Publications by authors named "Ville Sivonen"

15 Publications

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Simultaneous bilateral stapes surgery after follow-up of 13 years.

Acta Otolaryngol 2021 Jan 12;141(1):39-42. Epub 2020 Oct 12.

Department of Otorhinolaryngology - Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.

Background: Eighteen patients underwent simultaneous bilateral stapes surgery in 2003-2006.

Objectives: We evaluated the long-term outcomes in this patient group, and assessed their hearing in noise and binaural hearing.

Material And Methods: Fifteen patients returned questionnaires concerning their hearing, taste function, and balance. Thirteen patients underwent pure-tone and speech audiogram, Finnish matrix sentence test, video head impulse test, and clinical examination on average 13 years after surgery.

Results: We found no significant difference in air- and bone conduction pure-tone average, speech audiometry, and the air-bone gap between the 1-year and the late postoperative visits. One patient had bilaterally a partial loss of the vestibulo-ocular reflex of unknown cause.

Conclusions And Significance: The hearing results 13 years after simultaneous bilateral stapes surgery remained good without any significant delayed complications. Simultaneous bilateral stapes surgery is a viable treatment option in selected patients with otosclerosis.
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http://dx.doi.org/10.1080/00016489.2020.1828621DOI Listing
January 2021

An exploratory investigation of speech recognition thresholds in noise with auralisations of two reverberant rooms.

Int J Audiol 2020 Sep 23:1-10. Epub 2020 Sep 23.

Aalto Acoustics Lab, Department of Signal Processing and Acoustics, Aalto University, Espoo, Finland.

Objective: Speech-in-noise tests are widely used in hearing diagnostics but typically without reverberation, although reverberation is an inextricable part of everyday listening conditions. To support the development of more real-life-like test paradigms, the objective of this study was to explore how spatially reproduced reverberation affects speech recognition thresholds in normal-hearing and hearing-impaired listeners.

Design: Thresholds were measured with a Finnish speech-in-noise test without reverberation and with two test conditions with reverberation times of ∼0.9 and 1.8 s. Reverberant conditions were produced with a multichannel auralisation technique not used before in this context.

Study Sample: Thirty-four normal-hearing and 14 hearing-impaired listeners participated in this study. Five people were tested with and without hearing aids.

Results: No significant differences between test conditions were found for the normal-hearing listeners. Results for the hearing-impaired listeners indicated better performance for the 0.9 s reverberation time compared to the reference and the 1.8 s conditions. Benefit from hearing aid use varied between individuals; for one person, an advantage was observed only with reverberation.

Conclusions: Auralisations may offer information on speech recognition performance that is not obtained with a test without reverberation. However, more complex stimuli and/or higher signal-to-noise ratios should be used in the future.
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http://dx.doi.org/10.1080/14992027.2020.1817993DOI Listing
September 2020

The long-term learning effect related to the repeated use of the Finnish matrix sentence test and the Finnish digit triplet test.

Int J Audiol 2020 Oct 27;59(10):753-762. Epub 2020 Apr 27.

Department of Otorhinolaryngology, Kuopio University Hospital, Kuopio, Finland.

To assess are there learning-related improvements in the speech reception thresholds (SRTs) for the Finnish matrix sentence test (FMST) and the Finnish digit triplet test (FDTT) in repeated use over 12 months. Test sessions were scheduled at 0, 1, 3, 6 and 12 months, and each session included five FMST measurements and four FDTT measurements. The within-session and inter-session improvements in SRTs were analysed with a linear mixed model. Fifteen young normal-hearing participants. Statistically significant mean improvements of 2.0 dB SNR and 1.2 dB SNR were detected for the FMST and the FDTT, respectively, over the 12-month follow-up period. For the FMST, majority of the improvement occurred during the first two test sessions. For the FDTT, statistically significant differences were detected only in comparison to the first test session and to the first test measurement of every session over the 12-month follow-up. Repeated use of the FMST led to significant learning-related improvements, but the improvements appeared to plateau by the third test session. For the FDTT, the overall improvements were smaller, but a significant within-session difference between the first and consecutive FDTT measurements persisted throughout the test sessions.
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http://dx.doi.org/10.1080/14992027.2020.1753893DOI Listing
October 2020

The Finnish simplified matrix sentence test for the assessment of speech intelligibility in the elderly.

