Hearing Aid Clinic Research Articles

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.

Cultural competence in NHS hearing aid clinics: a mixed-methods case study of services for Deaf British sign language users in the UK

BackgroundThis study identified and explored how National Health Service (NHS) hearing aid clinics address cultural competence concerning Deaf British Sign Language (BSL) users. This was approached by (i) investigating how organisational processes meet the needs of Deaf signers from a hospital and hearing aid clinic perspective, (ii) analysing policies and guidelines to investigate if they equip practitioners to meet the needs of Deaf signers and (iii) exploring with practitioners who work in hearing aid clinics about their experiences of working with Deaf signers.MethodsThis study utilised a mixed-methods multiple case study design, incorporating documentary analysis and semi-structured interviews. Interview analysis was conducted using Reflexive Thematic Analysis (RTA). The research encompassed two hearing aid clinics in separate hospitals, producing 19 documents and eight interviews (four at each site) with audiologists ensuring a representative mix of professional experience levels.ResultsFour themes emerged from the integrated analysis: (1) Understanding Deaf signers; (2) Communicating with Deaf signers; (3) Barriers and Facilitators and (4) Service improvement. A noticeable gap in understanding BSL as both a language and a cultural system was apparent across various policies, strategies, training programmes and staff expertise. Over-reliance on interpreters provided a false sense of accessibility and most participants felt tentative to engage directly with Deaf signers. Positive practices observed at Sites A and B encompassed accurate identification of patients as Deaf signers, improved interpreter availability, communication methods, enhanced training and the encouragement of professional self-awareness.ConclusionThis is the first study that explores cultural competence of hearing aid clinics and its staff concerning Deaf signers in the UK. The results show both clinics require development to become an effective provider for culturally Deaf signers. Examples of how to design culturally competent practices have been provided to assist hearing aid clinics. The findings may be applicable to other underrepresented groups who are not typical users of conventional, acoustic hearing aids provided by the NHS.

Managing comorbid cognitive impairment and hearing loss in older adults: a UK survey of audiology and memory services.

midlife hearing loss is a potentially modifiable risk factor for dementia. Addressing comorbid hearing loss and cognitive impairment in services for older adults may offer opportunities to reduce dementia risk. to explore current practice and views amongst UK professionals regarding hearing assessment and care in memory clinics and cognitive assessment and care in hearing aid clinics. national survey study. Between July 2021 and March 2022, we distributed the online survey link via email and via QR codes at conferences to professionals working in National Health Service (NHS) memory services and audiologists working in NHS and private adult audiology services. We present descriptive statistics. 135 professionals working in NHS memory services and 156 audiologists (68% NHS, 32% private sector) responded. Of those working in memory services, 79% estimate that >25% of their patients have significant hearing difficulties; 98% think it useful to ask about hearing difficulties and 91% do so; 56% think it useful to perform a hearing test in clinic but only 4% do so. Of audiologists, 36% estimate that >25% of their older adult patients have significant memory problems; 90% think it useful to perform cognitive assessments, but only 4% do so. Main barriers cited are lack of training, time and resources. although professionals working in memory and audiology services felt addressing this comorbidity would be useful, current practice varies and does not generally address it. These results inform future research into operational solutions to integrating memory and audiology services.

Deaf signers and hearing aids: motivations, access, competency and service effectiveness

Objectives This study concerns culturally Deaf signers in the UK who use hearing aids and (i) explores motivations for hearing aid use (ii) identifies barriers and facilitators to accessing NHS hearing aid services, (iii) examines cultural competency of hearing aid clinics and (iv) identifies factors influencing effective adult hearing aid service provision. Design Online survey in British Sign Language and English that was informed by Deaf service users. Study sample 75 Deaf adult BSL users who wear hearing aids and use NHS hearing aid clinics. Results No specific reason emerged as outstandingly important for hearing aid use; however, assisting with lipreading (57%) and listening to music (52%) were rated as very/extremely important. Access issues reported were contacting clinics, poor communication with staff and lack of Deaf awareness. To be an effective and culturally competent hearing aid clinic for Deaf signers, a good understanding of Deaf culture and language was most rated as important (87%). Conclusion The study is the first that explores hearing aid use and experiences of accessing hearing aid clinics from Deaf signers’ perspectives. Enhancements to clinical practice are required to consider culturally Deaf people’s motivations for hearing aid use and make services more BSL-friendly.

