Probe-Determined Hearing-Aid Gain Compared to Functional and Coupler Gains

1985 ◽  
Vol 28 (3) ◽  
pp. 394-404 ◽  
Author(s):  
Jan Zemplenyi ◽  
Donald Dirks ◽  
Samuel Gilman
Keyword(s):  
Hearing Loss ◽  
Individual Variation ◽  
Optical Method ◽  
Hearing Aid ◽  
Sound Field ◽  
Operating Microscope ◽  
Average Difference ◽  
Ear Canal ◽  
The Individual ◽  
Functional Gain

In this investigation, hearing-aid gain as measured by a probe-earmold system was compared with gain determined from couplers (HA-2 coupler and ear simulator) and functional-gain measurements. Fifteen subjects with moderate sensorineural hearing loss were tested under aided and unaided conditions in the sound field. In order to determine the effect of the occluded ear canal length on these results, an optical method was developed using an operating microscope to measure the length of the individual subject's occluded ear canal. The results indicate that gain, as measured by the probe-earmold system, corrected for effects of occluded ear canal length, agrees closely with functional and ear-simulator gain through 4.0 kHz. At the frequencies of 5.0 and 6.0 kHz the probe-earmold system underestimated gain particularly when compared to measurements conducted with the ear simulator. Other comparisons were also made between gain measured in a HA-2 coupler and functional gain. The average differences between these measurements of gain agree with several previous investigations, but individual variation around the average difference was smaller than previously reported.

Comparison of Hearing-Aid Gain Using Functional, Coupler, and Probe-Tube Measurements

1986 ◽  
Vol 29 (2) ◽  
pp. 218-226 ◽  
Author(s):  
David Mason ◽  
Gerald R. Popelka
Keyword(s):  
Hearing Aids ◽  
Hearing Aid ◽  
Sound Field ◽  
Average Difference ◽  
Ear Canal ◽  
Tube System ◽  
Acoustic Characteristics ◽  
Standard Deviations ◽  
Functional Gain

Measurements of functional gain were compared first to coupler gain for 57 subjects using one of three hearing aid—earmold combinations and second to probe-tube gain for 12 subjects using in-the-ear hearing aids. The average difference between functional and coupler gain plotted as a function of frequency yielded results that were similar to previous reports, with the greatest effects occurring at 3000 and 4000 Hz. Significant differences were seen among hearing aid—earmold combinations at 3000, 4000, and 6000 Hz. Standard deviations for measurements between 750 and 2000 Hz were less than 5 dB and could be explained by variability of functional gain measures associated with test—retest variability of thresholds measured in a sound field. Below 750 Hz and above 2000 Hz, standard deviations exceeded 5 dB. The greater variability may be explained by differences in earmold venting, acoustic characteristics of the ear canal, and stimuli used to measure functional and coupler gain. Neither room nor hearing-aid noise appeared to affect the results significantly. When functional gain was compared to insertion gain measured with a probe-tube system, the average difference across frequencies was less than 1 dB. The variability of the differences at all frequencies, with the exception of 6000 Hz, was within the range reported for functional gain measurements. It was concluded that functional gain can be accurately estimated using probe-tube measurements.

Modified Earpieces and CROS for High Frequency Hearing Losses

1968 ◽  
Vol 11 (1) ◽  
pp. 204-218 ◽  
Author(s):  
Elizabeth Dodds ◽  
Earl Harford
Keyword(s):  
Hearing Loss ◽  
Hearing Aids ◽  
High Frequency ◽  
Hearing Aid ◽  
Sound Field ◽  
Intensity Level ◽  
Test Results ◽  
High Frequency Hearing Loss ◽  
Increased Sensitivity ◽  
Difficult Cases

Persons with a high frequency hearing loss are difficult cases for whom to find suitable amplification. We have experienced some success with this problem in our Hearing Clinics using a specially designed earmold with a hearing aid. Thirty-five cases with high frequency hearing losses were selected from our clinical files for analysis of test results using standard, vented, and open earpieces. A statistical analysis of test results revealed that PB scores in sound field, using an average conversational intensity level (70 dB SPL), were enhanced when utilizing any one of the three earmolds. This result was due undoubtedly to increased sensitivity provided by the hearing aid. Only the open earmold used with a CROS hearing aid resulted in a significant improvement in discrimination when compared with the group’s unaided PB score under earphones or when comparing inter-earmold scores. These findings suggest that the inclusion of the open earmold with a CROS aid in the audiologist’s armamentarium should increase his flexibility in selecting hearing aids for persons with a high frequency hearing loss.

