Factors influencing degree of hearing loss at presentation,hearing aid choice,and usage in first time hearing aid users in Singapore

Abstract

Objective: To examine the factors associated with late presentation at first hearing aid (HA) fitting, HA choice and usage among users in Singapore.

Design: Retrospective cross-sectional study.

Study sample: 1068 subjects issued with HAs at a tertiary hospital from 2001 to 2013.

Results: Half of the subjects presented with more severe (>55?dB) hearing loss (HL) in their better ear. In multivariable analysis, older age, Malay ethnicity, conductive and mixed HL, and combination type of HL were associated with more severe HL at first presentation. Over 70% of subjects were older than 65 years. Worse pure tone audiometry (PTA) thresholds of the better ear, gradual onset and sensorineural HL were associated with older age presentation. For unilaterally fitted subjects, PTA thresholds were the only determinant of having the better ear aided. Better PTA thresholds, younger age and sensorineural HL were associated with choosing in ear compared to behind the ear HAs. Younger age and worse PTA of the better ear were associated with ≥4?h of daily HA usage.

Conclusions: Age, ethnicity and type of HL were important determinants for more severe HL at first HA fitting. Older patients and those with better hearing were less likely to use their HAs regularly.     

Hearing aid benefit related to the POGO amplification formula, evaluated from insertion gain measurements of two BTE hearing aids

The purpose of the study was to perform clinical tests with two BTE-hearing aids (BTE-HAs) having different frequency characteristics--and to correlate the results of the clinical tests to self-assessed use and benefit. The material comprised 16 subjects (SS) (median age: 74.5 years, range: 70-83 years) with moderate, sensorineural hearing losses. Patient selection criteria were specified according to the requirements for amplification at 4 kHz. All SS were fitted with two different types of BTE-HAs which were compared by the SS in a 3-months field study. The effect of the HAs was subjectively evaluated by a questionnaire and objectively by determination of the discrimination score in background noise (DN measurements). Furthermore, the need of amplification was checked by repeated insertion gain (IG) measurements. There was no significant difference in final HA choice. The DN measurements and IG measurements (both measured at most comfortable listening level (MCL] were significantly better with one of the HAs. The conclusion is that a correlation exists between optimal discrimination score in background noise and amplification at 2 and 4 kHz. The objective findings, however, were not reflected in any of the subjective parameters.     

Progression of hearing loss and choice of hearing aids by patients in their 60s, 70s,and 80s and older: experience in the Japanese super-aged era

Abstract

Background: Demographic data of patients with sensorineural hearing loss (SNHL) in super-aged societies are still limited.

Aims/objectives: To report audiometric statistics of SNHL and hearing aid (HA) use in patients in their 60s, 70s, and 80s and older during the super-aged era.

Material and methods: Medical charts and audiograms of 2064 older patients with SNHL who visited a Japanese University Hospital in 2007–2018 were retrospectively reviewed. Among 270 patients referred to the HA service unit (HASU), the percentage of final decisions to continue using HAs was calculated.

Results: The average pure tone thresholds on initial visit to the clinic were 56.9, 60.6, 69.4, and 82.4?dB HL in patients in their 60s, 70s, 80s, and 90s, respectively. The rates of progression were 0.25, 0.87, 1.19, and 1.37?dB/year in patients in their 50s, 60s, 70s, and 80s, respectively. The percentage of patients in HASU who chose to use HAs did not differ among the 60s (59.3%), 70s (51.2%), and 80s and older (58.2%).

Conclusions and significance: The clinical picture of patients with SNHL in their 70s and 80s differs because progression accelerates exponentially through these ages. HAs can be recommended to older adult patients in all the age groups.     

