Comparison of Vent Effects between a Solid Earmold and a Hollow Earmold

2009 ◽  
Vol 20 (08) ◽  
pp. 480-491 ◽  
Author(s):  
Francis Kuk ◽  
Denise Keenan ◽  
Chi-chuen Lau
Keyword(s):  
Hearing Aids ◽  
Hearing Aid ◽  
High Frequency Hearing Loss ◽  
Thin Tube ◽  
Matlab Program ◽  
Data Collection And Analysis ◽  
Spss Software ◽  
The Difference ◽  
Single Blind ◽  
Maximum Available Gain

Background: Hollow earmolds have become a popular type of earmold used in thin-tube, microsize hearing aid fittings. It is desirable for clinicians to be familiar with their characteristics and limitations. Purpose: This investigation compared the effects of vent diameter between a traditional solid earmold and a hollow earmold that is used in modern thin-tube hearing aid fittings. Research Design: A single-blind, 2 × 4 factorial design was used. Study Sample: Eight adults with a high-frequency hearing loss participated. Intervention: Custom earmolds for use with thin-tube hearing aids were made for each participant. Two types of earmolds were made: a solid earmold with a traditional vent length and a hollow earmold where the thickness of the shell was the length of the vent. Vent diameters were 0, 1, 2, and 3 mm. Data Collection and Analysis: The vent effect was evaluated on real-ear aided response, real-ear occluded response during vocalization, subjective occlusion rating, insertion loss, and maximum available gain before feedback. Real-ear measurements were made with the Fonix 6500 probe-microphone real-ear system. Vocalizations from the participants were analyzed with a custom MATLAB program, and statistical analysis was conducted with SPSS software. Results: A systematic vent effect was seen with each earmold type as the nominal vent diameter changed. For the same vent diameter, the vent effect seen with the hollow earmold was greater than that of the solid earmold. Conclusions: Because of the difference in vent length (and thus acoustic mass) between a solid and a hollow earmold, the effect of vent diameter in a hollow earmold is more pronounced than that seen in a solid earmold of the same nominal vent diameter. Thus, a smaller vent diameter will be needed in a hollow earmold than in a solid earmold to achieve similar vent effects.

scholarly journals Comparison of In-Situ and Retrospective Self-Reports on Assessing Hearing Aid Outcomes

2020 ◽  
Author(s):  
Yu-Hsiang Wu ◽  
Elizabeth Stangl ◽  
Octav Chipara ◽  
Anna Gudjonsdottir ◽  
Jacob Oleson ◽  
...  
Keyword(s):  
Hearing Aids ◽  
Hearing Aid ◽  
Outcome Data ◽  
Self Report ◽  
Data Collection And Analysis ◽  
Self Reports ◽  
Outcome Difference ◽  
The Difference ◽  
Ecological Momentary

Abstract Background Ecological momentary assessment (EMA) is a methodology involving repeated surveys to collect in-situ self-reports that describe respondents' current or recent experiences. Audiology literature comparing in-situ and retrospective self-reports is scarce. Purpose To compare the sensitivity of in-situ and retrospective self-reports in detecting the outcome difference between hearing aid technologies, and to determine the association between in-situ and retrospective self-reports. Research Design An observational study. Study Sample Thirty-nine older adults with hearing loss. Data Collection and Analysis The study was part of a larger clinical trial that compared the outcomes of a prototype hearing aid (denoted as HA1) and a commercially available device (HA2). In each trial condition, participants wore hearing aids for 4 weeks. Outcomes were measured using EMA and retrospective questionnaires. To ensure that the outcome data could be directly compared, the Glasgow Hearing Aid Benefit Profile was administered as an in-situ self-report (denoted as EMA-GHABP) and as a retrospective questionnaire (retro-GHABP). Linear mixed models were used to determine if the EMA- and retro-GHABP could detect the outcome difference between HA1 and HA2. Correlation analyses were used to examine the association between EMA- and retro-GHABP. Results For the EMA-GHABP, HA2 had significantly higher (better) scores than HA1 in the GHABP subscales of benefit, residual disability, and satisfaction (p = 0.029–0.0015). In contrast, the difference in the retro-GHABP score between HA1 and HA2 was significant only in the satisfaction subscale (p = 0.0004). The correlations between the EMA- and retro-GHABP were significant in all subscales (p = 0.0004 to <0.0001). The strength of the association ranged from weak to moderate (r = 0.28–0.58). Finally, the exit interview indicated that 29 participants (74.4%) preferred HA2 over HA1. Conclusion The study suggests that in-situ self-reports collected using EMA could have a higher sensitivity than retrospective questionnaires. Therefore, EMA is worth considering in clinical trials that aim to compare the outcomes of different hearing aid technologies. The weak to moderate association between in-situ and retrospective self-reports suggests that these two types of measures assess different aspects of hearing aid outcomes.

