The Influence of Different Speech Processor and Hearing Aid Settings on Speech Perception Outcomes in Electric Acoustic Stimulation Patients
47
Citation
25
Reference
10
Related Paper
Citation Trend
Abstract:
Electric acoustic stimulation (EAS) is an increasingly popular means of treating individuals with a steeply sloping mid-to-high frequency hearing loss, who traditionally do not benefit from hearing instruments. These persons often have too much residual hearing to be considered for a cochlear implant. Several studies have demonstrated the ability both to preserve the remaining low-frequency hearing in these individuals, and to provide significant benefit through combining a cochlear implant with a hearing aid to amplify the same ear. These improvements in performance have been especially noted in noise. Often overlooked is that these outcomes may be influenced by the fitting parameters of both the cochlear implant and the hearing aid.This study assessed four EAS subjects, with a minimum of 1 month's EAS use, on eight different fitting parameters. Sentence testing in different noise levels (+15, +10, and +5 dB SPL) was conducted. Subjects also evaluated each condition using a visual analogue scale.Results demonstrated that a reduced overlap of cochlear implant and hearing aid amplification produced best results across listening conditions.The hearing aid should be fit to a patient-specific modified audiogram at least up to the point where low-frequency hearing is not measurable. The cochlear implant should be fit from a higher frequency point than is standard in patients without residual hearing in the implanted ear, to provide reduced overlap with the amplification provided by the hearing aid. Therefore, a small amount of overlap between the frequency ranges used by the hearing aid and the cochlear implant seems beneficial.Keywords:
Hearing aid
Audiogram
Hereditary hearing loss is characterized by remarkable phenotypic heterogeneity. Patients with the same pathogenic mutations may exhibit various hearing loss phenotypes. In the Chinese population, the c.235delC mutation is the most common pathogenic mutation of GJB2 and is closely related to hereditary recessive hearing loss. Here, we investigated the hearing phenotypes of patients with hearing loss associated with the homozygous c.235delC mutation, paying special attention to asymmetric interaural hearing loss. A total of 244 patients with the GJB2 c.235delC homozygous mutation encountered from 2007 to 2015 were enrolled. The severity of hearing loss was scaled with the American Speech-Language-Hearing Association (ASHA). Auditory phenotypes were analyzed, and three types of interaural asymmetry were defined based on audiograms: Type A (asymmetry of hearing loss severity), Type B (asymmetry of audiogram shape), and Type C (Type A plus Type B). Of the 488 ears (244 cases) examined, 71.93% (351) presented with profound hearing loss, 14.34% (70) with severe hearing loss, and 9.43% (46) with moderate to severe hearing loss. The most common audiogram shapes were descending (31.15%) and flat (24.18%). A total of 156 (63.93%) of the 244 patients exhibited asymmetric interaural hearing loss in terms of severity and/or audiogram shape. Type A was evident in 14 of these cases, Type B in 106, and Type C in 36. In addition, 211 of 312 ears (67.63%) in the interaural hearing asymmetry group showed profound hearing loss, and 59 (18.91%) exhibited severe hearing loss, with the most common audiogram shapes being flat (27.88%) and descending (22.12%). By contrast, in the interaural hearing symmetry group, profound hearing loss was observed in 140 ears (79.55%), and the most common audiograms were descending (46.59%) and residual (21.59%). Hearing loss associated with the GJB2 c.235delC homozygous mutation shows diverse phenotypes, and a considerable proportion of patients show bilateral hearing loss asymmetry.
Audiogram
Cite
Citations (7)
Genetic contribution to progressive hearing loss in adults is underestimated. Established machine learning-based software could offer a rapid supportive tool to stratify patients with progressive hearing loss. A retrospective longitudinal analysis of 141 adult patients presenting with hearing loss was performed. Hearing threshold was measured at least twice 18 months or more apart. Based on the baseline audiogram, hearing thresholds and age were uploaded to AudioGene v4® (Center for Bioinformatics and Computational Biology at The University of Iowa City, IA, USA) to predict the underlying genetic cause of hearing loss and the likely progression of hearing loss. The progression of hearing loss was validated by comparison with the most recent audiogram data of the patients. The most frequently predicted loci were DFNA2B, DFNA9 and DFNA2A. The frequency of loci/genes predicted by AudioGene remains consistent when using the initial or the final audiogram of the patients. In conclusion, machine learning-based software analysis of clinical data might be a useful tool to identify patients at risk for having autosomal dominant hearing loss. With this approach, patients with suspected progressive hearing loss could be subjected to close audiological followup, genetic testing and improved patient counselling.
