Bilateral Hearing Aid Users Research Articles

Binaural responses to a speech syllable are altered in children with hearing loss: Evidence from the frequency-following response

Background & rationaleIn prior work using non-speech stimuli, children with hearing loss show impaired perception of binaural cues and no significant change in cortical responses to bilateral versus unilateral stimulation. Aims of the present study were to: 1) identify bilateral responses to envelope and spectral components of a speech syllable using the frequency-following response (FFR), 2) determine if abnormalities in the bilateral FFR occur in children with hearing loss, and 3) assess functional consequences of abnormal bilateral FFR responses on perception of binaural timing cues. MethodsA single-syllable speech stimulus (/dα/) was presented to each ear individually and bilaterally. Participants were 9 children with normal hearing (MAge = 12.1 ± 2.5 years) and 6 children with bilateral hearing loss who were experienced bilateral hearing aid users (MAge = 14.0 ± 2.6 years). FFR temporal and spectral peak amplitudes were compared between listening conditions and groups using linear mixed model regression analyses. Behavioral sensitivity to binaural cues were measured by lateralization responses as coming from the right or left side of the head. ResultsBoth temporal and spectral peaks in FFR responses increased in amplitude in the bilateral compared to unilateral listening conditions in children with normal hearing. These measures of “bilateral advantage” were reduced in the group of children with bilateral hearing loss and associated with decreased sensitivity to interaural timing differences. ConclusionThis study is the first to show that bilateral responses in both temporal and spectral domains can be measured in children using the FFR and is altered in children with hearing loss with consequences to binaural hearing.

Exploring attentive listening in noise through the just-follow conversation task

Listening to a conversation demands comprehension, attention and prediction. To better understand the impact of these demands, as well as how hearing aids might alleviate them, a conversational listening test should be realistic, repeatable and relatable (i.e., have interpretable units). A test that potentially satisfies these needs is the just-follow conversation (JFC) task, where the listener adjusts the signal level to where they can understand, with effort, the gist of what is being said in a background of noise. Fifty-four participants sat in the centre of a circular loudspeaker array and adjusted the overall level of one monologue, one dialogue, two monologues or two dialogues presented in the front hemifield to where they could just follow the speech four times per trial. Signals were presented in surrounding fixed-level café and same-spectrum noise backgrounds. Bilateral hearing-aid users adjusted aided and unaided; non-users repeated each condition to evaluate reliability. Results showed an increase in JFC for dialogues re monologues. Individual JFC SNRs correlated with SSQ12 speech subscale scores as well as pure-tone threshold averages. JFC reliability was comparable to more objective speech understanding measures, but it may not be suitable to capture perceived conversational benefits for more subtle changes in hearing-aid processing. [Work supported by the UK Medical Research Council Grant No. MR/X003620/1 & WS Audiology.]

Investigating sound-field reproduction methods as perceived by bilateral hearing aid users and normal-hearing listeners.

A perceptual study was conducted to investigate the perceived accuracy of two sound-field reproduction approaches when experienced by hearing-impaired (HI) and normal-hearing (NH) listeners. The methods under test were traditional signal-independent Ambisonics reproduction and a parametric signal-dependent alternative, which were both rendered at different Ambisonic orders. The experiment was repeated in two different rooms: (1) an anechoic chamber, where the audio was delivered over an array of 44 loudspeakers; (2) an acoustically-treated listening room with a comparable setup, which may be more easily constructed within clinical settings. Ten bilateral hearing aid users, with mild to moderate symmetric hearing loss, wearing their devices, and 15 NH listeners were asked to rate the methods based upon their perceived similarity to simulated reference conditions. In the majority of cases, the results indicate that the parametric reproduction method was rated as being more similar to the reference conditions than the signal-independent alternative. This trend is evident for both groups, although the variation in responses was notably wider for the HI group. Furthermore, generally similar trends were observed between the two listening environments for the parametric method. The signal-independent approach was instead rated as being more similar to the reference in the listening room.

