Ear Hearing Aid Research Articles

Bilateral cochlear implantation or bimodal listening in the paediatric population: Retrospective analysis of decisive criteria

IntroductionIn children with bilateral severe to profound hearing loss, bilateral hearing can be achieved by either bimodal stimulation (CIHA) or bilateral cochlear implantation (BICI). The aim of this study was to analyse the audiologic test protocol that is currently applied to make decisions regarding the bilateral hearing modality in the paediatric population. MethodsPre- and postoperative audiologic test results of 21 CIHA, 19 sequential BICI and 12 simultaneous BICI children were examined retrospectively. ResultsDeciding between either simultaneous BICI or unilateral implantation was mainly based on the infant's preoperative Auditory Brainstem Response thresholds. Evolution from CIHA to sequential BICI was mainly based on the audiometric test results in the contralateral (hearing aid) ear after unilateral cochlear implantation. Preoperative audiometric thresholds in the hearing aid ear were significantly better in CIHA versus sequential BICI children (p < 0.001 and p = 0.001 in unaided and aided condition, respectively). Decisive values obtained in the hearing aid ear in favour of BICI were: An average hearing threshold measured at 0.5, 1, 2 and 4 kHz of at least 93 dB HL without, and at least 52 dB HL with hearing aid together with a 40% aided speech recognition score and a 70% aided score on the phoneme discrimination subtest of the Auditory Speech Sounds Evaluation test battery. ConclusionsAlthough pure tone audiometry offers no information about bimodal benefit, it remains the most obvious audiometric evaluation in the decision process on the mode of bilateral stimulation in the paediatric population. A theoretical test protocol for adequate evaluation of bimodal benefit in the paediatric population is proposed.

Study of External Ear and Middle Ear Functions and Hearing Aid Adjustments to Deal with Pathological Changes

Study of External Ear and Middle Ear Functions and Hearing Aid Adjustments to Deal with Pathological Changes

Surgical removal of hearing aid ear mold impression material from the middle ear: a report of two cases

Surgical removal of hearing aid ear mold impression material from the middle ear: a report of two cases

디지털 필터를 사용한 귓속형 보청기의 지향성 실현

디지털 필터를 사용한 귓속형 보청기의 지향성 실현

Ukrywać, maskować, kamuflować: kłopotliwa widzialność instrumentów amplifi kujących dźwięk

In the 19th century, the ear trumpet became a ubiquitous attribute of deaf people. This large clumsy device was synonymous with deaf issues such as misinterpretation and other communication difficulties, leading to deafness being seen as a funny impairment, in contrast to blindness. Deaf users wanted to hide these stigmatizing devices, therefore producers invented sophisticated ways of disguising them as hats, fans or even chairs. Similarly, producers of the new electric hearing aids of the time followed this trend by designing them in the form of bags, jewelry, and glasses (it was still better to be shortsighted than hard-of-hearing). The miniaturization afforded by transistors consequently served the same aim. However, trumpets and especially hearing aids reflect the social and cultural emancipation of deaf communities that took place over the course of the 20th century; from aids bashfully hidden to instruments available in vivid colors and styles (e.g. with animal patterns or in punk styles) and decorated with specially designed jewelry used by the “proud Deaf”. The article is based on twofold empirical research: object-oriented analysis of the ear trumpet and hearing aid collection at Thackray’s Medical Museum (Leeds, Great Britain), and analysis of hearing aid advertisements published in Volta Review since 1910.

A Longitudinal Study in Children With Sequential Bilateral Cochlear Implants: Time Course for the Second Implanted Ear and Bilateral Performance.

