Using the Real-Ear-to-Coupler Difference within the American Academy of Audiology Pediatric Amplification Guideline: Protocols for Applying and Predicting Earmold RECDs

2016 ◽  
Vol 27 (03) ◽  
pp. 264-275 ◽  
Author(s):  
Sheila Moodie ◽  
Jonathan Pietrobon ◽  
Eileen Rall ◽  
George Lindley ◽  
Leisha Eiten ◽  
...  
Keyword(s):  
Hearing Aids ◽  
Hearing Aid ◽  
Hearing Threshold ◽  
Analysis Data ◽  
Systematic Difference ◽  
Ear Canal ◽  
Hearing Aid Fitting ◽  
Coupling Procedure ◽  
Adults And Children ◽  
Age Range

Background: Real-ear-to-coupler difference (RECD) measurements are used for the purposes of estimating degree and configuration of hearing loss (in dB SPL ear canal) and predicting hearing aid output from coupler-based measures. Accurate measurements of hearing threshold, derivation of hearing aid fitting targets, and predictions of hearing aid output in the ear canal assume consistent matching of RECD coupling procedure (i.e., foam tip or earmold) with that used during assessment and in verification of the hearing aid fitting. When there is a mismatch between these coupling procedures, errors are introduced. Purpose: The goal of this study was to quantify the systematic difference in measured RECD values obtained when using a foam tip versus an earmold with various tube lengths. Assuming that systematic errors exist, the second goal was to investigate the use of a foam tip to earmold correction for the purposes of improving fitting accuracy when mismatched RECD coupling conditions occur (e.g., foam tip at assessment, earmold at verification). Study Sample: Eighteen adults and 17 children (age range: 3–127 mo) participated in this study. Data Collection and Analysis: Data were obtained using simulated ears of various volumes and earmold tubing lengths and from patients using their own earmolds. Derived RECD values based on simulated ear measurements were compared with RECD values obtained for adult and pediatric ears for foam tip and earmold coupling. Results: Results indicate that differences between foam tip and earmold RECDs are consistent across test ears for adults and children which support the development of a correction between foam tip and earmold couplings for RECDs that can be applied across individuals. Conclusions: The foam tip to earmold correction values developed in this study can be used to provide improved estimations of earmold RECDs. This may support better accuracy in acoustic transforms related to transforming thresholds and/or hearing aid coupler responses to ear canal sound pressure level for the purposes of fitting behind-the-ear hearing aids.

Self-Perception of Hearing Ability as a Strong Predictor of Hearing Aid Purchase

2009 ◽  
Vol 20 (06) ◽  
pp. 341-347 ◽  
Author(s):  
Catherine V. Palmer ◽  
Helena S. Solodar ◽  
Whitney R. Hurley ◽  
David C. Byrne ◽  
Kadyn O. Williams
Keyword(s):  
Hearing Aid ◽  
Strong Predictor ◽  
Hearing Threshold ◽  
Analysis Data ◽  
Clinical Settings ◽  
Self Perception ◽  
Hearing Ability ◽  
Threshold Data ◽  
Test Retest Reliability ◽  
Age Range

Background: Hearing threshold data are not particularly predictive of self-perceived hearing handicap or readiness to pursue amplification. Poor correlations between these measures have been reported repeatedly. When a patient is evaluated for hearing loss, it is common to collect both threshold data and the individual's self-perception of hearing ability. This is done to help the patient make an appropriate choice related to the pursuit of amplification or other communication strategies. It would be valuable, though, for the audiologist to be able to predict which patients are ready for amplification, which patients require more extensive counseling before pursuing amplification, and which patients simply are not ready for amplification regardless of the audiometric data. Purpose: The purpose of this study was to evaluate the following question for its potential usefulness as a determinant of patient readiness for amplification: “On a scale from 1 to 10, 1 being the worst and 10 being the best, how would you rate your overall hearing ability?” Research Design: The test–retest reliability and the predictive value of the question, based on final hearing aid purchase, were evaluated in a private practice setting. Study Sample: Eight hundred forty hearing-impaired adults in the age range from 18 to 95 years. Collection and Analysis: Data were collected retrospectively from patient files. Results and Conclusion: Results were repeatable and supported the use of this question in similar clinical settings.

