Comparing the Effect of Different Hearing Aid Fitting Methods in Bimodal Cochlear Implant Users

2019 ◽  
Vol 28 (1) ◽  
pp. 1-10 ◽  
Author(s):  
Jantien L. Vroegop ◽  
J. Gertjan Dingemanse ◽  
Marc P. van der Schroeff ◽  
André Goedegebure
Keyword(s):  
Cochlear Implant ◽  
Sound Localization ◽  
Hearing Aid ◽  
Hearing Aid Fitting ◽  
Speech In Noise ◽  
Localization Test ◽  
Fitting Procedures ◽  
Auditory Performance ◽  
Contralateral Ear ◽  
Noise Test

PurposeThe aim of the study was to investigate the effect of 3 hearing aid fitting procedures on provided gain of the hearing aid in bimodal cochlear implant users and their effect on bimodal benefit.MethodThis prospective study measured hearing aid gain and auditory performance in a cross-over design in which 3 hearing aid fitting methods were compared. Hearing aid fitting methods differed in initial gain prescription rule (NAL-NL2 and Audiogram+) and loudness balancing method (broadband vs. narrowband loudness balancing). Auditory functioning was evaluated by a speech-in-quiet test, a speech-in-noise test, and a sound localization test. Fourteen postlingually deafened adult bimodal cochlear implant users participated in the study.ResultsNo differences in provided gain and in bimodal performance were found for the different hearing aid fittings. For all hearing aid fittings, a bimodal benefit was found for speech in noise and sound localization.ConclusionOur results confirm that cochlear implant users with residual hearing in the contralateral ear substantially benefit from bimodal stimulation. However, on average, no differences were found between different types of fitting methods, varying in prescription rule and loudness balancing method.

Short-Term and Long-Term Hearing Aid Benefit and User Satisfaction: A Comparison between Two Fitting Protocols

2007 ◽  
Vol 18 (06) ◽  
pp. 482-495 ◽  
Author(s):  
Lu-Feng Shi ◽  
Karen A. Doherty ◽  
Tammy M. Kordas ◽  
Joseph T. Pellegrino
Keyword(s):  
Hearing Aids ◽  
User Satisfaction ◽  
Daily Life ◽  
Hearing Aid ◽  
Short Term ◽  
Hearing Aid Fitting ◽  
Speech In Noise ◽  
Noise Test ◽  
Hearing Aid Benefit

Currently published hearing aid fitting protocols recommend speech-in-noise testing and loudness measures, but it remains unclear how these measures affect hearing aid benefit and user satisfaction. This study compared two protocols in their effects on benefit and satisfaction. Protocol A included an electroacoustic analysis, real-ear measures, and hearing aid adjustments based on users' comments. Protocol B included all of Protocol A and a speech-in-noise test, loudness discomfort levels, and aided loudness. Thirty-two participants completed the Abbreviated Profile of Hearing Aid Benefit (APHAB) and the Satisfaction with Amplification in Daily Life (SADL) at 45 days and three months post–initial fitting. Fewer hearing aid adjustments were made to the hearing aids for participants fitted with Protocol B than participants fitted with Protocol A, but final gains were similar for both groups. Although similar APHAB scores were obtained for both protocols, SADL scores decreased between 45 days and three months for Protocol A. Los protocoles de amplificación de auxiliares auditivo actualmente publicados recomiendan pruebas de lenguaje en ruido y mediciones de apreciación subjetiva de la intensidad (sonoridad), pero no está claro cómo estas mediciones afectan el beneficio de un auxiliar auditivo y la satisfacción del usuario. El estudio comparó dos protocolos en cuanto a sus efectos sobre beneficio y satisfacción. El Protocolo A incluyó un análisis electroacústico, mediciones de oído real y ajuste en el auxiliar auditivo basados en los comentarios del usuario. El Protocolo B incluyó todas las pruebas del Protocolo A, además de una prueba de audición en ruido, de niveles de molestia en la apreciación subjetiva de la intensidad y de sonoridad amplificada. Treinta y dos participantes completaron el Perfil Abreviado de Beneficio del Auxiliar Auditivo (APHAB) y la prueba de Satisfacción con la Amplificación en la Vida Diaria (SADL) a los 45 días y a los tres meses de la adaptación inicial. Tuvieron que hacerse menos ajustes en el audífono en los auxiliares auditivos de participantes adaptados con el Protocolo B, que en los participantes adaptados con el Protocolo A, pero las ganancias finales fueron similares en ambos grupos. Aunque se obtuvieron puntajes APHAB similares en ambos protocolos, los puntajes SADL disminuyeron entre los 45 días y los tres meses para el Protocolo A.

