Unilateral hearing loss: benefits and satisfaction from the use of hearing aids

Aunilateral hearing loss is characterized by reduced hearing in one ear. The problems caused by sensory deprivation can be minimized with the use of hearing aids (HA).AimTo analyze the correlation between the prescribed grain and the insertion gain difference and with the results obtained regarding the benefit and satisfaction with the use of hearing aids in unilateral hearing impaired patients.Materials and MethodsProspective study with 15 subjects, mean age of 41.6 years, of both genders, users of hearing aids effectively. We used the International Questionnaire Results for hearing aids (International Outcome Inventory for Hearing Aids - IOI-HA), measured with a probe microphone.ResultsThe mean values in the analyses of the IOI-HA per item were positive and higher than four points. In relation to the objective measures, the frequencies in which we obtained the gain values which were closer to the target were: 1K Hz, 2K Hz and 500 Hz, respectively.ConclusionThe satisfaction of individuals using hearing aid unilaterally is not completely correlated to the prescribed gain, because even if the target is not being reached in some frequencies, the individuals were pleased as to the use of their hearing aids.     

Assessment of the Auditory Handicap in adults with unilateral hearing loss

Hearing impairment (HI) is characterized by unilateral hearing loss in one ear and can result in learning difficulties, language impairment and socio-emotional difficulties. To assess the perception of hearing handicap in adult subjects, patients with unilateral sensorineural HI, non-users of individual hearing aids.     

Audiological management of adults with hearing impairment in Malaysia

Objective: This study explored the nature of audiological services for adults with hearing impairment in Malaysia, with an emphasis on whether current services address clients’ overall functioning as described by the World Health Organisation’s International Classification of Functioning, Disability, and Health (ICF) framework. Design: An online survey exploring current practice, skills and confidence of audiologists, and the infrastructure and facilities available in their workplaces, was distributed to audiologists in Malaysia via professional associations and social media. Study sample: A total of 111 audiologists, 84.7% female and 15.3% male (range?=?23–44 years), participated in the study. Results: Although audiologists in Malaysia reported addressing all of the ICF domains, less than 26% of them assessed the patients’ speech perception, carried out real-ear measurements, or used outcome measures routinely. The majority of the audiologists reported feeling confident in managing adult patients. However, 83% of the audiologists indicated they wanted to improve their skills related to management of adult patients, particularly in the areas of counselling and auditory training. Conclusions: Inadequate infrastructure, resources and facilities in the workplace may have contributed to the gaps in service provision and influenced the current practice of audiological management for adult patients in Malaysia.     

Tone identification in Mandarin-speaking children with profound hearing impairment

ObjectivesLittle is known about the tone identification ability of Mandarin-speaking children with profound hearing impairment (HI) and fitted with hearing aids (HAs). The present study aimed to evaluate the Mandarin tone identification ability in children with profound HI and fitted with HAs, and explore the effects of hearing thresholds, the age of first HA fitting and the duration of HA use on Mandarin tone identification ability.MethodsSubjects were Mandarin-speaking children aged 5;4–12;6 years with profound HI (n = 41). The Mandarin Tone Identification Test was administered in five test conditions: in −10, −5, 0 and 5 dB signal-to-noise ratios (S/Ns) and quiet. Hearing aids were in the usual user's settings, optimized for the best speech reception, and the volume was set to comfortable listening level.ResultsTwo-way repeated measures ANOVA showed significant effects of test conditions and tone contrasts in Mandarin tone identification. Post-hoc pairwise comparisons showed significant difference in performance among the five test conditions. Results also indicated that, among the six tone contrasts, the Tone 1/Tone 2 and Tone 2/Tone 3 contrasts were the most difficult tone contrasts in quiet. No significant difference in performance was found among the six tone contrasts in noise. Pearson product-moment correlation showed that the age of first HA fitting, the duration of HA use, aided and unaided average thresholds as well as the aided hearing thresholds in the low frequency region were not significantly correlated with tone identification ability in the five test conditions.ConclusionsConsistent with previous findings, the Tone 1/Tone 2 and Tone 2/Tone 3 contrasts were the most difficult to identify in quiet; but the presence of noise resulted in these tone contrasts being equally difficult. Findings also suggest that the tone identification ability of children with profound HI needs to be improved. Although the age of first HA fitting and the duration of HA use were not significantly correlated with tone identification performance in children with profound HI, this finding does not preclude the importance of early HA fitting.     

