Hearing Aid Benefit Research Articles

Assessing Speech Audibility via Syllabic-Rate Neural Responses in Adults and Children With and Without Hearing Loss.

An objective method for assessing speech audibility is essential to evaluate hearing aid benefit in children who are unable to participate in hearing tests. With consonant-vowel syllables, brainstem-dominant responses elicited at the voice fundamental frequency have proven successful for assessing audibility. This study aimed to harness the neural activity elicited by the slow envelope of the same repetitive consonant-vowel syllables to assess audibility. In adults and children with normal hearing and children with hearing loss wearing hearing aids, neural activity elicited by the stimulus /su∫i/ or /sa∫i/ presented at 55-75 dB SPL was analyzed using the temporal response function approach. No-stimulus runs or very low stimulus level (15 dB SPL) were used to simulate inaudible conditions in adults and children with normal hearing. Both groups of children demonstrated higher response amplitudes relative to adults. Detectability (sensitivity; true positive rate) ranged between 80.1 and 100%, and did not vary by group or stimulus level but varied by stimulus, with /sa∫i/ achieving 100% detectability at 65 dB SPL. The average minimum time needed to detect a response ranged between 3.7 and 6.4 min across stimuli and listener groups, with the shortest times recorded for stimulus /sa∫i/ and in children with hearing loss. Specificity was >94.9%. Responses to the slow envelope of non-meaningful consonant-vowel syllables can be used to ascertain audible vs. inaudible speech with sufficient accuracy within clinically feasible test times. Such responses can increase the clinical usefulness of existing objective approaches to evaluate hearing aid benefit.

Comparative Effectiveness of Personal Sound Amplification Products Versus Hearing Aids for Unilateral Hearing Loss: A Prospective Randomized Crossover Trial.

This study compared hearing outcomes with use of personal sound amplification products (PSAPs) and hearing aids (HAs) in patients with moderate to moderately severe unilateral hearing loss. Thirty-nine participants were prospectively enrolled, and randomly assigned to use either one HA (basic or premium type) or one PSAP (basic or high-end type) for the first 8 weeks and then the other device for the following 8 weeks. Participants underwent a battery of examinations at three visits, including sound-field audiometry, word recognition score (WRS), speech perception in quiet and in noise, real-ear measurement, and self-report questionnaires. Functional gain was significantly higher with HAs across all frequencies (P < 0.001). While both PSAPs and HAs improved WRS from the unaided condition, HAs were superior to PSAPs. The speech recognition threshold in quiet conditions and signal-to-noise ratio in noisy conditions were significantly lower in the HA-aided condition than in the PSAP-aided condition, and in the PSAP-aided condition than in the unaided condition. Subjective satisfaction also favored HAs than PSAPs in questionnaires, Abbreviated Profile of Hearing Aid Benefit, International Outcome Inventory for Hearing Aids, and Host Institutional Questionnaire. While PSAPs provide some benefit for moderate to moderately severe unilateral hearing loss, HAs are more effective. This underscores the potential role of PSAPs as an accessible, affordable first-line intervention in hearing rehabilitation, particularly for individuals facing challenges in accessing conventional HAs.

Language Development in Children with Cochlear Implant using Bimodal Approach: SLP Perspective

Background: The development of language skills in children with cochlear implants is a vital area of research, particularly in understanding the impact of the bimodal approach. This study focuses on children with early language delays under the age of five, exploring how cochlear implantation and the bimodal approach influence their language development. Objective: The primary objective of this study was to evaluate the effectiveness of the bimodal approach (cochlear implant combined with a hearing aid) on language development in children with cochlear implants. The study aimed to understand the perspectives of speech-language pathologists (SLPs) on the challenges and successes associated with this approach. Methods: This descriptive study involved 50 SLPs from hospitals and rehabilitation centers across Pakistan, each with at least a year of clinical experience. Data were collected through a questionnaire focusing on various aspects of cochlear implantation and the bimodal approach. The questionnaire included questions on the age of implantation, additional medical complexities, effectiveness of the bimodal approach, and the impact on speech skills, social interaction, and cognitive functions. The study employed a cross-sectional design, and the data were analyzed using SPSS version 25 for statistical significance. Results: The majority (81.2%) of children received their cochlear implantation between 1-3 years. About 70.6% of respondents reported using a second hearing aid post-implantation. The bimodal approach was found effective by 78.4% of therapists in aiding speech comprehension. Approximately 88.2% believed that hearing devices improved speech skills, and 82.4% noted the benefit of an additional hearing aid. However, concerns were raised about potential dependencies on these devices. In terms of social and academic performance, 84.4% of therapists saw improvements. Conclusion: The study concludes that the bimodal approach is effective in enhancing language development in children with cochlear implants. Early implantation, combined with the use of a hearing aid, shows promising results in language acquisition and social interaction. Despite the limitations due to a small sample size and data collection constraints during the COVID-19 pandemic, the study provides valuable insights into the positive impact of the bimodal approach in language development.

