The purpose of this study was to investigate the efficiency of the Swiss hearing aid dispensing system, and to determine factors contributing to successful hearing aid provision. A national cross sectional survey was performed using a postal questionnaire with 8707 adult hearing aid owners (response rate 62%). To correct results for a potential non-response bias, 193 randomly selected non-respondents were contacted by telephone. Data on hearing loss and type of hearing aid were provided by the hearing aid dispensing practice. Logistic regression analyses were performed to identify determinants of non-regular use and dissatisfaction. Eighty-five percent used their device(s) regularly, 12% only occasionally and 3% never. Eighty percent were satisfied with their aids. Non-regular use of hearing aids was significantly associated with age, gender, regional language, total duration of use, type of amplification, hearing aid category, hearing loss, and dissatisfaction with and difficulties in managing the aid. Dissatisfaction was associated with regional language, total duration of use, difficulties in managing the aid, and non-regular use. It was concluded that rates of regular hearing aid use and satisfaction are high in Switzerland. AbstractThe purpose of this study was to investigate the efficiency of the Swiss hearing aid dispensing system, and to determine factors contributing to successful hearing aid provision.A national cross sectional survey was performed using a postal questionnaire with 8 707 adult hearing aid owners (response rate 62%). To correct results for a potential nonresponse bias, 193 randomly selected non-respondents were contacted by telephone. Data on hearing loss and type of hearing aid were provided by the hearing aid dispensing practice.Logistic regression analyses were performed to identify determinants of non-regular use and dissatisfaction. Eighty-five percent used their device(s) regularly, 12% only occasionally and 3% never. Eighty percent were satisfied with their aids. Non-regular use of hearing aids was significantly associated with age, gender, regional language, total duration of use, type of amplification, hearing aid category, hearing loss, dissatisfaction with and difficulties in managing the aid. Dissatisfaction was associated with regional language, total duration of use, difficulties in managing the aid, and non-regular use. It was concluded that rates of regular hearing aid use and satisfaction are high in Switzerland.

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The aim of the study was to examine central auditory processes compromised by age, age-related hearing loss, and the presentation of a distracting cafeteria noise using auditory event-related potentials (ERPs). In addition, the relation of ERPs to behavioral measures of discrimination was investigated. Three groups of subjects participated: young normal hearing, elderly subjects with normal hearing for their age, and elderly hearing-impaired subjects. Psychoacoustic frequency discrimination thresholds for a 1000-Hz pure tone were determined in quiet and in the presence of a contralateral cafeteria noise. To elicit ERPs, small frequency contrasts were presented with and without noise under unattended and attended conditions. In the attended condition, behavioral measures of dS detectability and reaction times were also obtained. Noise affected all measures of behavioral frequency discrimination significantly. Except N1, all ERP components in the standard and difference waveforms decreased significantly in amplitude and increased in latency to the same degree in all three subject groups, arguing against a specific age-related sensitivity to the effects of contralateral background noise. For N1 amplitude, the effect of noise was different in the three subject groups, with a complex interaction of age, hearing loss, and attention. Behavioral frequency discrimination was not affected by age but deteriorated significantly in the elderly subjects with hearing loss. In the electrophysiological test, age-related changes occurred at various levels. The most prominent finding in the response to the standard stimuli was a sustained negativity (N2) following P2 in the young subjects that was absent in the elderly, possibly indicating a deficit in the inhibition of irrelevant information processing. In the attended difference waveform, significantly larger N2b and smaller P3b amplitudes and longer N2b and P3b latencies were observed in the elderly indicating different processing strategies. The pronounced agerelated changes in the later cognitive components suggest that the discrimination of difficult contrasts, although behaviorally maintained, becomes more effortful in the elderly.

To clarify the contribution of the skull contents to the transmission of bone vibratory stimuli, and to examine the characteristics of such stimuli, we compared auditory thresholds and distortion-product otoacoustic emission (DPOAE) levels with a bone vibrator placed on various sites of the head, including the eye. The best audiometric thresholds and the highest DPOAE levels were obtained with the vibrator placed on the mastoid of the measuring side, or on the "ultrasound-window" of the temple. The audiometric thresholds obtained with the bone vibrator on the eye were similar to those of the forehead, and about 10 dB higher than at the best sites. DPOAEs were clearly present when elicited by a combination of air-conducted stimuli presented through an insert earphone and with the bone vibrator placed on the eye. These results indicate that vibratory sounds can be transmitted through the skull contents to the inner ear. The intracranial transmission pathway of the vibratory stimuli may play a significant role, particularly at low frequencies, and possibly also when the vibratory stimuli are applied on the skull bone.