Comparison of In-the-Ear and Over-the-Ear Hearing Aid Fittings

1986 ◽  
Vol 51 (4) ◽  
pp. 362-369 ◽  
Author(s):  
Donna M. Risberg ◽  
Robyn M. Cox
Keyword(s):  
Hearing Aids ◽  
High Frequency ◽  
Comparative Evaluation ◽  
Speech Intelligibility ◽  
Hearing Aid ◽  
Hearing Aid Fitting ◽  
The Difference ◽  
Functional Gain ◽  
The Relationship

A custom in-the-ear (ITE) hearing aid fitting was compared to two over-the-ear (OTE) hearing aid fittings for each of 9 subjects with mild to moderately severe hearing losses. Speech intelligibility via the three instruments was compared using the Speech Intelligibility Rating (SIR) test. The relationship between functional gain and coupler gain was compared for the ITE and the higher rated OTE instruments. The difference in input received at the microphone locations of the two types of hearing aids was measured for 10 different subjects and compared to the functional gain data. It was concluded that (a) for persons with mild to moderately severe hearing losses, appropriately adjusted custom ITE fittings typically yield speech intelligibility that is equal to the better OTE fitting identified in a comparative evaluation; and (b) gain prescriptions for ITE hearing aids should be adjusted to account for the high-frequency emphasis associated with in-the-concha microphone placement.

Modified Earpieces and CROS for High Frequency Hearing Losses

1968 ◽  
Vol 11 (1) ◽  
pp. 204-218 ◽  
Author(s):  
Elizabeth Dodds ◽  
Earl Harford
Keyword(s):  
Hearing Loss ◽  
Hearing Aids ◽  
High Frequency ◽  
Hearing Aid ◽  
Sound Field ◽  
Intensity Level ◽  
Test Results ◽  
High Frequency Hearing Loss ◽  
Increased Sensitivity ◽  
Difficult Cases

Persons with a high frequency hearing loss are difficult cases for whom to find suitable amplification. We have experienced some success with this problem in our Hearing Clinics using a specially designed earmold with a hearing aid. Thirty-five cases with high frequency hearing losses were selected from our clinical files for analysis of test results using standard, vented, and open earpieces. A statistical analysis of test results revealed that PB scores in sound field, using an average conversational intensity level (70 dB SPL), were enhanced when utilizing any one of the three earmolds. This result was due undoubtedly to increased sensitivity provided by the hearing aid. Only the open earmold used with a CROS hearing aid resulted in a significant improvement in discrimination when compared with the group’s unaided PB score under earphones or when comparing inter-earmold scores. These findings suggest that the inclusion of the open earmold with a CROS aid in the audiologist’s armamentarium should increase his flexibility in selecting hearing aids for persons with a high frequency hearing loss.

