Objectives-Most practitioners believe that use of two hearing aids is the ideal fitting for adults with bilateral symmetrical hearing loss. However, previous research has consistently shown that a substantial proportion of these patients actually prefer to use only one hearing aid. The current study explored whether this pattern of preferences is seen with technologically advanced hearing aids. In addition, a selection of variables that were available pre-fitting were used to attempt to predict which patients will prefer one hearing aid rather than two.Design-The study was designed as a 12-week field trial including structured and unstructured use of one and two hearing aids. Ninety-four subjects with mild to moderate bilaterally symmetrical hearing loss were bilaterally fit with 2005-2007 era hearing aids. Potential predictors included demographic, audiometric, auditory lifestyle, personality, and binaural processing variables. After the field trial, each subject stated his/her preference for one or two hearing aids and completed three self-report outcome questionnaires for their preferred fitting.Results-Previous research was confirmed with modern technology hearing aids: after the field trial 46% of the subjects preferred to use one hearing aid rather than two. Subjects who preferred two hearing aids tended to report better real-world outcomes than those who preferred one. Subjects who reported more hearing problems in daily life, who experienced more binaural loudness summation, and whose ears were more equivalent in dichotic listening were more likely to prefer to use two hearing aids. Contrary to conventional wisdom (ideas that are generally accepted as true), audiometric hearing loss and auditory lifestyle were not predictive of aiding preference. However, the best predictive approach from these data yielded accurate predictions for only two-thirds of subjects.Conclusions-Evidence-based practice calls for a conscientious melding of current evidence, clinical judgment, and patient preferences. The results of this research challenge practitioners to recognize that many patients who appear to be ideal candidates for bilateral aiding will actually prefer to wear only one hearing aid. Further, at this time there is not an accurate method that will predict which patients will prefer one hearing aid rather than two. Currently, the most effective approach open to practitioners would be to conduct a candid unbiased systematic field trial allowing each patient to compare unilateral and bilateral fittings in daily life. This might necessitate more fitting sessions and could perhaps add to the practitioner's burden. This downside should be weighed against the additional patient satisfaction that can be anticipated as a result of transparency in the fitting protocol, collaboration with the patient in the treatment decisions, and the knowledge of selecting the most cost-effective patient-centered solution.

Hearing assistive technologies include listening, alerting, and/or signaling devices that use auditory, visual, and/or tactile modalities to augment communication and/or facilitate awareness of environmental sounds. The importance of hearing assistive technologies in the management of adults with hearing loss was recently acknowledged in an evidence-based clinical practice guideline developed by the American Academy of Audiology. Most currently available evidence for hearing assistive technology use by adults focuses on frequency-modulated (FM) technology. Previous research is reviewed that demonstrates the efficacy of FM devices for adults in terms of laboratory measures of speech understanding in noise. Also reviewed are the outcomes from field trials of FM use by community-dwelling adults, which, to date, have been disappointing. Few to no individuals, in previous studies, elected to use FM devices at the end of the trial periods. Data are presented from a 1-group pretest-posttest study examining the role of extensive counseling, coaching, and instruction on FM use by adults. In addition, the potential influence of the cost of devices to the individual was eliminated by conducting the study with veterans who were eligible to receive FM systems through the Veterans Affairs National Hearing Aid Program. Positive outcomes were obtained at the end of a 6-week trial period and were found to remain 1 year after study completion. Implications for increasing the evidence base for the use of FM devices by adults are discussed.

The results of this study confirmed that the psychometric properties of the IOI-HA questionnaire are strong and are essentially the same for the veteran sample and the original private-pay sample. The veteran norms, however, produced higher outcomes than those established originally, possibly because of differences in the population samples and/or hearing aid technology. Clinical and research applications of the current findings are presented. Based on the results from the current study, the norms established here should replace the original norms for use in veterans with current hearing aid technology.

Listeners with HF SNHL perceived benefit and satisfaction from amplification with CIC hearing aids. Individuals with SNHL limited to the high frequencies should be considered candidates for amplification.

Abstract-The Epidemiology of Hearing Loss Study (EHLS)conducted in Beaver Dam, Wisconsin, was a population-based study that focused on the prevalence of hearing loss among 3,753 participants between 1993 and 1995. This article reports the results of several auditory measures from 999 veteran and 590 nonveteran males 48 to 92 years of age included in the EHLS. The auditory measures included pure tone thresholds, tympanometry and acoustic reflexes, word recognition in quiet and in competing message, and the Hearing Handicap Inventory for the Elderly-Screening (HHIE-S) version. Hearing loss in the auditory domains of pure tone thresholds, word recognition in quiet, and word recognition in competing message increased with age but were not significantly different for the veterans and nonveterans. No significant differences were found between participant groups on the HHIE-S; however, regarding hearing aid usage, mixed differences were found.

The behavioral and electrophysiological measures used in the present study clearly showed evidence of reduced binaural processing in ∼10 of the subjects in the present study who had symmetrical pure-tone sensitivity. These results underscore the importance of understanding binaural auditory processing and how these measures may or may not identify functional auditory problems.

Transcranial routing of signal (TCROS) was accomplished using completely-in-the-canal (CIC) hearing aids in 5 profoundly unilaterally hearing-impaired individuals. The functional gain realized by the participants far exceeded the gain predicted by measuring the acoustic output and real ear aided response of the hearing aids. The difference between predicted and functional gain increased with signal frequency and was attributed at least in part to mechanical vibration of the hearing aid in the external canal. Implications for fitting unilateral hearing loss using TCROS amplifying systems are discussed.

During a hearing loss management workshop, 10 listeners with normal hearing sensitivity and 18 listeners with sensorineural hearing loss compared four group assistive listening devices (ALDs)—FM, induction loop, infrared, and soundfield amplification—to no system. Listeners with hearing loss were tested using the ALDs alone and using the ALDs inductively coupled to personal in-the-ear (ITE) hearing aids. Significant improvements in word recognition ability with the FM, induction loop, and infrared systems were noted in listeners with normal hearing and with all ALD systems in listeners with hearing loss, as compared to performance with no system. Listeners with hearing loss performed better and preferred using the FM, induction loop, and infrared systems with headsets, but preferred the soundfield amplification system with their hearing aids. Both groups of listeners preferred the FM system over other systems in terms of performance, comfort, and ease of use.