Glasgow Hearing Aid Benefit Profile Research Articles

A validation study of the Swedish version of the Glasgow hearing aid benefit profile evaluated in otosclerosis subjects.

ObjectivesThe aim of this study was to translate the Glasgow Benefit Hearing Aid Profile (GHABP) to Swedish, and to analyze its validity and reliability in patients undergoing rehabilitation with surgery or hearing aids.MethodsThe GHABP was translated to Swedish following published guidelines. One version of the questionnaire was adapted to fit the surgical intervention. A modification was made to the questionnaire by removing the answer option “not applicable” (N/A) since it was found confusing by the subjects. A prospective multicenter cohort study was performed to validate the questionnaire. One hundred and twenty‐three individuals diagnosed with otosclerosis were included in the study prior to the intervention. The individuals were divided into three groups based on the intervention and previous hearing aid experience. Pure tone audiometry was performed 1 month prior and 1 year after the intervention. The Swedish version of the GHABP was completed by the individuals prior to the intervention, as well as 6 and 12 months after the intervention. Validity and reliability were assessed.ResultsThe Swedish versions of the GHABP were well accepted by the included individuals. The questionnaires showed good psychometric properties, with comparable results for the two different interventions and three separate intervention groups. Initial disability was more pronounced in more challenging listening situations. Disability was reduced after the intervention. The “Use,” “Benefit,” and “Satisfaction” domains demonstrated beneficial results; however, a ceiling effect was noted in the same domains. The reliability was overall very high.ConclusionThe Swedish version of the GHABP had good psychometric properties, with high validity and reliability. The same outcomes were found for the hearing aid and surgery groups. A ceiling effect was observed that can affect the questionnaire's ability to distinguish between subjects and measures over time.Level of evidence2c

Cogmed Training Does Not Generalize to Real-World Benefits for Adult Hearing Aid Users: Results of a Blinded, Active-Controlled Randomized Trial.

Objectives:Performance on working memory tasks is positively associated with speech-in-noise perception performance, particularly where auditory inputs are degraded. It is suggested that interventions designed to improve working memory capacity may improve domain-general working memory performance for people with hearing loss, to benefit their real-world listening. We examined whether a 5-week training program that primarily targets the storage component of working memory (Cogmed RM, adaptive) could improve cognition, speech-in-noise perception and self-reported hearing in a randomized controlled trial of adult hearing aid users with mild to moderate hearing loss, compared with an active control (Cogmed RM, nonadaptive) group of adults from the same population.Design:A preregistered randomized controlled trial of 57 adult hearing aid users (n = 27 experimental, n = 30 active control), recruited from a dedicated database of research volunteers, examined on-task learning and generalized improvements in measures of trained and untrained cognition, untrained speech-in-noise perception and self-reported hearing abilities, pre- to post-training. Participants and the outcome assessor were both blinded to intervention allocation. Retention of training-related improvements was examined at a 6-month follow-up assessment.Results:Per-protocol analyses showed improvements in trained tasks (Cogmed Index Improvement) that transferred to improvements in a trained working memory task tested outside of the training software (Backward Digit Span) and a small improvement in self-reported hearing ability (Glasgow Hearing Aid Benefit Profile, Initial Disability subscale). Both of these improvements were maintained 6-month post-training. There was no transfer of learning shown to untrained measures of cognition (working memory or attention), speech-in-noise perception, or self-reported hearing in everyday life. An assessment of individual differences showed that participants with better baseline working memory performance achieved greater learning on the trained tasks. Post-training performance for untrained outcomes was largely predicted by individuals’ pretraining performance on those measures.Conclusions:Despite significant on-task learning, generalized improvements of working memory training in this trial were limited to (a) improvements for a trained working memory task tested outside of the training software and (b) a small improvement in self-reported hearing ability for those in the experimental group, compared with active controls. We found no evidence to suggest that training which primarily targets storage aspects of working memory can result in domain-general improvements that benefit everyday communication for adult hearing aid users. These findings are consistent with a significant body of evidence showing that Cogmed training only improves performance for tasks that resemble Cogmed training. Future research should focus on the benefits of interventions that enhance cognition in the context in which it is employed within everyday communication, such as training that targets dynamic aspects of cognitive control important for successful speech-in-noise perception.

