Individualized Correction Factors in the Preselection of Hearing Aids

1992 ◽  
Vol 35 (2) ◽  
pp. 384-400 ◽  
Author(s):  
Selda Fikret-Pasa ◽  
Lawrence J. Revit
Keyword(s):  
Hearing Aids ◽  
Hearing Aid ◽  
Sound Field ◽  
Individual Variability ◽  
Correction Factors ◽  
High Frequencies ◽  
Reference Position ◽  
The Real ◽  
Prescription Practices ◽  
Positive Gain

This study investigated three issues involving corrections for individual ear acoustics in hearing aid prescriptions: (a) the extent to which inconsistencies in the sound-field reference position can affect comparative corrections for the real-ear unaided response (REUR); (b) the extent to which individual variability in the real-ear-to-coupler level difference (RECD) supports the use of individual measurements as opposed to an average-ear estimate; and (c) the adequacy of using KEMAR estimates of the effects of the location of the hearing aid microphone. In Experiment 1, KEMAR REURs using over-the-ear and under-the-ear reference positions were compared with KEMAR REURs using a center-of-head reference position. Maximum differences of 4–9 dB were found in the 1500- to 5000-Hz range, depending on test conditions. In Experiment 2, the ear canal response of an insert earphone was compared to the 2-cc coupler response of the same earphone to calculate the RECD. Individual RECDs for a population of hearing aid candidates were compared to the RECD for KEMAR. For 8 of the 15 subjects (9 of 18 ears), the RECD was more than 4 dB different from KEMAR at two or more third-octave frequencies between 500 and 4000 Hz. In Experiment 3, the effect of the location of the hearing aid microphone for in-the-ear (ITE) and in-the-canal (ITC) locations was compared with the over-the-ear (OTE) location for 18 ears and for KEMAR. The effects varied across individual ears, but all ears and KEMAR showed positive gain in the high frequencies for the ITE and ITC locations. The relevance of these results to hearing aid prescription practices is discussed.

scholarly journals Boothless Aided Audiometry: A Pilot Study

2021 ◽  
pp. 201010582110405
Author(s):  
Kenneth Wei De Chua ◽  
Heng Wai Yuen ◽  
Savitha Kamath
Keyword(s):  
Conventional Method ◽  
Hearing Aids ◽  
Hearing Aid ◽  
Free Field ◽  
Sound Field ◽  
High Volume ◽  
Moderate Degree ◽  
High Frequencies ◽  
Healthcare Needs

Background Although free-field aided audiometry is not the gold standard of hearing aid verification because of its many limitations, it is still circumstantially needed. The conventional method of sound-field aided audiometry requires a sound-proof booth. However, as clinicians face a high-volume of audiometric tests ordered daily at the otolaryngology clinic, a sound-proof booth may not be always available when needed. This study aims to explore if out-of-booth free-field aided audiometry can be just as reliable as the conventional method. Methods A pilot exploration of 10 patients (20 ears), with at least a moderate degree of bilateral symmetrical sensorineural hearing loss was conducted. Patients were recruited during their follow-up hearing aid appointments with their audiologist. All patients had been fitted with hearing aids for at least 6 months in duration, and their hearing aids were optimized. Results Out-of-booth aided audiometry for the main frequencies of interest was reliable with good correlation between the two methods at primary frequencies (500 Hz–4 KHz). However, results in the high frequencies were less reliable and needs to be interpreted cautiously. Conclusion Out-of-booth sound-field audiometry may be a quick and reliable method that can be used to fulfil its intended purpose with the added advantage of not needing an arguably expensive audiometric booth. However, not all frequencies of interest can be assessed with reliable measurements. Further larger studies are needed to validate the reliability of boothless sound-field audiometry to meet evolving healthcare needs.

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.

Noise Exposure Associated With Hearing Aid Use in Industry

1996 ◽  
Vol 39 (2) ◽  
pp. 251-260 ◽  
Author(s):  
Thomas G. Dolan ◽  
James F. Maurer
Keyword(s):  
Hearing Aids ◽  
Noise Exposure ◽  
Hearing Aid ◽  
Sound Field ◽  
High Gain ◽  
Sound Level ◽  
Weighted Averages ◽  
Hearing Aid Use ◽  
Listening Environments ◽  
Level Meter

Although noise may be innocuous in many vocational environments, there is a growing concern in industry that it can reach hazardous levels when amplified by hearing aids. This study examined the daily noise exposures associated with hearing aid use in industry. This was done by both laboratory and site measurements in which hearing aids were coupled to the microphone of an integrating sound level meter or dosimeter. The former method involved the use of recorded railroad and manufacturing noise and a Bruel and Kjaer 4128 Head and Torso simulator. In the latter procedure, a worker wore one of three hearing aids coupled to a dosimeter during 8-hour shifts in a manufacturing plant. Both methods demonstrated that even when amplified by mild-gain hearing aids, noise exposures rose from time-weighted averages near 80 dBA to well above the OSHA maximum of 90 dBA. The OSHA maximum was also exceeded when moderate and high gain instruments were worn in non-occupational listening environments. The results suggest that current OSHA regulations that limit noise exposure in sound field are inappropriate for hearing aid users.

