Non-electric aids to hearing: a short history

The historical development of non-electric aids to hearing is traced and a classification of the different types presented. Comparative measures of their different acoustical characteristics will be shown, indicating their relative value in various types of hearing losses. Attitudes towards such devices and principles involved in their selection in the 19th Century are discussed.     

Assessment of subjective outcome of hearing aid fitting: getting the client's point of view

This paper provides an overview of the measurement of hearing aid fitting outcomes in real life using self-report methods. Three topics are addressed: (1) why we should measure real-life outcomes; (2) seven different types of self-report outcome data; and (3) issues to consider in self-report outcome measurement. It is stressed that self-report data provide a unique view of the way that clients function and feel in their daily lives with regard to their hearing health. Self-report outcome data are multidimensional, and the different domains are only moderately correlated. When these types of data are gathered, it is essential to control relevant variables to safeguard validity and reliability.     

突发性聋的分型及药物治疗研究现状

突发性聋是耳科的常见急症之一,2015年我国发布的突发性聋诊断和治疗指南中根据听力曲线将突发性聋分为四型,并建议分型治疗.目前治疗突发性聋仍以药物治疗为主,常用糖皮质激素、改善微循环药物和营养神经药物.本文将从突发性聋的分型及药物治疗两个方面进行阐述,探讨各型突发性聋的特点和各类药物的作用机制.     

Hearing aid patients in private practice and public health (Veterans Affairs) clinics: are they different?

OBJECTIVE: In hearing aid research, it is commonplace to combine data across subjects whose hearing aids were provided in different service delivery models. There is reason to question whether these types of patients are always similar enough to justify this practice. To explore this matter, this investigation evaluated similarities and differences in self-report data obtained from hearing aid patients derived from public health (Veterans Affairs, VA) and private practice (PP) settings. DESIGN: The study was a multisite, cross-sectional survey in which 230 hearing aid patients from VA and PP audiology clinic settings provided self-report data on a collection of questionnaires both before and after the hearing aid fitting. Subjects were all older adults with mild to moderately severe hearing loss. About half of them had previous experience wearing hearing aids. All subjects were fitted with wide-dynamic-range-compression instruments and received similar treatment protocols. RESULTS: Numerous statistically significant differences were observed between the VA and PP subject groups. Before the fitting, VA patients reported higher expectations from the hearing aids and more severe unaided problems compared with PP patients with similar audiograms. Three wks after the fitting, VA patients reported more satisfaction with their hearing aids. On some measures VA patients reported more benefit, but different measures of benefit did not give completely consistent results. Both groups reported using the hearing aids an average of approximately 8 hrs per day. VA patients reported age-normal physical and mental health, but PP patients tended to report better than typical health for their age group. CONCLUSIONS: These data indicate that hearing aid patients seen in the VA public health hearing services are systematically different in self-report domains from those seen in private practice services. It is therefore risky to casually combine data from these two types of subjects or to generalize research results from one group to the other. Further, compared with PP patients, VA patients consistently reported more favorable hearing aid fitting outcomes. Additional study is indicated to explore the determinants of this result and its generalizability to other public health service delivery systems such as those in other countries. Moreover, efforts should be made to assess the potential for transferring positive elements from the VA system to the PP service delivery system, if possible.     

Hearing loss due to noise trauma

Three different types of noise-induced hearing loss have been reported in the literature. The two less common types are described here. Three cases of these two types from our clinic are reported. Since these 2 types of noise-induced hearing loss often involve low frequencies it is important to recognize them in compensation cases.     

Age differences in the use of informative/heuristic communicative functions in young children with and without hearing loss who are learning spoken language.

Previous research has suggested that the normal development of communicative functions proceeds from the directing or "instrumental" types to the informative or "heuristic" types with age. This paper describes a cross-sectional study of communicative function in children with profound hearing loss and children with normal hearing, from ages 12-54 months. The children with hearing loss were learning spoken English as their primary means of communication. The primary purpose of the study was to evaluate whether the pattern of age differences seen in the two groups of children (those with and without normal hearing) are similar patterns that occur at differing chronological ages, or whether they are dissimilar patterns altogether. A second purpose was to examine the relationship between the use of informative/heuristic functions and the acquisition of vocabulary and syntax. The data suggested a somewhat different pattern of communicative function development in children with and without hearing loss. In addition, the use of language for social purposes was closely related to the achievement of traditional language milestones. In both normally hearing children and in those with hearing loss, the correlations between the use of informative-heuristic functions and various measures of language development indicated that the more mature uses of language co-occur with increased frequency of communication, larger vocabulary, and longer utterance length. These results document that when linguistic improvements such as increasing vocabulary size and sentence length occur in deaf children learning spoken English, they are used for appropriate and informative social purposes that are commensurate with their language age.     