Audiogram
Otology
Cite
Citations (7)
Abstract One in six Americans suffers from hearing loss. While treatment with amplification is possible for many, the acceptance rate of hearing aids is low. Poor device fitting is one of the reasons. The hearing aid fitting starts with a detailed hearing assessment by a trained audiologist in a sound-controlled environment, using standard equipment. The hearing aid is adjusted step-by-step, following well-described procedures based on the audiogram. However, for many patients in rural settings, considerable travel time to a hearing center discourages them from receiving a hearing test and treatment. We hypothesize that hearing assessment with the patient’s hearing aid can reliably substitute the hearing test in the clinic. Over-the-counter hearing aids could be programmed from a distance and can be fine-tuned by the hearing aid wearer. This study shows that a patient-controlled hearing assessment via a hearing aid in a non-clinical setting is not statistically different from an audiologist-controlled hearing assessment in a clinical setting. The differences in hearing obtained with our device and the Gaussian Process are within 3 dB of the standard audiogram. At 250 Hz, the sound delivery with the hearing aid used in this study added an additional reduction of sound level, which was not compensated.
Audiogram
Audiologist
Hearing aid
Hearing test
Cite
Citations (0)
This research was conducted to evaluate the efficacy of an online speech perception test (SPT) for the measurement of hearing and hearing aid fitting in comparison with conventional methods. Phase 1 was performed with 88 people to evaluate the SPT for the detection of significant hearing loss. The SPT had high sensitivity (94%) and high selectivity (98%). In Phase 2, phonetic stimulus–response matrices derived from the SPT results for 408 people were used to calculate “Infograms™.” At every frequency, there was a highly significant correlation ( p < 0.001) between hearing thresholds derived from the Infogram and conventional audiograms. In Phase 3, initial hearing aid fittings were derived from conventional audiograms and Infograms for two groups of hearing impaired people. Unaided and aided SPTs were used to measure the perceptual benefit of the aids for the two groups. The mean increases between unaided and aided SPT scores were 19.6%, and 22.2% ( n = 517, 484; t = 2.2; p < 0.05) for hearing aids fitted using conventional audiograms and Infograms respectively. The research provided evidence that the SPT is a highly effective tool for the detection and measurement of hearing loss and hearing aid fitting. Use of the SPT reduces the costs and increases the effectiveness of hearing aid fitting, thereby enabling a sustainable teleaudiology business model.
Audiogram
Hearing aid
Stimulus (psychology)
Cite
Citations (24)
In 86 patients with sensorineural hearing loss we checked if the measuring results obtained by conventional audiometric procedures correlate with the subjective impression of hard hearing ascertained via a special questionnaire. For this purpose we compared the average hearing loss (500, 1000, 2000 Hz) of the puretone audiogram with the results obtained via the questionnaire developed by v. Wedel and Tegtmeier for assessing the social hearing handicap (SHH). We can see that there is good correlation between the SHH index values and the average hearing loss with frequencies of 0.5, 1.2 kHz in pancochlear perception hearing loss, whereas in patients with basocochlear perception hearing loss the SHHI cannot be calculated with the help of the puretone audiogram, nor will a widening of the frequency range up to 6 kHz lead to a better correlation between the average hearing loss and SHHI.
