Hearing Aids Research Articles

Evaluation of a semi-supervised self-adjustment fine-tuning procedure for hearing aids for asymmetrical hearing loss

Objective This study investigated a previously evaluated self-adjustment procedure with respect to its applicability for asymmetrical hearing loss (AHL). Self-adjusted settings were evaluated for speech recognition in noise and sound preference. Design Participants were given the possibility to adjust the left and right hearing aid separately using a two-dimensional user interface. Two different adjustment sequences were tested. Realistic everyday sound scenes in a laboratory environment were presented. The difference between the ears regarding their speech recognition in noise was tested with two spatial conditions, unaided as well as with the prescriptive formula and the self-adjusted setting. Study sample Nineteen experienced hearing aid users (median age 76 years) with different degrees of AHL were invited to participate in this study. Results Participants adjusted a higher gain slope across frequency in the worse ear than in the better one. The two adjustment sequences resulted in significantly different adjustment durations and gain settings. The difference between the ears regarding speech recognition in noise did not change with the self-adjustment. Overall, group-mean effect sizes were small compared to the parameter space. Conclusions The adjustment procedure can be used also by hearing aid users with AHL to find a possibly preferred gain setting.

Assessment of transparent alternative listening devices' effects on localization cues using head-related transfer function measurements

The past few years have seen a meteoric rise in technological advancements in the hearing health industry. New alternative listening devices, often referred to as "hearables", aim to become real "bionic ears" offering hearing protection, amplification, monitoring and even biosensing functionalities. With the recent approval of the "Over-the-Counter Hearing Aid Act" in the United States and the introduction of so-called "OTC" hearing aids, these alternative listening devices now have the potential to revolutionize the world of traditional auditory amplification. Since these devices may be used by individuals with hearing loss, it is important to consider how they might influence spatial auditory awareness. Therefore, this paper studies the effect of alternative listening devices on localization cues using the Head Related Transfer Function (HRTF). In this purpose, we measured the HRTFs on a Head and Torso Simulator (HATS) with and without digital listening devices. To evaluate the acoustic performance of these devices, the devices were set into their "acoustically transparent" mode. These measures enable a preliminary characterization of the effect of hearables and OTC devices on localization cues.

Adapting to non-human listening agencies

One central concept in soundscape studies has been that of an acoustic community, i.e. a group of people sharing an understanding of a listened environment, either acoustic or mediated. This understanding manifests in recognition of sound sources, their communicative function and their discoursive use in everyday life. The growing use of hearing aids, noise-cancelling headphones and other intelligent listening technology renders the soundscape more individual and at the same time introduces a non-human listening agency as a mediator to the individually calibrated soundscape. This raises conceptual and methodological questions of listening abilities in general and of how the listening experience is to be understood as taking place in a shared environment. To illuminate this problematic the paper will present as a case how listening through cochlear implants and their sound prosessors can be understood as a process of adaptation to a mediated acoustic community.

Force sensitivity calibration of artificial mastoids

The Standards and Calibration Laboratory (SCL) has set up a system for calibration of artificial mastoids to meet the growing demand for calibration of bone-conduction hearing aids and audiometers in the audiology industry of Hong Kong. An artificial mastoid (or mechanical coupler, as specified in IEC 60318-6) is a device that mimics the mechanical characteristics of the human mastoid (one of the bones of the skull behind the ear). It is basically composed of a dome-shaped structure and a force transducer. This paper mainly illustrates the method for measuring the force sensitivity level (in unit of dB re 1 pC/N) of an artificial mastoid in the frequency range of 125 Hz to 8 kHz. The calibration system has been automated to meet the demand for artificial mastoid calibration services in Hong Kong. This paper describes (i) the method of determining the force sensitivity level of an artificial mastoid, (ii) the measurement model and uncertainty evaluation, and (iii) the measurement results and details of the calibration system.

Delayed-X harmonic synthesizer cancelling narrow bandpass noises by control signals via aural cartilage conduction

When a transducer is put on an aural cartilage, the transmitted vibration generates sound in the external auditory canal (i.e., cartilage conduction). A hearing device based on the cartilage conduction does not need occluding the external auditory canal. When an active noise control can adapt only to unwanted noise, the device enables natural conversations with unprocessed voice in the noisy environment (selective cancelation). To accomplish the selective cancelation, we proposed delayed-X harmonics synthesizer (DXHS) algorithm to minimize the damage for the speech quality. A target noise in this study was bandpass noise through a gammatone filter (center frequency: 500 Hz) overlapping the speech spectrum. After tracing the spectral envelope of the noise by using linear predictive coding (LPC), the DXHS outputted five pure tones distributed around the peak of envelope, and each step size parameter was adjusted according to the amplitude of the envelope. As results, our proposed method showed the noise reduction of 11.3 dB maintaining the speech quality in the computer simulations. During the adaptation, the step size adjustment enabled round off the spectral peak of the bandpass noise to avoid sharpening it.