Older adults’ experiences and issues with hearing aids in the first six months after hearing aid fitting

Objectives: This study describes older adults’ experiences with a new hearing aid (HA) during the first 6 months after fitting. Design: In a longitudinally designed study, experiences and issues with HA use were assessed at a six-month follow-up appointment in individual structured interviews lasting 30?min. Associations between HA experiences and demographic factors, degree of hearing loss, and an objective measure of HA use (datalogging) were also examined. Study sample: 181?HA recipients (≥60 years) attending a six-month follow-up appointment. Results: Participants reported an average of 1.4 issues (range 0–5, median?=?1, mode?=?1) with HA use, the most common pertaining to the earmold (26.5%), sound quality (26.0%) and handling (25.5%). Participants who reported at least one issue had fewer hours of use per day, but were not more likely to be non-users (<30?min/day). Non-users (15.5%) were more likely to report no need for a HA and handling issues. Conclusions: Most older adults use their HAs regardless of reported issues. However, handling issues and no perceived need may interfere with HA usage among some adults with hearing impairment. Moreover, reported issues were associated with less frequent HA use. Follow-up support is thus important to address issues that may interfere with optimal use.     

Hearing impairment and hearing aid usage in Singapore

Objective: To examine the epidemiological and audiological profile, pattern of hearing aid (HA) fitting and usage among HA users in Singapore. Design: Retrospective cross-sectional study. Study sample: Cohort of 1068 subjects issued with HAs at a tertiary hospital between 2001 and 2013. Results: Mean age was 70?years with 50.8% male. Mean hearing loss (HL) was 63.1?dB and 69.5% had at least moderate-severe HL. Sensorineural HL was present in 66.4% and 69.8% had symmetrical HL. “Behind-the-Ear” HAs were cheaper than “In-Ear” HAs. Standard “Behind-The-Ear” HAs were also cheaper than “Receiver-in-Canal” HAs. Among In-Ear HAs, “In-the-Canal” and “Completely-in-Canal” were more popular than “In-the-Ear” HAs despite costing more. HA was used ≥4?days/week by 85.6% but >7?h per day by only 35.7%. Only 18% received bilateral first HA fitting. In multivariate analysis, younger age and symmetrical HL were predictors of bilateral HA uptake while better Pure-Tone-Audiometry of aided ear and >7?h of daily HA usage were predictors of successive HA fitting. Conclusions: HA users in Singapore were elderly and presented with advanced HL. Bilateral HA adoption and average daily use were low compared to other developed countries. Future research on understanding the suboptimal HA usage should explore patients' motivation, hearing disability, and HA effectiveness.     

Patient selection for incus body coupling of a totally implantable middle ear implant

