Skin reactions caused by bone-anchored hearing aid(BAHA) implantation

Objective: To report a case of intractable skin reactions caused by bone-anchored hearing aid (BAHA) implantation to improve our under-standing and treatment of BAHA implantation-caused skin reactions. Methods:We reported a case of severe skin reactions caused by BAHA implantation. Related literature were also reviewed. Results:We found grade IV skin reactions, including hyperplasia around the implant, which led to the removal of the BAHA implant 10 months after implantation. The findings indicated poor skin hygiene, allergy to titanium and inadequate surgicals skills as the possible causes of the skin reaction. Conclusion: Skin adverse reactions, usually rare in BAHA implantation patients, may cause implant removal and implantation failure. We suggest to further investigate the mechanisms underlying titanium allergy. Copyright ? 2016, PLA General Hospital Department of Otolaryngology Head and Neck Surgery. Production and hosting by Elsevier (Singapore) Pte Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

Development and Optimization of Universal Bone Conduction Hearing Spectacles

Background: Non-implantable bone anchored hearing devices (BCHDs) are utilized for patients with conductive or mixed hearing loss who are unsuitable for conventional hearing aids or have unresolved middle ear issues. These devices can be surgically implanted or attached using adhesive plates, dental sticks, elastic headbands, or bone conduction spectacles. Optimal fitting of bone conduction spectacles requires appropriate frame selection and contact pressure in the temporal and mastoid areas. The ANSI S3.6 and DIN EN ISO 389-3 standards recommend a contact area of approximately 1.75 cm2 and a maximum force of 5.4 N for effective sound transmission and comfort. Methods: This study aimed to evaluate the technical fit and mechanical stability of universal bone conduction hearing spectacles compared to established systems. A Sen-Pressure 02 thin-film sensor connected to an Arduino Uno R3 board measured contact force in the temporal and mastoid areas. Several BCHDs were tested, including the Bruckhoff la belle BC D50/70, Radioear B71 headset, Radioear B71 elastic headband, Cochlear Baha SoundArc M, and Cochlear Baha elastic headband, on a PVC artificial head, with data analyzed using ANOVA and LSD post hoc tests. Results: The la belle BC D50/70 spectacles showed comparable contact force to established BCHDs, ensuring adequate sound transmission and comfort. Significant differences were observed between the systems, with the Radioear B71 headset exhibiting the highest forces. The la belle BC D50/70 had similar forces to the Radioear B71 elastic headband. Conclusion: The la belle BC D50/70 universal bone conduction hearing spectacles are a technically equivalent alternative to established BCHDs, maintaining pressure below 5.4 N. Future research should explore the impact of different contact forces on performance and comfort, and the integration of force control in modified spectacles. This study indicates that the la belle BC D50/70 is a viable alternative that meets audiological practice requirements.

Investigation of hearing aid users'speech understanding in noise and their spectral-temporal resolution skills

Purpose:Our study aims to compare speech understanding in noise and spectral-temporal resolution skills with regard to the degree of hearing loss,age,hearing aid use experience and gender of hearing aid users.Methods:Our study included sixty-eight hearing aid users aged between 40-70 years,with bilateral mild and moderate symmetrical sensorineural hearing loss.Random gap detection test,Turkish matrix test and spectral-temporally modulated ripple test were implemented on the participants with bilateral hearing aids.The test results acquired were compared statistically according to different variables and the correlations were examined.Results:No statistically significant differences were observed for speech-in-noise recognition,spectraltemporal resolution among older and younger adults in hearing aid users(p>0.05).There wasn’t found a statistically significant difference among test outcomes as regards different hearing loss degrees(p>0.05).Higher performances were obtained in terms of temporal resolution in male participants and participants with more hearing aid use experience(p<0.05).Significant correlations were obtained between the results of speech-in-noise recognition,temporal resolution and spectral resolution tests performed with hearing aids(p<0.05).Conclusion:Our study findings emphasized the importance of regular hearing aid use and it showed that some auditory skills can be improved with hearing aids.Observation of correlations among the speechin-noise recognition,temporal resolution and spectral resolution tests have revealed that these skills should be evaluated as a whole to maximize the patient’s communication abilities.

