University Hospital for Hearing, Speech & Voice Disorders

301401, 302023, 302027, 302029, 302042, 302044

Audiometry, dysphagia, hearing disorders, hearing implants, hearing rehabilitation, neuroscience of language, paediatric audiology, speech & language disorders, swallowing disorders, and voice disorders

Artificial intelligence in audiology, hearing implant programming, hearing rehabilitation, neural correlates of speech comprehension, sound source localisation, speech & language acquisition, swallowing disorders

The University Hospital for Hearing, Speech and Voice Disorders (HSV) is Austria’s largest institution in the fields of clinical audiology, paediatric audiology and phoniatrics. It offers a comprehensive range of clinical services for the diagnosis and treatment of hearing, voice, swallowing and speech disorders and learning disorders in children. – The Hospital’s research facilities include the Psychoacoustic Laboratory and the Cognitive Neuroscience Laboratory. The Psychoacoustic Laboratory is equipped with an anechoic chamber for high-precision acoustic measurements in which human hearing functions can be assessed under very specific conditions. In the Cognitive Neuroscience Laboratory, neural processes underlying language acquisition in adults and children are investigated using specific methods, including electroencephalography (EEG), functional near-infrared spectroscopy (fNIRS) and magnetic resonance imaging (MRI). At the national level, the Hospital is the driving force behind the Austrian Universal Newborn Hearing Screening program. In addition to clinical care and scientific research, the education and training of medical students and speech therapy students is a major task of the HSV Hospital.

Voice and Swallowing in Ectodermal Dysplasia

Simone Graf, Leyla Pinggera, Philipp Zelger (in cooperation with Erlangen University Hospital) 

Based on the results of the University Hospital Erlangen from 2018 on voice abnormalities in ectodermal dysplasia (ED), this follow-up study envisages a systematic investigation, including subjective and objective assessment of the voice and swallowing, of patients with ED. Through inclusion of a larger patient sample as well as through detailed measurements and swallowing examinations, the study aims to gain further insights into the origin of the voice abnormalities in ED and to draw conclusions about the effects of ED on the act of swallowing.

Artificial Intelligence (AI) in Acoustic Dysphagia Diagnostics

Simone Graf, Hazem Salloum, Philipp Zelger (in cooperation with TU Munich)

The aim of this study is to investigate the efficacy of an AI-based algorithm for detecting swallowing disorders based on the analysis of sounds produced during swallowing. For this purpose, video endoscopic evaluation of the swallowing act (FEES) is applied simultaneously with the recording of swallowing sounds obtained through cervical auscultation. The recorded sounds are analysed with the support of AI methods. Finally, the results of the AI-based distinction between sound and abnormal swallowing are compared to the findings with the FEES.

Effect of additional osteopathic treatment in the therapy of functional dysphonia

Elisabeth Aggstein-Blassnigg

Functional dysphonia is mostly due to a functional imbalance of the muscles involved in voice production and is commonly treated with speech therapy. This study examines whether the therapeutic efficacy of speech therapy can be increased by additional osteopathic treatment, through which tensions or blockages in the neck, throat and jaw area are released. To this end, voice outcomes of patients who underwent solely speech therapy are compared with those of patients who received additional osteopathic treatment.

Chewing ability after radio- (chemo) therapy

Simone Graf, Hazem Salloum, Daniel Blümel, Philipp Zelger (in cooperation with Health University of Applied Sciences Tyrol)

Radio(-chemo) therapy in the head-neck area can have devastating long-term effects on swallowing. In this study, the Test of Masticating and Swallowing Solids (TOMASS) is used to assess the ability to chew and swallow solid foods in patients who underwent radio(-chemo)therapy and to compare the findings to the normative data of a healthy population. In addition, the effect of radio(-chemo)therapy on gender-specific differences in chewing ability shown in the normative data is examined.

Frequency compression study in SAMBA 2 users

Philipp Zelger, Viktor Koci, Josef Seebacher

Frequency compression is a proven feature in hearing aids. With the SAMBA 2 audio processor of the VIBRANT SOUNDBRIDGE, frequency compression is now also implemented in middle ear implants. When conventional amplification of high frequency sounds (such as consonants) is no longer sufficient to make them audible to the hearing aid user, it can be helpful to compress this frequency into a lower range that is better audible for the patient. The aim of this study is to evaluate the audiological and subjective results of frequency compression in middle ear implant users.

The effect of desynchronized electrical stimulation on speech understanding in noise and directional hearing in patients with bilateral cochlear implants

Josef Seebacher, Philipp Zelger

The latest generation of Cochlear Implant (CI) audio processors offers the possibility of delaying the sequence of the electrical stimulation of the auditory nerve to some extent. This allows the researcher to experimentally desynchronise the electrical stimulation in bilateral CI users. This study investigates the effect of desynchronization of signals on speech understanding in noise and on spatial hearing in bilateral CI users.