Objective—To evaluate audiologic selection criteria for incus body coupling (IBC) of a totally implantable middle ear implant (TI-MEI) for the treatment of sensorineural hearing loss (SNHL). Material and Methods—The protocol is specified in the Investigational Device Exemption of a Food and Drug Administration-approved multicenter clinical trial. The prospective study compared pre- and postoperative hearing levels using each patient as their own control. In addition, an implant on/off comparison was made. All patients had a follow-up interval of at least 6 months. Audiologic assessment tests included speech discrimination in quiet as the primary efficacy variable and pure-tone audiometry (aided thresholds), gain, speech recognition in noise and subject satisfaction using standardized questionnaires and visual analog scales (VASs) as secondary efficacy variables. The study group of patients (n = 13) was divided into 3 subgroups based on their pure-tone and speech discrimination scores: Group A consisted of 6 patients, Group B 9 patients and Group C of all 13 patients. All patients suffered from long-standing bilateral moderate to severe SNHL. Five patients were dissatisfied hearing aid (HA) users and eight subjects could not wear HAs. All patients were implanted with a TI-MEI which was coupled to the incus body. The amplification level of the device was set postoperatively using inductive digital fitting based on "most comfortable loudness" specifications. Results—The implant produced median improvements from 30% (optimally fit bilateral HAs; n = 5) and 50% (HA non-users; n = 8) to 70% word recognition at 60 dB SPL. Average word recognition scores at 60, 80 and 90 dB SPL in Groups A and B showed increases from 42% (interquartile range +27%, -12%) to 93.5% (+3%, -5%) and 92.5% (+3%, -7%), respectively. In the presence of background noise, the sentence recognition threshold ranged from -2 to 1 dB signal-to-noise ratio. Maximum amplification was 50 dB at 3 kHz and 55 dB at 4 kHz. In Groups A and B, VASs revealed improvements in both natural sound impression and clarity from 62-70% of a natural sound impression to maximum scores of 100%. Using the standardized Gothenburg profile, subjective evaluations of hearing, orientation, social behavior and self-confidence reached 96-98%, 92-96% and 84-92% of the maximum score for Groups A-C, respectively. Conclusions—In selected cases, IBC of the TI-MEI investigated herein may be indicated for the treatment of SNHL, provided the following four conditions are met. First, the patient does not derive sufficient benefit from conventional HAs. Second, the specific indication for IBC is restricted to situations that do not allow the coupling of the MEI to the long incus process (e.g. due to an anatomical variation of facial nerve location). Third, IBC is restricted to patients with a steeply sloped moderate to severe high frequency SNHL, amounting to 90 dB HL from 3 to 8 kHz. Patients with low frequency SNHL should not be operated on with the IBC technique, as maximum low frequency hearing loss at 0.5 kHz must not exceed 30 dB. Fourth, Schueller's X-ray should reveal normal mastoid pneumatization. Being restricted to a 6-month follow-up period, this paper provides early clinical results and no clinical evidence of long-term efficiency of the implant.     

The value of speech audiometry in hearing-aid rehabilitation.

The purpose of the present study was to evaluate the aided speech recognition score (SRS) as predictor of HA-use by relating aided SRS measurements to an extensive questionnaire describing the self-assessed use and benefit of an in-the-canal hearing aid (Danavox 131). A sample of 124 subjects with moderate, predominantly sensorineural hearing loss, 61 males and 63 females at a median age of 68 years, range 21-89, were included in the present investigation. The hearing-aid fitting was checked by insertion gain measurements based on the POGO amplification strategy, and the improvement in word recognition offered by the aid was expressed as the difference between the aided and unaided SRS measured in background noise (SRSN) (S/N = + 10 dB). Correlations between the aided SRSN and questions concerning the use and benefit of this type of hearing aid were performed after subdividing the sample into two age groups, below and above 70 years of age, in order to avoid differences in hearing aid gain which could be ascribed to an age effect. The results demonstrated that a prediction of the aided SRSN from the unaided SRSN can be performed. However, no significant correlation between the self-assessed time-related use, situational use or satisfaction and the aided SRSN could be found. It is concluded that aided SRSN with this clinical setup cannot predict the use or benefit of a modern hearing aid, though the measurements may, in combination with insertion gain measurements, prove useful for the comparison between different hearing aids, also in the individual person.     

Comparison of speech perception between monaural and binaural hearing in cochlear implant patients

Objective To assess the advantages of binaural hearing for cochlear implant (CI) users using a hearing aid (HA) for the contralateral ear.

Material and Methods The subjects comprised 3 males and 3 females (age range 48–84 years). All of them had been using a CI and HA for >6 months. Their speech perception was examined in quiet using monosyllables and Japanese Hearing in Noise Test (J-HINT) sentences. Speech perception in noise was examined using J-HINT sentences. Late cortical waves were measured while subjects listened to 1 kHz frequent and 2 kHz target tone stimuli. The latency of the event-related potential (P300) wave was compared for monaural and binaural hearing conditions.

Results Three subjects showed significantly better results for binaural than monaural (CI alone) hearing for monosyllables and HINT sentences (p<0.05; paired t-test). Subjects with better speech perception had been using an HA for longer than those with poor performance (18.3 vs 4.0 years). The overall average score was better for binaural than monaural hearing in the speech perception test under quiet and noisy conditions. Comparison of the latency of the P300 wave under monaural and binaural hearing conditions showed a significantly shorter latency for the latter (p=0.02; paired t-test).

