Effect of Age and Unaided Acoustic Hearing on Pediatric Cochlear Implant Users' Ability to Distinguish Yes/No Statements and Questions
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Abstract:
The purpose of this study was to evaluate the ability to discriminate yes/no questions from statements in three groups of children: bilateral cochlear implant (CI) users, nontraditional CI users with aidable hearing preoperatively in the ear to be implanted, and controls with normal hearing. Half of the nontraditional CI users had sufficient postoperative acoustic hearing in the implanted ear to use electric-acoustic stimulation, and half used a CI alone.Keywords:
Cochlear Implantation
Hearing aid
The negative attitude elicited by the presence of a hearing aid has been termed the "hearing aid effect." The purpose of this study was to examine the negative reactions associated with hearing aids among new hearing aid users themselves and their perception of the hearing aid effect in their immediate environment. This was accomplished through a questionnaire completed just prior to hearing aid fitting and again 6 months after initial use of amplification. The responses to the questionnaires were compared between individuals who had chosen either in the ear or behind the ear type hearing aids, and between those using either monaural or binaural instruments. The effect of age on the data was also examined. The results indicated that the hearing aid effect was not expected or perceived very widely among these subjects, as only about 10% of them reported sensing negative attitudes to the use of hearing aids. Positive responses to the benefits of hearing aid use from other people often fell short of expectations.
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Subjects with profound postlingual hearing loss completed the Hearing Performance Inventory (HPI) during the course of their hearing aid evaluations. Comparisons of responses to the HPI were made for (a) subjects who wore hearing aids versus subjects who did not, and (b) hearing aid users with losses greater than 100 dB versus users with losses between 80-100 dB. The former set of comparisons indicated consistently superior performance for the aided group, and the latter set indicated consistently superior performance for the 80-100 dB group. The HPI may be a valuable tool in hearing aid considerations.
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The cognitive P300 evoked potential was elicited by speech stimuli in successful cochlear implant recipients, and the resulting P300 morphology was remarkably similar to that of normal-hearing individuals. The P300 was elicited by the synthesized speech pair/da/and/di/ presented using an oddball paradigm to nine "good" Nucleus cochlear implant users and nine age-matched normal-hearing subjects (34-81 yr old). There were no significant differences in P300 amplitude and latency between the two groups. Moreover, the N1 and P2 potentials occurred at similar latencies in the two groups, although the N1 amplitude was significantly smaller in the cochlear implant users. The P300 was absent in one "poor" cochlear implant user. The results suggest that the P300 may serve as a useful tool for evaluating the cognitive aspects of auditory processing in cochlear implant recipients, and that it may aid in assessing the success of cochlear implantation.
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An analysis of hearing aid fittings in adults using cochlear implants and contralateral hearing aids
Objectives/Hypothesis: The objective of this study was to assess the appropriateness of hearing aid fittings within a sample of adult cochlear implant recipients who use a hearing aid in the contralateral ear (i.e., bimodal stimulation). Methods: The hearing aid gain was measured using real ear testing for 14 postlingually deaf English-speaking adults who use a cochlear implant in the contralateral ear. Unaided and aided audiometric testing assessed the degree of functional gain derived from hearing aid use. Results: On average, the target to actual output level difference was within 10 dB only at frequencies of 750 Hz and 1,000 Hz. Only 1 of the 14 study participants had a hearing aid for which the majority of the tested frequencies were within 10 dB of the target gain. In addition, a greater amount of functional gain (i.e., the increase in unaided behavioral thresholds after amplification) was provided for lower frequencies than higher frequencies. Conclusions: Hearing aid settings in our sample were suboptimal and may be regarded as a contributing factor to the variability in bimodal benefit. Refining hearing aid fitting strategies tailored to the needs of the concurrent cochlear implant and hearing aid user is recommended.
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Cochlear Implantation
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The present state of hearing-aid use in three schools for the hearing impaired in Britain was investigated by comparing the hearing threshold measured with a hearing-aid earphone whose output sound pressure level was calibrated in a 2-cm3 coupler to the hearing-aid output with all the controls set to the position at which they were regularly used. The results showed that the amplification level of hearing aids was considerably less that that expected from hearing thresholds. It was only in the group with hearing thresholds less that 80 dB SPL that the hearing-aid outputs exceeded 20-30 dB SPL above their hearing thresholds. In the group with hearing loss more than 100 dB SPL, 40% of the ears were getting no functional amplification even at frequencies below 1000 Hz.