Exploring the lived experiences of British Sign Language (BSL) users who access NHS adult hearing aid clinics: an interpretative phenomenological analysis

Objective To explore the lived experiences of culturally Deaf British Sign Language (BSL) users who access adult hearing aid services. Design Semi-structured qualitative interviews were conducted in BSL by the Deaf researcher and analysed using an Interpretative Phenomenological Analysis (IPA) approach. Study sample Eight Deaf BSL expert informants who were experienced users of NHS adult hearing aid clinics. Results Participants expressed dissatisfaction about audiology staff's lack of Deaf awareness and did not feel valued as Deaf signers. Participants' motivations for hearing aid use primarily concerned audibility rather than speech. Mismatch of perspectives on ‘hearing’ between audiologists and Deaf patients are discussed in the context of culturally sensitive services. Inadequate or uncertain linguistic access during appointments is considered in light of patient agency. Conclusion This is the first study to explore culturally Deaf signers' specific experiences of adult hearing aid services in the UK and their experiences of hearing aids. There are numerous reasons why Deaf signers wear hearing aids, but access to spoken language is not a priority. Limited Deaf awareness and cultural competence in adult hearing aid services can result in patient frustration and disempowerment. Suggestions for improvement in the Deaf signing patient experience are offered.

Using Contextual and Visual Cues to Improve Sung Word Recognition in Hearing Aid Users.

Older adults commonly experience hearing loss that negatively affects the quality of life and creates barriers to effective therapeutic interactions as well as music listening. Music therapists have the potential to address some needs of older adults, but the effectiveness of music interventions is dependent on the perception of spoken and musical stimuli. Nonauditory information, such as contextual (e.g., keywords, picture related to song) and visual cues (e.g., clear view of singer's face), can improve speech perception. The purpose of this study was to examine the benefit of contextual and visual cues on sung word recognition in the presence of guitar accompaniment. The researcher tested 24 community-dwelling older adult hearing aid (HA) users recruited through a university HA clinic and laboratory under 3 study conditions: (a) auditory stimuli only, (b) auditory stimuli with contextual cues, and (c) auditory stimuli with visual cues. Both visual and contextual nonauditory cues benefited participants on sung word recognition. Participants' music background and training were predictive of success without nonauditory cues, and visual cues provided greater benefit than contextual cues. Based on the results of this study, it is recommended that music therapists increase the accessibility of music interventions reliant upon lyric recognition through the incorporation of clear visual and contextual cues.

Health-Related Quality of Life Changes Associated With Hearing Loss

Utility is a single-value, preference-based measure of health-related quality of life that represents the desirability of a health state relative to being dead or in perfect health. Clinical, funding, and policy decisions rely on measured changes in utility. The benefit of hearing loss treatments may be underestimated because existing utility measures fail to capture important changes in quality of life associated with hearing loss. To develop a comprehensive profile of items that describe how quality of life is associated with hearing loss and its treatments that can be used to generate hearing-related quality of life measures, including a novel utility measure. This qualitative study, performed from August 1, 2018, to August 1, 2019, in tertiary referral centers, comprised a systematic literature review, focus groups, and semistructured interviews. The systematic review evaluated studies published from 1982 to August 1, 2018. Focus groups included 8 clinical experts experienced in the measurement, diagnosis, treatment, and rehabilitation of hearing loss. Semistructured interviews included 26 adults with hearing loss recruited from an institutional data set and outpatient hearing aid and otology clinics using stratified convenience sampling to include individuals of diverse ages, urban and rural residency, causes of hearing loss, severity of hearing loss, and treatment experience. A set of items and subdomains that collectively describe the association of hearing loss with health-related quality of life. The literature search yielded 2779 articles from the MEDLINE, Embase, Cochrane, PsycINFO, and CINAHL databases. Forty-five studies including 1036 individuals (age range, 18-84 years) were included. The focus group included 4 audiologists and 4 otologists. Hour-long semistructured interviews were conducted with 26 individuals (13 women; median age, 54 years; range, 25-83 years) with a broad range of hearing loss causes, configurations, and severities. From all 3 sources, a total of 125 items were generated and organized into 29 subdomains derived from the World Health Organization's International Classification of Functioning, Disability and Health. The association of hearing loss with quality of life is multidimensional and includes subdomains that are not considered in the estimation of health utility by existing utility measures. The presented comprehensive profile of items can be used to generate or evaluate measures of hearing-related quality of life, including utility measures.

