Epperson Madison V, Abdulrazzak Obada, Jones Gerilyn, Ibrahim Nadine I, Banakis Hartl Renee M
Department of Otolaryngology-Head & Neck Surgery, University of Michigan, Ann Arbor, Michigan, USA.
University of Arizona College of Medicine, Phoenix, Arizona, USA.
Laryngoscope. 2025 Aug 11. doi: 10.1002/lary.70034.
Individuals with single-sided deafness (SSD) may develop adaptive listening strategies with head movement patterns to optimize monaural localization and speech-in-noise understanding. Granular understanding of adaptive behaviors may better inform rehabilitation for SSD. We aimed to characterize head movements during a combined localization and speech-in-noise task to understand how adaptive behaviors emerge.
Prospective study from a tertiary referral center with 16 subjects with normal hearing (NH) and 15 SSD subjects. Sentences were played in a semi-anechoic chamber from one of 24 speakers in a 360° azimuthal configuration with a variable signal-to-noise ratio. Head position was captured via an electromagnetic tracking system. NH subjects completed the task twice, once with a deeply-seated earplug and supra-aural earmuff to simulate acute unilateral hearing loss and once unoccluded. Outcome measures included localization accuracy (mean absolute error, slope across targets), head movement (onset delay, total response time, total head displacement), and speech-in-noise performance.
Unoccluded NH subjects displayed accurate localization, minimal movement delay, rapid response time, low total head displacement, and high speech-in-noise percent correct compared to the occluded condition and SSD subjects. Localization accuracy and SIN performance were comparable between NH occluded and SSD; however, the groups had distinct head movement patterns.
Acute unilateral hearing loss leads to sharp declines in localization accuracy and speech-in-noise performance. In SSD, difficult listening conditions may prompt the development of distinct head movement patterns over time. This work provides key initial insight into adaptive listening strategies that individuals with SSD may acquire and utilize in complex listening environments.
单侧耳聋（SSD）患者可能会通过头部运动模式形成适应性听力策略，以优化单耳定位和噪声环境下的言语理解。对适应性行为的细致了解可为SSD的康复提供更好的指导。我们旨在描述在定位和噪声环境下言语任务相结合时的头部运动，以了解适应性行为是如何出现的。
在一家三级转诊中心进行的前瞻性研究，纳入16名听力正常（NH）的受试者和15名SSD受试者。在半消声室内，从24个扬声器中的一个以360°方位配置播放句子，信号噪声比可变。通过电磁跟踪系统记录头部位置。NH受试者完成任务两次，一次佩戴深插入式耳塞和耳罩以模拟急性单侧听力损失，一次不佩戴。观察指标包括定位准确性（平均绝对误差、跨目标斜率）、头部运动（起始延迟、总反应时间、总头部位移）和噪声环境下的言语表现。
与佩戴耳塞和SSD受试者相比，未佩戴耳塞的NH受试者表现出准确的定位、最小的运动延迟、快速的反应时间、低总头部位移和高噪声环境下言语正确百分比。NH佩戴耳塞组和SSD组的定位准确性和噪声环境下言语表现相当；然而，两组有不同的头部运动模式。
急性单侧听力损失会导致定位准确性和噪声环境下言语表现急剧下降。在SSD患者中，困难的听力条件可能会随着时间的推移促使形成不同的头部运动模式。这项工作为SSD患者在复杂听力环境中可能获得和利用的适应性听力策略提供了关键的初步见解。