Meeting the Best Practice for Hearing Aid Verification in Children: Challenges and Future Directions

2019 ◽  
Vol 28 (4) ◽  
pp. 877-894
Author(s):  
Nur Azyani Amri ◽  
Tian Kar Quar ◽  
Foong Yen Chong
Keyword(s):  
Clinical Practice ◽  
Hearing Aids ◽  
Best Practice ◽  
Hearing Aid ◽  
Evidence Based ◽  
Future Directions ◽  
Major Barrier ◽  
Klang Valley ◽  
Age Range ◽  
Fitting Hearing Aids

Purpose This study examined the current pediatric amplification practice with an emphasis on hearing aid verification using probe microphone measurement (PMM), among audiologists in Klang Valley, Malaysia. Frequency of practice, access to PMM system, practiced protocols, barriers, and perception toward the benefits of PMM were identified through a survey. Method A questionnaire was distributed to and filled in by the audiologists who provided pediatric amplification service in Klang Valley, Malaysia. One hundred eight ( N = 108) audiologists, composed of 90.3% women and 9.7% men (age range: 23–48 years), participated in the survey. Results PMM was not a clinical routine practiced by a majority of the audiologists, despite its recognition as the best clinical practice that should be incorporated into protocols for fitting hearing aids in children. Variations in practice existed warranting further steps to improve the current practice for children with hearing impairment. The lack of access to PMM equipment was 1 major barrier for the audiologists to practice real-ear verification. Practitioners' characteristics such as time constraints, low confidence, and knowledge levels were also identified as barriers that impede the uptake of the evidence-based practice. Conclusions The implementation of PMM in clinical practice remains a challenge to the audiology profession. A knowledge-transfer approach that takes into consideration the barriers and involves effective collaboration or engagement between the knowledge providers and potential stakeholders is required to promote the clinical application of evidence-based best practice.

Comparison of In-the-Ear and Over-the-Ear Hearing Aid Fittings

1986 ◽  
Vol 51 (4) ◽  
pp. 362-369 ◽  
Author(s):  
Donna M. Risberg ◽  
Robyn M. Cox
Keyword(s):  
Hearing Aids ◽  
High Frequency ◽  
Comparative Evaluation ◽  
Speech Intelligibility ◽  
Hearing Aid ◽  
Hearing Aid Fitting ◽  
The Difference ◽  
Functional Gain ◽  
The Relationship

A custom in-the-ear (ITE) hearing aid fitting was compared to two over-the-ear (OTE) hearing aid fittings for each of 9 subjects with mild to moderately severe hearing losses. Speech intelligibility via the three instruments was compared using the Speech Intelligibility Rating (SIR) test. The relationship between functional gain and coupler gain was compared for the ITE and the higher rated OTE instruments. The difference in input received at the microphone locations of the two types of hearing aids was measured for 10 different subjects and compared to the functional gain data. It was concluded that (a) for persons with mild to moderately severe hearing losses, appropriately adjusted custom ITE fittings typically yield speech intelligibility that is equal to the better OTE fitting identified in a comparative evaluation; and (b) gain prescriptions for ITE hearing aids should be adjusted to account for the high-frequency emphasis associated with in-the-concha microphone placement.

scholarly journals Auditory Profile-based Hearing-aid Fitting: A Proof-Of-Concept Study

2020 ◽  
Author(s):  
Raul Sanchez-Lopez ◽  
Michal Fereczkowski ◽  
Sébastien Santurette ◽  
Torsten Dau ◽  
Tobias Neher
Keyword(s):  
Hearing Aids ◽  
Hearing Aid ◽  
Data Driven ◽  
Proof Of Concept ◽  
Hearing Aid Fitting ◽  
Concept Study ◽  
Pure Tone Audiogram ◽  
Comprehensive Test ◽  
Study Support