Retrospective evaluation of secondary effects of hearing aids for tinnitus therapy in patients with hearing loss

ObjectiveAcoustic therapies including hearing aids and tinnitus control instruments are widely used in Japan but without high levels of evidence. The outpatient hearing aid clinic at our institution fits patients with hearing aids and instructs patients on how to use them to control tinnitus if present. In this study, we examined the effects of this approach on tinnitus. MethodsOne hundred and eleven of 138 patients who visited our hearing aid clinic from April 2016 to September 2018 purchased hearing aids after fitting. Sixty-six of these patients (31 men, 35 women; mean age 78.0 ± 8.0 years) had both hearing loss and tinnitus and were enrolled. The tinnitus was bilateral in 41 patients and unilateral in 25 (poor hearing ear, n = 16, good hearing ear, n = 9). Hearing aids were worn bilaterally by 23 patients and unilaterally by 43 (89 devices). Seventeen of the 23 patients wearing bilateral hearing aids had bilateral tinnitus and 6 had unilateral tinnitus, i.e., in 40 ears, the tinnitus side matched the hearing aid side (40 devices) and in 6 ears did not (6 devices). Twenty-four of 43 patients wearing unilateral hearing aids had bilateral tinnitus, meaning that in 24 ears the tinnitus side matched the hearing aid side (24 devices). In six of the remaining 19 cases with unilateral tinnitus, the hearing aid and tinnitus were on the same side (6 devices) and in 13 were on opposite sides (13 devices). Changes in the Tinnitus Handicap Inventory (THI), visual analog scale (VAS, for tinnitus discomfort, severity, and persistence), and Hospital Anxiety and Depression Scale scores were measured immediately before using a hearing aid and 12 months later. ResultsSignificant effects of hearing aids on tinnitus were observed in all subjects (THI, p = 0.0000030), VAS (severity, p = 0.000000066; discomfort, p = 0.0000013). Significant effects were observed with bilateral hearing aids (THI, p = 0.0012; VAS for severity, p = 0.00069; VAS for discomfort, p = 0.00052) and with unilateral hearing aids (THI, p = 0.00055; VAS for severity, p = 0.000034; VAS for discomfort, p = 0.00007). Spearman's rank correlation coefficient showed a significant positive correlation between the THI and VAS scores (p = 0.0033). In cases of bilateral tinnitus, significant differences were observed with bilateral hearing aids (THI, p = 0.011; VAS for severity, p = 0.0019; VAS for discomfort; p = 0.020) and with unilateral hearing aids (THI, p = 0.00069; VAS for severity, p = 0.00071; VAS for discomfort, p = 0.000093). ConclusionAcoustic therapy using hearing aids was effective for tinnitus. Even when bilateral, a unilateral hearing aid is able to improve tinnitus. When unilateral, the ipsilateral hearing aid is able to improve tinnitus.

Cartilage conduction hearing aid clinic in Kyushu University Hospital

Cartilage conduction hearing aid clinic in Kyushu University Hospital

A Comparison Study of the Auditory P300 Results of Elderly Patients with Sensorineural Hearing Loss

Objective: The purpose of this study was to compare the auditory P300 results of elderly patients with sensorineural hearing loss (SNHL) before and after hearing aid use. Material and Methods: A cross-sectional study was conducted from July, 2016 to April, 2017 at the Hearing Aid Clinic of Ramathibodi Hospital. Twenty-six elderly patients aged ≥60 with bilateral symmetrical SNHL who were referred for unilateral hearing aid fitting by otolaryngologist were included. The auditory P300 was recorded before and 2 months after hearing aid fitting. Results: The P300 waveforms, with a mean latency of 374.48 milliseconds and mean amplitude of 6.68 microvolts (µV), could be recorded in only 21 participants. At 2 months after hearing aid use, the mean P3 latency was 376.83 ms and mean amplitude was 8.77 µV. There was a statistically significant difference in amplitude of P300 2 months after hearing aid fitting (p-value=0.004). Conclusion: The auditory P300 results indicate an improvement in cognitive ability with higher amplitude. Thus, the P300 may be used to evaluate improvements in cognitive function after using a hearing aid. It can also be used as a guideline for explaining the benefits of hearing aid use to patients who initially rejected a hearing aid.