Effects of remote ear-nose-and-throat specialist assessment screening on self-reported hearing aid benefit and satisfaction

Objective To explore the impact of remote versus in-person ear-nose-and-throat (ENT) specialist screening before hearing treatment on self-reported hearing aid (HA) benefit and satisfaction among adult first-time HA users. Design Participants were randomised to either remote or in-person ENT assessment before treatment initiation. Hearing ability, hearing quality, and treatment satisfaction were assessed pre- and post-HA treatment using the SSQ12, IOI-HA, and selected items from the 2021 Danish national Patient-Reported Experience Measures. Average daily HA usage was also recorded. Study sample 751 adult potential first-time HA users with self-reported hearing impairment were included; 501 participants were remotely assessed in private or public audiological clinics, and 250 control group participants were assessed in-person by private ENT specialists. Of the 658 participants who completed the entire trial, 454 received HAs. Results No significant post-treatment HA benefit differences were found between groups. Remotely assessed HA recipients in private clinics expressed slightly higher staff and waiting time satisfaction. Participants with normal hearing and mild/moderate hearing loss reported higher pre-treatment hearing ability and quality. No significant difference in average daily HA usage was observed between groups. Conclusions Findings suggest that remote screening does not compromise patient-reported HA benefit and satisfaction when compared to in-person screening.

The Relationship Between Auditory Performances and Satisfaction of Unilateral Bone-Anchored Hearing in Conductive and Mixed Hearing Loss.

The aim of this study is to investigate the deviced and non-deviced auditory performance results of patients with unilateral bone-anchored hearing aid. Deviced and non-deviced free field hearing thresholds, speech discrimination, and sentence discrimination scores were evaluated. Shortened profile of the benefit from the hearing instrument (Abbreviated Profile of Hearing Aid Benefit) was used. A total of 17 patients participated in the study. The mean age was 37.9 ± 17.1 years. There was a statistically significant difference between the Abbreviated Profile of Hearing Aid Benefit satisfaction questionnaire and total scores, Background Noise (BN), Reverberation (RV) subscales according to device status (P -lt; .05). No significant difference was found between the Abbreviated Profile of Hearing Aid Benefit total score result of the group divided by the hearing aid threshold (P -gt; .05). No significant difference was found between the Abbreviated Profile of Hearing Aid Benefit total score result of the group divided by the threshold without a hearing aid (P -gt; .05). Bone-implanted hearing aids are effective and reliable amplification methods in patients with conductive and mixed hearing loss. Positive results of patient satisfaction and evaluation inventories were obtained from this study.

Combining MUSHRA Test and Fuzzy Logic in the Evaluation of Benefits of Using Hearing Prostheses

Assessing the effectiveness of hearing aid fittings based on the benefits they provide is crucial but intricate. While objective metrics of hearing aids like gain, frequency response, and distortion are measurable, they do not directly indicate user benefits. Hearing aid performance assessment encompasses various aspects, such as compensating for hearing loss and user satisfaction. The authors suggest enhancing the widely used APHAB (Abbreviated Profile of Hearing Aid Benefit) questionnaire by integrating it with the MUSHRA test. APHAB, a self-completed questionnaire for users, evaluates specific sound scenarios on a seven-point scale, with each point described by a letter, percentage, and description. Given the complexities, especially for older users, we propose converting the seven-point APHAB scale to a clearer 100-point MUSHRA scale using fuzzy logic rules. The paper starts with presenting the goals of the study, focused on the assessment of the benefits of hearing aid use, especially in the case of the elderly population. The introductory part includes an overview of methods for evaluating the effectiveness of hearing aid use. Then, the methodology for the data collection is presented. This is followed by a method modification that combines the MUSHRA (MUltiple Stimuli with Hidden Reference and Anchor) test and fuzzy logic processing and the commonly used hearing aid benefit assessment questionnaire, APHAB (Abbreviated Profile of Hearing Aid Benefit). The results of such a process are examined. A summary of the findings is given in the form of fuzzy logic-based rules, followed by a short discussion. Finally, the overall conclusion and possible future directions for the method development are presented.

