Profile Of Hearing Aid Benefit Research Articles

The Effects of Extended Input Dynamic Range on Laboratory and Field-Trial Evaluations in Adult Hearing Aid Users

Digital hearing aids using a 16-bit analog-to-digital converter (ADC) provide a 96-dB input dynamic range. The level at which the ADC peak clips and distorts input signals ranges between 95 and 105 dB SPL. Recent research evaluated the effect of extending the input dynamic range in a commercially available hearing aid. Although the results were promising, several limitations were noted by the authors. Laboratory testing was conducted using recordings from hearing aids set for a flat 50-dB loss; however, field testing was conducted with hearing aids fitted for their hearing loss. In addition, participants rarely encountered input levels of sufficient intensity to adequately test the feature and were unable to directly compare aids with and without extended input dynamic range (EIDR) under identical conditions. The effects of EIDR under realistic and repeatable test conditions both within and outside the laboratory setting were evaluated. A repeated measures design was used. The experiment was single-blinded. Twenty adults (14 males and six females) between the ages of 30 and 71 years (average age 62 years) who were experienced hearing aid users participated. Each participant was fit with Oticon Opn hearing instruments binaurally using the National Acoustics Laboratory-Nonlinear 1 fitting strategy. Participants completed a two-week trial period using hearing aids with EIDR and a two-week trial period without EIDR. The initial EIDR condition trial period was counterbalanced. After each trial, laboratory evaluations were obtained at 85 dBC using the Connected Speech Test, the Hearing in Noise Test, and the acceptable noise level (ANL). Satisfaction ratings were conducted at 85 dBC using speech in quiet and in noise as well as music. Field-trial evaluations were obtained using the abbreviated profile of hearing aid benefit (APHAB). Satisfaction ratings were also conducted in the field at 85 dBC using speech and music. After the study, each participant indicated which trial period they preferred overall. Repeated measures analysis of variances were conducted to assess listener performance. Pairwise comparisons were then completed for significant main effects. In the laboratory, results did not reveal significant differences between EIDR conditions on any speech perception in noise test or any satisfaction rating measurement. In the field, results did not reveal significant differences between the EIDR conditions on the APHAB or on any of the satisfaction rating measurements. Nine participants (45%) preferred the EIDR condition. Fifteen participants (75%) indicated that speech clarity was the most important factor in determining the overall preference. Sixteen participants (80%) preferred the EIDR condition that resulted in the lower ANL. The use of EIDR in hearing aids within and outside the laboratory under realistic and repeatable test conditions did not positively or negatively impact performance or preference. Results disagreed with previous findings obtained in the laboratory that suggested EIDR improved performance; however, results agreed with previous findings obtained in the field. Future research may consider the effect of hearing aid experience, input level, and noise acceptance on potential benefit with EIDR.

The Bonebridge in Adults with Mixed and Conductive Hearing Loss: Audiological and Quality of Life Outcomes

Background: Considering that hearing loss has a significant impact on social functioning, everyday activity and a person’s emotional state, one of the most important goals of hearing rehabilitation with bone conduction devices is improvement in a patient’s quality of life. Objectives: To measure self-assessed quality of life in patients implanted with the Bonebridge, a bone conduction device. Method: Prospective, observational, longitudinal study with one treatment group. Twenty-one patients with mixed or conductive hearing loss were included, and each individual served as its own control. The Abbreviated Profile of Hearing Aid Benefit (APHAB) was used to measure patient-reported quality of life before intervention and at 3 and 6 months after activation of the device. At the same time frames, pure-tone audiometry and speech understanding in quiet and in noise were tested. Results: Hearing-specific quality of life increased significantly after intervention and remained stable up to 6 months. Both word recognition in quiet and speech reception threshold in noise were significantly better after 6 months compared to before surgery. Outcomes of aided speech understanding were independent of initial bone conduction thresholds and equally high (word recognition score >75%) across the device’s indication range. Conclusions: The Bonebridge provides not only significant audiological benefit in both speech understanding in quiet and in noise, but also increases self-perceived quality of life in patients suffering from mixed and conductive hearing loss. Together with a very low rate and minor nature of adverse events, it is the state-of-the-art solution for hearing rehabilitation in patients with mixed or conductive hearing loss up to a bone conduction threshold of 45 dB HL.

