This review article presents an overview of all Digit Triplet Tests (DTT) and digits-in-noise tests (DIN) and their variations in language, speech material, masking noise, test procedures, and targeted population. The effects on aspects of validity, reliability, and feasibility are investigated.
Scoping review.
All studies referring to the DTT and DIN were collected from Pubmed and Embase. Search terms \"digit triplet test\" and \"digits in noise\" were used. Citations of selected articles were scanned backwards in time (the bibliography of the already selected research article) and forward in time (articles that cited the already selected research article). The search terms yielded 95 results in total. Eventually, 39 papers were selected.
Analyses showed psychometric reference-curves with steep slopes and speech reception thresholds with high measurement precision which are strongly associated with pure tone audiometry. High sensitivity and specificity to detect elevated pure tone thresholds were noted for test variants. Certain procedural modifications of the DTT and DIN can further improve the test. Additionally, large-scale application of the DTT and DIN is feasible.
The DTT and DIN are a very valuable tool for screening and diagnostics for a wide variety of populations.

Published studies assessing the association between cognitive performance and speech-in-noise (SiN) perception examine different aspects of each, test different listeners, and often report quite variable associations. By examining the published evidence base using a systematic approach, we aim to identify robust patterns across studies and highlight any remaining gaps in knowledge. We limit our assessment to adult unaided listeners with audiometric profiles ranging from normal hearing to moderate hearing loss. A total of 253 articles were independently assessed by two researchers, with 25 meeting the criteria for inclusion. Included articles assessed cognitive measures of attention, memory, executive function, IQ, and processing speed. SiN measures varied by target (phonemes or syllables, words, and sentences) and masker type (unmodulated noise, modulated noise, >2-talker babble, and ≤2-talker babble. The overall association between cognitive performance and SiN perception was r = .31. For component cognitive domains, the association with (pooled) SiN perception was as follows: processing speed ( r = .39), inhibitory control ( r = .34), working memory ( r = .28), episodic memory ( r = .26), and crystallized IQ ( r = .18). Similar associations were shown for the different speech target and masker types. This review suggests a general association of r≈.3 between cognitive performance and speech perception, although some variability in association appeared to exist depending on cognitive domain and SiN target or masker assessed. Where assessed, degree of unaided hearing loss did not play a major moderating role. We identify a number of cognitive performance and SiN perception combinations that have not been tested and whose future investigation would enable further fine-grained analyses of these relationships.

Few studies report outcomes of surgical management of postinflammatory medial canal fibrosis (PIMCF). The objectives were to compare short- and long-term outcomes after surgical repair of PIMCF at our institution and systematically aggregate published data for meta-analysis.
Medical records for the case series; PubMed, Scopus, and OVID/Medline for the systematic review/meta-analysis.
Patients undergoing surgical treatment of PIMCF were identified. Short-term (<2 years) and long-term (>2 years) postoperative outcomes were evaluated for the case series and aggregated for the meta-analysis.
At our institution, 16 patients (21 ears) were identified. Compared to the preoperative air-bone gap (ABG) (27.7 ± 7.5 dB), mean postoperative short-term ABG (8.2 ± 7.5 dB) and long-term ABG (15.3 ± 11.3 dB) were significantly improved (P < 0.001 for both). Although short-term restenosis rate was low (0%) among long-term follow-up patients, 64% (9 of 14) experienced some degree of recurrent canal narrowing, including one case of complete restenosis (7%). Similarly, meta-analysis pooled preoperative ABG (29.3 ± 9.7 dB, 95% confidence interval [CI] 27.0-31.6) improved significantly during short-term (11.4 ± 8.0 dB, 95% CI 8.3-4.5, P < 0.0001) and long-term (14.3 ± 9.6 dB, 95% CI 11.6-16.9, P = 0.0004) follow-ups, with partial deterioration in hearing over time. Long-term complete restenosis rate (13.8%) was worse than short-term (8.0%), with no significant difference over time (P = 0.85).
Postinflammatory medial canal fibrosis is a rare condition that can successfully be treated with surgery to restore patency of the external auditory canal. Patients who experience improved hearing early on, however, are at significant risk of restenosis and recurrence of their conductive hearing loss with time.
N/A. Laryngoscope, 2016 127:488-495, 2017.

