IMPORTANCE Hearing loss is a highly prevalent condition with multiple negative associated outcomes, yet few persons with hearing loss have hearing aids (HAs). Personal sound amplification products (PSAPs) could be an alternative low-cost solution to HAs, but data are lacking on the performance of PSAPs.OBJECTIVE To evaluate the clinical efficacy of a PSAP by comparing its performance with that of a basic HA and a premium HA in participants with mild, moderate, and moderately severe hearing impairment. DESIGN, SETTING, AND PARTICIPANTSA prospective, single-institution cohort study was performed with a total of 56 participants, including 19 with mild hearing loss, 20 with moderate hearing loss, and 17 with moderately severe hearing loss. All participants underwent 4 clinical hearing tests with each of the PSAP, basic HA, and premium HA, and all completed an evaluative questionnaire.INTERVENTIONS All hearing devices (PSAP, basic HA, and premium HA) were applied by a clinician to prevent bias and order effects; participants were blinded to the device in use, and sequence of devices was randomized. MAIN OUTCOMES AND MEASURESThe study used the Korean version of the hearing in noise test, the speech intelligibility in noise test, listening effort measurement using a dual-task paradigm, pupillometry, and a self-rating questionnaire regarding sound quality and preference. These tests were administered under the following 4 hearing conditions: unaided hearing, use of PSAP, use of basic HA, and use of premium HA. RESULTSThe study included 56 participants with a mean age of 56 years (interquartile range, 48-59 years); 29 (52%) were women. In the mild and moderate hearing loss groups, there was no meaningful difference between PSAP, basic HA, and premium HA for speech perception (Cohen d = 0.06-1.05), sound quality (Cohen d = 0.06-0.71), listening effort (Cohen d = 0.10-0.92), and user preference (PSAP, 41%; basic HA, 28%; premium HA, 31%). However, for the patients with moderately severe hearing loss, the premium HA had better performance across most tests (Cohen d = 0.60-1.59), and 70% of participants preferred to use the premium HA. CONCLUSIONS AND RELEVANCEThe results indicate that basic and premium HAs were not superior to the PSAP in patients with mild to moderate hearing impairment, which suggests that PSAPs might be used as an alternative to HAs in these patient populations. However, if hearing loss is more severe, then HAs, especially premium HAs, should be considered as an option to manage hearing loss.

No abstract

Objectives: To confirm the feasibility of personal sound amplification products (PSAPs), the study was conducted for three purposes: 1) to investigate electroacoustic characteristics of PSAPs, 2) to identify whether PSAPs provide adequate gain and output for three common hearing loss configurations, and 3) to compare the benefit of one representative PSAP (RPSAP) to a conventional hearing aid (HA) based on clinical hearing outcomes as a pilot study.Methods: The study consisted of three phases: electroacoustic analysis, simulated real-ear measurements (REMs), and clinical hearing experiments. Electroacoustic analysis and simulated REMs were performed in three basic (BeethoSOL, EarJJang, and Geniesori2) and three high-end PSAPs (Hearing Able, Olive Smart Ear, and SoriIn) using the Aurical Hearing Instrument Test box with a 2cc coupler. With regards to electroacoustic analysis, four electroacoustic characteristics (maximum output sound pressure level at 90 dB SPL, frequency range, equivalent input noise, and total harmonic distortion) were investigated. By simulated REMs, the appropriate level of the six PSAPs for three common hearing loss configurations (mild-to-moderate high-frequency hearing loss, moderate to moderately severe sloping hearing loss, and moderate flat hearing loss) was determined. Clinical experiments were carried out for the purpose of comparing the performance of RPSAP to HA. Before conducting clinical experiments, both RPSAP and HA were fitted by audiologists using REMs. Clinical experiments were administered using functional gain, a word recognition test, and the Korean version of the Hearing in Noise Test in six participants with bilateral moderate sensorineural hearing loss. Results: With regards to electroacoustic analysis, two high-end devices met all tolerances. In the case of simulated REMs, one basic and two high-end PSAPs showed appropriate level for three common hearing loss configurations. As for the clinical experiments, the RPSAP showed better performances than unaided, but slightly worse than HA under all test conditions.Conclusion: Our results demonstrated that certain PSAPs met all specified tolerances for electroacoustic analysis and had ability to approximate prescriptive targets in a well-controlled laboratory condition. The pilot clinical experiments explored the possibility that RPSAP could be served as a hearing assistive device for patients with moderate hearing loss.