AbstractObjectiveThe clinical characterization of hearing deficits for hearing-aid fitting purposes is typically based on the pure-tone audiogram only. In a previous study, a group of hearing-impaired listeners were tested using a comprehensive test battery designed to tap into different aspects of hearing. A data-driven analysis of the data yielded four clinically relevant patient subpopulations or “auditory profiles”. In the current study, profile-based hearing-aid settings were proposed and evaluated to explore their potential for providing more targeted hearing-aid treatment.DesignFour candidate hearing-aid settings were implemented and evaluated by a subset of the participants tested previously. The evaluation consisted of multi-comparison preference ratings carried out in realistic sound scenarios.ResultsListeners belonging to the different auditory profiles showed different patterns of preference for the tested hearing-aid settings that were largely consistent with the expectations.ConclusionThe results of this proof-of-concept study support further investigations into stratified, profile-based hearing-aid fitting with wearable hearing aids.

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 Perception of One’s Own Voice After Hearing-Aid Fitting for Naive Hearing-Aid Users and Hearing-Aid Refitting for Experienced Hearing-Aid Users

2020 ◽  
Vol 24 ◽  
pp. 233121652093246
Author(s):  
Johanna Hengen ◽  
Inger L. Hammarström ◽  
Stefan Stenfelt
Keyword(s):  
Hearing Impairment ◽  
Hearing Aids ◽  
Hearing Aid ◽  
Control Group ◽  
Voice Perception ◽  
Hearing Aid Fitting ◽  
Before And After ◽  
Vocal Intensity ◽  
First Time

Dissatisfaction with the sound of one’s own voice is common among hearing-aid users. Little is known regarding how hearing impairment and hearing aids separately affect own-voice perception. This study examined own-voice perception and associated issues before and after a hearing-aid fitting for new hearing-aid users and refitting for experienced users to investigate whether it was possible to differentiate between the effect of (unaided) hearing impairment and hearing aids. Further aims were to investigate whether First-Time and Experienced users as well as users with dome and mold inserts differed in the severity of own-voice problems. The study had a cohort design with three groups: First-Time hearing-aid users going from unaided to aided hearing ( n = 70), Experienced hearing-aid users replacing their old hearing aids ( n = 70), and an unaided control group ( n = 70). The control group was surveyed once and the hearing-aid users twice; once before hearing-aid fitting/refitting and once after. The results demonstrated that own-voice problems are common among both First-Time and Experienced hearing-aid users with either dome- or mold-type fittings, while people with near-normal hearing and not using hearing aids report few problems. Hearing aids increased ratings of own-voice problems among First-Time users, particularly those with mold inserts. The results suggest that altered auditory feedback through unaided hearing impairment or through hearing aids is likely both to change own-voice perception and complicate regulation of vocal intensity, but hearing aids are the primary reason for poor perceived sound quality of one’s own voice.

Do Modern Hearing Aids Meet ANSI Standards?

2016 ◽  
Vol 27 (08) ◽  
pp. 619-627 ◽  
Author(s):  
Jourdan T. Holder ◽  
Erin M. Picou ◽  
Jill M. Gruenwald ◽  
Todd A. Ricketts
Keyword(s):  
Quality Control ◽  
Hearing Aids ◽  
Hearing Aid ◽  
Analysis Data ◽  
National Standards ◽  
Control Measures ◽  
Input Noise ◽  
Release Times ◽  
Quality Control Testing ◽  
Equivalent Input Noise

