Open-Fit Domes and Children with Bilateral High-Frequency Sensorineural Hearing Loss: Benefits and Outcomes

2018 ◽  
Vol 29 (04) ◽  
pp. 348-356 ◽  
Author(s):  
Patti M. Johnstone ◽  
Kelly R. Yeager ◽  
Marnie L. Pomeroy ◽  
Nicole Hawk
Keyword(s):  
Hearing Loss ◽  
Experimental Design ◽  
Sound Localization ◽  
Hearing Aids ◽  
High Frequency ◽  
Repeated Measures ◽  
Age Groups ◽  
Localization Error ◽  
Older Children ◽  
Localization Accuracy

AbstractOpen-fit domes (OFDs) coupled with behind-the-ear (BTE) hearing aids were designed for adult listeners with moderate-to-severe bilateral high-frequency hearing loss (BHFL) with little to no concurrent loss in the lower frequencies. Adult research shows that BHFL degrades sound localization accuracy (SLA) and that BTE hearing aids with conventional earmolds (CEs) make matters worse. In contrast, research has shown that OFDs enhance spatial hearing percepts in adults with BHFL. Although the benefits of OFDs have been studied in adults with BHFL, no published studies to date have investigated the use of OFDs in children with the same hearing loss configuration. This study seeks to use SLA measurements to assess efficacy of bilateral OFDs in children with BHFL.To measure SLA in children with BHFL to determine the extent to which hearing loss, age, duration of CE use, and OFDs affect localization accuracy.A within-participant experimental design using repeated measures was used to determine the effect of OFDs on localization accuracy in children with BHFL. A between-participant experimental design was used to compare localization accuracy between children with BHFL and age-matched controls with normal hearing (NH).Eighteen children with BHFL who used CE and 18 age-matched NH controls. Children in both groups were divided into two age groups: older children (10–16 yr) and younger children (6–9 yr).All testing was done in a sound-treated booth with a horizontal array of 15 loudspeakers (radius of 1 m). The stimulus was a spondee word, “baseball”: the level averaged 60 dB SPL and randomly roved (±8 dB). Each child was asked to identify the location of a sound source. Localization error was calculated across the loudspeaker array for each listening condition.A significant interaction was found between immediate benefit from OFD and duration of CE usage. Longer CE usage was associated with degraded localization accuracy using OFDs. Regardless of chronological age, children who had used CEs for <6 yr showed immediate localization benefit using OFDs, whereas children who had used CEs for >6 yr showed immediate localization interference using OFDs. Development, however, may play a role in SLA in children with BHFL. When unaided, older children had significantly better localization acuity than younger children with BHFL. When compared to age-matched controls, children with BHFL of all ages showed greater localization error. Nearly all (94% [17/18]) children with BHFL spontaneously reported immediate own-voice improvement when using OFDs.OFDs can provide sound localization benefit to younger children with BHFL. However, immediate benefit from OFDs is reduced by prolonged use of CEs. Although developmental factors may play a role in improving localization abilities over time, children with BHFL will rarely equal that of peers without early use of minimally disruptive hearing aid technology. Also, the occlusion effect likely impacts children far more than currently thought.

Sound Localization Acuity in Children with Unilateral Hearing Loss Who Wear a Hearing Aid in the Impaired Ear

2010 ◽  
Vol 21 (08) ◽  
pp. 522-534 ◽  
Author(s):  
Patti M. Johnstone ◽  
Anna K. Náblek ◽  
Velma S. Robertson
Keyword(s):  
Hearing Loss ◽  
Early Intervention ◽  
Experimental Design ◽  
Sound Localization ◽  
Repeated Measures ◽  
Hearing Aid ◽  
Binaural Hearing ◽  
Normal Hearing ◽  
Unilateral Hearing Loss ◽  
Older Children

