Hearing Aid Assessment Research Articles

Evaluation of unilateral and bilateral bimodal bone conduction hearing intervention in patients with bilateral microtia-atresia

Objectives: To evaluate the therapeutic effects of unilateral/bilateral bone conduction hearing rehabilitation in patients with bilateral microtia accompanied with severe conductive hearing loss following staged auricle reconstruction and bonebridge implantation. Methods: Thirty-two patients, including 20 males and 12 females, with an average age of 11.8, who received surgical treatment in Peking Union Medical College Hospital (PUMCH) from March, 2016 to January, 2020 with bilateral microtia-atresia were included. Hearing thresholds, speech perception and high-resolution CT of the temporal bone were evaluated prior to surgery and individualized surgery plans (staged auricle reconstruction and bonebridge implantation) were made. Hearing thresholds and speech perception in quiet and noise (SNR = 5 dB) using unilateral Bonebridge were tested two weeks after the implantation surgery when the Bonebridge was activated and at 3th, 6th, 12th month after activation. Hearing thresholds and speech perception were also tested at least three months after the activation of the Bonebridge under three conditions: unaided, unilateral Bonebridge, and bilateral bone conduction hearing devices (Bonebridge plus contralateral ADHEAR). The international hearing aid assessment questionnaire (IOI-HA) and Glasgow children's benefit questionnaire were used to evaluate the subjective benefits of the patients. SPSS 21.0 software was used for statistical analysis. Results: Among these 32 patients, nine were conducted Bonebridge implantation surgery before auricle reconstruction, six were simultaneously with auricle reconstruction and 17 were implanted after auricle reconstruction surgery. Compared with unaided, the mean hearing thresholds (0.5, 1, 2, and 4 kHz) and speech perception following unilateral BCHD and bilateral BCHD attachment were improved significantly (P<0.05 each). The speech perceptin in noise of bilateral BCHD was better than unilateral (P<0.05 each). The modified questionnaire revealed high levels of patient satisfaction following use of both unilateral and bilateral devices. Conclusions: Individulized surgical procedures involving auricle reconstruction and Bonebridge implantation are safe and effective for patients with bilateral microtia-atresia, solving both appearance and hearing problems. Speech perception in noise is better following bilateral BCHD than unilateral BCHD attachment.

Comprehensive hearing aid assessment in adults with bilateral severe-profound sensorineural hearing loss who present for Cochlear implant evaluation

To comprehensively assess and describe functional auditory performance in a group of adults with bilateral, moderate sloping to profound sensorineural hearing loss who were dissatisfied users of well-fit bilateral hearing aids and presented for Cochlear implant evaluation. Participants were evaluated with bilateral hearing aids and after six months of bimodal (Cochlear implant and a contralateral hearing aid) hearing experience with a Cochlear implant and contralateral hearing aid. Study participants were assessed using pure tone audiometry, aided speech understanding in quiet (CNC words) and in noise (AzBio sentences at +10 and +5 dB SNR) in the sound field with unilateral and bilateral hearing aids fit to target. Participants completed subjective scales of quality of life, (Health Utilities Index Mark 3), hearing disability, (Speech, Spatial and Qualities of Hearing Scale) and a device use satisfaction scale. Participants ≥55 years were administered the Montreal Cognitive Assessment screening tool. One-hundred enrolled individuals completed baseline evaluations. Aided bilateral mean speech understanding scores were 28% for CNC words and 31%, and 17% for AzBio sentences at a +10 dB, and +5 dB SNR, respectively. Mean scale ratings were 0.46 for overall quality of life and 3.19 for functional hearing ability. Ninety percent of participants reported dissatisfaction with overall hearing performance. Evaluation results, including functional performance metrics quantifying the deleterious effects of hearing loss for overall wellbeing, underscore that bilateral hearing aids are not an effective treatment for individuals with bilateral, moderate sloping to profound sensorineural hearing loss. Individuals with this degree of hearing impairment, who demonstrate poor aided speech understanding and dissatisfaction with hearing abilities in everyday life, require timely referral to a Cochlear implant clinic for further evaluation.

