Trends in Amplification最新文献

The purpose of the study was to develop and examine a list of potential variables that may account for variability in the dispensing rates of four common hearing aid features. A total of 29 potential variables were identified and placed into the following categories: (1) characteristics of the audiologist, (2) characteristics of the hearing aids dispensed by the audiologist, (3) characteristics of the audiologist's patient population, and (4) evidence-based practice grades of recommendation for each feature. The potentially associative variables then were examined using regression analyses from the responses of 257 audiologists to a dispensing practice survey. There was a direct relation between price and level of hearing aid technology with the frequency of dispensing product features. There was also a direct relation between the belief by the audiologist that a feature might benefit patients and the frequency of dispensing that feature. In general, the results suggested that personal differences among audiologists and the hearing aids audiologists choose to dispense are related more strongly to dispensing rates of product features than to differences in characteristics of the patient population served by audiologists. An additional finding indicated that evidence-based practice recommendations were inversely related to dispensing rates of product features. This finding, however, may not be the result of dispensing trends as much as hearing aid manufacturing trends.

This investigation examined whether speech intelligibility in noise can be improved using a new, binaural broadband hearing instrument system. Participants were 36 adults with symmetrical, sensorineural hearing loss (18 experienced hearing instrument users and 18 without prior experience). Participants were fit binaurally in a planned comparison, randomized crossover design study with binaural broadband hearing instruments and advanced digital hearing instruments. Following an adjustment period with each device, participants underwent two speech-in-noise tests: the QuickSIN and the Hearing in Noise Test (HINT). Results suggested significantly better performance on the QuickSIN and the HINT measures with the binaural broadband hearing instruments, when compared with the advanced digital hearing instruments and unaided, across and within all noise conditions.

Since the advent of cochlear implantation, candidacy criteria have slowly broadened to include increasingly younger patients. Spurred by evidence demonstrating both perioperative safety and significantly increased speech and language benefit with early auditory intervention, children younger than 12 months of age are now being successfully implanted at many centers. This review highlights the unique challenges involved in cochlear implantation in the very young child, specifically diagnosis and certainty of testing, anesthetic risk, surgical technique, intraoperative testing and postoperative programming, long-term safety, development of receptive and expressive language, and outcomes of speech perception. Overall, the current body of literature indicates that cochlear implantation prior to 1 year of age is both safe and efficacious.

The method of paired comparisons was introduced into the hearing aid literature nearly 50 years ago. Over time, studies have found paired comparisons to be sensitive, valid, and reliable in determining either the perceptual difference or relative ranking among hearing aids and electroacoustic characteristics. With the increasing number of adjustable electroacoustic parameters in today's digital hearing aids-and the lack of procedural guidelines necessary to fit many of them-the method of paired comparisons provides the clinician with the ability to compare different devices, electroacoustic characteristics, memory settings, or combinations of these variables under the listener's everyday listening conditions. Furthermore, this procedure provides the clinician with the ability to individualize the prescriptive approach-which is predicated mainly on hearing threshold data and listening in quiet-so that a combination of parameters can be set to optimize the user's listening needs in a given environment. In this article, the authors present an overview of the theoretical principle supporting this procedure, the various paired-comparison strategies and associated approaches, the advantages of this method, and recommended procedures for implementing the method of paired comparisons in the fitting of today's sophisticated hearing aids.

Children with hearing loss, with early and appropriate amplification and intervention, demonstrate gains in speech, language, and literacy skills. Despite these improvements many children continue to exhibit disturbances in cognitive, behavioral, and emotional control, self-regulation, and aspects of executive function. Given the complexity of developmental learning, educational settings should provide services that foster the growth of skills across multiple dimensions. Transdisciplinary intervention services that target the domains of language, communication, psychosocial functioning, motor, and cognitive development can promote academic and social success. Educational programs must provide children with access to the full range of basic skills necessary for academic and social achievement. In addition to an integrated curriculum that nurtures speech, language, and literacy development, innovations in the areas of auditory perception, social emotional learning, motor development, and vestibular function can enhance student outcomes. Through ongoing evaluation and modification, clearly articulated curricular approaches can serve as a model for early intervention and special education programs. The purpose of this article is to propose an intervention model that combines best practices from a variety of disciplines that affect developmental outcomes for young children with hearing loss, along with specific strategies and approaches that may help to promote optimal development across domains. Access to typically developing peers who model age-appropriate skills in language and behavior, small class sizes, a co-teaching model, and a social constructivist perspective of teaching and learning, are among the key elements of the model.

