Systematic Review and Meta-Analysis of the Application of Virtual Reality in Hearing Disorders

Kwak Chanbeom,Han Woojae,Bahng Junghwa 대한청각학회 2022 Journal of Audiology & Otology Vol.26 No.4

Background and Objectives: Trendy technologies, such as artificial intelligence, virtual reality (VR), and augmented reality (AR) are being increasingly used for hearing loss, tinnitus, and vestibular disease. Thus, we conducted this systematic review and meta-analysis to identify the possible benefits of the use of VR and AR technologies in patients with hearing loss, tinnitus, and/or vestibular dysfunction, with the aim of suggesting potential applications of these technologies for both researchers and clinicians.Materials and Methods: Published articles from 1968 to 2022 were gathered from six electronic journal databases. Applying our specified inclusion and/or exclusion criteria, 23 studies were analyzed. As only one article on hearing loss and two articles on tinnitus were found, 20 studies on vestibular dysfunction were only finally included for the meta-analysis. Standardized mean differences (SMDs) were chosen as estimates to compare the studies. A funnel plot and Egger’s regression analysis were used to identify any risk of bias.Results: High heterogeneity (I2: 83%, τ2: 0.5431, p<0.01) was identified across the studies on vestibular dysfunction. VR-based rehabilitation was significantly effective for individuals with vestibular disease (SMDs: 0.03, 95% confidence interval [CI]: -0.08 to 0.15, p<0.05). A subgroup analysis revealed that only improvement in the subjective questionnaire was meaningful and statistically significant (SMDs: -0.66, 95% CI: -1.10 to -0.22).Conclusions: VR-based vestibular rehabilitation showed potential for subjective rating measures like Dizziness Handicap Index. The negative effect of aging on vestibular disease was indirectly confirmed. More clinical trials and an evidence-based approach are needed to confirm the implementation of state-of-the-art technology for hearing loss and tinnitus, representative diseases in neurotology.

Effect of noise and reverberation on speech recognition and listening effort for older adults

Kwak, Chanbeom,Han, Woojae,Lee, Jihyeon,Kim, Jinsook,Kim, Sungkyun John Wiley Sons Australia, Ltd 2018 GERIATRICS & GERONTOLOGY INTERNATIONAL Vol.18 No.12

<P><B>Aim</B></P><P>The purpose of the present study was to evaluate the speech recognition ability and degree of listening effort for older adults in noisy and reverberating environments.</P><P><B>Methods</B></P><P>A total of 80 participants (40 older and 40 younger adults) participated in a sentence recognition test under 20 conditions with four levels of background noise and five levels of reverberation time. In each condition, the degree of listening effort was self‐reported using a 5‐point Likert scale.</P><P><B>Results</B></P><P>The older and younger groups showed that both the error percentage of the sentence recognition task and scale of the listening effort increased as the background noise and reverberation time increased. In the sentence recognition task, the older group was more affected by the reverberation condition than the noisy background compared with their younger counterparts. For the listening effort, the older group had higher scales than the younger group in all conditions, thereby explaining that they required significant effort during the listening task.</P><P><B>Conclusions</B></P><P>The older adults had poorer speech perception ability and required more listening effort than their younger counterparts in all conditions. Reverberation reversely significantly affected the speech recognition and listening effort for the older adults when compared with the background noise, suggesting that an appropriate level of noise and reverberation should be considered for comfort and a less stressful listening environment for the older adult population. <B>Geriatr Gerontol Int 2018; 18: 1603–1608</B>.</P>