scholarly journals The use of speech sentence audiometry in a free sound field

2020 ◽  
Vol 5 (1) ◽  
pp. 36-39
Author(s):  
Mariya Yu. Boboshko ◽  
Irina P. Berdnikova ◽  
Natalya V. Maltzeva
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Hearing Aids ◽  
Speech Intelligibility ◽  
Normative Data ◽  
Hearing Aid ◽  
Sound Field ◽  
Normal Hearing ◽  
Significant Difference ◽  
Hearing Aid Benefit

Objectives -to determine the normative data of sentence speech intelligibility in a free sound field and to estimate the applicability of the Russian Matrix Sentence test (RuMatrix) for assessment of the hearing aid fitting benefit. Material and methods. 10 people with normal hearing and 28 users of hearing aids with moderate to severe sensorineural hearing loss were involved in the study. RuMatrix test both in quiet and in noise was performed in a free sound field. All patients filled in the COSI questionnaire. Results. The hearing impaired patients were divided into two subgroups: the 1st with high and the 2nd with low hearing aid benefit, according to the COSI questionnaire. In the 1st subgroup, the threshold for the sentence intelligibility in quiet was 34.9 ± 6.4 dB SPL, and in noise -3.3 ± 1.4 dB SNR, in the 2nd subgroup 41.7 ± 11.5 dB SPL and 0.15 ± 3.45 dB SNR, respectively. The significant difference between the data of both subgroups and the norm was registered (p

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

2017 ◽  
Vol 28 (10) ◽  
pp. 941-949 ◽  
Author(s):  
Charles E. Bishop ◽  
Elgenaid Hamadain ◽  
Jason A. Galster ◽  
Mary Frances Johnson ◽  
Christopher Spankovich ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Negative Impact ◽  
Hearing Aid ◽  
Sound Field ◽  
Spatial Separation ◽  
Binaural Hearing ◽  
Sensorineural Hearing ◽  
Convenience Sample ◽  
Hearing Aid Use

Background: 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. Purpose: To assess hearing aid outcomes for a group of individuals with USNHL with residual, aidable function. Research Design: A quasi-experimental study of hearing aid outcomes with paired comparisons made between unaided and aided test conditions. Study Sample: 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. Intervention: Each participant was fit with a digital behind-the-ear hearing aid coupled to a custom ear mold. Data Collection and Analysis: 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). Results: 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. Conclusions: 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.

Effect of Release Time on Preferred Gain and Speech Acoustics

2004 ◽  
Vol 15 (09) ◽  
pp. 605-615 ◽  
Author(s):  
Thomas F. Muller ◽  
Frances P. Harris ◽  
John C. Ellison
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Hearing Aid ◽  
Sensorineural Hearing ◽  
Speech Stimulus ◽  
Release Time ◽  
Ear Canal ◽  
Continuous Speech ◽  
Adaptive Procedure ◽  
Speech Acoustics

Eighteen experienced hearing aid users with mild to moderate sensorineural hearing loss were fit with a digital hearing instrument. An adaptive procedure was used to determine their preferred gain setting for continuous speech under six conditions. Release time (RT) was set to 40, 160, or 640 msec. A prerecorded speech stimulus was presented in quiet or in the presence of multitalker babble (10 dB signal-to-babble ratio); all other compression variables were fixed. Real-ear data obtained with settings for each condition suggest that RT did not affect gain preference; however, subjects preferred higher gain in the presence of the multitalker babble. The RMS amplitudes of 30 phonemic units were calculated using ear canal recordings of the speech stimulus for each subject in each condition. Altering RT resulted primarily in decreased amplitude with increased RT, but this effect was not predictable across listeners or conditions.