Comparison of In-Situ and Retrospective Self-Reports on Assessing Hearing Aid Outcomes.

Ecological momentary assessment (EMA) is a methodology involving repeated surveys to collect in-situ self-reports that describe respondents' current or recent experiences. Audiology literature comparing in-situ and retrospective self-reports is scarce. To compare the sensitivity of in-situ and retrospective self-reports in detecting the outcome difference between hearing aid technologies, and to determine the association between in-situ and retrospective self-reports. An observational study. Thirty-nine older adults with hearing loss. The study was part of a larger clinical trial that compared the outcomes of a prototype hearing aid (denoted as HA1) and a commercially available device (HA2). In each trial condition, participants wore hearing aids for 4 weeks. Outcomes were measured using EMA and retrospective questionnaires. To ensure that the outcome data could be directly compared, the Glasgow Hearing Aid Benefit Profile was administered as an in-situ self-report (denoted as EMA-GHABP) and as a retrospective questionnaire (retro-GHABP). Linear mixed models were used to determine if the EMA- and retro-GHABP could detect the outcome difference between HA1 and HA2. Correlation analyses were used to examine the association between EMA- and retro-GHABP. For the EMA-GHABP, HA2 had significantly higher (better) scores than HA1 in the GHABP subscales of benefit, residual disability, and satisfaction (p = 0.029-0.0015). In contrast, the difference in the retro-GHABP score between HA1 and HA2 was significant only in the satisfaction subscale (p = 0.0004). The correlations between the EMA- and retro-GHABP were significant in all subscales (p = 0.0004 to <0.0001). The strength of the association ranged from weak to moderate (r = 0.28-0.58). Finally, the exit interview indicated that 29 participants (74.4%) preferred HA2 over HA1. The study suggests that in-situ self-reports collected using EMA could have a higher sensitivity than retrospective questionnaires. Therefore, EMA is worth considering in clinical trials that aim to compare the outcomes of different hearing aid technologies. The weak to moderate association between in-situ and retrospective self-reports suggests that these two types of measures assess different aspects of hearing aid outcomes.

Efficacy of Bone-Anchored Hearing Aids in Single-Sided Deafness: A Systematic Review.

Bone-anchored hearing aids (BAHAs) have been known to partially restore some of the functions lost in subjects with single-sided deafness (SSD). Our aims in this systemic review were to analyze the present capabilities of BAHAs in the context of SSD, and to evaluate the efficacy of BAHAs in improving speech recognition in noisy conditions, sound localization, and subjective outcomes. A systematic search was undertaken until August 2015 by two independent reviewers, with disagreements resolved by consensus. Among 286 references, we analyzed 14 studies that used both subjective and objective indicators to assess the capabilities of a total of 296 patients in the unaided and aided situations. Although there was "no benefit" of BAHA implantation for sound localization, BAHAs certainly improved subjects' speech discrimination in noisy circumstances. In the six studies that dealt with sound localization, no significant difference was found after the implantation. Twelve studies showed the benefits of BAHAs for speech discrimination in noise. Regarding subjective outcomes of using the prosthesis in patients with SSD (abbreviated profile of hearing aid benefit [APHAB] and the Glasgow hearing aid benefit profile [GHABP], etc.), we noticed an improvement in the quality of life. This systematic review has indicated that BAHAs may successfully rehabilitate patients with SSD by alleviating the hearing handicap to a certain degree, which could improve patients' quality of life. This report has presented additional evidence of effective auditory rehabilitation for SSD and will be helpful to clinicians counseling patients regarding treatment options for SSD.

Patient benefit from Cochlear implantation in single-sided deafness: a 1-year follow-up.