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Hearing impaired
Hearing level
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We examined 114 patients aged 10 to 91 years with different kinds of hearing aids fitted in one ear only, the unaided ear acting as a control. They were re-examined several times during a period of follow-up from 1 to 9 years comparing the relative change in hearing due to hearing aid usage with various degrees of amplification of the aid. We compared the degree of hearing loss in the aided and unaided ear looking for evidence of a possible change in hearing related to the frequency of hearing aid usage in hours per day and in years, the maximum power output (MPO) and the gain of the aid. According to our findings there is no change in hearing between the aided and the unaided ear at the alpha = 0.05 probability level at least for 8 years. There is no effect of the long-term amplification of the hearing aid on deterioration of hearing comparing the aided ear and the unaided ear, but with high MPO of the aid, the patient should be followed up more frequently than with low MPO amplification.
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An analysis of hearing aid fittings in adults using cochlear implants and contralateral hearing aids
The objective of this study was to assess the appropriateness of hearing aid fittings within a sample of adult cochlear implant recipients who use a hearing aid in the contralateral ear (i.e., bimodal stimulation).The hearing aid gain was measured using real ear testing for 14 postlingually deaf English-speaking adults who use a cochlear implant in the contralateral ear. Unaided and aided audiometric testing assessed the degree of functional gain derived from hearing aid use.On average, the target to actual output level difference was within 10 dB only at frequencies of 750 Hz and 1,000 Hz. Only 1 of the 14 study participants had a hearing aid for which the majority of the tested frequencies were within 10 dB of the target gain. In addition, a greater amount of functional gain (i.e., the increase in unaided behavioral thresholds after amplification) was provided for lower frequencies than higher frequencies.Hearing aid settings in our sample were suboptimal and may be regarded as a contributing factor to the variability in bimodal benefit. Refining hearing aid fitting strategies tailored to the needs of the concurrent cochlear implant and hearing aid user is recommended.
Hearing aid
Cochlear Implantation
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Objective: The aim was to investigate whether frequency compression (FC) hearing aids provide additional benefit to that conferred by conventional amplification. Design: Participants wore the same hearing aid with FC enabled and disabled for six weeks (ABA design) in each condition. Speech recognition tests (in both quiet and in noise) were administered alongside two questionnaires. Performance was compared across the two signal processing conditions and at different time points. Study sample: Twelve experienced hearing-aid users (aged 65–84 years old) with moderate-to-severe high-frequency hearing loss participated in the study. Results: FC resulted in statistically significantly higher mean scores in all of the administered speech tests. Improvements over time were limited to high frequency phoneme perception. No effect of FC on self-report outcomes was observed. Conclusions: FC may lead to significant improvements in speech perception outcomes in both quiet and noise for many individuals. No participant was significantly disadvantaged by the use of FC.
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QUIET
Disadvantaged
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On the basis of a questionnaire—for assessing the social hearing handicap—the effect of monaural and binaural hearing aid treatment was related to: (1) routine in using the hearing aid, (2) diagnosis, (3) hearing loss, and (4) patient's age. In comparable groups treated monaurally and binaurally a greater reduction of the social hearing handicap was obtained in all cases within the groups wearing binaural hearing aids.
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To investigate the related factors that may influence the effect hearing aid for sensorineural hearing loss patients.Sixty cases with moderate to severe sensorineural hearing loss were selected. Audiological measurements were performed before and after hearing aiding. Factor analysis was carried out.The unaided hearing level (UHL), Speech perception thresher (SPT), speech recognition thresher (SRT), speech recognition score (SRS) and aided hearing level (AHL) have notable influence on the effect of hearing aid fitting. The most comfortable level (MCL), age, education period, hearing loss duration and aided duration also have some influence on the results.Hearing aid is not only a hearing compensating tool, it also has some therapeutic effect as well.
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