Hörgeräte: Indikationen, Technologie, Anpassung und Qualitätskontrolle

Abstract

Hearing loss can be caused by a number of different pathological conditions. Some of them can be successfully treated, mainly by surgery, depending on the individual's disease process. However, the treatment of chronic sensorineural hearing loss with damaged cochlear structures usually needs hearing rehabilitation by means of technical amplification. During the last 2 decades tremendous improvements in hearing aid technology led to a higher quality in the hearing rehabilitation process. For example, due to sophisticated signal processing the acoustic feedback path could be reduced and hence open fitting options are available for even more subjects. In particular for high-frequency hearing loss the use of open fitting is an option. Both the users' acceptance and the perceived sound quality were significantly increased by open fittings.However, we are still faced with a low level of readiness in many hearing impaired subjects to accept acoustic amplification. Since ENT specialists play a key-role in hearing aid provision, they should promote early hearing aid rehabilitation and include this in the counselling even in subjects with mild and moderate hearing loss. Recent investigations demonstrated the benefit of early hearing aid use in this group of patients since this may help to reduce subsequent damages as auditory deprivation, social isolation, development of dementia, and cognitive decline. For subjects with tinnitus, hearing aids may also support masking by environmental sounds and enhance cortical inhibition.The present paper describes the latest development of hearing aid technology and the current state of the art for amplification modalities. Implications for both hearing aid indication and provision are discussed.

Extended Preoperative Audiometry for Outcome Prediction and Risk Analysis in Patients Receiving Cochlear Implants

“…In the quasi-binomial model only, the duration of wearing a HA had an influence: a shorter duration of HA use was associated with better WRS70(CI). A timely provision of an HA and a sufficiently long period of its use are regarded as associated with better hearing ability and later CI provision [39,59]. These variables were not analysed as influencing factors in this study.…”

“…Technical adjustments can include modifications to the sound wave picked up by the device, such as volume adjustments, tone adjustments and suppression of disturbing noises, to enhance the listening experience for the hearing aid wearer. The weaker correlation between WRS65(HA) and WRS70(CI) may have been caused by the hearing aid's amplification mechanism [39], resulting in insufficient amplification at 65 dB SPL input volume when a high degree of hearing loss was present. In this context, inadequate CI fitting (resulting in the need for higher sound pressure levels for word comprehension) or possible technical difficulties should be considered [40][41][42].…”

“…This means that hearing aids have the potential to improve speech comprehension to some degree, depending on the severity of the cochlear damage. Thus, the fact that the correlation between WRS70(CI) and WRS80(HA) was found to be higher than that between WRS70(CI) and WRSmax may have been due to a technical adjustment of the auditory impression by the hearing aid [36,38,39]. Technical adjustments can include modifications to the sound wave picked up by the device, such as volume adjustments, tone adjustments and suppression of disturbing noises, to enhance the listening experience for the hearing aid wearer.…”

Speech recognition with hearing aids for 10 standard audiograms

“…Here, the primary aim is an improvement of speech recognition in quiet and, in particular, in noise [5,13]. In addition to the indication, an evaluation of the hearing aid by an ear, nose, and throat (ENT) physician is also vitally important [10,14,23].…”

Interventions against hearing loss as an integral component of successful tinnitus therapy

“…In this case, the hearing aids are not worn; the reasons are often fittings that are too open or too little amplification in the affected frequency range. A positive effect on tinnitus perception then fails to materialize [ 12 ].…”