The Effects of Type of Fitting, Technology and User Experience on Satisfaction with Hearing Aid Assessed by Persian Version of the MarkeTrak Survey

Background and Aim: Satisfaction with hearing aids is very important for continued use of the device and improving hearing status and quality of lives of people with hearing loss. MarkeTrak survey has been used for many years to track factors influencing satisfaction with hearing aids. This study aimed to make a valid and reliable Persian version of the MarkeTrak survey to measure the effects of type of fitting, experience and technology on hearing aid satisfaction. Methods: After confirmation of validity and reliability of the Persian MarkeTrak, 71 people participate in the study. The effects of bilateral versus unilateral hearing aids (type of fitting), experience and wireless versus non-wireless technology were tested. Results: Bilateral hearing aid users has significantly higher satisfaction rate than unilateral users (65.6±7.2 versus 59.9±17.7). The effects of experience with using hearing aids and type of technology did not reach statistical significance. Conclusion: Higher satisfaction with bilateral hearing aids might result from better sound quality in diverse listening conditions, spatial hearing and directionality with two ears rather than one ear. Keywords: Persian MarkeTrak; bilateral hearing aids; wireless; experience; satisfaction

Children using a unilateral cochlear implant and contralateral hearing aid: bimodal hearing outcomes when one ear is outside the UK (NICE 2009) audiological criteria for cochlear implantation – a single site case–control study

IntroductionIn the new revised National Institute for Health & Care Excellence (NICE, TA566, 2019) guidelines for cochlear implantation (CI) have clearly stipulated that the hearing loss must be bilateral. Prior...

Binaural pre-processing for contralateral sound field attenuation can improve speech-in-noise intelligibility for bilateral hearing-aid users

We have recently proposed a binaural sound pre-processing method to attenuate sounds contralateral to each ear and shown that it can improve speech intelligibility for normal-hearing (NH) people in simulated “cocktail party” listening situations (Lopez-Poveda et al., 2022, Hear Res 418:108,469). The aim here was to evaluate if this benefit remains for hearing-impaired listeners when the method is combined with two independently functioning hearing aids, one per ear. Twelve volunteers participated in the experiments; five of them had bilateral sensorineural hearing loss and seven were NH listeners with simulated bilateral conductive hearing loss. Speech reception thresholds (SRTs) for sentences in competition with a source of steady, speech-shaped noise were measured in unilateral and bilateral listening, and for (target, masker) azimuthal angles of (0°, 0°), (270°, 45°), and (270°, 90°). Stimuli were processed through a pair of software-based multichannel, fast-acting, wide dynamic range compressors, with and without binaural pre-processing. For spatially collocated target and masker sources at 0° azimuth, the pre-processing did not affect SRTs. For spatially separated target and masker sources, the pre-processing improved SRTs when listening bilaterally (improvements up to 10.7 dB) or unilaterally with the acoustically better ear (improvements up to 13.9 dB), while it worsened SRTs when listening unilaterally with the acoustically worse ear (decrements of up to 17.0 dB). Results show that binaural pre-processing for contralateral sound attenuation can improve speech-in-noise intelligibility in laboratory tests also for bilateral hearing-aid users.

Study protocol for a randomised controlled trial evaluating the benefits from bimodal solution with cochlear implant and hearing aid versus bilateral hearing aids in patients with asymmetric speech identification scores

IntroductionCochlear implant (CI) and hearing aid (HA) in a bimodal solution (CI+HA) is compared with bilateral HAs (HA+HA) to test if the bimodal solution results in better speech intelligibility and...

Factors underlying masking release by voice-gender differences and spatial separation cues in multi-talker listening environments in listeners with and without hearing loss.