The objective of the study was to evaluate the quality of life and benefit in patients with single-side deafness before and 1year after cochlear implantation. In a prospective observational study design, ten adult patients with single-sided deafness undergoing cochlear implantation were included. All patients had on the implantation side no speech discrimination with normal hearing aids. The contralateral side was normal or marginal hearing loss. For determining the subject benefit from cochlear implantation, each patient answered standardized questionnaires directly before implantation and 1year after. Regarding the questionnaire Speech, Spatial and Qualities of Hearing (SSQ), the tests yielded a significant difference in the subdomains "speech intelligibility" and "spatial hearing". The Nijmegen Cochlear Implant Questionnaire (NCIQ) showed a significant difference in the subdomain "basic sound perception", but not in the total score. The Glasgow Hearing Aid Benefit Profile (GHABP) showed on average moderate satisfaction in the subdomains "hearing aid benefit" and "residual disability". In general quality of life, no significant difference was found measured by the questionnaire EQ-5D-3L. One year after cochlear implantation, most patients with single-sided deafness showed benefits in hearing as measured by validated questionnaires However, not all patients reported a significant improvement in general quality of life. Therefore, it is important to inform patients adequately and offer alternative treatments before implantation.

Development of an Auditory Rehabilitation Training Programme for Hearing Impaired Adults in Saudi Arabia

Hearing impairment is one of the most common sensory disabilities, affecting millions of people worldwide. The current management of acquired hearing impairment in adults is usually in the form of hearing aids. An auditory rehabilitation programme may or may not be provided although literature suggests that such programmes may enhance hearing aid benefits. This study was conducted in an Arabic-speaking country, specifically Saudi Arabia, and is the first to develop an auditory rehabilitation intervention programme in the Arabic language that focuses on working age adults who are new hearing aid users. Method: Randomised intervention study design. Thirty-five participants with mild to severe acquired hearing loss (intervention group n=18, control group n=17). Results: Significant changes were found in the performance of the intervention group in the Minimal Audible Capabilities (MAC) test, a lip reading test and the Glasgow Hearing Aid Benefit Profile (GHABP) questionnaire when compared with the control group. No significant difference was found in speech test scores between the two groups. Conclusions: A short individualised auditory rehabilitation intervention programme can yield a significant improvement in the performance of hearing impaired adults by enhancing the benefits of hearing aid use.

Quality of Life and Satisfaction among Patients Who Use Hearing Aids

BACKGROUND: Hearing loss is a very common condition, especially among the elderly. A large number of people that have disabling hearing loss may benefit from hearing aids.AIM: The purpose of this study was to measure quality of life and satisfaction among patients who use hearing aids.METHODS: A cross-sectional study was conducted, in which 100 patients who came in contact with an audiology center in Athens took part. Glasgow Hearing Aid Benefit Profile (GHABP) and 12-Item Short Form Health Survey (SF-12) were used. Alongside with the questionnaires, demographic and relevant to their hearing aid information were collected. Student's t-test, Pearson correlation and Linear regression analysis with the sequential process of integration/abstraction to find independent factors associated with the various scales that generated dependency coefficients (b) and their standard errors (SE), were used.RESULTS: Patient's perception of disability affects use of hearing aid and patients' satisfaction. More specifically patients who used hearing aid more and perceived its benefits showed higher scores in the physical health of SF-12. Age was found to correlate statistically with patients' satisfaction from the hearing aid and decreases as age increases. Also greater subjective perception of disability caused by hearing loss means increased usage of a hearing aid and life satisfaction.CONCLUSION: Using a hearing aid improves physical aspects of quality of life of patients with hearing loss. The total duration of wearing a hearing aid and the degree of hearing loss play an important role in the use made by the patient.

An Exploratory Study Identifying a Possible Response Shift Phenomena of the Glasgow Hearing Aid Benefit Profile.

A then-test technique was used to investigate the possibility of a response shift in the Glasgow hearing aid benefit profile (GHABP).Following completion of part 1 of the GHABP, 16 adults were invited for hearing-aid follow up appointments. In accordance with then-test technique, participants were asked to think back to before they had their hearing-aids fitted and the GHABP part 1 was completed again to re-establish the disability and handicap scores. These scores were then compared with the initial GHABP part I scores. Paired T testing and Wilcoxon Rank tests were carried out to investigate the statistical significance of the response shift effect.Statistically significant differences were seen between initial and retrospective GHABP (disability) scores using t test. No significant differences could be seen between the initial and retrospective handicap scores. Results suggest participants may have demonstrated a possible response shift phenomenon with the disability construct of the GHABP questionnaire, related to a possible re-calibration effect or a denial of disability effect.This exploratory study suggests that the GHABP questionnaire may be subject to a response shift phenomena. We suggest that further more robust studies are completed to verify this and recommend that this could have psychological impact on participants when explaining the results of the outcome measure and may affect hearing aid use. There is also potential for this phenomenon to affect global GHABP scores specifically when demonstrating to stakeholders the overall success of an audiology service.