Auditory P300 in Elderly with Sensorineural Hearing Loss

Background: Hearing loss and cognitive impairment are common problems in older adults; several studies were conducted on the effects of hearing aid use relative to cognitive function in older adults. Most studies only used a verbal questionnaire which could lead to biased results. Therefore, the auditory P300 response from an electrophysiologic test provides an objective measure of central auditory function, including the cognitive process in the brain. Methodology: A cross-sectional study was conducted from July, 2016 to April, 2017 at The Hearing Aid Clinic in Ramathibodi Hospital. Participants were 26 elderly patients with bilateral symmetrical sensorineural hearing loss who were referred for unilateral hearing aid fitting by ENT doctors. The auditory P300 test results and MMSE-Thai scores were recorded before and 2 months after hearing aid fitting. Results: The P300 waveforms could be recorded from only 21 participants with a mean latency of 374.48 ms and mean amplitude of 6.68 μV. Two months after hearing aids were used, the mean P3 latency was 376.83 ms and the mean amplitude was 8.77 μV. There was a statistically significant difference in the amplitudes of P3 2 months after HA fitting (p=0.004). Moreover, the MMSE-Thai scores were also significantly higher (p=0.000). Conclusion: The auditory P300 components could be recorded from approximately 80% of the sensorineural hearing loss elderly patients in this study. The auditory P300 results showed an improvement in cognitive ability with higher amplitude, corresponding to an increase in MMSE-Thai scores. Thus, the P300 may be used to evaluate the improvement in cognitive function after using a hearing aid. This outcome can be a guideline in counseling patients who initially rejected hearing aids on the benefits of using the hearing aids.

Phyllis M. Tookey Kerridge and the science of audiometric standardization in Britain.

The provision of standardized hearing aids is now considered to be a crucial part of the UK National Health Service. Yet this is only explicable through reference to the career of a woman who has, until now, been entirely forgotten. Dr Phyllis Margaret Tookey Kerridge (1901-1940) was an authoritative figure in a variety of fields: medicine, physiology, otology and the construction of scientific apparatus. The astounding breadth of her professional qualifications allowed her to combine features of these fields and, later in her career, to position herself as a specialist to shape the discipline of audiometry. Rather than framing Kerridge in the classic 'heroic-woman' narrative, in this article we draw out the complexities of her career by focusing on her pursuit of standardization of hearing tests. Collaboration afforded her the necessary networks to explore the intricacies of accuracy in the measurement of hearing acuity, but her influence was enhanced by her ownership of Britain's first Western Electric (pure-tone) audiometer, which she placed in a specially designed and unique 'silence room'. The room became the centre of Kerridge's hearing aid clinic that, for the first time, allowed people to access free and impartial advice on hearing aid prescription. In becoming the guardian expert and advocate of the audiometer, Kerridge achieved an objectively quantified approach to hearing loss that eventually made the latter an object of technocratic intervention.

Referral rates of postlingually deafened adult hearing aid users for a cochlear implant candidacy assessment

Objective: The aims of this study were: to investigate the referral rates of postlingually deafened adult cochlear implant (CI) candidates from a hearing aid (HA) clinic for a CI candidacy assessment and to gain insight about factors influencing the referral pathways to CI assessments. Design: Two methodologies were used: a retrospective cohort study reviewing clinical files and a questionnaire to clinicians. Study sample: The files of 1249 adult clients from the HA clinic who had average puretone hearing thresholds greater or equal to 65 dB HL in the better hearing ear and unaided phoneme recognition scores of less than 50% in both ears were reviewed. All of the clinicians completed the online questionnaire. Results: Eighteen adults met the CI candidacy criteria, of whom 16 (89%) had a CI discussion with their audiologist, with 11 (61%) being referred for a CI evaluation. Of these 11, four proceeded to implantation. Questionnaire responses revealed the need for better information on candidacy and referral guidelines for HA audiologists, in addition to enhanced communication between HA and CI clinics. Conclusions: Overall the results indicate that the referral pathway to obtain a CI assessment is a barrier contributing to the low CI penetration rate in adults.

The Effect of Limited Counseling Time on Hearing Aid Uptake

Background and Objectives To determine appropriate counseling time for the first hearing aids user, we measured the effectiveness of first counseling time limit of 20 minutes for those who need hearing aids and collected predictive parameters during history taking. Subjects and Method We reviewed the medical records of 956 patients (age 66.5±12.1) with hearing impairment who needed hearing aids. We divided patients into two groups, those who had counseling time limited to 20 minutes and others who had no time limitation. Job status, working condition of noise status, social activity and audiological variables were analyzed as probable predicting factors influencing the purchasing of the hearing aid (penetration rate). Results Of the total 956 patients, 48.64% of subjects decided to purchase hearing aids at first counseling. The two groups showed no significant difference (p=0.396): 49.81% of the group without time limitation purchased the hearing aid and 47.04% of those with time limitation purchased the aid. The social status, right side pure tone threshold and right side tinnitus were significant for calculating the explanation power (64.15%) in the hearing aid uptake probability equation. Conclusion The level of social activity, hearing threshold and tinnitus were predictive variables obtained during the counseling. The time limitation of 20 minutes did not affect the rate of decision to purchase hearing aids. These results might help hearing clinics improve efficient time management at hearing aid clinics. Key words: Counseling ㆍ Hearing aids