Whether, and if so when, a second-ear cochlear implant should be provided to older, unilaterally implanted children is an ongoing clinical question. This study evaluated rate of speech recognition progress for the second implanted ear and with bilateral cochlear implants in older sequentially implanted children and evaluated localization abilities. A prospective longitudinal study included 24 bilaterally implanted children (mean ear surgeries at 5.11 and 14.25 years). Test intervals were every 3-6 months through 24 months postbilateral. Test conditions were each ear and bilaterally for speech recognition and localization. Overall, the rate of progress for the second implanted ear was gradual. Improvements in quiet continued through the second year of bilateral use. Improvements in noise were more modest and leveled off during the second year. On all measures, results from the second ear were poorer than the first. Bilateral scores were better than either ear alone for all measures except sentences in quiet and localization. Older sequentially implanted children with several years between surgeries may obtain speech understanding in the second implanted ear; however, performance may be limited and rate of progress gradual. Continued contralateral ear hearing aid use and reduced time between surgeries may enhance outcomes.

Effectiveness of Low Cut Modified Amplification using Receiver in the Canal Hearing Aid in Individuals with Auditory Neuropathy Spectrum Disorder.

Introduction The studies on hearing aid benefit in individuals with auditory neuropathy spectrum disorder (ANSD) shows limited benefit. Low cut modified amplification is found to be effective in few individuals with ANSD. With advancement in technology, receiver in the canal (RIC) hearing aids have proven to be more effective than traditional behind the ear (BTE) hearing aids. Objective Thus, the present study attempts to determine the effectiveness of low cut modified amplification using RIC and BTE. Method Twenty participants with ANSD were fitted with BTE and RIC using traditional and low cut modified amplification. We divided them into good and poor performers based on unaided speech identification scores (SIS). We then compared aided SIS and aided benefit across conditions in good and poor performers with ANSD across both conditions using BTE and RIC. Results The results of the study showed that the aided performance improved with low cut modified amplification in both BTE and RIC hearing aids. The improvement noticed with low-cut modified fitting with RIC was significant in more than BTE, especially in good performers with ANSD. Conclusion The improved clarity and naturalness of sound with RIC may have led to better aided scores and better acceptance of the hearing aid. Thus, low-cut modified amplification, preferably with RIC, needs to be attempted in fitting individuals with ANSD, especially in those with good unaided SIS in quiet.

Effects of Removing Low-Frequency Electric Information on Speech Perception With Bimodal Hearing.

The objective was to determine whether speech perception could be improved for bimodal listeners (those using a cochlear implant [CI] in one ear and hearing aid in the contralateral ear) by removing low-frequency information provided by the CI, thereby reducing acoustic-electric overlap. Subjects were adult CI subjects with at least 1 year of CI experience. Nine subjects were evaluated in the CI-only condition (control condition), and 26 subjects were evaluated in the bimodal condition. CIs were programmed with 4 experimental programs in which the low cutoff frequency (LCF) was progressively raised. Speech perception was evaluated using Consonant-Nucleus-Consonant words in quiet, AzBio sentences in background babble, and spondee words in background babble. The CI-only group showed decreased speech perception in both quiet and noise as the LCF was raised. Bimodal subjects with better hearing in the hearing aid ear (< 60 dB HL at 250 and 500 Hz) performed best for words in quiet as the LCF was raised. In contrast, bimodal subjects with worse hearing (> 60 dB HL at 250 and 500 Hz) performed similarly to the CI-only group. These findings suggest that reducing low-frequency overlap of the CI and contralateral hearing aid may improve performance in quiet for some bimodal listeners with better hearing.

Safety and effectiveness of the Vibrant Soundbridge in treating conductive and mixed hearing loss: A systematic review.

