Spatial separation and fundamental frequency (F0) separation are effective cues for improving the intelligibility of target speech in multi-talker scenarios. Previous studies predominantly focused on spatial configurations within the frontal hemifield, overlooking the ipsilateral side and the entire median plane, where localization confusion often occurs. This study investigated the impact of spatial and F0 separation on intelligibility under the above-mentioned underexplored spatial configurations. The speech reception thresholds were measured through three experiments for scenarios involving two to four talkers, either in the ipsilateral horizontal plane or in the entire median plane, utilizing monotonized speech with varying F0s as stimuli. The results revealed that spatial separation in symmetrical positions (front-back symmetry in the ipsilateral horizontal plane or front-back, up-down symmetry in the median plane) contributes positively to intelligibility. Both target direction and relative target-masker separation influence the masking release attributed to spatial separation. As the number of talkers exceeds two, the masking release from spatial separation diminishes. Nevertheless, F0 separation remains as a remarkably effective cue and could even facilitate spatial separation in improving intelligibility. Further analysis indicated that current intelligibility models encounter difficulties in accurately predicting intelligibility in scenarios explored in this study.

This study aimed to preliminarily investigate the associations between performance on the integrated Digit-in-Noise Test (iDIN) and performance on measures of general cognition and working memory (WM). The study recruited 81 older adult hearing aid users between 60 and 95 years of age with bilateral moderate to severe hearing loss. The Chinese version of the Montreal Cognitive Assessment Basic (MoCA-BC) was used to screen older adults for mild cognitive impairment. Speech reception thresholds (SRTs) were measured using 2- to 5-digit sequences of the Mandarin iDIN. The differences in SRT between five-digit and two-digit sequences (SRT5-2), and between five-digit and three-digit sequences (SRT5-3), were used as indicators of memory performance. The results were compared to those from the Digit Span Test and Corsi Blocks Tapping Test, which evaluate WM and attention capacity. SRT5-2 and SRT5-3 demonstrated significant correlations with the three cognitive function tests (rs ranging from -.705 to -.528). Furthermore, SRT5-2 and SRT5-3 were significantly higher in participants who failed the MoCA-BC screening compared to those who passed. The findings show associations between performance on the iDIN and performance on memory tests. However, further validation and exploration are needed to fully establish its effectiveness and efficacy.

OBJECTIVE: Motivated by the growing need for hearing screening in China, the present study has two objectives. First, to develop and validate a new test, called the Chinese Zodiac-in-noise (ZIN) test, for large-scale hearing screening in China. Second, to conduct a large-scale remote hearing screening in China, using the ZIN test developed.
METHODS: The ZIN test was developed following a similar procedure as the digits-in-noise test but emphasizes the importance of consonant recognition by employing the 12 zodiac animals in traditional Chinese culture as speech materials. It measures the speech reception threshold (SRT) using triplets of Chinese zodiac animals in speech-shaped noise with an adaptive procedure.
RESULTS: Normative data of the test were obtained in a group of 140 normal-hearing listeners, and the performance of the test was validated by comparisons with pure-tone audiometry in 116 listeners with various hearing abilities. The ZIN test has a reference SRT of -11.0 ± 1.6 dB in normal-hearing listeners with a test-retest variability of 1.7 dB and can be completed in 3 minutes. The ZIN SRT is highly correlated with the better-ear pure-tone threshold ( r = 0.82). With a cutoff value of -7.7 dB, the ZIN test has a sensitivity of 0.85 and a specificity of 0.94 for detecting a hearing loss of 25 dB HL or more at the better ear.A large-scale remote hearing screening involving 30,552 participants was performed using the ZIN test. The large-scale study found a hearing loss proportion of 21.0% across the study sample, with a high proportion of 57.1% in the elderly study sample aged over 60 years. Age and gender were also observed to have associations with hearing loss, with older individuals and males being more likely to have hearing loss.
CONCLUSIONS: The Chinese ZIN test is a valid and efficient solution for large-scale hearing screening in China. Its remote applications may improve access to hearing screening and enhance public awareness of hearing health.