Current State of Hearing Aid Clinic

We retrospectively analyzed the data of 387 patients who had no previous experience of using hearing aids, seen between 2009 and 2013 (164 males and 223 females). The average age of the overall subject population was 77.3 years (range 34 to 96 years); gender-wise, the average age of the males was 76.5 years (range 49 to 96), while that of the females was 77.9 (range 34 to 94). Of the 387 patients, 289 purchased hearing aids, representing a purchase rate of 74.7% during the five-year period, with the rate increasing year on year. The average hearing level of the ear for which the hearing aid was used was 61.5 dBHL ((500 Hz+1000 Hz+1000 Hz+2000 Hz)/4). The average hearing level of the patients who purchased a hearing aid was 64.2 dBHL, while that of the patient who didn’t purchase a hearing aid was 52.9 dBHL, with the hearing level in the former group being significantly higher than that in the latter group (p<0.05). In all, 37 patients wore hearing aids for both ears, representing a rate of use of bilateral hearing aids of 12.8%. We had aimed at providing hearing aids on rent for approximately two months. However, the mean rental period in patients who purchased hearing aids was 88.5 days.

補聴器外来の現況

補聴器外来の現況

Use of the Satisfaction With Amplification in Daily Life Questionnaire to Assess Patient Satisfaction Following Remote Hearing Aid Adjustments (Telefitting)

BackgroundHearing loss can affect approximately 15% of the pediatric population and up to 40% of the adult population. The gold standard of treatment for hearing loss is amplification of hearing thresholds by means of a hearing aid instrument. A hearing aid is an electronic device equipped with a topology of only three major components of aggregate cost. The gold standard of hearing aid fittings is face-to-face appointments in hearing aid centers, clinics, or hospitals. Telefitting encompasses the programming and adjustments of hearing aid settings remotely. Fitting hearing aids remotely is a relatively simple procedure, using minimal computer hardware and Internet access.ObjectiveThis project aimed to examine the feasibility and outcomes of remote hearing aid adjustments (telefitting) by assessing patient satisfaction via the Portuguese version of the Satisfaction With Amplification in Daily Life (SADL) questionnaire.MethodsThe Brazilian Portuguese version of the SADL was used in this experimental research design. Participants were randomly selected through the Rehabilitation Clinical (Espaco Reouvir) of the Otorhinolaryngology Department Medical School University of Sao Paulo. Of the 8 participants in the study, 5 were female and 3 were male, with a mean age of 71.5 years. The design consisted of two face-to-face sessions performed within 15 working days of each other. The remote assistance took place 15 days later.ResultsThe average scores from this study are above the mean scores from the original SADL normative data. These indicate a high level of satisfaction in participants who were fitted remotely.ConclusionsThe use of an evaluation questionnaire is a simple yet effective method to objectively assess the success of a remote fitting. Questionnaire outcomes can help hearing stakeholders improve the National Policy on Hearing Health Care in Brazil. The results of this project indicated that patient satisfaction levels of those fitted remotely were comparable to those fitted in the conventional manner, that is, face-to-face.

当院における乳幼児補聴器外来の現状

要旨: 当院を受診した初診年齢0歳児24症例に対して, 補聴器の試聴を開始し, 初診日齢, 新生児聴覚スクリーニングの有無, 平均聴力レベル, 補聴器装用開始日齢, 補聴器装用適合日齢, 補聴器適合に至るまでの問題点, 補聴器フィッティング状況 (音響利得,最大出力音圧 (MPO), 装用閾値の関係について), 決定補聴器について検討した。 全体的な傾向として, 初診日齢が早いほど, 補聴器装用開始日齢, 補聴器装用適合日齢も早く, 初診から補聴器適合までに6か月ほど時間を要しており, 初診から補聴器確定までの期間には個人差がみられた。 補聴器装用においての問題点では, 聴力評価13例 (54.2%), 装用困難9例 (37.5%), イヤモールド4例 (16.7%), ハウリング7例 (29.2%), 補聴器装用評価20例 (83.3%), 補聴器の特性4例 (16.7%) であり, 補聴器装用開始日齢から補聴器適合日齢までの期間が3か月以内と短い場合には問題点が少ない傾向にあったが, 補聴器適合日齢には関係なくみられた。