Clinical evaluation of an over-the-counter hearing aid (TEO First®) in elderly patients suffering of mild to moderate hearing loss.

BackgroundPresbycusis has a direct influence on autonomy of the elderly but hearing aids lack of affordability. Moreover a recent review demonstrate that electroacoustic characteristics of OTC hearing aids were generally not suitable for the elderly people. In our study, we assessed the clinical value of a new over-the-counter (OTC) hearing aid device (TEO First®) in the elderly.MethodThis prospective monocentric open label study included patients over 60 years of age with a mild to moderate presbycusis. Patients were assessed with acceptable noise level test (ANL), pure tone (PTA) and speech (SA) audiometry in silent and noisy environment, with and without TEO First®. A Glasgow Hearing Aid Benefit Profile, acceptability and satisfaction surveys were completed after one month of using the device.ResultsThirty one patients were included. There was an improvement of hearing with TEO First® in silence (SA: +39.2 %, p < 0.01; PTA: -9.04 dB, p < 0.01) or in noise (SA +47.7 %, p < 0.01; PTA: -5.23 dB, p < 0.05). After one month of use of the device, quality of life has improved with regards to the following parameters: decrease of perceived hearing difficulties during conversation without background noise (-9.6 % p = 0.018), in conversation with several people (-16.2 % p = 0.0076), decrease of negative emotions while watching TV (-18.5 % p = 0.011), during conversation without background noise (-16.5 % p = 0.0024), during conversation in noisy background (-17.1 % p = 0.027) and during conversation with several people (-20 % p = 0.014). The acceptability of the device was low to moderate.ConclusionTEO First® is an effective OTC hearing aid that improves the patient’s quality of life.Trial registrationCurrent Controlled Trials NCT01815788

The impact of self-efficacy, expectations, and readiness on hearing aid outcomes

Objective: To examine the impact of self-efficacy and expectations for hearing aids, and readiness to improve hearing, on hearing aid outcome measures in first-time adult hearing aid users Design: A prospective, single centre design. Predictor variables measured at the hearing assessment included measures of self-efficacy, expectations and readiness to improve hearing. Outcome measures obtained at six-week follow-up were the Glasgow Hearing Aid Benefit Profile and Satisfaction with Amplification in Daily Life. Study sample: A sample of 30 first-time adult hearing aid users were recruited through a public-sector funded audiology clinic. Results: When measured prior to hearing aid fitting, self-efficacy for hearing aids predicted satisfaction with hearing aids but was not related to other hearing aid outcomes. Expectations of hearing aids, in particular positive expectations, and readiness to improve hearing predicted outcomes for hearing aid satisfaction and benefit, although not hearing aid use. Hearing sensitivity was not correlated with hearing aid outcomes. Conclusions: These results suggest that assessment of expectations of hearing aids, and readiness to improve hearing, may be useful to help identify individuals attending audiology clinics who would most likely benefit from hearing aid provision.

Only Behavioral But Not Self-Report Measures of Speech Perception Correlate with Cognitive Abilities.

