Treatment

Treatment

Is “Mediocrity” the New Standard Protocol?

Based on returned surveys from 1,141 experienced hearing aid users and 884 new users, Kochkin et al (2010) reported that "quality control at the point of dispensing has not kept pace with technological improvements…there is great variability in the hearing aid fitting process, and it appears that critical aspects of the fitting protocol are not followed, despite general consensus among all the professional societies…." 

The authors noted the top 10 key mistakes made by dispensing professionals included:

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Cochlear Implants, Aging, and Speech-in-Noise

Fullgrabe and Moore (2015) recently reported that (even) for older people with normal hearing, speech-in-noise ability does indeed, decline with age. Therefore, Fullgrabe and Moore recommended tests beyond the audiogram to assess older people and their hearing/listening ability, and they reported it is necessary to take age into account, when addressing the audiological needs of older patients.

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Hearing Aids Compared to Combination Devices in Tinnitus Management

Henry et al (2015) investigated whether typical hearing aid fittings for tinnitus are more effective than hearing aids with built in noise/sound generators. Of note, the authors were unable to find previous investigations that addressed these exact same parameters. Parazzini et al (2011) determined that tinnitus therapy was equally effective with sound generators and open-fit hearing aids and, indeed, the net improvement across the two different sound sources was identical and indistinguishable (see Beck, 2011). 

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Real-Ear Measures: Status Quo 2015

Sanders et al (2015) report that not only are real-ear measures (REMs) an important part of all hearing aid best practice guidelines, REMs are simply a necessary part of each fitting. They note, as a result of acquiring REMs, it is likely “considerable subsequent adjustments” would need to be made to bring the hearing aid fitting into compliance with the prescription selected, such as NAL-NL2 or DSL v5.0.

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Acoustic Neuroma Patient Needs and Concerns

Leong and Lesser (2015) reported that 880 members of the British Acoustic Neuroma Association were e-mailed a survey of which 480 were returned from people who had been diagnosed and treated for acoustic neuroma, and 465 had complete data, used for analysis. Acoustic neuroma treatment ranged from surgical excision for 47 percent of the respondents, stereotactic radiosurgery was the treatment for 25 percent, some 23 percent  had serial MRIs, and the remaining 5 percent had surgery and stereotactic radiosurgery. 

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NAL vs DSL in Children with Severe-to-Profound Hearing Loss

Ching et al (2015) report on prescribed and measured gain, as prescribed by NAL-NL1 and DSL v5, using the Phonak Naida V SP hearing aid. Sixteen children (aged 7 to 17 years) with severe-to-profound sensorineural hearing loss (SNHL) participated. The Speech Intelligibility Index (SII) and estimated loudness of the fittings were calculated with input loudness levels of 50 (low), 65 (medium), and 80 dB (high) SPL. Of note, NAL aims to maximize speech intelligibility, whereas DSL aims to normalize loudness.

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Cochlear Implants and Pediatric Post-Op Pain and Dizziness

Birman, Gibson, and Elliott (2015) evaluated post-operative surgical pain in children (ages 16 years and younger), following cochlear implant surgery via assessment of analgesia use. Between August 2010 and November 2012, 98 children were implanted, 61 were reported. Of the 61 children who were reported, 19 children required no pain relief and 42 children used paracetamol (aka acetaminophen in the United States) Additionally, 1 child required oxycodeine for 1 day (following bilateral implant surgery), and codeine phosphate was used by 1 child for 3 days.

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Frequency Lowering for Patients with Mild-to-Moderate SNHL?

Alexander, Kopun, and Stelmachowicz (2014) report their results with regard to two frequency lowering protocols: (1) frequency transposition (FT) via the Widex Inteo (source region spanned 4.2 to 7 kHz, target region spanned 2.1 to 3.5 kHz) and (2) non-linear frequency compression (NFC) via the Phonak Naida (source region was spanned 4 to 6 kHz and target region was 4 to 4.7 k Hz).

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Non-Linear Frequency Compression and Speech Identification in Children

Hillock-Dunn et al evaluated 17 children (ages 9 to 17 years) with mild-to-profound sensorineural hearing loss (SNHL) with respect to two measures: (1) consonant identification in quiet and (2) spondee identification in noise. The researchers provided the Phonak Naida V SP “laboratory” non-linear frequency compression (NLFC) hearing aid, which allows NLFC to be turned on and off in the same device. Hearing aids were programmed to DSL v 5.0 targets.

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Re-Implanting Cochlear Implants

Mahtani et al (2014) report that the experience of some 30 adults (32 ears) who had re-implantation of their cochlear implants (CI) due to device failure for 17 patients, infection for 4 patients, pain for 2 patients, change to multi-channel device for 2 patients, head trauma for 2 patients, displaced device for 2 patients, partial insertion for 1 patient, and unknown for 2 patients.

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