation, there were indications of superposition of the ipsilateral and contralateral pathways at the cochlear level affecting the results. The precedence effect test indicated significantly worse results for BC stimulation than for AC stimulation with low-frequency stimulation while they were close for high-frequency stimulation; broad-band stimulation gave results that were slightly worse than the high-frequency results.

  • 184.
    Stenfelt, Stefan
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Technical Audiology. Linköping University, Faculty of Health Sciences.
    Zeitooni, Mehrnaz
    Linköping University, Department of Clinical and Experimental Medicine, Technical Audiology. Linköping University, Faculty of Health Sciences.
    Loudness functions with air and bone conduction stimulation in normal-hearing subjects using a categorical loudness scaling procedure2013In: Hearing Research, ISSN 0378-5955, E-ISSN 1878-5891, Vol. 301, p. 85-92Article in journal (Refereed)
    Abstract [en]

    In a previous study (Stenfelt and Håkansson, 2002) a loudness balance test between bone conducted (BC) sound and air conducted (AC) sound was performed at frequencies between 0.25 and 4 kHz and at levels corresponding to 30–80 dB HL. The main outcome of that study was that for maintaining equal loudness, the level increase of sound with BC stimulation was less than that of AC stimulation with a ratio between 0.8 and 0.93 dB/dB. However, because it was shown that AC and BC tone cancellation was independent of the stimulation level, the loudness level difference did not originate in differences in basilar membrane stimulation. Therefore, it was speculated that the result could be due to the loudness estimation procedure. To investigate this further, another loudness estimation method (adaptive categorical loudness scaling) was here employed in 20 normal-hearing subjects.

    The loudness of a low-frequency and a high-frequency noise burst was estimated using the adaptive categorical loudness scaling technique when the stimulation was bilaterally by AC or BC. The sounds where rated on an 11-point scale between inaudible and too loud. The total dynamic range for these sounds was over 80 dB when presented by AC (between inaudible and too loud) and the loudness functions were similar for the low and the high-frequency stimulation. When the stimulation was by BC the loudness functions were steeper and the ratios between the slopes of the AC and BC loudness functions were 0.88 for the low-frequency sound and 0.92 for the high-frequency sound. These results were almost equal to the previous published results using the equal loudness estimation procedure, and it was unlikely that the outcome stems from the loudness estimation procedure itself. One possible mechanism for the result was loudness integration of multi-sensory input. However, no conclusive evidence for such a mechanism could be given by the present study.

  • 185.
    Stenfelt, Stefan
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Technical Audiology. Linköping University, Faculty of Health Sciences.
    Zeitooni, Mehrnaz
    Linköping University, Department of Clinical and Experimental Medicine, Technical Audiology. Linköping University, Faculty of Health Sciences.
    Loudness Growth with Bone Conduction Stimulation in Normal Hearing Subjects Using a Categorical Scaling Procedure2012Conference paper (Refereed)
  • 186.
    Stenfelt, Stefan
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Technical Audiology. Linköping University, Faculty of Health Sciences.
    Østergaard-Olsen, Steen
    Dept Otorhinolaryngology, Head & Neck Surgery, University Hospital, Rigshospitalet, Copenhagen, Denmark.
    Mäki-Torkko, Elina
    Linköping University, Department of Clinical and Experimental Medicine, Technical Audiology. Linköping University, Faculty of Health Sciences.
    Nielsen, Lars-Holme
    Dept Otorhinolaryngology, Head & Neck Surgery, University Hospital, Rigshospitalet, Copenhagen, Denmark.
    Glad, Henrik
    Dept Otorhinolaryngology, Head & Neck Surgery, University Hospital, Rigshospitalet, Copenhagen, Denmark.
    Zeitooni, Mehrnaz
    Linköping University, Department of Clinical and Experimental Medicine, Technical Audiology. Linköping University, Faculty of Health Sciences.
    Comparison Of Two Digital Bone-Conduction Hearing Aids In Experienced Users: A Two-Center Study2011In: 3rd International Symposium on Bone Conduction Hearing – Craniofacial Osseointegration, Sarasota, Florida, 2011Conference paper (Refereed)
  • 187.
    Strömberg, Anna-Karin
    et al.
    Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping. Karolinska Hospital, Sweden.
    Olofsson, Åke
    Karolinska Institute, Sweden.
    Westin, Magnus
    Karolinska Hospital, Sweden.
    Duan, Maoli
    Karolinska Hospital, Sweden; Karolinska Institute Stockholm, Sweden.
    Stenfelt, Stefan
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences.
    Changes in cochlear function related to acoustic stimulation of cervical vestibular evoked myogenic potential stimulation2016In: Hearing Research, ISSN 0378-5955, E-ISSN 1878-5891, Vol. 340, p. 43-49Article in journal (Refereed)
    Abstract [en]

