scholarly journals Sound Localization and Lateralization by Bilateral Bone Conduction Devices, Middle Ear Implants, and Cartilage Conduction Hearing Aids

2021 ◽  
Vol 11 (4) ◽  
pp. 508-523
Author(s):  
Kimio Shiraishi
Keyword(s):  
Hearing Loss ◽  
Middle Ear ◽  
Sound Localization ◽  
Hearing Aids ◽  
Bone Conduction ◽  
Binaural Hearing ◽  
Normal Hearing ◽  
Aural Atresia ◽  
Middle Ear Implants ◽  
And Cartilage

Sound localization in daily life is one of the important functions of binaural hearing. Bilateral bone conduction devices (BCDs), middle ear implants, and cartilage conduction hearing aids have been often applied for patients with conductive hearing loss (CHL) or mixed hearing loss, for example, resulting from bilateral microtia and aural atresia. In this review, factors affecting the accuracy of sound localization with bilateral BCDs, middle ear implants, and cartilage conduction hearing aids were classified into four categories: (1) types of device, (2) experimental conditions, (3) participants, and (4) pathways from the stimulus sound to both cochleae. Recent studies within the past 10 years on sound localization and lateralization by BCDs, middle ear implants, and cartilage conduction hearing aids were discussed. Most studies showed benefits for sound localization or lateralization with bilateral devices. However, the judgment accuracy was generally lower than that for normal hearing, and the localization errors tended to be larger than for normal hearing. Moreover, it should be noted that the degree of accuracy in sound localization by bilateral BCDs varied considerably among patients. Further research on sound localization is necessary to analyze the complicated mechanism of bone conduction, including suprathreshold air conduction with bilateral devices.

Comparison of Carina active middle-ear implant with conventional hearing aids for mixed hearing loss

2016 ◽  
Vol 130 (4) ◽  
pp. 340-343 ◽  
Author(s):  
V A Savaş ◽  
B Gündüz ◽  
R Karamert ◽  
R Cevizci ◽  
M Düzlü ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Middle Ear ◽  
Hearing Aids ◽  
Bone Conduction ◽  
Patient Acceptance ◽  
Life Questionnaire ◽  
Active Middle Ear Implant ◽  
Mixed Hearing Loss ◽  
Glasgow Benefit Inventory ◽  
Middle Ear Implants

AbstractObjective:To compare the auditory outcomes of Carina middle-ear implants with those of conventional hearing aids in patients with moderate-to-severe mixed hearing loss.Methods:The study comprised nine patients (six males, three females) who underwent middle-ear implantation with Carina fully implantable active middle-ear implants to treat bilateral moderate-to-severe mixed hearing loss. The patients initially used conventional hearing aids and subsequently received the Carina implants. The hearing thresholds with implants and hearing aids were compared.Results:There were no significant differences between: the pre-operative and post-operative air and bone conduction thresholds (p> 0.05), the thresholds with hearing aids and Carina implants (p> 0.05), or the pre-operative (mean, 72.8 ± 19 per cent) and post-operative (mean, 69.9 ± 24 per cent) speech discrimination scores (p> 0.05). One of the patients suffered total sensorineural hearing loss three months following implantation despite an initial 38 dB functional gain. All except one patient showed clinical improvements after implantation according to quality of life questionnaire (Glasgow Benefit Inventory) scores.Conclusion:Acceptance of Carina implants is better than with conventional hearing aids in patients with mixed hearing loss, although both yield similar hearing amplification. Cosmetic reasons appear to be critical for patient acceptance.

scholarly journals Hearing Aid Treatment in Patients with Mixed Hearing Loss. Part I: Expected Benefit and Limitations after Stapes Surgery

2020 ◽  
Vol 25 (3) ◽  
pp. 125-132
Author(s):  
Nina Wardenga ◽  
Victoria Diedrich ◽  
Bernd Waldmann ◽  
Thomas Lenarz ◽  
Hannes Maier
Keyword(s):  
Hearing Loss ◽  
Middle Ear ◽  
Hearing Aids ◽  
State Of The Art ◽  
Treatment Success ◽  
Stapes Surgery ◽  
Pure Tone Average ◽  
Mixed Hearing Loss ◽  
Hearing Devices ◽  
Middle Ear Implants