Validity of P1 testing as an objective tool for hearing aid verification in children

Objective The aim of this study was to determine the efficiency of P1 as an objective tool for verification of hearing aids in children. Background Hearing loss in childhood interferes with the normal development of speech. The use of hearing aids improves speech perception. Cortical auditory-evoked potentials (CAEPs) (dominated by a large P1 response) may be a good tool for assessment of hearing aids. Patients and methods In this study, 200 children ranging in age from 3 to 6 years were divided into two groups: the control group (50 volunteers), which included children with normal hearing sensitivity, matched for age and sex with the study group, and the study group, which included 150 children with sensorineural hearing loss. This group was subdivided as follows: subgroup a (group with well-fitted hearing aids), subgroup b (poorly fitted group), and subgroup c (not wearing hearing aids). All were subjected to a full assessment of history, psychosocial evaluation, otological examination, basic audiological evaluation, and the CAEPs test, which was performed serially each month for subgroup a for 15 months. Results The P1 wave dominates the CAEPs as it appeared in 100% of the normal children. The N1 wave, in contrast, did not appear in all individuals. In the study subgroup a, P1 appeared with longer latency, which led to a decrease in hearing aid usage to normal after 15 months. Children of subgroup b showed less improvement in P1 latency. In subgroup c, only very few children gave for P1 with delayed latency. Conclusion P1 is reliable for the evaluation of hearing aids. It appears in all children and usually improves to normal values after 15 months of using suitable hearing aids. The N1 wave, in contrast, is not a reliable wave.

The use of a bone-anchored hearing aid (Baha ®) in children with severe behavioural problems—The Birmingham Baha ® programme experience

Objective A trial of a bone conductor is traditionally used to determine whether a bone-anchored hearing aid (Baha) will be beneficial to a child. However there is a subgroup of children where a Baha assessment is not possible due to severe behavioural/mental/sensory disorders. We describe our experience in a small series of such children. Method Retrospective case series review of four children at the severe end of the spectrum of behavioural difficulties who underwent Baha implantation where no formal preoperative hearing aid assessment was possible. The Glasgow Children's Benefit Inventory and a visual analogue scale assessing health status were used to determine the benefit of Baha implantation in this group. Results There was no surgical morbidity in this group although a more intensive postoperative follow up was required. All four children wore their hearing aids at least 8 h a day. Parents reported a positive impact of the Baha on the behaviour and mood of their children. The Baha showed a positive benefit when assessed using the Glasgow Children's Benefit Inventory and showed a positive change in health status. Conclusions We feel that our early experience with Baha in children with severe behavioural difficulties has been positive to date. Multidisciplinary teams should not dismiss these children even if a trial of a bone conductor is not possible. We feel that the bone-anchored hearing aid has been successful in our cases because the children do not physically feel the presence of the hearing aid.

Method and system for external assessment of hearing aids that include implanted actuators

A noninvasive method and system are provided for assessing the performance of implanted actuators of semi or fully-implantable hearing aid systems. The invention utilizes an externally positioned measurement device to obtain a test measure of the electrical signal passing through an implanted actuator when driven by a test signal of predetermined characteristics. In one embodiment, the measurement device may comprise a pair of coils for measuring the magnetic field generated by an implanted actuator utilized to simulate the middle ear of a patient. The magnetic field strength is directly related to the amount of current passing through the actuator. In turn, such current is inversely related to the electrical impedance present at the implanted actuator. Such electrical impedance is directly related to the mechanical impedance present at the interface between the implanted actuator and middle ear of a patient. As such, by driving an implanted actuator at one or more predetermined frequencies the resultant magnetic field measures may be utilized to assess whether the implanted actuator is operative and whether a desired interface between the actuator and the middle ear of patient (e.g. the ossicular chain) is present.