ROBUST ACOUSTIC SOURCE LOCALIZATION FOR DIGITAL HEARING AIDS IN NOISE AND REVERBERANT ENVIRONMENT

A new method in digital hearing aids to adaptively localize the speech source in noise and reverberant environment is proposed. Based on the room reverberant model and the multichannel adaptive eigenvalue decomposition （MCAED） algorithm, the proposed method can iteratively estimate impulse response coefficients between the speech source and microphones by the adaptive subgradient projection method. Then, it acquires the time delays of microphone pairs, and calculates the source position by the geometric method. Compared with the traditional normal least mean square （NLMS） algorithm, the adaptive subgradient projection method achieves faster and more accurate convergence in a low signal-to-noise ratio （SNR） environment. Simulations for glasses digital hearing aids with four-component square array demonstrate the robust performance of the proposed method.

Efficient design method of non-uniform cosine modulated filter bank for digital hearing aids

To promote the performance of the traditional multichannel filter bank which leads to speech quality degradation,an efficient design method of the non-uniform cosine modulated filter bank（CMFB） based on the audiogram for digital hearing aids is proposed. First, a low-pass prototype filter is designed by the linear iterative algorithm. Secondly,the uniform CMFB is achieved on the basis of the principle formulas. Then, the adjacent channels of a uniform filter bank which have low or gradual slopes are merged according to the trend of audiogram of the hearing impaired person. Finally,the corresponding non-uniform CMFB is obtained. Simulation results show that the signal processed by the proposed filter bank is similar to the original signal in a time-domain waveform and spectrogram without significant distortion or difference. The speech quality results show that the personal evaluation of speech quality（PESQ） of non-uniform CMFB is 35% higher than that of the traditional design, and the hearing-aid speech quality index（HASQI） increases by about 40%.

Auditory perceptual efficacy of nonlinear frequency compression used in hearing aids:A review

Many patients with sensorineural hearing loss have a precipitous high-frequency loss with relatively good thresholds in the low frequencies.This present paper briefly introduces and compares the basic principles of four types of frequency lowering algorithms with emphasis on nonlinear frequency compression(NLFC). A review of the effects of the NLFC algorithm on speech and music perception and sound quality appraisal is then provided. For vowel perception, it seems that the benefits provided by NLFC are limited, which are probably related to the parameter settings of the compression. For consonant perception, several studies have shown that NLFC provides improved perception of highfrequency consonants such as/s/and/z/. However, a few other studies have demonstrated negative results in consonant perception. In terms of sentence recognition, persistent use of NLFC might provide improved performance. Compared to the conventional processing, NLFC does not alter the speech sound quality appraisal and music perception as long as the compression setting is not too aggressive. In the subsequent section,the relevant factors with regard to NLFC settings, time-course of acclimatization, listener characteristics, and perceptual tasks are discussed.Although the literature shows mixed results on the perceptual efficacy of NLFC, this technique improved certain aspects of speech understanding in certain hearing-impaired listeners. Little research is available on speech perception outcomes in languages other than English. More clinical data are needed to verify the perceptual efficacy of NLFC in patients with precipitous high-frequency hearing loss. Such knowledge will help guide clinical rehabilitation of those patients.

Verification and validation of hearing aids:Opportunity not an obstacle

Verification and validation are objective and subjective measurements of hearing aid function. Many studies have provided rationales for performing these measurements as necessary for hearing aid practitioners to provide the highest level of care. Several researchers have suggested that completing these measurements as part of routine clinical care will reduce the number of return visits, reduce the number of aids returned for credit, and increase patient satisfaction. The purpose of this review article is to provide background, method and rationale for practitioners to use these measurements to improve their practice of hearing healthcare.