Conclusion Although the use of an HA alone showed marginal benefit for CI users, binaural hearing (CI + HA) resulted in a significant improvement in speech perception under various circumstances.     

A double-blind,randomized controlled trial exploring the efficacy of frequency lowering hearing aids in patients with high-frequency hearing loss

ObjectiveWhether linear frequency transposition (LFT) assists individuals with hearing difficulties has been studied for years, but no reliable comparison between LFT hearing aids (HAs) and conventional compression-type HAs has been conducted. Herein, we report on the first, relevant, double-blind, randomized controlled trial on this topic using a large sample size. We compared the efficacies of LFT HAs to those of compression-type HAs in patients with high-frequency hearing loss (HFHL); we also reviewed the literature.MethodsA total of 103 patients were randomized into three groups: conventional HAs featuring wide dynamic range compression (control group); HAs featuring LFT (LFT group); and HAs employing both LFT and wide dynamic range compression of high frequencies (combined group). Pure tone averages (PTAs), speech recognition thresholds (SRTs), word recognition scores (WRSs), and Abbreviated Profile of Hearing Aid Benefit (APHAB) inventories were assessed at the initial visit and after 3 months of HA use. Subject preferences in terms of continued use of their HAs were also evaluated.ResultsThe PTA, SRT, and WRS scores significantly improved in all three groups. No significant among-group differences were evident. The APHAB score significantly improved only in the control group; HA future-use preference was also highest in this group.ConclusionLFT did not provide an additional benefit for subjects with HFHL over conventional amplification and users preferred conventional HAs featuring wide dynamic range compression.     

Patient selection for incus body coupling of a totally implantable middle ear implant

OBJECTIVE: To evaluate audiologic selection criteria for incus body coupling (IBC) of a totally implantable middle ear implant (TI-MEI) for the treatment of sensorineural hearing loss (SNHL). MATERIAL AND METHODS: The protocol is specified in the Investigational Device Exemption of a Food and Drug Administration-approved multicenter clinical trial. The prospective study compared pre- and postoperative hearing levels using each patient as their own control. In addition, an implant on/off comparison was made. All patients had a follow-up interval of at least 6 months. Audiologic assessment tests included speech discrimination in quiet as the primary efficacy variable and pure-tone audiometry (aided thresholds), gain, speech recognition in noise and subject satisfaction using standardized questionnaires and visual analog scales (VASs) as secondary efficacy variables. The study group of patients (n = 13) was divided into 3 subgroups based on their pure-tone and speech discrimination scores: Group A consisted of 6 patients, Group B 9 patients and Group C of all 13 patients. All patients suffered from long-standing bilateral moderate to severe SNHL. Five patients were dissatisfied hearing aid (HA) users and eight subjects could not wear HAs. All patients were implanted with a TI-MEI which was coupled to the incus body. The amplification level of the device was set postoperatively using inductive digital fitting based on "most comfortable loudness" specifications. RESULTS: The implant produced median improvements from 30% (optimally fit bilateral HAs; n = 5) and 50% (HA non-users; n = 8) to 70% word recognition at 60 dB SPL. Average word recognition scores at 60, 80 and 90 dB SPL in Groups A and B showed increases from 42% (interquartile range +27%, -12%) to 93.5% (+3%, -5%) and 92.5% (+3%, -7%), respectively. In the presence of background noise, the sentence recognition threshold ranged from -2 to 1 dB signal-to-noise ratio. Maximum amplification was 50 dB at 3 kHz and 55 dB at 4 kHz. In Groups A and B, VASs revealed improvements in both natural sound impression and clarity from 62-70% of a natural sound impression to maximum scores of 100%. Using the standardized Gothenburg profile, subjective evaluations of hearing, orientation, social behavior and self-confidence reached 96-98%, 92-96% and 84-92% of the maximum score for Groups A-C, respectively. CONCLUSIONS: In selected cases, IBC of the TI-MEI investigated herein may be indicated for the treatment of SNHL, provided the following four conditions are met. First, the patient does not derive sufficient benefit from conventional HAs. Second, the specific indication for IBC is restricted to situations that do not allow the coupling of the MEI to the long incus process (e.g. due to an anatomical variation of facial nerve location). Third, IBC is restricted to patients with a steeply sloped moderate to severe high frequency SNHL, amounting to 90 dB HL from 3 to 8 kHz. Patients with low frequency SNHL should not be operated on with the IBC technique, as maximum low frequency hearing loss at 0.5 kHz must not exceed 30 dB. Fourth, Schueller's X-ray should reveal normal mastoid pneumatization. Being restricted to a 6-month follow-up period, this paper provides early clinical results and no clinical evidence of long-term efficiency of the implant.     