Objective: The purpose of the present study was to determine the fraction of patients with mixed hearing loss who can or cannot expect benefit from power hearing aids (HAs) after stapes surgery. Design: The audiological outcome of 374 stapes surgeries was used to calculate the patients’ individual postoperative requirements in terms of gain and output of HAs. These requirements were compared to the available gain and output provided by state-of-the-art power HAs at 0.5, 1.0, 2.0, and 4.0 kHz. According to these comparisons, ears were divided into three groups. For G0, required gain and output lay within the corresponding technical limits of the HAs at all frequencies. In G1, one or both requirements could not be fulfilled at 1 frequency. G2 combined all ears where the requirements lay beyond the HA’s technical limitations at 2 or more frequencies. Results: Stapes surgery resulted in an improvement of air-bone gap (ABG) in 84.5% of the cases by 15.7 dB on average. Based on pure-tone average (0.5, 1.0, 2.0, 4.0 kHz), 40.6% of all cases showed an ABG ≤10 dB. 44.9% of all cases did no longer need a HA after stapes surgery. A power HA would fulfill both audiological criteria at all 4 frequencies in 81.6% of cases that needed a HA postoperatively. However, 18.4% would not be sufficiently treatable at 1 or more frequencies (15.0% in G1, 3.4% in G2). Conclusions: The present study identified a subset of patients with mixed hearing loss after stapes surgery that cannot be treated sufficiently with available power HAs. As the residual ABG is an important reason for this lack of treatment success, the advancement of alternative hearing devices that circumvent the middle ear, such as powerful active middle ear implants, is indicated.

Auditory Outcomes with Hearing Rehabilitation in Children with Unilateral Hearing Loss: A Systematic Review

2017 ◽  
Vol 157 (4) ◽  
pp. 565-571 ◽  
Author(s):  
Swathi Appachi ◽  
Jessica. L. Specht ◽  
Nikhila Raol ◽  
Judith E. C. Lieu ◽  
Michael S. Cohen ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Speech Recognition ◽  
Sound Localization ◽  
Hearing Aids ◽  
Bone Conduction ◽  
Unilateral Hearing Loss ◽  
Hearing Rehabilitation ◽  
Hearing Devices ◽  
Bone Conduction Hearing ◽  
Speech Recognition In Noise

Objective Options for management of unilateral hearing loss (UHL) in children include conventional hearing aids, bone-conduction hearing devices, contralateral routing of signal (CROS) aids, and frequency-modulating (FM) systems. The objective of this study was to systematically review the current literature to characterize auditory outcomes of hearing rehabilitation options in UHL. Data Sources PubMed, EMBASE, Medline, CINAHL, and Cochrane Library were searched from inception to January 2016. Manual searches of bibliographies were also performed. Review Methods Studies analyzing auditory outcomes of hearing amplification in children with UHL were included. Outcome measures included functional and objective auditory results. Two independent reviewers evaluated each abstract and article. Results Of the 249 articles identified, 12 met inclusion criteria. Seven articles solely focused on outcomes with bone-conduction hearing devices. Outcomes favored improved pure-tone averages, speech recognition thresholds, and sound localization in implanted patients. Five studies focused on FM systems, conventional hearing aids, or CROS hearing aids. Limited data are available but suggest a trend toward improvement in speech perception with hearing aids. FM systems were shown to have the most benefit for speech recognition in noise. Studies evaluating CROS hearing aids demonstrated variable outcomes. Conclusions Data evaluating functional and objective auditory measures following hearing amplification in children with UHL are limited. Most studies do suggest improvement in speech perception, speech recognition in noise, and sound localization with a hearing rehabilitation device.

scholarly journals Subjective Outcomes With Bone Conduction and Middle Ear Implants for Patients Wth Conductive or Mixed Hearing Loss

2015 ◽  
Vol 18 (7) ◽  
pp. A364
Author(s):  
M Kosaner Kliess ◽  
R Zoehrer ◽  
B Schlick ◽  
M Mariacher ◽  
M Urban
Keyword(s):  
Hearing Loss ◽  
Middle Ear ◽  
Bone Conduction ◽  
Mixed Hearing Loss ◽  
Middle Ear Implants ◽  
Subjective Outcomes