Predicted Gain and Functional Gain With Transcranial Routing of Signal Completely-in-the-Canal Hearing Aids

2003 ◽  
Vol 12 (2) ◽  
pp. 84-90 ◽  
Author(s):  
Marc A. Fagelson ◽  
Colleen M. Noe ◽  
Owen D. Murnane ◽  
Jennifer S. Blevins
Keyword(s):  
Hearing Loss ◽  
Hearing Aids ◽  
Hearing Aid ◽  
Mechanical Vibration ◽  
Signal Frequency ◽  
Unilateral Hearing Loss ◽  
External Canal ◽  
The Difference ◽  
Acoustic Output ◽  
Functional Gain

Transcranial routing of signal (TCROS) was accomplished using completely-in-the-canal (CIC) hearing aids in 5 profoundly unilaterally hearing-impaired individuals. The functional gain realized by the participants far exceeded the gain predicted by measuring the acoustic output and real ear aided response of the hearing aids. The difference between predicted and functional gain increased with signal frequency and was attributed at least in part to mechanical vibration of the hearing aid in the external canal. Implications for fitting unilateral hearing loss using TCROS amplifying systems are discussed.

scholarly journals Contralateral Occlusion Test (COT): the effect of external ear canal occlusion with aging

CoDAS ◽  
2019 ◽  
Vol 31 (3) ◽  
Author(s):  
Luís Roque Reis ◽  
Luís Castelhano ◽  
Filipe Correia ◽  
Pedro Escada
Keyword(s):  
Hearing Loss ◽  
Tuning Fork ◽  
Age Groups ◽  
Sound Field ◽  
External Ear ◽  
Ear Canal ◽  
Occlusion Test ◽  
External Ear Canal ◽  
Hearing Thresholds ◽  
And Gender

ABSTRACT Purpose This study aimed to evaluate the effects of complete external ear canal occlusion on hearing thresholds with aging. The goal was to decide which tuning fork is more appropriate to use for the contralateral occlusion test (COT), in individuals of different ages. Methods Forty-two normal hearing subjects between 21 and 67 years were divided into three age groups (20-30 years, 40-50 years, and 60-70 years). Participants underwent sound field audiometry tests with warble tones, with and without ear canal occlusion. Each ear was tested with the standard frequencies (250, 500, 1000, and 2000 Hz). The contralateral ear was suppressed by masking. Results Hearing thresholds showed an increase as the frequency increased from 20.85 dB (250 Hz, 20-30 years group) to 48 dB (2000 Hz, 60-70 years group). The threshold differences between occlusion and no occlusion conditions were statistically significant and increased ranging from 11.1 dB (250 Hz, 20-30 years group) to 32 dB (2000 Hz, 20-30 years group). We found statistically significant differences for the three age groups and for all evaluations except to 500 Hz difference and average difference. The mean hearing loss produced by occlusion at 500 Hz was approximately 19 dB. We found no statistically significant differences between right and left ears and gender for all measurements. Conclusion We conclude that the use of the 512 Hz tuning fork is the most suitable for COT, and its use may allow clinicians to distinguish mild from moderate unilateral conductive hearing loss.

scholarly journals Stability of Audiometric Thresholds for Children with Hearing Aids Applying the American Academy of Audiology Pediatric Amplification Guideline: Implications for Safety

2016 ◽  
Vol 27 (03) ◽  
pp. 252-263 ◽  
Author(s):  
Ryan McCreery ◽  
Elizabeth Walker ◽  
Meredith Spratford ◽  
Benjamin Kirby ◽  
Jacob Oleson ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Power Law ◽  
Hearing Aids ◽  
Longitudinal Design ◽  
Hearing Aid ◽  
Ear Canal ◽  
Behavioral Threshold ◽  
Behavioral Thresholds ◽  
Safety Limit ◽  
Modified Power Law

Background: Children who wear hearing aids may be at risk for further damage to their hearing from overamplification. Previous research on amplification-induced hearing loss has included children using linear amplification or simulations of predicted threshold shifts based on nonlinear amplification formulae. A relationship between threshold shifts and the use of nonlinear hearing aids in children has not been empirically verified. Purpose: The purpose of the study was to compare predicted threshold shifts from amplification to longitudinal behavioral thresholds in a large group of children who wear hearing aids to determine the likelihood of amplification-induced hearing loss. Research Design: An accelerated longitudinal design was used to collect behavioral threshold and amplification data prospectively. Study Sample: Two-hundred and thirteen children with mild-to-profound hearing loss who wore hearing aids were included in the analysis. Data Collection and Analysis: Behavioral audiometric thresholds, hearing aid outputs, and hearing aid use data were collected for each participant across four study visits. Individual ear- and frequency-specific safety limits were derived based on the Modified Power Law to determine the level at which increased amplification could result in permanent threshold shifts. Behavioral thresholds were used to estimate which children would be above the safety limit at 500, 1000, 2000, and 4000 Hz using thresholds in dB HL and then in dB SPL in the ear canal. Changes in thresholds across visits were compared for children who were above and below the safety limits. Results: Behavioral thresholds decreased across study visits for all children, regardless of whether their amplification was above the safety limits. The magnitude of threshold change across time corresponded with changes in ear canal acoustics as measured by the real-ear-to-coupler difference. Conclusions: Predictions of threshold changes due to amplification for children with hearing loss did not correspond with observed changes in threshold over across 2–4 yr of monitoring amplification. Use of dB HL thresholds and predictions of hearing aid output to set the safety limit resulted in a larger number of children being classified as above the safety limit than when safety limits were based on dB SPL thresholds and measured hearing aid output. Children above the safety limit for the dB SPL criteria tended to be fit above prescriptive targets. Additional research should seek to explain how the Modified Power Law predictions of threshold shift overestimated risk for children who wear hearing aids.

