Audiological Results of the Bone-Anchored Hearing Aid HC200: Multicenter Results

1994 ◽  
Vol 103 (5) ◽  
pp. 368-374 ◽  
Author(s):  
Emmanuel A. M. Mylanus ◽  
Ad F. M. Snik ◽  
Frank F. Jorritsma ◽  
Cor W. R. J. Cremers ◽  
Hans Verschuure
Keyword(s):  
Speech Recognition ◽  
Hearing Aids ◽  
Signal To Noise Ratio ◽  
Hearing Aid ◽  
Bone Conduction ◽  
Hearing Level ◽  
Mixed Hearing Loss ◽  
Bone Anchored Hearing Aid ◽  
Bone Conduction Hearing Aid ◽  
Speech Recognition In Noise

Sixty-two patients with conductive or mixed hearing loss (average bone conduction threshold at 0.5, 1, and 2 kHz ranged from 1 to 44 dB hearing level) were fitted with a bone-anchored hearing aid (BAHA type HC200). Previously, 52 of them had used a conventional bone conduction hearing aid (CBHA) and 10 of them an air conduction hearing aid (ACHA). Audiological tests were conducted to compare the patients' performance with the BAHA to that with their previous conventional hearing aid. In the speech recognition in quiet test, only 5 patients in the CBHA group improved significantly: the majority had 100% scores with both hearing aids. In the speech recognition in noise test, 28 patients improved significantly. The mean improvement in the signal to noise ratio (S/N) in the CBHA group was −2.3 ± 2.4 dB. That none of the patients in the CBHA group performed worse with the BAHA led us to the conclusion that the BAHA is superior to the CBHA. None of the patients in the ACHA group achieved a better speech recognition in quiet score using the BAHA. On average, there was no significant improvement in the S/N ratio in the ACHA group, although in 6 patients the S/N ratio improved significantly, and in 1 patient it worsened significantly. From the whole group, the performance of only 2 patients, both in the ACHA group, was significantly worse with the BAHA on one of the speech recognition tests.

Binaural Application of the Bone-Anchored Hearing Aid

1998 ◽  
Vol 107 (3) ◽  
pp. 187-193 ◽  
Author(s):  
Ad F. M. Snik ◽  
Andy J. Beynon ◽  
Catharina T. M. van der Pouw ◽  
Emmanuel A. M. Mylanus ◽  
Cor W. R. J. Cremers
Keyword(s):  
Speech Recognition ◽  
Sound Localization ◽  
Hearing Aids ◽  
Hearing Aid ◽  
Bone Conduction ◽  
Listening Condition ◽  
Bone Anchored Hearing Aid ◽  
Bone Conduction Hearing ◽  
Bone Conduction Hearing Aid ◽  
Binaural Listening

Most, but not all, hearing-impaired patients with air conduction hearing aids prefer binaural amplification instead of monaural amplification. The binaural application of the bone conduction hearing aid is more disputable, because the attenuation (in decibels) of sound waves across the skull is so small (10 dB) that even one bone conduction hearing aid will stimulate both cochleas approximately to the same extent. Binaural fitting of the bone-anchored hearing aid was studied in three experienced bone-anchored hearing aid users. The experiments showed that sound localization, and speech recognition in quiet and also under certain noisy conditions improved significantly with binaural listening compared to the monaural listening condition. On the average, the percentage of correct identifications (within 45°) in the sound localization experiment improved by 53% with binaural listening; the speech reception threshold in quiet improved by 4.4 dB. The binaural advantage in the speech-in-noise test was comparable to that of a control group of subjects with normal hearing listening monaurally versus binaurally. The improvements in the scores were ascribed to diotic summation (improved speech recognition in quiet) and the ability to separate sounds in the binaural listening condition (improved sound localization and improved speech recognition in noise whenever the speech and noise signals came from different directions). All three patients preferred the binaural bone-anchored hearing aids and used them all day.

Are Two Ears Not Better Than One?

