SLPOtherEar and hearing2020

The Association Between Physiological Noise Levels and Speech Understanding in Noise.

Samantha Stiepan, Jonathan Siegel, Jungwha Lee and 2 others

PMID 31261213

WHAT IT FOUND

In 921 people with normal hearing, higher physiological noise floors in low and mid frequencies measured by otoacoustic emissions were associated with worse speech-in-noise scores; 28.7% had mild or worse difficulty despite normal audiograms.

Key findings

01Higher physiological noise floors between 0.75 and 4 kHz were associated with worse speech-in-noise scores, accounting for about 8% of score variability.

02Although all participants had audiometrically normal hearing, 28.7% had mild or worse speech-in-noise loss, defined as more than 3 dB SNR loss.

03High-frequency DPOAE levels between 12.5 and 16 kHz explained 1.7% of score variability in the unadjusted model, but the association was not significant after age adjustment.

STILL TO COME

How it was doneWhat they foundWhat it means for SLPs

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What it does not show

The study was retrospective and used data collected for another purpose, so it can show association but not cause. The sample had audiometrically normal hearing and only the better ear was tested, so the findings do not apply to people with hearing loss or to poorer ears. The models accounted for only a small share of speech-in-noise score variability. The authors could not readily assess linguistic, cognitive, or central processing factors that may also affect speech-in-noise performance. Otoacoustic emission noise-floor reporting varies between implementations and depends on the acoustic environment, so the measure is not straightforward to use clinically. The poorer performers showed higher otoacoustic emission levels, a paradoxical finding that the paper does not explain.

The easy way to misread this

Do not conclude that higher physiological noise causes speech-in-noise difficulty or that otoacoustic emission noise floors can be used clinically to explain a patient's problem. This was a retrospective association study, the noise-floor component accounted for about 8% of score variability, and the authors said current noise-floor reporting varies and is environment-dependent.

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