Objective and Subjective Hearing Aid Assessment Outcomes

To determine whether specific sentence recognition assessments were sensitive enough to serve as objective outcome measurements that document subjective improvements in speech understanding with hearing aids. The Revised Speech Perception in Noise test (R-SPIN; R. C. Bilger, J. M. Nuetzel, W. M. Rabinowitz, & C. Rzeczkowski, 1984), the Hearing in Noise Test (HINT; M. Nilsson, S. D. Soli, & J. A. Sullivan, 1994), and the Quick Speech-in-Noise test (QuickSIN; Etymotic Research, 2001; M. C. Killion, P. A. Niquette, G. I. Gudmundsen, L. J. Revit, & S. Banerjee, 2004) were administered to 21 hearing aid users to determine whether the tests could adequately document improvements in speech understanding with hearing aids compared with the research participants' self-assessments of their own performance. Comparisons were made between unaided and aided performance on these sentence tests and on the Hearing Aid Performance Inventory (HAPI; B. E. Walden, M. Demorest, & E. Hepler, 1984). The R-SPIN, the HINT Quiet threshold, and the QuickSIN signal-to-noise ratio (SNR) loss were the most sensitive of the sentence recognition tests to objectively assess improvements in speech perception performance with hearing aids. Comparisons among the subjective and objective outcome measures documented that HAPI ratings improved as performance on the R-SPIN, the HINT Quiet threshold, and the QuickSIN SNR loss improved. Objective documentation of subjective impressions is essential for determining the efficacy of treatment outcomes in hearing aid fitting. The findings reported here more clearly define the relationship between objective and subjective outcome measures in an attempt to better define true hearing aid benefit.

A computer method for assessing satisfaction with hearing aids

The purpose of this study was to evaluate a new clinical assessment, the Dynamic Assessment of Hearing Aids (DAHA), for a large clinical population. Unlike traditional questionnaire methods, the DAHA has patients use an intuitive graphical computer interface to record visual analogue ratings of satisfaction with various features of their hearing aids (e.g. clarity, cost, appearance). Data were collected from 191 participants.A subset of participants returned for retest. The DAHA items assess satisfaction with hearing aids within four domains: communication, physical features, sound quality, and personal reactions. The concurrent validity was determined by comparing DAHA results to those obtained with the satisfaction with amplification in daily life (SADL). Ratings for personal reactions to hearing aids indicate the most satisfaction, and ratings for communication (especially group conversations and phone use) indicate the least satisfaction. The DAHA total score was found to have good test/retest and high internal consistency. Concurrent validity was supported by a strong correlation between total scores on the DAHA and the SADL. Results suggest the DAHA maybe an effective tool for clinical use.SumarioEl objetivo de este estudio fue valorar un nuevo instrumento clínico, la “Evaluación dinámica de Auxiliares Auditivos” (DAHA), en una amplia población. A diferencia de los cuestionarios tradicionales, con el DAHA los pacientes utilizan una interfase gráfica intuitiva para grabar apreciaciones de satisfacción análogas visuales de varios atributos de sus auxiliares auditivos (p.ej. claridad, costo, apariencia). Se colectaron datos de 191 participantes. Un subgrupo de participantes regresó para una re-evaluación. Los ítem del DAHA evalúan la satisfacción que proporcionan los auxiliares auditivos en cuatro áreas: comunicación, características físicas, calidad de sonido y reacciones personales. La validez concomitante se determinó comparando los resultados del DAHA con los obtenidos en el de “Satisfacción con Amplificación en la Vida Diaria” (SADL). Los índices de reacciones personales a los auxiliares indicaron la mayor satisfacción y los índices de comunicación (especialmente conversación grupal y uso de teléfono) indicaron la menor satisfacción. Se encontró que la calificación total del DAHA tiene una alta consistencia interna y una buena calificación test/re-test. Hubo una alta correlación entre la calificación final en el DAHA y la de SADL. Los resultados sugieren que el DAHA puede ser una herramienta de uso clínico efectiva.