Int J Audiol 2020 Oct 18;59(10):763-771. Epub 2020 Mar 18.

Department of Otorhinolaryngology, Kuopio University Hospital, Finland.

A simplified version of the Finnish matrix sentence test (FMST) was developed to improve the reliability of hearing diagnostic for children and for patients with limited working memory capacity and/or vocabulary. Study 1 evaluated the word matrix of the Finnish simplified matrix sentence test (FINSIMAT) to rule out systematic differences between the new FINSIMAT test lists, and to provide reference values for normal-hearing (NH) young adults (YA). In Study 2, the FINSIMAT and the FMST were evaluated in elderly listeners with mild-to-moderate hearing impairment (HI). Twenty NH YAs participated in Study 1, and 16 elderly HI adults participated in Study 2. For NH YAs, the reference speech reception threshold (SRT) estimate and the slope for the FINSIMAT were -11.2 ± 1.0 dB signal-to-noise ratio (SNR) and 19.4 ± 1.9%/dB SNR. For the elderly HI listeners, the mean SRT estimates for the FINSIMAT and FMST were -4.1 and -3.6 dB SNR, respectively. The correlation between the FMST and FINSIMAT results was strong (r = 0.78,  < 0.001). The FINSIMAT showed comparable characteristics to the FMST and proved feasible for measurements in elderly HI listeners.
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http://dx.doi.org/10.1080/14992027.2020.1741704DOI Listing
October 2020

The efficacy of microphone directionality in improving speech recognition in noise for three commercial cochlear-implant systems.

Cochlear Implants Int 2020 05 11;21(3):153-159. Epub 2020 Mar 11.

Department of Otorhinolaryngology, Kuopio University Hospital, Kuopio, Finland.

To investigate the effect of fixed and adaptive microphone directionality on speech reception threshold (SRT) in noise when compared to omnidirectional mode in unilateral cochlear-implant (CI) use for three different CI systems. Twenty-four CI recipients with bilateral severe-to-profound hearing loss participated in the study. Eight recipients of each CI system were enrolled, and their SRT in noise was measured when the speech and noise signals were co-located in the front to serve as a baseline. The acute effect of different microphone directionalities on SRT in noise was measured with the noise emanating at 90° in the horizontal plane from the side of the CI sound processor (S0NCI). When compared to the baseline condition, the individual data revealed fairly similar patterns within each CI system. In the S0NCI condition, the average improvement in SRT in noise for fixed and adaptive directionalities over the omnidirectional mode was statistically significant and ranged from 1.2 to 6.0 dB SNR and from 3.7 to 12.7 dB SNR depending on the CI system, respectively. Directional microphones significantly improve SRT in noise for all three CI systems. However, relatively large differences were observed in the directional microphone efficacy between CI systems.
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http://dx.doi.org/10.1080/14670100.2019.1701236DOI Listing
May 2020

Impact noise of prostate biopsy devices.

Scand J Urol 2020 Apr 5;54(2):175-178. Epub 2020 Feb 5.

Department, of Otorhinolaryngology, Helsinki University Hospital, Helsinki, Finland.

To analyse the impact noise generated by prostate biopsy devices. In a laboratory setting, repeated impact noise was recorded at distances of 50 cm and 100 cm using five brands of device on chicken meat, an apple and an empty target. In a clinical setting, the impact noise levels of prostate biopsy devices were recorded in 40 real patient cases using three brands of device. In the laboratory setting, the average SPL (sound pressure level) peak level ranged from 104.3 to 121.3 dB. The highest impact noise levels were measured with the Monopty device, ranging from 114.8 to 122.4 dB. In the clinical setting, there were no statistical differences between repeated SPL values for each specific target. Also, the noise levels were equal when the same device brand was used at 50 cm and 100 cm. The highest SPLs were recorded with the Monopty device, which ranged from 110 to 127 dB. The corresponding values for the Max-Core and Multicore were from 106 to 122.5 dB and from 108 to 116.5 dB, respectively. Biopsy devices generate high peak levels of impact noise. Personnel performing biopsies are advised to consider using hearing protection, even though the impact noise may not induce permanent hearing loss.
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http://dx.doi.org/10.1080/21681805.2020.1716068DOI Listing
April 2020

Hybrid cochlear implantation: quality of life, quality of hearing, and working performance compared to patients with conventional unilateral or bilateral cochlear implantation.

