Prediction of Asymptotic Threshold Shift Caused by Hearing Aid Use

1994 ◽  
Vol 37 (6) ◽  
pp. 1450-1458 ◽  
Author(s):  
John H. Macrae
Keyword(s):  
Hearing Aids ◽  
Pure Tone ◽  
Hearing Aid ◽  
Threshold Shift ◽  
Temporary Threshold Shift ◽  
High Input ◽  
Hearing Aid Use ◽  
Sound Levels ◽  
Ambient Sound ◽  
Ambient Levels

This study used a well-verified mathematical model to predict asymptotic temporary threshold shift (ATS) caused by hearing aid use. The model determined the amounts of ATS to be expected if real ear insertion gains (REIGs) recommended by the current National Acoustic Laboratories (NAL) procedure are used. It also determined the consequences of use of excess REIG and of high input levels to hearing aids. If recommended REIGs are used and input levels are normal (average A-weighted input levels of about 61 dB SPL), ATS is unlikely to occur for clients who have typical audiograms with three-frequency average pure-tone thresholds (PTAs) less than 60 dB HL. For people with PTAs greater than 60 dB HL, small amounts of ATS can be expected to occur during hearing aid use, but these amounts of ATS are safe, that is, unlikely to be associated with permanent threshold shift (PTS) for individuals with all PTAs except those greater than about 100 dB HL. If REIGs are 15 dB greater than those recommended, the amounts of ATS will be unsafe for people with PTAs greater than about 80 dB HL. It appears unwise for clients who have this degree of hearing loss to use excess REIG. The use of excess REIG in high ambient levels of sound (average A-weighted input levels of about 75 dB SPL) is likely to cause PTS for hearing aid users with PTAs of about 50 dB HL or greater. Clients who prefer to use excess REIG should therefore avoid high ambient sound levels. The amount of amplification required for people with PTAs greater than about 100 dB HL is likely to cause PTS and is therefore inherently unsafe.

Temporary Threshold Shift Caused by Hearing Aid Use

1993 ◽  
Vol 36 (2) ◽  
pp. 365-372 ◽  
Author(s):  
John H. Macrae
Keyword(s):  
Hearing Aids ◽  
Noise Exposure ◽  
Hearing Aid ◽  
Threshold Shift ◽  
Temporary Threshold Shift ◽  
Noise Levels ◽  
Hearing Aid Use ◽  
Wide Range ◽  
The Mean ◽  
Modified Power Law

Temporary threshold shift (TTS) over a wide range of frequencies was found after 4 hours of hearing aid use by a 15-year-old student with severe sensorineural hearing loss who was using real-ear insertion gains 10 to 20 dB greater than those recommended by the current National Acoustic Laboratories (NAL) procedure for selecting the gain and frequency response of hearing aids. Measurements were made of her noise exposure during hearing aid use with a noise dosimeter. The real-ear insertion response and input-output function of her hearing aid were measured with a real-ear gain analyzer and were used to calculate in-ear noise levels from the noise levels measured by the dosimeter. The amount of TTS could be predicted from the in-ear noise levels and the student’s hearing levels (HLs) by means of a mathematical model consisting of the Modified Power Law (MPL) of Humes and Jesteadt (1991) combined with equations for predicting TTS in listeners with normal hearing published by Mills, Gilbert, and Adkins (1979). The mean of the instantaneous A-weighted in-ear noise levels proved to be the appropriate equivalent continuous level (ECL) for use in the predictions. The MPL was also used to determine safety limits for TTS due to hearing aid use. The observed TTS exceeded the safety limits at all frequencies up to and including 2000 Hz. It was therefore considered desirable for the girl to use less gain at frequencies from 500 to 1500 Hz.

Temporary and Permanent Threshold Shift Caused by Hearing Aid Use

1995 ◽  
Vol 38 (4) ◽  
pp. 949-959 ◽  
Author(s):  
John H. Macrae
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Hearing Aids ◽  
Hearing Aid ◽  
Sensorineural Hearing ◽  
Threshold Shift ◽  
Hearing Aid Use ◽  
Sound Levels ◽  
The Mean ◽  
Good Agreement

Excessive amplification by hearing aids causes temporary threshold shift (TTS) and permanent threshold shift (PTS). This investigation addressed the question whether it might be possible to predict the eventual amount of PTS caused by excessive amplification from the amount of TTS it causes after a day of hearing aid use. Asymptotic TTS (ATS) to be expected as a result of hearing aid use was predicted for 8 children with sensorineural hearing loss and the predicted ATS was compared with observed permanent deterioration of their thresholds attributed to hearing aid use. There was good agreement between the predicted ATS and observed PTS at 500 to 2000 Hz. It follows that, for prediction of PTS caused by hearing aid use, the mean of the sound levels produced in the ear by the hearing aid is the correct equivalent continuous level (ECL) to use and that the Modified Power Law (MPL) is the appropriate method of adjusting the predictions for sensorineural hearing loss, because these have been shown to be appropriate for prediction of TTS caused by hearing aid use. Predictions of the PTS to be expected for the children that were carried out using the MPL and the mean level as the ECL were in good agreement with the observed PTS at 500 to 2000 Hz, whereas predictions of PTS based on an alternative method of correction for sensorineural hearing loss (the Continuation Hypothesis) were significantly less than the observed amounts. The results of the PTS predictions therefore confirmed the conclusions drawn from the results of the ATS predictions.