Background: Disrupted binaural hearing is thought to contribute in part to the academic, social, and communication problems often associated with unilateral hearing loss (UHL) in childhood. It is not known, however, if putting a hearing aid in the impaired ear of a child with UHL will lead to bilateral or binaural benefit. This study seeks to utilize sound localization acuity measurements to assess hearing aid amplification efficacy in children with UHL. Purpose: To measure sound localization ability in children with UHL who use a hearing aid in the impaired ear to determine the extent to which amplification, age, early intervention, and degree of hearing loss affects localization acuity. Research Design: A within-subjects experimental design using repeated measures is used to determine the effect of amplification on localization acuity in children with UHL. A between-subjects experimental design is used to compare localization acuity between children with UHL and age-matched controls with normal hearing. Study Sample: Twelve children with UHL who used a hearing aid in the impaired ear and 12 age-matched controls with normal hearing. Children with UHL were divided into two groups based on degree of hearing loss. Children in both groups were divided into two age groups: older children (10–14 yr) and younger children (6–9 yr). Data Collection and Analysis: All testing was done in a sound-treated booth with a horizontal array of 15 loudspeakers (radius of 1 m). The stimulus was a spondee word, “baseball”: the level averaged 60 dB SPL and randomly roved (±8 dB). Each child was asked to identify the location of a sound source. Results: In the experimental study a significant interaction was found between hearing aid amplification and child age. A hearing aid significantly improved localization acuity in younger children with UHL and significantly impaired localization acuity in older children. A significant correlation was found between age at intervention and localization bilateral benefit. Children who were fit earlier showed bilateral benefit whereas children who were fit later showed bilateral interference. Development, however, may play a role in sound localization acuity. When unaided, older children had significantly better localization acuity than younger children with UHL. Conclusions: A hearing aid can provide bilateral localization benefit to some children with UHL. Early intervention may increase the likelihood of bilateral benefit. However, developmental factors appear to play a role in improving localization abilities over time for children with UHL. Nonetheless, without a means of establishing bilateral benefit with hearing aid amplification, localization performance in children with UHL will rarely equal that of peers.

Evaluation of Wideband Frequency Responses and Nonlinear Frequency Compression for Children with Cookie-Bite Audiometric Configurations

2014 ◽  
Vol 25 (10) ◽  
pp. 1022-1033 ◽  
Author(s):  
Andrew John ◽  
Jace Wolfe ◽  
Susan Scollie ◽  
Erin Schafer ◽  
Mary Hudson ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Speech Recognition ◽  
Hearing Aids ◽  
High Frequency ◽  
Repeated Measures ◽  
Nonsense Syllable ◽  
Nonlinear Frequency ◽  
Frequency Compression ◽  
Sentence Recognition ◽  
Phoneme Perception

Background: Previous research has suggested that use of nonlinear frequency compression (NLFC) can improve audibility for high-frequency sounds and speech recognition of children with moderate to profound high-frequency hearing loss. Furthermore, previous studies have generally found no detriment associated with the use of NLFC. However, there have been no published studies examining the effect of NLFC on the performance of children with cookie-bite audiometric configurations. For this configuration of hearing loss, frequency-lowering processing will likely move high-frequency sounds to a lower frequency range at which a greater degree of hearing loss exists. Purpose: The purpose of this study was to evaluate and compare the effects of wideband amplification and NLFC on high-frequency audibility and speech recognition of children with cookie-bite audiometric configurations. Research Design: This study consisted of a within-participant design with repeated measures across test conditions. Study Sample: Seven children, ages 6–13 yr, with cookie-bite audiometric configurations and normal hearing or mild hearing loss at 6000 and 8000 Hz, were recruited. Intervention: Participants were fitted with Phonak Nios S H2O III behind-the-ear hearing aids and Oticon Safari 300 behind-the-ear hearing aids. Data Collection: The participants were evaluated after three 4-to 6-wk intervals: (1) Phonak Nios S H2O III without NLFC, (2) Phonak Nios S H2O III with NLFC, and (3) Oticon Safari 300 with wideband frequency response extending to 8000 Hz. The order in which each technology was used was counterbalanced across participants. High-frequency audibility was evaluated by assessing aided thresholds (dB SPL) for warble tones and the high-frequency phonemes /sh/ and /s/. Speech recognition in quiet was measured with the University of Western Ontario (UWO) Plurals Test, the UWO Distinctive Features Difference (DFD) Test, and the Phoneme Perception Test vowel-consonant-vowel nonsense syllable test. Sentence recognition in noise was evaluated with the Bamford-Kowal-Bench Speech-In-Noise (BKB-SIN) Test. Analysis: Repeated-measures analyses of variance were used to analyze the data collected in this study. The results across the three different conditions were compared. Results: No difference in performance across conditions was observed for detection of high-frequency warble tones and the speech sounds /sh/ and /s/. No significant difference was seen across conditions for speech recognition in quiet when measured with the UWO Plurals Test, the UWO-DFD Test, and the Phoneme Perception Test vowel-consonant-vowel nonsense syllable test. Finally, there were also no differences across conditions on the BKB-SIN Test. Conclusions: These results suggest that NLFC does not degrade or improve audibility for and recognition of high-frequency speech sounds as well as sentence recognition in noise when compared with wideband amplification for children with cookie-bite audiometric configurations.

