Hearing Aid Benefit Research Articles

Over the counter hearing aids self-fitting using the Gaussian Process Classification

IntroductionTo provide better access to hearing aids and lower the devices' costs for patients with mild to moderate hearing loss, the Food and Drug Administration (FDA) changed its rules for hearing aid distribution, making them available to consumers over-the-counter without the supervision, involvement, or prescription of a licensed health care professional. While this regulation provides some patients direct access to hearing aids, the hearing aid fitting creates challenges for the patients and the hearing aid providers. OTC hearing aids should be programmable outside of a clinical setting. This study demonstrates that the self-fitting of hearing aids does not differ significantly from and is non-inferior to the fitting of the device by a licensed audiologist.MethodHearing aid and patient performance after fitting the device by the patient (self-fitting) and a certified audiologist (clinical fitting) were compared in a laboratory setting and a field trial. The laboratory session used a repeated-measures design to assess the reliability and validity of the self-fitting method. A 7–14 days of wear time was used for the field study. The outcome measures for the laboratory session were the differences in acoustical real-ear aided response (REAR). For the wear-time trial, the outcome was the clinical self-report measure of benefit (Abbreviated Profile of Hearing Aid Benefit, APHAB). The benefit of the hearing aid was tested after the self-fitting and the clinical fitting of the hearing aid with a speech-in-noise test (QucikSIN).ResultsThe test outcomes showed no statistically significant differences between repeated self-fitting and clinical fitting of the hearing aids. The hearing aid self-fitting was non-inferior to the clinical fitting.DiscussionIt is important to emphasize that the results and conclusion obtained in this study strictly relate to the specific self-fitting process using the Gaussian Process. Many other potential methods for fitting hearing aids exist and future field studies are required to compare the efficacy of the self-fitting methods.

Audiological and Subjective Benefits in a Child with Microtia and Atresia After Sequential Bilateral Implantation with Active Bone Conduction Devices: A Case Study

Background: With bilateral hearing loss, the main problems for the patient are speech understanding in noise and, especially in asymmetrical hearing loss, an inability to correctly localize sound sources. There are multiple methods of treatment and rehabilitation for people with conductive hearing loss, and one of them is to use an active bone conduction implant. This case study is designed to evaluate the auditory benefits and sound localization accuracy with active bilateral bone conduction implants—in comparison to unilateral ones—in a patient with congenital bilateral conductive hearing loss caused by a congenital malformation. We assess subjective and audiological benefits (functional, directional hearing, speech comprehension in quiet and noise). Case report: This study describes the results in a 15-year-old patient with bilateral congenital malformation of the outer ears and associated conductive hearing loss who was treated with two Bonebridge active bone conduction implants. Speech recognition ability, hearing thresholds, and sound localization were tested under three conditions: unaided, unilateral on the right-side, and bilateral on both sides. The patient filled in an Abbreviated Profile of Hearing Aid Benefit questionnaire (APHAB) to evaluate limitations in daily life caused by hearing impairment. The results show an improvement in free-field hearing thresholds and the ability to discriminate speech, both in quiet and in noise after implantation. Subjectively, the patient had significantly fewer problems with two implants than with one (or with no implant) in terms of hearing in everyday situations. Conclusions: Unilateral use of the Bonebridge device in a patient with congenital bilateral conductive hearing loss did not provide full benefits. However, bilateral implantation improved speech understanding in noise and sound localization.

Hearing aid benefit in daily life: a qualitative ecological momentary assessment study

