A Comparison of Conventional and In-Situ Audiometry on Participants with Varying Levels of Sensorineural Hearing Loss

2015 ◽  
Vol 26 (01) ◽  
pp. 068-079 ◽  
Author(s):  
Jürgen Kiessling ◽  
Melanie Leifholz ◽  
Steffen Unkel ◽  
Jörn Pons-Kühnemann ◽  
Charlotte Thunberg Jespersen ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Research Design ◽  
Hearing Aids ◽  
Hearing Aid ◽  
Hearing Threshold ◽  
Sensorineural Hearing ◽  
Threshold Levels ◽  
Wide Range

Background: In-situ audiometry is a hearing aid feature that enables the measurement of hearing threshold levels through the hearing instrument using the built-in sound generator and the hearing aid receiver. This feature can be used in hearing aid fittings instead of conventional pure-tone audiometry (PTA), particularly in places where no standard audiometric equipment is available. Differences between conventional and in-situ thresholds are described and discussed for some particular hearing aids. No previous investigation has measured and compared these differences for a number of current hearing aid models by various manufacturers across a wide range of hearing losses. Purpose: The purpose of this study was to perform a model-based comparison of conventionally and in-situ measured hearing thresholds. Data were collected for a range of hearing aid devices to study and generalize the effects that may occur under clinical conditions. Research Design: Research design was an experimental and regression study. Study Sample: A total of 30 adults with sensorineural hearing loss served as test persons. They were assigned to three subgroups of 10 subjects with mild (M), moderate to severe (MS), and severe (S) sensorineural hearing loss. Intervention: All 30 test persons underwent both conventional PTA and in-situ audiometry with four hearing aid models by various manufacturers. Data Collection and Analysis: The differences between conventionally and in-situ measured hearing threshold levels were calculated and evaluated by an exploratory data analysis followed by a sophisticated statistical modeling process. Results: At 500 and 1500 Hz, almost all threshold differences (conventional PTA minus in-situ data) were negative, i.e., in the low to mid frequencies, hearing loss was overestimated by most devices relative to PTA. At 4000 Hz, the majority of differences (7 of 12) were positive, i.e., in the frequency range above 1500 Hz, hearing loss was frequently underestimated. As hearing loss increased (M→MS→S), the effect of the underestimation decreased. At 500 and 1500 Hz, Resound devices showed the smallest threshold deviations, followed by Phonak, Starkey, and Oticon instruments. At 4000 Hz, this observed pattern partly disappeared and Starkey and Oticon devices showed a reversed effect with increasing hearing loss (M→MS→S). Because of high standard errors for the estimates, only a few explicit rankings of the devices could be established based on significant threshold differences (5% level). Conclusions: Differences between conventional PTA and in-situ threshold levels may be attributed to (1) frequency, (2) device/hearing loss, and (3) calibration/manufacturer effects. Frequency effects primarily resulting in an overestimation of hearing loss by in-situ audiometry in the low and mid frequencies are mainly due to sound drain-off through vents and leaks. Device/hearing loss effects may be due to leakage as well as boundary effects because in-situ audiometry is confined to a limited measurement range. Finally, different calibration approaches may result in different offset levels between PTA and in-situ audiometry calibration. In some cases, the observed threshold differences of up to 10–15 dB may translate to varied hearing aid fittings for the same user depending on how hearing threshold levels were measured.

Temporary Increase in Sensorineural Hearing Loss with Hearing Aid Use

1979 ◽  
Vol 88 (1) ◽  
pp. 86-91 ◽  
Author(s):  
H. Patricia Heffernan ◽  
Marsha R. Simons
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Hearing Aids ◽  
Hearing Aid ◽  
Hearing Threshold ◽  
Sensorineural Hearing ◽  
Temporary Increase ◽  
Hearing Aid Use ◽  
Hearing Thresholds ◽  
Power Outputs

Two cases are presented exhibiting temporary increases in sensorineural hearing loss following hearing aid use. Data suggesting this correlation are shown. There were no contributing middle ear problems during the period surveyed. The most significant changes in hearing thresholds were at frequencies 1000 and 2000 Hz. The use of different hearing aids, with decreased maximum power outputs, was not found to have similar effects on hearing threshold levels. A scheduling regime is recommended for introducing any new hearing aid to a child.

scholarly journals Investigating the Impact of Hearing Aid Use and Auditory Training on Cognition, Depressive Symptoms, and Social Interaction in Adults With Hearing Loss: Protocol for a Crossover Trial (Preprint)