A systematic review and meta-analysis assessing the effectiveness of alternative listening devices to conventional hearing aids in adults with hearing loss

Abstract

Recent technological advances have led to a rapid increase in alternative listening devices to conventional hearing aids. The aim was to systematically review the existing evidence to assess the effectiveness of alternative listening devices in adults with mild and moderate hearing loss. A systematic search strategy of the scientific literature was employed, reported in accordance with the Preferred Reporting Items for Systematic reviews and Meta-analyses (PRISMA) checklist. Eleven studies met eligibility for inclusion: two studies evaluated personal sound amplification products, and nine studies assessed remote microphone systems (frequency modulation, Bluetooth, wireless). The evidence in this review suggests that alternative listening devices improve behavioural measures of speech intelligibility relative to unaided and/or aided conditions. Evidence for whether alternative listening devices improve self-reported outcomes is inconsistent. The evidence was judged to be of poor to good quality and subject to bias due to limitations in study design. Our overall recommendation is that high-quality evidence (i.e. randomised controlled trials) is required to demonstrate the effectiveness of alternative listening devices. Such evidence is not currently available and is necessary to guide healthcare commissioners and policymakers when considering new service delivery models for adults with hearing loss.

Review registration: Prospective Register of Systematic Reviews (PROSPERO), CRD42015029582     

Cochrane corner: hearing aids for mild to moderate hearing loss in adults

This Cochrane corner features the review entitled “Hearing aids for mild to moderate hearing loss in adults” published in 2017. In their review, Ferguson et al. identified five randomised controlled trials (RCTs) involving 825 participants, with moderate quality of evidence shown for all domains except adverse effects. Results showed a large beneficial effect of hearing aids on hearing-specific health-related quality of life and listening ability, and a small yet significant beneficial effect on overall health-related quality of life. Ferguson et al. concluded that according to the available evidence, hearing aids are effective at improving hearing-specific health-related quality of life, general health-related quality of life and listening ability in adults with mild to moderate hearing loss. The evidence supports the widespread provision of hearing aids as the first-line clinical management for those seeking help for hearing difficulties.     

Multiple-channel non-linear power hearing instruments for children with severe hearing impairment: long-term follow-up

The long-term benefits of multiple-channel non-linear technology for children with severe hearing impairment have yet to be fully investigated over the longer term. Twenty-one children with severe hearing loss participated in a study comparing performance on measures of audibility, speech understanding (in quiet and noise) and listening situations between the children's current analog hearing aids and a test hearing aid with multiple-channel non-linear compression (DigiFocus II Compact Power). Results were obtained from the children at 2 weeks, 8 weeks, 6 months and 12 months following the fitting of a multiple-channel non-linear hearing instrument. Compared with the children's own hearing instruments, the test instruments provided improved audibility, improvement in speech understanding in quiet and noise, and an improvement in listening skills. The gains in speech understanding were greater in noise than in quiet, suggesting that the test hearing instrument provided greatest improvement when listening to speech in noise. While performance increased over time, there was no statistically significant evidence to support continued acclimatization.     

听障老年人的助听器验配

目的探讨听障老年人助听器验配的方法和技巧。方法对112名受试者进行跟踪随访，客观记录他们使用助听器的感受，分析助听器验配方法和技巧对助听器效果的影响。结果老年人的行为认知和听觉反应能力极大地左右着助听器的配戴效果；气骨导听阈，舒适阈，不适阈、言语识别阈的检查和使用对于老年人助听器验配十分重要；低频部分的听力补偿要低于目标值，高频部分要略高于目标增益值；老年人助听器配戴的适应期平均为3个月；双耳配戴的效果明显优于单耳。结论完全按照助听器验配软件设计的程序给老年人验配助听器很难达到理想的效果，而验配经验、技巧和验配后的适应性训练在其中发挥着巨大的作用。     

