scholarly journals Towards Auditory Profile-Based Hearing-Aid Fitting: Fitting Rationale and Pilot Evaluation

2021 ◽  
Vol 11 (1) ◽  
pp. 10-21
Author(s):  
Raul Sanchez-Lopez ◽  
Michal Fereczkowski ◽  
Sébastien Santurette ◽  
Torsten Dau ◽  
Tobias Neher

Background—The clinical characterization of hearing deficits for hearing-aid fitting purposes is typically based on the pure-tone audiogram only. In a previous study, a group of hearing-impaired listeners completed a comprehensive test battery that was designed to tap into different dimensions of hearing abilities. A data-driven analysis of the data yielded four clinically relevant patient sub-populations or “auditory profiles”. The purpose of the current study was to propose and pilot-test profile-based hearing-aid settings in order to explore their potential for providing more targeted hearing-aid treatment. Methods—Four candidate hearing-aid settings were developed and evaluated by a subset of the participants tested previously. The evaluation consisted of multi-comparison preference ratings that were carried out in realistic sound scenarios. Results—Listeners belonging to the different auditory profiles showed different patterns of preference for the tested hearing-aid settings that were largely consistent with the expectations. Conclusions—The results of this pilot evaluation support further investigations into stratified, profile-based hearing-aid fitting with wearable hearing aids.

2020 ◽  
Author(s):  
Raul Sanchez-Lopez ◽  
Michal Fereczkowski ◽  
Sébastien Santurette ◽  
Torsten Dau ◽  
Tobias Neher

AbstractObjectiveThe clinical characterization of hearing deficits for hearing-aid fitting purposes is typically based on the pure-tone audiogram only. In a previous study, a group of hearing-impaired listeners were tested using a comprehensive test battery designed to tap into different aspects of hearing. A data-driven analysis of the data yielded four clinically relevant patient subpopulations or “auditory profiles”. In the current study, profile-based hearing-aid settings were proposed and evaluated to explore their potential for providing more targeted hearing-aid treatment.DesignFour candidate hearing-aid settings were implemented and evaluated by a subset of the participants tested previously. The evaluation consisted of multi-comparison preference ratings carried out in realistic sound scenarios.ResultsListeners belonging to the different auditory profiles showed different patterns of preference for the tested hearing-aid settings that were largely consistent with the expectations.ConclusionThe results of this proof-of-concept study support further investigations into stratified, profile-based hearing-aid fitting with wearable hearing aids.


1986 ◽  
Vol 51 (4) ◽  
pp. 362-369 ◽  
Author(s):  
Donna M. Risberg ◽  
Robyn M. Cox

A custom in-the-ear (ITE) hearing aid fitting was compared to two over-the-ear (OTE) hearing aid fittings for each of 9 subjects with mild to moderately severe hearing losses. Speech intelligibility via the three instruments was compared using the Speech Intelligibility Rating (SIR) test. The relationship between functional gain and coupler gain was compared for the ITE and the higher rated OTE instruments. The difference in input received at the microphone locations of the two types of hearing aids was measured for 10 different subjects and compared to the functional gain data. It was concluded that (a) for persons with mild to moderately severe hearing losses, appropriately adjusted custom ITE fittings typically yield speech intelligibility that is equal to the better OTE fitting identified in a comparative evaluation; and (b) gain prescriptions for ITE hearing aids should be adjusted to account for the high-frequency emphasis associated with in-the-concha microphone placement.


2020 ◽  
Vol 16 (2) ◽  
pp. 85-94
Author(s):  
Eojini Bang ◽  
Kyoungwon Lee

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.


2020 ◽  
Vol 24 ◽  
pp. 233121652093246
Author(s):  
Johanna Hengen ◽  
Inger L. Hammarström ◽  
Stefan Stenfelt

