Perceptual Considerations in Designing and Fitting Hearing Aids for Music

Perceptual Considerations in Designing and Fitting Hearing Aids for Music

Perceptual Considerations in Designing and Fitting Hearing Aids for Music

Perceptual Considerations in Designing and Fitting Hearing Aids for Music

Comparison of Preferred Real-Ear Insertion Gain between Open- and Closed-Canal Fitting Hearing Aids

Purpose: To calculate the real-ear insertion gain (REIG) according to the types of hearing aids, we evaluated the preferred REIGs of Korean hearing-impaired listeners and psychoacoustic differences between open-canal fitting (OF) and closed-canal fitting (CF).Methods: The subjects with sensorineural hearing loss were divided into OF group (4 monaural fittings, 15 binaural fittings with 34 ears), and CF group (8 monaural fittings, 13 binaural fittings with 34 ears). There were no statistical differences in hearing threshold level (HTL) at each octave frequencies, word recognition score (WRS) and Korean Adaptation of the International Outcome Inventory for Hearing Aids (K-IOI-HA) between the two groups. When there was no need for further electroacoustic adjustment of the hearing aid, sharpness and occlusion of amplified sound, clarity of sentence, and loudness of noise were evaluated based on the everyday experience. And REIGs with international speech test signal and WRS in sound-treated room were measured.Results: Preferred REIG for HTL was low for OF compared to CF in 0.5 kHz and 0.75 kHz at input SPL of 55 dB, 0.5 kHz at 60 dB SPL, 0.25 kHz and 0.5 kHz at 80 dB SPL. However, there were no differences in aided WRS and psychoacoustics between the two groups.Conclusion: In this study, the preferred REIG of OF and CF groups showed a difference under 0.75 kHz although there were no psychoacoustic differences between the two groups. Therefore, the results of this study should be considered when formulating Korean-type hearing aid fitting formula.

Surgical Removal of Hearing Aid Earmold Impression Material in the Middle Ear

When fitting hearing aids, patients are required to make an earmold impression material for device fixation. It usually causes no problems, although in rare cases, the earmold passes through the middle ear through tympanic membrane perforations. 1 – 3 Foreign bodies may cause a delayed inflammatory reaction and deterioration of aeration, especially in the Eustachian tube. Herein, we report a rare case of earmold impression material as a foreign body in the middle ear that required surgical removal.

3D Printing of a BAHA Protective Cap

Mechanical feedback is one of the most common difficulties encountered when fitting hearing aids for toddlers and young children. We described the use of 3D printing to tailor a protective cap for a toddler with bilateral microtia/canal atresia to facilitate bone-anchoring hearing aid use.

Meeting the Best Practice for Hearing Aid Verification in Children: Challenges and Future Directions

Purpose This study examined the current pediatric amplification practice with an emphasis on hearing aid verification using probe microphone measurement (PMM), among audiologists in Klang Valley, Malaysia. Frequency of practice, access to PMM system, practiced protocols, barriers, and perception toward the benefits of PMM were identified through a survey. Method A questionnaire was distributed to and filled in by the audiologists who provided pediatric amplification service in Klang Valley, Malaysia. One hundred eight ( N = 108) audiologists, composed of 90.3% women and 9.7% men (age range: 23–48 years), participated in the survey. Results PMM was not a clinical routine practiced by a majority of the audiologists, despite its recognition as the best clinical practice that should be incorporated into protocols for fitting hearing aids in children. Variations in practice existed warranting further steps to improve the current practice for children with hearing impairment. The lack of access to PMM equipment was 1 major barrier for the audiologists to practice real-ear verification. Practitioners' characteristics such as time constraints, low confidence, and knowledge levels were also identified as barriers that impede the uptake of the evidence-based practice. Conclusions The implementation of PMM in clinical practice remains a challenge to the audiology profession. A knowledge-transfer approach that takes into consideration the barriers and involves effective collaboration or engagement between the knowledge providers and potential stakeholders is required to promote the clinical application of evidence-based best practice.