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.

Measurements of Loudness Growth in 1/2-Octave Bands for Children and Adults With Normal Hearing

1999 ◽  
Vol 8 (1) ◽  
pp. 40-46 ◽  
Author(s):  
Melisa R. Ellis ◽  
Michael K. Wynne
Keyword(s):  
Hearing Loss ◽  
Hearing Aids ◽  
Hearing Aid ◽  
Age Groups ◽  
Lower Boundary ◽  
Normal Hearing ◽  
Boundary Values ◽  
Simple Modification ◽  
Point Data ◽  
Loudness Growth

The loudness growth in 1/2-octave bands (LGOB) procedure has been shown previously to provide valid estimates of loudness growth for adults with normal hearing and those with hearing loss (Allen, Hall, & Jeng, 1990), and it has been widely incorporated into fitting strategies for adult hearing aid users by a hearing aid manufacturer. Here, we applied a simple modification of LGOB to children and adults with normal hearing and then compared the loudness growth functions (as obtained from end-point data) between the two age groups. In addition, reliability data obtained within a single session and between test sessions were compared between the two groups. Large differences were observed in the means between the two groups for the lower boundary values, the upper boundary values, and the range between boundaries both within and across all frequencies. The data obtained from children also had greater variance than the adult data. In addition, there was more variability in the data across test sessions for children. Many test-retest differences for children exceeded 10 dB. Adult test-retest differences were generally less than 10 dB. Although the LGOB with the modifications used in this study may be used to measure loudness growth in children, its poor reliability with this age group may limit its clinical use for children with hearing loss. Additional work is needed to explore whether loudness growth measures can be adapted successfully to children and whether these measures contribute worthwhile information for fitting hearing aids to children.

Otologics Fully Implantable Hearing Device Phase II Results

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P57-P57
Author(s):  
Drew M Horlbeck ◽  
Herman A Jenkins ◽  
Ben J Balough ◽  
Michael E Hoffer
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Phase Ii ◽  
Hearing Aids ◽  
Repeated Measures ◽  
Pure Tone ◽  
Sound Field ◽  
Sensorineural Hearing ◽  
Significant Difference ◽  
Hearing Device

Objective The efficacy of the Otologics Fully Implantable Hearing Device (MET) was assessed in adult patients with bilateral moderate to severe sensorineural hearing loss. Methods Surgical insertion of this totally implanted system was identical to the Phase I study. A repeated-measures within-subjects design assessed aided sound field thresholds and speech performances with the subject's own, appropriately fit, walk-in hearing aid(s) and the Otologics Fully Implantable Hearing Device. Results Six- and 12-month Phase II data will be presented. Ten patients were implanted and activated as part Phase II clinical trial. Three patients were lost to long term follow-up due to two coil failures and one ossicular abnormality preventing proper device placement. No significant differences between preoperative (AC = 59 dB, BC = 55 dB) and postoperative (AC = 61 dB, BC = 54 dB) unaided pure tone averages were noted (p < 0.05). Pure tone average implant aided thresholds (41 dB) were equivalent to that of walk-in-aided (37 dB) condition with no significant difference (p < 0.05) between patients’ walk-in-aided individual frequency thresholds and implant-aided thresholds. Word recognition scores and hearing in noise scores were similar between the walk-in-aided and for the implant-aided condition. Patient benefit scales will be presented at all end points. Conclusions Results of the Otologics MET Fully Implantable Hearing Device Phase II trial provide evidence that this fully implantable device is a viable alternative to currently available hearing aids in patients with sensorineural hearing loss.