Eur Arch Otorhinolaryngol 2017 Oct 31;274(10):3599-3604. Epub 2017 Jul 31.

Department of Ear and Oral Diseases, Tampere University Hospital, P.O. Box 2000, 33521, Tampere, Finland.

The objective of the present study is to evaluate the effect of hybrid cochlear implantation (hCI) on quality of life (QoL), quality of hearing (QoH), and working performance in adult patients, and to compare the long-term results of patients with hCI to those of patients with conventional unilateral cochlear implantation (CI), bilateral CI, and single-sided deafness (SSD) with CI. Sound localization accuracy and speech-in-noise test were also compared between these groups. Eight patients with high-frequency sensorineural hearing loss of unknown etiology were selected in the study. Patients with hCI had better long-term speech perception in noise than uni- or bilateral CI patients, but the difference was not statistically significant. The sound localization accuracy was equal in the hCI, bilateral CI, and SSD patients. QoH was statistically significantly better in bilateral CI patients than in the others. In hCI patients, residual hearing was preserved in all patients after the surgery. During the 3.6-year follow-up, the mean hearing threshold at 125-500 Hz decreased on average by 15 dB HL in the implanted ear. QoL and working performance improved significantly in all CI patients. Hearing outcomes with hCI are comparable to the results of bilateral CI or CI with SSD, but hearing in noise and sound localization are statistically significantly better than with unilateral CI. Interestingly, the impact of CI on QoL, QoH, and working performance was similar in all groups.
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http://dx.doi.org/10.1007/s00405-017-4690-9DOI Listing
October 2017

The development and evaluation of the Finnish digit triplet test.

Acta Otolaryngol 2016 Oct 28;136(10):1035-40. Epub 2016 Apr 28.

a Department of Otorhinolaryngology , Kuopio University Hospital , Kuopio , Finland ;

Objectives: The aim of the study was to develop a reliable and easily accessible screening test for primary detection of hearing impairment.

Methods: Digits 0-9 were used to form quasirandom digit triplets. First, digit specific intelligibility functions and speech recognition thresholds (SRTs) were determined. To homogenize the test material digits with steep intelligibility function slopes were chosen and level correction up to ±2 dB were applied to the digits as needed. Evaluation measurements were performed to check for systematic differences in intelligibility between the test lists and to obtain normative reference function for normal-hearing listeners.

Results: The mean SRT and the final slope of the test lists were -10.8 ± 0.1 dB signal-to-noise ratio (SNR) and 21.7 ± 1.8%/dB, respectively (measurements at constant level; inter-list variability). The mean SRT and slope of the test subjects were -10.8 ± 0.5 dB SNR and 23.4 ± 5.2%/dB (measurements at constant level; inter-subject variability). The mean SRT for normal-hearing young adults for a single adaptive measurement is -9.8 ± 0.9 dB SNR.

Conclusion: The Finnish digit triplet test is the first self-screening hearing test in the Finnish language. It was developed according to current standards, and it provides reliable and internationally comparable speech intelligibility measurements.
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http://dx.doi.org/10.1080/00016489.2016.1175662DOI Listing
October 2016

Single-Sided Deafness: The Effect of Cochlear Implantation on Quality of Life, Quality of Hearing, and Working Performance.

ORL J Otorhinolaryngol Relat Spec 2015 30;77(6):339-45. Epub 2015 Sep 30.

Department of Otorhinolaryngology, Tampere University Hospital, University of Tampere, Tampere, Finland.

Aims: To evaluate the effect of a cochlear implant (CI) on quality of life (QoL), quality of hearing (QoH), and working performance in patients with single-sided deafness (SSD).