Measurement of sound source localization in children: how to deal with measurement errors due to head movements

Philipp Zelger, Franz Muigg, Elisabeth Zangerl

Assessment of sound source localization in the free field requires the patient to keep his/ her head in a stable position throughout the examination – a requirement that young children are often unable to meet. However, head movements change the angle at which an external sound is perceived. Since the reliability of sound source localization depends on this angle, head movements can affect the measurement results. This study investigates a new approach to solve this problem: head movements are recorded by a webcam and the deviation of the head from the zero point is corrected by certain mathematical manipulations of the localization measures (see Figure 1).

Hearing Screening for Adults (the Inn.Health study on vascular health)

Josef Seebacher, Simone Graf, Franz Muigg (on behalf of HSV)

As the worldwide prevalence of hearing loss increases, the WHO recommends that hearing screening in adults aged 50 and more, be implemented as a part of a general health examination. However, there is currently no established method for hearing screening in adults. – In our study, a sample of 1000 adults recruited randomly from the Tyrolean population will be screened for hearing loss. The goal of the study is one the one hand to determine the prevalence of hearing disorders in different age groups of the population and on the other hand to test the feasibility of hearing screening in adults. The study is part of a larger study on vascular health named Inn.Health study and is performed in cooperation with various other Tyrolian health care institutions.

Outcome of hearing rehabilitation with a hearing implant

Viktor Weichbold, Franz Muigg

Within this research project, several studies investigated whether the outcome of hearing rehabilitation through a cochlear implant (CI) is influenced by variables like personality traits or social support. Regarding the former, no effects of personality on CI outcome were detected, but it was found that CI candidates had significantly lower levels of the personality trait Openness-to-experience than have normal hearing individuals. A five-year follow-up study of these patients showed that, despite hearing rehabilitation with a CI, Openness-to-experience remained at a significantly lowered level. Regarding social support, we found that high levels of social support are significantly associated with higher benefit from the CI.

Auditory processing disorders

Viktor Weichbold, Franz Muigg

In auditory processing disorder (APD), peripheral hearing is normal, but the central auditory system has difficulty processing auditory information. Clinical symptoms that are supposed to result from this disorder include poor auditory memory, inability to focus attention on hearing, reduced ability to localize sound sources, inability to distinguish small frequency differences, and difficulty understanding speech in background noise. Although these symptoms are indeed common in children, it is not yet clear whether and to what extent they are actually due to APD. The aim of this research project is to clarify this question.

Neural correlates of language development during infancy

Sonja Rossi, Isabella Thurner, Annika Rackl

Language acquisition is subject to several developmental steps. Behaviourally and clinically, we can assess for example the growth of vocabulary and the start of two-word-sentences. However, infants understand even more features of language before they actually start speaking on their own. We try to evaluate which speech perception abilities infants show during early infancy. We use neuroscientific measures to assess brain activity, the recruitment of different brain regions and the timing of neural processes in the brain. Electroencephalography (EEG) and functional near-infrared spectroscopy (fNIRS), both adopted simultaneously, can provide these parameters and allow the assessment of developmental steps without the cooperation of the infant. In particular, this project deals with the differentiation of native and non-native linguistic characteristics, as these bear the potential to early identify speech pathologies due to abnormal mechanisms in the brain. Infants put under investigation range from 3 to 24 months of age as these include the most crucial initial language processing steps, still not completely understood in research.

The impact of a cognitive training on speech comprehension in cochlear-implant patients

Sonja Rossi, Annika Rackl, Isabella Thurner, Josef Seebacher, Sophia Lodes

Speech processing is strongly interconnected with cognitive abilities. If a person has better cognitive abilities such as attention, processing speed, memory, or executive functions this might lead to different speech processing abilities. Hearing impairment impacts in particular speech comprehension. The exact mechanisms underlying the interaction between cognitive and speech comprehension abilities in hearing-impaired patients are still unclear. The supply with a cochlear-implant (CI) allows hearing again and it thus improves speech comprehension. However, the processing of the artificial electrical signal at the beginning of hearing with a CI has to be newly learned. This is associated with several neural plasticity mechanisms in the brain, which in turn are influenced by cognitive abilities. The question arises whether a training of cognitive functions after CI implantation increases speech comprehension abilities and thus improves the speech rehabilitation process. This study investigates whether a hearing and a cognitive training modulate neural correlates of speech comprehension in cochlear-implant patients 3 and 6 months after implant activation. Neural activity will be assessed simultaneously by two neuroscientific methods: the electroencephalography (EEG) and the functional near-infrared spectroscopy (fNIRS).