Hearing loss, depression, and cognition in younger and older adult CI candidates.

Hearing loss in old age is associated with cognitive decline and with depression. Our study aimed to investigate the relationship between hearing loss, cognitive decline, and secondary depressive symptoms in a sample of younger and older cochlear implant candidates with profound to severe hearing loss. This study is part of a larger cohort study designated to provide information on baseline data before CI. Sixty-one cochlear implant candidates with hearing loss from adulthood onwards (>18 years) were enrolled in this study. All had symmetrical sensorineural hearing loss in both ears (four-frequency hearing threshold difference of no more than 20 dB, PTA). Individuals with primary affective disorders, psychosis, below-average intelligence, poor German language skills, visual impairment, and a medical diagnosis with potential impact on cognition (e.g., neurodegenerative diseases,) were excluded. Four-frequency hearing thresholds (dB, PTA, better ear) were collected. Using the Abbreviated Profile of Hearing Aid Benefit, we assessed subjective hearing in noise. Clinical and subclinical depressive symptoms were assessed with the Beck Depression Inventory (BDI II). Cognitive status was assessed with a neurocognitive test battery. Our findings revealed a significant negative association between subjective hearing in noise (APHAB subscale "Background Noise") and BDII. However, we did not observe any link between hearing thresholds, depression, and cognition. Additionally, no differences emerged between younger (25-54 years) and older subjects (55-75 years). Unexpectedly, further unplanned analyses unveiled correlations between subjective hearing in quiet environments (APHAB) and cognitive performance [phonemic fluency (Regensburg Word Fluency), cognitive flexibility (TMTB), and nonverbal episodic memory (Nonverbal Learning Test), as well as subjective hearing of aversive/loud sounds (APHAB)], cognitive performance [semantic word fluency (RWT), and inhibition (Go/Nogo) and depression]. Duration of hearing loss and speech recognition at quiet (Freiburg Monosyllables) were not related to depression and cognitive performance. Impact of hearing loss on mood and cognition appears to be independent, suggesting a relationship with distinct aspects of hearing loss. These results underscore the importance of considering not only conventional audiometric measures like hearing thresholds but also variables related to hearing abilities during verbal communication in everyday life, both in quiet and noisy settings.

Neural envelope tracking predicts speech intelligibility and hearing aid benefit in children with hearing loss

Early assessment of hearing aid benefit is crucial, as the extent to which hearing aids provide audible speech information predicts speech and language outcomes. A growing body of research has proposed neural envelope tracking as an objective measure of speech intelligibility, particularly for individuals unable to provide reliable behavioral feedback. However, its potential for evaluating speech intelligibility and hearing aid benefit in children with hearing loss remains unexplored. In this study, we investigated neural envelope tracking in children with permanent hearing loss through two separate experiments. EEG data were recorded while children listened to age-appropriate stories (Experiment 1) or an animated movie (Experiment 2) under aided and unaided conditions (using personal hearing aids) at multiple stimulus intensities. Neural envelope tracking was evaluated using a linear decoder reconstructing the speech envelope from the EEG in the delta band (0.5-4 Hz). Additionally, we calculated temporal response functions (TRFs) to investigate the spatio-temporal dynamics of the response. In both experiments, neural tracking increased with increasing stimulus intensity, but only in the unaided condition. In the aided condition, neural tracking remained stable across a wide range of intensities, as long as speech intelligibility was maintained. Similarly, TRF amplitudes increased with increasing stimulus intensity in the unaided condition, while in the aided condition significant differences were found in TRF latency rather than TRF amplitude. This suggests that decreasing stimulus intensity does not necessarily impact neural tracking. Furthermore, the use of personal hearing aids significantly enhanced neural envelope tracking, particularly in challenging speech conditions that would be inaudible when unaided. Finally, we found a strong correlation between neural envelope tracking and behaviorally measured speech intelligibility for both narrated stories (Experiment 1) and movie stimuli (Experiment 2). Altogether, these findings indicate that neural envelope tracking could be a valuable tool for predicting speech intelligibility benefits derived from personal hearing aids in hearing-impaired children. Incorporating narrated stories or engaging movies expands the accessibility of these methods even in clinical settings, offering new avenues for using objective speech measures to guide pediatric audiology decision-making.