Speech intelligibility and auditory perception of pre-school children with Hearing Aid,cochlear implant and Typical Hearing

Purpose:There is a growing interest in speech intelligibility and audito ry perception of deaf children.The aim of the present study was to compare speech intelligibility and auditory perception of pre-school children with Hearing Aid(HA),Cochlear Implant(Cl),and Typical Hearing(TH).Methods:The research design was descriptive-analytic and comparative.The participants comprised 75 male pre-school children aged 4-6 years in the 2017-2018 from Tehran,Iran.The participants were divided into three groups,and each group consisted of 25 children.The first and second groups were respectively selected from pre-school children with HA and CI using the convenience sampling method,while the third group was selected from pre-school children with TH by random sampling method.All children completed Speech Intelligibility Rating and Catego ries of Auditory Performance Questionnaires.Results:The findings indicated that the mean scores of speech intelligibility and auditory perception of the group with TH were significantly higher than those of the other groups(P<0.0001).The mean scores of speech intelligibility in the group with CI did not significantly differ from those of the group with HA(P<0.38).Also,the mean scores of auditory perception in the group with CI were significantly higher than those of the group with HA(P<0.002).Conclusion:The results showed that auditory perception in children with CI was significantly higher than children with HA.This finding highlights the importance of cochlear implantation at a younger age and its significant impact on auditory perception in deaf children.

Research on Nonlinear Frequency Compression Method of Hearing Aid with Adaptive Compression Ratio

To make full use of the residual audible frequency band of hearing-loss patients and improve the intelligibility of speech,an adaptive nonlinear frequency compression(NFC)algorithm is proposed,which amplifies signals below the cutoff frequency while compresses signals above the cutoff frequency.Firstly,high-frequency signals are decomposed to critical band signals according to the BARK scale.Secondly,the global compression ratio is determined according to the patient's cutoff frequency and maximum audible frequency.Thirdly,the sub-band compression ratio is adaptively determined based on the global compression ratio and normalized average energy of subband signals.Finally,the high frequency signals are transposed to low frequency bands by compression mapping,and the phases are adjusted to the same as the original low frequency signals.Experimental results of speech intelligibility with nine subjects demonstrate that compared to conventional amplitude amplification and nonlinear frequency compression algorithms the proposed algorithm significantly improves the intelligibility of initials and sentences,while not affects the intelligibility of finals and tones significantly.

A comparison of the quality of life of parents of children using hearing aids and those using cochlear implants

Objective:The goal of this study was to evaluate the quality of life of parents of children who use hearing aids(HA)with those who use cochlear implants(CI)in the Indian context and document any differences found.Methods:The Kannada version of the AQoL-4D was administered in a modified fashion to 131 parents(87 HA and 44 CI).Sociodemographic details were collected for supplemental information on the intervention strategy used.Results:A total of 49 parents(29 HA and 20 CI)responded to the questionnaire sent.The mean total scores for both the groups were similar(HA group=17.9(SD=5.5),CI group=17.2(SD=3.4)),as was the score for the first subscale(HA group=8.6(SD=2.9);CI group=8.5(SD=2.6))of the AQoL-4D.No significant differences were found between the two groups on either scores[Total Score:U(N_(HA)=29,NCI=20)=280.5,z=0.194,p>0.05;Subscale 1 Score:U(N_(HA)=29,NCI=20)=281.5,z=-0.176,p>0.05].The degree of hearing loss in the hearing aid group was equivalent to that of the cochlear implant group but this did not appear to influence parental quality of life.Conclusion:Parents of children with hearing aids and cochlear implants appear to be similar on several psychosocial factors in the realms of functional,social,and psychological well-being.In terms of parental quality of life,hearing aids and cochlear implants appear to be equally effective intervention techniques.

SOUND SOURCE LOCALIZATION OF DIGITAL HEARING AIDS USING WAVELET BASED MULTIVARIATE STATISTICAL METHOD

The letter proposed a sound source localization method of digital hearing aids using wavelet based multivariate statistics with the Generalized Cross Correlation (GCC) algorithm. Haar wavelet is used to decompose GCC sequences and extract four wavelet characteristics. And then, Hotelling T2 statistical method is used to fuse the four wavelet characteristics. The statistical value is used to judge the number of sound sources and obtain corresponding time delay estimation which is used to localize the position of sound source. The experimental results show that the proposed method has better robustness in an environment with severe noise and reverberation. Meanwhile, the complexity of al-gorithm is moderate, which is available for sound source localization of hearing aids.