Voice-gender differences and spatial separation are important cues for auditory object segregation. The goal of this study was to investigate the relationship of voice-gender difference benefit to the breadth of binaural pitch fusion, the perceptual integration of dichotic stimuli that evoke different pitches across ears, and the relationship of spatial separation benefit to localization acuity, the ability to identify the direction of a sound source. Twelve bilateral hearing aid (HA) users (age from 30 to 75 years) and eleven normal hearing (NH) listeners (age from 36 to 67 years) were tested in the following three experiments. First, speech-on-speech masking performance was measured as the threshold target-to-masker ratio (TMR) needed to understand a target talker in the presence of either same- or different-gender masker talkers. These target-masker gender combinations were tested with two spatial configurations (maskers co-located or 60° symmetrically spatially separated from the target) in both monaural and binaural listening conditions. Second, binaural pitch fusion range measurements were conducted using harmonic tone complexes around a 200-Hz fundamental frequency. Third, absolute localization acuity was measured using broadband (125-8000 Hz) noise and one-third octave noise bands centered at 500 and 3000 Hz. Voice-gender differences between target and maskers improved TMR thresholds for both listener groups in the binaural condition as well as both monaural (left ear and right ear) conditions, with greater benefit in co-located than spatially separated conditions. Voice-gender difference benefit was correlated with the breadth of binaural pitch fusion in the binaural condition, but not the monaural conditions, ruling out a role of monaural abilities in the relationship between binaural fusion and voice-gender difference benefits. Spatial separation benefit was not significantly correlated with absolute localization acuity. In addition, greater spatial separation benefit was observed in NH listeners than in bilateral HA users, indicating a decreased ability of HA users to benefit from spatial release from masking (SRM). These findings suggest that sharp binaural pitch fusion may be important for maximal speech perception in multi-talker environments for both NH listeners and bilateral HA users.

Effects of the intensified frequency and time ranges on consonant enhancement in bilateral cochlear implant and hearing aid users.

A previous study demonstrated that consonant recognition improved significantly in normal hearing listeners when useful frequency and time ranges were intensified by 6 dB. The goal of this study was to determine whether bilateral cochlear implant (BCI) and bilateral hearing aid (BHA) users experienced similar enhancement on consonant recognition with these intensified spectral and temporal cues in noise. In total, 10 BCI and 10 BHA users participated in a recognition test using 14 consonants. For each consonant, we used the frequency and time ranges that are critical for its recognition (called “target frequency and time range”), identified from normal hearing listeners. Then, a signal processing tool called the articulation-index gram (AI-Gram) was utilized to add a 6 dB gain to target frequency and time ranges. Consonant recognition was monaurally and binaurally measured under two signal processing conditions, unprocessed and intensified target frequency and time ranges at +5 and +10 dB signal-to-noise ratio and in quiet conditions. We focused on three comparisons between the BCI and BHA groups: (1) AI-Gram benefits (i.e., before and after intensifying target ranges by 6 dB), (2) enhancement in binaural benefits (better performance with bilateral devices compared to the better ear alone) via the AI-Gram processing, and (3) reduction in binaural interferences (poorer performance with bilateral devices compared to the better ear alone) via the AI-Gram processing. The results showed that the mean AI-Gram benefit was significantly improved for the BCI (max 5.9%) and BHA (max 5.2%) groups. However, the mean binaural benefit was not improved after AI-Gram processing. Individual data showed wide ranges of the AI-Gram benefit (max −1 to 23%) and binaural benefit (max −7.6 to 13%) for both groups. Individual data also showed a decrease in binaural interference in both groups after AI-Gram processing. These results suggest that the frequency and time ranges, intensified by the AI-Gram processing, contribute to consonant enhancement for monaural and binaural listening and both BCI and BHA technologies. The intensified frequency and time ranges helped to reduce binaural interference but contributed less to the synergistic binaural benefit in consonant recognition for both groups.

Hearing Aids Enhance Music Enjoyment in Individuals With Hearing Loss.