Speech intelligibility and hearing aid benefit in a living room: Comparison of real and simulated acoustics

For hearing-impaired patients, a disparity between hearing aid benefit determined by conventional audiological assessment and observed in everyday life has been reported. Hence, ecologically valid testing methods to better reflect performance in real-world scenarios are required. Hereby, the living room is a highly relevant (home) environment for speech communication involving various target and interfering sources. This study examines speech intelligibility in an average German living room with a connected kitchen and acoustic reproductions of the real room using loudspeakers. Speech recognition thresholds were measured using the Oldenburg Sentence Test (OLSA) and a male-transformed version of the ISTS (International Speech Test Signal) as a masker. Aided and unaided hearing-impaired listeners, as well as a normal-hearing control group, participated. Three target positions were investigated, with the most challenging target position in the adjacent kitchen with an obstructed direct sound path. Interactive room acoustics simulation (allowing for head movements) was used to replicate the living room via a small-scale (four) loudspeaker array, as applicable in the clinical environment, and a large-scale, three-dimensional array with 86 loudspeakers. The study discusses the impact of room acoustics on speech intelligibility at different target positions and the relationship between real and simulated environments regarding hearing aid benefit.

Comparing the benefits of hearing aids and cochlear implants in real-world listening environments

Comparing outcomes between patients with bilateral hearing aids (HAs), bilateral cochlear implants (CIs), and bimodal fittings (CI + HA) are difficult because of the variations in hearing performance between the different devices and patient groups. This may impact patient counselling, device selection, and hearing outcomes for listeners with more severe hearing loss. This study seeks to identify the factors impacting the listening abilities of adults fitted with bilateral HAs, bilateral CIs, and bimodal fittings in noisy environments by comparing outcomes from commonly used clinical tests and a new task that emphasises realistic listening in background noise. By identifying these limiting factors from a variety of tests, optimising hearing aid fittings, and comparing between device configuration groups, the study will help understand where hearing aid devices no longer meet satisfactory individual outcomes, and a cochlear implant may improve long-term performance. This approach pushes toward considering real-world outcomes through realistic test measures when informing clinical counsel and device implantation or configuration recommendations. As such, adults with hearing loss can receive more tailored advice that validates their daily listening concerns and clinicians are granted a better understanding of how to improve the quality of life for their clients.

Patient-Reported Outcome Measures for Hearing Aid Benefit and Satisfaction: Content Validity and Readability.

Numerous patient-reported outcome measures (PROMs) are available to measure hearing aid benefit and satisfaction. It is unclear to what extent currently available PROMs on hearing aid outcomes, often developed decades ago, meet current guidelines for good content validity and readability. This study evaluated the content validity and readability of PROMs that focus on perceived hearing aid benefit and/or satisfaction. A literature review was conducted to identify eligible instruments. Content validity evaluation included mapping extracted questionnaire items to the World Health Organization's International Classification of Functioning, Disability and Health (ICF) framework. In addition, study design in content validity methodology was evaluated using the COnsensus-based Standards for the selection of health Measurement INstruments study design checklist for PROM instruments. Readability was estimated using the Simple Measure of Gobbledygook measure. Thirteen questionnaires were identified and evaluated. Item content focused primarily on the components of environmental factors as well as activity limitations and participation restrictions with less emphasis on body functions and personal factors. The content validity methodology analysis revealed an underuse or lack of reporting of a qualitative methodology in assessing patient and professional perspectives. All the included questionnaires exceeded the recommended sixth-grade reading level. The categories covered by hearing aid PROMs vary considerably, with no single instrument comprehensively covering all the key ICF components. Future development of hearing aid outcome measures should consider a mixed methodology approach for improved content validity and ensure an appropriate reading level.

Value of patient-reported outcome measures for evaluating the benefit of speech processor upgrading in patients with cochlear implants.