2017 ◽  
Author(s):  
Joanna Nkyekyer ◽  
Denny Meyer ◽  
Peter J Blamey ◽  
Andrew Pipingas ◽  
Sunil Bhar
Keyword(s):  
Hearing Loss ◽  
Depressive Symptoms ◽  
Social Interaction ◽  
Sensorineural Hearing Loss ◽  
Hearing Aids ◽  
Hearing Aid ◽  
Sensorineural Hearing ◽  
Auditory Training ◽  
Face To Face ◽  
Hearing Aid Use

BACKGROUND Sensorineural hearing loss is the most common sensory deficit among older adults. Some of the psychosocial consequences of this condition include difficulty in understanding speech, depression, and social isolation. Studies have shown that older adults with hearing loss show some age-related cognitive decline. Hearing aids have been proven as successful interventions to alleviate sensorineural hearing loss. In addition to hearing aid use, the positive effects of auditory training—formal listening activities designed to optimize speech perception—are now being documented among adults with hearing loss who use hearing aids, especially new hearing aid users. Auditory training has also been shown to produce prolonged cognitive performance improvements. However, there is still little evidence to support the benefits of simultaneous hearing aid use and individualized face-to-face auditory training on cognitive performance in adults with hearing loss. OBJECTIVE This study will investigate whether using hearing aids for the first time will improve the impact of individualized face-to-face auditory training on cognition, depression, and social interaction for adults with sensorineural hearing loss. The rationale for this study is based on the hypothesis that, in adults with sensorineural hearing loss, using hearing aids for the first time in combination with individualized face-to-face auditory training will be more effective for improving cognition, depressive symptoms, and social interaction rather than auditory training on its own. METHODS This is a crossover trial targeting 40 men and women between 50 and 90 years of age with either mild or moderate symmetric sensorineural hearing loss. Consented, willing participants will be recruited from either an independent living accommodation or via a community database to undergo a 6-month intensive face-to-face auditory training program (active control). Participants will be assigned in random order to receive hearing aid (intervention) for either the first 3 or last 3 months of the 6-month auditory training program. Each participant will be tested at baseline, 3, and 6 months using a neuropsychological battery of computer-based cognitive assessments, together with a depression symptom instrument and a social interaction measure. The primary outcome will be cognitive performance with regard to spatial working memory. Secondary outcome measures include other cognition performance measures, depressive symptoms, social interaction, and hearing satisfaction. RESULTS Data analysis is currently under way and the first results are expected to be submitted for publication in June 2018. CONCLUSIONS Results from the study will inform strategies for aural rehabilitation, hearing aid delivery, and future hearing loss intervention trials. CLINICALTRIAL ClinicalTrials.gov NCT03112850; https://clinicaltrials.gov/ct2/show/NCT03112850 (Archived by WebCite at http://www.webcitation.org/6xz12fD0B).

Prevalence and classification of asymmetric forms of sensorineural hearing loss in older age group

2021 ◽  
Vol 20 (5) ◽  
pp. 8-12
Author(s):  
T. Yu. Vladimirova ◽  
◽  
A. B. Martynova ◽  
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Hearing Aids ◽  
Hearing Threshold ◽  
Older Age ◽  
Sensorineural Hearing ◽  
Age Group ◽  
The Difference ◽  
The Right

The significance of asymmetric sensorineural hearing loss (ASNHL) is due to a special approach to diagnosis, followed by the process of hearing aids and auditory rehabilitation. Currently, there is no standard audiometric criterion for determining the forms of asymmetry, which significantly affects the assessment of the prevalence of ASNHL. The study aimed to assess the prevalence and classification of ASNHL forms in the older age group using two methods of calculation: 1) the difference in the average hearing threshold at speech frequencies (in the range of 0,5–4 kHz) ≥15 dB was detected in 14,14% of cases; 2) the different degree of hearing loss, according to the International classification, in the right and left ear was 35,98%. In most cases, asymmetry was manifested by bilateral sensorineural hearing loss of varying severity, prevailing in the group of long-livers – 82,6%. Given the potentially high prevalence of asymmetry depending on the audiological criterion, the results of the work are a reason for further research in the development of a unified method for verifying a clinically significant form of ASNHL.