Factors associated with success with hearing aids in older adults

Abstract

Objective: To examine associations between audiological and non-audiological factors and successful hearing aid use in older adults. Design: In a retrospective study, audiological factors, attitudinal beliefs (as derived from the health belief model), client demographics, psychological factors, and age-related factors were evaluated. Study sample: Participants included 160 individuals, 60 years or older, with unilateral or bilateral hearing impairment (HI), fitted with hearing aids for the first time in the previous two years. Participants were assigned to either an unsuccessful hearing aid owner group (n = 75) or a successful hearing aid owner group (n = 85) based on their self-reported hearing aid use and benefit. Results: A multivariate, binomial logistic regression model indicated five factors associated with group membership: participants who had greater support from significant others; more difficulties with hearing and communication in everyday life before getting hearing aids; more positive attitudes to hearing aids; coupled with greater perceived self-efficacy for advanced handling of hearing aids; or who were receiving more gain from their devices; were more likely to be successful hearing aid owners. Conclusions: These findings highlight the importance of addressing non-audiological factors in order to assist older adults achieve success with hearing aids.     

Post-lingual deafness: benefits of cochlear implants vs. conventional hearing aids

The technological advances in cochlear implants and processing strategies have enabled subjects affected by severe to profound hearing loss to hear sounds and recognize speech in various different degrees. The variability of hearing outcomes in subjects with post-lingual deafness has been significant and cochlear implant indications have been extended to include an ever larger population.ObjectiveThis paper aims to look into the groups of post-lingual deafness patients to find where cochlear implants have yielded better outcomes than conventional hearing aids.Materials and MethodsReview the literature available on databases SciELO, Cochrane, MEDLINE, and LILACS-BIREME. The publications selected for review were rated as A or B on evidence strength on the day of the review. Their authors analyzed and compared hearing aids and cochlear implants in populations of post-lingually deaf patients. Study Design: Systematic review.ResultsEleven out of the 2,169 papers searched were found to be pertinent to the topic and were rated B for evidence strength. Six studies were prospective cohort trials, four were cross-sectional studies and one was a clinical trial.ConclusionThe assessment done on the benefits yielded by post-lingually deaf subjects from cochlear implants showed that they are effective and provide for better results than conventional hearing aids.     

The relationship between pre-fitting expectations and willingness to use hearing aids

Hearing-aid use in the elderly population is problematic since not all people who would benefit from hearing aids actually obtain one. In this study, the relationship between pre-fitting expectations and willingness to use hearing aids is addressed.

One hundred adult hearing aid candidates (mean age 68.6 years) were randomly recruited from eight different private ENT practices. The subjects completed a questionnaire comprising a number of different aspects of expectation and some additional variables potentially influencing willingness to use hearing aids. Based on the outcome of the questionnaire a linear regression model predicting motivation to use hearing aids was calculated and evaluated.

Among the 11 parameters evaluated three contributed significantly to the model of willingness. The three predictor variables were expectations towards improvement of quality of life, stigmatization, and self-rated hearing ability. They accounted for about 55% of the variability in the data for willingness. Examination of a sub-sample three months after the survey had taken place revealed a distinct relationship between willingness and the decision to obtain or decline hearing aids.

In conclusion, the results strongly encourage supporting positive expectations in order to motivate individuals with hearing impairment to use hearing systems.     

广东地区聋儿助听器验配情况分析

目的：探讨广东省内不同经济发展水平地区聋儿助听器验配特点与社会经济发展水平的相关性.方法：选取广东地区常住居民家庭中首次配戴助听器的聋儿,按其家庭常居住地的社会经济发展水平的差异,分为经济较为发达的珠江三角洲地区（包括广州、深圳、珠海、佛山、东莞、中山）和经济相对欠发达的广东其他地区两大组,分别比较其第1次助听器验配时的年龄及性别比例、耳聋程度和助听器种类（数码/模拟）的选择.结果：①广东地区第1次配戴助听器聋儿的平均年龄为3.82岁,男、女比例为1.47：1,地区间差异不明显;②珠江三角洲地区第1次配机时残余听力听性脑干诱发电位Ⅴ波阈值超过90dBnHL的聋儿比例为86.36%,广东其他地区为93.85%,远比珠江三角洲地区高;③珠江三角洲地区第1次配戴助听器时选择数码助听器的聋儿为75.57%,广东其他地区为65.38%.结论：聋儿助听器验配特点与当地的社会经济发展水平密切相关;广东地区配戴助听器聋儿的男、女性别比例存在巨大差异,有待进一步探讨.     