Towards Size of Scene in Auditory Scene Analysis: A Systematic Review

Chanbeom Kwak,한우재 대한청각학회 2020 Journal of Audiology & Otology Vol.24 No.1

Auditory scene analysis is defined as a listener’s ability to segregate a meaningful message from meaningless background noise in a listening environment. To gain better understanding of auditory perception in terms of message integration and segregation ability among concurrent signals, we aimed to systematically review the size of auditory scenes among individuals. A total of seven electronic databases were searched from 2000 to the present with related key terms. Using our inclusion criteria, 4,507 articles were classified according to four sequential steps–identification, screening, eligibility, included. Following study selection, the quality of four included articles was evaluated using the CAMARADES checklist. In general, studies concluded that the size of auditory scene increased as the number of sound sources increased; however, when the number of sources was five or higher, the listener’s auditory scene analysis reached its maximum capability. Unfortunately, the score of study quality was not determined to be very high, and the number of articles used to calculate mean effect size and statistical significance was insufficient to draw significant conclusions. We suggest that study design and materials that consider realistic listening environments should be used in further studies to deep understand the nature of auditory scene analysis within various groups.

Efficacy of the Digit-in-Noise Test: A Systematic Review and Meta-Analysis

Kwak Chanbeom,Seo Jae-Hyun,Oh Yonghee,한우재 대한청각학회 2022 Journal of Audiology & Otology Vol.26 No.1

Background and Objectives: Although the digit-in-noise (DIN) test is simple and quick, little is known about its key factors. This study explored the considerable components of the DIN test through a systematic review and meta-analysis. Materials and Methods: After six electronic journal databases were screened, 14 studies were selected. For the meta-analysis, standardized mean difference was used to calculate effect sizes and 95% confidence intervals.Results: The overall result of the meta-analysis showed an effect size of 2.224. In a subgroup analysis, the patient’s hearing status was found to have the highest effect size, meaning that the DIN test was significantly sensitive to screen for hearing loss. In terms of the length of the presenting digits, triple digits had lower speech recognition thresholds (SRTs) than single or pairs of digits. Among the types of background noise, speech-spectrum noise provided lower SRTs than multi-talker babbling. Regarding language variance, the DIN test showed better performance in the patient’s native language(s) than in other languages.Conclusions: When uniformly developed and well validated, the DIN test can be a universal tool for hearing screening.

Comparison of Single-Task versus Dual-Task for Listening Effort

Kwak, Chanbeom,Han, Woojae The Korean Audiological Society and Korean Otologi 2018 Journal of Audiology & Otology Vol.22 No.2

<P><B>Background and Objectives</B></P><P>Depending on the kind of task and/or material, listeners sometimes need to pay attention to understand communication. The present study aimed to estimate a listener’s amount of effort needed to understand communication by using recognition score and response time as a function of signal-to-noise ratio (SNR) and to confirm his/ her task dependency for listening effort.</P><P><B>Subjects and Methods</B></P><P>Forty-eight young adults with normal hearing participated in the study. As stimuli, Korean Speech Perception in Noise test without a question tag and three consecutive digits were used for sentence recognition (or single-task) and arithmetic (or dual-task), respectively. Both tasks were measured in quiet and under four SNR (i.e., 0, -4, -8, -12 dB) conditions. Their outcomes were analyzed and compared in terms of percent correct and response time.</P><P><B>Results</B></P><P>Sentence recognition scores and arithmetic scores decreased as the level of noise increased. Response time for sentence recognition decreased as noise increased, whereas the response time for arithmetic increased as noise increased. In addition, there was a negative correlation between error percent and response time in the sentence recognition. Conversely, a positive correlation between error percent and response time appeared in the arithmetic test.</P><P><B>Conclusions</B></P><P>Listening effort showed a different pattern based on the kind of task, single vs. dual, while the dual-task required greater effort from the listener.</P>

Factors Influencing the Korean Version of the Digit-in-Noise Test

Kim Subin,Kwak Chanbeom,Han Woojae,Seo Jae-Hyun,Oh Yonghee 대한청각학회 2023 Journal of Audiology & Otology Vol.27 No.2

