老年听力障碍患者的听觉行为与助听器验配的干预和康复

我国已经开始步入老龄社会，这将会带来很多相应的社会问题，其中，老年性听力损失引起的听觉和交流障碍问题将严重影响老年人的生活质量，应该积极地给予干预和康复。助听器验配是对老年听力障碍患者听力干预和康复的最有效的手段，也是改善老年听力障碍患者听觉交流障碍的主要途径。因此，老年听力障碍患者助听器的验配就成为临床老年听力干预和康复关注的热点问题。本文从心理和听觉行为的角度阐述老年听力障碍患者助听器验配的干预和康复内容。     

聋儿验配助听器程序

助听器几乎可使所有的聋人受益 ,尤其是处在听觉、语言、智能等诸方面发育阶段的聋儿 ,如果能尽早配戴合适的助听器、并进行听觉语言训练 ,就能尽最大可能地恢复听觉言语功能 ,回归主流社会。然而 ,无语言、不能合作是聋儿的共性 ,他们对助听效果不能作出主观评定。因此 ,聋儿助听器验配较之成年耳聋患者的难度大、周期长 ,需要耳科医生、听力学家、聋儿家长或教师通力合作 ,遵循验配助听器的程序 ,使聋儿获得最佳助听效果。1　听力资料准备选择助听器最首要的是掌握准确的听力资料。1 1　了解聋儿耳聋的病因、病程、发病情况及伴随症状 ,对…     

助听器验配人员资质认证的重要性

1助听器验配师职业的由来临床上有相当一部分听力障碍患者通过治疗手段无法得到治愈。从听力损失程度粗分,这部分患者可分为有残余听力和残余听力甚少两大类。在世界范围内,对有残余听力且符合助听器使用条件的患者可通     

助听器验配工作指南(试行)

助听器是听力语言障碍者(以下简称听障者)专用的康复设备之一,须经过验配方能使用。如果验配条件或验配技术达不到要求,不但不能发挥其听力补偿的作用,甚至还会造成新的听力损伤。因此,为规范助听器验配的程序和方法,提高助听器配戴者的听觉康复质量,维护其合法权益,特制定本工     

指向性助听器的验配实验报告

指向性助听器的验配实验报告陈振声１宋戌１张文理论上认为，装有指向性传声器的助听器（指向性助听器），在接收来自前方的语声信息方面应优于装有全方向性传声器的助听器（全方向性助听器），但在实际应用过程中，这种理论上的优点能否发挥出来，尚需通过实践加以证明，...     

以人为本的服务理念和工具在助听器验配中的应用

助听器用户生活质量的变化,影响听力康复的效果。以人为本的服务理念和工具,可以帮助听力专业人员围绕用户个体设计听力康复方案,注重并尊重用户个人喜好,融入家庭成员和其他沟通伙伴,共同进行听力康复决策和目标设定。在注重用户个人需要,考虑其价值观、愿望、社交、心理和生活环境等因素后,才能帮助他们改善生活质量,最终提高使用者对助听器的接纳率和满意度。     

助听器验配公式的研发进展*

在过去的30年里,随着助听器技术的不断更新换代,越来越多的研究开始致力于增强听障人士的语音感知效果。由于听障患者在听力损失性质、类型和听力曲线特征等多方面存在差异,如何就不同声强、不同频率点设置目标增益是助听器验配公式要解决的一个问题。     

中国小儿助听器验配程序指南

日前，经中国残疾人康复协会听力语言康复专业委员会相关专家讨论，制定并颁布了《中国小儿助听器验配程序指南》(中国聋儿康复研究中心陈振声教授执笔)。为满足我国小儿助听器验配的需要及解决存在的问题。更好地为广大听障儿童服务。2005年第一季度，中国残疾人康复协会听力语言康复专业委员会将会同中国聋儿康复研究中心在全国行业内推行该指南。本刊特全文刊发以飨读者。     