Everyday relevance of APHAB questions : Influence on answer frequency

The Abbreviated Profile of Hearing Aid Benefit (APHAB) questionnaire measures subjective hearing impairment in different situations. Recently, asurvey demonstrated that some APHAB questions were answered more rarely than others. This study aims to evaluate the everyday relevance of each APHAB question and investigate whether this relevance for daily life influences answer frequency. Between July 2016 and November 2017, 517hearing impaired patients from 11ENT practices in Schleswig-Holstein, Germany, were evaluated using the APHAB. In parallel, the everyday relevance of each APHAB question for the subjects was assessed on afour-step scale (often/sometimes/rarely/never). The answers were listed in across table and statistically analyzed. The average age of all subjects was 67.4years (±14.0years); 45.3% were female and 54.7% were male. One APHAB question (no.21) was answered noticeably less often than the others. Overall, five types of distribution for the everyday relevance of APHAB questions could be determined. Using the χ2-test, no correlation between the frequency of answers and their everyday relevance could be detected (p < 0.001). No correlation between everyday relevance and answer frequency was detected. However, the five types of distribution could be used for an individual interpretation of single APHAB answers. In the future, apossible influence of everyday relevance on ranking within aspecific APHAB answer should be investigated.

Achieved Gain and Subjective Outcomes for a Wide-Bandwidth Contact Hearing Aid Fitted Using CAM2.

The objective of this study was to test the ability to achieve, maintain, and subjectively benefit from extended high-frequency amplification in a real-world use scenario, with a device that restores audibility for frequencies up to 10 kHz. A total of 78 participants (149 ears) with mild to moderately-severe sensorineural hearing loss completed one of two studies conducted across eight clinical sites. Participants were fitted with a light-driven contact hearing aid (the Earlens system) that directly drives the tympanic membrane, allowing extended high-frequency output and amplification with minimal acoustic feedback. Cambridge Method for Loudness Equalization 2 - High Frequency (CAM2)-prescribed gains for experienced users were used for initial fitting, and adjustments were made when required according to participant preferences for loudness and comfort or when measures of functional gain (FG) indicated that more or less gain was needed. Participants wore the devices for an extended period. Prescribed versus adjusted output and gain, frequency-specific FG, and self-perceived benefit assessed with the Abbreviated Profile of Hearing Aid Benefit, and a custom questionnaire were documented. Self-perceived benefit results were compared with those for unaided listening and to ratings with participants' own acoustic hearing aids. The prescribed low-level insertion gain from 6 to 10 kHz averaged 53 dB across all ears, with a range from 26 to 86 dB. After adjustment, the gain from 6 to 10 kHz decreased to an average of 45 dB with a range from 16 to 86 dB. Measured FG averaged 39 dB from 6 to 10 kHz with a range from 11 to 62 dB. Abbreviated Profile of Hearing Aid Benefit results revealed a significant improvement in communication relative to unaided listening, averaging 28 to 32 percentage points for the background noise, reverberation, and ease of communication subscales. Relative to participants' own hearing aids, the subscales ease of communication and aversiveness showed small but significant improvements for Earlens ranging from 6 to 7 percentage points. For the custom satisfaction questionnaire, most participants rated the Earlens system as better than their own hearing aids in most situations. Participants used and reported subjective benefit from the Earlens system. Most participants preferred slightly less gain at 6 to 10 kHz than prescribed for experienced users by CAM2, preferring similar gains to those prescribed for inexperienced users, but gains over the extended high frequencies were high relative to those that are currently available with acoustic hearing aids.

A Follow-Up Clinical Trial Evaluating the Consumer-Decides Service Delivery Model.

ObjectivesThere were 2 main objectives. The primary objective was to replicate a prior clinical trial of a consumer-decides (CD) approach to selecting hearing aids in older adults as a potential model for over-the-counter (OTC) intervention using less front-end screening of participants and a wider range of frequency-gain characteristics in the devices. The 2nd objective, only feasible if participant choices allowed, was to evaluate the efficacy of the CD approach relative to a CD-based placebo device.DesignThe design of this study is a single-site, prospective, double-blind clinical trial. Outcome measures were obtained after a typical 4- to 5-week trial period. An optional follow-up of a 4-week audiology-based (AB) best practices trial was also included for replication and comparison purposes.SettingOlder adults from the general community were recruited via newspaper and community flyers to participate at a university research clinic.ParticipantsParticipants were adults, aged 54–78 years, with mild–moderate hearing loss. Forty-one participants enrolled as a volunteer sample; 40 completed the intervention.Intervention(s)All participants received the same high-end digital mini–behind-the-ear hearing aids fitted bilaterally. CD participants self-selected their own preprogrammed hearing aids via an OTC-type model. One of the 3 devices from which participants could choose was programmed to be a placebo device with no functional gain.Primary and Secondary Outcome MeasuresThe primary outcome measure is the 66-item self-report Profile of Hearing Aid Benefit (Cox & Alexander, 1990). The secondary outcome measure is the Connected Speech Test (Cox, Alexander, & Gilmore, 1987) benefit. Additional measures of hearing aid benefit and usage were also obtained.ResultsPer-protocol analyses based on the data from the 40 (of 41) participants who completed the study were performed. Hearing aid outcomes from this follow-up CD (CD2) cohort were positive and generally the same as for the original CD cohort. CD service delivery model was efficacious relative to CD-based placebo control, with medium effect sizes observed. Approximately half of the CD2 group was likely to purchase hearing aids after the trial, similar to findings for the original CD cohort. Outcomes improved significantly for the 32 CD2 participants who elected to complete the optional 4-week AB trial. For this largely unscreened sample, more individuals with healthy hearing sought amplification, and many of these individuals (35%) chose placebo devices for both ears.ConclusionsPrior positive outcomes for CD service delivery have been replicated in a less restrictive approach to participant recruitment. The CD approach was again found to be efficacious. Significantly better outcomes were observed after subsequent AB service delivery follow-up, also replicating prior findings. Efficacious OTC models, including those using similar CD approaches to hearing aid self-selection, may increase accessibility and affordability of hearing aids for millions of older adults. Front-end guidance to consumers regarding the best path to intervention, ranging from self-screening of hearing online to a full audiologic assessment, appears to be critical to optimize the success of OTC approaches.Trial RegistrationClinicaltrials.gov: NCT01788432; https://clinicaltrials.gov/ct2/show/NCT01788423Supplemental Materialhttps://doi.org/10.23641/asha.7728479

