scholarly journals Fitting Assistive Technology for People with Hearing Loss: The Importance of Remote Microphone Systems′ Electroacoustic Verification

Author(s):  
Regina Tangerino de Souza Jacob ◽  
Elaine Cristina Moreto Paccola ◽  
Érika Cristina Bucuvic ◽  
Manoel Henrique Salgado

The remote microphone system (RMS) must be appropriately working when fitting it in a person with hearing loss. For this verification process, the concept of transparency is adopted. If it is not transparent, the hearing aid (HA) may not capture the user’s voice and his peers appropriately, or the RMS may not have the advantage in gain needed to emphasize the speaker’s voice. This study investigates the influence of the receiver’s gain setting on the transparency of different brands and models of RMS and HAs. It is a retrospective chart review with 277 RMS from three distinct brands (RMA, RMB, and RMC) and HAs. There was an association of the receiver’s gain setting with the variables: brand of the transmitter/receiver (p = 0.005), neck loop’s receiver vs. universal and dedicated receivers (p = 0.022), and between brands of HA and transmitter/receiver (p < 0.001). RMS transmitter (odds ratio [OR = 7.9]) and the type of receiver (neckloop [OR = 3.4]; universal [OR = 0.78]) presented a higher risk of not achieving transparency in default gain, confirming and extolling the need to include electroacoustic verification in the protocol of fitting, verification, and validation of RMS and HA.

2015 ◽  
Vol 24 (4) ◽  
pp. 462-468 ◽  
Author(s):  
Jessica J. Messersmith ◽  
Lindsey E. Jorgensen ◽  
Jessica A. Hagg

Purpose The purpose of this study was to determine whether an alternate fitting strategy, specifically adjustment to gains in a hearing aid (HA), would improve performance in patients who experienced poorer performance in the bimodal condition when the HA was fit to traditional targets. Method This study was a retrospective chart review from a local clinic population seen during a 6-month period. Participants included 6 users of bimodal stimulation. Two performed poorer in the cochlear implant (CI) + HA condition than in the CI-only condition. One individual performed higher in the bimodal condition, but the overall performance was low. Three age range–matched users whose performance increased when the HA was used in conjunction with a CI were also included. The HA gain was reduced beyond 2000 Hz. Speech perception scores were obtained pre- and postmodification to the HA fitting. Results All listeners whose HA was programmed using the modified approach demonstrated improved speech perception scores with the modified HA fit in the bimodal condition when compared with the traditional HA fit in the bimodal condition. Conclusion Modifications to gains above 2000 Hz in the HA may improve performance for bimodal listeners who perform more poorly in the bimodal condition when the HA is fit to traditional targets.


2018 ◽  
Vol 39 (04) ◽  
pp. 377-389 ◽  
Author(s):  
Susan Scollie ◽  
Danielle Glista

AbstractThis article provides a review of the current literature on the topic of frequency lowering hearing aid technology specific to the treatment of severe and profound levels of hearing impairment in child and adult listeners. Factors to consider when assessing listener candidacy for frequency lowering technology are discussed. These include factors related to audiometric assessment, the listener, the type of hearing aid technology, and the verification and validation procedures that can assist in determining candidacy for frequency lowering technology. An individualized candidacy assessment including the use of real-ear verification measures and carefully chosen validation tools are recommended for listeners requiring greater audibility of high-frequency sounds, when compared with amplification via conventional hearing aid technology.


2020 ◽  
Vol 31 (05) ◽  
pp. 354-362
Author(s):  
Paula Folkeard ◽  
Marlene Bagatto ◽  
Susan Scollie

Abstract Background Hearing aid prescriptive methods are a commonly recommended component of evidence-based preferred practice guidelines and are often implemented in the hearing aid programming software. Previous studies evaluating hearing aid manufacturers' software-derived fittings to prescriptions have shown significant deviations from targets. However, few such studies examined the accuracy of software-derived fittings for the Desired Sensation Level (DSL) v5.0 prescription. Purpose The purpose of this study was to evaluate the accuracy of software-derived fittings to the DSL v5.0 prescription, across a range of hearing aid brands, audiograms, and test levels. Research Design This study is a prospective chart review with simulated cases. Data Collection and Analysis A set of software-derived fittings were created for a six-month-old test case, across audiograms ranging from mild to profound. The aided output from each fitting was verified in the test box at 55-, 65-, 75-, and 90-dB SPL, and compared with DSL v5.0 child targets. The deviations from target across frequencies 250-6000 Hz were calculated, together with the root-mean-square error (RMSE) from target. The aided Speech Intelligibility Index (SII) values generated for the speech passages at 55- and 65-dB SPL were compared with published norms. Study Sample Thirteen behind-the-ear style hearing aids from eight manufacturers were tested. Results The amount of deviation per frequency was dependent on the test level and degree of hearing loss. Most software-derived fittings for mild-to-moderately severe hearing losses fell within ± 5 dB of the target for most frequencies. RMSE results revealed more than 84% of those hearing aid fittings for the mild-to-moderate hearing losses were within 5 dB at all test levels. Fittings for severe to profound hearing losses had the greatest deviation from target and RMSE. Aided SII values for the mild-to-moderate audiograms fell within the normative range for DSL pediatric fittings, although they fell within the lower portion of the distribution. For more severe losses, SII values for some hearing aids fell below the normative range. Conclusions In this study, use of the software-derived manufacturers' fittings based on the DSL v5.0 pediatric targets set most hearing aids within a clinically acceptable range around the prescribed target, particularly for mild-to-moderate hearing losses. However, it is likely that clinician adjustment based on verification of hearing aid output would be required to optimize the fit to target, maximize aided SII, and ensure appropriate audibility across all degrees of hearing loss.