Sympathetic hearing loss (SHL) is a rare complication that appears to occur when the immune system is primed against sequestered inner ear antigens. SHL has been implicated in delayed hearing loss after acoustic tumor removal, revision stapedectomy, and temporal bone fractures. We present 2 cases of suspected SHL after excision of skull base tumors during which the surgical approach had violated the otic capsule. Both patients experienced delayed contralateral sensorineural hearing loss. In comparing our cases with those previously reported, we hope to inspire others to do likewise and to develop an understanding of this clinical entity.

OBJECTIVE: A review of the development, evaluation, and application of the so-called \'matrix sentence test\' for speech intelligibility testing in a multilingual society is provided. The format allows for repeated use with the same patient in her or his native language even if the experimenter does not understand the language.
METHODS: Using a closed-set format, the syntactically fixed, semantically unpredictable sentences (e.g. \'Peter bought eight white ships\') provide a vocabulary of 50 words (10 alternatives for each position in the sentence). The principles (i.e. construction, optimization, evaluation, and validation) for 14 different languages are reviewed. Studies of the influence of talker, language, noise, the training effect, open vs. closed conduct of the test, and the subjects\' language proficiency are reported and application examples are discussed.
RESULTS: The optimization principles result in a steep intelligibility function and a high homogeneity of the speech materials presented and test lists employed, yielding a high efficiency and excellent comparability across languages. The characteristics of speakers generally dominate the differences across languages.
CONCLUSIONS: The matrix test format with the principles outlined here is recommended for producing efficient, reliable, and comparable speech reception thresholds across different languages.

OBJECTIVE: Systematically review the literature on the clinical outcome of bone conduction devices (BCD) and contralateral routing of sound systems (CROSS) for patients with single-sided deafness (SSD).
METHODS: PubMed, Embase, Cochrane Library, and CINAHL databases were searched up to April 7, 2014.
METHODS: All studies investigating BCD and CROSS for patients with SSD on speech perception in noise, sound localization, or quality of life were selected and critically appraised.
RESULTS: In total, 46 articles were retrieved, of which six satisfied the eligibility criteria. Critical appraisal showed that five studies (n = 91) carried a moderate to high directness of evidence and a low to moderate risk of bias. Subsequently, study characteristics and outcome measurements were extracted. Due to large heterogeneity between studies, pooling of data was not feasible. Studies did not show a clear advantage of BCD or CROSS on speech perception in noise. BCD and CROSS lead to the same sound localization ability as the unaided condition. Quality of life did not differ significantly between conditions; however, subjective speech communication did improve.
CONCLUSIONS: No high level of evidence studies compare BCD and CROSS in patients with SSD. Literature showed no beneficial effect of BCD or CROSS regarding speech perception in noise and sound localization. Subjective speech communication demonstrated a moderate improvement with BCD and CROSS. High evidence studies comparing all treatment options for single-sided deafness should be conducted.

The ability to recognize masked speech, commonly measured with a speech reception threshold (SRT) test, is associated with cognitive processing abilities. Two cognitive factors frequently assessed in speech recognition research are the capacity of working memory (WM), measured by means of a reading span (Rspan) or listening span (Lspan) test, and the ability to read masked text (linguistic closure), measured by the text reception threshold (TRT). The current article provides a review of recent hearing research that examined the relationship of TRT and WM span to SRTs in various maskers. Furthermore, modality differences in WM capacity assessed with the Rspan compared to the Lspan test were examined and related to speech recognition abilities in an experimental study with young adults with normal hearing (NH). Span scores were strongly associated with each other, but were higher in the auditory modality. The results of the reviewed studies suggest that TRT and WM span are related to each other, but differ in their relationships with SRT performance. In NH adults of middle age or older, both TRT and Rspan were associated with SRTs in speech maskers, whereas TRT better predicted speech recognition in fluctuating nonspeech maskers. The associations with SRTs in steady-state noise were inconclusive for both measures. WM span was positively related to benefit from contextual information in speech recognition, but better TRTs related to less interference from unrelated cues. Data for individuals with impaired hearing are limited, but larger WM span seems to give a general advantage in various listening situations.

