Richtinghoren door patiënten met eenzijdige sensorineurale doofheid (SSD): invloed van oorschelp karakteristieken, hoog-frequent gehoorverlies in het horende oor, en gebruik

van een beengeleidingshoortoestel Myrthe Hol

Department of Otorhinolaryngology, Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands

Emmanuel Mylanus and Prof. Ad Snik

Department of Biophysics, Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, The Netherlands

Martijn Agterberg, Rens Van de Goor, Marc Van Wanrooij and Prof. John Van Opstal

Hearing & Implants

Richtinghoren door patiënten met eenzijdige sensorineurale doofheid (SSD): invloed van oorschelp karakteristieken, hoog-frequent gehoorverlies in het horende oor, en gebruik

van een beengeleidingshoortoestel Myrthe Hol

Department of Otorhinolaryngology, Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands

Emmanuel Mylanus and Prof. Ad Snik

Department of Biophysics, Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, The Netherlands

Martijn Agterberg, Rens Van de Goor, Marc Van Wanrooij and Prof. John Van Opstal

Hearing & Implants

Binaural cues for sound localization in azimuth

♦ Interaural level differences (ILDs)

♦ Interaural time differences (ITDs)

Sound source

Shadow

Head

ILDs > 3 kHz ITDs < 1.5 kHz

Amplitude R1 L1

Monaural cues for sound localization in the vertical plane

HRTFs

Freq.

Ampl

.

40°

- 40°

40°

-40°

Ampl

.

Freq.

Ampl

.

Freq. Freq.

Ampl

.

- Complete dark, sound-attenuated room

- Listeners seated in the centre in a chair

- 58 speakers

- Duration 150 ms

- Roving sound level (45 - 65 dB SPL)

- Noises with different bandwidths

broadband (0.5 – 20 kHz) low-pass (0.5 – 1.5 kHz) high-pass (3 – 20 kHz)

(Hofman and Van Opstal, 1998)

60 40 20 0

Lo

cati

on

(d

eg)

0 500 Time in msec

Sound localization in azimuth and elevation

Stimulus Elevation (deg)

Response E

levation (deg)

Stimulus azimuth (deg)

Res

pons

e az

imut

h (d

eg)

Azimuth Elevation

Sound-localization normal hearing listeners

Gain (g) close to 1.0 means good sound localization

Sound-localization of SSD listener

Stimulus azimuth (deg)

Res

pons

e az

imut

h (d

eg)

Often SSD listeners perceive sounds at their hearing side

-90 -60 -30 0 30 60 90-90

-60

-30

0

30

60

90

αR = 1.1αT + 2.7

r2 = 0.94

Stimulus azimuth (deg)

Res

pons

e az

imut

h (d

eg)

-90 -60 -30 0 30 60 90-90

-60

-30

0

30

60

90

εR = 0.02εT + 8.4

r2 = 0.0081

Stimulus elevation (deg)

Res

pons

e el

evat

ion

(deg

)

-90 -60 -30 0 30 60 90-90

-60

-30

0

30

60

90

αR = 1.1αT - 0.068

r2 = 0.92

Stimulus azimuth (deg)

Res

pons

e az

imut

h (d

eg)

-90 -60 -30 0 30 60 90-90

-60

-30

0

30

60

90

εR = 0.83εT + 1.8

r2 = 0.91

Stimulus elevation (deg)

Res

pons

e el

evat

ion

(deg

)

Horizontal Vertical

Hofman and Van Opstal, 2003

Spectral cues for sound-localization of NH listeners

.5 1 2 4 8 16

ITD’s ILD’s + HRTF’s

AMP (dB)

Freq (kHz)

E = - 40 E = - 10

E = +20

Acoustic localization cues operate in different frequency bands:

BB

LP HP

Effect of Mould in Good Ear on Horizontal Sound Localization

in 2 SSD listeners

Surprisingly good (high gain) monaural sound localization

SSD patients use spectral-shape cues for localization in azimuth

Effect of high-frequency hearing loss on sound localization

Gain BCD on

Gai

n M

on

aura

l BCD does not affect monaural localization of listeners with SSD (n=19)

Red indicates PTA for 4 and 8 kHz ≥ 25 dB HL

Conclusions

Large variation in unaided sound localization abilities of patients with SSD Congenital/acquired High frequency loss in hearing ear SSD patients use spectral-shape cues for localization in azimuth Already at the age of 6 children localize BB noises (0.5 – 20 kHz) in azimuth and elevation as good as adults BCD does not deteriorate or improve directional hearing in listeners with SSD

Acknowledgements

Prof. C. Cremers, MD Dr. J. Leijendeckers

Dr. A. Bosman Rik Otten Tinna Arts

Gunter Windau Chris-Jan Beerendonk

Funding

The William Demants og Hustru Ida Emilies Fond

The Dutch Donders Institute for Brain, Cognition and Behaviour Radboud University Nijmegen Medical Center

Hearing & Implants

Nijmegen BI Team 2014

Ad Snik

Emmanuel Mylanus

Myrthe Hol

Maarten de Wolf

Arjan Bosman

Mieki Verbruggen

Teja Repkes

Maurice van Dongen

Carine Hendriks

Hubert Faber

Danielle van Gogh

Martijn Agterberg

Herman Kok

Rik Nelissen

Tamara Munnix