Seminars in Hearing最新文献

A number of studies have produced normative and developmental data and examples of wideband acoustic immittance (WAI) obtained in ears with pathologies and or dysfunction. However, incorporation of this tool into clinical audiology and otolaryngology practice has been slower than expected, potentially due to challenges with interpretation, integration into existing test batteries, and confidence in practical application. This article presents information aimed at helping clinicians increase their confidence in using this new tool by becoming more familiar and making connections with the ways that WAI outcomes both align with and add to standard immittance, audiometric and otologic diagnostic test outcomes. This article presents several case studies to demonstrate the use of WAI in realistic clinical settings. Each case presents a brief background, case history, audiologic/otologic findings, and initial recommendations, followed by a discussion on how the inclusion of WAI test outcomes aids in diagnostic decisions. The overall aim of this work is to identify the relationships among different diagnostic test outcomes, to demonstrate basic WAI interpretation principles, and encourage the reader to engage with this diagnostic tool in clinical practice.

As wideband absorbance (WBA) gains popularity, it is essential to understand the impact of different middle ear pathologies on the absorbance patterns as a function of frequency in children with various middle ear pathologies. More recently, the use of wideband tympanometry has enabled clinicians to conduct WBA at ambient pressure (WBA _amb ) as well as the pressurized mode (WBA _TPP ). This article reviews evidence for the ability of WBA measurements to accurately characterize the normal middle ear function across a wide range of frequencies and to aid in differential diagnosis of common middle ear disorders in children. Absorbance results in cases of otitis media with effusion, negative middle ear pressure, Eustachian tube malfunction, middle ear tumors, and pressure equalization tubes will be compared to age-appropriate normative data. Where applicable, WBA _amb as well as WBA _TPP will be reviewed in these conditions. The main objectives of this article are to identify, assess, and interpret WBA _amb and WBA _TPP outcomes from various middle ear conditions in children between the ages of 3 and 12 years.

The "cost" of hearing aids has been a perceived key driver of the uptake, or lack thereof, of hearing aids. The MarkeTrak 2022 survey included questions that focused on the cost of the hearing test and amplification devices, out-of-pocket expenses, third-party coverage, and the perceived value of the devices. The hearing test itself was perceived as a barrier for some as the expense of the visit or the lack of third-party coverage was often cited as a reason for not following through on a recommendation to get a test. For those persons who received a hearing test, financial constraints were noted to be the most significant reason for not following through on a recommendation for a hearing aid, particularly for those over the age of 65 years. Higher income levels or some third-party coverage for devices was related to higher adoption rates. For persons who did choose to purchase amplification devices, financial considerations were not among the most important factors in reaching that decision. A clear majority of persons who made the decision to purchase amplification were satisfied with the out-of-pocket expenses associated with the purchase. The MarkeTrak 2022 Survey also included questions designed to assess the price sensitivity of individuals to various scenarios regarding the cost (e.g., $1000/pair, $2000/pair, or $4000/pair) or the amount of third-party coverage (e.g., $1000/pair, $2000/pair, or Total Cost). Results indicate increased amounts of third-party coverage were a bigger motivator than simply lowered cost. The MarkeTrak Survey indicates perceived cost factors continue to play a role in decisions to pursue hearing care and/or amplification devices.

The MarkeTrak surveys conducted by the Hearing Industries Association have been looking at trends in the hearing industry since 1989. The latest survey, MarkeTrak 2022, reviews ongoing trends in hearing device adoption including PSAPs and implants, satisfaction with hearing aids and hearing professionals, and a look into insurance coverage and price considerations. These are discussed as they relate to the five key areas of the marketing mix: people, products, price, place, and perception. The key takeaways from this survey include: adoption has doubled in the past 25 years; more than 75% of hearing aid owners feel the hearing professional play an important role in their success with hearing aids; financial assistance has doubled since 1991 to 54%; and additional efforts are needed to educate consumers on the technology and benefits of hearing aids and early intervention.

The hearing aid market is rapidly evolving with advancements in features and potential changes in service delivery models, including the new over-the-counter device category. Data from the MarkeTrak 2022 survey indicate most hearing aid owners report regular quality-of-life benefits from hearing aids, even more than in previous surveys. The increased likelihood of hearing aid benefits might be attributable to modern hearing aid features advancements, such as wireless connectivity and rechargeable batteries. Hearing aid satisfaction rates have been relatively stable over the years, indicating that more than 80% of hearing aid owners are satisfied with their devices. Hearing aid satisfaction rates do not appreciably vary by fitting channel; hearing aid owners fitted in person, fitted remotely, or self-fit are similarly likely to report high satisfaction with their device. However, only respondents in the in-person channel gave establishment ratings (reflecting their willingness to recommend) that resulted and reflected a positive net promoter score. Given the potential for net promoter scores to be related to brand growth and customer loyalty, this finding has implications for the development of over-the-counter hearing aid service-delivery models. Additional work is warranted to explore the factors that negatively affect hearing aid owners' satisfaction with the companies delivering limited services.