IntroductionUnderstanding hearing aid wearer experiences in real-world settings is important to provide responsive and individualized hearing care. This study aimed to describe real-life benefits of hearing aids (HAs), as reported by hearing aid wearers through Ecological Momentary Assessment (EMA) in various listening environments.MethodQualitative content analysis of 1,209 open-text responses, provided through self-initiated EMAs, was conducted. The de-identified data was collected retrospectively via a smartphone app compatible with these HAs. Only text responses reflecting positive hearing aid experiences were analyzed. The 1,209 open-text responses were categorized into 18 pre-determined sub-categories, further organized into five overarching categories: Conversational, Leisure, Device-related aspects, Lifestyle, and Other factors.ResultsAcross these categories, 48 self-generated meaning units highlighted the multifaceted benefits of HAs. In particular, participants reported significant improvements in conversational settings, specifically during phone conversations and meetings, attributed to improved sound quality and speech understanding when wearing their HAs. During leisure activities, particularly TV watching and music listening, clearer sound and ease of Bluetooth streaming contributed to experienced benefits. Lifestyle improvements were reported in occupational and social settings, as hearing aid wearers stated enhanced communication and sound awareness. Device-related factors contributing to positive wearer experiences included extended battery life and the convenience of rechargeable batteries. The most prominent sub-category, other factors, underscored overall satisfaction, comfort with the device, and improved auditory experiences across various environments.ConclusionThis study reveals the diverse benefits of HAs in improving communication, listening experiences, and quality of life across various settings, as captured through EMA. By emphasizing features like direct streaming and rechargeability, the findings highlight the importance of personalized hearing care and the potential of real-time listener feedback to inform device enhancements and support strategies, advancing more tailored and effective hearing rehabilitation.

Uncovering the effects of pandemic conditions on hearing aid experiences: a dual perspective from audiologists and hearing aid users

Purpose: This study examines the effects of the pandemic on hearing aid experiences from the perspectives of audiologists and patients, as well as communication challenges faced by both users and non-users of hearing aids. Materials and Methods: The study consisted of two phases: a longitudinal study examining the services provided by audiologists during the peak of the COVID-19 pandemic and after the first vaccination dose. The second phase involved a survey of 120 elderly individuals with hearing loss, divided into hearing aid users and non-users for assessing communication challenges. Data was collected from comprehensive audiology clinics using a series of checklists. Results: Analysis of the frequency of services related to hearing aids revealed that during the peak period, the majority of visits were for acquiring batteries and hearing aids, while fewer visits were for fitting and fine-tuning the devices. After vaccination the pattern was changed. In the second phase, significant differences were observed between the hearing aid users and non-users with regards to their ability to comprehend speech while wearing mask, communicating at a safe distance, and following TV news. Conclusions: The distribution of requested services differed during the peak period and the post-vaccination period. There was a noticeable increase in the purchase and fitting of hearing aids after vaccination. However, patients encountered difficulties due to the limited availability of tele-audiology services and delayed services from hearing aid companies. The benefits of hearing aids were impacted by the pandemic as many people did not seek adjustments for their devices.

Hearing Loss, Hearing Aids, and Cognition.

Most observational studies examining the association between hearing loss (HL) and cognitive impairment used subjective measures of hearing and addressed only one dimension of cognition, and very few investigated the potential benefit of hearing aids (HAs). To evaluate objectively measured HL and several dimensions of cognition and estimate the association with HA use. A cross-sectional analysis of the CONSTANCES cohort study, which recruited participants from January 1, 2012, to December 31, 2020, was conducted. Participants were a representative sample of adults (age, 45-69 years) with audiometric data and cognitive evaluation from 21 preventive health centers in France. Data analysis was conducted from April 1 to September 15, 2023. The main exposure was HL, which was defined by a pure-tone average in the best ear higher than 20 dB hearing level for mild loss and 35 dB hearing level for disabling loss. Secondary exposure was self-reported HA use. Cognition was evaluated at study inclusion by a standardized battery of 5 cognitive tests conducted by trained neuropsychologists. A global cognitive score was computed from principal component analysis and global cognitive impairment was defined as having a score less than or equal to the 25th percentile of the distribution. The study population included 62 072 participants with audiometric data (mean [SD] age, 57.4 [7] years; 52% women). Overall, 38% (n = 23 768) had mild HL, 10% (n = 6012) had disabling HL, and 3% (n = 1668) were HA users. In multivariable analyses, mild HL (odds ratio [OR], 1.10; 95% CI, 1.05-1.15) and disabling HL (OR, 1.24; 95% CI, 1.16-1.33) were associated with greater global cognitive impairment. The odds of cognitive impairment did not differ significantly between all participants with HA use and participants with disabling HL without HAs (OR, 0.94; 95% CI, 0.83-1.07), except among participants with depression (OR, 0.62; 95% CI, 0.44-0.88). In this cohort study, an association between the severity of HL and global cognitive impairment was found. The use of HAs was not associated with significantly lower odds of cognitive impairment. The findings suggest that it may be useful to monitor cognitive function in middle-aged individuals with HL.