For many years, the therapeutic approach for conductive and/or mixed hearing loss has consisted of middle ear surgery with replacement of defect ossicles, and if possible the application of a hearing aid. Advances in technology have led to the introduction of electronmagnetic active implantable devices such as the Vibrant Soundbridge (VSB). With its various coupling techniques for different pathophysiological situations in the middle ear, the VSB offers greater improvement in the hearing performance of affected persons. PubMed, OvidSP (MEDLINE), EMBASE (DIMDI), the National Institue for Health research (NIHR) Centre for Reviews and Dissemination (including the National Health Service Economic Evaluation Database, Database of Abstracts of Reviews of Effects, and Health Technology Assessment), and the Cochrane Library were searched to identify articles published between January 2006 and April 2014 that evaluated the safety and effectiveness of the VSB in comparison to no intervention, bone conduction hearing implants (BCHI), and middle ear surgery plus hearing aids for adults and children with conductive or mixed hearing loss. Study selection and data extraction was carried out by multiple reviewers. Study quality was assessed using the Oxford Centre for Evidence-Based Medicine levels of evidence (2011); and a checklist available from the Evidence Analysis Library, Academy of Nutrition and Diabetics. Thirty-six publications were identified: 19 on VSB outcomes in 294 individuals, 13 on BCHI outcomes in 666 individuals, and four on middle ear surgery plus hearing aid outcomes in 43 individuals. Two systematic reviews were also identified. Heterogeneous outcome measures made it difficult to summarize data. In general, the VSB proved to be safe and effective when compared to no intervention and BCHI, and provided more and consistent hearing gain compared to middle ear surgery plus conventional hearing aids. As demonstrated in the literature, the VSB as an active device offers an effective alternative for patients with various middle ear pathologies, particularly with mixed hearing loss and failed previous tympanoplasties when classical ossiculoplasty could not provide enough functional gain. This new strategy in hearing rehabilitation has led to an improved quality of hearing and life. Laryngoscope, 126:1451-1457, 2016.

PO-0915 Therapeutic Options For Conductive Hearing Loss In Children With Cleft Palate

Background and aim Cleft lip and palate is a common congenital malformation correlated with otological disorders like Eustachian tube dysfunction, otitis media with effusion and conductive hearing loss correlated with speech disorders. Methods In our study we evaluate the therapeutic options for the conductive hearing loss in these children, such as: middle ear ventilation tube insertion, hearing aids and adenoidectomy. We conducted a retrospective chart review on 19 patients who underwent last follow-up during 2013, aged between 1 and 16, affected by cleft palate. We identified 3 cases of Treacher-Collins syndrome, 2 cases of CHARGE syndrome, 2 case sof Pierre Robin, 1 case of Goldhenar and 1 case of Di George syndrome. In 9 cases the cleft palate was isolated. In 14 cases we conducted phoniatric and logopaedic evaluations and 10 of these showed a speech disorder. Results We found a conductive hearing loss in 12 of the 19 children.2 of these patients used hearing aids with an improvementof speech performance; 1 patient underwent adenoidectomy for the appearance of sleep apnea but he modified his quality of voice with hypernasality and nasal emission after surgery; finally 9 children had spontaneous resolution of otitis media with effusion. Conclusions In conclusion we found that the more effective way to resolve the problem of conductive hearing loss and the resulting speech disorder is to use the hearing aids until the resolution of the hearing loss, which normally occurs around 7 years old.

Electromagnetic actuator for round window vibration to compensate for vibrant characteristics of ossicular chain

Round window (RW) vibration is a new technology to help people with hearing loss. Many RW approaches have been reported because the technology provides benefits. The main reason is that the new method can be implanted in patients who cannot use general middle ear hearing aids. Such patients, who lack a part of the ossicles, cannot preserve normal auditory response because the auditory path of RW vibration does not include the middle ear. Therefore, an electromagnetic RW actuator is implemented that compensates for the loss of middle ear's property. It has a vibrant frequency corresponding to normal characteristics of the human middle ear. © 2014 Institute of Electrical Engineers of Japan. Published by John Wiley & Sons, Inc.

Falhas técnicas dos aparelhos de amplificação sonora individual dispensados pelo Sistema Único de Saúde

Objetivo : investigar quais as principais falhas técnicas dos aparelhos de amplificação sonora individual fornecidos nos serviços do Sistema Único de Saúde.Métodos : foram analisadas as falhas técnicas dos aparelhos de amplificação sonora individual em cinco serviços credenciados pelo Ministério da Saúde, entre janeiro e maio de 2009, utilizando-se estatística descritiva.Resultados : as principais falhas técnicas encontradas nos dispositivos foram 37.44% de falha no amplificador, seguidas de 25.59% de falha no microfone. Os aparelhos de amplificação sonora individual retroauriculares e de categoria tecnológica A são os que apresentam maior ocorrência de falha técnica. O tempo de vida útil dos aparelhos de amplificação sonora individual sem apresentar defeito foi de 22 meses, em média. Na maior parte da população estudada, o custo para o conserto destes dispositivos foi entre R$500,00 e R$ 1000,00. Dos casos analisados, 51.82% entraram em contato com o serviço de saúde auditiva para buscar atendimento e verificar o problema e em 61% dos casos os aparelhos de amplificação sonora individual ainda estavam no prazo de garantia e foram consertados pela assistência técnica sem custo adicional para o paciente.Conclusão : a principal falha encontrada refere-se à falha do amplificador. Os AASI retroauricular e de categoria tecnológica A são os que apresentam maior ocorrência de falha técnica.

