Hearing aids: indications, technology, adaptation, and quality control

Hoppe, Ulrich; Hesse, Gerhard

doi:10.3205/cto000147

Cited by 14 publications

(9 citation statements)

References 104 publications

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“…Studies have reported that although HAs improve the hearing of people with hearing loss through different technologies ( Wu et al, 2019 ), they do not sufficiently compensate for speech perception abilities despite considerable advancements in digital technologies ( McCormack and Fortnum, 2013 ; Bisgaard and Ruf, 2017 ; Hoppe and Hesse, 2017 ; Johnson et al, 2018 ). Although in the current study, there was no group of new HA users who did not undergo the program, previous reports have shown that speech in noise performance after using HAs for 6 months did not show large perceptual improvements ( Karawani et al, 2018a ).…”

Section: Discussionmentioning

confidence: 99%

“…Individuals with sensorineural hearing loss generally use hearing aids (HAs) to compensate for hearing loss. Despite the advanced technology of HAs, many individuals demonstrate “hearing aids in the drawer” phenomena ( Bisgaard and Ruf, 2017 ), where they often remove one HA or become dissatisfied with the assistance they receive from it ( Hoppe and Hesse, 2017 ; Johnson et al, 2018 ). The most common reason people do not use their HAs is that they did not provide an additional benefit, particularly in noisy environments ( McCormack and Fortnum, 2013 ).…”

Section: Introductionmentioning

confidence: 99%

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Auditory Perceptual Exercises in Adults Adapting to the Use of Hearing Aids

Karah

Karawani

2022

Front. Psychol.

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Older adults with age-related hearing loss often use hearing aids (HAs) to compensate. However, certain challenges in speech perception, especially in noise still exist, despite today’s HA technology. The current study presents an evaluation of a home-based auditory exercises program that can be used during the adaptation process for HA use. The home-based program was developed at a time when telemedicine became prominent in part due to the COVID-19 pandemic. The study included 53 older adults with age-related symmetrical sensorineural hearing loss. They were divided into three groups depending on their experience using HAs. Group 1: Experienced users (participants who used bilateral HAs for at least 2 years). Group 2: New users (participants who were fitted with bilateral HAs for the first time). Group 3: Non-users. These three groups underwent auditory exercises for 3 weeks. The auditory tasks included auditory detection, auditory discrimination, and auditory identification, as well as comprehension with basic (syllables) and more complex (sentences) stimuli, presented in quiet and in noisy listening conditions. All participants completed self-assessment questionnaires before and after the auditory exercises program and underwent a cognitive test at the end. Self-assessed improvements in hearing ability were observed across the HA users groups, with significant changes described by new users. Overall, speech perception in noise was poorer than in quiet. Speech perception accuracy was poorer in the non-users group compared to the users in all tasks. In sessions where stimuli were presented in quiet, similar performance was observed among new and experienced uses. New users performed significantly better than non-users in all speech in noise tasks; however, compared to the experienced users, performance differences depended on task difficulty. The findings indicate that HA users, even new users, had better perceptual performance than their peers who did not receive hearing aids.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Auditory Perceptual Exercises in Adults Adapting to the Use of Hearing Aids

Karah

Karawani

2022

Front. Psychol.

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“…By building classification models to match patients into the auditory profiles using only features from the air-conduction audiogram, loudness scaling, and GOESA, we aimed for the applicability of the profiles in a variety of settings. First, in clinical routine, both the audiogram and a speech test, measuring the SRT, are the current standard in hearing aid fitting ( 56 ), and in Germany, the GOESA is included in the German guideline for hearing aid fitting ( 57 ). In addition, loudness scaling has proved promising for hearing aid adjustments ( 58 ).…”