OBJECTIVE: The study aimed to develop and validate the Mandarin digit-in-noise (DIN) test using four digit (i.e., two-, three-, four-, and five-digit) sequences. Test-retest reliability and criterion validity were evaluated. How the number of digits affected the results was examined. The research might lead to more informed choice of DIN tests for populations with specific cognitive needs such as memory impairment.
METHODS: The International Collegium of Rehabilitative Audiology guideline for developing the DIN was adapted to create test materials. The test-retest reliability and psychometric function of each digit sequence were determined among young normal-hearing adults. The criterion validity of each digit sequence was determined by comparing the measured performance of older adult hearing aid users with that obtained from two other well-established sentence-in-noise tests: the Mandarin hearing-in-noise test and the Mandarin Chinese matrix test. The relation between the speech reception thresholds (SRTs) of each digit sequence of the DIN test and working memory capacity measured using the digit span test and the reading span test were explored among older adult hearing aid users. Together, the study sample consisted of 54 young normal-hearing adults and 56 older adult hearing aid users.
RESULTS: The slopes associated with the two-, three-, four-, and five-digit DIN test were 16.58, 18.79, 20.42, and 21.09 %/dB, respectively, and the mean SRTs were -11.11, -10.99, -10.56, and -10.02 dB SNR, respectively. Test-retest SRTs did not differ by more than 0.74 dB across all digit sequences, suggesting good test-retest reliability. Spearman rank-order correlation coefficients between SRTs obtained using the DIN across the four digit (i.e., two-, three-, four-, and five-digit) sequences and the two sentence-in-noise tests were uniformly high ( rs = 0.9) across all participants, when data from all participants were considered. Results from the digit span test and reading span test correlated significantly with the results of the five-digit sequences ( rs = -0.37 and -0.42, respectively) but not with the results of the two-, three-, and four-digit sequences among older hearing aid users.
CONCLUSIONS: While the three-digit sequence was found to be appropriate for clinical use for assessment of auditory perception, the two-digit sequence could be used for hearing screening. The five-digit sequence could be difficult for older hearing aid users, and with its SRT related to working memory capacity, its use in the evaluation of speech perception should be investigated further. The Mandarin DIN test was found to be reliable, and the findings are in line with SRTs obtained using standardized sentence tests, suggesting good criterion validity.

Objective: To explore the safety and reliability of retrosigmoid approach BONEBRIDGE implantation in patients with auricle reconstruction using skin expansion flap. Methods: A retrospective analysis was conducted on 43 congenital aural atresia cases (43 ears) who underwent BONEBRIDGE implantation from September 2019 to January 2023 in Beijing Tongren Hospital. 30 males and 13 females were included in this work. The implantation age was 9-36 years old (median age=10 y/o). All cases underwent auricle reconstruction surgery using the posterior ear flap expansion method, with 36 cases using the single expanded postauricular flap method and 7 cases using two-flap method. BONEBRIDGE implant surgery was performed during the third stage of auricle reconstruction or after all stages. The hearing improvements were evaluated by comparing the changes in pure tone hearing threshold and speech recognition rate of patients before and after BONEBRIDGE implantation. Routine follow-up was conducted to observe the hearing results and complications. SPSS 14.0 software was applied for data statistical analysis. Results: All 43 patients healed well and had no surgical complications when discharge. The average bone conduction hearing threshold after surgery was (8.2±6.6) dBHL, and there was no statistically significant difference compared to the preoperative [(8.1±5.7) dBHL] (P=0.95). After surgery, the threshold of hearing assistance with power on was significantly lower than that without hearing assistance [(32.8±4.6) dBHL vs (60.5±5.5) dBHL], and the difference was statistically significant (P<0.001). The speech recognition rate of monosyllable words, disyllabic words and short sentences in quiet environment increased to 72%, 84%, and 98% respectively. The differences were statistically significant (P<0.001). The speech recognition rate of monosyllabic words, disyllabic words, and short sentences in noise environment was significantly increased by 70%, 80%, and 92% respectively (P<0.001). After a follow-up of 4 to 47 months (median=24 months), the hearing results were stable and the aesthetic outcomes were satisfying. One patient had delayed hematoma around coil of the implant. After aspiration and compressed dressing for one week, hematoma was not recurrent. Conclusion: For patients after auricle reconstruction using expanded postauricular flap, the preference of retrosigmoid approach is a good choice in terms of safety and reliability of operation, as well as aesthetic appearance.
目的： 探讨主动选择乙状窦后骨桥植入在先天性外中耳畸形患者皮肤扩张法耳廓再造术后的安全性和可靠性。 方法： 回顾性分析2019年9月至2023年1月在首都医科大学附属北京同仁医院行骨桥植入的43例（43耳）先天性外中耳畸形外耳道骨性闭锁或狭窄患者的临床资料。其中男性30例，女性13例；接受骨桥植入术时年龄9~36岁，中位数年龄10岁。所有患者均采用耳后皮瓣扩张法耳廓再造手术，其中扩张单皮瓣法36例，扩张双皮瓣法7例。于第三期术中或三期耳廓再造术后行乙状窦后骨桥植入手术。通过比较骨桥植入前后患者纯音听阈和言语识别率的变化，评估其听力改善效果。术后定期随访观察听力效果及并发症发生情况。应用SPSS 14.0软件进行数据统计分析。 结果： 43例患者术后均一期愈合。术后平均骨导听阈为（8.2±6.6）dBHL，与术前［（8.1±5.7）dBHL］相比差异无统计学意义（P=0.95）。术后开机助听听阈较未助听条件下听阈明显下降［（32.8±4.6）dBHL比（60.5±5.5）dBHL］，差异有统计学意义（P<0.001）。骨桥助听后，患者安静环境下单音节词、双音节词及短句的言语识别率分别提高至72%、84%和98%，与非助听相比差异有统计学意义（P值均<0.001）；助听后噪声环境下单音节词、双音节词及短句的言语识别率分别提高至70%、80%和92%，与非助听相比差异有统计学意义（P值均<0.001）。术后随访4~47个月（中位数24个月），患者助听效果稳定，耳廓外形较好。1例患者在术后6个月时出现植入体线圈周围血肿，经穿刺引流及加压包扎后血肿消退，无复发。 结论： 对于耳后皮瓣扩张法耳廓再造术后的患者，主动选择乙状窦后骨桥植入，既可减少手术瘢痕，达到外形美观的效果，又能获得术后稳定的助听效果，手术安全可靠。.