Long-term safety and subjective satisfaction of Bonebridge and Vibrant Soundbridge in congenital unilateral conductive hearing loss.

The objective of this study was to assess and compare the long-term safety and subjective satisfaction levels of Bonebridge (BB) and Vibrant Soundbridge (VSB) in patients with congenital unilateral conductive hearing loss (UCHL). The hearing effectiveness was measured using sound field hearing threshold (SFHT) and word recognition score (WRS). Long-term safety and subjective satisfaction levels were measured by questionnaires, including Speech, Spatial, and Qualities of Hearing Scale-12 (SSQ-12) and Abbreviated Profile of Hearing Aid Benefit (APHAB). Both BB and VSB were effective in improving the hearing of patients with congenital UCHL. Four of the 20 patients discontinued wearing the device postoperatively, and no complications were reported by long-term users. Patients experienced an overall improvement in their hearing experience across most subscales of SSQ-12 and a lower hearing problem rate across most subscales of the APHAB after implantation. However, the 'quality of hearing' subscale in the SSQ-12 did not show any improvement, and the aversiveness subscale in the APHAB exhibited a relatively higher percentage of reported problems after BB or VSB implantation. No significant differences were observed in SFHT, WRS, SSQ-12, and APHAB between the two groups. Both BB and VSB are effective in improving the hearing of UCHL patients, with high subjective satisfaction and low complication rates in the long-term postoperative period, with no significant difference between the two devices. Follow-up device fitting is essential, especially to address increased device sound or noise after surgery, reduce non-usage rates and achieve higher subjective satisfaction levels.

Long-term follow-up of Bonebridge BCI 601 implantation for microtia patients with aural atresia: acoustic and subjective benefits.

This study evaluated the long-term acoustic and subjective outcomes of Bonebridge bone conduction implant (BCI) 601 implantation in Taiwanese microtia patients with aural atresia (AA). A total of 41 microtia patients (26 with bilateral AA and 15 with unilateral AA) who received Bonebridge BCI 601 implantation between December 2014 and March 2021 at Chang Gung Memorial Hospital, Linkou, Taiwan, were included in this retrospective study. Acoustic outcomes, including the functional hearing gain (FHG), speech reception threshold (SRT), and word recognition score (WRS), were assessed. Subjective outcomes were assessed using the Chinese versions of four questionnaires: the Abbreviated Profile of Hearing Aid Benefit (APHAB); the Speech, Spatial and Qualities of Hearing Scale; the International Outcome Inventory for Hearing Aids; and the Satisfaction with Amplification in Daily Living. The mean follow-up duration was 6.3 years (range, 2.8-9.1). The mean unaided air conduction pure tone average (PTA4) was 65.3 ± 8.8 decibels (dB) hearing level (HL) and the mean aided sound field PTA4 was 31.1 ± 9.1 dB HL, resulting in a FHG of 34.2 ± 11.7 dB HL (p < 0.05). After Bonebridge implantation, the mean SRT in quiet, SRT in noise, WRS in quiet, and WRS in noise improved from 58.3 ± 7.4 dB HL to 29.4 ± 7.0 dB HL, from -1.4 ± 7.3 dB signal-to-noise ratio (SNR) to -9.6 ± 5.4 dB SNR, from 46.4 ± 26.9% to 93.8 ± 3.1%, and from 46.7 ± 21.8% to 72.7 ± 19.3%, respectively (p < 0.05). Additionally, the bilateral AA group exhibited greater SRT and WRS improvements compared to the unilateral AA group (p < 0.05). All mean subscale scores in the four questionnaires showed improvement after Bonebridge implantation, except for the mean aversiveness to sounds subscale score in the APHAB questionnaire. Bonebridge BCI 601 implantation provided long-term acoustic and subjective benefits to microtia patients with AA, particularly those with bilateral AA.