小儿助听器验配

为聋儿选配合适的助听器，对于发展聋儿在听／说两方面的交流能力，具有十分重要的意义。随着新生儿听力筛查计划的逐步实施，选配助听器的儿童的年龄越来越小；新的听力检查手段、新的助听器技术也在大量涌现，使得小儿听力学家面临新的挑战：需要一个系统化的、量化的、便于验证的选配手段，确保儿童能够全天使用，并安全、舒适地接收言语刺激。1994年，美国Vanderbilt大学等单位发起召开了“面向听力缺陷儿童的放大听力学”学术会议，该会议成立的小儿工作组发表了一份现状报告，并总结出一个较完善的小儿助听器选配指南。这其中的许多工作，都源于加拿大西安大略大学Richatd Seewald的研究小组。下文将以Seewald等人提出的理想感觉级(desired sensation level，DSL)处方公式为例，介绍小儿助听器的选配程序。     

成人助听器验配程序（建议之二）

咨询 了解患者现在的听力状况所带来的最大困惑和障碍。即想解决什么问题或来中心的目的。如：听得到但听不清楚，口齿不清，不会讲话等。了解病史，判断有无其他医疗康复(药物，手术等)的可能。了解耳部手术史，判断是否需要特殊的处理和注意。如骨导助听器，取耳样时注意等。了解患者的期望值和特殊需求。     

Effects of age on auditory and cognitive processing: implications for hearing aid fitting and audiologic rehabilitation

Recent advances in research and clinical practice concerning aging and auditory communication have been driven by questions about age-related differences in peripheral hearing, central auditory processing, and cognitive processing. A "site-of-lesion' view based on anatomic levels inspired research to test competing hypotheses about the contributions of changes at these three levels of the nervous system. A "processing' view based on psychologic functions inspired research to test alternative hypotheses about how lower-level sensory processes and higher-level cognitive processes interact. In the present paper, we suggest that these two views can begin to be unified following the example set by the cognitive neuroscience of aging. The early pioneers of audiology anticipated such a unified view, but today, advances in science and technology make it both possible and necessary. Specifically, we argue that a synthesis of new knowledge concerning the functional neuroscience of auditory cognition is necessary to inform the design and fitting of digital signal processing in "intelligent' hearing devices, as well as to inform best practices for resituating hearing aid fitting in a broader context of audiologic rehabilitation. Long-standing approaches to rehabilitative audiology should be revitalized to emphasize the important role that training and therapy play in promoting compensatory brain reorganization as older adults acclimatize to new technologies. The purpose of the present paper is to provide an integrated framework for understanding how auditory and cognitive processing interact when older adults listen, comprehend, and communicate in realistic situations, to review relevant models and findings, and to suggest how new knowledge about age-related changes in audition and cognition may influence future developments in hearing aid fitting and audiologic rehabilitation.     

Cochrane Corner: interventions to improve hearing aid use in adult auditory rehabilitation

This “Cochrane Corner” will be a recurring feature in the journal that highlights systematic reviews relevant to audiology, with invited commentary to aid clinical decision making. This first instalment features the Cochrane review “Interventions to Improve Hearing Aid Use in Adult Auditory Rehabilitation,” published in 2016. In their review, Barker et al identified 37 randomised controlled trials (RCTs) and concluded that there is low-quality evidence using self-management support and complex interventions (support plus delivery system design) in adult auditory rehabilitation. The review highlights the need for well-conducted studies in this area.     

Outcome measurement for patients receiving hearing aid services

OBJECTIVE: The purpose of this paper is to describe a useful patient report outcome measure for a hearing aid program that can be completed annually, with limited staff resources, and can be used to document performance excellence. STUDY DESIGN AND METHODS: The International Outcome Inventory for Hearing Aids (IOI-HA) questionnaire was mailed to all patients receiving new hearing aids and rehabilitative services during a 1 year period at Mayo Clinic (Rochester, MN). The data were analyzed to assess outcomes. RESULTS: Overall, patients reported a high level of satisfaction and an improved quality of life. The results compared favorably with published norms and with the previous year's results. CONCLUSION: The IOI-HA was implemented easily with little incremental cost. An annual project such as the one described can be used to demonstrate to administrators, patients, and payers that the clinic's rehabilitative hearing aid services have positive outcomes and that program quality is being monitored.     