Some Implications of Binaural Signal Selection for Hearing Aid Evaluation

1964 ◽  
Vol 7 (3) ◽  
pp. 279-289
Author(s):  
Allan J. Heffler ◽  
Martin C. Schultz
Keyword(s):  
Hearing Loss ◽  
Hearing Aids ◽  
Binaural Hearing ◽  
Normal Hearing ◽  
The Other ◽  
Auditory Training ◽  
Signal Selection ◽  
Long Duration ◽  
Selection For ◽  
Binaural Hearing Aids

Clinical techniques for evaluating binaural hearing aids have been inconclusive. This paper offers some explanations of shortcomings in present approaches, concentrating upon several characteristics to be included in an adequate clinical procedure. These are the presence of competing sound; S/N ratios permitting measurable increases in discrimination from advantageous listening conditions; elimination of localization and sidedness effects; and the requirement of long duration signals with credit for partial responses. The study was an approach on normal-hearing individuals under several S/N ratios, with occlusion of one ear as an experimental variable. Listening was accomplished under homophasic and antiphasic conditions for each combination of the other conditions. Results demonstrated significant differences among the listening conditions and the results have been rationalized in schema for testing binaural hearing aids under various hearing-loss circumstances. Applications to auditory training are discussed.

Efficacy of the active middle-ear implant in patients with sensorineural hearing loss

2013 ◽  
Vol 127 (S2) ◽  
pp. S8-S16 ◽  
Author(s):  
C L Butler ◽  
P Thavaneswaran ◽  
I H Lee
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Middle Ear ◽  
Hearing Aids ◽  
Sensorineural Hearing ◽  
Active Middle Ear Implant ◽  
Middle Ear Implant ◽  
Significant Difference ◽  
Middle Ear Implants ◽  
Better Than

AbstractIntroduction:This systematic review aims to advise on the effectiveness of the active middle-ear implant in patients with sensorineural hearing loss, compared with external hearing aids.Methods:A systematic search of several electronic databases, including PubMed and Embase, was used to identify relevant studies for inclusion.Results:Fourteen comparative studies were included. Nine studies reported on the primary outcome of functional gain: one found that the middle-ear implant was significantly better than external hearing aids (p < 0.001), while another found that external hearing aids were generally significantly better than middle-ear implants (p < 0.05). Six of the seven remaining studies found that middle-ear implants were better than external hearing aids, although generally no clinically significant difference (i.e. ≥10 dB) was seen.Conclusion:Generally, the active middle-ear implant appears to be as effective as the external hearing aid in improving hearing outcomes in patients with sensorineural hearing loss.

Sound Localization Acuity in Children with Unilateral Hearing Loss Who Wear a Hearing Aid in the Impaired Ear

2010 ◽  
Vol 21 (08) ◽  
pp. 522-534 ◽  
Author(s):  
Patti M. Johnstone ◽  
Anna K. Náblek ◽  
Velma S. Robertson
Keyword(s):  
Hearing Loss ◽  
Early Intervention ◽  
Experimental Design ◽  
Sound Localization ◽  
Repeated Measures ◽  
Hearing Aid ◽  
Binaural Hearing ◽  
Normal Hearing ◽  
Unilateral Hearing Loss ◽  
Older Children

