Effects Of Hearing Aids Research Articles

Effectiveness of Frequency-Lowering Hearing Aids and Electric Acoustic Stimulation Cochlear Implant for Treating People with a Severe-To-Profound High-Frequency Hearing Loss

Objectives The objective of this research project was to compare the effectiveness of frequency transposition frequency compression hearing aids and the electric acoustic stimulation EAS cochlear implant to improve speech recognition in participants with a sensorineural severe to profound high frequency hearing loss HFHL Design Ten adults with a severe to profound HFHL were recruited They were all tested with frequency compression and frequency transposition hearing aids following an ABAC single subject design four week baselines were completed with their own hearing aids followed by eight week trials with each device One participant also received an EAS implant after hearing aid trials Follow up time ranged from to weeks Speech recognition was measured each week using sentence and monosyllable lists in quiet and in noise The subjective benefit with each technology was assessed with standardized questionnaires Complementary data about the EAS implant effectiveness were also extracted from our database of EAS users nbsp Results Frequency lowering FL hearing aids improved speech recognition in five participants when compared to conventional hearing aids Others experienced either no gain or some degradation in speech recognition when using a FL algorithm Most participants reported better speech perception in everyday listening situations with FL hearing aids Still the participant who received an EAS implant obtained a greater improvement in speech recognition and reported a better benefit with this technology Data collected from our database of EAS patients validated that the EAS participant was representative of our EAS users rsquo population Conclusion The EAS implant appears as the first indication for treating people with a severe to profound HFHL it is also the costliest and most invasive alternative Thus and considering the significant benefit some participants obtained with FL hearing aids trials using these technologies should be considered on an individual basis prior to implantation

感音難聴に対する補聴器装用による聴覚機能への効果

感音難聴に対する補聴器装用による聴覚機能への効果

比較選択法によるサウンドジェネレータ付き補聴器と補聴器単独の耳鳴に対する効果と評価法の問題点

比較選択法によるサウンドジェネレータ付き補聴器と補聴器単独の耳鳴に対する効果と評価法の問題点

Study on treatment effect of hearing aids on bilateral prolonged tinnitus in Chinese patients

Purpose: This study aims to discuss the treatment effect of hearing aids on tinnitus. Methods Send questionnaires to 48 cases of bilateral prolonged tinnitus patients with course of more than 1 year to evaluate the subjective perception state of the tinnitus after 24 months. At the same time, follow up 10 cases of bilateral prolonged tinnitus patients without receiving the treatment of hearing aids and use them as the contrast group. Results: Through the treatment of 24 months, the treatment effects on tinnitus are as follows: 23 cases were cured (47.92%), 14 patients were improved significantly (29.17%), 6 cases were improved (12.5%), and 6 cases were invalid (12.5%). The overall effective rate was 87.5%.Conclusion: The hearing aids have treatment effect on the bilateral prolonged tinnitus patients in China.

Light-Driven Contact Hearing Aid for Broad-Spectrum Amplification: Safety and Effectiveness Pivotal Study.

Objective:Demonstrate safety and effectiveness of the light-driven contact hearing aid to support FDA clearance.Study Design:A single-arm, open-label investigational-device clinical trial.Setting:Two private-practice and one hospital-based ENT clinics.Patients:Forty-three subjects (86 ears) with mild-to-severe bilateral sensorineural hearing impairment.Intervention:Bilateral amplification delivered via a light-driven contact hearing aid comprising a Tympanic Lens (Lens) with a customized platform to directly drive the umbo and a behind-the-ear sound processor (Processor) that encodes sound into light pulses to wirelessly deliver signal and power to the Lens.Main Outcome Measures:The primary safety endpoint was a determination of “no change” (PTA4 < 10 dB) in residual unaided hearing at the 120-day measurement interval. The primary efficacy endpoint was improvement in word recognition using NU-6 at the 30-day measurement interval over the baseline unaided case. Secondary efficacy endpoints included functional gain from 2 to 10 kHz and speech-in-noise improvement over the baseline unaided case using both omnidirectional and directional microphones.Results:The results for the 86 ears in the study determined a mean change of −0.40 dB in PTA4, indicating no change in residual hearing (p < 0.0001). There were no serious device- or procedure-related adverse events, or unanticipated adverse events. Word recognition aided with the Earlens improved significantly (p < 0.0001) over the unaided performance, by 35% rationalized arcsine units on average. Mean functional gain was 31 dB across 2 to 10 kHz. The average speech-recognition threshold improvement over the unaided case for the Hearing in Noise Test was 0.75 dB (p = 0.028) and 3.14 dB (p < 0.0001) for the omnidirectional and directional microphone modes, respectively.Conclusion:The safety and effectiveness data supported a de novo 510(k) submission that received clearance from the FDA.