Cartilage Conduction Hearing Aid Fitting in Clinical Practice

2021 ◽  
Author(s):  
Tadashi Nishimura ◽  
Hiroshi Hosoi ◽  
Tomoko Sugiuchi ◽  
Nozomu Matsumoto ◽  
Takanori Nishiyama ◽  
...  
Keyword(s):  
Hearing Aids ◽  
Hearing Aid ◽  
Severe Stenosis ◽  
Aural Atresia ◽  
New Device ◽  
Data Collection And Analysis ◽  
Purchase Rate ◽  
Fitting In ◽  
Air Conduction ◽  
Assessment Results

Abstract Background Cartilage conduction hearing aids (CCHAs) were newly devised and spread fast in Japan since their launch in 2017. However, little knowledge is available for this new device. Purpose The aim of this study was to establish the knowledge of CCHAs and suggest their indication. Research Design Correlational study. Study Sample A total 256 patients were registered. Data Collection and Analysis The fitting of CCHAs was surveyed in nine institutions. The outcomes were assessed by audiometric tests. The patients were classified into seven groups, depending on the ear conditions. The clinical characteristics, assessment results, and purchase rates were compared among the groups. The assessment results of CCHAs were also compared with those of previously used hearing aids. Results Most patients who used CCHAs were classified into the bilateral closed (aural atresia or severe stenosis) ear (n = 65) or unilateral closed ear (n = 124) groups. The patients in these groups achieved good benefits that resulted in a high purchase rate. The bilateral continuous otorrhea group also supported a high purchase rate, although the benefits of CCHAs were not always excellent. In contrast, the purchase rate was poor in the patients who could use air conduction hearing aids (ACHAs) without absolute problems. As for using a CCHA as a contralateral routing of signals hearing aid, the benefits depended on the patients. Conclusions CCHAs are considered as a great option not only to the patients with closed ears but also to those who had difficulties in ACHAs usage.

scholarly journals Assessment of Hearing Aid Benefit Using Patient-Reported Outcomes and Audiologic Measures

2020 ◽  
Vol 25 (4) ◽  
pp. 215-223
Author(s):  
James R. Dornhoffer ◽  
Ted A. Meyer ◽  
Judy R. Dubno ◽  
Theodore R. McRackan
Keyword(s):  
Hearing Aids ◽  
Patient Reported Outcomes ◽  
Hearing Aid ◽  
Sound Field ◽  
Patient Reported Outcome ◽  
Middle Ear Implant ◽  
Patient Reported ◽  
The Difference ◽  
Patient Reported Measures ◽  
Hearing Aid Benefit

Purpose: To determine the contributions to hearing aid benefit of patient-reported outcomes and audiologic measures. Methods: Independent review was conducted on audiologic and patient-reported outcomes of hearing aid benefit collected in the course of a middle ear implant FDA clinical trial. Unaided and aided data were extracted from the preoperative profiles of 95 experienced hearing aid users, and the relationships between a patient-reported outcome and audiologic measures were assessed. The following data were extracted: unaided and aided pure-tone or warble-tone thresholds (PTA), word recognition in quiet (NU-6), Speech Perception in Noise (low-/high-context SPIN), and patient-reported benefit (Abbreviated Profile of Hearing Aid Benefit, APHAB). Hearing aid benefit was defined as the difference in thresholds or scores between unaided and aided conditions, as measured in the sound field. Correlations were computed among audiologic measures and global APHAB and subscale scores of hearing aid benefit. Results: Significant improvements in all audiologic measures and APHAB scores were observed comparing unaided to aided listening (all p < 0.001). However, correlations between audiologic and patient-reported measures of aided performance or hearing aid benefit were low-to-weak or absent. No significant correlations were found between aided audiologic measures (PTA, NU-6, SPIN) and any aided APHAB scores (all p > 0.0125), and significant relationships for hearing aid benefit were absent with only few exceptions. Hearing aid benefit defined by global APHAB using NU-6 and SPIN scores showed significant but weak positive correlations (r = 0.37, p < 0.001; r = 0.28, p = 0.005, respectively) and ease of communication APHAB subscale scores (r = 0.32, p < 0.001; r = 0.33, p = 0.001, respectively). Conclusion: Hearing aid benefit assessed with audiologic measures were poor predictors of patient-reported benefit. Thus, patient-reported outcomes may provide a unique assessment of patient-perceived benefit from hearing aids, which can be used to direct hearing aid programming, training, or recommendations of alternative hearing services.