Effectiveness of an Educational Seminar for Older Adults With Hearing Loss

Purpose: Despite the recognized benefits of aural rehabilitation (AR), its adoption has been limited. The purpose of this study was to investigate the effectiveness of group AR through an educational seminar for older adults with hearing loss, “Optimal Hearing,” evaluating the application of various patient-reported outcome measures. Method: Participants were older adults with hearing loss. The seminar covered content such as hearing loss and aging, audiogram interpretation, clear speech, lipreading, and hearing aids. Small group activities for personalized instruction also included: the Client Oriented Scale of Improvement (COSI), Communication Confidence Profile (CCP), and, a study-specific measure, the Optimum Hearing Questionnaire (OHQ). Results: Participants experienced significant improvements in various areas measured by the COSI. The CCP showed significant change in one item (confidence while conversing with friends in a noisy restaurant), while several items on the OHQ indicated significant changes postintervention. Conclusion: The findings suggest the potential clinical utility of these measures in group AR settings and the importance of individualized goal setting. Supplemental Material: https://doi.org/10.23641/asha.26824111

Factors affecting fat myringoplasty in elderly patients with chronic otitis media: A case control study

BackgroundWe compared and analyzed the surgical results of fat myringoplasty between elderly and young adult patients with chronic otitis media. We also investigated whether underlying diseases and other factors impact the surgical outcome.MethodsWe retrospectively reviewed the data of 141 patients who underwent fat myringoplasty for chronic otitis media for five years. They were compared by age, sex, underlying disease, perforation size, pre- and postoperative pure tone audiometry, postoperative otorrhea, postoperative re-perforation, and cause of re-perforation.ResultPostoperative re-perforation was more common in the elderly group, albeit with no significant difference (p = 0.072). The factors affecting re-perforation were insufficient fat graft (44.4%), postoperative infection (33.3%), and nasal blowing (22.2%). Our findings revealed no significant association between preoperative perforation size and re-perforation (p = 0.391). Additionally, we found no significant relationship between hypertension and re-perforation (p > 0.99), nor between age group and postoperative infection (p = 0.488). Diabetes was also not significant (p = 0.640). Following surgery, both groups exhibited a significant improvement in hearing.ConclusionAlthough age and underlying conditions play significant roles in the healing process, our results suggest that external factors such as infection, nasal blowing, cough, and insufficient grafted fat tissue have a similarly significant impact on surgical outcomes in elderly patients with COM as they do in adults. In conclusion, the decision to perform surgery in elderly patients with COM should be based on a comprehensive assessment of the patient’s overall health status, hearing, use of hearing aids, and the indications for surgery.

Spanish-speaking Patients' Experiences with Hearing Health Care.

Background/introduction: Health care providers working with Spanish-speaking patients must provide culturally and linguistically appropriate care to meet the communication needs of this population. Disparities related to hearing health care access remain understudied, leaving gaps in clinical practice and guidance for audiologists. The purpose of this study was to explore the experiences of Spanish-speaking patients with hearing loss when accessing hearing health care services through a limited income hearing aid program. Methods: Six Spanish-speaking patients (three monolingual Spanish, three bilingual Spanish/English) with hearing loss from the Oklahoma City metropolitan area completed in-depth, semi-structured interviews. Results/findings: Three main themes emerged: (1) perceived barriers to service delivery (cost, language, and transportation); (2) success with hearing health care (use of interpreters and reduced cost of services and amplification); and (3) cultural factors (family, religion, and use of home remedies). Discussion/conclusion: The themes identified can provide a foundation for service delivery of patient-centered services that are culturally and linguistically appropriate to help improve access to and quality of hearing health care, particularly for this population of patients. This study identified factors that may contribute to hearing health care disparities for Spanish-speaking adults, which may not be observed in other disciplines that are less communication-focused. Suggestions for improving services for audiologists serving Spanish-speaking patients are discussed.