Satisfaction assessment with Abbreviated Profile of Hearing Aid Benefit (APHAB) questionnaire on people using hearing aid having Real Ear Measurement (REM) eligibility.

Benefit and satisfaction from hearing aids can be measured in different ways. The aim of this study is to evaluate the benefits and satisfaction of the users from the hearing aids whose fitting are done suitably for hearing loss including ear mould. In this study Abbreviated Profile of Hearing Aid Benefit (APHAB) questionnaire which consists of 24 questions was used for hearing aid satisfaction assessment. Total 301 people having different type and degree hearing loss participated in the study. The ages of 141 men and 160 women participants were between 18-65 and the average age was 49.11 ± 13.89 year. 187 of the participants had hearing aid in only one ear and the 114 had in both ears. Degree of unilateral hearing loss was 31 slight, 64 moderate, 49 moderately severe, 35 severe and 8 profound. In the ear in which hearing aid was used, there was 134 sensorineural hearingloss, 53 mixture hearing loss. Degree of hearing loss of the people using hearing aid bilaterally was 24 slight, 79 moderate, 54 moderately severe, 48 severe and 23 profound. In 162 ears of people using hearing aid bilaterally there was sensorineural hearing loss and in 53 ears there was mixture hearing loss. In right ear average score of the maximum satisfaction was between 4.23-5.75 and in left ear it was between 4.20-5.72. While the degree of hearing loss was increasing, the average of satisfaction score was decreasing. In terms of using unilateral and bilateral hearing aid, statistically considerable difference was found. In terms of hearing loss statistically considerable difference couldn't be found. Satisfaction of hearing aid is decreasing inversely proportional with increasing of hearing loss (slight- profound degree) While the furthest satisfaction for right and left ear was slight degree, the least satisfaction was observed for profound hearing loss. Aid using satisfaction changes depend on using the aid in the right ear or in the left ear. Using bilateral hearing aid has increased patient satisfaction much more.

The Bonebridge implant in older children and adolescents with mixed or conductive hearing loss: Audiological outcomes

IntroductionFor children with conductive or mixed hearing loss, in whom use of conventional hearing aids is impossible or limited, use of bone conduction devices is recommended. The choice between the available types of devices depends mostly on the degree of hearing loss, age, and anatomical conditions. One device application in children older than 5 years is the Bonebridge implant. The aim of this study is to assess the benefits and safety of this device in children. MethodsThe material was a group of 11 older children and adolescents aged 10–17 years (mean = 14.7, SD = 2.45) with single-sided or bilateral conductive or mixed hearing loss, implanted unilaterally with the Bonebridge system at the World Hearing Center in Kajetany near Warsaw between 2014 and 2016. Benefits of the Bonebridge were assessed with warble tone audiometry and word audiometry in free field, as well as an APHAB (Abbreviated Profile of Hearing Aid Benefit) questionnaire before and after implantation. ResultsHearing tests showed a statistically significant improvement in hearing sensitivity and speech discrimination. Results of the questionnaire confirm the benefits of Bonebridge implantation to the older children in terms of their auditory performance under various acoustic conditions. ConclusionsAt a one-year follow up the Bonebridge system was found to be a safe, efficient, and effective tool for compensating for conductive or mixed hearing loss in older children and adolescents. For good anatomical conditions the Bonebridge implant provides a safe alternative to other popular bone conduction systems.