A comparison of CIC and BTE hearing aids for three-dimensional localization of speech

Abstract

Three-dimensional sound localization of speech in anechoic space was examined for eleven listeners with sensorineural hearing loss. The listeners were fitted bilaterally with CIC and BTE hearing aids having similar bandwidth capabilities. The goal was to determine whether differences in microphone placement for these two styles (CICs at the ear canal entrance; BTEs above the pinna) would influence the availability of pinna-related spectral cues and hence localization performance. While lateral and polar angle localization was unaffected by the hearing aid style, the rate of front-back reversals was lower with CICs. This pattern persisted after listeners accommodated to each set of aids for a six week period, although the overall rate of reversals declined. Performance on all measures in all conditions was considerably poorer than in a control group of listeners with normal hearing.

Sumario

Se evaluó la localización tridimensional de sonidos del habla en un espacio anecoide en once personas con pérdida auditiva sensorineural. A los once se les adaptaron CIC y BTE bilateralmente con capacidad de ancho de banda similar. El objetivo fue determinar si las diferencias en la colocación del micrófono con ambos tipos (CIC en el ingreso del conducto auditivo; BTE sobre el pabellón auricular) podría influenciar la disponibilidad de claves espectrales relacionadas con el pabellón y por ello, el rendimiento para la localización. Mientras que la localización del ángulo lateral y polar no fue afectada por el tipo de auxiliar, la tasa de inversiones frente-atrás fue menor con los CIC. Este patrón persistió después de que estas personas se acostumbraron a cada set de auxiliares por un período de seis semanas, a pesar de que declinó la tasa global de reversiones. El rendimiento en todas las mediciones y condiciones fue considerablemente más pobre que en el grupo control de personas con audición normal.     

Results of the bone-anchored hearing aid in unilateral hearing loss

OBJECTIVES: The advantages of binaural hearing are well established and universally accepted. However, a tendency remains to withhold the benefits of binaural hearing to adults and children with one normal ear. The purpose of this study is to demonstrate the benefit of the bone-anchored hearing aid (BAHA) in a group of patients with unilateral conductive or mixed hearing loss. STUDY DESIGN: This is a prospective study of nine patients (five males and four female patients) with conductive or mixed hearing loss who met the criteria for BAHA except for having normal hearing in the other ear. They had congenital aural atresia or mastoidectomies secondary to chronic ear infections with or without cholesteatoma or had a temporal bone tumor excised METHODS: Patients had evaluations before and after implantation, including audiological testing and responses to a standardized hearing handicap questionnaire. Statistical analyses of the data were made using the Wilcoxon signed rank test and the paired Student t test for repeated measures. RESULTS: All patients had tonal and spondee threshold improvement with BAHA when compared with thresholds before treatment. Speech recognition performance in BAHA-aided conditions was comparable to the patient's best score in unaided condition. Patients reported a significant improvement in their hearing handicap scores with the BAHA. CONCLUSIONS: The use of BAHA has significantly improved the hearing handicap scores in patients with unilateral conductive or mixed hearing loss. The proven safety and efficacy of the device promote its use in unilateral cases that traditionally had been left unaided.     

Results of hearing aids use dispensed by a publicly-funded health service

Hearing aid use and satisfaction can be used to analyze the effectiveness of hearing rehabilitation, an issue few explored in Brazilian users.ObjectiveEvaluate hearing aid use dispensed in a publicly-funded health service after one year, the interventions needed and users' satisfaction.MethodProspective observational cross-sectional study. Hearing aid users were invited by telephone to participate in an evaluation of hearing aid use.Results200 hearing aid users attended the evaluation (47% of sample loss); 76.5% of the subjects were using hearing aids bilaterally, 10.5% unilaterally and 13.0% none of them; 99.5% of users needed some kind of intervention. Users who kept wearing their hearing aids were considered “satisfied”.ConclusionActive search by telephone showed that hearing aid users who attend this publicly-funded health service have difficulties to attend follow-up appointments. Most of the users that came for evaluation kept using their hearing aids; non-use rate was 13%. Practically all hearing aid users needed some kind of intervention. Despite the high level of satisfaction, those findings did not include users who did not participate in evaluation, which could represent subjects less adhered to the treatment. Results highlighted the need of periodical follow-ups to ensure the effectiveness of auditory rehabilitation.