Background and Objectives The present study aims to investigate whether the cochlear implant electrode array design affects the electrophysiological and psychophysical measures. Subjects and Methods Eighty five ears were used as data in this retrospective study. They were divided into two groups by the electrode array design: lateral wall type (LW) and perimodiolar type (PM). The electrode site was divided into three regions (basal, medial, apical). The evoked compound action potential (ECAP) threshold, T level, C level, dynamic range (DR), and aided air conduction threshold were measured. Results The ECAP threshold was lower for the PM than for the LW, and decreased as the electrode site was closer to the apical region. The T level was lower for the PM than for the LW, and was lower on the apical region than on the other regions. The C level on the basal region was lower for the PM than for the LW whereas the C level was lower on the apical region than on the other regions. The DRs on the apical region was greater for the PM than for the LW whereas the DR was narrower on the apical region than on the other regions. The aided air conduction threshold was not different for the electrode design and frequency. Conclusions The current study would support the advantages of the PM over the LW in that the PM had the lower current level and greater DR, which could result in more localized neural stimulation and reduced power consumption.

the purposes of this study are to investigate the neural representation of a speech stimulus in the auditory system of individuals with normal hearing (NH) and those with hearing aids (HAs) and to explore the impact of noise reduction algorithms (NR) on auditory brainstem response to complex sounds (cABR). Twenty NH individuals and 28 HA users completed puretone audiometry, the Korean version of the Hearing in Noise Test (K-HINT), and cABR. In 0 and +5 dB signal-to-noise ratios (SNRs), the NH group was tested in /da/ only (quiet) and /da/ with white noise (WN) conditions while the HA group was tested in /da/ only, /da/ WN, /da/ WN NR ON, and /da/ WN NR OFF conditions. Significant differences were observed between /da/ only and /da/ WN conditions for F0 in both groups, but no SNR effect was observed for both groups. Findings of this study are consistent with previous literature that diminished cABR amplitudes indicate reduced representation of sounds in the auditory system. This is the first to examine the effect of a specific HA feature on cABR responses. Hearing loss is a public health problem; the World Health Organization reports that 466 million people around the world experience disabling hearing loss 1. For those who are diagnosed with sensorineural hearing loss, HAs that amplify acoustic signals are often recommended as a major rehabilitative option. HAs should be fitted appropriately based on each patient's audiogram and characteristics, and a typical HA fitting appointment involves verification and validation. Patients are typically fitted with HAs with the aim of improving speech recognition in both quiet and noisy environments. Therefore, HAs contain features, such as NR, directional microphones, speech enhancement, or frequency lowering, to increase speech intelligibility. Speech intelligibility is one's ability to hear and understand speech signals. It is a natural, but complex process as both peripheral and central systems are involved 2-5. Compared to speech recognition in noise, speech recognition in a quiet environment is less challenging for individuals with HAs 6,7. When noise is present, speech signals get distorted, so it becomes challenging even for individuals with NH to understand speech 6,8. HAs have been shown to improve speech intelligibility in individuals with hearing loss. Hallgren, Larsby, Lyxell, and Arlinger (2005) compared the listening effort of HA users' aided and unaided performance in quiet and noisy environments. Perceived effort was lower and word identification scores were higher with HA use 6. However, there is a lack of evidence if various technical features employed in HAs are truly beneficial for speech understanding in noise. Brons, Houben, and Dreschler (2014) examined the effect of single-microphone NR on twenty individuals with sensorineural hearing loss. Although NR decreased annoyance caused by noise, it did not increase speech intelligibility; one of the randomly coded HA recordings in the study, NR2, was preferred the most by the participants, but showed the lo...