scholarly journals A Literature Review of Bimodal Fitting

2020 ◽  
Vol 16 (4) ◽  
pp. 265-275
Author(s):  
Junghwa Bahng ◽  
Soo Hee Oh
Keyword(s):  
Cochlear Implant ◽  
Frequency Band ◽  
Hearing Aid ◽  
Low Frequency ◽  
Balance Test ◽  
Band Frequency ◽  
Hearing Aid Fitting ◽  
Fitting Procedures ◽  
Band Adjustment ◽  
Bimodal Hearing

Although there are quite a few bimodal cochlear implant users, bimodal fitting guidelines were not fully developed. Bimodal fitting optimization is one of the factors that contribute to successful bimodal outcomes. The purpose of this study is to investigate recent literatures related to bimodal fitting to establish evidence based bimodal fitting guidelines. Three databases including Google Scholar, PubMed publisher, and PLOS One were searched to review bimodal fitting literatures. A total of 599,604 articles were identified by using ten bimodal relevant keywords at the initial stage. Then, we included 192 articles with abstract review, inclusion and exclusion criteria and removals of duplicates. Lastly, two authors reviewed full texts and identified a total of 19 bimodal fitting articles. Results were categorized into type of bimodal intervention, procedures, and outcomes. Bimodal fitting procedures, test materials, and questionnaires were also summarized. A total of 18 articles consist of bimodal hearing aid fitting covering hearing aid fitting formula, gain adjustment, loudness balance, frequency band, frequency lowering technology, and overall bimodal fitting guidelines. Only one article includes bimodal cochlear implant fitting with low frequency band adjustment. Several factors including real-ear measurement, loudness balance test, frequency band selection considering cochlear dead region, and subjective questionnaires are considered to optimize bimodal hearing aid fitting. Bimodal fitting guidelines considering several relevant factors will optimize bimodal fitting and improve bimodal benefits.

Can Behavioral Speech-In-Noise Tests Improve the Quality of Hearing Aid Fittings?

2011 ◽  
Vol 7 (1) ◽  
pp. 8-14
Author(s):  
Robert Moore ◽  
Susan Gordon-Hickey
Keyword(s):  
Working Memory ◽  
Speech Perception ◽  
Performance Test ◽  
Hearing Aid ◽  
Speech Perception In Noise ◽  
Speech In Noise ◽  
Acceptable Noise Level ◽  
Perceptual Performance ◽  
Noise Test

The purpose of this article is to propose 4 dimensions for consideration in hearing aid fittings and 4 tests to evaluate those dimensions. The 4 dimensions and tests are (a) working memory, evaluated by the Revised Speech Perception in Noise test (Bilger, Nuetzel, & Rabinowitz, 1984); (b) performance in noise, evaluated by the Quick Speech in Noise test (QSIN; Killion, Niquette, Gudmundsen, Revit, & Banerjee, 2004); (c) acceptance of noise, evaluated by the Acceptable Noise Level test (ANL; Nabelek, Tucker, & Letowski, 1991); and (d) performance versus perception, evaluated by the Perceptual–Performance test (PPT; Saunders & Cienkowski, 2002). The authors discuss the 4 dimensions and tests in the context of improving the quality of hearing aid fittings.

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.

