DSLchild-Algorithm-Based Hearing Aid Fitting Can Improve Speech Comprehension in Mildly Distressed Patients with Chronic Tinnitus and Mild-to-Moderate Hearing Loss

Abstract

Background: Patients with chronic tinnitus and mild-to-moderate hearing loss (HL) can experience difficulties with speech comprehension (SC). The present study investigated SC benefits of a two-component hearing therapy. Methods: One-hundred-seventy-seven gender-stratified patients underwent binaural DSLchild-algorithm-based hearing aid (HA) fitting and conducted auditory training exercises. SC was measured at four timepoints under three noise interference conditions each (0, 55, and 65 dB): after screening (t0; without HAs), HA- fitting (t1), additional auditory training (t2), and at 70-day follow-up (t3). Repeated-measure analyses of covariance investigated the effects of HAs (t0–t1), auditory training (t1–t2), and the stability of the combined effect (t2–t3) on SC per noise interference level and HL subgroup. Correlational analyses examined associations between SC, age, and psychological indices. Results: Patients showed mildly elevated tinnitus-related distress, which was negatively associated with SC in patients with mild but not moderate HL. At 0 dB, the intervention lastingly improved SC for patients with mild and moderate HL; at 55 dB, for patients with mild HL only. These effects were mainly driven by HAs. Conclusions: The here-investigated treatment demonstrates some SC-benefit under conditions of no or little noise interference. The auditory training component warrants further investigation regarding non-audiological treatment outcomes.

Hearing Aid Use Time Is Causally Influenced by Psychological Parameters in Mildly Distressed Patients with Chronic Tinnitus and Mild-to-Moderate Hearing Loss

“…Expanding on the above-reported results [ 26 , 27 , 28 ], we use data from the original randomized controlled crossover study that investigated the effects of a hearing therapy protocol on TRD and SC. The present study examines pooled data from the crossover study’s two intervention arms and includes N = 177 patients with chronic tinnitus and mild-to-moderate HL (age mean = 59.61 years; SD = 7.46) who were examined at screening (t 0 ), pre- and post-treatment (t 1 − t 2 ), and at a 70-day follow up timepoint (t 3 ) (see also [ 27 ]). The study was conducted according to the principles of the Declaration of Helsinki and approved by the Charité’s Ethics Committee (EA1/114/17).…”

“…The hearing therapy combined binaural DSL child algorithm-based HA fittings and a 14-day auditory self-study program (terzo © Hearing Therapy). For detailed information on sample characteristics at screening [ 28 ] as well as study design, sample characteristics at baseline, the examined hearing therapy, and the obtained self-report measures, readers are referred to the current study’s predecessor papers [ 26 , 27 ].…”

“…Second, Pearson correlation coefficients r investigated (1) associations between general audiological as well as distress-related self-report data at pre- and post-treatment and HA use time, as well as (2) possible differences in any such associations for patient subgroups who differed on factors identified in Step 1. Here, similar to our approach in [ 27 ], coefficients were compared using MedCalc ( ; accessed on 19 August 2022), where applicable. Correlational effects were interpreted according to Cohen [ 36 ] ( r ≥ 0.10 = small effect, r ≥ 0.30 = moderate effect, r ≥ 0.50 = strong effect).…”

“…Of note, analyses revealed no significant effects for the post- to follow up period—likely owing to the relative stability of all treatment-related effects (cf. [ 26 , 27 ]). The present paper thus limits itself to reporting findings for the t 1 -t 2 intervention period.…”

“…Against the background of interacting influences of HL, chronic tinnitus symptomatology, psychological distress, and SC difficulties, few studies have investigated the effectiveness of HAs on tinnitus-related distress (TRD) or SC in silence or noise in patients with chronic tinnitus and mild-to-moderate HL. Two recent studies from our group aimed to fill this gap and reported beneficial effects of a 21-day hearing therapy on TRD [ 26 ] and SC in silence for patients with mild or moderate, and 55 dB noise-interference for patients with mild HL only [ 27 ]. Treatment involved binaural Desired Sensation Level (DSL) child algorithm-based HA fittings and auditory self-study training.…”