Effect of hearing aids use on speech stimulus decoding through speech-evoked ABR

IntroductionThe electrophysiological responses obtained with the complex auditory brainstem response (cABR) provide objective measures of subcortical processing of speech and other complex stimuli. The cABR has also been used to verify the plasticity in the auditory pathway in the subcortical regions. ObjectiveTo compare the results of cABR obtained in children using hearing aids before and after 9 months of adaptation, as well as to compare the results of these children with those obtained in children with normal hearing. MethodsFourteen children with normal hearing (Control Group – CG) and 18 children with mild to moderate bilateral sensorineural hearing loss (Study Group – SG), aged 7–12 years, were evaluated. The children were submitted to pure tone and vocal audiometry, acoustic immittance measurements and ABR with speech stimulus, being submitted to the evaluations at three different moments: initial evaluation (M0), 3 months after the initial evaluation (M3) and 9 months after the evaluation (M9); at M0, the children assessed in the study group did not use hearing aids yet. ResultsWhen comparing the CG and the SG, it was observed that the SG had a lower median for the V–A amplitude at M0 and M3, lower median for the latency of the component V at M9 and a higher median for the latency of component O at M3 and M9. A reduction in the latency of component A at M9 was observed in the SG. ConclusionChildren with mild to moderate hearing loss showed speech stimulus processing deficits and the main impairment is related to the decoding of the transient portion of this stimulus spectrum. It was demonstrated that the use of hearing aids promoted neuronal plasticity of the Central Auditory Nervous System after an extended time of sensory stimulation.

Difference of auditory brainstem responses by stimulating to round and oval window in animal experiments

ABSTACTTo ensure the safety and efficacy of implantable hearing aids, animal experiments are an essential developmental procedure, in particular, auditory brainstem responses (ABRs) can be used to verify the objective effectiveness of implantable hearing aids. This study measured and compared the ABRs generated when applying the same vibration stimuli to an oval window and round window. The ABRs were measured using a TDT system 3 (TDT, USA), while the vibration stimuli were applied to a round window and oval window in 4 guinea pigs using a piezo-electric transducer with a proper contact tip. A paired t-test was used to determine any differences between the ABR amplitudes when applying the stimulation to an oval window and round window. The paired t-test revealed a significant difference between the ABR amplitudes generated by the round and oval window stimulation (t = 10.079, α < .0001). Therefore, the results confirmed that the biological response to round window stimulation was not the same as that to oval window stimulation.

The Hearing Aid ‘Effect’ as a Function of Race and Gender

The Hearing Aid ‘Effect’ as a Function of Race and Gender

TeleAudiology in the Veterans Health Administration.

To assess effectiveness of TeleAudiology for hearing aid services. Retrospective case-control. Ambulatory Veterans Health Administration and Community-Based Outpatient Clinics (CBOCs). 42,697 veterans who received hearing aids from January through September, 2014. TeleAudiology (TA) and conventional in-person (IP) audiology care. International Outcome Inventory for Hearing Aids (IOI-HA) outcomes data. The IOI-HA is a 7-item survey used to assess hearing aid effectiveness. Scored from 7 to 35 points, higher scores are more favorable. Among veterans nationwide who received hearing aids and completed the IOI-HA survey, 1,009 received TA and 41,688 received IP care. TA and IP groups have comparable mean IOI-HA values (TA = 29.6, SD = 3.9; IP = 28.7, SD = 4.2). Although comparison showed a statistically significant difference (p < 0.0001, t test), principally because of large sample size, the distinction is not clinically meaningful.Subgroup analysis of veterans from San Francisco and six affiliated CBOCs showed 169 received TA and 338 received IP care. TA and IP groups have similar mean age (TA = 74, SD = 9.8; IP = 76, SD = 10.3) and sex distribution (TA male = 100%; IP male = 96%) with statistically significant (p < 0.01, t test) but clinically insignificant differences. Mean IOI-HA scores (TA = 30.7, SD = 3.6; IP = 30.5, SD = 3.1) are not different between groups (p > 0.05, t test). TA and IP encounters to provide hearing aid services to veterans are comparable, as both are highly effective based on IOI-HA results. The noninferiority of TA suggests its adoption to non-veterans may improve access while preserving high satisfaction. Financial impact of migration to TA will require future econometric analysis.

