Real-ear measures (REM) are recommended in hearing aid fitting. However, reports suggest that only approximately 30 percent of audiologists routinely perform REM. Rationale (or excuses) for not performing REM are numerous, but little peer-reviewed research has been conducted to support or refute the use of REM in regards to benefit in speech understanding and subjective quality of fitting.
Patients with unilateral hearing loss can present with variable issues. Much is dependent on the severity of the hearing loss (threshold and speech understanding), age of onset, hearing status of contralateral ear, and presence of comorbidities (e.g., vertigo, cognitive status, central auditory processing, hyperacusis, tinnitus, disease/pathology/disorder, etc.). Adult-onset severe-to-profound unilateral sensorineural hearing loss with normal hearing sensitivity in the contralateral ear presents a unique dilemma.
Barker et al (2015) report that evidence indicates hearing aid use can reduce rates of depression and anxiety. Further, hearing aid use can improve emotional stability and independence, can reduce social isolation, and improve quality of life. However, non-use after acquisition ranges from 5 to 40 percent. Of note, non-adherence is not a unique problem relating to hearing aids, non-adherence occurs across patients associated with multiple health-care disciplines.
Brons et al (2015) examined whether dynamic range compression and noise reduction work in tandem or in opposition to each other. They report that the literature on the interaction of these two strategies is scarce. The role of noise reduction is to “reduce hearing aid gain for background noises, while preserving gain for speech…” and the role of dynamic compression is to alter the hearing aid gain, based on the input level so as to fit sound levels into the dynamic range of the wearer.
Cochlear Implants, Normal Hearing, and Single-Sided Deafness
Many reports in the literature have demonstrated that cochlear implants are a reasonable, successful, and viable option for people with severe-to-profound unilateral hearing loss (Arndt et al 2011; Baguley, 2010; Buechner et al 2010; Popelka et al 2010; Van Zon et al 2015; Van De Heyning et al 2008).