FDA Rejects Citizen Petitions for Over-the-Counter Hearing Aids

FDA Rejects Citizen Petitions for Over-the-Counter Hearing Aids

Hearing and vision loss within residential care facilities ‐the need for improved service delivery

Objective: To assess the level of hearing impairment within residential care facilities and to determine the efficacy of providing aural rehabilitation services within the facility.Method: 178 elderly residents participated in this project. The procedures included case history, pure‐tone screening, otoscopic examination, vision screening, hearing aid assessment and sentence identification.Results: Despite 87.1% of participants having a significant hearing impairment only 43.3% currently wore hearing aids. Linked to poor hearing aid use was the fact that 43.9% of hearing aids required some degree of maintenance. Otoscopic examination revealed 42.1% of ear canals to be occluded with cerumen to a degree that medical intervention was required. Sentence identification revealed the importance of aiding and access to contextual and visual cues (lip‐reading) for this population.Conclusions: This study confirms the high prevalence of hearing impairment amongst the elderly and makes a case for increased rehabilitation services being directed towards this population particularly in the areas of hearing aid maintenance, cerumen removal and delivery of communication skills training to residential care workers.

A universal newborn hearing screening program in Taiwan

Objective: Mackay Memorial Hospital and the Children's Hearing Foundation established a pilot universal newborn hearing screening program in November 1998. Our objective was to assess the feasibility, accuracy and cost effectiveness of implementing universal newborn hearing screening in Taiwan. Method: Between November 1998 and October 2000 a total of 6765 newborns were screened for hearing loss prior to discharge from the wellborn nursery at Mackay Memorial Hospital. The average age of the subjects at the initial screening test was 52 h. The program employed a three stage hearing screening protocol using transient evoked otoacoustic emmisions (TEOAE) screening with referral for diagnostic auditory brainstem response assessment. Results: The mean TEOAE screening time per ear was 41.43 s. The overall pass rate at the time of hospital discharge was 93.6%. Thus achieving an acceptable referral rate of 6.4% for diagnostic audiological assessments. Nine newborns were identified with permanent bilateral hearing impairment. 26 newborns were identified with permanent unilateral hearing impairment. Infants identified with bilateral hearing loss were immediately referred to the Children's Hearing Foundation for hearing aid assessment and fitting. Infants as young as 5 weeks of age were successfully fitted with hearing instruments and enrolled in the family centered early intervention program at the Children's Hearing Foundation. Conclusion: The frequency of bilateral congenital hearing loss requiring amplification in this population is shown to be approximately 1 in 752 newborns. This finding is consistent with previous research, which has indicated hearing loss to be the most frequently occurring birth defect. Universal newborn hearing screening using TEOAEs proved to be a cost effective and feasible method of identifying congenital hearing loss in Taiwan. The existence of many successful screening programs worldwide and the availability of fast, objective, reliable and inexpensive hearing screening procedures means that universal newborn hearing screening is becoming the standard of care.

Personality and the Subjective Assessment of Hearing Aids

Relatively little is known about the influence of patients' personality features on the responses they make to self-assessment items used to measure the outcome of a hearing aid fitting. If the personality of the hearing aid wearer has a significant influence on self-report outcome data, it would be important to explore the relevant personality variables and to be cognizant of their effects when using subjective outcome data to justify decisions about clinical services or other matters. This investigation explored the relationship between several personality attributes and responses to the Abbreviated Profile of Hearing Aid Benefit (APHAB). It found that more extroverted patients tend to report more hearing aid benefit in all speech communication situations. In addition, patients with a more external locus of control tend to have more negative reactions to loud environmental sounds, both with and without amplification. Anxiety also played a small additional role in determining APHAB responses. Although personality variables were found to explain a relatively small amount of the variance in APHAB responses (usually around 10%), these outcomes should alert practitioners and researchers to the potential effects of personality variables in all self-report data.

Clinical assessment of modern hearing aids.

The increasing complexity of the non-linear signal processing of modern hearing aids makes the use of clinical assessment of hearing aid benefit more and more important. The paper discusses the general structure of such studies with regard to choice of test subjects, reference hearing aids and the advantage of double-blind and cross-over design. Assessment should contain at least the three dimensions: perceived hearing aid benefit (preferably including perceived sound quality and preference between test and reference aids), speech recognition in noise, and electroacoustic verification by means of real-ear measurements.