Background and Objectives: The digits-in-noise (DIN) test was developed as a simple and time-efficient hearing-in-noise test worldwide. The Korean version of the DIN (K-DIN) test was previously validated for both normal-hearing and hearing-impaired listeners. This study aimed to explore the factors influencing the outcomes of the K-DIN test further by analyzing the threshold (representing detection ability) and slope (representing test difficulty) parameters for the psychometric curve fit.Subjects and Methods: In total, 35 young adults with normal hearing participated in the K-DIN test under the following four experimental conditions: 1) background noise (digit-shaped vs. pink noise); 2) gender of the speaker (male vs. female); 3) ear side (right vs. left); and 4) digit presentation levels (55, 65, 75, and 85 dB). The digits were presented using the method of constant stimuli procedure. Participant responses to the stimulus trials were used to fit a psychometric function, and the threshold and slope parameters were estimated according to pre-determined criteria. The accuracy of fit performance was determined using the root-mean-square error calculation.Results: The listener’s digit detection ability (threshold) was slightly better with pink noise than with digit-shaped noise, with similar test difficulties (slopes) across the digits. Gender and the tested ear side influenced neither the detection ability nor the task difficulty. Additionally, lower presentation levels (55 and 65 dB) elicited better thresholds than the higher presentation levels (75 and 85 dB); however, the test difficulty varied slightly across the presentation levels.Conclusions: The K-DIN test can be influenced by stimulus factors. Continued research is warranted to understand the accuracy and reliability of the test better, especially for its use as a promising clinical measure.

Effect of Background Music for Attentive Concentration in Working

Sihun Park,Chanbeom Kwak,Woojae Han 한국청각언어재활학회 2020 Audiology and Speech Research Vol.16 No.3

Purpose: Recently, many young people have preferred to work in café than traditional library because the café is equipped with coffee, music, and cozy seats. When working in the café, whether listeners’ attentive concentration could be affected by a kind of the background music needs to be investigated as the purpose of the present study. We also aimed to confirm the attentive concentration of listeners might be caused by their music inclination. Methods: A total of ninety young adults was randomly assigned as five kinds of background music [e.g., rhythm and blues (R&B)/ballad, dance/rock, classic/jazz, fast beats, slow beats] and no music after responding to simple questions to ask their preference of music genre. While listening to the music, the subjects took an attentive concentration test, namely Frankfurter aufmerksamkeits-inventar (FAIR). The obtained data were analyzed by three subcategories of the FAIR test which consists of performance, quality, and continuity. Results: For the music genre, classic/jazz showed significantly higher continuity scores than R&B/ballad, fast beats, and no music, which means that classic/jazz music of the café could help the workers maintain the attention. In the subgroup who listened to preferred music genre, their performance scores (i.e., selective attention) was significantly higher than that of the participants who being exposed to non-preferred music. Conclusion: Current results supports that music genre and individual music inclination may partially affect listener’s ability of the attentive concentration when background music was presented in the café, although a further study to find certain possible causal factors with objective methods should be followed.

Update on Bone-Conduction Auditory Brainstem Responses: A Review

Seo, Young Joon,Kwak, Chanbeom,Kim, Saea,Park, Yoon Ah,Park, Kyoung Ho,Han, Woojae The Korean Audiological Society and Korean Otologi 2018 Journal of Audiology & Otology Vol.22 No.2

<P>Auditory brainstem responses (ABR) have been used as a powerful and the most common objective tool to evaluate hearing sensitivity and to diagnose the types of hearing loss and neurological disorders, through the auditory peripheral pathway to a central level of the brainstem, since 1971. Although bone-conduction (BC) ABR could be an alternative to air-conduction (AC) ABR, as the former overcomes some limitations of the latter, the majority of clinicians rarely utilize it due to a lack of knowledge and no routine test administration. This review presents the weaknesses of AC ABR that apply to all clinical population, and discusses the development of BC ABR. The optimal placements of bone oscillators to obtain favorable clinical outcomes in infants, children, and adults, and the appropriate stimuli for BC ABR are examined. While providing absolute thresholds and latencies of BC ABR based on previous studies compared to AC ABR, this review includes clinical data of infants and young children with both normal hearing in terms of maturation, and with pathology such as congenital external auditory canal atresia. We recommend the future clinical application of BC ABR for candidacy as well as for patients with BC hearing implants.</P>