EFFECTIVENESS OF THE ADHEAR BONE CONDUCTION DEVICE FITTED BILATERALLY IN A CHILD WITH CONDUCTIVE HEARING LOSS: CASE STUDY

IntroductionFrequently, bone conduction hearing aids on a softband are not tolerated by children due to pressure on the head or visual esthetics. By way of contrast, a non-surgical hearing system – Adhear (Med-El, Innsbruck, Austria) – allows the sound processor to be attached using a noninvasive adhesive adapter. The objective of this study was to evaluate the effectiveness of the Adhear system and assess its subjective benefits in a child who had bilateral conductive hearing loss.Case reportThe Adhear system was tested in a 13-year-old child with bilateral conductive hearing loss. Pure tone audiometry and speech audiometry in quiet were performed without and then with a pair of devices placed bilaterally. Word recognition scores (WRS) at 50 and 65 dB SPL in quiet were measured using the Pruszewicz monosyllabic Polish word test. After 4 weeks, subjective hearing benefit and experience with the Adhear system was done using the APHAB (&lt;i&gt;Abbreviated Profile of Hearing Aid Benefit&lt;/i&gt;) questionnaire.ResultsWith Adhear, WRS at 50 dB SPL increased significantly from an unaided score of 10% to 80%. The result of free-field audiometry with Adhear on both sides indicated a hearing level within the normal range.ConclusionsAdhear is an effective rehabilitation option for children with bilateral conductive hearing loss.

Comparison between the international outcome inventory for hearing aids questionnaire and real-ear measurement.

The international outcome inventory for hearing aids (IOI-HA) is a questionnaire widely used to assess the subjective benefits of hearing aids. This study aimed to evaluate the relationship between IOI-HA outcomes and target mismatch in real-ear measurement (REM). Thirty-four ears of 25 patients who had worn hearing aids were evaluated using the Korean version of the IOI-HA and REM after fitting for 2 months. Real-ear insertion gain (REIG) was measured at three different levels of input intensity-50, 65, and 80 dB sound pressure level (SPL)-and a frequency range of 0.25 to 6 kHz. Factors 1 and 2 and total IOI-HA scores were compared with the mismatches of REIGs and target gains of REM. Factor 1, Factor 2, and total IOI-HA scores were 14.6 ± 3.5, 11.4 ± 2.2, and 25.9 ± 5.1, respectively. The averages of the difference of REIGs and target gains in REM at 50, 65, and 80 dB SPL input levels were -3.1 ± 6.7, -2.3 ± 7.2, and -3.0 ± 8.2, respectively. Factors 1 and 2 scores of the IOI-HA showed significant correlations with target mismatch in REM at 1 kHz and 0.75 kHz frequencies, respectively. Total IOI-HA scores had significant correlations with target mismatches in REM at 0.75 and 1 kHz frequencies. IOI-HA scores correlated with target mismatch in REM at mid frequencies. The IOI-HA can be a useful screening measure for evaluating the necessity of further adjustments in hearing aids through REM at mid frequencies.

Performance of hybrid gain formula versus traditional fitting formulas in hearing aid fitting in tinnitus patients with hearing loss.

Hearing aid fitting can be challenging when tinnitus accompanies hearing loss, as speech intelligibility and quality of life are affected by both hearing loss and tinnitus perception. However, studies focusing on the optimal hearing aid fitting for this group are scarce. Here, we aim to investigate the performance of alternative hearing aid fitting scenarios in improving hearing aid benefit and managing tinnitus. Sixty-six participants were included in the study and randomly divided into three groups based on the fitting formula: NAL-NL2, DSL pediatric and hybrid gain fitting procedure (covering NAL-NL2 for low frequencies and DSL pediatric formulas for high frequencies). Hearing aid benefit was evaluated using the Abbreviated Profile of Hearing Aid Benefit (APHAB) questionnaire and speech perception in noise (SPIN). To evaluate tinnitus perception, psychoacoustic characteristics of tinnitus were determined, and the Tinnitus Handicap Inventory (THI) was gathered. The NAL-NL2 fitting procedure showed better results in hearing aid benefit and SPIN compared to the DSL pediatric procedure. In the DSL pediatric procedure, better results were obtained in tinnitus management compared to NAL-NL2. There was no difference between the hybrid fitting procedure and DSL pediatric in tinnitus management. The hybrid fitting procedure also did not differ from NAL-NL2 in SPIN and hearing aid benefit. Here, we propose a hybrid gain fitting procedure that can be a better alternative to boost hearing aid performance and tinnitus management in clinical practice.