This study investigated the effects of long-term unilateral and bilateral amplification on central auditory processing in elderly people with symmetrical hearing loss using late auditory evoked potentials. It was hypothesized that in the unilateral setting stimulation of the aided ear would yield an acclimatization effect with larger amplitudes and shorter latencies of the components P1, N1 and P2 compared to those of the unaided ear. Auditory evoked potentials were elicited by 500, 1000 and 2000 Hz pure tones at 55, 70 and 85 dB SPL presentation level delivered either to the left or right ear. Unilaterally and bilaterally fitted experienced hearing-aid users and a control group of normally hearing adults, all aged at least 60 years, participated. The responses of the unilateral hearing-aid users did not differ significantly for any of the components P1, N1 or P2 between the aided and unaided ears, but a significant interaction between ear and frequency was present for P2 amplitudes. P2 amplitudes were significantly smaller for the 0.5-and 1-kHz stimuli and tended to be larger for the 2-kHz stimulus in the aided ear suggesting an acclimatization effect. Larger P2 amplitudes were observed in the unilaterally fitted group, which was interpreted as a correlate of more effortful auditory processing in unilaterally fitted people. This study investigated the effects of long-term unilateral and bilateral amplification on 2 central auditory processing in elderly people with symmetrical hearing loss using late 3 auditory evoked potentials. It was hypothesized that in the unilateral setting stimulation 4 of the aided ear would yield an acclimatization effect with larger amplitudes and shorter 5 latencies of the components P1, N1 and P2 compared to those of the unaided ear. 6Auditory evoked potentials were elicited by 500, 1000 and 2000 Hz pure tones at 55, 7 70 and 85 dB SPL presentation level delivered either to the left or right ear. Unilaterally 8 and bilaterally fitted experienced hearing-aid users and a control group of normally 9 hearing adults, all aged at least 60 years, participated. The responses of the unilateral 10 hearing-aid users did not differ significantly for any of the components P1, N1 or P2 11 between the aided and unaided ears, but a significant interaction between ear and 12 frequency was present for P2 amplitudes. P2 amplitudes were significantly smaller for 13 the 0.5-and 1-kHz stimuli and tended to be larger for the 2-kHz stimulus in the aided 14 ear suggesting an acclimatization effect. Larger P2 amplitudes were observed in the 15 unilaterally fitted group, which was interpreted as a correlate of more effortful auditory 16 processing in unilaterally fitted people. 17 18

The present investigation further analysed results of a previously reported survey with a large sample of hearing aid owners (Bertoli et al, 2009) to determine the individual and technological factors related to hearing aid outcome. In particular the associations of hearing loss, level of signal processing, and fitting type (bilateral versus unilateral fitting) with hearing aid use, satisfaction with and management of the aid were evaluated. A sub-group with symmetrical hearing loss was analysed (n = 6027). Regular use was more frequent in bilateral users and in owners of devices with more complex signal processing, but the strongest determinant of regular use was severity of hearing loss. Satisfaction was higher in the group wearing simple devices, while fitting type and degree of hearing loss had no influence on satisfaction rates. Moderate and severe hearing loss was associated more frequently with poor management of the aid than mild hearing loss. It was concluded that bilateral amplification and advanced signal processing features may contribute to successful hearing aid fitting, but the resulting differences must be considered to be relatively small. AbstractThe present investigation further analyzed results of a previously reported survey with a large sample of hearing aid owners (Bertoli et al, 2009) to determine the individual and technological factors related to hearing aid outcome. In particular the associations of hearing loss, level of signal processing, and fitting type (bilateral versus unilateral fitting) with hearing aid use, satisfaction with and management of the aid were evaluated. A sub-group with symmetrical hearing loss was analyzed (n=6027). Regular use was more frequent in bilateral users and in owners of devices with more complex signal processing, but the strongest determinant of regular use was severity of hearing loss. Satisfaction was higher in the group wearing simple devices, while fitting type and degree of hearing loss had no influence on satisfaction rates. Moderate and severe hearing loss was associated more frequently with poor management of the aid than mild hearing loss. It was concluded that bilateral amplification and advanced signal processing features may contribute to successful hearing aid fitting, but the resulting differences must be considered to be relatively small.

Overall, the present study provides evidence of gender-specific factors that influence hearing aid use patterns in men and women and of groups at higher risk for nonregular hearing aid use. Men with steeper audiogram slopes and the other subgroups of men and women with an increased risk for nonregular use should given particular attention when fitting their aids. As common risk factors for nonregular use, poor handling and low satisfaction should be addressed during the fitting process for all users. Further research is needed to clarify the differential influence of asymmetric hearing loss on hearing aid use in men and women. This information could improve hearing aid use and should be incorporated into daily clinical practice.

We analyzed the cortical responses to standard stimuli presented in an auditory oddball paradigm from two groups of young and elderly participants in unattended and attended conditions. A sustained negativity (N2) followed N1 and P2 in the responses of the young participants. This negativity was reduced or absent in the elderly. With attention, the early portion of N2 (N2early) decreased in both groups, whereas the late portion (N2late) increased only in young participants. We suggest inhibitory processes at the origin of this component. The lack of N2 in the elderly participants is consistent with structural changes in the aging brain and supports the hypothesis of a specific age-related deficit in the inhibition of irrelevant information processing.