Effect of Sensorineural Hearing Loss on Loudness Discomfort Level and Most Comfortable Loudness Judgments

1978 ◽  
Vol 21 (4) ◽  
pp. 668-681 ◽  
Author(s):  
Candace Kamm ◽  
Donald D. Dirks ◽  
Max R. Mickey
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Hearing Threshold ◽  
Sensorineural Hearing ◽  
Intersubject Variability ◽  
Adaptive Procedure ◽  
Speech Stimuli ◽  
Wide Range ◽  
Sensorineural Hearing Impairment ◽  
Comfortable Loudness

A simple up-down adaptive procedure was used to estimate the 50% point on the psychometric function for loudness discomfort level (LDL) and the two functions describing the range of most comfortable loudness (MCL) for listeners with sensorineural hearing impairment. For pure tone and speech stimuli, median LDL and MCL levels were observed at relatively constant SPLs for subjects with hearing loss ≤ 50 dB HL and at progressively higher SPLs with further increase in hearing loss. Correlation analysis verified a statistically significant relationship between LDL and magnitude of hearing loss. The nonlinear relationship between LDL and hearing loss together with the large intersubject variability in the data suggest that prediction of LDL from hearing threshold would often be highly inaccurate. These results also demonstrate that averaging LDL data across a group of subjects with a wide range of hearing loss may lead to inaccurate conclusions regarding the effects of sensorineural hearing loss on LDL.

Evaluation of Hardwire Personal Assistive Listening Devices

1994 ◽  
Vol 3 (2) ◽  
pp. 71-77 ◽  
Author(s):  
James J. Dempsey ◽  
Mark Ross
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Hearing Aids ◽  
Hearing Aid ◽  
Low Frequency ◽  
Sensorineural Hearing ◽  
Clinical Implications ◽  
Frequency Responses ◽  
Subjective Evaluations ◽  
Potential Benefits

A large number of personal amplifiers have recently become available commercially. These devices have not been classified as hearing aids by the FDA and are therefore not subject to the FDA rules and regulations governing the sales of hearing aid devices. In this investigation, several of these personal amplifiers were evaluated to determine potential benefits and problems for each device. The devices were evaluated electroacoustically and, also, subjectively by a group of adults with sensorineural hearing loss. The results of the electroacoustic evaluation revealed very sharply peaked frequency responses. The subjective evaluations revealed tremendous variability, with some preferences for power and low-frequency amplification. Clinical implications of these results and suggestions for further research are provided.

Bone-anchored hearing aids and unilateral sensorineural hearing loss: why do patients reject them?

2015 ◽  
Vol 129 (4) ◽  
pp. 321-325 ◽  
Author(s):  
D Siau ◽  
B Dhillon ◽  
R Andrews ◽  
K M J Green
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Hearing Aids ◽  
Uptake Rate ◽  
Hearing Aid ◽  
Significant Proportion ◽  
Sensorineural Deafness ◽  
Sensorineural Hearing ◽  
Device Implantation ◽  
Bone Anchored Hearing Aid

AbstractObjectives:This study aimed to report the bone-anchored hearing aid uptake and the reasons for their rejection by unilateral sensorineural deafness patients.Methods:A retrospective review of 90 consecutive unilateral sensorineural deafness patients referred to the Greater Manchester Bone-Anchored Hearing Aid Programme between September 2008 and August 2011 was performed.Results:In all, 79 (87.8 per cent) were deemed audiologically suitable: 24 (30.3 per cent) eventually had a bone-anchored hearing aid implanted and 55 (69.6 per cent) patients declined. Of those who declined, 26 (47.3 per cent) cited perceived limited benefits, 18 (32.7 per cent) cited reservations regarding surgery, 13 (23.6 per cent) preferred a wireless contralateral routing of sound device and 12 (21.8 per cent) cited cosmetic reasons. In all, 32 (40.5 per cent) suitable patients eventually chose the wireless contralateral routing of sound device.Conclusion:The uptake rate was 30 per cent for audiologically suitable patients. Almost half of suitable patients did not perceive a sufficient benefit to proceed to device implantation and a significant proportion rejected it. It is therefore important that clinicians do not to rush to implant all unilateral sensorineural hearing loss patients with a bone-anchored hearing aid.

scholarly journals Effects of Expansion on Consonant Recognition and Consonant Audibility

2009 ◽  
Vol 20 (02) ◽  
pp. 119-127 ◽  
Author(s):  
Marc Brennan ◽  
Pamela Souza
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Tympanic Membrane ◽  
Research Design ◽  
Hearing Aid ◽  
Sensorineural Hearing ◽  
Low Level ◽  
Low Intensity ◽  
Consonant Recognition ◽  
Speech Token

Background: Hearing aid expansion is intended to reduce the gain for low-level noise. However, expansion can also degrade low-intensity speech. Although it has been suggested that the poorer performance with expansion is due to reduced audibility, this has not been measured directly. Furthermore, previous studies used relatively high expansion kneepoints. Purpose: This study compared the effect of a 30 dB SPL and 50 dB SPL expansion kneepoint on consonant audibility and recognition. Research Design: Eight consonant-vowel syllables were presented at 50, 60, and 71 dB SPL. Recordings near the tympanic membrane were made of each speech token and used to calculate the Aided Audibility Index (AAI). Study Sample: Thirteen subjects with mild to moderate sensorineural hearing loss. Results: Expansion with a high kneepoint resulted in reduced consonant recognition. The AAI correlated significantly with consonant recognition across all conditions and subjects. Conclusion: If consonant recognition is the priority, audibility calculations could be used to determine an optimal expansion kneepoint for a given individual.

