Search

Purpose Assessing cochlear implant (CI)-associated patient outcomes is a focus of implant research. Most studies have analyzed outcomes retrospectively with low patient numbers and few measurement time points. In addition, standardized CI-specific health-related quality of life (HRQoL) instruments have not been used. To address this, we prospectively assessed HRQoL in patients before and after implantation. Methods We assessed HRQoL using the Nijmegen Cochlear Implant Questionnaire (NCIQ), Abbreviated Profile of Hearing Aid Benefit (APHAB), Hearing Participation Scale (HPS), and the Visual Analogue Scale (VAS) in 100 deaf or severely hearing-impaired patients (57 unilaterally deaf and 43 bilaterally deaf) before and 3, 6, and 12 months after cochlear implantation. We compared the results of unilaterally and bilaterally hearing-impaired patients and patients with or without a hearing aid. Principal component (PCA) and exploratory factor analyses (EFA) were also conducted. Results The NCIQ measured improvements in all 6 domains after CI and correlated well with other QoL instruments. The PCA revealed that the NCIQ can be better explained by physical, physical advanced, and socio-psychological components. The APHAB score ameliorated over time, except for the background noise domain. The overall HPS score improved over time, but the hearing handicap subscore significantly decreased. Sociodemographic influences on the questionnaire scores were relatively weak. Conclusion Assessing HRQoL is essential for quantifying the patient outcome after CI. NCIQ scores in our patient cohort showed improved HRQoL in all domains and we recommend that the NCIQ be used as a first-line questionnaire for assessing QoL in hearing-impaired patients after CI.

The Bonebridge implant can be a satisfactory solution for patients with conductive or mixed hearing loss (CHL or MHL), or with single-sided deafness (SSD). The aim of the study was to assess patients’ self-reported benefits with the Bonebridge and characterize the relationships between pre-implantation audiometric data, auditory functioning, and satisfaction after implantation. A focus was to see whether different types of hearing loss were associated with particular benefits. The study sample consisted of 81 patients. Procedures comprised pure tone audiometry before implantation, the Abbreviated Profile of Hearing Aid Benefit (APHAB) questionnaire, and a structured interview asking about satisfaction. Statistically significant improvements after implantation were found in all groups (CHL, MHL, SSD) on the APHAB questionnaire. In the structured interview, patients with SSD were the least satisfied. No significant correlation was found between pre-operative air-bone gap and bone conduction thresholds or with APHAB score. Bonebridge implantation is beneficial to patients with CHL or MHL, or with SSD. Assessment of patients for Bonebridge implantation is complex, and audiometric data should be complemented by patient-reported outcomes to provide deeper insight into their individual needs and attitudes.

Objectives :To analyze the performance of cochlear implants in French patients aged 65 and over, implanted between 2012 and 2016, using data from the French national registry for cochlear implants (EPIIC). Materials and methods : The French national registry incorporates patient data from before implantation and for three years after implantation, stratified in different age groups (18–39, 40–64 years, 65–74 years and > 75 years). Here, we assessed the latter two categories. Hearing was assessed using mono- and disyllabic words in a silent background. The Category of Auditory Performance (CAP) scale was also implemented and subjects took the Abbreviated Profile of Hearing Aid Benefit (Aphab) questionnaire. Results : The population aged over 65 accounted for 38% (n = 1193) of the 3178 adult implanted patients. The performance for mono- and disyllabic words in silence, the CAP scores and the APHAB questionnaire answers for ease of communication, background noise and reverberation were dramatically improved at one year post-implantation (P < 0.0001 for each score) and remained stable between one and three years thereafter. The percentage improvement was similar across all age groups. The scores for loud-noise intolerance did not change after cochlear implantation in any age group. Conclusion : Cochlear implants improve hearing and communication in subjects aged 65 and over, with comparable efficiency to that achieved in younger subjects. Cochlear implantation should thus be proposed whenever hearing aids provide only limited benefit. However, between 2012 and 2016, cochlear implantation was given to less than 1% of the French population aged 65 and over with profound deafness.

Objective: To assess the performance of an active transcutaneous implantable-bone conduction device (TI-BCD), and to evaluate the benefit of device digital signal processing (DSP) features in challenging listening environments. Design: Participants were tested at 1- and 3-month post-activation of the TI-BCD. At each session, aided and unaided phoneme perception was assessed using the Ling-6 test. Speech reception thresholds (SRTs) and quality ratings of speech and music samples were collected in noisy and reverberant environments, with and without the DSP features. Self-assessment of the device performance was obtained using the Abbreviated Profile of Hearing Aid Benefit (APHAB) questionnaire. Study sample: Six adults with conductive or mixed hearing loss. Results: Average SRTs were 2.9 and 12.3 dB in low and high reverberation environments, respectively, which improved to −1.7 and 8.7 dB, respectively with the DSP features. In addition, speech quality ratings improved by 23 points with the DSP features when averaged across all environmental conditions. Improvement scores on APHAB scales revealed a statistically significant aided benefit. Conclusions: Noise and reverberation significantly impacted speech recognition performance and perceived sound quality. DSP features (directional microphone processing and adaptive noise reduction) significantly enhanced subjects’ performance in these challenging listening environments.