To investigate music appreciation in hearing aid (HA) users with varying levels of hearing loss (HL). Cross-sectional, within-subjects design. Tertiary medical center, community. Adults (≥18 yr) bilateral HA users. HA usage. Outcome variables included self-reported music enjoyment measures (pleasantness, musicality, naturalness) with and without HAs assessed with visual analogue scales (10 indicates highest level of enjoyment, 0 the least). Exposure variables include HL (better ear pure-tone average) and speech discrimination (word recognition scores [WRS]). Demographic information was collected. One hundred nine bilateral HA users completed the study. Mean (standard deviation) age was 66.6 years (16.8 yr); 52.3% were female patients. Mean (standard deviation) better ear pure-tone average was 51.1 dB (16.3 dB) HL. Increased severity of HL and worse WRS were associated with decreased music enjoyment ( p < 0.05) across all measures without HAs, adjusting for sex, age, education, race, HA type, age of HL diagnosis, duration of HL, duration of HA use, musical preference, and musical experience. However, these associations were attenuated or no longer significant with HA usage. Moreover, among all subjects, HAs (vs. no HAs) provided increased music enjoyment in pleasantness (HA, 6.94, no HA, 5.74; p < 0.01), musicality (HA, 7.35; no HA, 6.13, p < 0.01), and naturalness (HA, 6.75; no HA, 6.02; p = 0.02). HA users report increased music enjoyment with HAs compared with without HAs. Increased severity of HL and worse WRS were independently associated with decreased unaided music enjoyment. HA usage seems to mitigate this effect, particularly for those with worse HL.

Children with Conductive Hearing Loss Fitted with Hearing Aids: Outcomes and Caregiver Experiences in South Africa.

Introduction Hearing aids are a frequent management option for children with conductive hearing loss (CHL) and it is necessary to determine the efficacy of outcomes. Limited information regarding caregivers' perceptions and experiences are available to examine outcomes in this population. Objectives To describe hearing aid outcomes and caregivers' experiences for children with CHL who wear behind-the-ear (BTE) hearing aids. Methods Retrospective review of clinical data from 19 children between 0 and 13 years of age with CHL, who were fitted with BTE hearing aids between January 2017 and March 2020. Hearing aid outcomes were documented at one month post-hearing aid fitting, via average daily use and caregiver and teacher reports obtained through the Parents' Evaluation of Aural/oral performance of Children (PEACH) and the Teachers' Evaluation of Aural/oral performance of Children (TEACH). Telephonic surveys were conducted with 13 caregivers to explore their experiences. Qualitative data from open-ended questions were analyzed thematically. Results The average hearing aid use was 6.5 hours/day (2.0 standard deviation, SD; range 4.1-10.3) for bilateral hearing aid users. Questionnaire results indicated that most children (PEACH - 83.3% and TEACH - 92.3%) used their hearing aids more than 75% of the time. Participants performed better in quiet environments with limited sensitivity to loud sounds at home and at school. Reported challenges included stigma and device compliance. Conclusions Children with CHL used their hearing aids for comparable hours (5-8 hours/day), as reported for children with sensorineural hearing loss, but less than the recommended 10 hours/day required for adequate language development. Caregivers reported benefits equivalent to expectations, with challenges similar to those reported in high-income countries.

Speech Perception in Bilateral Hearing Aid Users With Different Grades of Asymmetric Hearing Loss.

Hearing loss is associated with decreased speech perception as well as with changes in the auditory pathway. The effects of those changes on binaural speech perception with hearing aids are not yet fully understood. To provide further evidence on the functional changes of the auditory pathway, several speech perception tests (unilateral and bilateral, aided and unaided, in quiet, and in noise) were conducted in a population of 370 bilateral hearing aid users covering the entire range of the World Health Organization’s most recent classification of hearing loss. To characterize the effects of asymmetric hearing thresholds, a generalized linear model was used for regression analysis. The model revealed a detrimental effect of the poorer ears’ thresholds on both the unaided and the aided unilateral word recognition scores that were attained by the better ear. Moreover, aided binaural word recognition (in quiet and in noise) was affected to a degree that cannot be explained on the sole basis of bilateral summation. Thus, this study provides evidence that there is reorganization and altered functioning of the afferent and efferent auditory pathways due to asymmetric hearing loss. Consequently, more attention should be paid to provision with a hearing aid as early as possible, and separately for each ear.