scholarly journals Analysis of the results of hearing aids fitting using the questionnaire «Glasgow Hearing Aid Benefit Profile»

2015 ◽  
Vol 22 (1) ◽  
pp. 32-33
Author(s):  
L. E. Golooanooa ◽  
E. V. Zhiunskaya ◽  
M. . Yu
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Hearing Aids ◽  
Hearing Aid ◽  
Sensorineural Hearing ◽  
Hearing Aid Fitting ◽  
Bilateral Sensorineural Hearing Loss ◽  
Hearing Aid Benefit

164 patients with moderate to severe ehronie bilateral sensorineural hearing loss were asked to fill in the Glasgow hearing aid benefit profile. Its usefulness was showed in eases of diffieult hearing aid fitting.

Prescriptive Amplification Recommendations for Hearing Losses with a Conductive Component and Their Impact on the Required Maximum Power Output: An Update with Accompanying Clinical Explanation

2013 ◽  
Vol 24 (06) ◽  
pp. 452-460 ◽  
Author(s):  
Earl E. Johnson
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Compression Ratio ◽  
Hearing Aids ◽  
Power Output ◽  
Hearing Aid ◽  
Bone Conduction ◽  
Sensorineural Hearing ◽  
Maximum Power Output ◽  
Conductive Component

Background: Hearing aid prescriptive recommendations for hearing losses having a conductive component have received less clinical and research interest than for losses of a sensorineural nature; as a result, much variation remains among current prescriptive methods in their recommendations for conductive and mixed hearing losses (Johnson and Dillon, 2011). Purpose: The primary intent of this brief clinical note is to demonstrate differences between two algebraically equivalent expressions of hearing loss, which have been approaches used historically to generate a prescription for hearing losses with a conductive component. When air and bone conduction thresholds are entered into hearing aid prescriptions designed for nonlinear hearing aids, it was hypothesized that that two expressions would not yield equivalent amounts of prescribed insertion gain and output. These differences are examined for their impact on the maximum power output (MPO) requirements of the hearing aid. Subsequently, the MPO capabilities of two common behind-the-ear (BTE) receiver placement alternatives, receiver-in-aid (RIA) and receiver-in-canal (RIC), are examined. Study Samples: The two expressions of hearing losses examined were the 25% ABG + AC approach and the 75% ABG + BC approach, where ABG refers to air-bone gap, AC refers to air-conduction threshold, and BC refers to bone-conduction threshold. Example hearing loss cases with a conductive component are sampled for calculations. The MPO capabilities of the BTE receiver placements in commercially-available products were obtained from hearing aids on the U.S. federal purchasing contract. Results: Prescribed gain and the required MPO differs markedly between the two approaches. The 75% ABG + BC approach prescribes a compression ratio that is reflective of the amount of sensorineural hearing loss. Not all hearing aids will have the MPO capabilities to support the output requirements for fitting hearing losses with a large conductive component particularly when combined with significant sensorineural hearing loss. Generally, current RIA BTE products have greater output capabilities than RIC BTE products. Conclusions: The 75% ABG + BC approach is more appropriate than the 25% ABG + AC approach because the latter approach inappropriately uses AC thresholds as the basis for determining the compression ratio. That is, for hearing losses with a conductive component, the AC thresholds are not a measure of sensorineural hearing loss and cannot serve as the basis for determining the amount of desired compression. The Australian National Acoustic Laboratories has been using the 75% ABG + BC approach in lieu of the 25% ABG + AC approach since its release of the National Acoustic Laboratories—Non-linear 1 (NAL-NL1) prescriptive method in 1999. Future research may examine whether individuals with conductive hearing loss benefit or prefer more than 75% restoration of the conductive component provided adequate MPO capabilities to support such restoration.

scholarly journals Hearing Aids as a Treatment for Tinnitus Patients with Slight to Mild Sensorineural Hearing Loss

2018 ◽  
Vol 39 (02) ◽  
pp. 123-134 ◽  
Author(s):  
Carole Johnson ◽  
Johnathan Baldwin ◽  
Kristen Barton ◽  
Caitlyn Mathews ◽  
Jeffrey Danhauer ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Logistic Regression ◽  
Sensorineural Hearing Loss ◽  
Hearing Aids ◽  
Hearing Aid ◽  
Retrospective Chart Review ◽  
Sensorineural Hearing ◽  
Stepwise Logistic Regression ◽  
Tinnitus Severity ◽  
Point Increase

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.

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