Good speech perception and communication skills in everyday life are crucial for participation and well-being, and are therefore an overarching aim of auditory rehabilitation. Both behavioral and self-report measures can be used to assess these skills. However, correlations between behavioral and self-report speech perception measures are often low. One possible explanation is that there is a mismatch between the specific situations used in the assessment of these skills in each method, and a more careful matching across situations might improve consistency of results. The role that cognition plays in specific speech situations may also be important for understanding communication, as speech perception tests vary in their cognitive demands. In this study, the role of executive function, working memory (WM) and attention in behavioral and self-report measures of speech perception was investigated. Thirty existing hearing aid users with mild-to-moderate hearing loss aged between 50 and 74 years completed a behavioral test battery with speech perception tests ranging from phoneme discrimination in modulated noise (easy) to words in multi-talker babble (medium) and keyword perception in a carrier sentence against a distractor voice (difficult). In addition, a self-report measure of aided communication, residual disability from the Glasgow Hearing Aid Benefit Profile, was obtained. Correlations between speech perception tests and self-report measures were higher when specific speech situations across both were matched. Cognition correlated with behavioral speech perception test results but not with self-report. Only the most difficult speech perception test, keyword perception in a carrier sentence with a competing distractor voice, engaged executive functions in addition to WM. In conclusion, any relationship between behavioral and self-report speech perception is not mediated by a shared correlation with cognition.

Analysis of the results of hearing aids fitting using the questionnaire «Glasgow Hearing Aid Benefit Profile»

164 patients with moderate to severe ehronie bilateral sensorineural hearing loss were asked to fill in the Glasgow hearing aid benefit profile. Its usefulness was showed in eases of diffieult hearing aid fitting.

The benefits of using bluetooth accessories with hearing aids

Objective: To investigate the benefits in reported outcomes after providing bluetooth accessories for established hearing aid users. Design: Prospective observational study using validated quantitative outcome measures and detailed patient narrative before and two months after patients were provided with bluetooth accessories. Study sample: Twelve patients with bilateral NHS hearing aids participated. They had a wide range of ages and hearing loss. Results: After two months, 10 patients reported substantial additional benefit and kept the accessories; two returned them for various reasons. Statistically significant changes were seen in two validated outcome measures: the Glasgow Hearing Aid Benefit Profile and the International Outcome Inventory – Hearing Aids, but not in the Speech, Spatial and Qualities of Hearing Scale. Two notable benefits were reported: some described hearing the emotion and mood in a voice for the first time; others were amazed to report an improved ability to hear film or to hold conversations over the telephone. Conclusions: The provision of bluetooth accessories can give additional reported benefit for some patients – we need better knowledge about who benefits, and whether further support/training to individuals would make a difference.

Sensitivity to temporal fine structure and hearing-aid outcomes in older adults

Objective: To investigate the effect of sensitivity to temporal fine structure (TFS) on subjective measures of hearing aid outcome.Design: Prior to receiving hearing aids, participants completed a test to assess sensitivity to TFS and two self-assessment questionnaires; the Glasgow Hearing Aid Benefit Profile (GHABP), and the Speech, Spatial and Qualities of hearing (SSQ-A). Follow-up appointments, comprised three self-assessment questionnaires; the GHABP, the SSQ-B, and the International Outcome Inventory for Hearing Aid Outcomes (IOI-HA).Study sample: 75 adults were recruited from direct referral clinics.Results: Two thirds of participants were found to have good sensitivity to TFS; listeners with good sensitivity to TFS rated their hearing abilities higher at pre-fitting (SSQ-A) than those with poor sensitivity to TFS. At follow-up, participants with good sensitivity to TFS showed a smaller improvement on SSQ-B over listeners with poor sensitivity to TFS. Among the questionnaires, only the SSQ showed greater sensitivity to measure subjective differences between listeners with good and poor sensitivity to TFS.Conclusions: The clinical identification of a patient's ability to process TFS information at an early stage in the treatment pathway could prove useful in managing expectations about hearing aid outcomes.

Evaluation of cost-utility in middle ear implantation in the ‘Nordic School': a multicenter study in Sweden and Norway

Conclusion: Hearing restoration using an active middle ear implant (AMEI) is a highly cost-effective treatment for a selected group of patients with no other possibilities for auditory rehabilitation. Objectives: To evaluate the cost-utility of using an AMEI for hearing rehabilitation. Methods: This was a prospective, multicenter, single-subject repeated study in six tertiary referral centers. Twenty-four patients with sensorineural (SNHL), conductive (CHL), and mixed hearing loss (MHL) were implanted with the AMEI Vibrant Soundbridge® (VSB) for medical reasons. All patients were previously rehabilitated with conventional hearing aids. Multiple validated quality of life patient questionnaires, Health Utilities Index (HUI 2 and 3), and Glasgow Hearing Aid Benefit Profile (GHABP) were used to determine the utility gain and quality adjusted life years (QALY). Directly related treatment costs for the implantation were calculated and related to utility gain and QALY. Results: The cost/QALY for patients with SNHL was estimated at €7260/QALY, and for patients with C/MHL at €12 503/QALY.