Methods: Using specific questionnaires, we measured QoL, QoH, and working performance in 7 SSD patients scheduled for CI surgery of the affected ear. Sound localization and speech perception in noise were also assessed. All questionnaires and tests were performed before the CI surgery and at 6 and 12 months after CI activation.

Results: The QoL, QoH, sound localization, and speech perception in noise had improved statistically significantly after CI surgery. Communication with co-workers became easier, and the patients were less fatigued after the working day.

Conclusions: CI clearly improves QoL, QoH, and working performance in patients with SSD.
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http://dx.doi.org/10.1159/000439176DOI Listing
September 2016

Characteristics and international comparability of the Finnish matrix sentence test in cochlear implant recipients.

Int J Audiol 2015 28;54 Suppl 2:80-7. Epub 2015 Aug 28.

b HörTech gGmbH , Oldenburg , Germany.

Objectives: The first Finnish sentence-based speech test in noise--the Finnish matrix sentence test--was recently developed. The aim of this study was to determine the characteristics of the new test with respect to test-retest reliability, speech recognition curve, and international comparability in Finnish cochlear implant (CI) recipients.

Design: The speech reception thresholds (SRT) were measured by means of an adaptive test procedure and compared with the results of the traditional Finnish word test. Additional measurements for concurrent slope and SRT estimation were conducted to determine the speech recognition curve and to check the test-retest reliability.

Study Sample: The measurements were performed on 78 Finnish CI recipients. In a subset of 25 patients, additional measurements for test-retest reliability and slope determination were performed.

Results: The mean SRT was -3.5 ± 1.7 dB SNR, with only a weak correlation with the Finnish word test. Test-retest reliability was within ± 1 dB and the mean slope of the speech recognition curve was 14.6 ± 3.6 %/dB. The rehabilitation results were similar to the results published for the German matrix test.

Conclusions: The Finnish matrix test was found to be suitable and efficient in CI recipients with similar characteristics as the German matrix test.
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http://dx.doi.org/10.3109/14992027.2015.1070309DOI Listing
September 2016

Sequential bilateral cochlear implantation improves working performance, quality of life, and quality of hearing.

Acta Otolaryngol 2015 May 13;135(5):440-6. Epub 2015 Feb 13.

Department of Otorhinolaryngology, Tampere University Hospital and the University of Tampere , Tampere.

Conclusions: This prospective study shows that working performance, quality of life (QoL), and quality of hearing (QoH) are better with two compared with a single cochlear implant (CI). The impact of the second CI on the patient's QoL is as significant as the impact of the first CI.

Objectives: To evaluate the benefits of sequential bilateral cochlear implantation in working, QoL, and QoH.

Methods: We studied working performance, work-related stress, QoL, and QoH with specific questionnaires in 15 patients with unilateral CI scheduled for sequential CI of another ear. Sound localization performance and speech perception in noise were measured with specific tests. All questionnaires and tests were performed before the second CI surgery and 6 and 12 months after its activation.

Results: Bilateral CIs increased patients' working performance and their work-related stress and fatigue decreased. Communication with co-workers was easier and patients were more active in their working environment. Sequential bilateral cochlear implantation improved QoL, QoH, sound localization, and speech perception in noise statistically significantly.
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http://dx.doi.org/10.3109/00016489.2014.990056DOI Listing
May 2015

Binaural directivity patterns for normal and aided human hearing.

Authors:
Ville P Sivonen

Ear Hear 2011 Sep-Oct;32(5):674-7

Department of Signal Processing and Acoustics, School of Science and Technology, Aalto University, Espoo, Finland.

Objective: The aim of this brief report was to investigate binaural directivity patterns for normal and aided hearing, as opposed to conventional monaural measures.

Design: Head-related transfer functions for an artificial head measured at the entrance to the ear canal and above the pinnae and a binaural loudness model for directional sounds were used to estimate binaural directivity patterns for normal human hearing and behind-the-ear (BTE) hearing devices in the horizontal plane.

Results: The results show that binaural directivity patterns are smoother than the corresponding monaural patterns, and that there are clear frequency-dependent differences in binaural directivity between the two measurement positions.