An Investigation of Temporary Threshold Shift Caused by Hearing Aid Use

1994 ◽  
Vol 37 (1) ◽  
pp. 227-237 ◽  
Author(s):  
John H. Macrae
Keyword(s):  
Mathematical Model ◽  
Hearing Loss ◽  
Hearing Aid ◽  
Threshold Shift ◽  
Temporary Threshold Shift ◽  
Hearing Aid Use ◽  
Gain Reduction ◽  
The Mathematical Model ◽  
Békésy Audiometry ◽  
Modified Power Law

Temporary threshold shift (TTS) caused by hearing aid use was measured by Bekesy audiometry in a group of individuals with severe sensorineural hearing loss. The accuracy with which a mathematical model consisting of the Modified Power Law (MPL) (Humes & Jesteadt, 1991) combined with equations for predicting TTS in normal listeners (Mills, Gilbert, & Adkins, 1979) could predict the TTS was evaluated. When the exponent of the MPL was set to 0.15, the predicted TTS was significantly greater than the observed TTS at two out of six frequencies. When the exponent was increased to 0.20, there were no significant differences between the predictions and the observations. With this value of the exponent, the mathematical model was able to predict the observed TTS as accurately as it could be measured. The MPL was used to derive safety limits for TTS, and gain reduction was recommended as the best method of reducing TTS to the safety limits.

Use of a Mild-Gain Hearing Aid by Middle-Age Normal-Hearing Adults Who Do and Do Not Self-Report Trouble Hearing in Background Noise

2020 ◽  
Vol 29 (3) ◽  
pp. 419-428
Author(s):  
Jasleen Singh ◽  
Karen A. Doherty
Keyword(s):  
Hearing Aids ◽  
Background Noise ◽  
Middle Age ◽  
Hearing Aid ◽  
Normal Hearing ◽  
Self Report ◽  
Hearing Aid Use ◽  
Hearing Handicap ◽  
Before And After ◽  
Hearing Problems

Purpose The aim of the study was to assess how the use of a mild-gain hearing aid can affect hearing handicap, motivation, and attitudes toward hearing aids for middle-age, normal-hearing adults who do and do not self-report trouble hearing in background noise. Method A total of 20 participants (45–60 years of age) with clinically normal-hearing thresholds (< 25 dB HL) were enrolled in this study. Ten self-reported difficulty hearing in background noise, and 10 did not self-report difficulty hearing in background noise. All participants were fit with mild-gain hearing aids, bilaterally, and were asked to wear them for 2 weeks. Hearing handicap, attitudes toward hearing aids and hearing loss, and motivation to address hearing problems were evaluated before and after participants wore the hearing aids. Participants were also asked if they would consider purchasing a hearing aid before and after 2 weeks of hearing aid use. Results After wearing the hearing aids for 2 weeks, hearing handicap scores decreased for the participants who self-reported difficulty hearing in background noise. No changes in hearing handicap scores were observed for the participants who did not self-report trouble hearing in background noise. The participants who self-reported difficulty hearing in background noise also reported greater personal distress from their hearing problems, were more motivated to address their hearing problems, and had higher levels of hearing handicap compared to the participants who did not self-report trouble hearing in background noise. Only 20% (2/10) of the participants who self-reported trouble hearing in background noise reported that they would consider purchasing a hearing aid after 2 weeks of hearing aid use. Conclusions The use of mild-gain hearing aids has the potential to reduce hearing handicap for normal-hearing, middle-age adults who self-report difficulty hearing in background noise. However, this may not be the most appropriate treatment option for their current hearing problems given that only 20% of these participants would consider purchasing a hearing aid after wearing hearing aids for 2 weeks.

On the Potential Deterioration in Hearing Due to Hearing Aid Usage

1981 ◽  
Vol 24 (1) ◽  
pp. 3-15 ◽  
Author(s):  
Larry E. Humes ◽  
Fred H. Bess
Keyword(s):  
Hearing Aid ◽  
Threshold Shift ◽  
Temporary Threshold Shift ◽  
Hearing Sensitivity

This manuscript examines the issue of potential decline in hearing sensitivity due to hearing aid usage through an analysis of data obtained from the temporary threshold shift (TTS) paradigm. Following a critique of the traditional measures of TTS, the concept of integrated TTS (ITTS) is reviewed and data on hearing-aid-induced ITTS are presented. In addition, a series of equations relating permanent threshold shift (PTS) to a recently developed measure of noise dose (Dn) is derived and predictions for hearing-aid-induced PTS are made. Recommended gain settings established to protect the hearing of a person wearing a hearing aid from further decline following various durations of hearing aid usage are also provided.