Evaluation of Speech Recognition Skills in Different Noises with the Turkish Matrix Sentence Test in Hearing Aid Users.

Objective:This study aimed to analyze the effectiveness of the Turkish matrix sentence test in evaluating the speech recognition performance of hearing aid users under different noise conditions.Methods:Speech recognition performance of 42 individuals, 20 to 65 years of age (mean 49.1±14 years) with bilateral sensorineural hearing loss was measured in noise with the Turkish matrix sentence test without a background noise and with headphones. Additionally, the participants’ speech recognition thresholds were measured with a matrix test while wearing their hearing aid under three different listening conditions in which the phases of speech and noise stimuli were changed with constant and fluctuating noise.Results:Speech-recognition thresholds were better in fluctuating noise than in constant noise in all listening conditions, and this difference was statistically significant (p=0.02). In both types of noise, speech-recognition thresholds of bilateral hearing aid users (n=29) were lower (better) than those of unilateral hearing aid users (n=13) under three different listening conditions, but there was no statistically significant difference (p=0.67). Speech-recognition thresholds without hearing aids were statistically higher (worse) than those obtained with hearing aids (p=0.001).Conclusion:Since the Turkish matrix sentence test gives useful results, this test can be used in the diagnosis, follow-up, and rehabilitation planning of hearing aid users. We observed that speech intelligibility was better, although there were differences among those with hearing loss when the speech test was conducted in fluctuating background noise with the Turkish matrix sentence test.

Right-Ear Advantage for Unaided and Aided Speech Perception in Noise in Older Adults

Objective: To investigate whether the magnitude of the right-ear advantage (REA) for speech perception in noise decreased in aided conditions as compared with unaided conditions in older adults bilaterally fitted with hearing aids. A secondary aim was to determine the effect of audibility on the right- and left-ear processing for speech stimuli in both aided and unaided conditions.Methods: Forty-two older adult, bilateral hearing-aid users were selected. Pure-tone audiometry and the hearing-in-noise test (HINT) were carried out and real-ear insertion gain (REIG) was measured in all participants. All HINT stimuli were delivered via loudspeakers in the free field in both aided and unaided conditions.Results: Right-ear scores for HINT were significantly better than the left ear in both unaided and aided conditions. No significant differences in the magnitude of the REA between the unaided HINT and aided HINT scores were found. Regression models showed that audibility explained 47% and 53% of the variance in unaided HINT scores in the right and left ears, respectively. For the aided HINT scores, age and audibility explained 46% of the variability for the left-ear scores, while for the right ear, the only remaining significant variable in the model was REIG, which explained 12% of the right-ear HINT scores.Conclusion: Right-ear processing is significantly more efficient for speech stimuli in both unaided and aided conditions in older adults. Audibility affected unaided speech perception in right and left ears similarly however this was not the case in the aided condition. Audibility was associated with aided speech perception in noise in the left ear only.

Why Ecological Momentary Assessment Surveys Go Incomplete: When It Happens and How It Impacts Data.

