Toward an Individual Binaural Loudness Model for Hearing Aid Fitting and Development.
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ABSTRACT:
SUBMITTER: Pieper I
PROVIDER: S-EPMC8258351 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:ObjectiveThe purpose of this study was to design and to verify a new hearing-aid fitting strategy (Aescu HRL-1) based on the acoustic features of Mandarin. The subjective and objective outcomes were compared to those fitted with NAL-NL1 (National Acoustic Laboratory Non-Linear, version1) in Mandarin-speaking hearing-aid users.DesignFifteen subjects with sensorineural hearing loss participated in this preliminary study. Each subject wore a pair of four-channel hearing aids fitted with the Aescu HRL-1 and NAL-NL1 prescriptions alternatively for 1 month. Objective and subjective tests including the Mandarin Monosyllable Recognition Test (MMRT), Mandarin Hearing in Noise Test (MHINT), International Outcome Inventory for Hearing Aids (IOI-HA), and a sound-quality questionnaire were used to evaluate the performance of the two prescriptions.ResultsThe mean MMRT scores were 79.9% and 81.1% for NAL-NL1 and Aescu HRL-1 respectively. They are not statistically different. The corresponding MHINT signal-to-noise ratios were 0.87 and 0.85 dB, also, no significant difference was found between these two strategies. However, in subjective questionnaires, overall, the sound-quality and IOI-HA scores were higher for Aescu HRL-1.ConclusionsThe speech recognition performance based on Aescu HRL-1 is as good as that of NAL-NL1 for Mandarin-speaking hearing-aid users. Moreover, the subjects generally responded that Aescu HRL-1 provides a more natural, richer, and better sound quality than does NAL-NL1.
| S-EPMC3835675 | biostudies-literature
Project description:Dissatisfaction with the sound of one's own voice is common among hearing-aid users. Little is known regarding how hearing impairment and hearing aids separately affect own-voice perception. This study examined own-voice perception and associated issues before and after a hearing-aid fitting for new hearing-aid users and refitting for experienced users to investigate whether it was possible to differentiate between the effect of (unaided) hearing impairment and hearing aids. Further aims were to investigate whether First-Time and Experienced users as well as users with dome and mold inserts differed in the severity of own-voice problems. The study had a cohort design with three groups: First-Time hearing-aid users going from unaided to aided hearing (n = 70), Experienced hearing-aid users replacing their old hearing aids (n = 70), and an unaided control group (n = 70). The control group was surveyed once and the hearing-aid users twice; once before hearing-aid fitting/refitting and once after. The results demonstrated that own-voice problems are common among both First-Time and Experienced hearing-aid users with either dome- or mold-type fittings, while people with near-normal hearing and not using hearing aids report few problems. Hearing aids increased ratings of own-voice problems among First-Time users, particularly those with mold inserts. The results suggest that altered auditory feedback through unaided hearing impairment or through hearing aids is likely both to change own-voice perception and complicate regulation of vocal intensity, but hearing aids are the primary reason for poor perceived sound quality of one's own voice.
| S-EPMC7887686 | biostudies-literature
Project description:The primary purpose of the present experiment was to test whether the binaural equal-loudness-ratio hypothesis (i.e., the loudness ratio between monaural and binaural tones presented at the same Sound Pressure Level, SPL, is independent of SPL) holds for hearing-impaired listeners with bilaterally symmetrical hearing losses. The outcome of this experiment provided a theoretical construct for modeling loudness-growth functions. A cross-modality matching task between string length and tones was used to measure three loudness functions for eight listeners: two monaural (left and right) and one binaural. A multiple linear regression was performed to test the significance of presentation mode (monaural vs binaural and left vs right), level, and their interaction. Results indicate that monaural loudness functions differ between the ears of two listeners. The interaction between presentation mode (binaural/monaural) and level was significant for one listener. Although significant, these differences were quite small. Generally, the binaural equal-loudness-ratio hypothesis appears to hold for hearing-impaired listeners. These data also indicate that loudness-growth functions in two ears of an individual are more similar than loudness-growth functions in ears from different listeners. Finally, it is demonstrated that loudness-growth functions can be constructed for individual listeners from binaural level difference for equal-loudness data.