    Evaluation of cervical evoked myogenic potentials (c-VEMP) is commonly applied in clinical investigations of patients with suspected neurotological symptoms. Short intense acoustic stimulation of peak levels close to 130 dB SPL is required to elicit the responses. A recent publication on bilateral significant sensorineural hearing loss related to extensive VEMP stimulation motivates evaluations of immediate effects on hearing acuity related to the intense acoustic stimulation required to elicit c-VEMP responses. The aim of the current study was to investigate changes in DPOAE-levels and hearing thresholds in relation to c-VEMP testing in humans. More specifically, the current focus is on immediate changes in hearing thresholds and changes in DPOAE-levels at frequencies 0.5 octaves above the acoustic stimulation when applying shorter tone bursts than previously used. Hearing acuity before and immediately after exposure to c-VEMP stimulation was examined in 24 patients with normal hearing referred for neurotologic testing. The stimulation consisted of 192 tonebursts of 6 ms and was presented at 500 Hz and 130 dB peSPL. Bekesy thresholds at 0.125-8 kHz and DPOAE I/O growth functions with stimulation at 0.75 and 3 kHz were used to assess c-VEMP related changes in hearing status. No significant deterioration in Bekesy thresholds was detected. Significant reduction in DPOAE levels at 0.75 (0.5-1.35 dB) and 3 kHz (1.6-2.1 dB) was observed after c-VEMP stimulation without concomitant changes in cochlear compression. The results indicated that there was no immediate audiometric loss related to c-VEMP stimulation in the current group of patients. The significant reduction of DPOAE levels at a wider frequency range than previously described after the c-VEMP test could be related to the stimulation with shorter tone bursts. The results show that c-VEMP stimulation causes reduction in DPOAE-levels at several frequencies that corresponds to half the reductions in DPOAE levels reported after exposure to the maximally allowed occupational noise for an 8 h working day. Consequently, extended stimuli intensity or stimulation repetition with c-VEMP testing should be avoided to reduce the risk for noise-induced cochlear injury.

  • 188.
    Strömberg, Anna-Karin
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuroscience.
    Stenfelt, Stefan
    Linköping University, Department of Clinical and Experimental Medicine, Technical Audiology. Linköping University, Faculty of Health Sciences.
    Olofsson, Åke
    Karolinska Institutet.
    Westin, M
    Karolinska Institutet.
    Duan, Maoli
    Karolinska Institutet.
    Evaluation of temporary cochlear depression in patients after low-frequency cVEMP exposure by means of Békésy audiometry and DPOAEs2012Conference paper (Refereed)
  • 189.
    Sörqvist, Patrik
    et al.
    Linköping University, The Swedish Institute for Disability Research. Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences. University of Gävle, Sweden.
    Stenfelt, Stefan
    Linköping University, The Swedish Institute for Disability Research. Linköping University, Department of Clinical and Experimental Medicine, Technical Audiology. Linköping University, Faculty of Health Sciences.
    Rönnberg, Jerker
    Linköping University, The Swedish Institute for Disability Research. Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences.
    Working Memory Capacity and Visual-Verbal Cognitive Load Modulate Auditory-Sensory Gating in the Brainstem: Toward a Unified View of Attention2012In: Journal of cognitive neuroscience, ISSN 0898-929X, E-ISSN 1530-8898, Vol. 24, no 11, p. 2147-2154Article in journal (Refereed)
    Abstract [en]