2012 ◽  
Vol 23 (03) ◽  
pp. 171-181 ◽  
Author(s):  
Rachel A. McArdle ◽  
Mead Killion ◽  
Monica A. Mennite ◽  
Theresa H. Chisolm
Keyword(s):  
Hearing Loss ◽  
Speech Recognition ◽  
Hearing Aids ◽  
Repeated Measures ◽  
Signal To Noise Ratio ◽  
Hearing Aid ◽  
Binaural Hearing ◽  
Analysis Experiment ◽  
Insert Earphones ◽  
Speech Recognition In Noise

Background: The decision to fit one or two hearing aids in individuals with binaural hearing loss has been debated for years. Although some 78% of U.S. hearing aid fittings are binaural (Kochkin , 2010), Walden and Walden (2005) presented data showing that 82% (23 of 28 patients) of their sample obtained significantly better speech recognition in noise scores when wearing one hearing aid as opposed to two. Purpose: To conduct two new experiments to fuel the monaural/binaural debate. The first experiment was a replication of Walden and Walden (2005), whereas the second experiment examined the use of binaural cues to improve speech recognition in noise. Research Design: A repeated measures experimental design. Study Sample: Twenty veterans (aged 59–85 yr), with mild to moderately severe binaurally symmetrical hearing loss who wore binaural hearing aids were recruited from the Audiology Department at the Bay Pines VA Healthcare System. Data Collection and Analysis: Experiment 1 followed the procedures of the Walden and Walden study, where signal-to-noise ratio (SNR) loss was measured using the Quick Speech-in-Noise (QuickSIN) test on participants who were aided with their current hearing aids. Signal and noise were presented in the sound booth at 0° azimuth under five test conditions: (1) right ear aided, (2) left ear aided, (3) both ears aided, (4) right ear aided, left ear plugged, and (5) unaided. The opposite ear in (1) and (2) was left open. In Experiment 2, binaural Knowles Electronics Manikin for Acoustic Research (KEMAR) manikin recordings made in Lou Malnati's pizza restaurant during a busy period provided a typical real-world noise, while prerecorded target sentences were presented through a small loudspeaker located in front of the KEMAR manikin. Subjects listened to the resulting binaural recordings through insert earphones under the following four conditions: (1) binaural, (2) diotic, (3) monaural left, and (4) monaural right. Results: Results of repeated measures ANOVAs demonstrated that the best speech recognition in noise performance was obtained by most participants with both ears aided in Experiment 1 and in the binaural condition in Experiment 2. Conclusions: In both experiments, only 20% of our subjects did better in noise with a single ear, roughly similar to the earlier Jerger et al (1993) finding that 8–10% of elderly hearing aid users preferred one hearing aid.

scholarly journals Vibrant Soundbridge and Bone Conduction Hearing Aid in Patients with Bilateral Malformation of External Ear

2015 ◽  
Vol 20 (01) ◽  
pp. 034-038 ◽  
Author(s):  
Maria Mondelli ◽  
Thais Mariano ◽  
Heitor Honório ◽  
Rubens Brito
Keyword(s):  
Hearing Loss ◽  
Speech Perception ◽  
Hearing Aids ◽  
Hearing Aid ◽  
Bone Conduction ◽  
External Ear ◽  
Vibrant Soundbridge ◽  
Mixed Hearing Loss ◽  
Bone Conduction Hearing ◽  
Bone Conduction Hearing Aid

Introduction Hearing loss is the most common clinical finding in patients with malformation of the external ear canal. Among the possibilities of treatment, there is the adaptation of hearing aids by bone conduction and the adaptation of implantable hearing aids. Objective To assess speech perception with the use of Vibrant Soundbridge (VBS - MED-EL, Innsbruck, Austria) associated with additional amplification in patients with bilateral craniofacial malformation. Method We evaluated 11 patients with bilateral malformation over 12 years with mixed hearing loss or bilateral conductive. They were using the Softband (Oticon Medical, Sweden) and bone conduction hearing aid in the ear opposite the one with the VSB. We performed the evaluation of speech perception using the Hearing in Noise Test. Results Participants were eight men and three women with a mean of 19.5 years. The signal / noise ratio presented significant results in patients fitted with VSB and bone conduction hearing aid. Conclusion The results of speech perception were significantly better with use of VBS combined with bone conduction hearing aids.