소음성 난청의 효율적인 예방을 위한 첨도 측정법의 이해

유성화(Sunghwa You),곽찬범(Chanbeom Kwak),김세아(Saea Kim),이장원(Jangwon Lee),정승엽(Seungyeop Jeong),이은성(Eunsung Lee),송현욱(Hyunwook Song),Nour Alsabbagh,한우재(Woojae Han) 한국청각언어재활학회 2018 Audiology and Speech Research Vol.14 No.3

Purpose: In general, energy metrics, i.e., LAeq 8 hours, have been applied as a risk indicator of noise exposure. However, there are some limitations of LAeq measurement since it considers only the amount of average energy of noise and is not appropriate for measuring the complex noise. In light of this, the kurtosis metrics have been introduced by many contemporary researchers to be applied as an alternative measure. Methods: In the main body, we introduced the weakness of current noise exposure criteria, compared between Gaussian and non-Gaussian noise, briefly explained the concepts of kurtosis metrics, and scrutinized more applications of the kurtosis metrics by summarizing previous 7 research papers. Results: Compare to the Gaussian noise, the non-Gaussian noise has been found to have stronger cochlear damage effects on the outer and inner hair cells and led to permanent hearing loss in the higher frequencies. Noise exposure trauma levels were dramatically increased as the kurtosis levels increased. Although kurtosis metrics are a good indicator or measure, it still need to be adjusted in terms of frequency-specificity. Conclusion: Since the kurtosis metrics are not implemented in Korea, especially in the industrial field, we need to develop a new measurement approach using the kurtosis metrics on workers and then provide scientific based criteria for effectively preventing their potential risk of developing noise-induced hearing loss.

Effects of Natural Versus Synthetic Consonant and Vowel Stimuli on Cortical Auditory-Evoked Potential

Song Hyunwook,Jeon Seungik,Shin Yerim,한우재,Kim Saea,Kwak Chanbeom,Lee Eunsung,Kim Jinsook 대한청각학회 2022 Journal of Audiology & Otology Vol.26 No.2

Background and Objectives: Natural and synthetic speech signals effectively stimulate cortical auditory evoked potential (CAEP). This study aimed to select the speech materials for CAEP and identify CAEP waveforms according to gender of speaker (GS) and gender of listener (GL).Subjects and Methods: Two experiments including a comparison of natural and synthetic stimuli and CAEP measurement were performed of 21 young announcers and 40 young adults. Plosive /g/ and /b/ and aspirated plosive /k/ and /p/ were combined to /a/. Six bisyllables–/ga/-/ka/, /ga/-/ba/, /ga/-/pa/, /ka/-/ba/, /ka/-/pa/, and /ba/-/pa/–were formulated as tentative forwarding and backwarding orders. In the natural and synthetic stimulation mode (SM) according to GS, /ka/ and /pa/ were selected through the first experiment used for CAEP measurement.Results: The correction rate differences were largest (74%) at /ka/-/ pa/ and /pa/-/ka/; thus, they were selected as stimulation materals for CAEP measurement. The SM showed shorter latency with P2 and N1-P2 with natural stimulation and N2 with synthetic stimulation. The P2 amplitude was larger with natural stimulation. The SD showed significantly larger amplitude for P2 and N1-P2 with /pa/. The GS showed shorter latency for P2, N2, and N1-P2 and larger amplitude for N2 with female speakers. The GL showed shorter latency for N2 and N1-P2 and larger amplitude for N2 with female listeners.Conclusions: Although several variables showed significance for N2, P2, and N1-P2, P1 and N1 did not show any significance for any variables. N2 and P2 of CAEP seemed affected by endogenous factors.