OBJECTIVE: This manuscript describes a case in which, based on clinical observations, we hypothesize that a change in a cochlear implant recipient\'s electrode impedance and performance was attributed to a change in the recipient\'s physiology rather than a device failure. Of particular note was the finding that electrode impedances decreased after a period of nonuse of the implant as well as after steroid treatment.
METHODS: Retrospective single-subject case study review.
METHODS: Outpatient clinic.
METHODS: This paper describes outcomes for a 75-year-old male cochlear implant user.
METHODS: A change in electrode impedance and a decrease in speech recognition were addressed through cochlear implant programming, periods of nonuse of the implant, provision of steroids, and bilateral cochlear implantation.
METHODS: The primary measures of interest were serial assessment of electrode impedance and speech recognition. Secondary measures included assessment of implant stimulation levels and electrophysiologic responses.
RESULTS: Electrode impedances decreased (improved) after a period of nonuse of the implant as well as after provision of steroid treatment. Recipient performance also improved but did not return to baseline levels.
CONCLUSIONS: Atypical fluctuations in electrode impedance were observed with periods of CI use and nonuse. Additionally, after a 10-month period of constant fluctuation of electrode impedances with atypical morphology, electrode impedances stabilized to normal levels with a typical morphology within 3 days of steroid treatment. Given these observations, we hypothesized that the change in this recipient\'s electrode impedance as well as the decrease in this implant recipient\'s performance may be attributed to his physiology rather than to the device failure. Changes in electrode impedance accompanied by a decrease in this patient\'s performance were successfully addressed by a period of nonuse of the implant, provision of steroids, and an increase in the pulse width of the biphasic pulsatile signal used for stimulation. It should be noted that the results of this case are anecdotal in nature and may not apply to all cochlear implant recipients experiencing electrode impedance changes and/or deterioration in performance.

OBJECTIVE: To examine the safety and effectiveness of fully implantable middle ear devices in the treatment of hearing loss.
METHODS: MEDLINE, EMBASE, The Cochrane Library, Web of Science, CINAHL, PsycINFO, and the Centre for Reviews and Dissemination were searched without date or language limits.
METHODS: Titles and abstracts of 7,700 citations were screened, and 30 articles were selected for full review, of which, 7 articles on the Esteem and 13 on the Carina met the study\'s eligibility criteria.
METHODS: Information was extracted using a pretested data abstraction form, and study quality was assessed using the Oxford Centre for Evidence-Based Medicine Levels of Evidence.
RESULTS: Because of heterogeneity across studies, meta-analysis was not performed, and comparisons were made by structured review.
CONCLUSIONS: The majority of studies were quasi-experimental, prepost comparisons of aided and unaided conditions. Complication rates with the Esteem were higher than with the Carina, and most commonly included taste disturbance. However, device failure was common with the Carina, predominately related to charging difficulties. For both devices, clinically significant improvements in functional gain, speech reception, and speech recognition over the unaided condition were found. In studies comparing the Esteem or Carina to hearing aids, findings were mixed. Although improvements in functional gain were similar to those for hearing aids, speech recognition and quality of life were greater with the implants. Despite limited evidence, these devices seem to offer a relatively safe and effective treatment option, particularly for patients who are medically unable to wear conventional hearing aids.

OBJECTIVE: To systematically review the outcomes of bilateral versus unilateral bone-anchored hearing aids (BAHA) for individuals with bilateral permanent conductive hearing loss (CHL) with the goal of (1) deriving clinically oriented insights into the advantages and disadvantages of bilateral fitting and (2) identifying gaps in knowledge to stimulate future research.
METHODS: Medline, EMBASE, and Cochrane databases were searched for studies of all languages published between 1977 and July 2011.
METHODS: Studies were included if subjects of any age had permanent bilateral CHL and bilateral implanted BAHAs. Outcome measures of interest were any subjective or objective audiologic measures, quality of life indicators, or reports of adverse events.
RESULTS: In all, 628 abstracts were generated from the literature searches; 11 studies met the criteria for data extraction and analysis. All 11 studies were observational. In most studies, comparisons between unilateral and bilateral BAHA were intra-subject. Bilateral BAHA provided audiologic benefit compared to unilateral BAHA (improved thresholds for tones [2 studies], speech in quiet [5 studies] and in noise [3 studies], and improved localization/lateralization [3 studies]) and patients\' perceived subjective benefit from bilateral BAHA (3 studies). Disadvantages of bilateral BAHAs included listening in noise in some conditions (3 studies), presumed additional cost, and presumed increase in adverse event risk.
CONCLUSIONS: Bilateral BAHA provided additional objective and subjective benefit compared to unilateral BAHA; however, there was a limited number of studies available with good quality evidence. Aspects of bilateral BAHA that would benefit from further investigation are described, and recommendations for bilateral BAHA candidacy criteria are provided.