scholarly journals Conventional Amplification for Children and Adults with Severe-to-Profound Hearing Loss

2018 ◽  
Vol 39 (04) ◽  
pp. 364-376 ◽  
Author(s):  
Emily Benson ◽  
Ryan McCreery ◽  
Lindsey Jorgensen

AbstractThe primary goal of amplification is to restore audibility without causing discomfort; for someone with severe-to-profound hearing loss, the reduced dynamic range poses unique challenges in hearing-assistive device fitting. These challenges, including physiological limitation, processing difficulties, technology constraints, and other confounding factors, must be considered when selecting, fitting, and counseling for appropriate amplification. Many of the advanced features in hearing aids do not adequately address the unique characteristics of patients with severe-to-profound hearing loss. This review article will attempt to unravel some of the challenges and associated considerations when fitting adults and children with severe-to-profound hearing loss.

Author(s):  
Santosh Kumar Swain

<p>Tinnitus is the perception of a sound without any external auditory input and patient experiences as a ringing or buzzing sound in the ear or head. Tinnitus is a common and troublesome clinical entity that has existed for centuries. However, the exact etiology for tinnitus is not known. Electrical suppression of the tinnitus by cochlear implant is a secondary benefit to many cochlear implant recipients. Cochlear implants are often helpful to improve speech perception for those suffered with severe to profound hearing loss where hearing aids are no longer beneficial. There is high prevalence of tinnitus among patients with profound hearing loss which often reduced after cochlear implant. Although only few cochlear implant recipients show complete elimination of tinnitus after implantation and many uses result in improvement or stabilization. Cochlear implant causes appearance of homolateral tinnitus in small percentage of the cases. However, none of the cases of tinnitus which appear after cochlear implantation are thought to be severe to the patient. All literatures of cochlear implant and tinnitus were identified via Scopus, Google scholar, Medline and PubMed and analysed individually. Articles of cochlear implant and tinnitus included according to specified eligibility criteria. The review article analysed case series, case reports and original research on cochlear implant and tinnitus published in the English language. The aim of this review article is to provide a comprehensive review of the cochlear implant and its role in tinnitus.</p>


2010 ◽  
Vol 20 (1) ◽  
pp. 27-31
Author(s):  
Lyn Robertson

Abstract Learning to listen and speak are well-established preludes for reading, writing, and succeeding in mainstream educational settings. Intangibles beyond the ubiquitous test scores that typically serve as markers for progress in children with hearing loss are embedded in descriptions of the educational and social development of four young women. All were diagnosed with severe-to-profound or profound hearing loss as toddlers, and all were fitted with hearing aids and given listening and spoken language therapy. Compiling stories across the life span provides insights into what we can be doing in the lives of young children with hearing loss.


2019 ◽  
Vol 23 ◽  
pp. 233121651988761 ◽  
Author(s):  
Gilles Courtois ◽  
Vincent Grimaldi ◽  
Hervé Lissek ◽  
Philippe Estoppey ◽  
Eleftheria Georganti

The auditory system allows the estimation of the distance to sound-emitting objects using multiple spatial cues. In virtual acoustics over headphones, a prerequisite to render auditory distance impression is sound externalization, which denotes the perception of synthesized stimuli outside of the head. Prior studies have found that listeners with mild-to-moderate hearing loss are able to perceive auditory distance and are sensitive to externalization. However, this ability may be degraded by certain factors, such as non-linear amplification in hearing aids or the use of a remote wireless microphone. In this study, 10 normal-hearing and 20 moderate-to-profound hearing-impaired listeners were instructed to estimate the distance of stimuli processed with different methods yielding various perceived auditory distances in the vicinity of the listeners. Two different configurations of non-linear amplification were implemented, and a novel feature aiming to restore a sense of distance in wireless microphone systems was tested. The results showed that the hearing-impaired listeners, even those with a profound hearing loss, were able to discriminate nearby and far sounds that were equalized in level. Their perception of auditory distance was however more contracted than in normal-hearing listeners. Non-linear amplification was found to distort the original spatial cues, but no adverse effect on the ratings of auditory distance was evident. Finally, it was shown that the novel feature was successful in allowing the hearing-impaired participants to perceive externalized sounds with wireless microphone systems.