Subjective evaluation of single microphone noise reduction with different time constants

Abstract

Objective: Previous studies on single microphone noise reduction (NR) in hearing aids (HAs) have shown that some NR algorithms provide beneficial effects in terms of listener preference. To improve HA user satisfaction, we are interested in characteristics that determine preferences for NR, and in the inter-individual variability. The aim of this study was to test if dynamic properties of NR influence listener preference.

Design: The gain reduction at speech offsets of a NR algorithm was slowed down by applying temporal exponential smoothing. At speech onsets the gain recovery was left unchanged. Test signals consisted of speech in continuous and modulated speech-shaped background noise, processed with three time constants: 0, 100, and 200?ms.

Study sample: 16 Normal hearing (NH) and 16 hearing impaired (HI) subjects participated in a paired-comparison listening test.

Results: NH subjects as a group had a significant preference for NR with time constants of 100, or 200?ms (slower acting NR). HI listeners as a group preferred NR over no NR, but had no clear preference for fast or slow NR. Patterns of preference differed between individual listeners.

Conclusions: NR dynamics had an impact on individual listener preference and should be considered when optimising HAs.     

Hearing impairment among adults: The impact of cardiovascular diseases and cardiovascular risk factors

Objective: To investigate the influence of cardiovascular diseases on hearing impairment (HI) among adults. Furthermore, to seek other potential risk factors for HI, such as smoking, obesity, and socioeconomic class. Design: A cross-sectional, unscreened, population-based, epidemiological study among adults. Study sample: The subjects (n = 850), aged 54–66 years, were randomly sampled from the population register. A questionnaire survey, an otological examination, and pure-tone audiometry were performed. Results: Cardiovascular diseases did not increase the risk for HI in a propensity-score adjusted logistic regression model: OR 1.24, 95% CI 0.79 to 1.96 for HI defined by better ear hearing level (BEHL), and OR 1.48, 95% CI 0.96 to 2.28 for HI defined by worse ear hearing level (WEHL), in the 0.5–4 kHz frequency range. Heavy smoking is a risk factor for HI among men (BEHL: OR 1.96, WEHL: OR 1.88) and women (WEHL: OR 2.4). Among men, obesity (BEHL, OR 1.85) and lower socioeconomic class (BEHL: OR 2.79, WEHL: OR 2.28) are also risk factors for HI. Conclusion: No significant association between cardiovascular disease and HI was found.     

Binaural–bimodal hearing: Concomitant use of a unilateral cochlear implant and a contralateral hearing aid