Healthcare Professionals' Knowledge, Skills, and Information Needs Pertaining to Hearing Loss and Hearing Aids in Swedish Nursing Homes: A Cross-Sectional Study and Psychometric Evaluation.

Hearing loss increases with age and due to increased life expectancy there is an increase in the number of individuals living with hearing loss. Older people with hearing loss residing in nursing homes are often dependent on healthcare professionals to help them with their hearing aids. The aim of the study was to translate and test the psychometric properties of a Swedish version of a Norwegian questionnaire and to assess healthcare professionals' self-reported knowledge, experience, skills, competence, and information needs pertaining to residents' hearing loss and hearing aids in the Swedish context. A Norwegian questionnaire was translated and adapted, and thereafter distributed to healthcare professionals in nine nursing homes in mid Sweden between 2020 and 2021, and 313 questionnaires were returned. An exploratory factor analysis demonstrated adequate factorial structure in six factors, satisfying construct validity and internal consistency for the Swedish version. A confirmatory factor analysis showed a satisfactory model fit. Healthcare professionals reported having the skills required for handling hearing aids, but reported lower scores for having received information about hearing aids, taking initiatives to refer residents to hearing healthcare units, and checking for earwax. Registered nurses generally reported lower perceived knowledge and practical skills concerning hearing aids. Seventy-seven percent of the total group reported a need for information regarding hearing aid maintenance. Healthcare professionals reported that the majority of nursing home residents need help with their hearing aids, but only a minority of these professionals had received education on hearing loss and training in hearing aid maintenance. Enrolled nurses and care assistants demonstrated higher levels of competence in handling hearing aids compared to registered nurses. In order to ensure safe and effective care, as well as facilitate communication among older adults with hearing loss, healthcare professionals need appropriate education and training.

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.

What is an impact of hearing aids primarily fitted for presbyacusis on quality of life in patients complaining of tinnitus: a pilot study

ObjectiveTo assess the secondary effect of hearing aids primarily fitted for presbyacusis and their impact on the quality of life of patients complaining of tinnitus. DesignPilot case studyStudy sampleAdults with presbyacusis hearing loss were recruited in the Asker ENT clinic in Norway. Twenty consecutive patients were included in the pilot study.MethodsTwenty patients who were diagnosed with presbyacusis and additional tinnitus by the hearing tests (pure tone audiometry and speech audiometry) and medical interviews were recruited for the study. The level of their tinnitus distress was measured by the Tinnitus Handicap Inventory (THI) before and around 2 months after the hearing aid fitting. The results were afterwards statistically analyzed using paired sampled t-tests in Excel.ResultsThe data showed that hearing aids fitted primarily for presbyacusis can improve the quality of life in individuals suffering from tinnitus (p = 0.001504). In our sample, women showed higher levels of complaints about their tinnitus, compared to men. We found that age was an influencing factor on the outcomes of hearing aid usage for both presbyacusis and tinnitus, as people in this study before the age of 75 benefited less than patients above 75 (p = 0.005). All patients with moderate hearing loss in our sample showed significant improvement in their quality of life in regard to their tinnitus complaint, with a statistical value of p = 0.044. Also, patients with the lower levels of THI (slight and mild) were the groups who had the most clinically significant improvements in tinnitus distress. Finally, while analyzing the answers to all the THI questionnaire questions from the patients who did not show improvements in THI scores, a pattern of having trouble sleeping was detected as the most probable factor.ConclusionsThe results showed that hearing aids fitted primarily for presbycusis can have a positive influence on the perception of tinnitus and their quality of life.

A novel optical acoustic fabric based on intensity-modulated flexible air-filled fiber adapter for sound sensing

This study proposes and demonstrates an optical acoustic fabric design method to detect sound, which is based on intensity-modulated flexible air-filled fiber adapter (FAFFA). A FAFFA was woven into the weft center of the polyamide fabric as weft, and the FAFFA was realized by connecting polymer optical fibers at each end of an flexible tube. The principle of the optical acoustic fabric is to allow the flexible tube to deform with the resonance of the polyamide fabric, subsequently changing the light intensity in the FAFFA. The macro-scale finite element method and ray tracing optical simulation investigated the operating principle of optical acoustic fabric and performance of FAFFA structures, and the influence of fabric parameters was evaluated by meso-scale finite element simulation. The yarn of the optical fiber acoustic fabric has low Young’s modulus and high flexibility. The proposed FAFFA structure is simple to prepare and has good maneuverability, which breaks away from the constraints of the traditional optical acoustic sensor membrane structure. This proposed optical acoustic fabric is easy to prepare, simple in principle and highly flexible. Along with wireless devices, the use of the optical acoustic fabric can be further extended to “hearing aids” for special individuals in wearable applications.