Speech Recognition with the Bone-Anchored Hearing Aid Determined Objectively and Subjectively

1994 ◽  
Vol 73 (2) ◽  
pp. 115-117 ◽  
Author(s):  
AFM Snik ◽  
EAM Mylanus ◽  
CWRJ Cremers
Keyword(s):  
Speech Recognition ◽  
Hearing Aid ◽  
Skin Irritation ◽  
Bone Conduction ◽  
Bone Anchored Hearing Aid ◽  
Bone Conduction Hearing ◽  
Bone Conduction Hearing Aid ◽  
Air Conduction ◽  
Head Level ◽  
Better Than

Some patients with a bone-conduction hearing aid experience serious problems such as skin irritation or headaches and inconsistency in the sound quality due to shifting of the transducer over the mastoid. The Bone Anchored Hearing Aid (BAHA) provides direct bone-conduction and therefore evades these problems. Results of 58 patients fitted with either the head level BAHA HC200 or the more powerful HC220 were available for evaluation. Speech recognition-in-quiet and in-noise tests were performed in order to make a comparison between the patients’ performance with their individually adapted BAHA and their previous hearing aid. Furthermore, all the patients filled out a questionnaire, involving questions on speech recognition-in-quiet and in-noisy surroundings. Individual comparisons of the audiological and questionnaire results in the subgroup of patients who had used a bone-conduction hearing aid showed that the results with the BAHA were comparable with or significantly better than those with the previous bone-conduction hearing aid. The results in the patients who had previously used an air-conduction hearing aid were ambiguous.

Speech intelligibility with bilateral bone-anchored hearing aids: the Birmingham experience

2002 ◽  
Vol 116 (S28) ◽  
pp. 47-51 ◽  
Author(s):  
Sunil N. Dutt ◽  
Ann-Louise McDermott ◽  
Stuart P. Burrell ◽  
Huw R. Cooper ◽  
Andrew P. Reid ◽  
...  
Keyword(s):  
Speech Recognition ◽  
Hearing Aids ◽  
Speech Intelligibility ◽  
Hearing Aid ◽  
Case Series ◽  
Subjective Analysis ◽  
Objective Testing ◽  
Speech In Noise ◽  
Bone Anchored Hearing Aid ◽  
Speech Recognition In Noise

The Birmingham bone-anchored hearing aid (BAHA) programme, since its inception in 1988, has fitted more than 300 patients with unilateral bone-anchored hearing aids. Recently, some of the patients who benefited extremely well with unilateral aids applied for bilateral amplification. To date, 15 patients have been fitted with bilateral BAHAs. The benefits of bilateral amplification have been compared to unilateral amplification in 11 of these patients who have used their second BAHA for 12 months or longer. Following a subjective analysis in the form of comprehensive questionnaires, objective testing was undertaken to assess specific issues such as ‘speech recognition in quiet’, ‘speech recognition in noise’ and a modified ‘speech-in-simulated-party-noise’ (Plomp) test.‘Speech in quiet’ testing revealed a 100 per cent score with both unilateral and bilateral BAHAs. With ‘speech in noise’ all 11 patients scored marginally better with bilateral aids compared to best unilateral responses. The modified Plomp test demonstrated that bilateral BAHAs provided maximum flexibility when the origin of noise cannot be controlled as in day-to-day situations. In this small case series the results are positive and are comparable to the experience of the Nijmegen BAHA group.

Comparisons of Speech Recognition in Noise by Mildly-to-Moderately Hearing-Impaired Children Using Hearing Aids and FM Systems

1984 ◽  
Vol 49 (4) ◽  
pp. 409-418 ◽  
Author(s):  
David B. Hawkins
Keyword(s):  
Speech Recognition ◽  
Hearing Aids ◽  
Signal To Noise Ratio ◽  
Hearing Aid ◽  
Adaptive Procedure ◽  
Two Measures ◽  
Direct Input ◽  
Speech Recognition In Noise ◽  
Omnidirectional Microphones ◽  
Impaired Children

Four hearing aid arrangements (monaural-omnidirectional, monaural-directional, binaural-omnidirectional, binaural-directional) and a number of FM system-personal hearing aid combinations (including direct input, neck loop, and silhouette inductor—monaural and binaural—and environmental microphone on and off) were evaluated in a school classroom on nine children with mild-to-moderate sensorineural hearing losses. Two measures of speech recognition in noise were employed. First, the signal-to-noise ratio (S/N) yielding 50% identification of spondees was determined using a simple up-down adaptive procedure. Second, word recognition scores were obtained for three amplification arrangements at two different S/Ns (+6 and + 15 dB). The average FM advantage over a personal hearing aid was equivalent to a 15-dB improvement in S/N. Activation of the hearing aid microphone caused most of the FM advantage to disappear. The benefit offered by the FM system decreased as the environmental S/N increased but remained significant even at +15 dB. Significant improvement also was found with the use of directional as compared to omnidirectional microphones, both in the hearing aids and FM teacher microphone.