Conclusion. The benefit obtained with a contralateral hearing aid (HA) in unilateral cochlear implantees improves over time, at least during the first year after implantation. Objective. To evaluate binaural–bimodal auditory ability and its early changes over time after unilateral cochlear implantation in patients with residual hearing in the non-implanted ear, in which they use an HA. Material and methods. Sentence identification in background noise was tested in 12 patients (3 post-lingual adults and 9 pre-lingual adults and older children) under 3 listening conditions: cochlear implant (CI) alone, HA alone and CI?+?HA. The presentation level was 55 dB HL with a signal-to-noise ratio of +10 dB. Subjects were tested after 1–6 months of concomitant use of both devices and again after a further 7–12 months. Results. At the first testing session, the mean score in background noise was 34.9% with CI alone (range 0–90%) and 41.1% with both devices (range 0–100%). Seven patients could recognize sentences in noise with CI alone, and four of them showed further improvement with added amplification. At the second session, at which all subjects could recognize sentences in noise with the CI alone, seven showed further improvement with added amplification. The mean score was 60.6% with CI alone (range 10–99%) and 75.5% with both devices (range 52–100%).     

Perception of hearing impairment and the willingness to use hearing aids in an elderly population in southern Taiwan: A community-based study

Objectives: To estimate the prevalence and severity of hearing impairment (HI), the self-perception of HI, and the willingness to use a hearing aid (HA) in the elderly population in southern Taiwan. Design: This community-based study was performed in a metropolitan hospital. A questionnaire about the perception of HI and the willingness to use a HA was used. The severity of HI in speech-frequency pure-tone average (PTA) was evaluated. The associations between sex, age, severity of HI, self-perception of HI, and the willingness to use a HA were analysed. Study sample: A total of 599 volunteers were recruited from the health management center; 324 (54.1%) males and 275 (45.9%) females, who were 65 years of age or older. Results: The prevalence of HI?>25 dBHL in the elderly was 78%. The predicted levels for elderly persons to perceive HI and hearing difficulties were 34.38 dBHL and 54.38 dBHL, respectively. Males and younger participants were more willing to use HA. The primary reasons for refusing HA use were discomfort (25.1%) and a self-perception that the HA was unnecessary (19.7%). Conclusions: The prevalence of HI was high among the elderly population in southern Taiwan. Age and sex were the determinants of HA use.     

Output signal-to-noise ratio and speech perception in noise: effects of algorithm

Objective: The aims of this study were to: 1) quantify the amount of change in signal-to-noise ratio (SNR) as a result of compression and noise reduction (NR) processing in devices from three hearing aid (HA) manufacturers and 2) use the SNR changes to predict changes in speech perception. We hypothesised that the SNR change would differ across processing type and manufacturer, and that improvements in SNR would relate to improvements in performance. Design: SNR at the output of the HAs was quantified using a phase-inversion technique. A linear mixed model was used to determine whether changes in SNR across HA conditions were predictive of changes in aided speech perception in noise. Study sample: Two groups participated: 25 participants had normal-hearing and 25 participants had mild to moderately severe sensorineural hearing loss. Results: The HAs programmed for both groups changed the SNR by a small, but statistically significant amount. Significant interactions in SNR changes were observed between HA devices and processing types. However, the change in SNR was not predictive of changes in speech perception. Conclusion: Although observed significant changes in SNR resulting from compression and NR did not convert to changes in speech perception, these algorithms may serve other purposes.     

Clinical study of a digital vs an analogue hearing aid.

Digital signal processing in hearing instruments has brought new perspectives to the compensation of hearing impairment and may result in alleviation of the adverse effects of hearing problems. This study compares a commercially available digital signal processing hearing aid (HA) (Senso) with a modern analogue HA with programmable fitting (Logo). The HAs tested are identical in appearance and, in spite of a different mode of operation, the study design ensured blinding of the test subjects. Outcome parameters were: improvements in speech recognition score in noise (deltaSRSN) with the HAs; overall preference for HA; overall satisfaction; and various measures of HA performance evaluated by a self-assessment questionnaire. A total of 28 experienced HA users with sensorineural hearing impairment were included and 25 completed the trial. No significant differences were found in deltaSRSN between the two HAs. Eleven subjects indicated an overall preference for the digital HA, 10 preferred the analogue HA and 4 had no preference. Concerning overall satisfaction, 8 subjects rated the digital HA superior to the analogue one, whereas 7 indicated a superior rating for the analogue HA and 10 rated the HAs equal. Acceptability of noise from traffic was the only outcome parameter which gave a significant difference between the HAs in favour of the digital HA. It is concluded that there are no significant differences in outcome between the digital and analogue signal processing HAs tested by these experienced HA-users.     