Section: Discussionmentioning

confidence: 99%

A flexible data-driven audiological patient stratification method for deriving auditory profiles

et al. 2022

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For characterizing the complexity of hearing deficits, it is important to consider di erent aspects of auditory functioning in addition to the audiogram. For this purpose, extensive test batteries have been developed aiming to cover all relevant aspects as defined by experts or model assumptions. However, as the assessment time of physicians is limited, such test batteries are often not used in clinical practice. Instead, fewer measures are used, which vary across clinics. This study aimed at proposing a flexible data-driven approach for characterizing distinct patient groups (patient stratification into auditory profiles) based on one prototypical database (N =) containing audiogram data, loudness scaling, speech tests, and anamnesis questions. To further maintain the applicability of the auditory profiles in clinical routine, we built random forest classification models based on a reduced set of audiological measures which are often available in clinics. Di erent parameterizations regarding binarization strategy, cross-validation procedure, and evaluation metric were compared to determine the optimum classification model. Our data-driven approach, involving model-based clustering, resulted in a set of patient groups, which serve as auditory profiles. The auditory profiles separate patients within certain ranges across audiological measures and are audiologically plausible. Both a normal hearing profile and profiles with varying extents of hearing impairments are defined. Further, a random forest classification model with a combination of a one-vs.-all and one-vs.-one binarization strategy, -fold cross-validation, and the kappa evaluation metric was determined as the optimal model. With the selected model, patients can be classified into of the auditory profiles with adequate precision (mean across profiles = . ) and sensitivity (mean across profiles = . ). The proposed approach, consequently, allows generating of audiologically plausible and interpretable, data-driven clinical auditory profiles, providing an e cient way of characterizing hearing deficits, while maintaining clinical applicability. The method should by design be applicable to all audiological data sets from clinics or research, and in addition be flexible to summarize Frontiers in Neurology frontiersin.org Saak et al. . /fneur. .information across databases by means of profiles, as well as to expand the approach toward aided measurements, fitting parameters, and further information from databases.

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“…For the professional singer, a series of audiometric and vestibular function tests can monitor progress, and options for hearing devices such as hearing aids may be considered to amplify sounds and frequencies that are affected. 12 Newer hearing aids feature directional microphones, wind noise elimination and binaural coupling. 12 Early assessment may help in determining the role of cochlear implants, as infections spread to the inner ear structures rapidly and may occur within hours of the diagnosis of meningitis.…”