Audiogram
Cite
Citations (1)
Abstract One in six Americans suffers from hearing loss. While treatment with amplification is possible for many, the acceptance rate of hearing aids is low. Poor device fitting is one of the reasons. The hearing aid fitting starts with a detailed hearing assessment by a trained audiologist in a sound-controlled environment, using standard equipment. The hearing aid is adjusted step-by-step, following well-described procedures based on the audiogram. However, for many patients in rural settings, considerable travel time to a hearing center discourages them from receiving a hearing test and treatment. We hypothesize that hearing assessment with the patient’s hearing aid can reliably substitute the hearing test in the clinic. Over-the-counter hearing aids could be programmed from a distance and fine-tuned by the hearing aid wearer. This study shows that a patient-controlled hearing assessment via a hearing aid in a non-clinical setting is not statistically different from an audiologist-controlled hearing assessment in a clinical setting. The differences in hearing obtained with our device and the Gaussian Process are within 3 dB of the standard audiogram. At 250 Hz, the sound delivery with the hearing aid used in this study added an additional reduction of sound level, which was not compensated.
Audiogram
Audiologist
Hearing aid
Hearing test
Cite
Citations (2)
For a fourteen-year old girl with a pronounced ski-slope bilateral hearing loss of 100-120 dB and with a dynamic range of approx. 10 dB, a tailor-made true binaural hearing aid was made. Establishing the acoustical characteristics of the hearing aid based on details from audiograms proved not to yield satisfactory results. Consequently an adjustment of the acoustical data according to the method of trial and error was initiated. By applying this method, a satisfactory result was obtained. The suitability of an audiogram to describe the optimum characteristics of hearing aids may thus be questioned. Likewise it seems substantiated that it is possible to compensate for even very difficult hearing losses by tailoring the acoustical characteristics of the hearing aid very carefully. Consequences of the individual fitting of hearing aids in general will be discussed.
Audiogram
Hearing aid
Cite
Citations (0)
This paper describes the analysis of a database of over 180,000 patient records, collected from over 23,000 patients, by the hearing aid clinic at James Cook University Hospital in Middlesbrough, UK. These records consist of audiograms (graphs of the faintest sounds audible to the patient at six different pitches), categorical data (such as age, gender, diagnosis and hearing aid type) and brief free text notes made by the technicians. This data is mined to determine which factors contribute to the decision to fit a BTE (worn behind the ear) hearing aid as opposed to an ITE (worn in the ear) hearing aid.From PCA (principal component analysis) four main audiogram types are determined, and are related to the type of hearing aid chosen. The effects of age, gender, diagnosis, masker, mould and individual audiogram frequencies are combined into a single model by means of logistic regression. Some significant keywords are also discovered in the free text fields by using the chi-squared (χ(2)) test, which can also be used in the model. The final model can act a decision support tool to help decide whether an individual patient should be offered a BTE or an ITE hearing aid.The final model was tested using 5-fold cross validation, and was able to replicate the decisions of audiologists whether to fit an ITE or a BTE hearing aid with precision in the range 0.79 to 0.87.A decision support system was produced to predict the type of hearing aid which should be prescribed, with an explanation facility explaining how that decision was arrived at. This system should prove useful in providing a "second opinion" for audiologists.
Audiogram
Hearing aid
Categorical variable
Hearing test
Cite
Citations (29)
Electric acoustic stimulation (EAS) is an increasingly popular means of treating individuals with a steeply sloping mid-to-high frequency hearing loss, who traditionally do not benefit from hearing instruments. These persons often have too much residual hearing to be considered for a cochlear implant. Several studies have demonstrated the ability both to preserve the remaining low-frequency hearing in these individuals, and to provide significant benefit through combining a cochlear implant with a hearing aid to amplify the same ear. These improvements in performance have been especially noted in noise. Often overlooked is that these outcomes may be influenced by the fitting parameters of both the cochlear implant and the hearing aid.This study assessed four EAS subjects, with a minimum of 1 month's EAS use, on eight different fitting parameters. Sentence testing in different noise levels (+15, +10, and +5 dB SPL) was conducted. Subjects also evaluated each condition using a visual analogue scale.Results demonstrated that a reduced overlap of cochlear implant and hearing aid amplification produced best results across listening conditions.The hearing aid should be fit to a patient-specific modified audiogram at least up to the point where low-frequency hearing is not measurable. The cochlear implant should be fit from a higher frequency point than is standard in patients without residual hearing in the implanted ear, to provide reduced overlap with the amplification provided by the hearing aid. Therefore, a small amount of overlap between the frequency ranges used by the hearing aid and the cochlear implant seems beneficial.
Hearing aid
Audiogram
Cite
Citations (47)