The Effect of Monaurally Fitted Hearing Aid Use on the Evolution of Presbycusis

2021 ◽  
pp. 000348942199527
Author(s):  
Gabriel Dunya ◽  
Fadi Najem ◽  
Aurelie Mailhac ◽  
Samer Abou Rizk ◽  
Marc Bassim
Keyword(s):  
Word Recognition ◽  
Pure Tone ◽  
Hearing Aid ◽  
Residual Hearing ◽  
Inclusion Criteria ◽  
Pure Tone Average ◽  
Hearing Aid Use ◽  
Deprivation Effect ◽  
Significant Difference

Objective: The effect of hearing aid use on the evolution of presbycusis has not been well described in the literature, with only a handful of publications addressing this topic. This paper aims to evaluate the long-term use of amplification and its effect on pure-tone thresholds and word recognition scores. Method: Monaurally fitted patients were followed with serial audiograms. Data was collected from hearing aid centers. Seventy-seven patients with presbycusis met the inclusion criteria and participated in the present study. The progression of hearing loss in both pure tone thresholds and word recognition scores were compared between the hearing aid ears (HA), and the non-hearing aid ears (NHA). Pure tone thresholds were analyzed by comparing the pure tone average at the initial and last audiograms. Word Recognition Scores (WRS) were analyzed using the model of Thornton and Raffin (1978), and by comparing the change in the absolute values of WRS from the initial to the last audiogram between the HA ear and the NHA ear. Results: No significant difference in pure-tone thresholds between the HA ear and NHA ear was found at the last audiogram ( P = .696), even after dividing the patients into groups based on the duration of amplification. Both methods of analysis of patients’ WRS showed a statistically significant worsening in NHA ( P < .05). Conclusion: The present study supports the previously defined auditory deprivation effect on non-fitted ears, which showed worsening of word recognition over time and no effect on pure tone average. It provides an additional argument for the counseling of patients with presbycusis considering amplification, and highlights the importance of bilateral amplification in preserving the residual hearing of hearing impaired patients.

Hearing Technology Use and Management in School-Age Children: Reports from Data Logs, Parents, and Teachers

2017 ◽  
Vol 28 (10) ◽  
pp. 883-892 ◽  
Author(s):  
Samantha J. Gustafson ◽  
Todd A. Ricketts ◽  
Anne Marie Tharpe
Keyword(s):  
Hearing Loss ◽  
Hearing Aids ◽  
Hearing Aid ◽  
Parent Report ◽  
School Age Children ◽  
School Age ◽  
Data Logging ◽  
Hearing Aid Use ◽  
System Use ◽  
Children With Hearing Loss

Background: Consistency of hearing aid and remote microphone system use declines as school-age children with hearing loss age. One indicator of hearing aid use time is data logging, another is parent report. Recent data suggest that parents overestimate their children’s hearing aid use time relative to data logging. The potential reasons for this disparity remain unclear. Because school-age children spend the majority of their day away from their parents and with their teachers, reports from teachers might serve as a valuable and additional tool for estimating hearing aid use time and management. Purpose: This study expands previous research on factors influencing hearing aid use time in school-age children using data logging records. Discrepancies between data logging records and parent reports were explored using custom surveys designed for parents and teachers. Responses from parents and teachers were used to examine hearing aid use, remote microphone system use, and hearing aid management in school-age children. Study Sample: Thirteen children with mild-to-moderate hearing loss between the ages of 7 and 10 yr and their parents participated in this study. Teachers of ten of these children also participated. Data Collection and Analysis: Parents and teachers of children completed written surveys about each child’s hearing aid use, remote microphone system use, and hearing aid management skills. Data logs were read from hearing aids using manufacturer’s software. Multiple linear regression analysis and an intraclass correlation coefficient were used to examine factors influencing hearing aid use time and parent agreement with data logs. Parent report of hearing aid use time was compared across various activities and school and nonschool days. Survey responses from parents and teachers were compared to explore areas requiring potential improvement in audiological counseling. Results: Average daily hearing aid use time was ˜6 hr per day as recorded with data logging technology. Children exhibiting greater degrees of hearing loss and those with poorer vocabulary were more likely to use hearing aids consistently than children with less hearing loss and better vocabulary. Parents overestimated hearing aid use by ˜1 hr per day relative to data logging records. Parent-reported use of hearing aids varied across activities but not across school and nonschool days. Overall, parents and teachers showed excellent agreement on hearing aid and remote microphone system use during school instruction but poor agreement when asked about the child’s ability to manage their hearing devices independently. Conclusions: Parental reports of hearing aid use in young school-age children are largely consistent with data logging records and with teacher reports of hearing aid use in the classroom. Audiologists might find teacher reports helpful in learning more about children’s hearing aid management and remote microphone system use during their time at school. This supplementary information can serve as an additional counseling tool to facilitate discussion about remote microphone system use and hearing aid management in school-age children with hearing loss.