The Abbreviated Profile of Hearing Aid Benefit (APHAB) questionnaire reports subjective hearing impairments in four typical conditions. We investigated the association between the frequency-specific probability of hearing loss and scores from the unaided APHAB (APHABu) to determine whether the APHABu could be useful in primary diagnoses of hearing loss, in addition to pure tone and speech audiometry. This retrospective study included database records from 6558 patients (average age 69.0 years). We employed a multivariate generalised linear mixed model to analyse the probabilities of hearing losses (severity range 20–75 dB, evaluated in 5-dB steps), measured at different frequencies (0.5, 1.0, 2.0, 4.0, and 8.0 kHz), for nearly all combinations of APHABu subscale scores (subscale scores from 20 to 80%, evaluated in steps of 5%). We calculated the probability of hearing loss for 28,561 different combinations of APHABu subscale scores (results available online). In general, the probability of hearing loss was positively associated with the combined APHABu score (i.e. increasing probability with increasing scores). However, this association was negative at one frequency (8 kHz). The highest probabilities were for a hearing loss of 45 dB at test frequency 2.0 kHz, but with a wide spreading. We showed that the APHABu subscale scores were associated with the probability of hearing loss measured with audiometry. This information could enrich the expert’s evaluation of the subject’s hearing loss, and it might help resolve suspicious cases of aggravation. The 0.5 and 8.0 kHz frequencies influenced hearing loss less than the frequencies in-between, and 2.0 kHz was most influential on intermediate degree hearing loss (around 45 dB), which corresponded to the frequency-dependence of speech intelligibility measured with speech audiometry. Electronic supplementary material The online version of this article (doi:10.1007/s00405-016-4385-7) contains supplementary material, which is available to authorized users.

Ercan, S. The Effect Of Double Vent On Patient Satisfaction Of Ear Mold. Hacettepe University Institute Of Health Sciences, Master Thesis In Audiology And Speech Patology Program, Ankara, 2018. The hearing aid is the most suitable amplification method especially for the hearing loss affected by the inner ear. A suitable hearing aid should be able to deliver quality sound to the ear by providing the benefit needed by the individual at the frequencies at which hearing loss occurs. It is the most ideal hearing aid in terms of the type, grade and configuration of hearing loss and is an important step for choosing the right pattern. Ventilation opening to the ear mold is determined according to hearing loss as well as selection according to patient comfort. Our study aimed to demonstrate the effect of hearing aids on audiologic evaluations of single and double opening ventilation tubes suitable for ear molds and patient satisfaction. For this purpose, audiological measurements and REM evaluations of 30 patients (50 ears) using bilateral hearing aid with sensorineural hearing loss were performed bilaterally, APHAB questionnaire and VAS scale were applied and the results were compared between single ventilation and double ventilation. As a result of the study, there was no statistically significant difference between free field thresholds and speech discrimination scores (p> 0.05). There was no statistically significant difference between the REAR measurements (p> 0.05). There was a statistically significant difference (p 0.01). APHAB subscales showed a strong correlation between positive ventilation and ventilation (p 0,05), REM uygulamasında cihaz kazancının değişmediği gözlenmiştir, REAR ölçümlerinde istatistiksel olarak anlamlı fark gözlenmemiştir (p>0,05). Yapılan APHAB memnuniyet anketinde tek vent ile cihazsız, çift vent ile cihazsız karşılaştırmalarında istatistiksel olarak anlamlı fark gözlenmiştir (p0,01). APHAB alt ölçeklerinin tek vent ve çift vent arasında pozitif yönde güçlü bir korelasyon bulunmuştur (p