老年感音神经性听力障碍患者助听器验配效果分析

在我国,感音神经性听力障碍患者对助听器的认知度和接受度较低,已验配助听器的患者助听器常戴率不高,助听器使用者对助听器综合效果的满意率也不高。老年感音神经性听力障碍患者助听器效果差异化非常明显。本文重点讨论如何依据听力障碍的类型、听力曲线特征以及临床表现,为不同类型的老年感音神经性听力障碍患者进行个性化的助听器验配,力求使助听器效果最大化。     

Diagnosis and Treatment of Auditory Neuropathy and Related Research

Introduction Deafness is one of the most common otologic diseases and a major disease that greatly impacts the Chinese population. From the Second National Sample Survey of Disabled Persons, it is estimated that there are 27,800,000 hearing disabled persons in China, about 2.14% of     

不同类型听力下降伴耳鸣治疗的疗效分析

目的通过分析耳鸣与听力下降的关系,总结耳鸣与不同类型听力下降的关联性,以及不同类型听力下降所伴有耳鸣的治疗效果。方法分析2016年1月~2017年6月因“耳鸣”或者因“听力下降伴有耳鸣”就诊的急性耳鸣患者188例,其中男102例,女86例;年龄23~62岁,平均年龄44岁。双侧耳鸣者65例,单侧耳鸣者123例。所有患者入院时均进行电测听及耳鸣检查,根据听力曲线类型对耳鸣患者进行分组,其中听力正常者12例,低频听力下降者36例,高频听力下降者84例,平坦听力下降者42例,全聋型14例。入院后所有患者予以行营养神经、改善循环、激素冲击等治疗,并于入院当日、第3天、第5天及第10天行听力检查及耳鸣检查,比较各组患者耳鸣治疗的疗效。结果不同听力下降类型的耳鸣患者构成比比较,差异具有统计学意义（P＜0.05）。听力正常者耳鸣治疗有效率为91.67%（11/12）,低频听力下降组耳鸣治疗有效率为83.33%（30/36）,高频听力下降组耳鸣治疗有效率为54.76%（46/84）,平坦型听力下降组耳鸣治疗有效率为69.05%（29/42）,全聋型听力下降组耳鸣治疗有效率为28.57%（4/14）,对各组的耳鸣治疗有效率进行比较,差异具有统计学意义（P＜0.05）。结论高频听力下降者耳鸣发生率最高,听力正常者耳鸣发生率最低。听力正常及低频听力下降者耳鸣治疗有效率最高,高频听力及全聋者耳鸣治疗效果较差。     

Requirements on speech processing hearing aids for the profoundly deaf, some preliminary remarks.

Many severely hard of hearing and profoundly deaf persons seem to get very little help from an ordinary hearing aid. This observation has prompted the development of tactile speech processing aids. These aids should however only be used if it can be shown that the subject has no useful residual hearing. In the case of a profound hearing loss the audiogram might in some cases show tactile sensations in the ear. To get a better estimation of the remaining auditory capacity experiments have been made with frequency discrimination measurements, and with speech tests consisting of rhyming word pairs. Results from these different tests are summarized in relation to an audiogram classification system. Two tactile speech processing aids are described. Evaluation studies with these aids show positive results but these results must be compared with the results that can be obtained with ordinary hearing aids and different types of auditory speech processing hearing aids. The possibility to use extreme auditory recording must also be studied. In this case the transmitted signal is not speech-like and it is possible that this limits their usefulness. Experiments with this type of aids might however give valuable information about how the human perceptual systems process signals derived from the original speech signal.     

Cochrane corner: platinum-induced hearing loss after treatment for childhood cancer

This Cochrane Corner features the review entitled “Platinum-induced hearing loss after treatment for childhood cancer” published in 2016. In their review, van As et al. identified 13 cohort studies including 2837 participants with a hearing test after treatment with a platinum-based therapy for different types of childhood cancers. All studies had problems related to quality of the evidence. The reported frequency of hearing loss varied between 1.7% and 90.1% for studies that included a definition of hearing loss; none of the studies provided data on tinnitus. Only two studies evaluated possible risk factors. One study found a higher risk of hearing loss in people treated with the combination of cisplatin plus carboplatin compared to treatment with cisplatin only and for exposure to aminoglycosides. The other found that age at treatment (lower risk in older children) and single maximum cisplatin dose (higher risk with an increasing dose) were significant predictors for hearing loss, while gender was not. This systematic review shows that children treated with platinum analogues are at risk of developing hearing loss, but the exact prevalence and risk factors remain unclear.     