Cognitive Benefits of Hearing Aids in Elderly Indian Population: A Longitudinal Study.

The online version contains supplementary material available at 10.1007/s12070-024-04939-7.

Comparing Self-Fitting Strategies for Over-the-Counter Hearing Aids

Fewer than 20% of US adults with hearing loss use hearing aids due to barriers like high cost. Over-the-counter (OTC) hearing aids offer a potential solution, incorporating self-fitting strategies via smartphone apps. Self-fitting strategies have been validated for Food and Drug Administration (FDA)-approved OTC hearing aids compared with prescription-based approaches. However, no direct comparative analysis exists between in situ audiometry and self-adjustment strategies using self-fitting OTC (OTC-SF) hearing aids. To compare self-adjustment and in situ audiometry self-fitting strategies in OTC-SF hearing aids for adults with mild to moderate hearing difficulties. A crossover, within-participant pseudorandomized clinical trial was conducted between July and November 2023. Twenty-eight participants were pseudo-randomly assigned to 1 of the 2 self-fitting strategies, and they experienced both interventions for 4 consecutive weeks. The self-adjustment group manually adjusted settings, including overall gain and spectral tilt, using Lexie B2 hearing aids, while the in situ audiometry group used Lexie B2 Plus hearing aids (Lexie Hearing by hearX Group), with an automated fitting based on in situ tests conducted through the app. The primary outcome was Abbreviated Profile of Hearing Aid Benefit (APHAB). Secondary outcomes were International Outcome Inventory for Hearing Aids (IOI-HA), speech-in-noise tests (DIN and QuickSIN), and real-ear measurements (REMs). Measures were completed at baseline and after the 4-week field trial using each strategy. Twenty-eight participants (mean [SD] age, 60.2 [12.0] years) were included; 14 men and 14 women. Self-adjustment and in situ audiometry strategies produced no clinically meaningful differences across various outcome measures, including overall APHAB benefit (Cohen d = 0.2; 95% CI, -0.2 to 0.6) and overall IOI-HA satisfaction (Rosenthal r = 0.0; 95% CI, -0.3 to 0.2). Self-adjustment users reported higher satisfaction (Rosenthal r = -0.4; 95% CI, -0.6 to -0.1) and longer daily use (Rosenthal r = -0.3; 95% CI, -0.5 to 0.0) compared with those using in situ audiometry. No clinically meaningful differences were observed in speech-in-noise benefit and real-ear measurements. In this clinical trial of OTC-SF hearing aids, self-adjustment and in situ audiometry strategies resulted in similar outcomes. However, self-adjustment may produce higher satisfaction and longer daily use, highlighting the potential advantages of active user involvement in the fitting process. Further investigation is needed for long-term outcomes. ClinicalTrials.gov Identifier: NCT05782153.

Focusing on positive listening experiences improves hearing aid outcomes in first-time hearing aid users: a randomized controlled trial

Objective The objective of this study was to investigate whether positive focus (PF), an intervention that asks hearing aid users to focus on positive listening experiences, improves hearing aid outcomes for first-time hearing aid users. Design The participants were randomised into a control or PF group. They were fitted with hearing aids and followed for six months after fitting. The PF group was asked to report positive listening experiences in their daily life via an app. Participants in both groups were periodically prompted by the app to answer questionnaires about hearing aid satisfaction and benefit. Two follow-up visits at approximately one and six months were performed. Study sample 20 adult first-time hearing aid users in the control and 18 in the PF group. Results Hearing aid satisfaction and benefit scores were significantly better in the PF group, already at two weeks and throughout the six months. In the PF group, the hearing aid outcomes were positively correlated with the number of submitted positive reports. Conclusions These results point to the importance of asking first-time hearing aid users to focus on positive listening experiences and to reflect upon them. This can lead to improved short- and long-term hearing aid outcomes.