Subjective hearing loss in hearing-impaired patients can be assessed by inventory questionnaires. The abbreviated profile of hearing aid benefit (APHAB) measures subjective hearing loss in four typical hearing situations (subscales). It is used to fit hearing aids in patients with statutory insurance in Germany. In addition, the unaided APHAB (APHABu) can be used as a primary diagnostic instrument in audiology. There are no published data regarding the sensitivity and specificity of the unaided APHABu. Therefore, we investigated these parameters for detecting hearing loss of at least 25 dB at any frequency between 0.5 and 8.0 kHz. We used the APHABu to determine hearing loss in 245 subjects aged 50 years and older without any reported disease of the ears. Due to incomplete answering of the APHAB form, 55 subjects have been excluded. We also measured the pure-tone thresholds by air conduction for all octave frequencies between 0.5 and 8 kHz. Receiver operating characteristic (ROC) curves and the Youden Index were used to determine the diagnostic value of the APHABu, particularly sensitivity and specificity, in three different ways: (1) separately for ease of communication (ECu), background noise (BNu), and hearing with reverberation (RVu) subscales; (2) with the mean value of ECu, BNu, and RVu; and (3) with a logistic regression model. The area under the ROC curve was lower for BN only (0.83) and nearly equal for all other methods (0.87–0.89). Depending on how we performed the analyses, the sensitivity of the APHABu was 0.70–0.84 (single subscales), 0.76 (mean value of ECu, BNu, and RVu), or 0.85 (logistic regression model). The specificity was 0.79–0.95. The use of single APHABu subscales for determining the sensitivity and specificity of the APHABu due to confusing results. In comparison, the use of the mean value of ECu, BNu, and RVu and the use of the logistic regression model due to equal values in the ROC curves but a higher sensitivity in the logistic regression model. Therefore, we would recommend the last method for determining the sensitivity and specificity of the APHABu.

Objective: Comparing analog and digital hearing aids reducing disability caused by hearing deficiency among moderate to severe sensorineural hearing-impaired persons. Method and Material: This descriptive-analytic study was carried out on two groups of subjects participated in this study in some audiology clinics of hearing aid since May 2002 to October 2003. Twenty subjects wore analog hearing aids and twenty one subjects wore digital hearing aids. In this study , no subject had previous middle ear or psychological problems. APHAB questionnaire was completed before using hearing aid and 2 months after to determine benefit of hearing aid use. Results: Total score mean of APHAB inventory before and after use of analoge hearing aids were 52.215+6.420 and 32.300+3.443 respectively. Also total score mean of APHAB inventory before and after use of digital hearing aids were 54.9252+9.028 and 26.321+10.916 respectively. There was no significant difference between total mean score of APHAB inventory before and after using analog and digital hearing aids (P=0.058).While there was significant difference between total mean score of APHAB questionnaire before and after use of analog hearing aids (P

Artigo original(p.77-87) Submitted by ROBERTO PAULO CORREIA DE ARAÚJO (ppgorgsistem@ufba.br) on 2016-09-13T13:12:08Z No. of bitstreams: 1 R. Ci. méd. biol., v.2, n.1-2003.pdf: 261327 bytes, checksum: 90f186d57c6d9199c4a8d05e666b62c1 (MD5) Made available in DSpace on 2016-09-13T13:12:08Z (GMT). No. of bitstreams: 1 R. Ci. méd. biol., v.2, n.1-2003.pdf: 261327 bytes, checksum: 90f186d57c6d9199c4a8d05e666b62c1 (MD5) Previous issue date: 2003-01 O objetivo deste trabalho foi quantificar e comparar as dificuldades auditivas e o benefício da amplificação em novos usuários de aparelho auditivo segundo as variáveis tipo de amplificação linear e não linear e tempo de uso, por meio do questionário de auto-avaliação APHAB. Foram avaliados 42 pacientes adultos com perda auditiva de grau leve a severo, distribuídos de acordo com o tipo de amplificação utilizada, sendo 13 pacientes usuários de amplificação não linear e 29 pacientes usuários de amplificação linear. O questionário de auto-avaliação APHAB, desenvolvido por Cox e Alexander em 1995, foi aplicado aos pacientes dos diferentes grupos antes da adaptação e após dois e seis meses. Para a análise estatística, foi utilizado o teste ANOVA com nível de significância de 5%. Os pacientes usuários de circuitos de amplificação linear apresentaram melhor desempenho nas subescalas FC (facilidade de comunicação), RV (reverberação) e BA (barulho ambiente), não sendo esta diferença estatisticamente significativa. O benefício obtido após dois e seis meses de uso da amplificação foi satisfatório. O desconforto para sons intensos, subescala (SI), foi maior para os pacientes usuários de amplificação linear. Não foram constatadas diferenças significativas no desempenho de pacientes usuários de circuitos de amplificação linear e não linear, porém houve uma tendência de os pacientes usuários de amplificação linear apresentarem menor dificuldade em diferentes ambientes acústicos. O benefício com o uso do aparelho de amplificação é satisfatório independentemente do tipo de amplificação e do tempo de uso. Salvador