A Dynamic Speech Comprehension Test for Assessing Real-World Listening Ability.

Many listeners with hearing loss report particular difficulties with multitalker communication situations, but these difficulties are not well predicted using current clinical and laboratory assessment tools. The overall aim of this work is to create new speech tests that capture key aspects of multitalker communication situations and ultimately provide better predictions of real-world communication abilities and the effect of hearing aids. A test of ongoing speech comprehension introduced previously was extended to include naturalistic conversations between multiple talkers as targets, and a reverberant background environment containing competing conversations. In this article, we describe the development of this test and present a validation study. Thirty listeners with normal hearing participated in this study. Speech comprehension was measured for one-, two-, and three-talker passages at three different signal-to-noise ratios (SNRs), and working memory ability was measured using the reading span test. Analyses were conducted to examine passage equivalence, learning effects, and test-retest reliability, and to characterize the effects of number of talkers and SNR. Although we observed differences in difficulty across passages, it was possible to group the passages into four equivalent sets. Using this grouping, we achieved good test-retest reliability and observed no significant learning effects. Comprehension performance was sensitive to the SNR but did not decrease as the number of talkers increased. Individual performance showed associations with age and reading span score. This new dynamic speech comprehension test appears to be valid and suitable for experimental purposes. Further work will explore its utility as a tool for predicting real-world communication ability and hearing aid benefit.

The Effects of Hearing Impairment, Age, and Hearing Aids on the Use of Self-Motion for Determining Front/Back Location.

There are two cues that listeners use to disambiguate the front/back location of a sound source: high-frequency spectral cues associated with the head and pinnae, and self-motion-related binaural cues. The use of these cues can be compromised in listeners with hearing impairment and users of hearing aids. To determine how age, hearing impairment, and the use of hearing aids affect a listener's ability to determine front from back based on both self-motion and spectral cues. We used a previously published front/back illusion: signals whose physical source location is rotated around the head at twice the angular rate of the listener's head movements are perceptually located in the opposite hemifield from where they physically are. In normal-hearing listeners, the strength of this illusion decreases as a function of low-pass filter cutoff frequency, this is the result of a conflict between spectral cues and dynamic binaural cues for sound source location. The illusion was used as an assay of self-motion processing in listeners with hearing impairment and users of hearing aids. We recruited 40 hearing-impaired participants, with an average age of 62 yr. The data for three listeners were discarded because they did not move their heads enough during the experiment. Listeners sat at the center of a ring of 24 loudspeakers, turned their heads back and forth, and used a wireless keypad to report the front/back location of statically presented signals and of dynamically moving signals with illusory locations. Front/back accuracy for static signals, the strength of front/back illusions, and minimum audible movement angle were measured for each listener in each condition. All measurements were made in each listener both aided and unaided. Hearing-impaired listeners were less accurate at front/back discrimination for both static and illusory conditions. Neither static nor illusory conditions were affected by high-frequency content. Hearing aids had heterogeneous effects from listener to listener, but independent of other factors, on average, listeners wearing aids exhibited a spectrally dependent increase in "front" responses: the more high-frequency energy in the signal, the more likely they were to report it as coming from the front. Hearing impairment was associated with a decrease in the accuracy of self-motion processing for both static and moving signals. Hearing aids may not always reproduce dynamic self-motion-related cues with sufficient fidelity to allow reliable front/back discrimination.

Effects of Hearing Loss on Dual-Task Performance in an Audiovisual Virtual Reality Simulation of Listening While Walking.