Patients with acochlear implant (CI) should be evaluated for anew speech processor every 6years. The aim of this analysis was to assess the subjective and audiological benefit of upgrades. Speech understanding and subjective benefit were analyzed in 99patients with the old and the new speech processor after 4weeks of wearing. Speech understanding was assessed using the Freiburg monosyllabic test in quiet (FBE) at 65 dB and 80 dB, and the Oldenburg Sentence Test (OLSA) at 65 dB noise with adaptive speech sound level. The Abbreviated Profile of Hearing Aid Benefit (APHAB) was used to assess subjective hearing impairment, and the Audio Processor Satisfaction Questionnaire (APSQ) was used to assess subjective satisfaction. The speech processor upgrade resulted in asignificant improvement of speech understanding in quiet at 65 dB (mean difference 8.9 ± 25.9percentage points, p < 0.001) and 80 dB (mean difference 8.1 ± 29.7percentage points, p < 0.001) and in noise (mean difference 3.2 ± 10.7 dBsignal-to-noise ratio [S/N], p = 0.006). Using the APHAB, asignificant improvement (mean difference 0.07 ± 0.16, p < 0.001) in hearing impairment was demonstrated in all listening situations. The APSQ showed significantly higher patient satisfaction with the new speech processor (mean difference 0.42 ± 1.26, p = 0.006).A comparative assessment of the benefit based on subjective and speech audiometric results identified aproportion of patients (35-42%) who subjectively benefited from the upgrade but had no measurable benefit based on speech audiometry. There was asignificant improvement in audiologically measurable and subjectively reflected speech understanding and patient satisfaction after the upgrade. In patients with only asmall improvement in audiologically measurable speech understanding, the subjective benefit should also be assessed with validated measurement instruments in order to justify an upgrade to the payers in the health sector.

A Systematic Review of the Audiological Efficacy of Cartilage Conduction Hearing Aids and the Factors Influencing Their Clinical Application.

This systematic review evaluates the efficacy and benefit of cartilage conduction hearing aids (CC-HAs) and that factors that influence purchasing decisions. The hearing thresholds and functional gain following CC-HA wear were synthesised. A one-way analysis of variance compared the differences in the hearing thresholds and functional gain at individual frequencies and in patients with a variety of pathological changes. The synchronised aided hearing threshold and functional gain at 2.0 kHz were significantly better than at 0.5, 1.0, and 4.0 kHz. There was no significant difference in the synchronised unaided hearing thresholds across individual frequencies between 0.5 and 4.0 kHz. The synchronised functional gain in patients with atresia was significantly greater than in patients with aural atresia or stenosis and middle ear pathologies with normal ear canals. The acceptability of CC-HAs in terms of purchase decision is influenced by the condition of the external auditory meatus and severity of hearing loss, with the highest purchase rate seen in patients with aural atresia or stenosis. CC-HAs' fitting procedure advantages and cosmetic considerations make these devices a viable and preferred choice for individuals with microtia and aural atresia. Additional research to evaluate the benefits towards emotional well-being is crucial to gain insights into the psychological impact of CC-HA use.

Hearing Aids Reduce Self-Perceived Difficulties in Noise for Listeners With Normal Audiograms.

This study assessed hearing aid benefits for people with a normal audiogram but hearing-in-noise problems in everyday listening situations. Exploratory double-blinded case-control study whereby participants completed retrospective questionnaires, ecological momentary assessments, speech-in-noise testing, and mental effort testing with and without hearing aids. Twenty-seven adults reporting speech-in-noise problems but normal air conduction pure-tone audiometry took part in the study. They were randomly separated into an experimental group that trialed mild-gain hearing aids with advanced directional processing and a control group fitted with hearing aids with no gain or directionality. Self-reports showed mild-gain hearing aids reduce hearing-in-noise difficulties and provide a better hearing experience (i.e., improved understanding, participation, and mood). Despite the self-reported benefits, the laboratory tests did not reveal a benefit from the mild-gain hearing aids, with no group differences on speech-in-noise tests or mental effort measures. Further, participants found the elevated cost of hearing aids to be a barrier for their adoption. Hearing aids benefit the listening experience in some listening situations for people with normal audiogram who report hearing difficulties in noise. Decreasing the price of hearing aids may lead to greater accessibility to those seeking remediation for their communication needs.