    Two fundamental research questions have driven attention research in the past: One concerns whether selection of relevant information among competing, irrelevant, information takes place at an early or at a late processing stage; the other concerns whether the capacity of attention is limited by a central, domain-general pool of resources or by independent, modality-specific pools. In this article, we contribute to these debates by showing that the auditory-evoked brainstem response (an early stage of auditory processing) to task-irrelevant sound decreases as a function of central working memory load (manipulated with a visual-verbal version of the n-back task). Furthermore, individual differences in central/domain-general working memory capacity modulated the magnitude of the auditory-evoked brainstem response, but only in the high working memory load condition. The results support a unified view of attention whereby the capacity of a late/central mechanism (working memory) modulates early precortical sensory processing.

  • 190.
    Thodi, Chryssola
    et al.
    European University Cyprus, Nicosia.
    Parazzini, M.
    Istituto di Ingegneria Biomedica, Milano, Italy.
    Kramer, Sophia
    VU University Medical Center, Amsterdam, The Netherlands.
    Davis, Adrian
    Royal Free London NHS Foundation Trust, London, UK.
    Stenfelt, Stefan
    Linköping University, Department of Clinical and Experimental Medicine, Technical Audiology. Linköping University, Faculty of Health Sciences.
    Janssen, Thomas
    Technische Universitaet Muenchen, Germany.
    Smith, Pauline
    Royal Free London NHS Foundation Trust, London, UK.
    Stevens, Dye
    Cardiff University, Wales, UK.
    Pronk, Marieke
    VU University Medical Center, Amsterdam, The Netherlands.
    Anteunis, L. I.
    University Medical Centre, Maastricht, The Netherlands .
    Schirkonyer, Volker
    Technische Universitaet Muenchen, Germany.
    Grandori, Ferdinando
    Istituto di Ingegneria Biomedica, Milano, Italy.
    Adult Hearing Screening: Follow-Up and Outcomes2013In: American Journal of Audiology, ISSN 1059-0889, E-ISSN 1558-9137, Vol. 22, p. 183-185Article in journal (Refereed)
    Abstract [en]

    PURPOSE:

    To screen hearing and evaluate outcomes in community-dwelling older adults.

    METHOD:

    Three thousand and twenty-five adults responded to an invitation to be screened by questionnaire, otoscopy, and pure-tone audiometry. Pure-tone average (PTA) >35 dB HL in the worse ear, unilateral hearing loss, or otoscopic findings were the criteria for referral for services. A questionnaire related to compliance with referral recommendations was completed by telephone interview for 160 randomly selected participants after 1-2 years from referral.

    RESULTS:

    The referral rate for audiologic/hearing aid evaluation was 46%, and referral for cerumen removal/medical evaluation was 17%. Of the people referred for audiologic/hearing aid evaluation, 18% tried a hearing aid; 2 years later, 11% were using a hearing aid. Screening recommendations affected participants' decision to seek help. Study participants stated that the screening was helpful, it should be offered to everybody, and they would participate in future screenings.

    CONCLUSION:

    Although adult hearing screening offered timely identification of hearing loss for adults seeking help, follow-up with hearing aid treatment was low.

  • 191.
    Thodi, Chryssola
    et al.
    Cyprus Audiology Center, Nicosia, Cyprus.
    Parazzini, Marta
    Istituto di Ingegneria Biomedica, Milano.
    Kramer, Sophia
    VU University Medical Center, Amsterdam.
    Davis, Adrian
    MRC Hearing and Communication Group, London.
    Stenfelt, Stefan
    Linköping University, Department of Clinical and Experimental Medicine, Technical Audiology. Linköping University, Faculty of Health Sciences.
    Janssen, Thomas
    Technische Universität München.
    Stephens, Dayfydd
    Cardiff University.
    Smith, Pauline
    MRC Hearing and Communication Group, London.
    Pronk, Marieke
    VU University Medical Center, Amsterdam.
    Grandori, Ferdi
    Istituto di Ingegneria Biomedica, Milano.
    Adult hearing screening: the Cyprus Pilot Program2011In: Audiology Research, ISSN 2039-4349, Vol. 1, p. 69-70Article in journal (Refereed)
    Abstract [en]