Most activities of daily living require the dynamic integration of sights, sounds, and movements as people navigate complex environments. Nevertheless, little is known about the effects of hearing loss (HL) or hearing aid (HA) use on listening during multitasking challenges. The objective of the current study was to investigate the effect of age-related hearing loss (ARHL) on word recognition accuracy in a dual-task experiment. Virtual reality (VR) technologies in a specialized laboratory (Challenging Environment Assessment Laboratory) were used to produce a controlled and safe simulated environment for listening while walking. In a simulation of a downtown street intersection, participants completed two single-task conditions, listening-only (standing stationary) and walking-only (walking on a treadmill to cross the simulated intersection with no speech presented), and a dual-task condition (listening while walking). For the listening task, they were required to recognize words spoken by a target talker when there was a competing talker. For some blocks of trials, the target talker was always located at 0° azimuth (100% probability condition); for other blocks, the target talker was more likely (60% of trials) to be located at the center (0° azimuth) and less likely (40% of trials) to be located at the left (270° azimuth). The participants were eight older adults with bilateral HL (mean age = 73.3 yr, standard deviation [SD] = 8.4; three males) who wore their own HAs during testing and eight controls with normal hearing (NH) thresholds (mean age = 69.9 yr, SD = 5.4; two males). No participant had clinically significant visual, cognitive, or mobility impairments. Word recognition accuracy and kinematic parameters (head and trunk angles, step width and length, stride time, cadence) were analyzed using mixed factorial analysis of variances with group as a between-subjects factor. Task condition (single versus dual) and probability (100% versus 60%) were within-subject factors. In analyses of the 60% listening condition, spatial expectation (likely versus unlikely) was a within-subject factor. Differences between groups in age and baseline measures of hearing, mobility, and cognition were tested using t tests. The NH group had significantly better word recognition accuracy than the HL group. Both groups performed better when the probability was higher and the target location more likely. For word recognition, dual-task costs for the HL group did not depend on condition, whereas the NH group demonstrated a surprising dual-task benefit in conditions with lower probability or spatial expectation. For the kinematic parameters, both groups demonstrated a more upright and less variable head position and more variable trunk position during dual-task conditions compared to the walking-only condition, suggesting that safe walking was prioritized. The HL group demonstrated more overall stride time variability than the NH group. This study provides new knowledge about the effects of ARHL, HA use, and aging on word recognition when individuals also perform a mobility-related task that is typically experienced in everyday life. This research may help inform the development of more effective function-based approaches to assessment and intervention for people who are hard-of-hearing.

Impact of Hearing Aid Technology on Outcomes in Daily Life I: The Patients' Perspective.

One of the challenges facing hearing care providers when recommending hearing aids is the choice of device technology level. Major manufacturers market families of hearing aids that are described as spanning the range from basic technology to premium technology. Premium technology hearing aids include acoustical processing capabilities (features) that are not found in basic technology instruments. These premium features are intended to yield improved hearing in daily life compared with basic-feature devices. However, independent research that establishes the incremental effectiveness of premium-feature devices compared with basic-feature devices is lacking. This research was designed to explore reported differences in hearing abilities for adults using premium- and basic-feature hearing aids in their daily lives. This was a single-blinded, repeated, crossover trial in which the participants were blinded. All procedures were carefully controlled to limit researcher bias. Forty-five participants used carefully fitted bilateral hearing aids for 1 month and then provided data to describe the hearing improvements or deficiencies noted in daily life. Typical participants were 70 years old with mild to moderate adult-onset hearing loss bilaterally. Each participant used four pairs of hearing aids: premium- and basic-feature devices from brands marketed by each of two major manufacturers. Participants were blinded about the devices they used and about the research questions. All of the outcomes were designed to capture the participant's point of view about the benefits of the hearing aids. Three types of data were collected: change in hearing-related quality of life, extent of agreement with six positively worded statements about everyday hearing with the hearing aids, and reported preferences between the premium- and basic-feature devices from each brand as well as across all four research hearing aids combined. None of these measures yielded a statistically significant difference in outcomes between premium- and basic-feature devices. Participants did not report better outcomes with premium processing with any measure. It could reasonably be asserted that the patient's perspective is the gold standard for hearing aid effectiveness. While the acoustical processing provided by premium features can potentially improve scores on tests conducted in contrived conditions in a laboratory, or on specific items in a questionnaire, this does not ensure that the processing will be of noteworthy benefit when the hearing aid is used in the real world challenges faced by the patient. If evidence suggests the patient cannot detect that premium features yield improvements over basic features in daily life, what is the responsibility of the provider in recommending hearing aid technology level? In the present research, there was no evidence to suggest that premium-feature devices yielded better outcomes than basic-feature devices from the patient's point of view. All of the research hearing aids were substantially, but equally, helpful. Further research is needed on this topic with other hearing aids and other manufacturers. In the meantime, providers should insist on scientifically credible independent evidence to support effectiveness claims for any hearing help devices.