Ecological momentary assessment (EMA) often requires respondents to complete surveys in the moment to report real-time experiences. Because EMA may seem disruptive or intrusive, respondents may not complete surveys as directed in certain circumstances. This article aims to determine the effect of environmental characteristics on the likelihood of instances where respondents do not complete EMA surveys (referred to as survey incompletion), and to estimate the impact of survey incompletion on EMA self-report data. An observational study. Ten adults hearing aid (HA) users. Experienced, bilateral HA users were recruited and fit with study HAs. The study HAs were equipped with real-time data loggers, an algorithm that logged the data generated by HAs (e.g., overall sound level, environment classification, and feature status including microphone mode and amount of gain reduction). The study HAs were also connected via Bluetooth to a smartphone app, which collected the real-time data logging data as well as presented the participants with EMA surveys about their listening environments and experiences. The participants were sent out to wear the HAs and complete surveys for 1 week. Real-time data logging was triggered when participants completed surveys and when participants ignored or snoozed surveys. Data logging data were used to estimate the effect of environmental characteristics on the likelihood of survey incompletion, and to predict participants' responses to survey questions in the instances of survey incompletion. Across the 10 participants, 715 surveys were completed and survey incompletion occurred 228 times. Mixed effects logistic regression models indicated that survey incompletion was more likely to happen in the environments that were less quiet and contained more speech, noise, and machine sounds, and in the environments wherein directional microphones and noise reduction algorithms were enabled. The results of survey response prediction further indicated that the participants could have reported more challenging environments and more listening difficulty in the instances of survey incompletion. However, the difference in the distribution of survey responses between the observed responses and the combined observed and predicted responses was small. The present study indicates that EMA survey incompletion occurs systematically. Although survey incompletion could bias EMA self-report data, the impact is likely to be small.

Haptic sound-localisation for use in cochlear implant and hearing-aid users

Users of hearing-assistive devices often struggle to locate and segregate sounds, which can make listening in schools, cafes, and busy workplaces extremely challenging. A recent study in unilaterally implanted CI users showed that sound-localisation was improved when the audio received by behind-the-ear devices was converted to haptic stimulation on each wrist. We built on this work, using a new signal-processing approach to improve localisation accuracy and increase generalisability to a wide range of stimuli. We aimed to: (1) improve haptic sound-localisation accuracy using a varied stimulus set and (2) assess whether accuracy improved with prolonged training. Thirty-two adults with normal touch perception were randomly assigned to an experimental or control group. The experimental group completed a 5-h training regime and the control group were not trained. Without training, haptic sound-localisation was substantially better than in previous work on haptic sound-localisation. It was also markedly better than sound-localisation by either unilaterally or bilaterally implanted CI users. After training, accuracy improved, becoming better than for sound-localisation by bilateral hearing-aid users. These findings suggest that a wrist-worn haptic device could be effective for improving spatial hearing for a range of hearing-impaired listeners.

Masking Release for Speech-in-Speech Recognition Due to a Target/Masker Sex Mismatch in Children With Hearing Loss.

The goal of the present study was to compare the extent to which children with hearing loss and children with normal hearing benefit from mismatches in target/masker sex in the context of speech-in-speech recognition. It was hypothesized that children with hearing loss experience a smaller target/masker sex mismatch benefit relative to children with normal hearing due to impairments in peripheral encoding, variable access to high-quality auditory input, or both. Eighteen school-age children with sensorineural hearing loss (7 to 15 years) and 18 age-matched children with normal hearing participated in this study. Children with hearing loss were bilateral hearing aid users. Severity of hearing loss ranged from mild to severe across participants, but most had mild to moderate hearing loss. Speech recognition thresholds for disyllabic words presented in a two-talker speech masker were estimated in the sound field using an adaptive, forced-choice procedure with a picture-pointing response. Participants were tested in each of four conditions: (1) male target speech/two-male-talker masker; (2) male target speech/two-female-talker masker; (3) female target speech/two-female-talker masker; and (4) female target speech/two-male-talker masker. Children with hearing loss were tested wearing their personal hearing aids at user settings. Both groups of children showed a sex-mismatch benefit, requiring a more advantageous signal to noise ratio when the target and masker were matched in sex than when they were mismatched. However, the magnitude of sex-mismatch benefit was significantly reduced for children with hearing loss relative to age-matched children with normal hearing. There was no effect of child age on the magnitude of sex-mismatch benefit. The sex-mismatch benefit was larger for male target speech than for female target speech. For children with hearing loss, the magnitude of sex-mismatch benefit was not associated with degree of hearing loss or aided audibility. The findings from the present study indicate that children with sensorineural hearing loss are able to capitalize on acoustic differences between speech produced by male and female talkers when asked to recognize target words in a competing speech masker. However, children with hearing loss experienced a smaller benefit relative to their peers with normal hearing. No association between the sex-mismatch benefit and measures of unaided thresholds or aided audibility were observed for children with hearing loss, suggesting that reduced peripheral encoding is not the only factor responsible for the smaller sex-mismatch benefit relative to children with normal hearing.