Postoperative Validation of Bone-Anchored Implants in the Single-Sided Deafness Population

OBJECTIVE: The purpose of this study was to present objective and subjective outcomes on speech-in-noise testing as a predictor of patient performance after bone-anchored implant surgery in patients with single-sided deafness (SSD). DESIGN: Retrospective review of adult subjects who received bone-anchored implants for the indication of SSD comparing results on speech-in-noise measures in the unaided condition to postoperative aided condition using the patient's external bone-anchored implant processor as a validation of device performance. SETTING: Tertiary referral center providing outpatient surgical and audiologic care. PATIENTS: Adult English speaking subjects with SSD who underwent bone-anchored implantation between 2005 and 2010. INTERVENTION: Subjects were evaluated with speech-in-noise measures in the sound field using a 90/270 speaker configuration in both the unaided and aided implant condition for validation of implant performance. Subjective benefit was evaluated using the Glasgow Hearing Aid Benefit Profile. MAIN OUTCOME MEASURES: Outcome measures included signal-to-noise ratio (SNR) loss and word recognition ability in noise as measured using the QuickSIN and the Glasgow Hearing Aid Benefit Profile. RESULTS: A significant improvement in speech-in-noise measures was noted in the postoperative aided condition when compared with the unaided condition (Wilcoxon signed-rank test, p < 0.0001). Significant decrease in disability postoperatively also was observed (Wilcoxon signed-rank test, p < 0.001). Positive associations were observed for postoperative aided SNR loss and benefit, satisfaction, and use. Passing-Bablok regression analysis showed the preoperative and postoperative results to be statistically equivalent. CONCLUSION: The results support the use of speech-in-noise measures as an accurate postimplantation assessment of overall benefit in patients with SSD. SNR loss is a good predictor of postoperative subjective benefit and satisfaction.

Bone‐Anchored Implantation for Single‐Sided Deafness in Patients with Less Than Profound Hearing Loss

The benefit of bone-anchored implantation (BAI) for the treatment of single-sided deafness (SSD) is well established. In this study, the authors sought to evaluate objective hearing outcomes and subjective benefits in patients undergoing BAI for SSD with residual hearing in the implanted ear. Case series with chart review. Academic tertiary referral center. All adult, English-speaking patients undergoing BAI for SSD from 2004 to 2010 were included. Patients were divided into 2 groups: (1) residual hearing in the affected ear (≤ 90 db hearing level [HL] pure-tone average [PTA]) and (2) profound hearing loss in the affected ear (>90 dB HL PTA). Patients underwent pre- and postoperative objective hearing outcomes testing including speech-in-noise and monosyllabic word tests. Subjective outcomes were measured pre- and postoperatively using the Glasgow Hearing Aid Benefit Profile (GHABP). Patients in both groups showed significant improvement in all objective hearing measures following implantation (P < .0001), and there were no significant differences in objective hearing outcomes between groups. Subjective benefits from BAI varied across patients according to GHABP results, but patients with residual hearing in the affected ear trended toward improved satisfaction with their device postoperatively. Individuals with SSD and residual cochlear reserve can be successfully implanted with BAI, achieving significant improvements in objective hearing measures. Postoperative improvements do not seem to correlate with the preoperative audiometric testing scores. Although subjective benefit varies across patients, BAI is clearly a viable rehabilitation option for patients with SSD and less than profound hearing loss.