Lessons from LOCHI.

Lessons from LOCHI.

The evaluation of hearing aid effect in presbycusis

Objective:To evaluate the effect of hearing aid in presbycusis. Method:Using the method of international outcome inventory for hearing aids(IOI-HA)and medium acoustic intensity(65 dBSPL) word recognition score(WRS), to evaluate the effect of hearing aid in moderate and severe presbycusis. Result:After the hearing aid of moderate presbycusis, The improved value of monosyllabic words and recognition rate in quite and noise statement(SNR=5) were 31.15%, 23.21%, 44.11%.However, improved values in severe presbycusis were 37.51%, 48.47%，50.17%, before and after hearing aid, the difference of the improved average value was statistically significant(P <0.05); Both the moderate and severe presbycusis were satisfacted with hearing aid.The IO-HA scores of moderate and severe presbycusis ranged from 15 to 34.The difference of IOIHA score of moderate and severe presbycusis had no statistical significance(P >0.05); moderate and severe presbycusis with high satisfaction with HA of quiet statement,and low satisfaction of monosyllabic words listening, and the degree of satisfaction was higher in patients with moderate to severe hearing loss in noise statement.Conclusion:Speech audiometry is an important method to assess the effect of hearing aid; IOI-HA is a timeconsuming short, subjective method.The combine of multiple evaluations have guiding significance to debugging of hearing aid expected effect and hearing aid device.

Ipoacusia e declino cognitivo: revisione della letteratura

SUMMARYAge-related hearing loss (ARHL) has a multifactorial pathogenesis and it is an inevitable hearing impairment associated with reduction of communicative skills related to ageing. Increasing evidence has linked ARHL to more rapid progression of cognitive decline and incidental dementia. Many aspects of daily living of elderly people have been associated to hearing abilities, showing that hearing loss (HL) affects the quality of life, social relationships, motor skills, psychological aspects and function and morphology in specific brain areas. Epidemiological and clinical studies confirm the assumption of a relationship between these conditions. However, the mechanisms are still unclear and are reviewed herein. Long-term hearing deprivation of auditory inputs can impact cognitive performance by decreasing the quality of communication leading to social isolation and depression and facilitate dementia. On the contrary, the limited cognitive skills may reduce the cognitive resources available for auditory perception, increasing the effects of HL. In addition, hearing loss and cognitive decline may reflect a 'common cause' on the auditory pathway and brain. In fact, some pathogenetic factors are recongised in common microvascular disease factors such as diabetes, atherosclerosis and hypertension. Interdisciplinary efforts to investigate and address HL in the context of brain and cognitive ageing are needed. Surprisingly, few studies have been adressed on the effectiveness of hearing aids in changing the natural history of cognitive decline. Effective interventions with hearing aids or cochlear implant may improve social and emotional function, communication, cognitive function and positively impact quality of life. The aim of this review is to overview new insights on this challenging topic and provide new ideas for future research.

Effects of Sound-Induced Hearing Loss and Hearing Aids on the Perception of Music

Exposure to high-level music produces several physiological changes in the auditory system that lead to a variety of perceptual effects. Damage to the outer hair cells within the cochlea leads to a loss of sensitivity to weak sounds, loudness recruitment (a more rapid than normal growth of loudness with increasing sound level), and reduced frequency selectivity. Damage to inner hair cells and/or synapses leads to degeneration of neurons in the auditory nerve and to a reduced flow of information to the brain. This leads to poorer auditory discrimination and may contribute to reduced sensitivity to the temporal fine structure of sounds and to poor pitch perception. Hearing aids compensate for the effects of threshold elevation and loudness recruitment via multichannel amplitude compression, but they do not compensate for reduced frequency selectivity or loss of inner hair cells/synapses/neurons. Multichannel compression can impair some aspects of the perception of music, such as the ability to hear out one instrument or voice from a mixture. The limited frequency range and irregular frequency response of most hearing aids is associated with poor sound quality for music. Finally, systems for reducing acoustic feedback can have undesirable side effects when listening to music.