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.     

Hearing in a 54- to 66-year-old population in northern Finland

Abstract

There are only a few large, population-based epidemiological studies on hearing impairment (HI) in adults. The objective of this study was to investigate the prevalence of HI and possible differences between ears in older adults. The subjects (n = 850), aged 54–66 years, were randomly sampled from the population register. A questionnaire survey, an otological examination, and pure-tone audiometry were performed. Another questionnaire was mailed to collect information on non-participants. The prevalence of HI averaged over the frequencies of 0.5, 1, 2, and 4 kHz for the better ear ≥20 dB HL was 26.7% (men: 36.8%, women: 18.4%). There was no difference between left and right ear pure-tone averages over the frequencies 0.5, 1, 2, and 4 kHz (PTA_{0.5–4 kHz}), but a significant difference of ?0.8 dB HL was found for the low frequencies 0.125, 0.25, and 0.5 kHz (PTA_{0.125–0.5 kHz}), and 4.4 dB HL for the high frequencies over 4, 6, and 8 kHz (PTA_{4–8 kHz}). In conclusion, HI was a highly prevalent finding in this age group.

Sumario

Existen pocos estudios epidemiológicos grandes, basados en la población, sobre impedimentos auditivos (HI) en adultos. El objetivo de este estudio fue investigar la prevalencia de HI y posibles diferencias entre los oídos de adultos mayores. La muestra de sujetos (n = 850), con edades de 54–66 años, se hizo al azar, a partir de registros de población. Se aplicó un cuestionario y se realizó un examen otológico y una audiometría de tonos puros. Otro cuestionario fue enviado por correo para colectar información de los no participantes. La prevalencia de HI promediada en las frecuencias de 0.5, 1, 2, y 4 kHz en el mejor oído, >20 dB HL, fue de 26.7% (hombres: 36.8%; mujeres: 18.4%). No hubo diferencia entre los promedios con tonos puros en oídos derecho o izquierdo en las frecuencias de 0.5, 1, 2, y 4 kHz (PTA 0.5–4 kHz), pero si una diferencia significativa de -0.8 dB HL, encontrada en las frecuencias graves de 0.125, 0.25 y 0.5 kHz (PTA 0.125–0.5 kHz), y 4.4 dB HL en las frecuencias agudas de 4, 6 y 8 kHz (PTA 4–8 kHz). En conclusión, el HI fue un hallazgo altamente prevalente en este grupo de edad.     

Functional hearing in the classroom: assistive listening devices for students with hearing impairment in a mainstream school setting

Objective: To assess the benefit of assistive listening devices (ALDs) for students with hearing impairment in mainstream schools. Design: Speech recognition (CNC words) in background noise was assessed in a typical classroom. Participants underwent testing using four device configurations: (1) HA(s)/CI(s) alone, (2) soundfield amplification, (3) remote microphone (Roger Pen) on desk and (4) remote microphone at the loudspeaker. A sub-group of students subsequently underwent a 2-week classroom trial of each ALD. Degree of improvement from baseline [HA(s)/CI(s)] alone was assessed using teacher and student Listening Inventory for Education-Revised (LIFE-R) questionnaires. Study sample: In all, 20 students, aged 12.5–18.9 years, underwent speech recognition assessment. In total, 10 of these participated in the classroom trial. Hearing loss ranged from mild-to-profound levels. Results: Performance in each ALD configuration was higher than for HAs/CIs alone (p?p?p?>?0.05). Conclusion: Speech recognition improvements were demonstrated with the implementation of both remote microphones and soundfield systems. Both students and teachers reported functional hearing advantages in the classroom when using the remote microphone in concert with their standard hearing devices.