Models to predict positive and negative effects of cochlear implantation on tinnitus.

ObjectivesThe effect of cochlear implantation on tinnitus is heterogeneous: implantation does not always reduce tinnitus and may even worsen tinnitus. Therefore, it is important to know which factors influence the consequences of cochlear implantation for tinnitus. To date, no consensus has been reached regarding the factors that influence tinnitus. This study aimed to create prognostic models, using binary logistic regression analyses to predict positive or negative changes in tinnitus after cochlear implantation.MethodsFor this study we retrospectively sent two questionnaire packages to 117 cochlear implant patients.ResultsIn the binary logistic regression analyses of the responses to the questionnaires, it was not possible to create a significant model to predict a positive effect of cochlear implantation on tinnitus. However, a negative effect of cochlear implantation on tinnitus was predictable, using a backward stepwise selection method in a model including the Abbreviated Profile of Hearing Aid Benefit (APHAB) and Tinnitus Handicap Questionnaire (THQ) (P < .001, Nagelkerke R2 = 0.529).ConclusionsOur results suggest that the lower the preoperative tinnitus handicap and the preoperative hearing handicap, the higher the chance that cochlear implantation will worsen tinnitus. More research needs to be done, preferable in a big prospective study, to make this model instrumental for clinical decision making and preoperative patient counselling. However, our results might suggest that preoperative THQ and APHAB screening could be meaningful. Especially in patients who are afraid to develop tinnitus or tinnitus worsening as complication of cochlear implantation.Level of Evidence4

Audiological and clinical outcomes of a transcutaneous bone conduction hearing implant: Six-month results from a multicentre study.

To compare the hearing performance of patients with conductive and mild mixed hearing loss and single-sided sensorineural deafness provided with a new transcutaneous bone conduction hearing implant (the Baha Attract System) with unaided hearing as well as aided with a sound processor on a softband. Furthermore, to evaluate safety and subjective benefit before and after implantation of the test device. Fifty-four adult patients in five participating centres were enrolled in this prospective study. Baseline data were collected during a pre-operative visit, and after a softband trial, all patients were implanted unilaterally. Follow-up visits were scheduled at 10days, 4, 6, 12weeks and 6months. Free-field hearing thresholds pure-tone average (PTA4 in dB HL; mean threshold at 500, 1000, 2000, 4000Hz; primary outcome measure). Individual free-field hearing thresholds, speech recognition in quiet and in noise, soft tissue status during follow-up and subjective benefit as measured with the Abbreviated Profile of Hearing Aid Benefit (APHAB), Speech, Spatial and Qualities of Hearing Scale (SSQ) and Health Utilities Index (HUI) questionnaires. Implantation of the Baha Attract System resulted in favourable audiological outcomes compared to unaided conditions. On the primary outcome parameter, a statistically significant improvement was observed compared to unaided hearing for the patients with conductive/mixed hearing loss (mean PTA4 difference -20.8dB HL, SD 9.8; P<0.0001) and for the patients with single-sided sensorineural deafness (SSD) (mean PTA4 difference -21.6dB HL, SD 12.2; P<0.0001). During all audiology tests, the non-test ear was blocked. Statistically significant improvements were also recorded in speech tests in quiet and noise compared to unaided hearing for the conductive/mixed hearing loss group and for speech in quiet in the SSD group. Compared to the pre-operative measurement with softband, no significant differences were recorded in the PTA4 free-field hearing threshold or the other audiological outcomes in either of the groups (P>0.05). Soft tissue-related issues observed during follow-up included numbness, pain/discomfort at the implant site and to a lesser extent pressure-related skin complications. A declining trend was noted in the rate of these complications during follow-up. Approximately 20% of patients reported some degree of numbness and 38% (slight) pain/discomfort at final follow-up of 6months. Good results on the subjective benefit questionnaires were observed, with statistically significant improvements on APHAB and SSQ questionnaires, and on the hearing attribute of HUI3. The Baha Attract System provided a significant improvement in hearing performance and subjective benefit compared to the pre-operative unaided condition (with the non-test ear blocked). Hearing performance of the Baha Attract was similar to a test situation with the same sound processor on a softband. A proportion of the patients reported numbness and pain/discomfort at the implant site during follow-up, especially during the first post-operative weeks. Based on the results of the current multicentre study, the Baha Attract can be considered as a treatment option for patients with the aforementioned hearing losses. Especially in the SSD patients, a careful selection procedure is warranted. Therefore, a pre-operative trial should be part of the decision-making process before fitting a patient with the Baha Attract System.