Neural Correlates of Emotional Prosody Processing in women and men

Sonja Rossi, Claudia Hofmann

The project aims at investigating neural processes of verbally transmitted emotions in women and men.  Most studies investigate visually presented emotions, for example in faces. However, the emotion can also be elicited by the voice, which is termed emotional prosody. In the present project we elucidate neural mechanisms, in particular the exact timing of processing and the brain regions supporting emotional prosody by means of the simultaneous application of electroencephalography (EEG) and functional near-infrared spectroscopy (fNIRS). Sentences without any meaning but spoken in a neutral, happy, or angry emotional prosody by a female and male voice are auditorily presented to the study participants. A separate analysis is performed in women and men. The results of this study may provide important insights into differences and/or similarities in neural processing of emotion perception in women and men.

Can bilingual infants learn a new language?

Sonja Rossi

Bilingualism is known to lead to efficient neural mechanisms in the brain, capable to increase cognitive functions. However, some previous studies showed delayed processing in bilinguals due to the higher cognitive load they are faced with. The present study investigates neural processes in the brain while bilingual infants aged 6 and 18 months learn regularities of an unknown language. The methods adopted include the electroencephalography (EEG) and the functional near-infrared spectroscopy (fNIRS), assessing fast dynamic temporal and good spatial aspects of language learning. The research questions of the present study focus on whether bilinguals are more flexible learners than monolinguals providing superior learning abilities with respect to a new language or whether a word-object associative learning context provides a more laborious learning setting and thus leading to delayed and differential processing mechanisms.

Zelger P, Zorowka P, Schmutzhard J, Galvan O, Rossi S, Stephan K, Seebacher J (2024) Localization of Low- and High-Frequency Sounds in Cochlear Implant Recipients Using a Contralateral Hearing Aid. Otol Neurotol. 45(3):e228-e233.

Muigg F, Zelger P, Seebacher J, Schmutzhard J, Weichbold VW. (2024) Does cochlear implantation affect personality of hearing-impaired patients? A five-year follow-up study. Acta Otolaryngol. 144(5-6):366-370.

Weichbold V, Kühn H, Muigg F (2024) Entwicklung einer Kurzversion des Nijmegen Cochlear Implant Questionnaire in deutscher Sprache [Development of a German short version of the Nijmegen Cochlear Implant Questionnaire]. HNO. 72(8):565-570.

Muigg F, Rossi S, Kühn H, Weichbold V (2024) Perceived social support improves health-related quality of life in cochlear implant patients. Eur Arch Otorhinolaryngol. 281(9):4757-4762.

Mair MM, Schröcksnadel R, Stephan K, Seebacher J, Zelger P, Muigg F, Gottfried T, Franke-Trieger A, Schmutzhard J (2024) Electrically Evoked Stapedius Reflex Measurements in Cochlear Implantation and its Application in the Postoperative Fitting Process. J Vis Exp. 21(208).

Zelger P, Seebacher J, Graf S, Rossi S (2024) Is it too loud? Ask your brain! Neuroimage. 299:120796. doi: 10.1016/j.neuroimage.2024.120796

Muigg F, Zelger P, Rossi S, Kühn H, Schmutzhard J, Graf S, Weichbold V. (2024) Health-related quality of life in vibrant soundbridge patients: generic and specific measures, short-term and long-term outcomes. Eur Arch Otorhinolaryngol. 281(12):6669-6675.

Salloum H, Graf S, Schilling B, Richter L, Jeleff-Wölfler O, Feussner H, Ostler D, Wilhelm D, Fuchtmann J. (2024) Deep Learning-based Artificial Intelligence in Audio based Analysis of Swallowing using Cervical Auscultation. CDBME. 10(2):16-19.

Seebacher J, Franke-Trieger A, Weichbold V, Galvan O, Schmutzhard J, Zorowka P. Stephan K (2023) Sound localisation of low- and high-frequency sounds in cochlear implant users with single-sided deafness. Int J Audiol. 62(1):71-78.

Weichbold V, Zelger P, Galvan O, Muigg F (2023) Five-Year Observation Period of Quality of Life After Cochlear Implantation. Otol Neurotol. 44(3):e155-e159.

Zelger P, Brunner A, Zelger B, Willenbacher E, Unterberger SH, Stalder R, Huck CW, Willenbacher W, Pallua JD (2023) Deep learning analysis of mid-infrared microscopic imaging data for the diagnosis and classification of human lymphomas. J Biophotonics. 16(11):e202300015

MED-EL; Financial Funding of the Study “Hearing Screening for Adults” (2025 –)

MED-EL; Financial Funding of the Project “Development of a Telemedical Patient Portal for the University Clinic for HSS” (2023 – 25)

FH Gesundheit, Innsbruck, Austria

Institut für Psychologie, Leopold Franzens Universität Innsbruck, Austria

Institut für Fachdidaktik, Leopold Franzens Universität Innsbruck, Austria

Institut für Romanistik, Karl Franzens Universität Graz, Austria

HNO-Abteilung, Klinikum Wels-Grieskirchen, Wels, Austria

Cochlear Implant Center, Technische Universität Dresden, Dresden, Germany

Max Planck Institut für Kognitions- und Neurowissenschaften, Leipzig, Germany

College of Engineering, University of Washington, Washington, USA