Amount of Frequency Compression in Bimodal Cochlear Implant Users Is a Poor Predictor for Audibility and Spatial Hearing

2021 ◽  
pp. 1-14
Author(s):  
Snandan Sharma ◽  
Waldo Nogueira ◽  
A. John van Opstal ◽  
Josef Chalupper ◽  
Lucas H. M. Mens ◽  
...  
Keyword(s):  
Speech Recognition ◽  
Cochlear Implant ◽  
Sound Localization ◽  
High Frequency ◽  
Hearing Aid ◽  
Spatial Hearing ◽  
Meaningful Improvement ◽  
Frequency Compression ◽  
Knee Point ◽  
Localization Performance

Purpose Speech understanding in noise and horizontal sound localization is poor in most cochlear implant (CI) users with a hearing aid (bimodal stimulation). This study investigated the effect of static and less-extreme adaptive frequency compression in hearing aids on spatial hearing. By means of frequency compression, we aimed to restore high-frequency audibility, and thus improve sound localization and spatial speech recognition. Method Sound-detection thresholds, sound localization, and spatial speech recognition were measured in eight bimodal CI users, with and without frequency compression. We tested two compression algorithms: a static algorithm, which compressed frequencies beyond the compression knee point (160 or 480 Hz), and an adaptive algorithm, which aimed to compress only consonants leaving vowels unaffected (adaptive knee-point frequencies from 736 to 2946 Hz). Results Compression yielded a strong audibility benefit (high-frequency thresholds improved by 40 and 24 dB for static and adaptive compression, respectively), no meaningful improvement in localization performance (errors remained > 30 deg), and spatial speech recognition across all participants. Localization biases without compression (toward the hearing-aid and implant side for low- and high-frequency sounds, respectively) disappeared or reversed with compression. The audibility benefits provided to each bimodal user partially explained any individual improvements in localization performance; shifts in bias; and, for six out of eight participants, benefits in spatial speech recognition. Conclusions We speculate that limiting factors such as a persistent hearing asymmetry and mismatch in spectral overlap prevent compression in bimodal users from improving sound localization. Therefore, the benefit in spatial release from masking by compression is likely due to a shift of attention to the ear with the better signal-to-noise ratio facilitated by compression, rather than an improved spatial selectivity. Supplemental Material https://doi.org/10.23641/asha.16869485

Horizontal sound localization in cochlear implant users with a contralateral hearing aid

2016 ◽  
Vol 336 ◽  
pp. 72-82 ◽  
Author(s):  
Lidwien C.E. Veugen ◽  
Maartje M.E. Hendrikse ◽  
Marc M. van Wanrooij ◽  
Martijn J.H. Agterberg ◽  
Josef Chalupper ◽  
...  
Keyword(s):  
Cochlear Implant ◽  
Sound Localization ◽  
Hearing Aid

scholarly journals Reducing the Device Delay Mismatch Can Improve Sound Localization in Bimodal Cochlear Implant/Hearing-Aid Users

2019 ◽  
Vol 23 ◽  
pp. 233121651984387 ◽  
Author(s):  
Stefan Zirn ◽  
Julian Angermeier ◽  
Susan Arndt ◽  
Antje Aschendorff ◽  
Thomas Wesarg
Keyword(s):  
Cochlear Implant ◽  
Sound Localization ◽  
Delay Line ◽  
Hearing Aid ◽  
Interaural Time Differences ◽  
Localization Accuracy ◽  
Everyday Situation ◽  
Acclimatization Period ◽  
Study Participants ◽  
Line P

In users of a cochlear implant (CI) together with a contralateral hearing aid (HA), so-called bimodal listeners, differences in processing latencies between digital HA and CI up to 9 ms constantly superimpose interaural time differences. In the present study, the effect of this device delay mismatch on sound localization accuracy was investigated. For this purpose, localization accuracy in the frontal horizontal plane was measured with the original and minimized device delay mismatch. The reduction was achieved by delaying the CI stimulation according to the delay of the individually worn HA. For this, a portable, programmable, battery-powered delay line based on a ring buffer running on a microcontroller was designed and assembled. After an acclimatization period to the delayed CI stimulation of 1 hr, the nine bimodal study participants showed a highly significant improvement in localization accuracy of 11.6% compared with the everyday situation without the delay line ( p < .01). Concluding, delaying CI stimulation to minimize the device delay mismatch seems to be a promising method to increase sound localization accuracy in bimodal listeners.

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