Preference for One or Two Hearing Aids Among Adult Patients

Abstract

Objectives-Most practitioners believe that use of two hearing aids is the ideal fitting for adults with bilateral symmetrical hearing loss. However, previous research has consistently shown that a substantial proportion of these patients actually prefer to use only one hearing aid. The current study explored whether this pattern of preferences is seen with technologically advanced hearing aids. In addition, a selection of variables that were available pre-fitting were used to attempt to predict which patients will prefer one hearing aid rather than two.Design-The study was designed as a 12-week field trial including structured and unstructured use of one and two hearing aids. Ninety-four subjects with mild to moderate bilaterally symmetrical hearing loss were bilaterally fit with 2005-2007 era hearing aids. Potential predictors included demographic, audiometric, auditory lifestyle, personality, and binaural processing variables. After the field trial, each subject stated his/her preference for one or two hearing aids and completed three self-report outcome questionnaires for their preferred fitting.Results-Previous research was confirmed with modern technology hearing aids: after the field trial 46% of the subjects preferred to use one hearing aid rather than two. Subjects who preferred two hearing aids tended to report better real-world outcomes than those who preferred one. Subjects who reported more hearing problems in daily life, who experienced more binaural loudness summation, and whose ears were more equivalent in dichotic listening were more likely to prefer to use two hearing aids. Contrary to conventional wisdom (ideas that are generally accepted as true), audiometric hearing loss and auditory lifestyle were not predictive of aiding preference. However, the best predictive approach from these data yielded accurate predictions for only two-thirds of subjects.Conclusions-Evidence-based practice calls for a conscientious melding of current evidence, clinical judgment, and patient preferences. The results of this research challenge practitioners to recognize that many patients who appear to be ideal candidates for bilateral aiding will actually prefer to wear only one hearing aid. Further, at this time there is not an accurate method that will predict which patients will prefer one hearing aid rather than two. Currently, the most effective approach open to practitioners would be to conduct a candid unbiased systematic field trial allowing each patient to compare unilateral and bilateral fittings in daily life. This might necessitate more fitting sessions and could perhaps add to the practitioner's burden. This downside should be weighed against the additional patient satisfaction that can be anticipated as a result of transparency in the fitting protocol, collaboration with the patient in the treatment decisions, and the knowledge of selecting the most cost-effective patient-centered solution.

Interferência binaural no processo de seleção e adaptação de próteses auditivas: revisão sistemática

“…The greatest challenges for the professionals who work with hearing aids are the patients who seem to be candidates to use two aids, but prefer to use only one. However, those who present better results, product of the binaural summation and fusion, are more proper to choose two aids 22 . Based on these findings, the adaptation in both ears is rethought, not to be generalized for all patients with bilateral hearing loss 22 .…”

“…However, those who present better results, product of the binaural summation and fusion, are more proper to choose two aids 22 . Based on these findings, the adaptation in both ears is rethought, not to be generalized for all patients with bilateral hearing loss 22 . Studies have shown probable alteration of auditory processing in elderly people, what may result in the presence of binaural interference, affecting the processes related to the perceptual organization of the auditory information 16,36 .…”

“…A research performed to evaluate the speech recognition in noise between adults and elderly people without hearing loss demonstrated that the elderly people required more auditory cognitive and processing resources to understand speech in noise 32 . The preference and the benefit reported with one or two hearing aids are not related to the level of technology of the hearing aids [6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22] . Neither the age is limit factor to obtain benefits with digital technology 33 .…”

“…In another study, 94 subjects with symmetric sensorial hearing loss, with mild and moderate degrees were evaluated. From these, 46% preferred to use only one hearing aid, and the ones who preferred aids in both ears presented more positive performance in daily living activities 22 .…”

“…So, to evaluate one of the abilities of the auditory processing, related to binaural interference, literature has described the Dichotic Digits Test 8,9,20,[21][22][23] . This test evaluates the binaural integration, with the purpose of verifying the ability of grouping the components of the acoustic signal in figure-toground and of identifying them, and the binaural separation, what enables directed evaluation and listening for each ear separately 20,24 .…”