1992 ◽  
Vol 3 (4) ◽  
pp. 162-166
Author(s):  
Lissette Navas ◽  
Susan M King ◽  
Ronald Gold

The morbidity and mortality of patients with bacterial meningitis treated initially with cefuroxime were studied and compared with the results of a previous prospective study of patients treated initially with ampicillin plus chloramphenicol in the same institution from 1979 to 1983. A retrospective chart review was completed in all cases of microbiologically confirmed bacterial meningitis admitted to the Hospital for Sick Children in Toronto, Ontario between January 1, 1984 and August 1, 1988. During this period all patients were treated initially with intravenous cefuroxime. The 167 children reviewed ranged in age from six weeks to 17.1 years (median 11.6 months). The case fatality rate was 7.8% and the rate of hearing deficit 13%. There were no statistically significant differences in abnormal neurological outcome (20 versus 20%, respectively), hearing loss (12.9 versus 13%, respectively), and case fatality rate (6.4 versus 7.8%, respectively) between the cohort of 1979–83 and the present study. The rate of hearing loss following meningitis caused byHaemophilus influenzaetype b increased from 7.3 to 11.7% (P=0.26).


2018 ◽  
Vol 29 (08) ◽  
pp. 764-779 ◽  
Author(s):  
Pamela Souza ◽  
Eric Hoover ◽  
Michael Blackburn ◽  
Frederick Gallun

AbstractSevere hearing loss impairs communication in a wide range of listening environments. However, we lack data as to the specific objective and subjective abilities of listeners with severe hearing loss. Insight into those abilities may inform treatment choices.The primary goal was to describe the audiometric profiles, spectral resolution ability, and objective and subjective speech perception of a sample of adult listeners with severe hearing loss, and to consider the relationships among those measures. We also considered the typical fitting received by individuals with severe loss, in terms of hearing aid style, electroacoustic characteristics, and features, as well as supplementary device use.A within-subjects design was used.Participants included 36 adults aged 54–93 yr with unilateral or bilateral severe hearing loss.Testing included a full hearing and hearing aid history; audiometric evaluation; loudness growth and dynamic range; spectral resolution; assessment of cochlear dead regions; objective and subjective assessment of speech recognition; and electroacoustic evaluation of current hearing aids. Regression models were used to analyze relationships between hearing loss, spectral resolution, and speech recognition.For speech in quiet, 60% of the variance was approximately equally accounted for by amount of hearing loss, spectral resolution, and number of dead regions. For speech in noise, only a modest proportion of performance variance was explained by amount of hearing loss. In general, participants were wearing amplification of appropriate style and technology for their hearing loss, but the extent of assistive technology use was low. Subjective communication ratings depended on the listening situation, but in general, were similar to previously published data for adults with mild-to-moderate loss who did not wear hearing aids.The present data suggest that the range of abilities of an individual can be more fully captured with comprehensive testing. Such testing also offers an opportunity for informed counseling regarding realistic expectations for hearing aid use and the availability of hearing assistive technology.


2021 ◽  
Author(s):  
Muhibullah S Tora ◽  
James G Malcolm ◽  
Zayan Mahmooth ◽  
Amit Pujari ◽  
Rima S Rindler ◽  
...  

Abstract BACKGROUND Cranioplasty (CP) following decompressive craniectomy (DC) is a common neurosurgical procedure for cranial cosmesis and protection. There is uncertainty regarding the complication rates and potential benefits related to the timing of CP. OBJECTIVE To investigate the impact of the timing of CP on complication rates for different etiologies of DC. METHODS A retrospective chart review was performed of all CP cases between 2004 and 2018 for traumatic and nontraumatic indications of DC. Demographics, clinical characteristics, and complications were collected. Early and late CP were defined as replacement of the bone flap at ≤90 and &gt;90 d following DC, respectively. RESULTS A total of 278 patients were included, receiving 81 early and 197 late CPs. When analyzing all patients, early CP was associated with a statistically significant higher odds of any complication (odds ratio [OR]: 3.25, P &lt; .001), reoperation (OR: 2.57, P = .019), hydrocephalus (OR: 6.03, P = .003), and symptomatic extra-axial collections (OR: 9.22, P = .003). Subgroup analysis demonstrated statistically significant higher odds of these complications only for the CP trauma subgroup, but not the nontrauma subgroup. The odds of complications postCP demonstrated a statistically significant decrease of 4.4% for each week after DC (Unit Odds Ratio [U-OR]: 0.956, P = .0363). CONCLUSION In our retrospective series, early CP was associated with higher odds of postoperative complications compared to late CP in the trauma subgroup. Greater care should be taken in preoperative planning and increased vigilance postoperatively for complications with this potentially more vulnerable subpopulation. Future prospective controlled trials are needed to elucidate optimal timing for CP.