Perceptions of hearing loss and hearing technology among the general public and healthcare providers: a scoping review

ObjectivesSynthesise literature related to perceptions of hearing loss and hearing technology (hearing aids, cochlear implants) among the general public and healthcare providers who do not specialise in ear and hearing...

OTC Hearing Aids Perform Well in People with Mild to Moderate Hearing Loss.

According to this study.

Outcome Evaluation of BAHA Attract System Implantations.

Bone Anchored Hearing Aids (BAHAs) are currently well-utilized for treatment of hearing-impaired patients with unilateral or bilateral mixed and conductive hearing loss as well as patients with single sided deafness. The objective of this study is to evaluate outcome of BAHA Attract system in terms of surgical, functional,audiological and cosmetic results This is a prospective observational study of 15 consecutive patients of single sided deafness (SSD) who qualified for and underwent BAHA Attract surgery at a tertiary care hospital over a duration of two years. Parameters analysed were: (1) Surgery and wound healing, (2) Post-operative functional results (Bern Benefit for Single sided deafness questionnaire (BBSSQ)), (3) audiological results (free field speech in noise audiometry in two situations: with signal from implanted side and from contralateral side), (4) Cosmetic results (introduction of novel Three Points Scoring System (TPSS). Clinico-radiological planning of surgical site for implant is also described.Mean surgical time was 39 minutes and healing was uneventful in 73 % of patients. All patients reported improvement in all ten hearing situations with maximum improvement for sound localization. Significant improvement of speech in noise was seen especially when signal was presented from implanted side. All patient had full score in TPSS for cosmesis except one patient. This was the same patient in whom clinico-radiologically planned site was discarded intraoperatively due to overpneumatised temporal bone.BAHA Attract system is safeand effective solution for single sided deafness with acceptable cosmesis.

The impact of device satisfaction on family quality of life in hearing aid users

The impact of device satisfaction on family quality of life in hearing aid users

Outcome measures of cochlear implant recipients versus hearing aid users in severe sensorineural hearing loss among Egyptian children.

Outcome measures of cochlear implant recipients versus hearing aid users in severe sensorineural hearing loss among Egyptian children.

Hearing and vision rehabilitation for people with dementia in five European countries (SENSE-Cog): a randomised controlled trial

The effect of hearing and vision difficulties on the risk of developing dementia and worsening outcomes in people already living with dementia is well established. We evaluated the clinical impact of a hearing and vision rehabilitation and support programme on quality of life in people with mild-to-moderate dementia and concurrent sensory difficulties. We conducted a parallel-group, multicentre, observer-blind, superiority randomised controlled trial in seven older adult clinics in five European countries (Cyprus, France, Greece, Ireland, and the UK). People with mild-to-moderate dementia with adult-acquired hearing difficulties, vision difficulties, or both were randomly assigned (1:1) along with their care partner to an 18-week home-basedsensory support intervention (SSI) of tailored hearing and vision rehabilitation and support, or to care as usual. Randomisation was blocked (block size of four, six, or eight) and stratified by country, with allocation assigned via a remote web-based system. The SSI included: full hearing assessment, vision assessment, or both; fitting of hearing aids, glasses, or other sensory aids; and home-based support from a sensory support therapist to assist adherence and uptake of sensory aids, foster social networking, and optimise the home sensory environment. Care as usual involved no additional intervention beyond services normally available to people with dementia at the respective sites. The primary outcome was health-related quality of life (Dementia Quality of Life Instrument [DEMQoL]) score at 36weeks, reported as an adjusted mean difference. Analyses were done according to the intention-to-treat principle. This trial is registered with the ISRCTN Registry, ISRCTN17056211. Between May 4, 2018, and May 6, 2021, 252people with mild-to-moderate dementia were randomly assigned, of whom 251 (n=126in the SSI group and n=125in the care as usual group) were included in the analysis. The mean age of participants was 79·6years (SD 5·8), and 132 (53%) were women. After a median follow-up time of 37·7weeks (IQR 36·2-39·0), the mean DEMQoL score was 92·8 (SD 15·2) in the SSI group and 92·8 (14·0) in the care as usual group (adjusted difference 0·18, 95% CI -2·13to 2·30, p=0·87). Among 114adverse events reported for 56 (44%) participants in the SSI group, ten events in nine participants were related or possibly related to the intervention (medical device pain or discomfort n=6, ear pain n=1, scratch to the ear n=1, sore eye n=1, redness n=1; all of grade 1). Serious adverse events were reported for 25 (20%) participants in the SSI group and 16 (13%) in the care as usual group. Six (5%) participants in the SSI group and five (4%) in the care as usual group died. None of the serious adverse events or deaths were related to the study intervention or procedures. This study showed no improvement in quality in life in participants who received the intervention in thelonger term. Sensory difficulties are common in people with dementia and interventions aimed at improving sensory-cognitive health should be explored further. EU Horizon2020.