Characterization of the Ear Canal Bacterial Flora Present in Hearing Aids (HA) Wearing Subjects

The use of hearing aids (HA) is considered a predisposing factor for ear microbial infections. We undertook this study to compare the presence and nature of the microbial flora inhabiting of ears of HA and non-HA (nHA) users. Swab samples of the ears of HA and nHA users were collected from the Institute of Otolaryngology, “Cattolica del Sacro Cuore” University “Agostino Gemelli”, Rome, Italy. Swab samples were taken from the ear canal of 57 HA and 33 nHA users. The components of the microbial flora present on each swab sample were identified and characterized at the level of species. A total of 41 different bacterial species were identified. A statistically significant prevalence of polymicrobial communities was found in ears presenting signs of inflammation (2.5 ± 1.7 vs 2.1 ± 1.3;P = 0.02) and in HA users (2.3 ± 1.2 vs 1.7 ± 1.0;P = 0.002). Few putative pathogens were detected. Candida albicans spp. was not isolated in our study. A small number of swab samples presented no microbial growth. Bacterial species isolated from HA users with and without inflammation were assayed for the ability to form biofilm. Among gram-positive and gram-negative bacteria, S. aureus, CoNS, P. aeruginosa and K. pneumoniae were found to be strong biofilm producers. S. aureus and P. aeruginosa, isolated only from the ears of HA and nHA users presenting signs of inflammation, were further analyzed for their antibiotic-resistance profile and characterized by the Multilocus Sequence Typing (MLST) assay. The highest rates of antibacterial resistance were in S. aureus to penicillin (75.5%) and in P. aeruginosa, to amoxicillin-clavulanic acid, cefotaxime, ertapenem, tigecycline and trime-thoprim-sulfamethoxazole (100%). Moreover, three S. aureus strains (37.5%) were methicillin-resistant (MRSA). Of the eight S. aureus isolates, we identified six sequence types (ST) indicating that 75% are likely independent clones. For what it concerned P. aeruginosa, six different STs were assigned. Interestingly, two out of the six strains presented newly identified ST values. This study sheds new light on the combined effect of the presence of HA devices and signs of external ear inflammation on the composition of the ear bacterial flora. Our results reinforce the need to practice careful hygiene of HA devices to prevent serious ear canal infections.

Sensori-Neural Hearing Loss Client’s Performance with Receiver-In-Canal (RIC) Hearing Aids

Background: Individuals fitted with hearing aids complain of the unnatural sound quality of their voice, other internally generated sounds such as chewing and swallowing sounds “hollow”, “muffled” sounds. Receiver-In-Canal hearing aids are favored due to small size, discrete appearance and ability to minimize occlusion. Aim: To compare the performance of Receiver-In-Canal (RIC) to traditional ear tip (ET), ear moulds (EM) fittings using Functional gain measures. Method: Ten subjects with flat moderately severe sensori neural hearing loss participated in the study. Subjective unaided and aided measures for digital BTE hearing aids with ear tip, ear mould or Receiver-In-Canal for pure tones of 250 Hz, 500 Hz, 1000 Hz, 2000 Hz, 4000 Hz were obtained. Results and Discussion: Higher scores were obtained with Receiver-In-Canal fitting on Functional gain measures. No significant difference between all the three conditions was obtained at low frequencies especially at 500 Hz, as Receiver-In-Canal hearing aids attenuate low frequency sounds automatically when the ear is left open (up to 30 dB less amplification at 500 Hz) especially for hearing in noisy situations. Conclusion: The results suggest that Receiver-In-Canal fittings are an effective means of overcoming the major barriers to the acceptance of amplification and further suggest the clinical importance of subjective measures in measuring aided benefit of open-fit devices in the rehabilitation of person’s with moderately severe to severe SN hearing loss.