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.

Age And Sex Matched Data- Two Ears Improved Social Interaction And Quality Of Life

Introduction: Hearing aids are electronic devices used by individuals with hearing loss to improve their quality of life. It is more useful to use bilateral hearing aids. Thus, the localization of the sound is better determined and an additional 6-10 dB increase in sound intensity can be achieved. In our study, we compared the satisfaction level of patients with hearing loss who used unilateral or bilateral devices. Methods: Patients with bilateral sensorineural hearing loss and using unilateral or bilateral hearing aids for at least 3 months and whose hearing loss cannot be treated with medical or surgical treatments were included. International Outcome Inventory for Hearing Aids Turkish Version (IOI-HA- R) was administered to them. Results: Matched data were used to standardize age and gender between the groups. In high school bilateral fitting increased. There was no difference between the groups in terms of hearing pure tone thresholds and speech discriminations. There was a significant difference between the groups in terms of the mean score of question 5 (p=0.047), question 7 (p=0.022) and mean total scale (p=0.028) in IOI-HA-TR. Conclusion: As a result, we found that the satisfaction level of bilateral hearing aid users was higher. Bilateral hearing aid use has a positive effect on the social life of patients and increases their quality of life.

Factors Associated With Successful Setup of a Self-Fitting Hearing Aid and the Need for Personalized Support.

Self-fitting hearing aids have the potential to increase the accessibility of hearing health care. The aims of this study were to (1) identify factors that are associated with the ability to successfully set up a pair of commercially available self-fitting hearing aids; 2) identify factors that are associated with the need for knowledgeable, personalized support in performing the self-fitting procedure; and (3) evaluate performance of the individual steps in the self-fitting procedure. Sixty adults with hearing loss between the ages of 51 and 85 took part in the study. Half of the participants were current users of bilateral hearing aids; the other half had no previous hearing aid experience. At the first appointment, participants underwent assessments of health locus of control, hearing aid self-efficacy, cognitive status, problem-solving skills, demographic characteristics, and hearing thresholds. At the second appointment, participants followed a set of computer-based instructions accompanied by video clips to self-fit the hearing aids. The self-fitting procedure required participants to customize the physical fit of the hearing aids, insert the hearing aids into the ear, perform self-directed in situ audiometry, and adjust the resultant settings according to their preference. Participants had access to support with the self-fitting procedure from a trained clinical assistant (CA) at all times. Forty-one (68%) of the participants achieved a successful self-fitting. Participants who self-fit successfully were significantly more likely than those who were unsuccessful to have had previous experience with hearing aids and to own a mobile device (when controlling for four potential covariates). Of the 41 successful self-fitters, 15 (37%) performed the procedure independently and 26 (63%) sought support from the CA. The successful self-fitters who sought CA support were more likely than those who self-fit independently to have a health locus of control that is externally oriented toward powerful others. Success rates on the individual steps in the self-fitting procedure were relatively high. No one step was more problematic than any other, nor was there a systematic tendency for particular participants to make more errors than others. Steps that required use of the hearing aids in conjunction with the self-fitting app on the participant's mobile device had the highest rates of support use. The findings of this study suggest that nonaudiologic factors should be considered when selecting suitable candidates for the self-fitting hearing aids evaluated in this study. Although computer-based instructions and video clips were shown to improve self-fitting skill acquisition relative to past studies in which printed instruction booklets were used, the majority of people are still likely to require access to support from trained personnel while carrying out the self-fitting procedure, especially when this requires the use of an app.