Digital Marketing for Private Practice: How to Attract New Patients

Digital marketing in the hearing profession can be confusing, difficult, and make any private practice owner or manager frustrated with the results they are or are not getting. This article provides a digital marketing plan for getting new patients to contact your office for hearing healthcare services. Patients are confused when researching hearing aids, audiologists, and hearing tests. Some Web sites advertise bypassing licensed professionals, recommending only an online hearing test or an audiogram faxed into their office for the purpose of fitting hearing aids or other technology. We know this system does not take the place of a licensed professional but, Web sites that provide this information are very believable. Practitioners and managers are frustrated and confused by what they should be doing online. Patients continue to find other sources of misinformation before locating an established practice that can help them hear better and get much more out of their hearing healthcare. This article will give each reader a plan for getting results online and attracting new patients to their practice for less money than any other marketing medium available today.

Differences in Word and Phoneme Recognition in Quiet, Sentence Recognition in Noise, and Subjective Outcomes between Manufacturer First-Fit and Hearing Aids Programmed to NAL-NL2 Using Real-Ear Measures

The American Speech-Language-Hearing Association (ASHA) and American Academy of Audiology (AAA) have created Best Practice Guidelines for fitting hearing aids to adult patients. These guidelines recommend using real-ear measures (REM) to verify that measured output/gain of hearing aid(s) match a validated prescriptive target. Unfortunately, approximately 70–80% of audiologists do not routinely use REM when fitting hearing aids, instead relying on a manufacturer default “first-fit” setting. This is problematic because numerous studies report significant differences in REM between manufacturer first-fit and the same hearing aids using a REM or programmed-fit. These studies reported decreased prescribed gain/output in the higher frequencies for the first-fit compared with the programmed fit, which are important for recognizing speech. Currently, there is little research in peer-reviewed journals reporting if differences between hearing aids fitted using a manufacturer first-fit versus a programmed-fit result in significant differences in speech recognition in quiet, noise, and subjective outcomes.To examine if significant differences were present in monosyllabic word and phoneme recognition (consonant-nucleus-consonant; CNC) in quiet, sentence recognition in noise (Hearing in Noise Test; HINT), and subjective outcomes using the Abbreviated Profile of Hearing Aid Benefit (APHAB) and the Speech, Spatial and Qualities of Hearing (SSQ) questionnaires between hearing aids fit using one manufacturer’s first-fit and the same hearing aids with a programmed-fit using REM to National Acoustic Laboratories Nonlinear Version 2 (NAL-NL2) prescriptive target.A double-blind randomized crossover design was used. Throughout the study, one investigator performed all REM whereas a second investigator measured speech recognition in quiet, noise, and scored subjective outcome measures.Twenty-four adults with bilateral normal sloping to moderately severe sensorineural hearing loss with no prior experience with amplification.The hearing aids were fit using the proprietary manufacturer default first-fit and a programmed-fit to NAL-NL2 using real-ear insertion gain measures. The order of the two fittings was randomly assigned and counterbalanced. Participants acclimatized to each setting for four weeks and returned for assessment of performance via the revised CNC word lists, HINT, APHAB, and SSQ for the respective fitting.(1) A significant median advantage of 15% (p < 0.001; 95% CI: 9.7–24.3%) for words and 7.7% (p < 0.001; 95% CI: 5.9–10.9%) for phonemes for the programmed-fit compared with first-fit at 50 dB sound pressure level (SPL) and 4% (p < 0.01; 95% CI: 1.7–6.3%) for words at 65 dB SPL; (2) No significant differences for the HINT reception threshold for sentences (RTS); (3) A significant median advantage of 4.2% [p < 0.04; 95% confidence interval (CI): −0.6–13.2%] for the programmed-fit compared with the first-fit for the background noise subscale problem score for the APHAB; (4) No significant differences on the SSQ.Improved word and phoneme recognition for soft and words for average speech in quiet were reported for the programmed-fit. Seventy-nine percent of the participants preferred the programmed-fitting versus first-fit. Hearing aids, therefore, should be verified and programmed using REM to a prescriptive target versus no verification using a first-fit.