scholarly journals Evaluation of Hearing Aid Manufacturers' Software-Derived Fittings to DSL v5.0 Pediatric Targets

2020 ◽  
Vol 31 (05) ◽  
pp. 354-362
Author(s):  
Paula Folkeard ◽  
Marlene Bagatto ◽  
Susan Scollie
Keyword(s):  
Hearing Loss ◽  
Hearing Aids ◽  
Speech Intelligibility ◽  
Chart Review ◽  
Hearing Aid ◽  
Test Case ◽  
Data Collection And Analysis ◽  
Speech Intelligibility Index ◽  
Programming Software ◽  
Test Level

Abstract Background Hearing aid prescriptive methods are a commonly recommended component of evidence-based preferred practice guidelines and are often implemented in the hearing aid programming software. Previous studies evaluating hearing aid manufacturers' software-derived fittings to prescriptions have shown significant deviations from targets. However, few such studies examined the accuracy of software-derived fittings for the Desired Sensation Level (DSL) v5.0 prescription. Purpose The purpose of this study was to evaluate the accuracy of software-derived fittings to the DSL v5.0 prescription, across a range of hearing aid brands, audiograms, and test levels. Research Design This study is a prospective chart review with simulated cases. Data Collection and Analysis A set of software-derived fittings were created for a six-month-old test case, across audiograms ranging from mild to profound. The aided output from each fitting was verified in the test box at 55-, 65-, 75-, and 90-dB SPL, and compared with DSL v5.0 child targets. The deviations from target across frequencies 250-6000 Hz were calculated, together with the root-mean-square error (RMSE) from target. The aided Speech Intelligibility Index (SII) values generated for the speech passages at 55- and 65-dB SPL were compared with published norms. Study Sample Thirteen behind-the-ear style hearing aids from eight manufacturers were tested. Results The amount of deviation per frequency was dependent on the test level and degree of hearing loss. Most software-derived fittings for mild-to-moderately severe hearing losses fell within ± 5 dB of the target for most frequencies. RMSE results revealed more than 84% of those hearing aid fittings for the mild-to-moderate hearing losses were within 5 dB at all test levels. Fittings for severe to profound hearing losses had the greatest deviation from target and RMSE. Aided SII values for the mild-to-moderate audiograms fell within the normative range for DSL pediatric fittings, although they fell within the lower portion of the distribution. For more severe losses, SII values for some hearing aids fell below the normative range. Conclusions In this study, use of the software-derived manufacturers' fittings based on the DSL v5.0 pediatric targets set most hearing aids within a clinically acceptable range around the prescribed target, particularly for mild-to-moderate hearing losses. However, it is likely that clinician adjustment based on verification of hearing aid output would be required to optimize the fit to target, maximize aided SII, and ensure appropriate audibility across all degrees of hearing loss.

Evaluation of the International Outcome Inventory for Hearing Aids in a Veteran Sample

2009 ◽  
Vol 20 (06) ◽  
pp. 374-380 ◽  
Author(s):  
Sherri L. Smith ◽  
Colleen M. Noe ◽  
Genevieve C. Alexander
Keyword(s):  
Psychometric Properties ◽  
Hearing Aids ◽  
Normative Data ◽  
Hearing Aid ◽  
Digital Signal ◽  
Critical Difference ◽  
Male Veterans ◽  
Data Collection And Analysis ◽  
Hearing Difficulty ◽  
Test Retest Reliability