Etiologies of the Hearing Loss and Their Impacts at the Patients Worn Hearing Aid in the International Center of Hearing Correction in Abidjan (ICHC)

Objective: Determine the etiologies and their impacts of hearing loss at the patients’ worn hearing aid in the international center of hearing correction in Abidjan (ICHC). Material and Method: The study is of transverse and analytical type realized in the ICHC from July 1999 to June 2010. It concerned the files of patients’ worn hearing aid in the center. The patients worn initially in another center but followed in the ICHC were excluded. Data were collected from medical files of patients and concerned etiologies, age, type, degree of hearing loss as well as the prosthetic gains and the satisfaction. Results: Fifteen etiologies were listed with in first three rows the meningitis (17.9%) the presbyacusis (17.5%) and chronic otitis media (12.1%). The degrees of hearing loss in the seven etiologies most frequent were severe and profound in 87.6% of cases to the right and 82.8% to the left. The prosthetic pure tonal gain was significant in case of sound trauma and sudden hearing loss. The prosthetic speech reception threshold gain was only significant in case of presbyacusis and sudden hearing loss. The satisfaction of hearing aids was significant in case of presbyacusis, sudden hearing loss and the sound trauma. Conclusion: The main clauses etiologies were the meningitis and the presbyacusis. The tonal and speech prosthetic gain were significant in case of sudden hearing loss.

Efficacy of Remote Hearing Aids Programming Using Teleaudiology: A Systematic Review

Telemedicine is defined as a system that allows healthcare workers to deliver their services and consultations to the patients remotely without the need of their physical presence within academic institutions, hospitals, and medical clinics aiming to reduce the personal contact and limiting it to the need only. The field of telemedicine is growing every day and facilitating more flexible services for patients around the world especially during COVID-19 pandemic. Methods: This systematic review was conducted according to the Cochrane Handbook for Systematic Reviews. Database search was made on several databases including PubMed/Medline, Scopus, Web of Science, Publons, EMBASE, and Google Scholar using the relevant keywords. Inclusion criteria for articles in our study included the following original research (primary research articles), addressing the efficacy of teleaudiology for hearing aids programming and satisfaction of patients. Results: Seven studies were included in this systematic review article. Included studies were assessed using Cochrane handbook guidelines. Conclusions: The results of this work based on the currently available literature denote that remote programming for the hearing aids using modern technology is effective and provide comparable results with the standard face-to-face clinic programming, even for patients with no previous experience in hearing aids fitting in either of in-person physical presence programming or remotely over the internet using teleconferencing which is known as teleaudiology. Most of the results were positive and support the continuity to develop better facilities to improve the teleaudiology to be an essential part of hearing aids programming with its different types. Minimal results provided negative impact from the participating patients, this resulted because of the non-upgraded infrastructure and facilities of the audiology clinic or the personal computer of the patient in his home/ workplace or both sides don’t have enough specifications to smoothly perform this modern approach.

Hearing Aid

A man realized that he needed to purchase ahearing aid, but he was unwilling to spend muchmoney. "How much do they run?"he asked theclerk. "That depends," said. the salesman. "Theyrun from 2 to 2000."

Designing Wireless Charger Circuit for Hearing Aids Using Radio Frequency Waves

In this paper, an attempt has been made to produce a recipient system of wireless charge for a simple hearing aid so that electrical signal would be generated through detecting and receiving radio frequency waves (RF). The purpose of this design is to receive wireless charge for hearing aids and basically for any electronic device which is not required to a high energy for being setup. In this study, it has been demonstrated that as the amount of radio receiving energy increases, distance of receiver from antenna should be decreased;otherwise, either maximum amount of the receiving energy, or signal power density of the transmitter should be increased. Since it is impossible to be performed, it is decided to set up an energy receiving system constructed by rectenna and charge Circuit and to adjust their parameters to provide energy requirements for a device with low-power consumption. In this paper, different components of an energy receiving system from radio frequency band have been mentioned and a diagram block has been suggested. Subsequently, input impedance of designed antenna has been adjusted by provided relations. This impedance should be adjusted with the total impedance of regarded hearing aid Circuit by which the highest amount of received signal power is transferred to the battery of hearing aids. Received signal is converted to a dc voltage by rectifier diode. Finally, by applying a voltage regulator which has been designed using a common-collector amplifier not only the output voltage is kept constant, but the power is also strengthened. The battery of the hearing aids will be charged using the obtained power and voltage.