Self-Reported Benefit and Satisfaction with a Beamforming Body-Worn Hearing Aid for Elderly Adults.

Hearing impairment is a leading cause of disability globally and is particularly prevalent in elderly populations. Hearing aids are commonly recommended to mitigate the adverse effects on communication associated with hearing loss. However, the acceptability of hearing aids to elderly individuals is low and the majority of potential users do not wear hearing aids. Most hearing aids are designed with a discreet form factor in mind, to minimize device visibility. Given the range of comorbidities associated with hearing loss in the elderly, this conventional form factor may not always be optimal. The present study examined the experiences of elderly individuals with a recently developed, unconventional, body-worn hearing instrument, the EasyHear™ Grand (Logital Co. Ltd., Hong Kong). The bilaterally fitted instrument incorporates large controls, a color display, beamforming sound processing, and Bluetooth capabilities. Forty-three elderly participants (mean age=71; range 46-88 years) were surveyed to gauge level of benefit and satisfaction with the device and opinions regarding the hearing aid. They were assessed using three standardized questionnaires (the International Outcome Inventory-Hearing Aids, the Profile of Hearing Aid Benefit, and the Client Oriented Scale of Improvement) and through open-ended, structured interviews. Participants rated their EasyHear device fitting highly for hours of use and improved quality of life and rated the device favorably for improved communication and benefit in background noise. A majority of users felt the device improved listening ability in their expressed area of greatest need, and also for their second highest prioritized area of greatest need. Less than 10% of users felt their listening was only occasionally or hardly ever improved when using the body-worn device. Benefit and satisfaction ratings with the EasyHear Grand were comparable to those in studies involving conventional form factor devices. Interviews highlighted areas where users felt the device could be improved—extra noise reduction, changes to device dimensions, receiver/eartip fit, and cableless technology were among the areas mentioned. Many participants valued smartphone linkage and Bluetooth capability. The EasyHear Grand, with its body-worn design and large, simple controls, was well accepted by the majority of participants. Hearing aids that break from conventional design formats may benefit many elderly individuals with hearing impairment and promote increased user acceptability.

The influence of time of hearing aid use on auditory perception in various acoustic situations

The assessment of sound perception in hearing aids, especially in the context of benefits that a prosthesis can bring, is a complex issue. The objective parameters of the hearing aids can easily be determined. These parameters, however, do not always have a direct and decisive influence on the subjective assessment of quality of the patient's hearing while using a hearing aid. The paper presents the development of a method for the assessment of auditory perception and the effectiveness of applying hearing aids for hearing-impaired people during a short-term use. The method involves a questionnaire based on the APHAB (Abbreviated Profile of Hearing Aid Benefit) assessment questionnaire, a measure of self-reported auditory disability. The study includes additional criteria, such as measuring the number of hours and days of use of hearing aids, the degree of hearing loss and the patient's experience. A web-based application is developed to enable to carry out such an examination from any computer with access...

Bilateral Cochlear Implantation Versus Bimodal Hearing in Patients With Functional Residual Hearing: A Within-subjects Comparison of Audiologic Performance and Quality of Life

Evaluate performance and quality of life changes after sequential bilateral cochlear implantation in patients with preoperative residual hearing functioning in a bimodal hearing configuration. Retrospective analysis using within-subjects repeated measures design. Tertiary otologic center. Twenty-two adult patients with bilateral sensorineural hearing loss who used bimodal hearing before second cochlear implant (CI) meeting the following criteria: 1) preoperative residual hearing (≤80 dB HL at 250 Hz) in the ear to be implanted, 2) implantation with current CI technology (2013-2016), 3) consonant-nucleus-consonant (CNC) speech recognition testing in the bimodal condition preoperatively and bilateral CI condition postoperatively. Cochlear implantation. CNC and AzBio sentence scores in quiet and noise (+5 SNR). Subjective measures of communication difficulty and sound quality were also administered. Twenty-two patients (mean 64 yr, 68% men) were included. At an average follow-up of 11.8 months, CNC scores in the bilateral CI condition (mean 63%, standard deviation [SD] = 22) were significantly better than preoperative bimodal scores with repeated measures analysis (mean 55%, SD = 22) (p = 0.03). AzBio scores in quiet were also higher with bilateral CI (mean 76%, SD = 24) compared with bimodal listening (mean 69%, SD = 29) (p = 0.0007). Global abbreviated profile of hearing aid benefit (APHAB) and overall speech, spatial, and qualities of hearing (SSQ) scores exhibited significant improvement following bilateral implantation (p = 0.006 for both analyses). For patients using a bimodal hearing configuration with substantial residual hearing in the non-CI ear, bilateral cochlear implantation yields improved audiologic performance and better subjective quality of life, irrespective of the ability to preserve acoustic hearing during the second sided implantation.