Decline of speech understanding in the hearing impaired elderly listeners who visited our hearing aid clinic

The aim of this study was to investigate distinctive change in the hearing impaired elderly listeners, especially about speech recognition. Subjects were 525 patients (235 males, 290 females), from 60 to 98 years of age who had visited the Hearing Aid Clinic of Otorhinolaryngology, National Center for Geriatrics and Gerontology Hospital, between June 2001 and December 2012. Pure-tone air conduction threshold determination was administered to each subject. The speech audiometry materials used to define speech discrimination ability were Japanese monosyllabic word lists, 67S word lists. Sex- and age-specific trends in maximum discrimination score (MDS) and rollover index (RI) were shown in this study. RI was computed by the formula (PBmax-PBmin)/PBmax. PBmax has almost the same meaning as MDS in Japan. PBmin represented the lowest PB score above the test intensity level of PBmax. Mean MDSs were 80.8% in their sixties, 75.3% in their seventies, 60.7% in their eighties, and 45.5% in their nineties. The rate of decrease in mean MDS per decade accelerated in the older generation. Mean RIs were 0.18 in patients in their sixties, 0.24 in their seventies, 0.30 in their eighties, and 0.30 in their nineties. It increased until the age of eighties. In the model 1, multiple logistic analyses were performed to examine the effect of age (in 10-year increments), sex and mean hearing levels in pure tone average of values at 500, 1000, 2000, 4000 Hz (in 10 dB increments) on the MDS < 60%. Significant associations were observed between MDS < 60% and age (odds ratio, 3.03; 95% confidence interval, 2.38 to 3.85), and mean hearing levels in pure tone average of values at 500, 1000, 2000, 4000 Hz (2.33; 2.03 to 2.68). Sex was not associated with MDS < 60%. In the model 2, multiple logistic analyses adjusted for age and sex were performed to examine the effect of hearing level at test frequencies of 125, 250, 500, 1000, 2000, 4000, and 8000 Hz (in 10 dB increments)on the MDS < 60%. Significant associations were observed between MDS < 60% and hearing level at 250 Hz (2.04; 1.44 to 2.89), and 2000 Hz (1.46; 1.16 to 1.83), and 4000 Hz(1.24; 1.02 to 1.50). These outcomes suggest that the important point in qualifying the fitting of hearing aid is to present the list words at an adequate sound pressure level for evaluation of speech understanding especially in the hearing impaired elderly listeners.

Clinical reasons for returning hearing aids.

Background and ObjectivesIncreases in older aged populations and exposure to complicated noise environments have increased the number of hearing-impaired patients, creating greater demands for hearing aids. We have assessed the reasons that individuals rejected wearing and returned properly prescribed hearing aids, as well as differences in individual factors between younger and elderly adults.Subjects and MethodsOf 1138 patients for whom hearing aids were prescribed at Kyung Hee University Medical Center Hearing Aid Clinic, 81 (6.14%) returned their hearing aids, including 36 patients aged <65 years and 45 aged ≥65 years. Patient-related, hearing-related, and hearing aid-related factors were assessed by retrospective chart analysis and phone survey and compared in the two groups.ResultsThe primary symptoms reported by the 81 patients who returned their hearing aids were hearing disturbance, ringing, and fullness in the ear, in that order and in both groups. The rate of hearing aid return was similar in elderly females and males (p=0.288). The spondee recognition threshold was significantly higher in younger than in elderly adults (63.3±14.0 dB vs. 55.6±14.74 dB, p=0.019), but the hearing aid return rate was highest in patients with moderate hearing loss in both groups. In evaluating the reasons for return of hearing aids, we found that ineffectiveness of the device was the most frequent reason, accounting for 32.0% of returns, the highest percentage in both groups, with the most frequent patient problem caused by management difficulty in elderly and financial difficulty in younger adults.ConclusionsThe reasons for hearing aid return were different in two groups. Financial considerations were cited more by younger adults, while difficulties in managing hearing aids were cited more frequently by elderly adults. Patients in both groups, however, reported that the most frequent reasons for return were inadequate hearing improvement and inconvenience wearing the hearing aid due to noise amplification.