UNASSIGNED: To develop the Cantonese matrix (YUEmatrix) test according to the international standard procedure and examine possible different outcomes in another tonal language.
UNASSIGNED: A 50-word Cantonese base-matrix was established. Word-specific speech recognition functions, speech recognition thresholds (SRT), and slopes were obtained. The speech material was homogenised in intelligibility by applying level corrections up to ± 3 dB. Subsequently, the YUEmatrix test was evaluated in five aspects: training effect, test-list equivalence, test-retest reliability, establishment of reference data for normal-hearing Cantonese-speakers, and comparison with the Cantonese-Hearing-In-Noise-Test.
UNASSIGNED: Overall, 64 normal-hearing native Cantonese-speaking listeners.
UNASSIGNED: SRT measurements with adaptive procedures resulted in a reference SRT of -9.7 ± 0.7 dB SNR for open-set and -11.1 ± 1.2 dB SNR for the closed-set response format. Fixed SNR measurements suggested a test-specific speech intelligibility function slope of 15.5 ± 0.7%/dB. Seventeen 10-sentences base test lists were confirmed to be equivalent with respect to speech intelligibility. Training effect was not observed after two measurements of 20-sentences lists.
UNASSIGNED: The YUEmatrix yields comparable results to matrix tests in other languages including Mandarin. Level adjustments to homogenise sentences appear to be less effective for tonal languages than for most other languages developed so far.

This study evaluated whether listening with an eye closure (EC) strategy improves speech recognition in noise (SRN) under different visual conditions. Previous research suggests EC may enhance activation of cortical systems involved in listening and attention. Study hypotheses were that EC listening leads to better SRN than eyes open listening, that listening in darkness leads to better SRN than in light, and EC listening leads to more improved SRN in light compared to darkness.
SRN with the Cantonese Hearing in Noise Test (CHINT) under four conditions was assessed: (1) eyes open with lights on, (2) EC with lights on, (3) eyes open in darkened room, and (4) EC in darkened room. ANOVA determined potential differences among conditions and effect sizes were calculated.
Fifty-six young adults (age range 18-35 years) with bilaterally normal hearing.
Significant effects for EC and presence/absence of an external visual stimulus on SRN were found. Post-hoc analysis found a statistically significant difference between eyes open and closed in light, with a large effect size, indicating EC resulted in the greatest improvement in SRN when in the presence of an external visual stimulus. However, differences compared with known CHINT inter-list variability lacked clinical importance.
EC did significantly improve SRN and is a potential strategy for challenging listening situations when feasible, although no changes are needed for CHINT norms or testing procedures in relation to EC status.