    Hearing loss is the third most common condition affecting adults over 65 (Cruickshanks et al., 1998). It can affect quality of life, limiting the ability to communicate efficiently, and leading to isolation, psychological strain, and functional decline (LaForge, Spector, Sternberg, 1992; Yueh, Shapiro, MacLean, Shekelle, 2003). Communication limitations impinge on the person directly, as well as the family, friends, and social circle. Reports on hearing loss among adults indicate that less than 25% of people who can benefit from amplification are actually using hearing aids, and that people diagnosed with a hearing loss delay seeking amplification by about seven years (Kochkin, 1997). Often, family members are the driving force behind a person with a hearing loss who decides to seek help. Adult hearing screening programs might have a positive effect on raising public awareness on hearing loss and its implications, and shortening delay time for intervention. There is no routine hearing screening for the adult population in Cyprus. The health system provides hearing tests for beneficiaries upon physician recommendation or self-referral. The Cyprus pilot adult hearing screening program (ΑΠΑΣ- EVERYONE- Greek acronym for Screening- Intervention-Hearing-Participation to Life) screened hearing in retired adults.

  • 192.
    Voss, Susan
    et al.
    Smith College, Northampton, Massachusetts, USA.
    Stenfelt, Stefan
    Linköping University, Department of Clinical and Experimental Medicine, Technical Audiology. Linköping University, Faculty of Health Sciences.
    Neely, Stephen
    Boys Town National Research Hospital, Omaha, Nebraska, USA.
    Rosowski, John
    Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA.
    Factors that introduce intrasubject variability into ear-canal absorbance measurements2013In: Ear and Hearing, ISSN 0196-0202, E-ISSN 1538-4667, Vol. 34, no Supplement 1, p. 60s-64sArticle in journal (Refereed)
    Abstract [en]

    Wideband immittance measures can be useful in analyzing acoustic sound flow through the ear and also have diagnostic potential for the identification of conductive hearing loss as well as causes of conductive hearing loss. To interpret individual measurements, the variability in test–retest data must be described and quantified. Contributors to variability in ear-canal absorbance–based measurements are described in this article. These include assumptions related to methodologies and issues related to the probe fit within the ear and potential acoustic leaks. Evidence suggests that variations in ear-canal cross-sectional area or measurement location are small relative to variability within a population. Data are shown to suggest that the determination of the Thévenin equivalent of the ER-10C probe introduces minimal variability and is independent of the foam ear tip itself. It is suggested that acoustic leaks in the coupling of the ear tip to the ear canal lead to substantial variations and that this issue needs further work in terms of potential criteria to identify an acoustic leak. In addition, test–retest data from the literature are reviewed.

  • 193.
    Zeitooni, Mehrnaz
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences.
    Mäki-Torkko, Elina
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences.
    Stenfelt, Stefan
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences.
    Binaural Hearing Ability With Bilateral Bone Conduction Stimulation in Subjects With Normal Hearing: Implications for Bone Conduction Hearing Aids.2016In: Ear and Hearing, ISSN 0196-0202, E-ISSN 1538-4667, Vol. 37, no 6, p. 690-702Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: The purpose of this study is to evaluate binaural hearing ability in adults with normal hearing when bone conduction (BC) stimulation is bilaterally applied at the bone conduction hearing aid (BCHA) implant position as well as at the audiometric position on the mastoid. The results with BC stimulation are compared with bilateral air conduction (AC) stimulation through earphones.

    DESIGN: Binaural hearing ability is investigated with tests of spatial release from masking and binaural intelligibility level difference using sentence material, binaural masking level difference with tonal chirp stimulation, and precedence effect using noise stimulus.