Dissatisfaction with the sound of one’s own voice is common among hearing-aid users. Little is known regarding how hearing impairment and hearing aids separately affect own-voice perception. This study examined own-voice perception and associated issues before and after a hearing-aid fitting for new hearing-aid users and refitting for experienced users to investigate whether it was possible to differentiate between the effect of (unaided) hearing impairment and hearing aids. Further aims were to investigate whether First-Time and Experienced users as well as users with dome and mold inserts differed in the severity of own-voice problems. The study had a cohort design with three groups: First-Time hearing-aid users going from unaided to aided hearing ( n = 70), Experienced hearing-aid users replacing their old hearing aids ( n = 70), and an unaided control group ( n = 70). The control group was surveyed once and the hearing-aid users twice; once before hearing-aid fitting/refitting and once after. The results demonstrated that own-voice problems are common among both First-Time and Experienced hearing-aid users with either dome- or mold-type fittings, while people with near-normal hearing and not using hearing aids report few problems. Hearing aids increased ratings of own-voice problems among First-Time users, particularly those with mold inserts. The results suggest that altered auditory feedback through unaided hearing impairment or through hearing aids is likely both to change own-voice perception and complicate regulation of vocal intensity, but hearing aids are the primary reason for poor perceived sound quality of one’s own voice.


2013 ◽  
Vol 128 (1) ◽  
pp. 35-42
Author(s):  
M L McNeil ◽  
M Gulliver ◽  
D P Morris ◽  
F M Makki ◽  
M Bance

AbstractIntroduction:Patients receiving a bone-anchored hearing aid have well-documented improvements in their quality of life and audiometric performance. However, the relationship between audiometric measurements and subjective improvement is not well understood.Methods:Adult patients enrolled in the Nova Scotia bone-anchored hearing aid programme were identified. The pure tone average for fitting the sound-field threshold, as well as the better and worse hearing ear bone conduction and air conduction levels, were collected pre-operatively. Recipients were asked to complete the Speech, Spatial and Qualities of Hearing questionnaire; their partners were asked to complete a pre- and post-bone anchored hearing aid fitting Hearing Handicap Inventory for Adults questionnaire.Results:Forty-eight patients who completed and returned the Speech, Spatial and Qualities of Hearing questionnaire had partners who completed the Hearing Handicap Inventory for Adults questionnaire. The results from the Speech, Spatial and Qualities of Hearing questionnaire correlated with the sound-field hearing threshold post-bone-anchored hearing aid fitting and the pure tone average of the better hearing ear bone conduction (total Speech, Spatial and Qualities of Hearing Scale to the pre-operative better hearing ear air curve (r = 0.3); worse hearing ear air curve (r = 0.27); post-operative, bone-anchored hearing aid-aided sound-field thresholds (r = 0.35)). An improvement in sound-field threshold correlated only with spatial abilities. In the Hearing Handicap Inventory for Adults questionnaire, there was no correlation between the subjective evaluation of each patient and their partner.Conclusion:The subjective impressions of hearing aid recipients with regards to speech reception and the spatial qualities of hearing correlate well with pre-operative audiometric results. However, the overall magnitude of sound-field improvement predicts an improvement of spatial perception, but not other aspects of hearing, resulting in hearing aid recipients having strongly disparate subjective impressions when compared to those of their partners.


2005 ◽  
Vol 16 (10) ◽  
pp. 822-828 ◽  
Author(s):  
Jackie L. Clark ◽  
Ross J. Roeser

A 23-month-old female was referred for hearing aid fitting after failing newborn hearing screening and being diagnosed with significant hearing loss through subsequent diagnostic testing. Auditory brainstem response (ABR) and behavioral testing revealed a moderate-to-severe bilateral mixed hearing loss. Prior to the hearing aid evaluation, tympanostomy tubes had been placed bilaterally with little or no apparent change in hearing sensitivity. Initial testing during the hearing aid fitting confirmed earlier findings, but abnormal middle ear results were observed, requiring referral for additional otologic management. Following medical clearance, binaural digital programmable hearing aids were fit using Desired Sensation Level parameters. Behavioral testing and probe microphone measures showed significant improvements in audibility. Decrease in hearing sensitivity was observed six months following hearing aid fitting. Radiological studies, ordered due to the mixed component and decreased hearing sensitivity, revealed large vestibular aqueduct syndrome (LVAS). Based on the diagnosis of LVAS, a cochlear implant was placed on the right ear; almost immediate speech-language gains were observed.