Cutaneous sensory nerve as a substitute for auditory nerve in solving deaf-mutes' hearing problem: an innovation in multi-channel-array skin-hearing technology

The current use of hearing aids and artificial cochleas for deaf-mute individuals depends on their auditory nerve. Skin-hearing technology, a patented system developed by our group, uses a cutaneous sensory nerve to substitute for the auditory nerve to help deaf-mutes to hear sound. This paper introduces a new solution, multi-channel-array skin-hearing technology, to solve the problem of speech discrimination. Based on the filtering principle of hair cells, external voice sig- nals at different frequencies are converted to current signals at corresponding frequencies using electronic multi-channel bandpass filtering technology. Different positions on the skin can be stimulated by the electrode array, allowing the perception and discrimination of external speech signals to be determined by the skin response to the current signals. Through voice frequen- cy analysis, the frequency range of the band-pass filter can also be determined. These findings demonstrate that the sensory nerves in the skin can help to transfer the voice signal and to dis- tinguish the speech signal, suggesting that the skin sensory nerves are good candidates for the replacement of the auditory nerve in addressing deaf-mutes＇ hearing problems. Scientific hearing experiments can be more safely performed on the skin. Compared with the artificial cochlea, multi-channel-array skin-hearing aids have lower operation risk in use, are cheaper and are more easily popularized.

Development of an Auditory Rehabilitation Training Programme for Hearing Impaired Adults in Saudi Arabia

Hearing impairment is one of the most common sensory disabilities, affecting millions of people worldwide. The current management of acquired hearing impairment in adults is usually in the form of hearing aids. An auditory rehabilitation programme may or may not be provided although literature suggests that such programmes may enhance hearing aid benefits. This study was conducted in an Arabic-speaking country, specifically Saudi Arabia, and is the first to develop an auditory rehabilitation intervention programme in the Arabic language that focuses on working age adults who are new hearing aid users. Randomised intervention study design. Thirty-five participants with mild to severe acquired hearing loss （intervention group n = 18, control group n = 17）. Significant changes were found in the performance of the intervention group in the Minimal Audible Capabilities （MAC） test, a lip reading test and the Glasgow Hearing Aid Benefit Profile （GHABP） questionnaire when compared with the control group. No significant difference was found in speech test scores between the two groups. A short individualised auditory rehabilitation intervention programme can yield a significant improvement in the performance of hearing impaired adults by enhancing the benefits of hearing aid use.

Effect analysis of unilateral deaf adults wearing bone-conduction hearing aids:A case report

The prevalence of unilateral deafness(SSD)or asymmetric hearing loss(AHL)among patients with hearing impairments ranges from 7.2%to 15.0%,indicating a relatively significant proportion.However,these individuals often overlook their hearing loss,resulting in delayed or inadequate treatment.This oversight can lead to a lack of binaural summation and squelch effect,as well as the head shadow effect,which can significantly impact their speech recognition and sound localization abilities,especially in noisy environments.Recently,a groundbreaking Sound Bite™Pinyin®Bone Conduction Hearing Aid(HA)device has been has been introduced as a viable alternative to traditional percutaneous stimulation hearing assistance devices.This innovative device harnesses bone conduction technology to convey sound vibrations directly to the inner ear via the bones of the jaw and skull,effectively bypassing the air conduction pathway that is commonly compromised in individuals with hearing loss.This report details the evaluation and adjustment process of a HA device worn by a 31-year-old female patient who suffers from a congenital ossicular chain deformity in her right ear,while maintaining normal hearing in her left ear.The report comprehensively covers the hearing thresholds of the 31-year-old female patient on the day of fitting the hearing aid and one month later.It also presents assessments of the hearing aid’s performance through the Abbreviated Profile of Hearing Aid Benefit(APHAB)questionnaire,conducted three days after adjustment,one month later,and one year later.Furthermore,the report details the evaluation of the patient’s sound localization ability,comparing her performance before and after wearing the hearing aid device.Additionally,it includes measurements of her speech recognition ability for monosyllabic words and Yang Yang Ge words,which are specific tests in the Chinese language,conducted two years after the initial fitting of the hearing aid.The discovery that bone-anchored hearing devices can significantly enhance hearing thresholds in patients with unilateral conductive hearing loss represents a significant milestone.These devices not only improve speech recognition ability but also enhance sound localization in noisy environments.This improvement is accompanied by a high level of subjective satisfaction among patients,indicating a positive impact on their overall quality of life.