    RESULTS: In all tests, results with bilateral BC stimulation at the BCHA position illustrate an ability to extract binaural cues similar to BC stimulation at the mastoid position. The binaural benefit is overall greater with AC stimulation than BC stimulation at both positions. The binaural benefit for BC stimulation at the mastoid and BCHA position is approximately half in terms of decibels compared with AC stimulation in the speech based tests (spatial release from masking and binaural intelligibility level difference). For binaural masking level difference, the binaural benefit for the two BC positions with chirp signal phase inversion is approximately twice the benefit with inverted phase of the noise. The precedence effect results with BC stimulation at the mastoid and BCHA position are similar for low frequency noise stimulation but differ with high-frequency noise stimulation.

    CONCLUSIONS: The results confirm that binaural hearing processing with bilateral BC stimulation at the mastoid position is also present at the BCHA implant position. This indicates the ability for binaural hearing in patients with good cochlear function when using bilateral BCHAs.

  • 194.
    Zeitooni, Mehrnaz
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Technical Audiology. Linköping University, Faculty of Health Sciences.
    Stenfelt, Stefan
    Linköping University, Department of Clinical and Experimental Medicine, Technical Audiology. Linköping University, Faculty of Health Sciences.
    Mäki-Torkko, Elina
    Linköping University, Department of Clinical and Experimental Medicine, Technical Audiology. Linköping University, Faculty of Health Sciences.
    Binaural hearing with bone conduction stimulation in normal hearing subjects2013Conference paper (Refereed)
  • 195.
    Zhao, Mingduo
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Speech language pathology, Audiology and Otorhinolaryngology. Linköping University, Faculty of Medicine and Health Sciences.
    Fridberger, Anders
    Linköping University, Department of Clinical and Experimental Medicine, Divison of Neurobiology. Linköping University, Faculty of Medicine and Health Sciences.
    Stenfelt, Stefan
    Linköping University, Department of Clinical and Experimental Medicine, Division of Speech language pathology, Audiology and Otorhinolaryngology. Linköping University, Faculty of Medicine and Health Sciences.
    Bone conduction hearing in the Guinea pig and the effect of artificially induced middle ear lesions2019In: Hearing Research, ISSN 0378-5955, E-ISSN 1878-5891, Vol. 379, p. 21-30Article in journal (Refereed)
    Abstract [en]

    Although human bone conduction (BC) hearing is well investigated, there is a lack of information about BC hearing in most other species. In humans, the amount of conductive loss is estimated as the difference between the air conduction (AC) and BC thresholds. Similar estimations for animals are difficult since in most species, the normal BC hearing thresholds have not been established. In the current study, the normal BC thresholds in the frequency range between 2 kHz and 20 kHz are investigated for the Guinea pig. Also, the effect of a middle ear lesion, here modelled by severing the ossicles (ossicular discontinuity) and gluing the ossicles to the bone (otosclerosis), is investigated for both AC and BC. The hearing thresholds in the Guinea pigs were estimated by a regression of the amplitude of the compound action potential (CAP) with stimulation level and was found robust and gave a high resolution of the threshold level. The reference for the BC thresholds was the cochlear promontory bone velocity. This reference enables comparison of BC hearing in animals, both intra and inter species, which is independent on the vibrator and stimulation position. The vibration was measured in three orthogonal directions where the dominating vibration directions was in line with the stimulation direction, here the ventral direction. The BC thresholds lay between -10 and 3 dB re 1 mu m/s. The slopes of CAP growth function were similar for AC and BC at low and high frequencies, but slightly lower for BC than AC at frequencies between 8 and 16 kHz. This was attributed to differences in the stimulus levels used for the slope estimation and not a real difference in CAP slopes between the stimulation modalities. Two kinds of middle ear lesions, ossicular discontinuity and stapes glued to the surrounding bone, gave threshold shifts of between 23 and 53 dB for AC while it was below 16 dB when the stimulation was by BC. Statistically different threshold shifts between the two types of lesions were found where the AC threshold shifts for a glued stapes at 2 and 4 kHz were 9-18 dB greater than for a severed ossicular chain, and the BC threshold shifts for a glued stapes at 4 and 12 kHz were 8-9 dB greater than fora severed ossicular chain. (C) 2019 Elsevier B.V. All rights reserved.

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