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

scholarly journals A Study on the Preferred Real-Ear Insertion Gain of Multi-Channel Hearing Aid for the Korean with Sensorineural Hearing Loss

2020 ◽  
Vol 16 (2) ◽  
pp. 85-94
Author(s):  
Eojini Bang ◽  
Kyoungwon Lee
Keyword(s):  
Word Recognition ◽  
Hearing Aids ◽  
Hearing Aid ◽  
Hearing Aid Fitting ◽  
High Frequencies ◽  
Frequency Bands ◽  
Before And After ◽  
Fitting Procedures ◽  
Linear Version ◽  
Gain Adjustment

Purpose: This study aimed to compare the preferred real-ear insertion gain for Korean (PREIG-K) wearing multi-channel hearing aid with the National Acoustics Laboratories-Non-Linear version 2 (NAL-NL2; National Acoustic Laboratories) gains in order to develop Korean hearing aid fitting formula.Methods: A total of thirty one (62 ears) Korean hearing aid users were included in this study. All subjects wore in-the-canal or custom hearing aids in both ears. Individual hearing aid fitting procedures involved to adjust the gains for 50, 65, and 80 dB sound pressure level of speech across low, high, and wideband frequency bands based on participant’s subjective responses. In addition, only the high frequency bands of 1 kHz or more of the PREIG-K were re-adjusted to be the same as NAL-NL2 gain and then the word recognition scores (WRSs) were compared before and after the adjusting gain. Results: The results showed that the PREIG-K increased up to 1.5 kHz with the maximum amount, then the PREIG-K decreased across the frequencies. For all half octave frequencies, the PREIG-Ks were substantially less than the NAL-NL2. When the PREIG-K of high frequencies were re-adjusted same as the NAL-NL2 gains, the WRSs of the PREIG-K were not significantly different before and after gain adjustment. The slopes up to 1.5 kHz frequencies of the PREIG-K were steeper than the slopes of NAL-NL2 gain, however similar to the slope of manufactures’ fitting formulae.Conclusion: The development of an effective hearing aid fitting formula for improving the communication abilities of hearing-impaired Korean will require further experiments considering the language, physical characteristics, and word recognition used by Koreans.

scholarly journals Assessment of Hearing Aid Benefit Using Patient-Reported Outcomes and Audiologic Measures

2020 ◽  
Vol 25 (4) ◽  
pp. 215-223
Author(s):  
James R. Dornhoffer ◽  
Ted A. Meyer ◽  
Judy R. Dubno ◽  
Theodore R. McRackan
Keyword(s):  
Hearing Aids ◽  
Patient Reported Outcomes ◽  
Hearing Aid ◽  
Sound Field ◽  
Patient Reported Outcome ◽  
Middle Ear Implant ◽  
Patient Reported ◽  
The Difference ◽  
Patient Reported Measures ◽  
Hearing Aid Benefit

Purpose: To determine the contributions to hearing aid benefit of patient-reported outcomes and audiologic measures. Methods: Independent review was conducted on audiologic and patient-reported outcomes of hearing aid benefit collected in the course of a middle ear implant FDA clinical trial. Unaided and aided data were extracted from the preoperative profiles of 95 experienced hearing aid users, and the relationships between a patient-reported outcome and audiologic measures were assessed. The following data were extracted: unaided and aided pure-tone or warble-tone thresholds (PTA), word recognition in quiet (NU-6), Speech Perception in Noise (low-/high-context SPIN), and patient-reported benefit (Abbreviated Profile of Hearing Aid Benefit, APHAB). Hearing aid benefit was defined as the difference in thresholds or scores between unaided and aided conditions, as measured in the sound field. Correlations were computed among audiologic measures and global APHAB and subscale scores of hearing aid benefit. Results: Significant improvements in all audiologic measures and APHAB scores were observed comparing unaided to aided listening (all p < 0.001). However, correlations between audiologic and patient-reported measures of aided performance or hearing aid benefit were low-to-weak or absent. No significant correlations were found between aided audiologic measures (PTA, NU-6, SPIN) and any aided APHAB scores (all p > 0.0125), and significant relationships for hearing aid benefit were absent with only few exceptions. Hearing aid benefit defined by global APHAB using NU-6 and SPIN scores showed significant but weak positive correlations (r = 0.37, p < 0.001; r = 0.28, p = 0.005, respectively) and ease of communication APHAB subscale scores (r = 0.32, p < 0.001; r = 0.33, p = 0.001, respectively). Conclusion: Hearing aid benefit assessed with audiologic measures were poor predictors of patient-reported benefit. Thus, patient-reported outcomes may provide a unique assessment of patient-perceived benefit from hearing aids, which can be used to direct hearing aid programming, training, or recommendations of alternative hearing services.