Conclusion: The data can be used in the signal processing of BTE hearing aid systems to mimic the binaural directivity of normal, unoccluded ears.
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http://dx.doi.org/10.1097/AUD.0b013e31821a481fDOI Listing
January 2012

Vowel confusion patterns in adults during initial 4 years of implant use.

Clin Linguist Phon 2011 Feb 11;25(2):121-44. Epub 2010 Nov 11.

Faculty of Humanities, Logopedics, and Department of Otorhinolaryngology. Oulu University Hospital, University of Oulu, Finland.

This study investigated adult cochlear implant users' (n = 39) vowel recognition and confusions by an open-set syllable test during 4 years of implant use, in a prospective repeated-measures design. Subjects' responses were coded for phoneme errors and estimated by the generalized mixed model. Improvement in overall vowel recognition was highest during the first 6 months, showing statistically significant change until 4 years, especially for the mediocre performers. The best performers improved statistically significantly until 18 months. The poorest performers improved until 12 months and exhibited more vowel confusions. No differences were found in overall vowel recognition between Nucleus24M/24R and Med-ElC40+ device users (matched comparison), but certain vowels showed statistically significant differences. Vowel confusions between adjacent vowels were evident, probably due to the implant users' inability to discriminate formant frequencies. Vowel confusions were also dominated by vowels whose average F1 and/or F2 frequencies were higher than the target vowel, indicating a basalward shift in the confusions.
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http://dx.doi.org/10.3109/02699206.2010.514692DOI Listing
February 2011

Directional loudness and binaural summation for wideband and reverberant sounds.

J Acoust Soc Am 2007 May;121(5 Pt1):2852-61

Department of Otorhinolaryngology, University Hospital of Oulu, P.O. Box 22, 90029 OYS, Finland.

In an earlier investigation [Sivonen and Ellermeier, J. Acoust. Soc. Am. 119, 2965-2980 (2006)], the effect of sound incidence angle on loudness was investigated for anechoic, narrowband sounds. In the present follow-up investigation, the effect of incidence angle on loudness was investigated using wideband sounds under anechoic conditions and narrowband sounds under reverberant conditions. Five listeners matched the loudness of a sound coming from five incidence angles in the horizontal plane to that of the same sound with frontal incidence. These directional loudness matches were obtained with an adaptive, two-alternative, two-interval, forced-choice procedure. The stimuli were presented to the listeners via individual binaural synthesis. The results show that loudness depends on sound incidence angle in both experiments. The wideband and reverberant sounds, however, yielded significantly smaller directional effects than had been obtained for the same listeners when anechoic, narrowband sounds were used. When modeling the binaural summation underlying the loudness matches, a power summation of the at-ear signals yielded good predictions for all types of stimuli investigated.
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http://dx.doi.org/10.1121/1.2717497DOI Listing
May 2007

Directional loudness in an anechoic sound field, head-related transfer functions, and binaural summation.

J Acoust Soc Am 2006 May;119(5 Pt 1):2965-80

Sound Quality Research Unit (SQRU), Department of Acoustics, Aalborg University, Fredrik Bajers Vej 7 B5, 9220 Aalborg East, Denmark.

The effect of sound incidence angle on loudness was investigated using real sound sources positioned in an anechoic chamber. Eight normal-hearing listeners produced loudness matches between a frontal reference location and seven sources placed at other directions, both in the horizontal and median planes. Matches were obtained via a two-interval, adaptive forced-choice (2AFC) procedure for three center frequencies (0.4, 1, and 5 kHz) and two overall levels (45 and 65 dB SPL). The results showed that loudness is not constant over sound incidence angles, with directional sensitivity varying over a range of up to 10 dB, exhibiting considerable frequency dependence, but only minor effects of overall level. The pattern of results varied substantially between subjects, but was largely accounted for by variations in individual head-related transfer functions. Modeling of binaural loudness based on the at-ear signals favored a sound-power summation model, according to which the maximum binaural gain is only 3 dB, over competing models based on larger gains, or on the summation of monaural loudness indices.
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http://dx.doi.org/10.1121/1.2184268DOI Listing
May 2006