Many tinnitus patients report difficulties understanding speech in noise or competing talkers, despite having \"normal\" hearing in terms of audiometric thresholds. The interference caused by tinnitus is more likely central in origin. Release from informational masking (more central in origin) produced by competing speech may further illuminate central interference due to tinnitus. In the present study, masked speech understanding was measured in normal hearing listeners with or without tinnitus. Speech recognition thresholds were measured for target speech in the presence of multi-talker babble or competing speech. For competing speech, speech recognition thresholds were measured for different cue conditions (i.e., with and without target-masker sex differences and/or with and without spatial cues). The present data suggest that tinnitus negatively affected masked speech recognition even in individuals with no measurable hearing loss. Tinnitus severity appeared to especially limit listeners\' ability to segregate competing speech using talker sex differences. The data suggest that increased informational masking via lexical interference may tax tinnitus patients\' central auditory processing resources.

BACKGROUND: Bonebridge is an suitable option for conductive hearing loss, however, the traditional approach cannot accomplished a satisfying implantation for patients with congenital malformation or radical mastoidectomy.
OBJECTIVE: To evaluate the clinical application of retrosigmoid sinus approach in Bonebridge implantation and postoperative evaluation.
METHODS: 11 patients who underwent retrosigmoid sinus approach Bonebridge implantation from March 2016 to September 2019 were retrospectively analyzed, including 6 males and 5 females, aged 12-54 years old (30.6 in average). Among them, 4 cases had undergone bilateral radical mastoidectomy, 6 cases had bilateral congenital aural atresia or stenosis, and 1 case had unilateral congenital aural atresia.
RESULTS: All patients underwent Bonebridge implantation through retrosigmoid sinus approach according to the preoperative image reconstruction and plan. There was no surgical injury of sigmoid sinus or cerebrospinal fluid leakage during the operation. The aided threshold obtained an increase of 32.32 dB HL; the speech recognition rates of bisyllabic words, monosyllabic words and sentence were 79.6%, 67.8% and 75.0%, respectively. After 11-53 months of follow-up, the hearing effect was stable and no long-term complications occurred.
CONCLUSIONS: The retrosigmoid sinus approach is an effective surgical approach for patients with congenital ear deformities or radical cavity after mastoidectomy.

UNASSIGNED: To evaluate the long-term safety and efficacy of the Clip coupler attached to the stapes head in patients with unilateral congenital aural atresia (CAA).
UNASSIGNED: This single-center retrospective study included 16 Mandarin-speaking patients who had unilateral microtia accompanied by CAA. All patients were divided into two groups: the short-term follow-up group (n = 9) and the long-term follow-up group (n = 7). The floating mass transducer of the Vibrant Soundbridge (VSB) was positioned in the stapes head by the Clip coupler. The safety of the VSB was investigated by comparing preoperative and postoperative bone-conduction (BC) thresholds as well as by complications. The effectiveness was evaluated by functional gain (FG), word recognition score (WRS), speech reception threshold (SRT) and signal-to-noise ratio (SNR).
UNASSIGNED: Pre- and post-operative BC thresholds were no different in all patients. And no complications developed. VSB-aided thresholds in the free-field had improved significantly in both short- and long-term follow-up groups. The improvements of WRS were observed in two groups. The monosyllabic VSB-aided WRS in the long-term follow-up group was significantly higher than that in the short-term follow-up group. When speech was from the impaired ear and noise presented to the side of normal ear (SVSBNCL), lower SNRs were found in two groups after VSB implantation. However, there was no statistical difference in aided SNR between the two groups at SVSBNCL status.
UNASSIGNED: Our results show that the FMT connected to the stapes head is a secure and useful device for patients with unilateral CHL/MHL, not only in terms of improved hearing thresholds, but also improved speech intelligibility in quiet and noisy environments.