Background: The American National Standards Institute (ANSI) provides standards used to govern standardization of all hearing aids. If hearing aids do not meet specifications, there are potential negative implications for hearing aid users, professionals, and the industry. Recent literature has not investigated the proportion of new hearing aids in compliance with the ANSI specifications for quality control standards when they arrive in the clinic before dispensing. Purpose: The aims of this study were to determine the percentage of new hearing aids compliant with the relevant ANSI standard and to report trends in electroacoustic analysis data. Research Design: New hearing aids were evaluated for quality control via the ANSI S3.22-2009 standard. In addition, quality control of directional processing was also assessed. Study Sample: Seventy-three behind-the-ear hearing aids from four major manufacturers, that were purchased for clinical patients were evaluated before dispensing. Data Collection and Analysis: Audioscan Verifit (version 3.1) hearing instrument fitting system was used to complete electroacoustic analysis and directional processing evaluation of the hearing aids. Frye’s Fonix 8000 test box system (Fonix 8000) was also used to cross-check equivalent input noise (EIN) measurements. These measurements were then analyzed for trends across brands and specifications. Results: All of the hearing aids evaluated were found to be out of specification for at least one measure. EIN and attack and release times were the measures most frequently out of specification. EIN was found to be affected by test box isolation for two of the four brands tested. Systematic discrepancies accounted for ˜93% of the noncompliance issues, while unsystematic quality control issues accounted for the remaining 7%. Conclusions: The high number of systematic discrepancies between the data collected and the specifications published by the manufacturers suggests there are clear issues related to the specific protocols used for quality control testing. These issues present a significant barrier for hearing aid dispensers when attempting to accurately determine if a hearing aid is functioning appropriately. The significant number of unsystematic discrepancies supports the continued importance of quality control measures of new and repaired hearing aids to ensure that the device is functioning properly before it is dispensed and to avoid future negative implications of fitting a faulty device.

Long-term complications of bone-anchored hearing aids: a 14-year experience

2008 ◽  
Vol 123 (2) ◽  
pp. 170-176 ◽  
Author(s):  
K Badran ◽  
A K Arya ◽  
D Bunstone ◽  
N Mackinnon
Keyword(s):  
Hearing Aids ◽  
Revision Surgery ◽  
Hearing Aid ◽  
Retrospective Case ◽  
Tertiary Referral Centre ◽  
Skin Reactions ◽  
Operative Complications ◽  
Adults And Children ◽  
Bone Anchored Hearing Aid

AbstractObjectives:To report cases of long-term surgical complications, implant failure and revision surgery, within a large bone-anchored hearing aid programme.Study design:Retrospective, case–cohort study.Setting:Tertiary referral centre.Patients:One hundred and sixty-five adults and children who had undergone a total of 177 bone-anchored hearing aid implantations.Intervention:Diagnosis and explanation of adverse events and device failure.Main outcome measures:Operative complications and survival analysis, surgical challenges related to revisions, and causes of failure.Results:Twenty-one per cent of patients (3.4 per cent of those observed) suffered from skin reactions; this rate did not increase over time. Seventeen per cent had loss of osseointegration at a median interval of 6.3 months. Loss of osseointegration was observed more frequently in patients with a 3 mm compared with a 4 mm fixture (p < 0.001). Intra-operatively, the only complication was bleeding, occurring in 3 per cent of patients. Post-operative complications included: primary bleeding (2 per cent); severe skin reactions requiring intravenous antibiotics, cautery or grafting (8 per cent); thickening or overgrowth of skin requiring excision (8 per cent); failure of osseointegration requiring a new fixture (18 per cent); and graft necrosis requiring revision (1 per cent). In two patients, it was necessary to explore the area to remove overgrowth of bone. In 16 patients (10 per cent), the bone-anchored hearing aid had to be abandoned due to failure of osseointegration (n = 4), dissatisfaction with the aid (n = 6), intolerable pain (n = 4), hair growth around the abutment (n = 1) or recurrent infections (n = 1). In 12 of these patients, the bone-anchored hearing aid was removed surgically. Overall, 57 patients (34 per cent) underwent revision surgery.Conclusion:Awareness of complications is becoming increasingly important in bone-anchored hearing aid programme. A substantial workload of device maintenance should be anticipated, and patients should be appropriately counselled beforehand. Ninety per cent of our patients chose to persevere with this form of hearing rehabilitation.

Can audiometric results predict qualitative hearing improvements in bone-anchored hearing aid recipients?