| S-EPMC2723906 | biostudies-other
Project description:ObjectivesUsher syndrome is the leading cause of hereditary deaf-blindness. Most patients with Usher syndrome type IIa start using hearing aids from a young age. A serious complaint refers to interference between sound localisation abilities and adaptive sound processing (compression), as present in today's hearing aids. The aim of this study was to investigate the effect of advanced signal processing on binaural hearing, including sound localisation.Design and participantsIn this prospective study, patients were fitted with hearing aids with a nonlinear (compression) and linear amplification programs. Data logging was used to objectively evaluate the use of either program. Performance was evaluated with a speech-in-noise test, a sound localisation test and two questionnaires focussing on self-reported benefit.ResultsData logging confirmed that the reported use of hearing aids was high. The linear program was used significantly more often (average use: 77%) than the nonlinear program (average use: 17%). The results for speech intelligibility in noise and sound localisation did not show a significant difference between type of amplification. However, the self-reported outcomes showed higher scores on 'ease of communication' and overall benefit, and significant lower scores on disability for the new hearing aids when compared to their previous hearing aids with compression amplification.ConclusionsPatients with Usher syndrome type IIa prefer a linear amplification over nonlinear amplification when fitted with novel hearing aids. Apart from a significantly higher logged use, no difference in speech in noise and sound localisation was observed between linear and nonlinear amplification with the currently used tests. Further research is needed to evaluate the reasons behind the preference for the linear settings.
| S-EPMC5516239 | biostudies-literature
Project description:Longitudinal electronic health records from a large sample of new hearing-aid (HA) recipients in the US Veterans Affairs healthcare system were used to evaluate associations of fitting laterality with long-term HA use persistence as measured by battery order records, as well as with short-term HA use and satisfaction as assessed using the International Outcome Inventory for Hearing Aids (IOI-HA), completed within 180 days of HA fitting. The large size of our dataset allowed us to address two aspects of fitting laterality that have not received much attention, namely the degree of hearing asymmetry and the question of which ear to fit if fitting unilaterally. The key findings were that long-term HA use persistence was considerably lower for unilateral fittings for symmetric hearing loss (HL) and for unilateral worse-ear fittings for asymmetric HL, as compared to bilateral and unilateral better-ear fittings. In contrast, no differences across laterality categories were observed for short-term self-reported HA usage. Total IOI-HA score was poorer for unilateral fittings of symmetric HL and for unilateral better-ear fittings compared to bilateral for asymmetric HL. We thus conclude that bilateral fittings yield the best short- and long-term outcomes, and while unilateral and bilateral fittings can result in similar outcomes on some measures, we did not identify any HL configuration for which a bilateral fitting would lead to poorer outcomes. However, if a single HA is to be fitted, then our results indicate that a better-ear fitting has a higher probability of long-term HA use persistence than a worse-ear fitting.
| S-EPMC10467180 | biostudies-literature
Project description:Direct drive hearing devices, which deliver a signal directly to the middle ear by vibrating the tympanic membrane via a lens placed in contact with the umbo, are designed to provide an extension of audible bandwidth, but there are few studies of the effects of these devices on preference, speech intelligibility, and loudness. The current study is the first to compare aided speech understanding between narrow and extended bandwidth conditions for listeners with hearing loss while fitted with a direct drive hearing aid system. The study also explored the effect of bandwidth on loudness perception and investigated subjective preference for bandwidth. Fifteen adult hearing aid users with symmetrical sensorineural hearing loss participated in a prospective, within-subjects, randomized single-blind repeated-measures study. Participants wore the direct drive hearing aids for 4 to 15 weeks (average 6 weeks) prior to outcome measurement. Outcome measures were completed in various bandwidth conditions achieved by reducing the gain of the device above 5000 Hz or by filtering the stimuli. Aided detection thresholds provided evidence of amplification to 10000 Hz. A significant improvement was found in high-frequency consonant detection and recognition, as well as for speech in noise performance in the full versus narrow bandwidth conditions. Subjective loudness ratings increased with provision of the full bandwidth available; however, real-world trials showed most participants were able to wear the full bandwidth hearing aids with only small adjustments to the prescription method. The majority of participants had either no preference or a preference for the full bandwidth setting.