2018 ◽  
Vol 39 (02) ◽  
pp. 123-134 ◽  
Author(s):  
Carole Johnson ◽  
Johnathan Baldwin ◽  
Kristen Barton ◽  
Caitlyn Mathews ◽  
Jeffrey Danhauer ◽  
...  

AbstractPersons with clinically significant tinnitus also may have mild sensorineural hearing loss (MSNHL). The purpose of this study was to describe patients with tinnitus and MSNHL and factors predicting hearing-aid uptake (HAU). We conducted a retrospective chart review with regression modeling of patients presenting to a specialty tinnitus clinic over a 2.5-year period. Stepwise logistic regression on data from patient charts was conducted. Of 133 patients seen, two-thirds had MSNHL (95% confidence interval [CI]: 58.9–75.0; mean age = 53.4 years; standard deviation = 14.5); approximately 50% had severe-to-catastrophic tinnitus. Logistic regression indicated that four-frequency pure-tone average (FFPTA; left) (β = 0.3899, χ 2 = 10.96, degrees of freedom [DF] = 1, p = 0.0009) and age (β = 0.1273, χ 2 = 4.86, DF = 1, p = 0.0274) were positively associated with HAU; tinnitus severity was inversely related (β = − 1.0533, χ 2 = 4.24, DF = 1, p = 0.0395). Adjusting for key variables, odds of receiving hearing aids was 1.14 (95% CI: 1.01–1.27) times higher with every year increase in age, 1.48 (95% CI: 1.17–1.86) times higher per one point increase in FFPTA (left), and 0.35 (95% CI: 0.13–0.95) times less per one point increase in tinnitus severity score. Reasons why HAU was not high for this special sample of young adults with severe tinnitus and MSNHL are discussed; hearing aid treatment requires extensive counseling and follow-up for this population.


2021 ◽  
Vol 4 (3) ◽  
pp. e000287
Author(s):  
Manvinder Kaur ◽  
Viviane Grandpierre ◽  
Irina Oltean ◽  
Arielle Weir ◽  
Ahmed Nasr

ObjectiveThe aims were to describe the management of umbilical hernias, to define postoperative complications, and to identify the characteristics of patients that were more likely to have spontaneous resolution of their hernia.MethodsAll patients referred for umbilical hernia at the Children’s Hospital of Eastern Ontario from January 1990 to April 2017 were examined via retrospective chart review. Spontaneous resolution of umbilical hernia was examined using binary logistic regression.ResultsWe included 2621 patients presenting with an umbilical hernia. A total of 1587 (60.5%) patients underwent surgical repair at a median age of 3.6 years (IQR 2.3–5.4). Surgical complications consisted of infection (n=3), bleeding (n=3), hematoma (n=3), and anesthesia-related complications (n=3). For every one-unit increase in defect size, the odds of a spontaneous resolution of the hernia were 5% lower while controlling for prematurity and the presence of comorbidities [adjusted odds ratio (aOR)=0.95; 95% confidence intervel (CI) 0.93 to 0.97]. Premature babies were 80% less likely to experience hernia resolution compared with non-premature babies (aOR=0.20; 95% CI 0.03 to 0.74).ConclusionThe odds of spontaneous resolution were lower for premature babies and were negatively correlated with defect size.


2020 ◽  
Vol 29 (3) ◽  
pp. 163-166
Author(s):  
Chengjie Lee ◽  
Paul Yugendra ◽  
Choon Peng Jeremy Wee ◽  
Jen Heng Pek

Background: Patients with traumatic injuries presenting to the emergency department (ED) may be referred to another hospital for further management. Unnecessary referrals can inflate health-care costs and workload, as well as reduce provider and patient satisfaction. Objectives: In this study, we determined the proportion of unnecessary trauma referrals and described the characteristics of this patient population. Methods: A retrospective chart review was carried out between 1 January and 31 December 2016. Data regarding demographics, diagnosis and clinical course at the ED were collected in standardised forms. A referral was defined as unnecessary if the patient was discharged from the ED without a therapeutic procedure performed. Results: There were 121 trauma referrals. The mean age was 39.0±18.3 years old, and 94 (77.7%) patients were male. Seventy-eight (64.5%) of the referrals were from EDs in the same health-care cluster. Overall, 15 (12.3%) referrals were unnecessary, and of these, nine patients had sustained burns or were suffering from smoke inhalation. The length of stay of these unnecessary referrals was 197.0±96.2 minutes. Referring ED outside the health-care cluster was significantly associated with unnecessary referrals (odds ratio=4.42, 95% confidence interval 1.40–13.97, p=0.007). Conclusion: More than 1 in 10 trauma referrals were unnecessary. Further collaborative prospective studies with other EDs are needed to elucidate the underlying reasons for such unnecessary referrals so that targeted solutions can be implemented to reduce them in the future.


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