Section: Discussionmentioning

confidence: 99%

Hearing Loss from S. Suis Meningitis In A Middle-Aged Couple

Hosojima

2022

Philipp J Otolaryngol Head Neck Surg

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Streptococcus suis is a bacterial pathogen causing a wide range of infections including meningitis, lung infections, arthritis, sepsis and endocarditis.1 Over the years, an increasing number of cases have been reported among humans especially in countries in Southeast Asia specifically in Vietnam and Thailand where pig-rearing is common.2 One of the prominent symptoms of S. suis infection is hearing loss that may be present during the onset or a few days after.1 We report two cases of adult S. suis meningitis presenting with bilateral hearing loss. CASE REPORT Our first patient was a 57-year-old man who presented with a one day history of generalized weakness initially unaccompanied by any other symptoms. The previous day, he was still able to walk but was generally weak, and preferred to stay in bed. That evening, he developed high grade fever (40oC) that was temporarily relieved by paracetamol. There were two episodes of vomiting previously ingested food but no headache. By late evening, he was noted to have increased sleeping time, opening eyes spontaneously, responding mostly with yes or no, and following commands but drowsing back to sleep. On the day of admission, he could sustain spontaneous eye opening with no regard and groaned in response to questions without following commands. High grade fever persisted and he was rushed to the Emergency Room. On examination, he was febrile at 40.5oC, hypertensive at 160/80mmHg, tachycardic at 109 with a Glasgow Coma Scale (GCS) of 9/15 (E4V1M6), and was given O2 support at 1LPM by nasal cannula. He presented with spontaneous eye opening, no regard and did not follow commands. He had meningeal signs- nuchal rigidity but no Kernig’s sign. Cranial CT scans showed no acute territorial infarct or intracranial hemorrhage, and a stable chronic lacunar infarct versus prominent perivascular space in the left lentiform nucleus. A COVID rt-PCR test was negative. Complete blood count showed leukocyte count of 5,220/mm3 with 72% neutrophils and a platelet count of 57,800/mm3. Bleeding parameters showed prothrombin time of 14.4 seconds, INR of 1.23 and an elevated PTT of 45.3. He was started on Meropenem and Vancomycin and admitted to the Neurological Critical Care Unit while awaiting clearance for lumbar puncture (being on anti-coagulants). Our second patient was his wife, a 51-year-old professional singer with no known co-morbidities who was also admitted due to fever and headache. At the time her husband was admitted, she had febrile episodes as high as 40oC associated with pressure-like headache over both occipital areas (rated PS 7/10) as well as joint pain and nape pain. There were no associated cough, colds, dysuria, otalgia or otorrhea. Paracetamol afforded temporary relief but fever intermittently recurred the next day and she was admitted for further evaluation and management even though her COVID rt-PCR test was negative. On initial examination at the ER, she was still febrile at 38.5C. She was awake, coherent and oriented to 3 spheres. Complete blood count showed leukocytosis, while C Reactive Protein and Erythrocyte Sedimentation Rate were elevated. Magnetic Resonance Imaging (MRI) showed diffuse FLAIR hyperintensities along bilateral cerebral sulci and cerebellar interfoliar spaces with associated leptomeningeal enhancement. There was also enhancement along the ventral surface of the brain stem. A CNS infection was suspected and lumbar puncture was performed. Her CSF showed gram positive cocci in pairs and chains with a possible streptococcus infection, but no fungal elements or acid fast bacilli. Both CSF and blood culture and sensitivity specimens tested positive for Streptococcus suis sensitive to Penicillin. She and her husband were started on intravenous Penicillin. Both patients had improvement in headache and nape pain over the next two days. However, they both reported persistent, progressive dizziness and bilateral hearing loss, and showed signs of vestibular dysfunction. The vestibular dysfunction was so severe that both patients were bed-bound and needed assistance in ambulating throughout their hospital stay. Their hearing was described as distorted, with a sensation of being underwater. Hearing tests revealed profound sensorineural hearing loss on the right and moderate sensorineural hearing loss on the left for the husband, and severe sensorineural hearing loss on the right and moderate sensorineural hearing loss on the left, downsloping at 6000 to 8000 Hz in both ears for the wife. Both patients were started on intravenous Dexamethasone, which they completed (together with Penicillin) over the course of 16 days. They were also given Betahistine tablets for dizziness, metoclopramide for nausea and Vitamin B complex. Repeat cranial MRI showed significant interval regression in the diffuse FLAIR hyperintensities and associated leptomeningeal enhancement along bilateral cerebral sulci and cerebellar interfoliar spaces. Repeat lumbar punctures showed no growth of any pathogen and resolution of S. suis infection. Serial hearing tests showed stable hearing loss for both patients. After 2 months from the onset of infection, both patients continued to experience dizziness, vestibular dysfunction and hearing loss. Although both were now able to ambulate, they still needed assistance in daily activities including driving. They still could not tolerate sudden head movements; even nodding and turning the head from side-to- side elicited dizziness. The wife’s singing was greatly affected as the right ear had persistent severe hearing loss. Sounds were perceived as distorted, described as ‘scratches;’ her right ear would hear higher frequencies, while the left ear heard lower frequencies. The perceived imbalance in frequencies posed a challenge to singing the right tune, but she continues to perform and sing professionally despite her hearing condition. She adapted through repetition, practicing until she achieved muscle memory in getting the right tone. They were offered several options for managing the residual symptoms including rehabilitation, hearing aids and early cochlear implantation. It was subsequently determined that they both ate at a Korean barbecue restaurant days before the onset of symptoms. However, they ordered chicken barbeque and did not eat any pork dishes.

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Hearing aids: indications, technology, adaptation, and quality control

Cited by 14 publications

References 104 publications

Auditory Perceptual Exercises in Adults Adapting to the Use of Hearing Aids

Auditory Perceptual Exercises in Adults Adapting to the Use of Hearing Aids

A flexible data-driven audiological patient stratification method for deriving auditory profiles

Hearing Loss from S. Suis Meningitis In A Middle-Aged Couple

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