A "virtual hearing aid" for comparing hearing aids in children: a double-blind crossover study.

In this study, a "virtual hearing aid" was used to compare different types of hearing aids. A digital hearing aid (Oticon DigiFocus Compact) and an analogue, automatic reference hearing aid were compared in a group of 17 schoolchildren (median age: 10 years) with moderate to severe, symmetrical, sensorineural hearing loss. Differences in performance were assessed using routine diagnostic methods (speech recognition performance tests, loudness scaling), subjective assessments (questionnaires) and the "virtual hearing aid". Guaranteeing double-blind testing conditions, the "virtual hearing aid" offers the possibility to directly compare individual in-situ recordings of different hearing aids. In contrast to the clear subjective preferences for the digital hearing aid, we could not obtain any significant results with routine diagnostic methods. Using the "virtual hearing aid", the subjective comparison and speech recognition performance tasks yielded significant differences. The "virtual hearing aid" proved to be suitable for directly comparing different hearing aids under double-blind testing conditions.     

Speech perception in noise for children with auditory neuropathy/dys-synchrony type hearing loss

OBJECTIVE: To evaluate the effect of background noise on speech perception in children with auditory neuropathy/dys-synchrony (AN/AD) type hearing loss. DESIGN: Open and closed-set speech perception abilities were assessed in 12 school-age children who had been diagnosed with AN/AD in infancy. Data were also obtained from a cohort of subjects with sensorineural (SN) hearing loss and from a group of normal-hearing children. RESULTS: Closed-set speech understanding was more affected by the presence of a competing signal in the hearing impaired than in the normal-hearing subjects. The mean S/N ratio required to identify a spondee in noise was -11.5 +/- 2.0 dB for the normal group, whereas the ratio required for the SN group was -5.4 +/- 5.1 dB and for the AN/AD group was -2.5 +/- 4.7 dB. Closed-set perception in noise was not significantly different for the AN/AD children and their SN counterparts although there was a trend toward poorer performance in the AN/AD group. The effect of background noise on open-set speech perception was also similar across hearing-impaired subjects although again, the AN/AD cohort tended to show greater difficulties in noise than their SN peers. CONCLUSIONS: Listening in background noise was more difficult for our group of children with AN/AD-type hearing loss than for their normal-hearing peers. However, the noise effects were not consistent across subjects and some children demonstrated reasonable perceptual ability at low signal-to-noise ratios. The ways in which speech understanding is affected by competing signals may be different for different types of hearing deficit, but the results of this investigation indicate that significant perceptual disruption occurs both in children with auditory neuropathy/dys-synchrony and sensorineural type hearing loss.     

2～5岁听障儿童家长教养方式及影响因素的研究

目的考察全面康复模式下2～5岁听障儿童家长教养方式的特点及其影响因素,为家长指导工作提供参考依据。方法选取133名2～5岁听障儿童家长作为被试,采用家长教养方式问卷施测。结果2～5岁听障儿童家长在教养方式各维度上的表现倾向存在显著差异（P〈0．05）,民主性维度得分最高,其次为专制性、不一致性,溺爱性、放任性维度的得分最低。听障儿童的年龄、助听设备、康复时间、主要照顾人类型及其受教育程度、家庭结构对教养方式的某些方面具有显著影响,主要表现在民主性、专制性和不一致性维度上（P〈0．05）,听障儿童的性别和主要照顾人的职业对家长教养方式的影响均不显著（P〉0．05）。结论2～5岁听障儿童家长的教养方式具有明显特点,且受家庭、社会环境、康复等多方面因素的影响。     

Hearing loss after head injury

Sixty head injury patients were evaluated for hearing loss; ten underwent ABER testing. Forty percent of the cases had hearing loss of different degrees. The audiometric pattern was variable in the different types of injuries, although the incidence of conductive deafness was quite low (5%). In most of the cases of sensorineural hearing loss, the end organ was implicated. Recruitment was demonstrated in the ABERs, as well as in the retrocochlear lesions, by studying the IPLs present.     