Audiological outcomes in cases with mucopolysaccharidoses (Morquio′s disease)

Background: The mucopolysaccharidoses (MPS) is an autosomal recessive disorder, caused due to malfunctioning of certain lysosomal enzymes involved in degradation of glycosaminoglycans. This report presents audiological evaluation findings found in two siblings with Morquio syndrome (MPS type IV). Materials and Methods: The present study evaluated two individuals (case A: 18-year-old male and case B: 15-year-old female) with a routine audiological evaluation including pure tone audiometry, speech audiometry, and immittance evaluation. Results: Case 'A' and 'B' were assessed for three consecutive audiological evaluations over time in a span of 2 years. For case A, all three evaluations revealed same degree of hearing loss in both ears. However, for case B, results reveal that there was increase in degree of hearing loss in both ears. Further, immittance results in both case A and B revealed middle ear pathology in both ears in all the three evaluations. Hence, it can be concluded that there was no progression in severity of hearing loss in case A; however, same was observed in case 'B'. In addition to that, at present both case A and B are using moderate gain digital behind the ear hearing aid in both the ears which is enabling them to communicate better. Conclusion: To conclude on these case reports of the siblings, otologist and audiologist need to be aware of this relevant information and take immediate steps to provide services to patients. Regular follow-up of the clients is an important aspect as it is highlighted in present study.

Implementation of a direct install 3-pole type EM transducer in round window niche for implantable middle ear hearing aids

Since the 1980's, various types of implantable hearing aids using unique means for delivering acoustic power to the inner ear have been developed. Recently, implantable hearing aids that stimulate the round window by the middle ear transducer have received great attention because it reduces loading effect at the ossicular chain. In this study, we have implemented a direct install 3-pole type EM transducer in round window niche for implantable middle ear hearing aid. The 3-pole type EM transducer consists of two permanent magnets and three coils and exhibit structural features that minimize leakage flux, thereby permitting high efficiency and low magnetic field interference. The stapes velocity was measured using a laser Doppler vibrometer in response to the round window stimulation from the transducer. To verify the usefulness of the 3-pole type EM transducer, we compared the stapes vibration characteristics produced by the transducer and those from a sound source. The magnitude of stapes velocity due to the round window stimulation at 1 mArms was equivalent to that of stapes velocity at 94 dB SPL sound stimulation. Thus, the evaluation study shows that the 3-pole type EM transducer is suitable for implantable hearing devices.

Mitigation of excessive acoustic compliance and trapped volume insertion gain in ear-sealing listening devices: Toward a safe, full-frequency-response hearing aid

When a sound producing device is sealed in the ear canal, acoustical compliances resulting from pressurization of the trapped volume lead to dramatic boosts in SPL, up to 60 dB, especially at low frequencies. This has been found to result in listener fatigue, and to trigger the acoustic (stapedius) reflex, as well as producing temporary threshold shift. Repeated exposure can cause temporary threshold shift to become permanent. Hearing aids avoid this problem by suppressing frequencies below about 300 Hz, where the effect is most pronounced. Other devices, such as ear buds and professional in-ear monitors, offer wider frequency response and thus expose listeners to potentially dangerous sound pressures. The acoustical compliance and trapped volume insertion gain is measured for ear buds and hearing aids by comparing SPL, measured in the ear canal, for sealed and unsealed conditions. New ear sealing technology is demonstrated that allows release of the excess acoustical compliance and thus mitigates the trapped volume insertion gain: (1) a vent covered with a flexible membrane, and (2) an inflatable bubble seal. This novel technology has allowed the creation of a hybrid device with hearing aid functionality that also has the broad frequency response of professional in-ear monitors.