Short-term benefit in a very large group (N = 4,584) following hearing aid treatment was estimated using a revised version of the Self-Assessment of Communication (SAC-Hx). A total of 4,584 veterans with adult-onset hearing loss and mean audiometric findings consistent with a mild to severe, sloping, symmetrical, sensorineural hearing impairment were fitted with hearing aids. Responses to the SAC-Hx were gathered prior to and then 6 weeks following hearing aid fitting. Benefit was defined as the difference between the baseline and the posttreatment SAC-Hx scores. Hearing aid treatment resulted in robust and statistically significant benefit in each category of self-perceived communication consequences. Prior experience influenced benefit: New hearing aid users demonstrated the greatest magnitude of benefit, but even previously satisfied and dissatisfied users obtained significant benefit after new hearing aid fitting. Duration of experience did not have a remarkable effect on the magnitude of benefit: All groups with various durations of experience obtained comparable benefit. Severity of the baseline scores paralleled degree of hearing impairment when impairment was defined using a better ear pure tone average at 1,000, 2,000, 3,000, and 4,000 Hz. Also, severity of perceived communication consequences paralleled poorer monosyllabic word recognition. Hearing aid treatment provided a functional, robust, and statistically significant benefit to individuals in all categories of hearing impairment (normal, mild, moderate, severe, and profound). This report demonstrates the feasibility of the SAC-Hx as a tool to efficiently assess outcome domains in hearing aid fitting.

The auditory midbrain implant (AMI) is a new hearing prosthesis designed for stimulation of the inferior colliculus in deaf patients who cannot sufficiently benefit from cochlear implants. The authors have begun clinical trials in which five patients have been implanted with a single shank AMI array (20 electrodes). The goal of this review is to summarize the development and research that has led to the translation of the AMI from a concept into the first patients. This study presents the rationale and design concept for the AMI as well a summary of the animal safety and feasibility studies that were required for clinical approval. The authors also present the initial surgical, psychophysical, and speech results from the first three implanted patients. Overall, the results have been encouraging in terms of the safety and functionality of the implant. All patients obtain improvements in hearing capabilities on a daily basis. However, performance varies dramatically across patients depending on the implant location within the midbrain with the best performer still not able to achieve open set speech perception without lip-reading cues. Stimulation of the auditory midbrain provides a wide range of level, spectral, and temporal cues, all of which are important for speech understanding, but they do not appear to sufficiently fuse together to enable open set speech perception with the currently used stimulation strategies. Finally, several issues and hypotheses for why current patients obtain limited speech perception along with several feasible solutions for improving AMI implementation are presented.

When hearing aid gain is prescribed by software, gain is calculated based on the average acoustics for the age of patient, gender, mold type, and so on. The acoustics of the individual's ear often vary from the average values, so there will be a mismatch between the prescribed gain and the real-ear gain. Real-ear measurement can be used to verify the gain and adjust it to meet targets, but the quality of the match will be limited by the number of channels and the flexibility of the hearing aid. A potential way to improve this process is to generate a filter that compensates for variations in real-ear insertion gain due to individual ear acoustics. Such a filter could be included in the processing path of a digital hearing aid. This article describes how such a filter can be generated using the windowing method, and the principle is demonstrated in a real ear. The approach requires communication between the real-ear measurement and hearing aid programming software. A finite impulse response filter with group delay just over 2 ms matched insertion gain to target values within the acceptable tolerance defined by British Society of Audiology guidelines.