Background: Disrupted binaural hearing is thought to contribute in part to the academic, social, and communication problems often associated with unilateral hearing loss (UHL) in childhood. It is not known, however, if putting a hearing aid in the impaired ear of a child with UHL will lead to bilateral or binaural benefit. This study seeks to utilize sound localization acuity measurements to assess hearing aid amplification efficacy in children with UHL. Purpose: To measure sound localization ability in children with UHL who use a hearing aid in the impaired ear to determine the extent to which amplification, age, early intervention, and degree of hearing loss affects localization acuity. Research Design: A within-subjects experimental design using repeated measures is used to determine the effect of amplification on localization acuity in children with UHL. A between-subjects experimental design is used to compare localization acuity between children with UHL and age-matched controls with normal hearing. Study Sample: Twelve children with UHL who used a hearing aid in the impaired ear and 12 age-matched controls with normal hearing. Children with UHL were divided into two groups based on degree of hearing loss. Children in both groups were divided into two age groups: older children (10–14 yr) and younger children (6–9 yr). Data Collection and Analysis: All testing was done in a sound-treated booth with a horizontal array of 15 loudspeakers (radius of 1 m). The stimulus was a spondee word, “baseball”: the level averaged 60 dB SPL and randomly roved (±8 dB). Each child was asked to identify the location of a sound source. Results: In the experimental study a significant interaction was found between hearing aid amplification and child age. A hearing aid significantly improved localization acuity in younger children with UHL and significantly impaired localization acuity in older children. A significant correlation was found between age at intervention and localization bilateral benefit. Children who were fit earlier showed bilateral benefit whereas children who were fit later showed bilateral interference. Development, however, may play a role in sound localization acuity. When unaided, older children had significantly better localization acuity than younger children with UHL. Conclusions: A hearing aid can provide bilateral localization benefit to some children with UHL. Early intervention may increase the likelihood of bilateral benefit. However, developmental factors appear to play a role in improving localization abilities over time for children with UHL. Nonetheless, without a means of establishing bilateral benefit with hearing aid amplification, localization performance in children with UHL will rarely equal that of peers.

Assessment of expressive vocabulary outcomes in hearing-impaired children with hearing aids: do bilaterally hearing-impaired children catch up?

2006 ◽  
Vol 120 (8) ◽  
pp. 619-626 ◽  
Author(s):  
C Kiese-Himmel ◽  
M Reeh
Keyword(s):  
Hearing Loss ◽  
Hearing Aids ◽  
Repeated Measures ◽  
Binaural Hearing ◽  
Normal Hearing ◽  
Hearing Impaired ◽  
Expressive Vocabulary ◽  
Clinical Tool ◽  
Impaired Children ◽  
Hearing Impaired Children

Objective: To evaluate expressive vocabulary growth in hearing-impaired preschool children wearing hearing aids.Design: Prospective analysis of the outcomes of children included in the 1994 German ‘Goettinger Hoer-Sprachregister’ (GHR) series, using a repeated-measures paradigm in six- to nine-month intervals (t1–t3).Subjects: Twenty-seven children (aged 2.0–4.4 years) with bilateral sensorineural hearing loss (with averages at frequencies of 0.5, 1, 2 and 4 kHz of >20 to >90 dB in the better ear) from the 1994 GHR series. The children were diagnosed at a mean age of 31.4 months (standard deviation (SD) 10.6 months) and fitted with a binaural hearing aid at a mean age of 32.3 months (SD 10.5 months). Nonverbal intelligence was average (five missing data entries). Standardized, age-appropriate picture naming tests (the ‘Sprachentwicklungstest für 2-jährige Kinder’, the Kaufman Assessment Battery for Children subtest vocabulary, and the ‘Aktiver Wortschatztest für drei- bis sechsjährige Kinder’) were carried out at three time points and results compared with data from children with normal hearing. The test raw scores were converted to T scores (mean = 50; SD = 10).Results: On average, the children scored far below the normative population at t1 (mean = 28.9; SD = 11.3) and slowly improved as they got older (at t3, mean = 34.1; SD = 16.1; p = 0.010). Children with mild or moderate hearing loss improved most notably (mean difference t1–t3; p = 0.001), except for one child of deaf parents. Two of the five mildly hearing-impaired children and two of the eleven moderately hearing-impaired children caught up with their normal hearing peers with regards to expressive vocabulary. Such expressive vocabulary achievements were not seen in any children with >70 dB hearing loss or in six of the eleven children (55 per cent) with a 40–70 dB hearing loss, despite receiving adequate personal amplification.Conclusion: Testing expressive vocabulary size is a useful clinical tool in assessing linguistic lexical outcome.

scholarly journals Benefits of active middle ear implants over hearing aids in patients with sloping high tone hearing loss: comparison with hearing aids

2017 ◽  
Vol 37 (3) ◽  
pp. 218-223
Author(s):  
J.M. Lee ◽  
J.H. Jeon ◽  
I.S. Moon ◽  
J.Y. Choi
Keyword(s):  
Hearing Loss ◽  
Middle Ear ◽  
Hearing Aids ◽  
Hearing Aid ◽  
High Tone ◽  
Sono Stati ◽  
Hearing In Noise ◽  
Middle Ear Implants ◽  
Noise Test ◽  
Hearing Aid Benefit