정원창 구동기의 진동체 성능 평가를 위한 내이 물리모델

Recently, various hearing aids are developed to overcome hearing loss. There are available hearing aids, such as air conduction hearing aid, implantable middle ear hearing aid and so on. But air conduction hearing aid is inconvenience caused by howling, and ossicle chain driving type implantable middle ear hearing aid has some week point due to problem of possible nercobiosis of coupling spot along incus long process. In recent years, in order to improve these shortcomings round window (RW) driving hearing aid has been paying attention. In this paper, the physical cochlear model is proposed for a performance evaluation of the RW driving hearing aids of a transducer. In order to verify an experiment proposed on a performance of physical cochlear model, the transducer which has ossicles characteristics is used. By measuring and comparing the frequency characteristics of transducer with ossicles and human temporal bone, performance of physical cochlear model was verified. As from the result of experiment, it is expected that an implemented cochlear model is useful for evaluating characteristics of RW transducer.

Vibrant sound bridge application to middle ear windows versus conventional hearing aids: a comparative study based on international outcome inventory for hearing aids

In this study, we aimed to compare the outcomes of satisfaction of the patients who used hearing aids preceding the vibrant sound bridge (VSB) application on middle ear windows (14 oval window and 5 round window). Nineteen adult patients with conductive or mixed hearing loss were included in the study. All patients used behind the ear hearing aids on the site which was selected for VSB application. The patients used hearing aids for at least 3 months before the VSB operation. The floating mass transducer (FMT) was placed on one of the middle ear windows (oval or round) in VSB operation. The patients were evaluated with International Outcome Inventory for Hearing Aids (IOI-HA) preoperatively after at least 3 months trial of conventional hearing aid and postoperatively after 3 months use of VSB. No perioperative problem was encountered. The total score of IOI-HA was significantly higher with VSB compared with conventional hearing aids (p < 0.05). No statistically significant difference was found between the daily use, residual activity limitations, satisfaction, impact on others, quality of life between middle ear implant and hearing aid (p > 0.05). The IOI-HA scores were significantly higher with the middle ear implant than the conventional hearing aid regarding benefit and residual participation restrictions (p < 0.05). Although the scores for quality of life assessment was similar between VSB and hearing aid use, there was a superiority of VSB in terms of benefit and residual participation restrictions as well as overall IOI-HA scores as the FMT was placed on one of the middle ear windows.

External auditory canal microbiology and hearing aid use

ObjectiveThe aim of this study was to determine the presence and nature of bacterial flora on hearing aids and the ears of this population. We wonder if the microbiology of the ears with hearing aid wearing differs from the other ear. SettingTertiary referral center. DesignA prospective, clinical study. Subjects and methodsThree samples were taken, one from the surface of the hearing aid's ear mold; one from the hearing aid-wearing ear canal and the last one from the ear without hearing aid. Samples were cultured to determine qualitatively and quantitatively the pathogenic microorganisms present. ResultsA total of 123 samples, obtained from 41 hearing aid users, were analyzed. Methicillin-resistant coagulase-negative staphylococci, methicillin-susceptible Staphylococcus aureus, methicillin-resistant S. aureus, Pseudomonas aeruginosa, Escherichia coli, Acinetobacter species, Staphylococcus auricularis, and Stenotrophomonas maltophilia were identified organisms. ConclusionsWe identified unexpected microorganisms both on hearing aids and hearing aid using ears. This study demonstrates that using hearing aid alters the ear canal flora. To avoid otitis externa, it is important to use an appropriate hygiene routine to clean and disinfect hearing aids and ear molds.

Presbycusis, Part 2: Can You Hear the Music of Life?