Cochlear Implantation in Children with Postlingual Progressive Steeply Sloping High-Frequency Hearing Loss

2017 ◽  
Vol 28 (10) ◽  
pp. 913-919 ◽  
Author(s):  
Margaret A. Meredith ◽  
Jay T. Rubinstein ◽  
Kathleen C. Y. Sie ◽  
Susan J. Norton
Keyword(s):  
Hearing Loss ◽  
Speech Perception ◽  
Hearing Aids ◽  
Cochlear Implantation ◽  
High Frequency ◽  
Case Series ◽  
Hearing Preservation ◽  
Rapid Improvement ◽  
Retrospective Case ◽  
Monosyllabic Word

Background: Children with steeply sloping sensorineural hearing loss (SNHL) lack access to critical high-frequency cues despite the use of advanced hearing aid technology. In addition, their auditory-only aided speech perception abilities often meet Food and Drug Administration criteria for cochlear implantation. Purpose: The objective of this study was to describe hearing preservation and speech perception outcomes in a group of young children with steeply sloping SNHL who received a cochlear implant (CI). Research Design: Retrospective case series. Study Sample: Eight children with steeply sloping postlingual progressive SNHL who received a unilateral traditional CI at Seattle Children’s Hospital between 2009 and 2013 and had follow-up data available up to 24 mo postimplant were included. Data Collection and Analysis: A retrospective chart review was completed. Medical records were reviewed for demographic information, preoperative and postoperative behavioral hearing thresholds, and speech perception scores. Paired t tests were used to analyze speech perception data. Hearing preservation results are reported. Results: Rapid improvement of speech perception scores was observed within the first month postimplant for all participants. Mean monosyllabic word scores were 76% and mean phoneme scores were 86.7% at 1-mo postactivation compared to mean preimplant scores of 19.5% and 31.0%, respectively. Hearing preservation was observed in five participants out to 24-mo postactivation. Two participants lost hearing in both the implanted and unimplanted ear, and received a sequential bilateral CI in the other ear after progression of the hearing loss. One participant had a total loss of hearing in only the implanted ear. Results reported in this article are from the ear implanted first. Bilateral outcomes are not reported. Conclusions: CIs provided benefit for children with steeply sloping bilateral hearing loss for whom hearing aids did not provide adequate auditory access. In our cohort, significant improvements in speech understanding occurred rapidly postactivation. Preservation of residual hearing in children with a traditional CI electrode is possible.

scholarly journals Real-World Performance of a Reverse-Horn Vent

2005 ◽  
Vol 16 (09) ◽  
pp. 653-661
Author(s):  
Francis Kuk ◽  
Denise Keenan ◽  
Chi-Chuen Lau ◽  
Nick Dinulescu ◽  
Richard Cortez ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Hearing Aids ◽  
High Frequency ◽  
Objective Measures ◽  
Subjective Ratings ◽  
High Frequency Hearing Loss ◽  
Speech In Noise ◽  
Objective Performance ◽  
Occlusion Effect

The present study compared differences in subjective and objective performance in completely-in-the-canal (CIC) hearing aids with conventional uniform 1.5 mm parallel vents and another with a reverse horn vent where the diameter increased from 1.5 mm on the lateral faceplate to 3 mm on the medial opening of the hearing aid. Nine hearing-impaired persons with a high-frequency hearing loss participated. The test battery included unaided in situ thresholds, amount of available gain before feedback, speech in quiet, speech in noise (HINT), subjective ratings of hollowness and tolerance, objective measures of the occlusion effect, and real-ear aided response. Results showed less available gain before feedback but less occlusion effect for subjective ratings and objective measures with the reverse horn vent. This type of vent design may be useful to increase the effective vent diameter of custom (including CIC) hearing aids.

Tinnitus Suppression Effect of Hearing Aids in Patients With High-frequency Hearing Loss

2019 ◽  
Vol 40 (7) ◽  
pp. 865-871 ◽  
Author(s):  
Natalia Yakunina ◽  
Woo Hyun Lee ◽  
Yoon-Jong Ryu ◽  
Eui-Cheol Nam
Keyword(s):  
Hearing Loss ◽  
Hearing Aids ◽  
High Frequency ◽  
High Frequency Hearing Loss ◽  
Suppression Effect

scholarly journals Hearing threshold levels and hearing loss among people in Zhejiang, China: a population-based cross-sectional study