In questo studio retrospettivo, abbiamo confrontato i benefici oggettivi e soggettivi degli impianti attivi dell’orecchio medio (AMEI) rispetto alle tradizionali protesi acustiche (HA) nei pazienti con perdita dell’udito per le frequenze acute. Trentaquattro pazienti con ipoacusia neurosensoriale sono stati trattati con l’impianto di AMEI. Tra questi, sei avevano un audiogramma “in discesa” con perdita dell’udito per le frequenze acute, ed avevano usato per più di sei mesi HA. È stata quindi eseguita una valutazione oggettiva, tramite l’audiometria tonale e il test di riconoscimento delle parole, una versione coreana del “Hearing in Noise Test” (K-HINT), ed una valutazione soggettiva tramite il seguente questionario: Abbreviated Profile of Hearing Aid Benefit (APHAB). I pazienti sono stati sottoposti ai suddetti test in tre occasioni distinte: 1) prima della chirurgia, senza protesi; 2) prima della chirurgia, con HA; 3) tre mesi dopo l’impianto di AMEI. Il guadagno medio per le alte frequenze (≥ 2 kHz) si è rivelato migliore con AMEI che con HA. Sebbene il risultato non ha raggiunto un livello di significatività statistica, gli impianti attivi dell’orecchio medio hanno mostrato un punteggio di riconoscimento delle parole superiore rispetto a HA. Ad ogni modo, il livello di comoda udibilità al quale il punteggio di riconoscimento delle parole è stato testato si è rivelato significativamente più basso con AMEI rispetto ad HA. Al K-HINT i pazienti con AMEI hanno mostrato un migliore riconoscimento rispetto ai risultati ottenuti con HA, sia in condizione di quiete sia di rumore. Gli score APAHB hanno rivelato che i pazienti erano più soddisfatti con AMEI. L’uso degli impianti attivi dell’orecchio medio in pazienti con perdita dell’udito per le frequenze acute ha permesso di ottenere risultati migliori rispetto all’utilizzo delle protesi tradizionali. Basandoci su questi dati, gli AMEI hanno offerto risultati oggettivi e soggettivi migliori, e pertanto, potrebbero rappresentare una valida alternativa per il trattamento delle ipoacusie con audiogramma in discesa.

scholarly journals Benefits of Cartilage Conduction Hearing Aids for Speech Perception in Unilateral Aural Atresia

2021 ◽  
Vol 11 (2) ◽  
pp. 284-290
Author(s):  
Sakie Akasaka ◽  
Tadashi Nishimura ◽  
Hiroshi Hosoi ◽  
Osamu Saito ◽  
Ryota Shimokura ◽  
...  
Keyword(s):  
Speech Recognition ◽  
Speech Perception ◽  
Hearing Aids ◽  
Developmental Disorders ◽  
Conductive Hearing Loss ◽  
Hearing Aid ◽  
Bone Conduction ◽  
Binaural Hearing ◽  
Aural Atresia ◽  
Conductive Hearing

Severe conductive hearing loss due to unilateral aural atresia leads to auditory and developmental disorders, such as difficulty in hearing in challenging situations. Bone conduction devices compensate for the disability but unfortunately have several disadvantages. The aim of this study was to evaluate the benefits of cartilage conduction (CC) hearing aids for speech perception in unilateral aural atresia. Eleven patients with unilateral aural atresia were included. Each participant used a CC hearing aid in the atretic ear. Speech recognition scores in the binaural hearing condition were obtained at low speech levels to evaluate the contribution of aided atretic ears to speech perception. Speech recognition scores were also obtained with and without presentation of noise. These assessments were compared between the unaided and aided atretic ear conditions. Speech recognition scores at low speech levels were significantly improved under the aided atretic ear condition (p < 0.05). A CC hearing aid in the unilateral atretic ear did not significantly improve the speech recognition score in a symmetrical noise presentation condition. The binaural hearing benefits of CC hearing aids in unilateral aural atresia were predominantly considered a diotic summation. Other benefits of binaural hearing remain to be investigated.

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