Fluctuating Hearing Loss in the Only Hearing Ear: Cochlear Implantation in the Contralateral Deaf Side.

Objective To investigate the hearing performance of adult patients presenting unilateral deafness with contralateral fluctuating hearing loss who received a cochlear implant on the deaf side. Study Design Case series with chart review. Setting University tertiary referral center. Subjects and Methods Preoperatively and at 6 and 12 months postoperatively, 23 patients underwent pure tone audiometry and speech audiometry with disyllabic and monosyllabic words in a quiet environment and sentences in quiet and noisy (signal-to-noise ratio +10 dB SPL) environments under best-aided conditions. The Abbreviated Profile of Hearing Aid Benefit (APHAB) inventory was evaluated preoperatively and at 6 and 12 months postoperatively. Results No difference was found between pre- and postoperative tests for disyllabic and monosyllabic words. For sentences in quiet and noisy environments, a difference between pre- and postoperative performance was present at 1 year ( P = .002 and P = .02, respectively). In a noisy environment, a difference was present at 6 and 12 months postoperatively as compared with the preoperative value (mean ± SD: 6 months: 42% ± 7.1% vs 61% ± 6.5%, P = .016). A significant improvement in the APHAB score was found at 6 and 12 months postimplantation (Friedman's 2-way analysis of variance by ranks, P < .001). The number of years of hearing deprivation of the deaf ear was not correlated with performance. Conclusion When incapacitating fluctuating hearing loss occurs in patients presenting a contralateral deaf ear, a cochlear implant is indicated in the latter ear, significantly improving performance in noisy conditions and allowing a better quality of communication to be achieved.

Effect of Cochlear Implantation on Quality of Life in Adults with Unilateral Hearing Loss

Objective: Patients with moderate-to-profound sensorineural hearing loss in 1 ear and normal hearing in the contralateral ear, known as unilateral hearing loss (UHL) or single-sided deafness (SSD), may experience improved quality of life with the use of a cochlear implant (CI) in the affected ear. Quality of life assessment before and after implantation may reveal changes to aspects of hearing beyond those explicitly evaluated with behavioral measures. Methods: The present report completed 2 experiments investigating quality of life outcomes in CI recipients with UHL. The first experiment assessed quality of life during the 1st year of device use with 3 questionnaires: the Speech, Spatial, and Qualities of Hearing Scale (SSQ), the Abbreviated Profile of Hearing Aid Benefit (APHAB), and the Tinnitus Handicap Inventory. Twenty subjects were evaluated preoperatively and 1, 3, 6, 9, and 12 months post-activation. Quality of life results were compared over the study period using traditional scoring methods and the SSQ pragmatic subscales. Subscales specific to localization and speech perception in noise were compared to behavioral measures at the preoperative and 12-month intervals. The 2nd experiment evaluated quality of life preoperatively and at the 12-month interval for CI recipients with UHL and CI recipients with bilateral hearing loss, including conventional CI users and those listening with electric-acoustic stimulation (EAS). The 3 cohorts differed in CI candidacy criteria, including the amount of residual hearing in the contralateral ear. Results: For subjects with moderate-to-profound UHL, receipt of a CI significantly improved quality of life, with benefits noted as early as 1 month after initial activation. The UHL cohort reported less perceived difficulty at the pre- and postoperative intervals than the conventional CI and EAS cohorts, which may be due to the presence of the normal-hearing ear. Each group experienced a significant benefit in quality of life on the APHAB with CI use. Conclusions: Cochlear implantation in cases of substantial UHL may offer significant improvements in quality of life. Quality of life measures revealed a reduction in perceived tinnitus severity and subjective improvements in speech perception in noise, spatial hearing, and listening effort. While self-report of difficulties were lower for the UHL cohort than the conventional CI and EAS cohorts, subjects in all 3 groups reported an improvement in quality of life with CI use.

Comparison of the Effects of Middle Ear Implants and Conventional Hearing Aids on Cognitive Function