A Speech-to-Noise Ratio Test with the Bone-Anchored Hearing Aid: A Comparative Study

1986 ◽  
Vol 94 (4) ◽  
pp. 421-426 ◽  
Author(s):  
Peder Carlsson ◽  
Bo Håkansson ◽  
Ulf Rosenhall ◽  
Anders Tjellström
Keyword(s):  
Hearing Aid ◽  
Bone Conduction ◽  
Ratio Test ◽  
Speech Discrimination ◽  
Impaired Hearing ◽  
Minor Surgery ◽  
Bone Anchored Hearing Aid ◽  
Bone Conduction Hearing ◽  
Noise Ratio ◽  
Bone Conduction Hearing Aid

Hitherto, for persons with impaired hearing who cannot use an air conduction hearing aid, the only alternative has been a conventional spring-loaded bone conduction hearing aid. Now, with minor surgery, a titanium screw can be implanted in the bone behind the ear and a coupling, which penetrates the skin, can be attached, giving a new kind of hearing aid—the “bone-anchored hearing aid.” Improved quality of sound is one of the patients’ subjective assessments. Improvement was not confirmed by a standard speech-discrimination test. With new speech material consisting of sentences in noise, the speech-to-noise ratio (SN) has been determined for 24 patients. Patients who previously used a conventional bone conduction hearing aid improved their SN on the average by 3.3 dB. The most important difference between the two aids related to improved SN is probably the increased audibility between 600 and 6000 Hz.

The Effects of Changes in Head Angle on Auditory and Visual Input for Omnidirectional and Directional Microphone Hearing Aids

2003 ◽  
Vol 12 (1) ◽  
pp. 41-51 ◽  
Author(s):  
Paula Henry ◽  
Todd Ricketts
Keyword(s):  
Hearing Loss ◽  
Speech Recognition ◽  
Hearing Aids ◽  
Visual Cues ◽  
Signal To Noise Ratio ◽  
Hearing Aid ◽  
Recognition Performance ◽  
Binaural Hearing ◽  
Increase Signal Intensity ◽  
Visual Mode

Improving the signal-to-noise ratio (SNR) for individuals with hearing loss who are listening to speech in noise provides an obvious benefit. Although binaural hearing provides the greatest advantage over monaural hearing in noise, some individuals with symmetrical hearing loss choose to wear only one hearing aid. The present study tested the hypothesis that individuals with symmetrical hearing loss fit with one hearing aid would demonstrate improved speech recognition in background noise with increases in head turn. Fourteen individuals were fit monaurally with a Starkey Gemini in-the-ear (ITE) hearing aid with directional and omnidirectional microphone modes. Speech recognition performance in noise was tested using the audiovisual version of the Connected Speech Test (CST v.3). The test was administered in auditory-only conditions as well as with the addition of visual cues for each of three head angles: 0°, 20°, and 40°. Results indicated improvement in speech recognition performance with changes in head angle for the auditory-only presentation mode at the 20° and 40° head angles when compared to 0°. Improvement in speech recognition performance for the auditory + visual mode was noted for the 20° head angle when compared to 0°. Additionally, a decrement in speech recognition performance for the auditory + visual mode was noted for the 40° head angle when compared to 0°. These results support a speech recognition advantage for listeners fit with one ITE hearing aid listening in a close listener-to-speaker distance when they turn their head slightly in order to increase signal intensity.

scholarly journals Hearing Aid Treatment for Patients with Mixed Hearing Loss. Part II: Speech Recognition in Comparison to Direct Acoustic Cochlear Stimulation

2020 ◽  
Vol 25 (3) ◽  
pp. 133-142
Author(s):  
Nina Wardenga ◽  
Ad F.M. Snik ◽  
Eugen Kludt ◽  
Bernd Waldmann ◽  
Thomas Lenarz ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Speech Recognition ◽  
Middle Ear ◽  
Hearing Aids ◽  
Dynamic Range ◽  
Hearing Aid ◽  
Middle Ear Surgery ◽  
Promising Alternative ◽  
Mixed Hearing Loss ◽  
Technical Specifications

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.

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