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/).

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.

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.

不同助听模式下儿童言语康复效果观察

观察不同助听模式下儿童言语康复效果。随机挑选苏州大学附属儿童医院2022年1月—2023年8月收治的60例听障儿童,且分为A组、B组,每组患儿数量均为30例。A组使用单侧人工耳蜗植入,B组使用双耳双模式,对两组患儿CAP评分、SIR评分、SSQ-P评分、语言康复效果进行观察。结果显示,助听前,两组患儿CAP评分情况比较无显著差异(P>0.05);助听后,B组患儿CAP评分要明显高于A组(P<0.05)。助听前,两组患儿SIR评分情况比较无显著差异(P>0.05);助听后,B组患儿SIR评分要明显高于A组(P<0.05)。B组患儿SSQ-P总分要明显高于A组(P<0.05)。A组患儿言语康复有效率为76.67%,B组患儿言语康复有效率为93.33%,B组患儿言语康复效果明显好于A组(P<0.05)。研究发现,听障儿童利用双耳双模式的助听模式具有较好的言语康复效果,临床推广应用价值高。

言语测听与助听器干预及效果评估

言语测听是一种以标准化言语信号为基础的听力学测试方法,旨在评估听障患者对言语的辨别和理解能力。相比纯音测听,言语测听不仅能反映患者是否能听懂言语,还能反映患者的中枢听觉功能、认知功能等整合能力。言语测听在听力干预及康复中极为重要,尤其是在助听器干预方面。本文重点阐述言语测听在助听器验配前后及听力康复效果评估全过程中的应用,包括预测听障患者助听效果、辅助精准调试、评估助听干预效果、制订个性化康复方案以及提供长期随访量化指标等,旨在整体提升听障患者对听力干预效果的满意度。此外,未来的言语测听将借助个性化康复、社会参与和心理支持等方面的新技术和模式,进一步提升听障患者的生活质量和听力康复效果。

耳膜激振式压电作动器的设计与测试

为解决传统助听器高频增益受限及中耳植入物需侵入性手术的问题,文中设计、制作和测试了一种直接驱动耳膜的压电作动器。该作动器是一种新型的听觉假肢,融合了完全耳道式助听器的放置方式与中耳植入物的音质。作动器的前端直接激励耳膜,补偿患者的听力损失。针对压电叠堆存在输出位移不足的问题,引入了复合二级位移放大器,并采用多目标遗传算法对其位移放大比进行了优化。为优化作动器的频率特性,建立了作动器-人耳耦合力学模型,通过有限元分析确定了作动器的最佳结构参数。制作出作动器样机,并进行了测试试验,评估其听力补偿性能。结果表明:该作动器具有工作频带宽(0.1~10 kHz)、谐波失真度小(THD≤0.12%)、无需侵入性手术及高频性能优异的优点。因此,该作动器适用于耳膜激振的听损补偿,为感音神经性听力损伤的临床治疗提供一种新的方案。

双耳双模式干预者言语情感识别研究

目的研究双耳双模式干预者言语情感识别能力及特点,为单侧人工耳蜗植入(CI)者的听觉言语康复提供参考。方法招募17例双模式干预语后聋成人参与研究,20例正常听力成人及18例单侧CI语后聋成人作为对照组,采用自编的情感识别测试软件对三组言语情感识别能力进行测试。结果①相较于正常听力者,双模式干预者和单侧CI者情感识别的正确率降低,反应时间延长(P<0.05);②双模式干预者和单侧CI者情感识别率无显著差异(P>0.05),但双模式干预者的反应时间比单侧CI者缩短(P<0.05);③双模式干预者在女声材料中的反应时间比男声材料显著快0.14 s。双模式干预者对中性情感的识别率最高,为96.67%;对恐惧情感的识别率最低,为41.82%。结论相较于正常听力者,汉语双模式干预者的言语情感识别能力仍有明显缺陷,但比单侧CI者更好。汉语CI者非植入耳配戴HA可以改善情感识别能力。