Maximum Real-Ear Gain of In-the-Ear Hearing Aids

1991 ◽  
Vol 34 (2) ◽  
pp. 351-359 ◽  
Author(s):  
Faye N. Erickson ◽  
Dianne J. Van Tasell
Keyword(s):  
Individual Differences ◽  
Hearing Aids ◽  
Hearing Aid ◽  
Hearing Impaired ◽  
Volume Control ◽  
Ear Canal ◽  
Shell Size ◽  
Maximum Gain ◽  
Functional Gain

Three hearing aid manufacturers provided custom full-shell in-the-ear hearing aids for each of 3 hearing-impaired subjects. Each manufacturer was instructed that the hearing aids should provide the maximum possible acoustic gain within the limits of hearing aid shell size and available components. Coupler gain, insertion gain, and functional gain were measured for each hearing aid. Gain measures were made with the volume control at either the full-on setting or the highest setting possible before the onset of acoustical feedback. Full-on coupler gain curves were similar across all nine hearing aids. Individual differences in concha/ear canal size and in the fit of the hearing aids produced substantial variance in insertion gain across hearing aids. Peak insertion gain varied from 41 to 58 dB. If 10 dB reserve gain is allowed, the range of estimated peak use gain from these maximum-gain in-the-ear hearing aids is 31–48 dB.

scholarly journals EHealth and Its Role in Supporting Audiological Rehabilitation: Patient Perspectives on Barriers and Facilitators of Using a Personal Hearing Support System With Mobile Application as Part of the EVOTION Study

2022 ◽  
Vol 9 ◽  
Author(s):  
Louisa Murdin ◽  
Mark Sladen ◽  
Hannah Williams ◽  
Doris-Eva Bamiou ◽  
Athanasios Bibas ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Support System ◽  
Hearing Aids ◽  
User Satisfaction ◽  
Hearing Aid ◽  
Cost Effective ◽  
Mobile App ◽  
Auditory Training ◽  
Technical Problems ◽  
The Individual

BackgroundHearing loss is a major public health challenge. Audiology services need to utilise a range of rehabilitative services and maximise innovative practice afforded by technology to actively promote personalized, participatory, preventative and predictive care if they are to cope with the social and economic burden placed on the population by the rapidly rising prevalence of hearing loss. Digital interventions and teleaudiology could be a key part of providing high quality, cost-effective, patient-centred management. There is currently very limited evidence that assesses the hearing impaired patient perspective on the acceptance and usability of this type of technology.AimThis study aims to identify patient perceptions of the use of a hearing support system including a mobile smartphone app when used with Bluetooth-connected hearing aids across the everyday life of users, as part of the EVOTION project.MethodsWe applied a questionnaire to 564 participants in three countries across Europe and analysed the following topics: connectivity, hearing aid controls, instructional videos, audiological tests and auditory training.Key FindingsOlder users were just as satisfied as younger users when operating this type of technology. Technical problems such as Bluetooth connectivity need to be minimised as this issue is highly critical for user satisfaction, engagement and uptake. A system that promotes user-controllability of hearing aids that is more accessible and easier to use is highly valued. Participants are happy to utilise monitoring tests and auditory training on a mobile phone out of the clinic but in order to have value the test battery needs to be relevant and tailored to each user, easy to understand and use. Such functions can elicit a negative as well as positive experience for each user.ConclusionOlder and younger adults can utilise an eHealth mobile app to complement their rehabilitation and health care. If the technology works well, is tailored to the individual and in-depth personalised guidance and support is provided, it could assist maximisation of hearing aid uptake, promotion of self-management and improving outcomes.

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