Long-Term Benefit Perception, Complications, and Device Malfunction Rate of Bone-Anchored Hearing Aid Implantation for Profound Unilateral Sensorineural Hearing Loss

To longitudinally evaluate short- and long-term subject satisfaction/benefit perception, device usage rates, complication rates, and external device repair rates of bone-anchored hearing aid (BAHA) implantation on a cohort of adult subjects with profound unilateral sensorineural hearing loss (PUSHL). Prospective clinical trial. Tertiary referral center. Fifty-six adults with PUSHL, 21 of which underwent BAHA implantation (followed for an average of 3.2 years after implantation; range, 0.8-4.6 yr). Short- and long-term satisfaction/benefit perception outcomes consisting of the Glasgow Hearing Aid Benefit Profile, Abbreviated Profile of Hearing Aid Benefit, and Single-Sided Deafness Questionnaire, including a comparison of results between implanted and nonimplanted subjects. Short- and long-term device usage rates, complications, and device failure issues also were carefully documented. There were statistically significant improvements in nearly all measures of benefit perception documented as well as a high rate of long-term device usage (81%). Although satisfaction and benefit perception outcomes generally tended to regress over time when compared with initial short-term outcomes, long-term scores still tended to be significantly improved nevertheless as compared with preoperative levels. Approximately 38% of implants experienced severe local skin reactions (Grade 2 and above) around the implant site at some point throughout the follow-up period, whereas only one (4.8%) required implant removal. 66.7% of subjects required repair of their external sound processor. BAHA implantation seems to provide a high level of short- and long-term perceived benefit and satisfaction in subjects with PUSHL and high rate of long-term device usage. Implant site adverse local skin reactions and repairs of the external sound processor were quite common.

Management of single-sided deafness with the bone-anchored hearing aid

Objectives The benefits of the bone-anchored hearing aid (BAHA) for rehabilitation of conductive and mixed hearing loss are well established. Recently, the BAHA was used to rehabilitate patients with single-sided deafness (SSD). In this study, the benefits of the BAHA in SSD are presented. Study Design Case series with planned data collection. Setting Tertiary referral center. Subjects and Methods Twenty-one consecutive adult patients with SSD underwent single-stage BAHA implantation on the side of deafness. Testing in sound field was performed using the hearing-in-noise test (HINT) in both unaided and aided conditions. Speech and noise signals were delivered through two speakers oriented in two test paradigms. The outcomes were expressed as signal-to-noise (S/N) ratios. Subjective benefit analyses were determined through two questionnaires: the Abbreviated Profile of Hearing Aid Benefit (APHAB) and the Glasgow Hearing Aid Benefit Profile (GHABP). Results All subjects demonstrated significant improvement in speech reception thresholds with the HINT using the BAHA, especially with the 90/270 speaker paradigm, in which the mean improvement over the unaided condition was 5.5 dB SPL (range, 2.0-11.0 dB; P = 0.00001). Qualitative subjective outcome measures demonstrated additional benefits. Conclusion In SSD patients, the BAHA provides significant subjective benefits and improves speech understanding in noise.

A Multicenter Trial of an Assess-and-Fit Hearing Aid Service Using Open Canal Fittings and Comply Ear Tips

Large potential benefits have been suggested for an assess-and-fit approach to hearing health care, particularly using open canal fittings. However, the clinical effectiveness has not previously been evaluated, nor has the efficiency of this approach in a National Health Service setting. These two outcomes were measured in a variety of clinical settings in the United Kingdom. Twelve services in England and Wales participated, and 540 people with hearing problems, not previously referred for assessment, were included. Of these, 68% (n = 369) were suitable and had hearing aids fitted to NAL NL1 during the assess-and-fit visit using either open ear tips, or Comply ear tips. The Glasgow Hearing Aid Benefit Profile was used to compare patients fitted with open ear tips with a group of patients from the English Modernization of Hearing Aid Services evaluation, who used custom earmolds. This showed a significant improvement in outcome for those with open ear tips after allowing for age and hearing loss in the analysis. In particular, the benefits of using bilateral open ear tips were significantly larger than bilateral custom earmolds. This assess-and-fit model showed a mean service efficiency gain of about 5% to 10%. The actual gain will depend on current practice, in particular on the separate appointments used, the numbers of patients failing to attend appointments, and the numbers not accepting a hearing aid solution for their problem. There are potentially further efficiency and quality gains to be made if patients are appropriately triaged before referral.