Tolerable Hearing Aid Delays. V. Estimation of Limits for Open Canal Fittings

Objectives: Open canal fittings are a popular alternative to close-fitting earmolds for use with patients whose low-frequency hearing is near normal. Open canal fittings reduce the occlusion effect but also provide little attenuation of external air-borne sounds. The wearer therefore receives a mixture of air-borne sound and amplified but delayed sound through the hearing aid. To explore systematically the effect of the mixing, we simulated with varying degrees of complexity the effects of both a hearing loss and a high-quality hearing aid programmed to compensate for that loss, and used normal-hearing participants to assess the processing. Design: The off-line processing was intended to simulate the percept of listening to the speech of a single (external) talker. The effect of introducing a delay on a subjective measure of speech quality (disturbance rating on a scale from 1 to 7, 7 being maximal disturbance) was assessed using both a constant gain and a gain that varied across frequency. In three experiments we assessed the effects of different amounts of delay, maximum aid gain and rate of change of gain with frequency. The simulated hearing aids were chosen to be appropriate for typical mild to moderate high-frequency losses starting at 1 or 2 kHz. Two of the experiments used simulations of linear hearing aids, whereas the third used fast-acting multichannel wide-dynamic-range compression and a simulation of loudness recruitment. In one experiment, a condition was included in which spectral ripples produced by comb-filtering were partially removed using a digital filter. Results: For linear hearing aids, disturbance increased progressively with increasing delay and with decreasing rate of change of gain; the effect of amount of gain was small when the gain varied across frequency. The effect of reducing spectral ripples was also small. When the simulation of dynamic processes was included (experiment 3), the pattern with delay remained similar, but disturbance increased with increasing gain. It is argued that this is mainly due to disturbance increasing with increasing simulated hearing loss, probably because of the dynamic processing involved in the hearing aid and recruitment simulation. Conclusions: A disturbance rating of 3 may be considered as just acceptable. This rating was reached for delays of about 5 and 6 msec, for simulated hearing losses starting at 2 and 1 kHz, respectively. The perceptual effect of reducing the spectral ripples produced by comb-filtering was small; the effect was greatest when the hearing aid gain was small and when the hearing loss started at a low frequency.