Reliability and Stability of Various Hearing-Aid Outcome Measures in a Group of Elderly Hearing-Aid Wearers

1996 ◽  
Vol 39 (5) ◽  
pp. 923-935 ◽  
Author(s):  
Larry E. Humes ◽  
Dan Halling ◽  
Maureen Coughlin
Keyword(s):  
Outcome Measures ◽  
Hearing Aids ◽  
Repeated Measures ◽  
Nonsense Syllable ◽  
Hearing Aid ◽  
Objective Measure ◽  
The Elderly ◽  
Elderly Persons ◽  
Hearing Aid Use ◽  
Hearing Handicap

Twenty elderly persons with hearing impairment were fit with binaural in-the-ear hearing aids and followed for a 6-month period post-fit. Several hearing-aid outcome measures were obtained at 0, 7, 15, 30, 60, 90, and 180 days post-fit. Outcome measures included (a) objective measures of benefit obtained with nonsense-syllable materials in quiet (CUNY Nonsense Syllable Test, NST) and sentences in multitalker babble (Hearing in Noise Test, HINT); (b) two subjective measures of benefit, one derived from pre-fit/post-fit comparisons on a general scale of hearing handicap (Hearing Handicap Inventory for the Elderly, HHIE) and the other based on a subjective scale of post-fit hearing-aid benefit (Hearing Aid Performance Inventory, HAPI); (c) a questionnaire on hearing-aid satisfaction; (d) an objective measure of hearing-aid use; and (e) a subjective measure of hearing-aid use. Reliability and stability of each measure were examined through repeated-measures analyses of variance, a series of test-retest correlations, and, where possible, scatterplots of the scores against their corresponding 95% critical differences. Many of the measures were found to be both reliable and stable indicators of hearing-aid outcome.

scholarly journals Factors Influencing Help Seeking, Hearing Aid Uptake, Hearing Aid Use and Satisfaction With Hearing Aids: A Review of the Literature

2010 ◽  
Vol 14 (3) ◽  
pp. 127-154 ◽  
Author(s):  
Line Vestergaard Knudsen ◽  
Marie Öberg ◽  
Claus Nielsen ◽  
Graham Naylor ◽  
Sophia E. Kramer
Keyword(s):  
Hearing Aids ◽  
Help Seeking ◽  
Hearing Aid ◽  
Review Of The Literature ◽  
Factors Influencing ◽  
Hearing Aid Use

Hearing Loss, Control, and Demographic Factors Influencing Hearing Aid Use Among Older Adults

1998 ◽  
Vol 41 (3) ◽  
pp. 527-537 ◽  
Author(s):  
Dean C. Garstecki ◽  
Susan F. Erler
Keyword(s):  
Older Adults ◽  
Hearing Loss ◽  
Hearing Aids ◽  
Psychological Control ◽  
Hearing Aid ◽  
Demographic Factors ◽  
Ego Strength ◽  
Hearing Sensitivity ◽  
Hearing Aid Use ◽  
Hearing Handicap

Preference for non-use of hearing aids among older adults who are candidates for amplification remains to be explained. Clinical studies have examined the contribution of consumer attitudes, behaviors, and life circumstances to this phenomenon. The present study extends the interests of earlier investigators in that it examines psychological control tendencies in combination with hearing loss and demographic variables among older adults who elected to accept (adherents) or ignore (nonadherents) advice from hearing professionals to acquire and use hearing aids. One hundred thirty-one individuals participated by completing measures of hearing, hearing handicap, psychological control, depression, and ego strength. Participants were asked to provide demographic information and personal opinions regarding hearing aid use. Adherence group and gender differences were noted on measures of hearing sensitivity, psychological control, and demographic factors. Female adherents demonstrated greater hearing loss and poorer word recognition ability but less hearing handicap, higher internal locus of control, higher ego strength, and fewer depressive tendencies than female nonadherents. They reported demographic advantages. Female adherents assumed responsibility for effective communication. Although male adherents and nonadherents did not differ significantly demographically, male adherents were more accepting of their hearing loss, took responsibility for communication problems, and found hearing aids less stigmatizing. Implications for clinical practice and future clinical investigations are identified and discussed. Results are expected to be of interest to clinicians, clinical investigators, and health care policymakers.

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