T he results of our open-ended avenues of inquiry in preaudiology screening of 10 participants revealed they were incapable of hearing sounds in the environment nor were they able to engage in meaningful conversation with caregiver(s). The results of postaudiology screening show that all 10 could hear sounds in the environment by various pitch ranges and rhythms. Many sounds had been long forgotten, such as household appliances, street traffic, train whistles, and birds. Another benefit to hearing technology was socialization. Participants said they attended Sunday worship services and heard the sermons (either in church or by television) and participated in singing sacred songs. Other comments participants gave concerning their morale, life satisfaction, and social support were the following:Communication has improved and I'm happier, less confused, and less sad because now I can hear what other people are saying to me.Now, I can play cards with my grandson!I can carry on a conversation now-before I was pretending to hear-now I hear and participate in conversations.I can return to driving to visit my friends.I will now engage in theatrical and music performances because I can hear.CAREGIVERSDespite caregivers' concerns that the caregiver scale (see Appendix A) and the annoying problem behaviors log calendar (see Appendix B) were too difficult to understand and complete, 7 of 10 caregivers were (a) compliant in tracking the number of hours participants wore their hearing aids (see Table 1) and (b) compliant in tracking participants' annoying problem behaviors and assigning a value from 0 (least) to 4 (most) that reflected their frustrations with participants. Table 2 illustrates the outcome of caregiver logs over an 8-week period and the total number of hours that participants wore their hearing aids for the study. The results of three remaining caregivers were dissimilar: (a) a caregiver and parent withdrew 1 week into the study; (b) a caregiver and parent spent 4 weeks waiting for ear canal impressions and hearing aids so that by the time the hearing aids were fitted and worn for 4 weeks, the study had ended. This prevented the student researcher from measuring results; and (c) a caregiver only completed one out of eight log sheets on her parent during the 8-week period for reasons that are speculative.Results of Caregiver ScaleAll eight participants, for which there were completed caregiver logs, revealed either some annoying problem behaviors lessened or they disappeared altogether with the use of hearing technology in less than 30 days. There was an equal division among analyses by caregivers in the pretreatment Mini Mental State Examination (MMSE) dementia instrument of participant behaviors.On the one hand, one half of caregivers rated their parent or spouse as not having dementia behaviors: (a) not suspicious of other people hiding and stealing their property, (b) cognizant of living in their own homes, and (c) never demonstrating behaviors of paranoia or suspiciousness.On the other hand, one half of caregivers rated their parent or spouse as having dementia behaviors: (a) believing someone other than himself or herself was hiding their property, (b) talking to imaginary people, (c) hoarding or hiding property from caregivers, and (d) hearing voices or imagining conversations with other people.Yet after wearing hearing aids for 30 days, these annoying problem behaviors lessened or they discontinued altogether.Because the primary investigator did not administer the MMSE scale before and after to 10 participants, measurement of cognitive test scores are unavailable. However, based on the student researcher's observations of participants throughout the study, she has rated participant behaviors in both pretreatments and posttreatments (see Table 2). The student researcher did not observe behavioral signs of dementia in three participants for 8 weeks. …

Presbycusis, Part 1: Can You Hear the Music Of Life?

We used a novel approach allowing participants in this study to self-monitor their hearing sensitivity to familiar sounds in the environment. The objective of this approach was to establish whether participants in the 80-89 and 90-99 age groups would recognize the degree of their hearing impairment. It was our hope that participants would value audiology treatment and that it would improve their quality of life over a short period. The pilot study took place in a clinical environment where participants answered survey questions before and after audiology treatment, which pertained to their hearing impairment, morale, social support, and life satisfaction. Caregivers were included in the research to rate and record participants' problem behaviors (e.g., shouting, anger, agitation, repetitive speech dialog, and depression) before, during, and after treatment. This research validates other scientists' findings that annoying problem behaviors may actually be the result of hearing loss because of a person's inability to recognize speech. The pilot study shows that participants with mild dementia adapted well to speech and sounds in the natural environment without agitation as well as to management of hearing aids within a 30-day period. The participants with moderate dementia were slower to adapt. All participants with dementia required the cooperation of their caregivers to maintain hygiene of ear canals and hearing aids and insertion. This study suggests that the sooner people receive treatment for hearing loss, the quicker they are to recognize speech and to master hearing aid technology.