Background and Objectives The association between hearing impairment and cognitive function has been established in previous studies. The aim of this study was to compare the effects of conventional hearing aids and middle ear implants on cognitive function. Subjects and Method This study included 22 participants who underwent middle ear implantation between October 2013 and September 2016. Their mean age at surgery was 70 years. Using Pure tone audiometry (PTA), the Speech discrimination test (SDT), and the Abbreviated Profile of Hearing Aid Benefit (APHAB) questionnaire, we compared audiologic benefits of three conditions [without hearing aids, with conventional hearing aids, or with Vibrant Sound bridge (VSB)]. Cognitive ability was evaluated using neuropsychological testings (Seoul Neuropsychological Screening Battery) at intervals of approximately eight weeks. Results The results of PTA showed a 7.96 dB HL gain with conventional hearing aids and a 10.00 dB HL gain with the use of VSB. SDT results showed a 4.10% gain with conventional hearing aids and a 10% gain with the use of VSB. Results of the APHAB questionnaire showed a significant increase with the use of VSB compared to conventional hearing aids. In the Korean Mini-Mental State Examination, a slight improvement was observed after middle ear implantation. In the Digit Span Test and Korean-Boston Naming Test, a significant improvement was seen with the use of VSB compared to conventional hearing aids. Conclusion The use of middle ear implants in rehabilitation of hearing communication in patients showed improvements in cognitive abilities, compared to the use of conventional hearing aids. Key words: Hearing loss ㆍ Cognition ㆍ Middle ear implant ㆍ Hearing aids

Outcomes of Hearing Aid Use by Individuals with Unilateral Sensorineural Hearing Loss (USNHL).

Unilateral sensorineural hearing loss (USNHL) can have a negative impact on functions associated with the advantages of balanced, binaural hearing. Although single-sided deafness, which is a complete loss of audibility in one ear, has gained increased interest in the published research, there is a gap in the literature concerning hearing aid outcomes for individuals with residual, or otherwise "aidable," hearing in the affected ear. To assess hearing aid outcomes for a group of individuals with USNHL with residual, aidable function. A quasi-experimental study of hearing aid outcomes with paired comparisons made between unaided and aided test conditions. A convenience sample of twenty-two individuals with USNHL, with sufficient residual hearing in the affected ear as to receive audibility from use of a hearing aid, were recruited into the study from September 2011 to August 2012. Each participant was fit with a digital behind-the-ear hearing aid coupled to a custom ear mold. Assessments were performed at baseline (unaided) and after a three-month field trial (aided) with primary outcomes involving objective measures in sound field yielding signal-to-noise ratio loss (SNR Loss) via the Quick Speech-in-Noise Test and word recognition scores (WRS) via the Northwestern University Auditory Test, No. 6. Outcomes also involved the administration of two well-established subjective benefit questionnaires: The Abbreviated Profile of Hearing Aid Benefit (APHAB) and the 49-item Speech, Spatial, and Qualities of Hearing Scale (SSQ49). As a group, participants showed significantly improved median SNR Loss thresholds when aided in a test condition that included spatial separation of speech and noise, with speech stimuli directed toward the worse ear and noise stimuli directed toward the better ear (diff. = -4.5; p < 0.001). Hearing aid use had a small, though statistically significant, negative impact on median SNR Loss thresholds, when speech and noise stimuli originated from the same 0° azimuth (diff. = 1.0; p = 0.018). This was also evidenced by the median WRS in sound field (diff. = -6.0; p = 0.006), which was lowered from 98% in the unaided state to 92% in the aided state. Results from the SSQ49 showed statistically significant improvement on all subsection means when participants were aided (p < 0.05), whereas results from the APHAB were generally found to be unremarkable between unaided and aided conditions as benefit was essentially equal to the 50th percentile of the normative data. At the close of the study, it was observed that only slightly more than half of all participants chose to continue use of a hearing aid after their participation. We observed that hearing aid use by individuals with USNHL can improve the SNR Loss associated with the interference of background noise, especially in situations when there is spatial separation of the stimuli and speech is directed toward the affected ear. In addition, hearing aid use by these individuals can provide subjective benefit, as evidenced by the APHAB and SSQ49 subjective benefit questionnaires.

Is the Device-Oriented Subjective Outcome (DOSO) Independent of Personality?

Self-report questionnaires are a frequently used method of evaluating hearing aid outcomes. Studies have shown that personality can account for 5-20% of the variance in response to self-report measures. As a result, these influences can impact results and limit their generalizability when the purpose of the study is to examine the technological merit of hearing aids. To reduce personality influences on self-report outcome data, the Device-Oriented Subjective Outcome (DOSO) was developed. The DOSO is meant to demonstrate outcomes of the amplification device relatively independent of the individual's personality. Still, it is unknown if the DOSO achieves its original goal. The purpose of this study was to examine the relationship between personality and the DOSO. The relationship between personality and several widely used hearing-related questionnaires was also examined. This is a nonexperimental study using a correlational design. A total of 119 adult hearing aid wearers participated in the study. The NEO Five-Factor Inventory was used to measure five personality traits (Neuroticism, Extraversion, Openness, Agreeableness, and Conscientiousness). The initial (unaided) hearing disablement, residual (aided) hearing disablement, and hearing aid benefit and satisfaction was measured using the DOSO, Hearing Handicap Inventory for the Elderly/Adult, Abbreviated Profile of Hearing Aid Benefit, and Satisfaction with Amplification in Daily Life. The relationship between personality and each questionnaire was examined using a correlation analysis. All of the DOSO subscales were found to be significantly correlated to personality, regardless of whether age and better-ear hearing thresholds were controlled. Individuals who reported poorer hearing aid outcomes tended to have higher Neuroticism scores, while those who scored higher in Extraversion, Openness, and Agreeableness were more likely to report better outcomes. Across DOSO subscales, the maximum variance explained by personality traits ranged from 6% to 11%. Consistent with the literature, ∼3-18% of the variance of other hearing-related questionnaires was attributable to personality. The degree to which personality affects the DOSO is similar to other hearing-related questionnaires. Although the variance accounted for by personality is not large, researchers and clinicians should not assume that the results of the DOSO are independent of personality.