The United States does not ensure equitable access to hearing health care for all age groups, largely because these services are costly and even unobtainable in some places. Barriers to care are discussed within a context of the social determinants of health, under-representativeness of hearing-care professionals from historically marginalized communities, older adults and age-related hearing loss, and associated health conditions. The MarkeTrak 2022 study generated a sample of 15,138 respondents with information on 43,597 individuals. Data analysis revealed that self-reported hearing difficulty appears to increase with age with a rate of 12.4% for adults 18 years of age and older. A substantial proportion of individuals with hearing difficulty assumed that their problem was age-related, followed by exposure to loud sound and noise. Individuals with hearing difficulty were nearly three to four times more likely to have tinnitus, cognitive problems, and issues with balance and falling than those with no hearing problems. Self-reported hearing difficulty was lower for historically marginalized groups (7%) than for the White population (12%). Recommendations are presented to reduce the burden of hearing difficulty and hearing aid deserts for rural and urban populations.

As with many professions, audiology is continuing to evolve. More specifically in terms of hearing device technology, we see evolution in remote accessibility to providers, public knowledge of devices, and services provided by hearing care professionals. Each of these topics plays a role in an individual's decision to pursue any sort of hearing care services. Given the variety of new devices soon coming to the market (over-the-counter devices), it is important for the audiologist to understand patient motivators and how they have a great impact on both the practice of audiology as well as the patient's overall satisfaction. The goal of this article is to investigate the MarkeTrak 2022 data to determine the trends in adoption and use of hearing aids as well as examine predictive factors that can be used to better understand hearing aid adoption.

Hearing loss is increasingly recognized as a chronic disease that warrants treatment. Depression, social isolation, loneliness, and poorer cognitive performance have all been linked to untreated and undertreated adult-onset hearing loss. A significant subset of the patient population with hearing loss is inadequately rehabilitated by hearing aids alone and may benefit from cochlear implantation. Yet, it is estimated that less than 10% of those who qualify have received implants to date. A national survey was conducted online in November and December 2021. Subjects were identified using Dynata panelists and river sampling. Enrollment occurred on a rolling basis. Upfront sample management techniques were used to control the distribution, balancing the respondent cohort to the 2018 U.S. Census on age, household income, sex, marital status, household size, race/ethnicity, and education. Among 15,138 adult respondents with a mean (SD) age of 51 (17) years (54% female), only 10% reported being very familiar with cochlear implants, and 31% of those with hearing difficulty reported that they have "never heard" of a cochlear implant. Females were statistically significantly more likely to report some degree of familiarity with cochlear implants than men (34 vs. 26%; p  < 0.01). The greatest familiarity with cochlear implants was observed among those aged 35 to 44 years (18% reporting "very familiar"), whereas only 9% of those aged 65 to 74, 10% aged 75 to 84, and 8% ≥85 reported being very familiar ( p  < 0.01). Those identifying as White/Caucasian were statistically significantly more likely to report familiarity with cochlear implants than those identifying as Black/African American and Hispanic/Latino/Spanish (33 vs. 56 vs. 50% responding that they had "never heard" of cochlear implants; p  < 0.01). Among adults with hearing difficulty, nearly 80% report having never talked with a medical or hearing care professional about cochlear implants. Limited cochlear implant awareness likely influences its widespread underutilization across the United States. Sex, age, and race disparities compound these issues among men, the Medicare-aged population, and those identifying as Black/African American and Hispanic/Latino/Spanish.

The MarkeTrak survey of the trends in hearing aid use, satisfaction and adoption in the United States has been conducted since 1989 by the Hearing Industries Association. It provide the hearing aid industry with valuable about the consumers view of the products and services within the industry. The EuroTrak survey is conducted by the European Hearing Instrument Manufactures Association. It is the counterpart to MarkeTrak and provides similar data for over a dozen countries in Europe, and Asia. While there are differences in the distribution models and reimbursement methods for these counties, many of the key metrics concerning hearing aid use and satisfaction can be compared.