2013 ◽  
Vol 128 (1) ◽  
pp. 35-42
Author(s):  
M L McNeil ◽  
M Gulliver ◽  
D P Morris ◽  
F M Makki ◽  
M Bance
Keyword(s):  
Pure Tone ◽  
Hearing Aid ◽  
Subjective Evaluation ◽  
Bone Conduction ◽  
Hearing Threshold ◽  
Sound Field ◽  
Hearing Aid Fitting ◽  
Pure Tone Average ◽  
Hearing Handicap ◽  
Bone Anchored Hearing Aid

AbstractIntroduction:Patients receiving a bone-anchored hearing aid have well-documented improvements in their quality of life and audiometric performance. However, the relationship between audiometric measurements and subjective improvement is not well understood.Methods:Adult patients enrolled in the Nova Scotia bone-anchored hearing aid programme were identified. The pure tone average for fitting the sound-field threshold, as well as the better and worse hearing ear bone conduction and air conduction levels, were collected pre-operatively. Recipients were asked to complete the Speech, Spatial and Qualities of Hearing questionnaire; their partners were asked to complete a pre- and post-bone anchored hearing aid fitting Hearing Handicap Inventory for Adults questionnaire.Results:Forty-eight patients who completed and returned the Speech, Spatial and Qualities of Hearing questionnaire had partners who completed the Hearing Handicap Inventory for Adults questionnaire. The results from the Speech, Spatial and Qualities of Hearing questionnaire correlated with the sound-field hearing threshold post-bone-anchored hearing aid fitting and the pure tone average of the better hearing ear bone conduction (total Speech, Spatial and Qualities of Hearing Scale to the pre-operative better hearing ear air curve (r = 0.3); worse hearing ear air curve (r = 0.27); post-operative, bone-anchored hearing aid-aided sound-field thresholds (r = 0.35)). An improvement in sound-field threshold correlated only with spatial abilities. In the Hearing Handicap Inventory for Adults questionnaire, there was no correlation between the subjective evaluation of each patient and their partner.Conclusion:The subjective impressions of hearing aid recipients with regards to speech reception and the spatial qualities of hearing correlate well with pre-operative audiometric results. However, the overall magnitude of sound-field improvement predicts an improvement of spatial perception, but not other aspects of hearing, resulting in hearing aid recipients having strongly disparate subjective impressions when compared to those of their partners.

Large Vestibular Aqueduct Syndrome: A Case Study

2005 ◽  
Vol 16 (10) ◽  
pp. 822-828 ◽  
Author(s):  
Jackie L. Clark ◽  
Ross J. Roeser
Keyword(s):  
Hearing Loss ◽  
Hearing Aids ◽  
Hearing Aid ◽  
Behavioral Testing ◽  
Hearing Aid Fitting ◽  
Hearing Sensitivity ◽  
Vestibular Aqueduct ◽  
Brainstem Response ◽  
Large Vestibular Aqueduct Syndrome ◽  
Large Vestibular Aqueduct

A 23-month-old female was referred for hearing aid fitting after failing newborn hearing screening and being diagnosed with significant hearing loss through subsequent diagnostic testing. Auditory brainstem response (ABR) and behavioral testing revealed a moderate-to-severe bilateral mixed hearing loss. Prior to the hearing aid evaluation, tympanostomy tubes had been placed bilaterally with little or no apparent change in hearing sensitivity. Initial testing during the hearing aid fitting confirmed earlier findings, but abnormal middle ear results were observed, requiring referral for additional otologic management. Following medical clearance, binaural digital programmable hearing aids were fit using Desired Sensation Level parameters. Behavioral testing and probe microphone measures showed significant improvements in audibility. Decrease in hearing sensitivity was observed six months following hearing aid fitting. Radiological studies, ordered due to the mixed component and decreased hearing sensitivity, revealed large vestibular aqueduct syndrome (LVAS). Based on the diagnosis of LVAS, a cochlear implant was placed on the right ear; almost immediate speech-language gains were observed.

Sign in / Sign up

Export Citation Format

Share Document