Programmable Telecoil Responses

1994 ◽  
Vol 3 (2) ◽  
pp. 59-64 ◽  
Author(s):  
Stephanie A. Davidson ◽  
Colleen M. Noe
Keyword(s):  
Hearing Aids ◽  
Hearing Aid ◽  
Speech Understanding ◽  
The Real ◽  
Inductively Coupled

Ten experienced hearing aid users were tested to evaluate an assistive listening device inductively coupled to three different hearing aids—their own BTE hearing aid and associated telecoil, a programmable hearing aid with the telecoil programmed using the manufacturer's algorithm, and the same programmable hearing aid with the telecoil programmed so that the real-ear gain obtained with the hearing aid-assistive listening device combination matched a prescriptive target. Results indicated that modifying the telecoil response to match a prescriptive target can result in enhanced speech understanding and higher preference rankings.

Wireless CROS Versus Transcranial CROS for Unilateral Hearing Loss

1995 ◽  
Vol 4 (1) ◽  
pp. 52-59 ◽  
Author(s):  
Michael Valente ◽  
Lisa G. Potts ◽  
Maureen Valente ◽  
Joel Goebel
Keyword(s):  
Hearing Loss ◽  
Hearing Aids ◽  
Hearing Aid ◽  
Unilateral Hearing Loss ◽  
Sensation Level ◽  
The Real

Eight subjects with unilateral hearing loss were fitted with wireless CROS and transcranial BTE CROS hearing aids. Results revealed that two subjects preferred the BTE transcranial CROS; four subjects preferred the wireless CROS; one subject found both hearing aid systems to be equally satisfactory; and one subject rejected both CROS fittings. In addition, a fitting strategy is introduced using probe microphone analysis to: (a) measure trans-cranial thresholds (TCT) in the unaidable ear in dB SPL measured near the eardrum, and (b) determine the sensation level of the real ear aided response (REAR-TCT) for uncorrected and corrected speech-weighted noise. The results highlight some of the difficulties associated with successfully fitting a transcranial CROS hearing aid.

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.

scholarly journals Difference between the Default Telecoil (T-Coil) and Programmed Microphone Frequency Response in Behind-the-Ear (BTE) Hearing Aids

2012 ◽  
Vol 23 (05) ◽  
pp. 366-378 ◽  
Author(s):  
Daniel B. Putterman ◽  
Michael Valente
Keyword(s):  
Frequency Response ◽  
Hearing Aids ◽  
Repeated Measures ◽  
Mixed Model ◽  
Hearing Aid ◽  
Primary Concern ◽  
The Real ◽  
Repeated Measures Design ◽  
Significant Difference ◽  
The Mean

Background: A telecoil (t-coil) is essential for hearing aid users when listening on the telephone because using the hearing aid microphone when communicating on the telephone can cause feedback due to telephone handset proximity to the hearing aid microphone. Clinicians may overlook the role of the t-coil due to a primary concern of matching the microphone frequency response to a valid prescriptive target. Little has been published to support the idea that the t-coil frequency response should match the microphone frequency response to provide “seamless” and perhaps optimal performance on the telephone. If the clinical goal were to match both frequency responses, it would be useful to know the relative differences, if any, that currently exist between these two transducers. Purpose: The primary purpose of this study was to determine if statistically significant differences were present between the mean output (in dB SPL) of the programmed microphone program and the hearing aid manufacturer's default t-coil program as a function of discrete test frequencies. In addition, pilot data are presented on the feasibility of measuring the microphone and t-coil frequency response with real-ear measures using a digital speech-weighted noise. Research Design: A repeated-measures design was utilized for a 2-cc coupler measurement condition. Independent variables were the transducer (microphone, t-coil) and 11 discrete test frequencies (15 discrete frequencies in the real-ear pilot condition). Study Sample: The study sample was comprised of behind-the-ear (BTE) hearing aids from one manufacturer. Fifty-two hearing aids were measured in a coupler condition, 39 of which were measured in the real-ear pilot condition. Hearing aids were previously programmed and verified using real-ear measures to the NAL-NL1 (National Acoustic Laboratories—Non-linear 1) prescriptive target by a licensed audiologist. Data Collection and Analysis: Hearing aid output was measured with a Fonix 7000 hearing aid analyzer (Frye Electronics, Inc.) in a HA-2 2-cc coupler condition using a pure-tone sweep at an input level of 60 dB SPL with the hearing aid in the microphone program and 31.6 mA/M in the t-coil program. A digital speech weighted noise input signal presented at additional input levels was used in the real-ear pilot condition. A mixed-model repeated-measures analysis of variance (ANOVA) and the Tukey Honestly Significant Difference (HSD) post hoc test were utilized to determine if significant differences were present in performance across treatment levels. Results: There was no significant difference between mean overall t-coil and microphone output averaged across 11 discrete frequencies (F(1,102) = 0, p < 0.98). A mixed-model repeated-measures ANOVA revealed a significant transducer by frequency interaction (F(10,102) = 13.0, p < 0.0001). Significant differences were present at 200 and 400 Hz where the mean t-coil output was less than the mean microphone output, and at 4000, 5000, and 6300 Hz where the mean t-coil output was greater than the mean microphone output. Conclusions: The mean t-coil output was significantly lower than the mean microphone output at 400 Hz, a frequency that lies within the typical telephone bandwidth of 300–3300 Hz. This difference may partially help to explain why some patients often complain the t-coil fails to provide sufficient loudness for telephone communication.

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