Background: The International Outcome Inventory for Hearing Aids (IOI-HA) was developed as a global hearing aid outcome measure targeting seven outcome domains. The published norms were based on a private-pay sample who were fitted with analog hearing aids. Purpose: The purpose of this study was to evaluate the psychometric properties of the IOI-HA and to establish normative data in a veteran sample. Research Design: Survey. Study Sample: The participants were 131 male veterans (mean age of 74.3 years, SD = 7.4) who were issued hearing aids with digital signal processing (DSP). Intervention: Hearing aids with DSP that were fitted bilaterally between 2005 and 2007. Data Collection and Analysis: Veterans were mailed two copies of the IOI-HA. The participants were instructed to complete the first copy of the questionnaire immediately and the second copy in two weeks. The completed questionnaires were mailed to the laboratory. The psychometric properties of the questionnaire were evaluated. As suggested by Cox and colleagues, the participants were divided into two categories based on their unaided subjective hearing difficulty. The two categories were (1) those with less hearing difficulty (none-to-moderate category) and (2) those who report more hearing difficulty (moderately severe+ category). The norms from the current veteran sample then were compared to the original, published sample. For each hearing difficulty category, the critical difference values were calculated for each item and for the total score. Results: A factor analysis showed that the IOI-HA in the veteran sample had the identical subscale structure as reported in the original sample. For the total scale, the internal consistency was good (Chronbach's α = 0.83), and the test–retest reliability was high (λ = 0.94). Group and individual norms were developed for both hearing difficulty categories in the veteran sample. For each IOI-HA item, the critical difference scores were <1.0. This finding suggests that for any item on the IOI-HA, there is a 95 percent chance that an observed change of one response unit between two test sessions reflects a true change in outcome for a given domain. Conclusions: The results of this study confirmed that the psychometric properties of the IOI-HA questionnaire are strong and are essentially the same for the veteran sample and the original private-pay sample. The veteran norms, however, produced higher outcomes than those established originally, possibly because of differences in the population samples and/or hearing aid technology. Clinical and research applications of the current findings are presented. Based on the results from the current study, the norms established here should replace the original norms for use in veterans with current hearing aid technology.

The Hearing Aid Effect in 2013

2014 ◽  
Vol 25 (09) ◽  
pp. 893-903 ◽  
Author(s):  
Erik P. Rauterkus ◽  
Catherine V. Palmer
Keyword(s):  
Hearing Aids ◽  
Hearing Aid ◽  
Young Men ◽  
Standard Size ◽  
Post Hoc Analysis ◽  
The Past ◽  
Data Collection And Analysis ◽  
Significant Difference ◽  
Post Hoc ◽  
Negative Attributes

Background: The hearing aid effect is the term used to describe the assignment of negative attributes to individuals using hearing aids. The effect was first empirically identified in 1977 when it was reported that adults rating young children with and without hearing aids assigned negative attributes to the children depicted with hearing aids. Investigations in the 1980s and 1990s reported mixed results related to the extent of the hearing aid effect but continued to identify, on average, some negative attributes assigned to individuals wearing hearing aids. Purpose: The specific aim of this research was to investigate whether the hearing aid effect has diminished in the past several decades by replicating the methods of previous studies for testing the hearing aid effect while using updated devices. Research Design: Five device configurations were rated across eight attributes. Results for each attribute were considered separately. Study Sample: A total of 24 adults judged pictures of young men wearing various ear level technologies across 8 attributes on a 7-point Likert scale. Five young men between ages 15 and 17 yr were photographed wearing each of five device configurations including (1) a standard-sized behind-the-ear (BTE) hearing aid coupled to an earmold with #13 tubing, (2) a mini-BTE hearing aid with a slim tube open-fit configuration, (3) a completely-in-the-canal hearing aid that could not be seen because of its location in the ear canal, (4) an earbud, and (5) a Bluetooth receiver. Data Collection and Analysis: The 24 raters saw pictures of each of the 5 young men with each wearing one of the 5 devices so that devices and young men were never judged twice by the same observer. All judgments of each device, regardless of the young man modeling the device, were combined in the data analysis. The effect of device types on judgments was tested using a one-way between-participant analysis of variance. Results: There was a significant difference on the judgment of age and trustworthiness level among the five devices. However, our post hoc analysis revealed that only two significant effects were present. People wearing a completely-in-the-canal aid (nothing visible in the ear) were rated significantly older than people wearing an earbud, and people wearing the standard-size BTE with earmold were rated significantly more trustworthy than people who wore the Bluetooth device. Conclusions: It was hypothesized that the hearing aid effect would be diminished in 2013 compared with data reported in the past. This proved to be the case, as no hearing aid condition was rated as more negative than any of the non–hearing aid device conditions. In fact, models wearing the standard-size BTE with earmold were rated as more trustworthy than models wearing the Bluetooth device. The standard-sized BTE with earmold condition is the configuration that can be directly compared with previous research because similar devices were used in those studies. These results indicate that the hearing aid effect has diminished, if not completely disappeared, in the 21st century.