2020 ◽  
pp. 026565902096996
Author(s):  
Damaris F Estrella-Castillo ◽  
Héctor Rubio-Zapata ◽  
Lizzette Gómez-de-Regil

Profound hearing loss can have serious and irreversible consequences for oral language development in children, affecting spoken and written language acquisition. Auditory-verbal therapy has been widely applied to children with hearing loss with promising results, mainly in developed countries where cochlear implants are available. An evaluation was done of auditory perception in 25 children 5 to 8 years of age, with profound hearing loss, users of 4- or 5-channel hearing aids, and enrolled in a personalized auditory-verbal therapy program. Regarding initial auditory perception skills, children performed better on the Noises and Sounds block than on the Language block. By subscales, top performance was observed for auditory analysis (Noises and Sounds) and auditory recognition (Language). A series of t-tests showed that significant improvement after Auditory-verbal therapy occurred in global scores for Noises and Sounds and for Language blocks, regardless of sex, urban or rural community origin, nuclear or extended family. The study provides evidence of deficiencies in auditory in children with profound bilateral hearing loss and how this might improve after receiving Auditory-verbal therapy. Nevertheless, the descriptive study design prevents conclusions regarding the effectiveness of the therapy. Subsequent research must take into account intrinsic and environmental factors that might play a mediating role in the benefits of Auditory-verbal therapy for auditory perception.


2021 ◽  
Author(s):  
Jae Sang Han ◽  
Yong-Ho Park ◽  
Jae-Jun Song ◽  
Il Joon Moon ◽  
Woojoo Lee ◽  
...  

BACKGROUND Despite the increasing prevalence of hearing loss, the cost and psychological barriers to use of hearing aids may prevent individuals with hearing loss from using these aids. Hearing loss patients can benefit from smartphone-based hearing aid applications (SHAAs), which are smartphone applications that use a mobile device as sound amplifier. OBJECTIVE The aims of this study were to determine how ear, nose and throat (ENT) outpatients perceived SHAAs, analyze factors that affected this, and estimate costs of annual subscription to an application through a self-administered questionnaire survey of smartphone users and hearing specialists. METHODS The study employed cross-sectional, multi-center survey of both ENT outpatients and hearing specialists. The questionnaire was designed to collect personal information about the respondents as well as responses to 18 questions concerning SHAAs in 5 domains: knowledge, needs, cost, expectations, and information. Questions about the expected cost of SHAAs were included in the questionnaire distributed to hearing experts. RESULTS Among 219 smartphone users and 42 hearing specialists, only eight respondents (3.7%) recognized SHAAs, while 47 of 261 respondents (21.5%) reported considering using an assistive device to improve their hearing capacities. Average perception score was 2.81 (95% CI 2.65-2.97), lower than the grade point average of 3. Among factors that shaped perceptions of SHAAs, the needs category received the lowest scores (2.02, 95% CI 1.83-2.20) whereas the cost category received the highest scores (3.29, 95% CI 3.14-3.44). Age was correlated with the information domain (P = .000) and an increased level of hearing impairment resulted in significantly higher points in the needs category (P = .000). Patients expected the cost of an annual application subscription to an SHAA to be about 86 USD, and predicted cost was associated with economic status (P = .200) and was noticeably higher than the prices expected by hearing specialists (P < .001). CONCLUSIONS Outpatients expected SHAAs to cost more than hearing specialists. However, SHAA perception was relatively low. In this regard, enhanced awareness of SHAAs is required to popularize SHAAs. CLINICALTRIAL None


2003 ◽  
Vol 14 (02) ◽  
pp. 084-099 ◽  
Author(s):  
Francis K. Kuk ◽  
Lisa Potts ◽  
Michael Valente ◽  
Lidia Lee ◽  
Jay Picirrillo

The present study examined the phenomenon of acclimatization in persons with a severe-to-profound hearing loss. A secondary purpose was to examine the efficacy of a digital nonlinear power hearing aid that has a low compression threshold with expansion for this population. Twenty experienced hearing aid users wore the study hearing aids for three months and their performance with the study hearing aids was evaluated at the initial fitting, one month, and three months after the initial fitting. Performance of their current hearing aids was also evaluated at the initial fitting. Speech recognition testing was conducted at input levels of 50 dB SPL and 65 dB SPL in quiet, and 75 dB SPL in noise at a +10 SNR. Questionnaires were used to measure subjective performance at each evaluation interval. The results showed improvement in speech recognition score at the one-month evaluation over the initial evaluation. No significant improvement was seen at the three-month evaluation from the one-month visit. In addition, subjective and objective performance of the study hearing aids was significantly better than the participants' own hearing aids at all evaluation intervals. These results provided evidence of acclimatization in persons with a severe-to-profound hearing loss and reinforced the precaution that any trial of amplification, especially from linear to nonlinear mode, should consider this phenomenon.


1980 ◽  
Vol 23 (2) ◽  
pp. 470-479 ◽  
Author(s):  
Elmer Owens ◽  
Sharon Fujikawa

Subjects with profound postlingual hearing loss completed the Hearing Performance Inventory (HPI) during the course of their hearing aid evaluations. Comparisons of responses to the HPI were made for (a) subjects who wore hearing aids versus subjects who did not, and (b)hearing aid users with losses greater than 100 dB versus users with losses between 80-100 dB. The former set of comparisons indicated consistently superior performance for the aided group, and the latter set indicated consistently superior performance for the 80-100 dB group. The HPI may be a valuable tool in hearing aid considerations.