Selecting Appropriate Tests to Assess the Benefits of Bilateral Amplification With Hearing Aids.

The aim of this study was to investigate the effect of bilateral hearing aids (HA) in subjects with mild and moderate-to-severe hearing loss. This study was designed as a within-subject feasibility study. Bilateral HA use was assessed using different laboratory tests on speech reception, listening effort, noise tolerance, and localization. All data were evaluated with bilateral and unilateral HA fittings. Forty experienced bilateral HA users were included with hearing impairment ranging from mild to moderate-to-severe. Subjects were stratified into two groups based on the degree of hearing loss. Speech reception in noise, listening effort, and localization tests showed a bilateral benefit for the moderate-to-severely hearing-impaired subjects. A bilateral benefit was also observed for listening effort in the mildly hearing-impaired group. The assessment of listening effort shows promise as a measure of bilateral HA benefit for mild hearing impairment. Localization and speech reception in noise tests provide additional value for larger losses. The next step is to compare experienced unilateral with bilateral HA users.

Are Experienced Hearing Aid Users Faster at Grasping the Meaning of a Sentence Than Inexperienced Users? An Eye-Tracking Study

This study assessed the effects of hearing aid (HA) experience on how quickly a participant can grasp the meaning of an acoustic sentence-in-noise stimulus presented together with two similar pictures that either correctly (target) or incorrectly (competitor) depict the meaning conveyed by the sentence. Using an eye tracker, the time taken by the participant to start fixating the target (the processing time) was measured for two levels of linguistic complexity (low vs. high) and three HA conditions: clinical linear amplification (National Acoustic Laboratories-Revised), single-microphone noise reduction with National Acoustic Laboratories-Revised, and linear amplification ensuring a sensation level of ≥ 15 dB up to at least 4 kHz for the speech material used here. Timed button presses to the target stimuli after the end of the sentences (offline reaction times) were also collected. Groups of experienced (eHA) and inexperienced (iHA) HA users matched in terms of age, hearing loss, and working memory capacity took part (N = 15 each). For the offline reaction times, no effects were found. In contrast, processing times increased with linguistic complexity. Furthermore, for all HA conditions, processing times were longer (poorer) for the iHA group than for the eHA group, despite comparable speech recognition performance. Taken together, these results indicate that processing times are more sensitive to speech processing-related factors than offline reaction times. Furthermore, they support the idea that HA experience positively impacts the ability to process noisy speech quickly, irrespective of the precise gain characteristics.

Do Hearing Aids Improve Affect Perception?

Normal-hearing listeners use acoustic cues in speech to interpret a speaker's emotional state. This study investigates the effect of hearing aids on the perception of the emotion dimensions arousal (aroused/calm) and valence (positive/negative attitude) in older adults with hearing loss. More specifically, we investigate whether wearing a hearing aid improves the correlation between affect ratings and affect-related acoustic parameters. To that end, affect ratings by 23 hearing-aid users were compared for aided and unaided listening. Moreover, these ratings were compared to the ratings by an age-matched group of 22 participants with age-normal hearing.For arousal, hearing-aid users rated utterances as generally more aroused in the aided than in the unaided condition. Intensity differences were the strongest indictor of degree of arousal. Among the hearing-aid users, those with poorer hearing used additional prosodic cues (i.e., tempo and pitch) for their arousal ratings, compared to those with relatively good hearing. For valence, pitch was the only acoustic cue that was associated with valence. Neither listening condition nor hearing loss severity (differences among the hearing-aid users) influenced affect ratings or the use of affect-related acoustic parameters. Compared to the normal-hearing reference group, ratings of hearing-aid users in the aided condition did not generally differ in both emotion dimensions. However, hearing-aid users were more sensitive to intensity differences in their arousal ratings than the normal-hearing participants.We conclude that the use of hearing aids is important for the rehabilitation of affect perception and particularly influences the interpretation of arousal.