Predicted Gain and Functional Gain With Transcranial Routing of Signal Completely-in-the-Canal Hearing Aids

2003 ◽  
Vol 12 (2) ◽  
pp. 84-90 ◽  
Author(s):  
Marc A. Fagelson ◽  
Colleen M. Noe ◽  
Owen D. Murnane ◽  
Jennifer S. Blevins
Keyword(s):  
Hearing Loss ◽  
Hearing Aids ◽  
Hearing Aid ◽  
Mechanical Vibration ◽  
Signal Frequency ◽  
Unilateral Hearing Loss ◽  
External Canal ◽  
The Difference ◽  
Acoustic Output ◽  
Functional Gain

Transcranial routing of signal (TCROS) was accomplished using completely-in-the-canal (CIC) hearing aids in 5 profoundly unilaterally hearing-impaired individuals. The functional gain realized by the participants far exceeded the gain predicted by measuring the acoustic output and real ear aided response of the hearing aids. The difference between predicted and functional gain increased with signal frequency and was attributed at least in part to mechanical vibration of the hearing aid in the external canal. Implications for fitting unilateral hearing loss using TCROS amplifying systems are discussed.

Speech perception, real-ear measurements and self-perceived hearing impairment after remote and face-to-face programming of hearing aids: A randomized single-blind agreement study

2019 ◽  
pp. 1357633X1988354 ◽  
Author(s):  
Frederic Venail ◽  
Marie C Picot ◽  
Gregory Marin ◽  
Sylvain Falinower ◽  
Jacques Samson ◽  
...  
Keyword(s):  
Speech Perception ◽  
Confidence Interval ◽  
Correlation Coefficient ◽  
Intraclass Correlation Coefficient ◽  
Hearing Aids ◽  
Hearing Aid ◽  
Intraclass Correlation ◽  
Speech Understanding ◽  
Face To Face ◽  
Single Blind

Introduction Current literature does not provide strong evidence that remote programming of hearing aids is effective, despite its increasing use by audiologists. We tested speech perception outcomes, real-ear insertion gain, and changes in self-perceived hearing impairment after face-to-face and remote programming of hearing aids in a randomized multicentre, single-blind crossover study. Methods Adult experienced hearing aid users were enrolled during routine follow-up visits to audiology clinics. Hearing aids were programmed both face to face and remotely, then participants randomly received either the face-to-face or remote settings in a blinded manner and were evaluated 5 weeks later. Participants then received the other settings and were evaluated 5 weeks later. Results Data from 52 out of 60 participants were analysed. We found excellent concordance in performance of hearing aids programmed face to face and remotely for speech understanding in quiet (phonetically balanced kindergarten test – intraclass correlation coefficient of 0.92 (95% confidence interval: 0.87–0.95)), and good concordance in performance for speech understanding in noise (phonetically balanced kindergarten +5 dB signal-to-noise ratio – intraclass correlation coefficient of 0.71 (95% confidence interval: 0.55–0.82)). Face-to-face and remote programming took 10 minutes (±2.9) and 10 minutes (±2.8), respectively. Real-ear insertion gains were highly correlated for input sound at 50, 65 and 80 dB sound pressure levels. The programming type did not affect the abbreviated profile of hearing aid questionnaire scores. Conclusions In experienced hearing aid users, face-to-face and remote programming of hearing aids give similar results in terms of speech perception, with no increase in the time spent on patients’ care and no difference in self-reported hearing benefit. ClinicalTrials.gov Identifier NCT02589561

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