Written Instructions vs. Audiology Service for PSAP Use

Written Instructions vs. Audiology Service for PSAP Use

ZASTOSOWANIE IMPLANTU ŚLIMAKOWEGO U PACJENTA Z ZESPOŁEM COGANA I GŁĘBOKIM ODBIORCZYM UBYTKIEM SŁUCHU: STUDIUM PRZYPADKU

BackgroundCogan’s syndrome is a very rare autoimmune disease characterized by the coexistence of inflammatory lesions in the eyeball and inner ear dysfunction. The symptoms of Cogan’s syndrome within the inner ear appear suddenly and resemble Meniere’s disease symptoms: severe vertigo, nausea, vomiting, and usually bilateral, fluctuating sensorineural hearing loss with concomitant tinnitus.Case reportA 59-year-old woman was admitted to the Otolaryngology Head and Neck Surgery Clinic to undergo cochlear implantation. At 57 years of age, the patient had been diagnosed with scleritis. About a year later, vertigo and nausea arose, followed by rapidly progressing hearing loss – at first in the left ear and subsequently in the right, accompanied by tinnitus. At the time of implantation, the patient’s speech discrimination score was 0% for both ears. Taking into consideration the audiometric tests results and imaging scans, promontorial cochleostomy was carried out during the cochlear implantation procedure. In the postoperative period, no complications were observed. After 24 months of using the speech processor, the subjective assessment of speech intelligibility given by the patient on a 0–10 scale was 8.5 in quiet and 5.0 in a noisy environment. The patient could identify 95% of monosyllabic words in silence and 35% in noise (in conditions of SNR +10 dB, speech level at 70 dB HL, and noise level at 60 dB HL). The benefits obtained were confirmed by results of an Abbreviated Profile of Hearing Aid Benefit (APHAB) questionnaire. The patient is presently eligible for cochlear implantation in the other ear.ConclusionsCochlear implantation was effective in improving hearing in a patient with Cogan’s syndrome.

Aesthetic and hearing rehabilitation in patients with bilateral microtia-atresia

ObjectivesTo evaluate the safety and efficacy of auricle reconstruction and active transcutaneous bone-conduction implantation in patients with bilateral microtia-atresia. DesignPatients were chosen prospectively, with each being his/her own control. SettingThe setting was a tertiary referral center. ParticipantsTwelve patients, aged 6–18 years, with bilateral microtia-atresia suffering from bilateral conductive hearing loss. All had an upper bone conduction threshold limit of 45 dB HL at frequencies of 0.5–4 kHz. Main outcome measuresPatient satisfaction with the reconstructed auricle was rated as highly satisfactory, basically satisfactory, or unsatisfactory. Mean pure-tone thresholds and speech audiometry test results were compared among patients unaided, with a soft-band Bonebridge, and with an implanted Bonebridge. Subjective satisfaction was analyzed using three questionnaires: the Abbreviated Profile of Hearing Aid Benefit (APHAB), the Glasgow children's benefit inventory (GCBI), and the International Outcome Inventory for Hearing Aids (IOI-HA). ResultsAll patients who underwent auricle reconstruction expressed satisfaction with their appearance. The mean pure-tone thresholds of unaided patients and those with soft-band and implanted Bonebridge were 55.25 ± 3.43 dBHL, 31.37 ± 3.03 dBHL, and 21.25 ± 2.16 dBHL, respectively. The mean speech discrimination scores measured in a sound field with a presentation level of 65 dB SPL under these three conditions were 46.0 ± 0.11%, 80.0 ± 0.09%, and 94.0 ± 0.02%, respectively. Questionnaires demonstrated patients' benefits and satisfaction with this surgery. ConclusionsThe surgical procedure involving auricle reconstruction and Bonebridge implantation was safe and effective for patients with bilateral microtia-atresia, solving both appearance and hearing problems.