A scale for hearing aid benefit measures and auditory disability

Quoting disability scores or measures of hearing aid benefit based on percent correct word identification or on dB signal-to-noise ratio at criterion performance poses a communication problem as scientists and clinicians may have no intuitive understanding of the scales involved. In particular, percent correct does not allow direct comparison of differences obtained at different performance levels, for example by different subject groups. In circumstances where the better ear hearing levels are known to be a major determinant of disability, it is both possible and legitimate to transform performance measures such as percent correct into a dB HL equivalent. In two sets of data from clinical research projects this relationship is shown to be linear, allowing a particularly simple transformation and giving an already understood scale. This transformation procedure has been cross-validated against the acoustic gain used in a sample of patients with conductive losses where the hearing loss is purely an attenuation. The procedure is offered as a metric for expressing the benefits of management.     

Measures for the assessment of hearing aid provision and rehabilitation

To determine the effectiveness of the provision of a hearing aid, some measure of benefit is desirable. Direct determination of benefit is difficult, not least due to the problems inherent in defining what benefit actually is. An alternative approach is to assess aspects of hearing aid use of performance that relate to benefit. Hours of daily use, satisfaction and self-rated performance are measures that might be expected to relate to benefit. The studies reported in this paper examine the relevance and repeatability of these measures. It is concluded that this three-parameter approach provides a simple, relevant and useful way of assessing benefit from amplification which has application in both individual and group studies.     

External auditory canal microbiology and hearing aid use

Objective

The aim of this study was to determine the presence and nature of bacterial flora on hearing aids and the ears of this population. We wonder if the microbiology of the ears with hearing aid wearing differs from the other ear.

Setting

Tertiary referral center.

Design

A prospective, clinical study.

Subjects and methods

Three samples were taken, one from the surface of the hearing aid's ear mold; one from the hearing aid-wearing ear canal and the last one from the ear without hearing aid. Samples were cultured to determine qualitatively and quantitatively the pathogenic microorganisms present.

Results

A total of 123 samples, obtained from 41 hearing aid users, were analyzed. Methicillin-resistant coagulase-negative staphylococci, methicillin-susceptible Staphylococcus aureus, methicillin-resistant S. aureus, Pseudomonas aeruginosa, Escherichia coli, Acinetobacter species, Staphylococcus auricularis, and Stenotrophomonas maltophilia were identified organisms.

Conclusions

We identified unexpected microorganisms both on hearing aids and hearing aid using ears. This study demonstrates that using hearing aid alters the ear canal flora. To avoid otitis externa, it is important to use an appropriate hygiene routine to clean and disinfect hearing aids and ear molds.     

Cortical auditory responses according to hearing rehabilitation in unilateral hearing loss

ObjectiveTo assess the impact of rehabilitation systems (CROS: Contralateral Routing of Signal; BAHA: Bone-Anchored Hearing Aid; CI: cochlear implant) on cortical auditory evoked potentials (CAEP) and auditory performance in unilateral hearing loss.Subjects and methodTwenty-one adults with unilateral hearing loss, using CROS (n = 6), BAHA (n = 6) or CI (n = 9), were included. Seven normal-hearing subjects served as controls. CAEPs were recorded for a (/ba/) speech stimulus; for patients, tests were conducted with and without their auditory rehabilitation. Amplitude and latency of the various CAEP components of the global field power (GFP) were measured, and scalp potential fields were mapped. Behavioral assessment used sentence recognition in noise, with and without spatial cues.ResultsOnly CI induced N1 peak amplitude change (P < 0.05). CI and CROS increased polarity inversion amplitude in the contralateral ear, and frontocentral negativity on the scalp potential map. CI improved understanding when speech was presented to the implanted ear and noise to the healthy ear, and vice-versa.ConclusionCochlear implantation had the greatest impact on CAEP morphology and auditory performance. A longitudinal study could analyze progression of cortical reorganization.