Short- and long-term effects of remote synchronous fine-tuning for first-time hearing aid users: a randomised controlled trial

Objective To evaluate the short- and long-term effect of remote synchronous fine-tuning and follow-up visits on hearing-related problems and hearing aid (HA) benefits for first-time HA users. Design A randomised controlled trial. Study sample Patients at public tax-funded HA clinics in Sweden due for aural rehabilitation (AR) were randomised to either an intervention group (n = 33) or a control group (n = 36). Both groups completed the conventional AR process, but the intervention group received synchronous remote fine-tuning of HAs and online follow-up visits. Outcome measures were used before and after intervention, and 6 months and 1 year after intervention. Results Both groups improved hearing-related problems measured with the Hearing Handicap Inventory for the Elderly/Adults over time, and no significant differences were found between the groups. Such improvements were also found for the Abbreviated Profile of Hearing Aid Benefit except for the subscale aversiveness. Both groups decreased the use of HAs in hours/day over time. The intervention group reported significant improvements in activity limitation when measured directly after the intervention, compared to the control group. Conclusion Synchronous remote fine-tuning and follow-ups for first-time HA users did not influence the outcomes of hearing-related problems and HA benefits differently from standard care at our clinic.

Open-fitting hearing aids: a comparative analysis between open behind-the-ear and open completely-in-the-canal instant-fit devices.

Our study aims to assess the open-fitting capabilities and vent properties of traditional open-fitting behind-the-ear (open BTE) hearing aids to instant-fit open-fitting completely-in-the-canal (open CIC) systems. The study analysed data from 40 patients grouped in two groups based on the used hearing aids. Free field pure tone and speech audiometry were performed to obtain the free-field pure tone average and free-field word recognition score (WRS). The matrix sentence test was employed to evaluate the auditory performance and functional outcomes of patients. The Satisfaction with Amplification in Daily Life (SADL) and the Abbreviated Profile of Hearing Aid Benefit (APHAB) questionnaire were used to assess the personal satisfaction and benefit provided by the hearing aid. Real ear measurements were conducted to objectively evaluate the Real-Ear Unaided Gain (REUG) and Real-Ear Occluded Gain (REOG) of the two groups. For this purpose, six frequency bands (band 1 from 125 to 200Hz, band 2 from 250 to 400Hz, band 3 from 500 to 800Hz, band 4 from 1000 to 1600Hz, band 5 from 2000 to 3150Hz, and band 6 from 4000 to 6300Hz) were defined and compared. Free-field WRS exhibited a significant difference (p-value = 0.004) between open BTE and open CIC, with better results for the open BTE. Matrix test speech reception threshold scores did not differ significantly between groups. No statistical significant difference were observed between APHAB and SADL total scores. Correlation tests revealed a negative correlation between SRT and APHAB scores in the open BTE group, not seen in the open CIC. No statistically significant difference was observed for all bands of REUG values, demonstrating comparability in terms of acoustic resonance of the external auditory canal. Comparing the REOG recorded in the two groups a significant difference was observed for bands 2 through 6. While the average REOG values for bands 5 and 6 were higher in patients with traditional open BTE aids, in contrast, for bands 2, 3, and 4, the REOG values for the open CIC group were higher and statistically significant compared to patients wearing traditional open-fitting BTE hearing aids. Patients with open CIC seem to perform worse in quiet environments compared to noisy ones, as indicated by the free field WRS score. However, the absence of differences in functional performance assessed with the matrix sentence test, and in the psychosocial aspects, makes these devices a good solution for individuals who reject hearing aids due to aesthetic concerns. The differences in terms of real ear measurements, while statistically significant, do not negatively impact overall performance.