| S-EPMC8060758 | biostudies-literature
Project description:ObjectivesToday, approximately 70 to 80% of hearing aid fittings are made with silicone instant ear tips rather than custom earmolds. Nevertheless, little is known about the impact of instant ear tips on the acoustic coupling between the hearing aid receiver and the individual ear canal, even though it can have a major impact on the overall sound of the hearing aids. This study aimed to investigate the acoustic properties of different instant ear tip types and their across-subject variability, the within-subject reliability of those properties, and the influence of the users' level of experience with ear-tip insertion on the acoustics. Furthermore, subjective ratings of occlusion produced by the ear tips were considered.DesignFive types of instant ear tips (Open, Tulip, Round [2-vent], Round [1-vent], Double Domes) provided by the hearing aid manufacturer Widex were considered in this study. Probe-microphone measurements were performed at the eardrums of 30 participants (60 ears). In the first experiment, the real ear occluded insertion gain and the vent effect (VE) were measured, and the listeners rated the subjective occlusion experienced with each ear tip. In the second experiment, the same measurements were repeated six times per participant. The within-subject variability of the acoustic ear tip properties was investigated as well as the impact of the degree of users' experience with ear tip insertion on the resulting real ear measurements.ResultsAll tested ear tips were, on average, acoustically transparent up to 1 kHz except Double Domes, which were only transparent up to 600 Hz. Distinct VE profiles were found for each ear tip type, but a large across-subject variability was observed for both real ear occluded insertion gain and VE. However, the within-subject reliability was high. The measured VE was highly correlated with the perceived occlusion. Finally, no significant effect of the level of experience in ear tip insertion on the acoustic properties of the ear tips was found, but the within-subject variability was larger in the less experienced group.ConclusionsThese results suggest that the acoustic properties of instant ear tips and their coupling to the individual ear canal impact the resulting hearing aid fitting and should be considered by the hearing care professionals and reflected in the fitting software. The high within-subject reliability indicates that the ear tip acoustics remain stable for the individual in daily use. Finally, real ear measurements should be considered an essential part of the hearing aid fitting process in clinical practice to ensure an optimal fit for the individual hearing aid user.
| S-EPMC9592182 | biostudies-literature
Project description:OBJECTIVES:Previous work has suggested that individual characteristics, including amount of hearing loss, age, and working memory ability, may affect response to hearing aid signal processing. The present study aims to extend work using metrics to quantify cumulative signal modifications under simulated conditions to real hearing aids worn in everyday listening environments. Specifically, the goal was to determine whether individual factors such as working memory, age, and degree of hearing loss play a role in explaining how listeners respond to signal modifications caused by signal processing in real hearing aids, worn in the listener's everyday environment, over a period of time. DESIGN:Participants were older adults (age range 54-90 years) with symmetrical mild-to-moderate sensorineural hearing loss. We contrasted two distinct hearing aid fittings: one designated as mild signal processing and one as strong signal processing. Forty-nine older adults were enrolled in the study and 35 participants had valid outcome data for both hearing aid fittings. The difference between the two settings related to the wide dynamic range compression and frequency compression features. Order of fittings was randomly assigned for each participant. Each fitting was worn in the listener's everyday environments for approximately 5 weeks before outcome measurements. The trial was double blind, with neither the participant nor the tester aware of the specific fitting at the time of the outcome testing. Baseline measures included a full audiometric evaluation as well as working memory and spectral and temporal resolution. The outcome was aided speech recognition in noise. RESULTS:The two hearing aid fittings resulted in different amounts of signal modification, with significantly less modification for the mild signal processing fitting. The effect of signal processing on speech intelligibility depended on an individual's age, working memory capacity, and degree of hearing loss. Speech recognition with the strong signal processing decreased with increasing age. Working memory interacted with signal processing, with individuals with lower working memory demonstrating low speech intelligibility in noise with both processing conditions, and individuals with higher working memory demonstrating better speech intelligibility in noise with the mild signal processing fitting. Amount of hearing loss interacted with signal processing, but the effects were small. Individual spectral and temporal resolution did not contribute significantly to the variance in the speech intelligibility score. CONCLUSIONS:When the consequences of a specific set of hearing aid signal processing characteristics were quantified in terms of overall signal modification, there was a relationship between participant characteristics and recognition of speech at different levels of signal modification. Because the hearing aid fittings used were constrained to specific fitting parameters that represent the extremes of the signal modification that might occur in clinical fittings, future work should focus on similar relationships with more diverse types of signal processing parameters.