Value of patient-reported outcome measures for evaluating the benefit of speech processor upgrading in patients with cochlear implants. German version

Patients with acochlear implant (CI) should be evaluated for anew speech processor every 6years. The aim of this analysis was to assess the subjective and audiological benefit of upgrades. Speech understanding and subjective benefit were analyzed in 99patients with the old and the new speech processor after 4weeks of wearing. Speech understanding was assessed using the Freiburg monosyllabic test in quiet (FBE) at 65 dB and 80 dB, and the Oldenburg Sentence Test (OLSA) at 65 dB noise with adaptive speech sound level. The Abbreviated Profile of Hearing Aid Benefit (APHAB) was used to assess subjective hearing impairment, and the Audio Processor Satisfaction Questionnaire (APSQ) was used to assess subjective satisfaction. The speech processor upgrade resulted in asignificant improvement of speech understanding in quiet at 65 dB (mean difference 8.9 ± 25.9percentage points, p < 0.001) and 80 dB (mean difference 8.1 ± 29.7percentage points, p < 0.001) and in noise (mean difference 3.2 ± 10.7 dBsignal-to-noise ratio [S/N], p = 0.006). Using the APHAB, asignificant improvement (mean difference 0.07 ± 0.16, p < 0.001) in hearing impairment was demonstrated in all listening situations. The APSQ showed significantly higher patient satisfaction with the new speech processor (mean difference 0.42 ± 1.26, p = 0.006).A comparative assessment of the benefit based on subjective and speech audiometric results identified aproportion of patients (35-42%) who subjectively benefited from the upgrade but had no measurable benefit based on speech audiometry. There was asignificant improvement in audiologically measurable and subjectively reflected speech understanding and patient satisfaction after the upgrade. In patients with only asmall improvement in audiologically measurable speech understanding, the subjective benefit should also be assessed with validated measurement instruments in order to justify an upgrade to the payers in the health sector.

Evaluating the Benefit of Hearing Aid Using Paired Words in Tamil

Purpose: Subjective measurements, such as speech audiometry, are essential to determine the perception of speech as it provides insight regarding perceptual abilities. The present study aimed to develop paired word test stimuli in Tamil and evaluate their utility for assessing the benefits of a hearing aid. Methods: The stimuli were 30 paired words which were paired to rhythm containing almost all vowels and consonants of the Tamil language differing in one or more distinctive features, such as place, manner, voicing features of consonants, and height, duration, and rounding features of vowels. The paired words test was administered to 60 participants with normal hearing and 60 participants with hearing impairment. The correct identification scores and their percentage were computed to notice the benefit provided by their hearing aids. Results: The overall performance of individuals with normal hearing on the paired identification was high, suggesting that these paired word test materials could be used for individuals with hearing impairment to assess hearing aid benefit. A greater improvement in recognition scores for paired words was obtained after being fitted with a hearing aid in individuals with hearing impairment. It was noticed that due to hearing loss, the audibility of perception reduces, yielding lower scores in paired word identification. Conclusion: When the proper fitting was done, the percentage of identification scores was increased. Therefore, the present study concludes that speech perception abilities can be evaluated and quantified using these paired word tests.

Comparison of Active Bone Conduction Hearing Implant Systems in Unilateral and Bilateral Conductive or Mixed Hearing Loss.

To assess and compare binaural benefits and subjective satisfaction of active bone conduction implant (BCI) in patients with bilateral conductive or mixed hearing loss fitted with bilateral BCI and patients with monaural conductive hearing loss fitted with monaural BCI. ITA Matrix test was performed both on patients affected by bilateral conductive or mixed hearing loss fitted with monaural bone conduction hearing implant (Bonebridge, Med-El) before and after implantation of contralateral bone conduction hearing implant and on patients with monaural conductive or mixed hearing loss before and after implantation of monaural BCI. The Abbreviated Profile of Hearing Aid Benefit (APHAB) questionnaire was administered to both groups of subjects and the results were compared with each other. Patients of group 1 reported a difference of 4.66 dB in the summation setting compared to 0.79 dB of group 2 (p < 0.05). In the squelch setting, group 1 showed a difference of 2.42 dB compared to 1.53 dB of group 2 (p = 0.85). In the head shadow setting, patients of group 1 reported a difference of 7.5 dB, compared to 4.61 dB of group 2 (p = 0.34). As for the APHAB questionnaire, group 1 reported a mean global score difference of 11.10% while group 2 showed a difference of -4.00%. Bilateral BCI in patients affected by bilateral conductive or mixed hearing loss might show more advantages in terms of sound localisation, speech perception in noise and subjective satisfaction if compared to unilateral BCI fitting in patients affected by unilateral conductive hearing impairment. This may be explained by the different individual transcranial attenuation of each subject, which might lead to different outcomes in terms of binaural hearing achievement. On the other hand, patients with unilateral conductive or mixed hearing loss fitted with monaural BCI achieved good results in terms of binaural hearing and for this reason, there is no absolute contraindication to implantation in those patients.