Long-Term Outcomes of Self-Fit vs Audiologist-Fit Hearing Aids

With rising interest in over-the-counter (OTC) hearing aids as an alternative to traditional audiologist-fit devices, understanding their long-term efficacy is crucial. However, given the novelty of the US Food and Drug Administration category of OTC hearing aids, minimal evidence currently supports their long-term efficacy. To compare the long-term self-reported outcomes at 8 months of self-fit OTC hearing aids to the same hearing aids fit by audiologists. Building on a previous randomized clinical trial, this follow-up comparative effectiveness research study reassessed a number of the original participants that were not lost to follow-up. Participants were initially divided into those with self-fit OTC hearing aids and those with audiologist-fit devices. Approximately 8 months after fitting, participants completed self-reported questionnaires. Missing data were addressed through multiple imputation. The original noninferiority trial was conducted at the University of Pretoria in South Africa from April 2022 to August 2022. The current analysis took place between July 7, 2023, to November 20, 2023. In the original trial, participants in the self-fit device group received a pair of OTC hearing aids and independently fit them with remote support as needed. The audiologist-fit device group received the same hearing aids fit by a certified audiologist using best practices. The main outcomes were self-reported hearing aid benefit, measured using the Abbreviated Profile of Hearing Aid Benefit (APHAB) and the International Outcome Inventory for Hearing Aids (IOI-HA). Of 64 participants in the trial, 44 participants were included in the extension study (21 [47.7%] in the audiologist-fit group; 23 [52.3%] in the self-fit group). The mean (SD) age of these participants was 63.0 (13.2) years, and 21 (47.7%) were male. At the long-term follow-up, self-fit and audiologist-fit groups showed no significant differences in the APHAB global score (mean difference, 0.02 [95% CI, -7.1 to 7.1]; Cohen d, 0.01 [95% CI, -0.5 to 0.5]) or the IOI-HA total score (mean difference, 1.5 [95% CI, -1.4 to 4.4]; Cohen d, 0.3 [95% CI, -0.2 to 0.8]). From 6 weeks to 8 months, no clinically meaningful group-time interaction was found between groups for the APHAB global score (Cohen d, 0.1 [95% CI, -0.2 to 0.3]), but a significant interaction for the IOI-HA total score was found (Cohen d, -0.6 [95% CI, -0.8 to -0.3]), with the self-fit group generally performing better. This comparative effectiveness research study demonstrated that self-fit OTC hearing aids can offer comparable long-term benefits to audiologist-fit hearing aids for individuals with mild to moderate hearing loss.

Tinnitus reduction after active bone-conduction implantation in patients with single-sided deafness: a prospective multicenter study.

Single-sided deafness (SSD) presents significant challenges for patients, including compromised sound localization, reduced speech recognition, and often, tinnitus. These issues are typically addressed using interventions such as cochlear implantation (CI) and bone conduction implant (BCI). However, evidence regarding the efficacy of BCI in reducing tinnitus in SSD patients remains limited. This study explored the ability of a novel active transcutaneous BCI (Bonebridge BCI602) to alleviate tinnitus in SSD patients. Prospective cohort multicenter study. Tertiary referral hospitals. A prospective multicenter study of 30 SSD patients was conducted. The patients were divided into two groups: those with (n = 19) and without (n = 11) tinnitus. Audiometric assessments, subjective questionnaires including the Abbreviated Profile of Hearing Aid Benefit (APHAB) and the Bern Benefit in Single-Sided Deafness (BBSS), and tinnitus evaluations with the Tinnitus Handicap Inventory (THI) and tinnitogram were conducted before and after BCI surgery. THI scores after surgery were significantly reduced in SSD patients with tinnitus. Subjective satisfaction improved in both the tinnitus and non-tinnitus groups; however, the former group exhibited a significantly greater improvement in the APHAB questionnaire score. According to tinnitograms, the loudness of tinnitus decreased, particularly in patients with ipsilateral tinnitus. Patients with residual hearing had greater reductions in their THI scores. However, three patients without residual hearing had a relative worsening of tinnitus after surgery. The Bonebridge BCI602 effectively reduced tinnitus in SSD patients, particularly in those with residual hearing. Subjective satisfaction improved in both the tinnitus and non-tinnitus groups. These findings demonstrate the therapeutic potential of BCI for managing SSD and associated tinnitus.

Client Oriented Scale of Improvement in First-Time and Experienced Hearing Aid Users: An Analysis of Five Predetermined Predictability Categories through Audiometric and Speech Testing.