Longitudinal follow-up of hearing, speech, and language skills in 6-year-old children with congenital moderate hearing loss

ObjectivesChildren born with moderate hearing loss present with speech and language outcomes at both ends of the spectrum. To explore reasons for this, the objective of this study was to follow up a group of children born with moderate sensorineural hearing loss at 6 years of age (n=7) by investigating their outcomes in hearing, speech, and language development from time point of hearing aid fitting at 6 months. Another objective was to investigate the relationship between earlier outcomes on precursing variables to the current status in auditory, speech and language development. MethodEarlier data from a project with the same participants of auditory variables, speech, and language development were compared to the current study outcomes at 6 years of age. Children in this study performed standardized tests of phonology (SVANTE), expressive vocabulary (BNT), and speech-in-noise test (Hagerman´s sentences). Parents reported on their child´s functional auditory performance in everyday life (PEACH), and demographics and general development (questionnaire). Etiology and frequency of speech and language-directed intervention from time point of diagnosis to 6 years of age were collected through medical journals. ResultsHearing levels were stable over time in all children but one, who had received bilateral cochlear implants. Performance on speech-in-noise testing varied in aided condition (-0.8 to 8, mean 2.65, SD 3.09) and unaided condition (7.2 dB to 21.2 dB, mean 12.06, SD 4.82). Scores on the PEACH indicated further review in four of the seven children. Mean group score on consonant proficiency had increased from 3 to 6 years of age and were within age norms. Vocabulary scores were below the norms of children with typical hearing. Outcomes on vocabulary measures at 2.5 years years showed strong correlations that were significant to scores on the BNT at 6 years of age (r = 0.87, p = 0.05). Correlations between hours of hearing aid use and vocabulary was not significant at 6 years of age. The frequency of intervention sessions in the first 6 years varied between participants (4 to 55, mean 19.1, SD 17.1). ConclusionDespite homogeneous hearing and other background variables in the participants from birth, large individual variations in speech and language outcomes at 6 years of age were found. Considering the many factors involved that impact the development of children with moderate hearing loss, the results suggest that monitoring early precursors in auditory, speech and language development may be helpful in setting commensurate goals for each child. Detecting additional conditions that may pose challenges in future speech and language as early as possible is important. There is ample room for improvement in terms of increasing the frequency of intervention for children with moderate hearing loss and their families.

Hearing loss in patients with dementia in Saudi Arabia.

To determine the prevalence of hearing loss in patients with dementia, examine the use of hearing aids in those with hearing loss, and ascertain if the cause of hearing loss is central or peripheral in origin. A retrospective cohort study involving 143 patients with dementia which was conducted in Saudi Arabia from 2020 to 2023 in King Abdulaziz Medical City, Riyadh, Saudi Arabia, to determine hearing loss. The study included patients aged ≥60 years who had dementia, hearing loss, and neurological diseases. Those with Parkinson's disease and secondary epilepsy were excluded. Data was analyzed for its demographics, clinical features, predisposing factors, treatment, dementia duration and progression, and hearing loss outcomes. All statistical analyses were performed using IBM's SPSS software, version 29.0.0. Statistical significance was established at a p-value of ≤0.05 and a confidence interval of 95%. The findings indicated that 88.8% of the 143 patients exhibited dementia, with Alzheimer's disease being the most prevalent type. Moreover, 18.2% had hearing issues, and 11.2% had other complaints. Audiometry was performed in 15.4% of the cases. Hearing loss was present in 14.7% of the patients, being primarily bilateral, ranging from mild to severe. This study has clarified the link between hearing loss and dementia onset and has emphasized the need for early evaluation and intervention for individuals with hearing impairment.