The Association Between Physiological Noise Levels and Speech Understanding in Noise

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by Stiepan, Samantha; Siegel, Jonathan; Lee, Jungwha; Souza, Pamela; Dhar, Sumitrajit via Ear and Hearing - Published Ahead-of-Print

Objectives: Traditionally, elevated hearing thresholds have been considered to be the main contributors to difficulty understanding speech in noise; yet, patients will often report difficulties with speech understanding in noise despite having audiometrically normal hearing. The purpose of this cross-sectional study was to critically evaluate the relationship of various metrics of auditory function (behavioral thresholds and otoacoustic emissions) on speech understanding in noise in a large sample of audiometrically normal-hearing individuals. Design: Behavioral hearing thresholds, distortion product otoacoustic emission (DPOAE) levels, stimulus-frequency otoacoustic emission levels, and physiological noise (quantified using OAE noise floors) were measured from 921 individuals between 10 and 68 years of age with normal pure-tone averages. The quick speech-in-noise (QuickSIN) test outcome, quantified as the signal-to-noise ratio (SNR) loss, was used as the metric of speech understanding in noise. Principle component analysis (PCA) and linear regression modeling were used to evaluate the relationship between the measures of auditory function and speech in noise performance. Results: Over 25% of participants exhibited mild or worse degree of SNR loss. PCA revealed DPOAE levels at 12.5 to 16 kHz to be significantly correlated with the variation in QuickSIN scores, although correlations were weak (R2 = 0.017). Out of all the metrics evaluated, higher levels of self-generated physiological noise accounted for the most variance in QuickSIN performance (R2 = 0.077). Conclusions: Higher levels of physiological noise were associated with worse QuickSIN performance in listeners with normal hearing sensitivity. We propose that elevated physiological noise levels in poorer speech in noise performers could diminish the effective SNR, thereby negatively impacting performance as seen by poorer QuickSIN scores. ACKNOWLEDGMENTS: The authors thank Drs. Uzma Wilson, Niall Klyn, Courtney Glavin, Jungmee Lee, Gayla Poling, and Ms. Vickie Hellyer along with many other collaborators for assistance with recruitment, data collection, and analysis. This work was supported by NIH/NIDCD grants no. R01DC008420 (to S. D. and J. S.) and Northwestern University. The authors have no conflicts of interest to disclose. Received May 11, 2018; accepted May 3, 2019. Address for correspondence: Samantha Stiepan, Northwestern University, Room 1–246, Francis Searle Building, 2240 Campus Drive, Evanston, IL 60208, USA. E-mail: smstiepan@u.northwestern.edu Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.