Objectives: The aim of our investigation was to explore the relationship between unaided pure-tone and speech audiometry and self-reported aided performance measured according to five predetermined COSI categories among first-time hearing aid users and experienced hearing aid users. Methods: Data from 286 patients were retrospectively evaluated. We divided the sample into first-time hearing aid users (G1) and experienced hearing aid users (G2). The correlation between unaided tonal and speech audiometry and five preliminary selected client-oriented scale of improvement (COSI) categories was studied. Results: A greater percentage of hearing aid users aged >80 years and a higher prevalence of severe-to-profound hearing loss in G2 group were observed (p < 0.05). For the total cohort, a mean hearing threshold of 60.37 ± 18.77 db HL emerged in the right ear, and 59.97 ± 18.76 db HL was detected in the left ear (p > 0.05). A significant statistical difference was observed in the group of first-time hearing aid users for the "Television/Radio at normal volume" item, where patients with a lower speech intellection threshold (SIT) were associated with higher COSI scores (p = 0.019). Studying the relationship between the speech reception threshold (SRT) and the COSI item "conversation with 1 or 2 in noise" evidenced worse speech audiometry in patients who scored ≤2 among experienced hearing aid users (p = 0.00012); a higher mean 4-8 kHz frequencies threshold for the better ear was found within the G2 group among those who scored ≤2 in the COSI item "conversation with 1 or 2 in quiet" (p = 0.043). Conclusions: Our study confirms a poor correlation between unaided tonal and speech audiometry and self-reported patient assessment. Although we included only five COSI categories in this study, it is clear that unaided audiometric tests may drive the choice of proper hearing rehabilitation, but their value in predicting the benefit of hearing aids remains limited.

The Output Signal-to-Noise Ratio and Speech Perception in Noise: The Effect of Multichannel and Free-Channel Hearing Aids

Background and Aim: The output Signal-to-Noise Ratio (SNR) is one of the essential factors in hearing aid benefits. There is limited evidence regarding SNR improvement by the Channel-Free (CFHA) and Multi-Channel Hearing Aid (MCHA) and the speech understanding in noise through them. This study aimed to investigate the extent to which output SNR was modified by CFHA and MCHA processing and the variation in aided speech recognition abilities with a change in output SNR. Methods: Thirty-six participants aged 50–65 years were included. A chosen CFHA and MCHA were used to obtain the output SNR and sentence recognition in noise in four different processing algorithms (linear, linear+noise reduction, WDRC, WDRC+noise reduction). Hagerman’s phase inversion technique was used to measure the attenuation of noise and, in turn, to obtain the output SNR of the hearing aid. Results: In all hearing aid processing algorithms among those with normal hearing and people with hearing loss, the output of CFHA revealed higher attenuation values than that of MCHA. There was a significant effect of the hearing aids and processing algorithms in both normal and individuals with hearing impairment on the mean SNR. Further, multiple linear regression analysis results showed that whether the hearing is channel-free or multi- channel significantly predicted speech recognition scores, while output SNR and processing algorithms did not. Conclusion: The signal processing algorithms in CFHA had greater noise attenuation values, better output SNR, and speech recognition scores, showing an advantage over the modern MCHA among individuals with hearing impairment. Keywords: Channel-free hearing aids; multi-channel hearing aids; sensorineural hearing loss; speech recognition

A Randomized Crossover Study in Single-Sided Deafness Comparing a Cartilage Conduction CROS System and an Air-Conduction CROS System.

To investigate if cartilage conduction (CC) rerouting devices are noninferior to air-conduction (AC) rerouting devices for single-sided deafness (SSD) patients by measuring objective and subjective performance using speech-in-noise tests that resemble a realistic hearing environment, sound localization tests, and standardized questionnaires. Prospective, single-subject randomized, crossover study. Anechoic room inside a university. Nine adults between 21 and 58 years of age with severe or profound unilateral sensorineural hearing loss. Patients' baseline hearing was assessed; they then used both the cartilage conduction contralateral routing of signals device (CC-CROS) and an air-conduction CROS hearing aid (AC-CROS). Patients wore each device for 2 weeks in a randomly assigned order. Three main outcome measures were 1) speech-in-noise tests, measuring speech reception thresholds; 2) proportion of correct sound localization responses; and 3) scores on the questionnaires, "Abbreviated Profile of Hearing Aid Benefit" (APHAB) and "Speech, Spatial, and Qualities of Hearing Scale" with 12 questions (SSQ-12). Speech reception threshold improved significantly when noise was ambient, and speech was presented from the front or the poor-ear side with both CC-CROS and AC-CROS. When speech was delivered from the better-ear side, AC-CROS significantly improved performance, whereas CC-CROS had no significant effect. Both devices mainly worsened sound localization, whereas the APHAB and SSQ-12 scores showed benefits. CC-CROS has noninferior hearing-in-noise performance except when the speech was presented to the better ear under ambient noise. Subjective measures showed that the patients realized the effectiveness of both devices.