2020 ◽  
Vol 25 (3) ◽  
pp. 133-142
Author(s):  
Nina Wardenga ◽  
Ad F.M. Snik ◽  
Eugen Kludt ◽  
Bernd Waldmann ◽  
Thomas Lenarz ◽  
...  

Background: The conventional therapy for severe mixed hearing loss is middle ear surgery combined with a power hearing aid. However, a substantial group of patients with severe mixed hearing loss cannot be treated adequately with today’s state-of-the-art (SOTA) power hearing aids, as predicted by the accompanying part I of this publication, where we compared the available maximum power output (MPO) and gain from technical specifications to requirements for optimum benefit using a common fitting rule. Here, we intended to validate the theoretical assumptions from part I experimentally in a mixed hearing loss cohort fitted with SOTA power hearing aids. Additionally, we compared the results with an implantable hearing device that circumvents the impaired middle ear, directly stimulating the cochlea, as this might be a better option. Objectives: Speech recognition outcomes obtained from patients with severe mixed hearing loss supplied acutely with a SOTA hearing aid were studied to validate the outcome predictions as described in part I. Further, the results obtained with hearing aids were compared to those in direct acoustic cochlear implant (DACI) users. Materials and Methods: Twenty patients (37 ears with mixed hearing loss) were provided and fitted with a SOTA power hearing aid. Before and after an acclimatization period of at least 4 weeks, word recognition scores (WRS) in quiet and in noise were studied, as well as the speech reception threshold in noise (SRT). The outcomes were compared retrospectively to a second group of 45 patients (47 ears) using the DACI device. Based on the severity of the mixed hearing loss and the available gain and MPO of the SOTA hearing aid, the hearing aid and DACI users were subdivided into groups with prediction of sufficient, partially insufficient, or very insufficient hearing aid performance. Results: The patients with predicted adequate SOTA hearing aid performance indeed showed the best WRS in quiet and in noise when compared to patients with predicted inferior outcomes. Insufficient hearing aid performance at one or more frequencies led to a gradual decrease in hearing aid benefit, validating the criteria used here and in the accompanying paper. All DACI patients showed outcomes at the same level as the adequate hearing aid performance group, being significantly better than those of the groups with inadequate hearing aid performance. Whereas WRS in quiet and noise were sensitive to insufficient gain or output, showing significant differences between the SOTA hearing aid and DACI groups, the SRT in noise was less sensitive. Conclusions: Limitations of outcomes in mixed hearing loss individuals due to insufficient hearing aid performance can be accurately predicted by applying a commonly used fitting rule and the 35-dB dynamic range rule on the hearing aid specifications. Evidently, when outcomes in patients with mixed hearing loss using the most powerful hearing aids are insufficient, bypassing the middle ear with a powerful active middle ear implant or direct acoustic implant can be a promising alternative treatment.


2010 ◽  
Vol 21 (03) ◽  
pp. 169-175 ◽  
Author(s):  
Kathy S. Halpin ◽  
Kay Y. Smith ◽  
Judith E. Widen ◽  
Mark E. Chertoff

Background: Universal Newborn Hearing Screening (UNHS) was introduced in Kansas in 1999. Prior to UNHS a small percentage of newborns were screened for and identified with hearing loss. Purpose: The purpose of this study was to determine the effects of UNHS on a local early intervention (EI) program for young children with hearing loss. Research Design: This was a retrospective study based on the chart review of children enrolled in the EI program during target years before and after the establishment of UNHS. Study Sample: Charts for 145 children were reviewed. Data Collection and Analysis: The chart review targeted the following aspects of the EI program: caseload size, percentage of caseload identified by UNHS, age of diagnosis, age of enrollment in EI, degree of hearing loss, etiology of hearing loss, late onset of hearing loss, age of hearing aid fit, percentage of children fit with hearing aids by 6 mo, percentage of children with profound hearing loss with cochlear implants, and percentage of children with additional disabilities. Results: Changes in the EI program that occurred after UNHS were increases in caseload size, percentage of caseload identified by UNHS, percentage of children fit with hearing aids by 6 mo of age, and percentage of children with profound hearing loss with cochlear implants. There were decreases in age of diagnosis, age of enrollment in EI, and age of hearing aid fit. Before UNHS, the majority of children had severe and profound hearing loss; after UNHS there were more children with mild and moderate hearing loss. The percentage of known etiology and late-onset hearing loss was approximately the same before and after UNHS, as was the percentage of children with additional disabilities. Conclusion: UNHS had a positive impact on caseload size, age of diagnosis, age of enrollment in EI, and age of hearing aid fit. The percentage of the caseload identified in the newborn period was about 25% before UNHS and over 80% after its implementation. After UNHS, the EI caseload included as many children with mild and moderate hearing loss as with severe and profound loss. By the last reporting year in the study (academic year 2005–2006) all children with profound hearing losses had cochlear implants.


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