BMJ Open ◽  
2019 ◽  
Vol 9 (4) ◽  
pp. e027152 ◽  
Author(s):  
Dahui Wang ◽  
Huai Zhang ◽  
Haiyan Ma ◽  
Long Zhang ◽  
Lei Yang ◽  
...  
Keyword(s):  
Hearing Loss ◽  
High Frequency ◽  
Age Groups ◽  
Hearing Threshold ◽  
Population Based ◽  
Cross Sectional Study ◽  
Zhejiang Province ◽  
Sectional Study ◽  
Cross Sectional ◽  
High Frequency Hearing Loss

Hearing loss (≥26 dB threshold in the better ear), as a common chronic condition in humans, is increasingly gaining attention. Relevant research in China is relatively scarce, so we conduct a population-based study to investigate the prevalence of hearing loss among age groups, genders and ears in Zhejiang province, China, from September 2016 to June 2018.Study designPopulation-based cross-sectional studyParticipantsA total of 3754 participants aged 18–98 years and living in Zhejiang province, China.Outcome measuresPure-tone audiometric thresholds were measured at frequencies of 0.125–8 kHz for each subject. All participants were asked to complete a structured questionnaire, in the presence of a healthcare official.ResultsThe prevalence of speech-frequency and high-frequency hearing loss was 27.9% and 42.9%, respectively, in Zhejiang. There were significant differences in auditory thresholds at most frequencies among the age groups, genders (male vs female: 31.6%vs24.1% at speech frequency; 48.9% vs 36.8% at high frequency) and ears. In addition to the common factors affecting both types of hearing loss, a significant correlation was found between personal income and speech-frequency hearing loss (OR=0.69, 95% CI 0.52 to 0.92), and between hyperlipidaemia and high-frequency hearing loss (OR=1.45, 95% CI 1.02 to 2.07).ConclusionThe prevalence of hearing loss was high among people living in Zhejiang, particularly males, and in the left ear. Moreover, hearing thresholds increased with age. Several lifestyle and environment factors, which can be influenced by awareness and education, were significantly associated with hearing loss.

scholarly journals Listener Performance with a Novel Hearing Aid Frequency Lowering Technique

2017 ◽  
Vol 28 (09) ◽  
pp. 810-822 ◽  
Author(s):  
Benjamin J. Kirby ◽  
Judy G. Kopun ◽  
Meredith Spratford ◽  
Clairissa M. Mollak ◽  
Marc A. Brennan ◽  
...  
Keyword(s):  
Signal Processing ◽  
Hearing Loss ◽  
Speech Perception ◽  
Hearing Aids ◽  
High Frequency ◽  
Hearing Aid ◽  
Sound Quality ◽  
Processing Strategy ◽  
Listening Effort ◽  
At Home

AbstractSloping hearing loss imposes limits on audibility for high-frequency sounds in many hearing aid users. Signal processing algorithms that shift high-frequency sounds to lower frequencies have been introduced in hearing aids to address this challenge by improving audibility of high-frequency sounds.This study examined speech perception performance, listening effort, and subjective sound quality ratings with conventional hearing aid processing and a new frequency-lowering signal processing strategy called frequency composition (FC) in adults and children.Participants wore the study hearing aids in two signal processing conditions (conventional processing versus FC) at an initial laboratory visit and subsequently at home during two approximately six-week long trials, with the order of conditions counterbalanced across individuals in a double-blind paradigm.Children (N = 12, 7 females, mean age in years = 12.0, SD = 3.0) and adults (N = 12, 6 females, mean age in years = 56.2, SD = 17.6) with bilateral sensorineural hearing loss who were full-time hearing aid users.Individual performance with each type of processing was assessed using speech perception tasks, a measure of listening effort, and subjective sound quality surveys at an initial visit. At the conclusion of each subsequent at-home trial, participants were retested in the laboratory. Linear mixed effects analyses were completed for each outcome measure with signal processing condition, age group, visit (prehome versus posthome trial), and measures of aided audibility as predictors.Overall, there were few significant differences in speech perception, listening effort, or subjective sound quality between FC and conventional processing, effects of listener age, or longitudinal changes in performance. Listeners preferred FC to conventional processing on one of six subjective sound quality metrics. Better speech perception performance was consistently related to higher aided audibility.These results indicate that when high-frequency speech sounds are made audible with conventional processing, speech recognition ability and listening effort are similar between conventional processing and FC. Despite the lack of benefit to speech perception, some listeners still preferred FC, suggesting that qualitative measures should be considered when evaluating candidacy for this signal processing strategy.

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