| S-EPMC6786927 | biostudies-literature
Project description:OBJECTIVES:The objective was to determine self-adjusted output response and speech intelligibility index (SII) in individuals with mild to moderate hearing loss and to measure the effects of prior hearing aid experience. DESIGN:Thirteen hearing aid users and 13 nonusers, with similar group-mean pure-tone thresholds, listened to prerecorded and preprocessed sentences spoken by a man. Starting with a generic level and spectrum, participants adjusted (1) overall level, (2) high-frequency boost, and (3) low-frequency cut. Participants took a speech perception test after an initial adjustment before making a final adjustment. The three self-selected parameters, along with individual thresholds and real-ear-to-coupler differences, were used to compute output levels and SIIs for the starting and two self-adjusted conditions. The values were compared with an NAL second nonlinear threshold-based prescription (NAL-NL2) and, for the hearing aid users, performance of their existing hearing aids. RESULTS:All participants were able to complete the self-adjustment process. The generic starting condition provided outputs (between 2 and 8?kHz) and SIIs that were significantly below those prescribed by NAL-NL2. Both groups increased SII to values that were not significantly different from prescription. The hearing aid users, but not the nonusers, increased high-frequency output and SII significantly after taking the speech perception test. Seventeen of the 26 participants (65%) met an SII criterion of 60% under the generic starting condition. The proportion increased to 23 out of 26 (88%) after the final self-adjustment. Of the 13 hearing aid users, 8 (62%) met the 60% criterion with their existing hearing aids. With the final self-adjustment, 12 out of 13 (92%) met this criterion. CONCLUSIONS:The findings support the conclusion that user self-adjustment of basic amplification characteristics can be both feasible and effective with or without prior hearing aid experience.
| S-EPMC6289875 | biostudies-literature
Project description:Ecological momentary assessment (EMA) was used in 24 adults with mild-to-moderate hearing loss who were seeking first hearing-aid (HA) fitting or HA renewal. At two stages in the aural rehabilitation process, just before HA fitting and after an average 3-month HA adjustment period, the participants used a smartphone-based EMA system for 3 to 4 days. A questionnaire app allowed for the description of the environmental context as well as assessments of various hearing-related dimensions and of well-being. In total, 2,042 surveys were collected. The main objectives of the analysis were threefold: First, describing the "auditory reality" of future and experienced HA users; second, examining the effects of HA fitting for individual participants, as well as for the subgroup of first-time HA-users; and third, reviewing whether the EMA data collected in the unaided condition predicted who ultimately decided for or against permanent HA use. The participants reported hearing-related disabilities across the full range of daily listening tasks, but communication events took the largest share. The effect of the HA intervention was small in experienced HA users. Generally, much larger changes and larger interindividual differences were observed in first-time compared with experienced HA users in all hearing-related dimensions. Changes were not correlated with hearing loss or with the duration of the HA adjustment period. EMA data collected in the unaided condition did not predict the cancelation of HA fitting. The study showed that EMA is feasible in a general population of HA candidates for establishing individual and multidimensional profiles of real-life hearing experiences.
| S-EPMC8020740 | biostudies-literature