Towards an Ecological Audiology

An acoustic laboratory for reproduction of speech and acoustic environments is presented along with two sound field tests. Its design has been inspired by the LEDE (Living End Dead End) principle for construction of radio and music control rooms. The equipment and the 12 loudspeakers can simultaneously reproduce several stereophonic and monophonic recordings. The interesting feature is that the delayed first reflex in the LEDE room allows for a realistic perception of the recording room. A preliminary presentation of two newly developed tests for sound field listening is given. In DSIN. Directional Speech In Noise, the JFC (just follow conversation) threshold for continuous discourse is determined in 12 directions in quiet and in noise from +/- 60 degrees azimuth. In SEIT (Sound Environmental Identification Test), stereophonic acoustic environments are presented and the subject is asked to identify specific components and to characterize each environment as closely as possible. Results from tests with normal hearing subjects and examples of results with hearing impaired subjects are presented. The potential of the technique for use in aural rehabilitation, functional definition of auditory communication and quality assessment of hearing aids is discussed. It is pointed out that the term ecological audiology is suitable for describing the interaction between the communicating individual and the environment in a broad sense.

Estimation of nonsense syllable intelligibility

An intelligibility estimation test comprising nonsense syllables that were recorded separately, and then concatenated, is under development for hearing aid assessment. Consonant-vowel-consonant syllables (CVCs) are presented along with a visual display on a computer monitor that identifies each syllable with an animated pointer as it is presented to the listener. After presentation of a list of 50–60 CVCs, the listener is asked to estimate the consonant percent-correct score. A major advantage of the test is rapid administration. Percent-correct estimates were collected from 16 normal-hearing subjects presented with CVCs masked by a speech-shaped noise and with high- and low-pass filtered CVCs. In all test conditions, actual percent-correct scores were obtained for comparison. In noise and under filtering, estimates are slightly higher than actual scores. However, estimates increase with speech-to-noise ratio (dB) at a rate of about 4% per dB, similar to the actual percent-correct scores. The crossover frequency derived from the filtering experiment was approximately 1700 Hz, nearly identical to that reported by French and Steinberg [J. Acoust. Soc. Am. 19, 90–119 (1947)]. Hence, articulation theory principles may be applicable. This test may serve as a speedy assessment tool for evaluating and selecting hearing aids. [Work supported by NIH.]

Hearing aids: value for money and health gain

The aim of this study was to assess the ability of hearing aids to reduce the handicap associated with hearing impairment in adults. Fifty adults aged over 60 who were supplied with an NHS hearing aid had their hearing handicap and communication function recorded at initial hearing aid assessment, and after three months of aid use. Hearing communication function was assessed by a key informant. Hearing aid use was associated with considerable score improvements for social and emotional function [20.5, 95 per cent confidence interval (Cl) 15.4-25.6] and communication function (22.9, 95 percent Cl 14.6-31.2). Younger people recorded the greatest reduction in handicap. Overall satisfaction with hearing aid performance was high. Hearing aids are effective in reducing hearing handicap in adults. They represent a good buy for purchasers seeking to achieve health gain for adults with hearing impairment.

Application of the National Acoustics Laboratories' Hearing Aid Selection Procedure and a New Hearing Aid Assessment Questionnaire

Application of the National Acoustics Laboratories' Hearing Aid Selection Procedure and a New Hearing Aid Assessment Questionnaire

Hearing Aid Assessment and Use in Audiologic Habilitation.

Hearing Aid Assessment and Use in Audiologic Habilitation.

Hearing Aid Assessment and Use in Audiologic Habilitation, edited by William R. Hodgson and Paul H. Skinner

First Page

Hearing Aid Assessment and Use in Audiologic Habilitation

Hearing Aid Assessment and Use in Audiologic Habilitation

Hearing Aid Assessment and Use in Audiologic Habilitation.

Hearing Aid Assessment and Use in Audiologic Habilitation.