突发性聋患者血常规、血脂、血液流变学的水平及其与预后的相关性

目的检测突发性聋(Sudden deafness,SD)患者外周血血常规、血脂、血液流变学的水平,并与健康正常人相比,同时探讨这些指标与其疗效的关系。方法回顾性分析2018年1月至2019年6月148例突发性聋(简称突聋)患者的临床资料,与同期的160例健康对照者相比较,分析不同听阈曲线类型(低频下降型、平坦下降型、高频下降型及全聋型)的突聋患者血常规相关指标白细胞、中性粒细胞、淋巴细胞、平均血小板体积(mean platelet volume,MPV)、血小板/淋巴细胞比值(platelet lymphocyte ratio,PLR)及中性粒细胞/淋巴细胞比值(neutrophil-to-lymphocyte,NLR),血脂相关指标(总胆固醇、甘油三酯),血液流变学(血浆粘度、全血粘度高切、全血粘度中切、全血粘度低切)的水平及其与突发性聋疗效的相关性。结果①突聋组血常规、血脂、血液流变学与对照组的比较:突聋组白细胞、中性粒细胞、淋巴细胞、MPV、NLR、PLR、总胆固醇、甘油三酯、全血粘度中切与对照组相比差异有统计学意义(P<0.05),其中突聋组患者白细胞、中性粒细胞、MPV、NLR、PLR、总胆固醇、全血粘度中切均较对照组升高,淋巴细胞、甘油三酯较对照组降低。突聋组血浆粘度、全血粘度高切、全血粘度低切较对照组升高,差异无统计学意义(P>0.05)。②不同类型听阈曲线突聋患者血常规、血脂、血液流变学的比较:低频下降型、平坦下降型、高频下降型及全聋型患者的白细胞、中性粒细胞、MPV、NLR、PLR与对照组相比明显升高;其淋巴细胞与对照组相比明显降低;低频下降型总胆固醇、全血粘度高切、中切、低切较对照组升高;平坦下降型总胆固醇、全血粘度高切、中切较对照组升高;全聋型总胆固醇、全血粘度高切较对照组升高,以上差异均有统计学意义(P<0.05)。高频下降型总胆固醇、全血粘度高切、中切、低切较对照组升高,各类型突聋患者与对照组的甘油三酯、血浆粘度差异,均无明显统计学意义(P>0.05)。③不同类型听阈曲线突聋患者不同疗效的血常规、血脂、血液流变学的比较:突聋组治疗无效组白细胞、中性粒细胞、NLR、血浆粘度、全血粘度高切、低切较治疗有效组升高;低频下降型治疗无效组的白细胞、中性粒细胞、NLR、全血粘度低切较治疗有效组升高;高频下降型治疗无效组的白细胞、中性粒细胞、全血粘度高切、中切、低切较治疗有效组升高;平坦下降型治疗无效组的白细胞、中性粒细胞、淋巴细胞、血浆粘度较治疗有效组升高;全聋型治疗无效组的白细胞、中性粒细胞、NLR、PLR较治疗有效组升高,以上差异均有统计学意义(P<0.05)。④突聋组患者血常规指标中白细胞、中性粒细胞、NLR与预后呈负相关性,血液流变学指标中的血浆粘度、全血粘度低切与预后呈负相关性。结论突聋患者可能存在炎症感染、脂代谢异常以及血流变学异常,同时发现突聋患者的白细胞、中性粒细胞、NLR、血浆粘度、全血粘度低切对其预后能起到一定的预测作用。临床工作中,我们应该关注突聋患者的血常规、血液流变学指标,可给予抗感染、降低血粘度等治疗,可能有助于其预后。     

突发性聋患者耳鸣程度及耳鸣疗效的相关因素分析

目的 研究影响突发性聋伴耳鸣患者耳鸣严重程度及远期疗效的相关因素.方法 回顾性分析2017年3月～2019年5月荆州市中心医院收治的106例单侧突发性聋伴耳鸣患者随访半年临床资料.观察耳鸣严重程度及耳鸣疗效与性别、年龄、侧别、初始听力损失程度、听力曲线类型、初诊时间、耳聋疗效的关系.结果 耳鸣严重程度与不同性别、年龄、...     

Variable-speech-rate audiometry for hearing aid evaluation

A new hearing aid evaluation method using variable-speech-rate audiometry (VSRA) was developed. VSRA was newly created based on the Japanese speech audiometry authorized by the Japan Audiological Society. The ordinary speech audiometry can not reveal a temporal factor in word discrimination ability of the hearing impaired. Since, with VSRA, we can compare several performance-intensity curves obtained from different speech-rate speech audiometries, the impact on the auditory system of each patient by the fast or slow speech rate could be easily determined. Taking the temporal factor of the auditory systems into consideration by using VSRA, hearing aid evaluation was performed for a master hearing aid with three types of signal processing and fitting for 36 hearing impaired subjects. Then hearing aid evaluation was performed using VSRA for a newly developed portable multi-function digital hearing aid with two types of signal processing and analog hearing aids which had been used by hearing-impaired patients. As a result, VSRA was useful for hearing aid evaluation, in particular, for cases when ordinary normal speech rate audiometry does not provide a significant difference in word discrimination scores. In addition, using VSRA revealed that amplitude compression is more effective for improvement of word discrimination than linear amplification.