Assessment of the Effectiveness of a Short-term Hearing Aid Use in Patients with Different Degrees of Hearing Loss

The study presents evaluating the effectiveness of the hearing aid fitting process in the short-term use (7 days). The evaluation method consists of a survey based on the APHAB (Abbreviated Profile of Hearing Aid Benefit) questionnaire. Additional criteria such as a degree of hearing loss, number of hours and days of hearing aid use as well as the user’s experience were also taken into consideration. The outcomes of the benefit obtained from the hearing aid use in various listening environments for 109 hearing aid users are presented, including a degree of their hearing loss. The research study results show that it is possible to obtain relevant and reliable information helpful in assessing the effectiveness of the shortterm (7 days) hearing aid use. The overall percentage of subjects gaining a benefit when communicating in noise is the highest of all the analyzed and the lowest in the environment with reverberation. The statistical analysis performed confirms that in the listening environments in which conversation is held, a subjective indicator determined by averaging benefits for listening situations individually is statistically significant with respect to the degree of hearing loss. Statistically significant differences depending on the degree of hearing loss are also found separately for noisy as well as reverberant environments. However, it should be remembered that this study is limited to three types of hearing loss, i.e. mild, moderate and severe. The acceptance of unpleasant sounds gets the lowest rating. It has also been observed that in the initial period of hearing aid use, the perception of unpleasant sounds has a big influence on the evaluation of hearing improvement.

Hearing Rehabilitation Using Bone Conduction Implants in Patients With Single-Sided Deafness After Vestibular Schwannoma Removal

Background and Objectives Vestibular schwannoma (VS) itself or treatment of VS can cause single-sided deafness (SSD), a unilateral sensorineural hearing loss. Patients of SSD experience communication problems, which can be frustrating. For decades, many types of bone conduction implants (BCIs) have been developed and used to treat such hearing problems. In this study, we evaluated the effectiveness of BAHD surgery to treat SSD patients’ hearing impairment and analysed the complications patients suffer.Subjects and Method A retrospective chart review was conducted on 12 patients who had undergone BCIs, such as Baha Attract, Bonebridge, and Sophono implantation, after removal of VS. From 2016 to 2021, one senior surgeon at a single tertiary hospital performed surgery for SSD rehabilitation. The authors analysed the clinical features, radiologic findings (CT and MRI), hearing tests (pure tone audiogram [PTA], speech audiogram [SA], and Korea hearing in noise test), subjective satisfaction scores (abbreviated profile of hearing aid benefit), and surgical outcomes of the patients.Results All patients underwent temporal MRI, temporal bone CT scan, PTA, and SA at least 3 years after VS removal and confirmed no residual tumour or serviceable contralateral hearing at the last follow-up. Among the patients (12), eight received Baha Attract implantation, three received Bonebridge implantation, and one received Sophono implantation. On the average, patients’ ipsilateral hearing outcomes improved by 82.7 dB (from 115.8±9.8 dB to 33.1±9.5 dB).Conclusion There are many methods of hearing rehabilitation in SSD that are used after VS, but BCI seemed to be the most useful treatment.

Cartilage Conduction Hearing Aids in Clinical Practice.

A relatively loud sound is audible when a vibrator is attached to the aural cartilage. This form of conduction is referred to as cartilage conduction (CC). In Japan, a new type of hearing aid has been developed using CC and has been available in clinical practice since 2017. A clinical study conducted prior to its launch demonstrated its benefits, particularly in patients with aural atresia who were unable to use air conduction hearing aids. Several studies have been published on the benefits of CC hearing aids since their introduction into clinical practice. Most of the patients included in these studies had canal stenosis or aural atresia, and the purchase rates of CC hearing aids in these patients were relatively high. However, the number of patients with canal-open ears was small, with overall poor results in the trials, with the exception of patients with continuous otorrhea. CC hearing aids are considered a good option for compensating for hearing loss in ears with canal stenosis or atresia in both bilateral and unilateral cases. However, CC hearing aids are not currently considered the first choice for patients with a canal-open ear.