2005 ◽  
Vol 16 (07) ◽  
pp. 461-472 ◽  
Author(s):  
Gustav H. Mueller ◽  
Ruth A. Bentler

Clinical measurement of the loudness discomfort level (LDL) historically has been part of the hearing aid fitting procedure, and this clinical practice remains popular today. LDL measurements also are recommended in contemporary hearing aid fitting protocols. Yet, surveys show that many hearing aid users are dissatisfied with the loudness of their hearing aids. In this evidence-based review article, we evaluate the effectiveness of clinical LDL measurements. Specifically, we asked the question "Are the clinical measurements of LDL for adult patients predictive of aided acceptance and satisfaction of loudness for high inputs in the real world?" Nearly 200 articles were reviewed; three met the criteria set forth in this review. The evidence supported using unaided LDLs for selecting the maximum real-ear output of hearing aids. No study using aided LDLs or aided loudness verification met the criteria. The level of the evidence for the three articles using unaided LDLs was low; no higher than Level 4. The limited number of studies, the level of evidence, and the statistical power of the studies prevents us from making a strong recommendation concerning the clinical use of LDL measures. Additional research in this area, especially research employing randomized controlled trials would be a useful addition to this body of literature.


2020 ◽  
Vol 16 (2) ◽  
pp. 133-139 ◽  
Author(s):  
Young Kwon Han ◽  
Kyoungwon Lee

Purpose: Several studies have reported the differences between Korean and other countries’ speech in long-term average speech spectrum (LTASS) and band importance function. Authors tried to identify the conversational speech level, the resulting spectrum, and the LTASS for Korean. The purpose of this study was to support the production of a Korean-type hearing aid fitting formula to effectively improve the sound quality of hearing aids and the communication abilities with hearing aids, and to standardize the sound stimuli required to measure the performance of hearing aids. Methods: A total of 73 participants with normal hearing and with no specific voice and language deficits was voluntarily recruited from capital, Gyeongsang and Jeolla areas. The conversational speech level was measured by vocalizing ‘soft,’ ‘moderate,’ ‘raised,’ and ‘loud’ at a distance of 1.0 m from the speaker. And LTASS was measured by vocalizing it at a distance of 0.2 m from the speaker. Results: There was a difference in the mean of males and females in the conversation level, but no significant regional differences were shown. The conversational speech level corresponding to 30th, 65th, and 99th percentiles was 59.67, 64.74, and 79.07 dB sound pressure level, respectively. And the speech spectrum of 30th, 65th, and 99th percentile and LTASS showed in different forms from the international speech test signal. Conclusion: The results of this study should help to calculate the Korean type hearing aid fitting formula and should be used as the basic data to determine the characteristics of the sound stimuli when measuring the performance of the hearing aid.


2019 ◽  
Vol 62 (11) ◽  
pp. 4150-4164 ◽  
Author(s):  
Inge de Ronde-Brons ◽  
Wim Soede ◽  
Wouter Dreschler

Purpose The aim of the study was to evaluate the application of a modified version of the Amsterdam Inventory for Auditory Disabilities and Handicap to inventory self-reported hearing difficulties pre and post hearing aid fitting in 6 dimensions: detection, speech in silence, speech in noise, localization, discrimination, and noise tolerance. Method Questionnaires pre and post hearing aid fitting were collected during regular practice of hearing aid provision. Data of 740 subjects are presented; 337 already used hearing aids, and 403 were new users. Results Group-averaged scores improved due to hearing aid fitting for all 6 dimensions. Based on a criterion previously defined for the Amsterdam Inventory for Auditory Disabilities and Handicap questionnaire, 66% of subjects had a significant individual improvement in sum score. Experienced users showed lower improvement in scores, whereas their aided prescores were, on average, not better than the (unaided) score of 1st users. Conclusions The questionnaire can be applied as a structured approach to inventory hearing problems in 6 dimensions prior to hearing aid fitting and to systematically evaluate the effects of hearing aid fitting after a trial period. The data presented here can serve as normative data for comparison of individual subjects in clinical practice.


2013 ◽  
Vol 23 (2) ◽  
pp. 31-42
Author(s):  
Marlene P. Bagatto

Fitting hearing aids to infants with hearing loss can be completed in a systematic and evidence-based manner. This is because there are clinical protocols and technologies available so that pediatric audiologists can fit hearing aids to their patients with hearing loss during the early months of life. Early hearing aid fitting supports speech and language development, however, the way in which the hearing aid is fitted can significantly impact the infant’s progress. A four-stage process for infant hearing aid fitting is offered as a framework with which to execute the essential components of the procedure. Key aspects of the pediatric hearing aid fitting process are described with a focus on elements that may impact an infant’s progress with hearing aids if not implemented.


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