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PubMed2005

[Universal hearing screening in newborns -- recommendations for organizing and conducting universal hearing screening for congenital hearing loss in Germany].

The Interdisciplinary Consensus Conference for Newborn Hearing Screening (IKKNHS) has worked out joint recommendations for universal hearing screening of newborns. In the consensus paper, 11 professional associations and scientific societies in the fields of gynecology and obstetrics, ENT, pediatrics, and phoniatrics and pedaudiology came to an agreement how to implement newborn hearing screening in Germany. The paper deals with the following topics: goals of universal newborn hearing screening, target group of hearing screening, schedule for screening, personnel involved in the screening program, technologies and framework conditions of hearing screening, documentation, continuous quality control of screening, confirmation diagnostics for conspicuous test subjects, motivation to take part in screening, information on newborn hearing screening, tracking, various infrastructural situations in urban and rural regions, follow-up care, in-patient vs. out-patient screening, cost factors of screening, reporting children with permanent hearing loss to the German Central Registry for hearing loss in children.

Animals↗
PubMed1990

[Directional hearing of unilaterally hearing impaired--especially sense of sound direction in monaural hearing impairment and monaural deafness].

I. OBJECTIVE. The present study was undertaken in order to determine the onset of monaural deafness, especially whether it is congenital or acquired, making an investigation into the sense of sound direction in monaural hearing impairment and monaural deafness and comparing them between hearing-impaired patients and normal hearers. II. SUBJECTS. This study was carried out on 26 patients with monaural hearing impairment, 22 patients with monaural deafness and 10 normal hearers. III. METHODS. A circle with a radius of 1.3m was drawn around a fixed patient's position in a sound proof room, and the circle was divided into 16 directions at an equal angle of 22.5 degrees. A blindfolded hearer was instructed to listen to a speaker for white noise of 60dB (A) for one second and verbally answer in which direction he heard the noise. The normal hearers were tested in 4-, 8-, and 16-directions, and the hearing-impaired patients were tested in only 8-directions. IV. RESULTS. 1. Normal Hearers The rate of correct answers decreased with increasing directions of sound. The incorrect answers in 4-direction testing were only confusion between forward and backward directions, and similar incorrect answers were made in 8- and 16-direction testing. All other incorrect answers were errors of less than 45 degrees. 2. Monaurally Hearing-impaired Patients The rate of correct answers on the whole was low. There was such a relationship between the rate of correct answers and the mean hearing level of patients that the total rate of correct answers decreased with increasing hearing impairment. This correlation was statistically significant, and there was a still more significant correlation between the degree of hearing impairment and the rate of correct answers as to the right and left directions. Incorrect answers were errors of 90 degrees or less on the healthy side, while errors were made for all directions on the affected side. 3. Monaurally Deaf Patients The rate of correct answers was by far lower on the affected side. Whereas many errors were within 45 degrees on the healthy side, errors were made for all directions on the affected side. Judging from the onset of hearing loss, the monaurally deaf patients were divided into a group of 8 patients who obviously had sudden acquired deafness and a group of 9 patients who were presumed to have congenital monaural deafness. The mean rate of correct answers of the former group was superior to the latter group's, particularly on the effected side.

Adolescent↗
PubMedDate not supplied

Perception of hearing loss and hearing handicap on hearing aid use by nursing home residents.

The purpose of this study was to examine the perception of hearing loss and self-assessed hearing handicap on hearing aid use by nursing home residents. Sixty elderly individuals who had a hearing loss and wore hearing aids were given the Nursing Home Hearing Handicap Index and were asked specific questions related to hearing aid use. The overall results indicated that there was a moderate correlation among all three variables. It was determined that nursing home residents consistently use their hearing aids. However, amplification does not address all the communication needs of the nursing home resident. Assistive listening devices and environmental modification would improve communication ability and the quality of life of the nursing home resident.

Aged↗
PubMedDate not supplied

Hearing health and care: the need for improved hearing loss prevention and hearing conservation practices.

Hearing loss affects 31 million Americans, particularly veterans who were exposed to harmful levels of noise during military functions. Many veterans also receive treatment with ototoxic medications, which may exacerbate preexisting hearing loss. Thus, hearing loss is the most common and tinnitus the third most common service-connected disability among veterans. Poor implementation of hearing protection programs and a lack of audiometric testing during medical treatment leave veterans vulnerable to unrecognized and untreated hearing loss until speech communication is impaired. Individualized audiometric testing techniques, including assessment of high frequencies, can be used in clinical and occupational settings to detect early hearing loss. Antioxidants also may alleviate cochlear damage caused by noise and ototoxicity. Ultimately, hearing loss prevention requires education on reducing occupational and recreational noise exposure and counseling on the risks and options available to patients. Technological advances will improve monitoring, allow better noise engineering controls, and lead to more effective hearing protection.

Anti-Infective Agents↗
PubMedDate not supplied

Hearing performance in noise of cochlear implant patients versus severely-profoundly hearing-impaired patients with hearing aids.

It is possible for most post-lingually deaf patients to attain significant open speech recognition following cochlear implantation. In contrast, many severely-profoundly sensorineural hearing-impaired patients receive no benefit from their hearing aids, especially in situations with background noise. The aim of the study was to evaluate the speech recognition ability in quiet and in noise of post-lingually deaf adults implanted with Combi 40/40+ cochlear implants versus severely-profoundly sensorineural hearing-impaired patients fitted with hearing aids. For this purpose, we tested two groups of patients: one that had received cochlear implants (n=22) and a group of subjects with severe-profound sensorineural hearing impairment, fitted with hearing aids (n = 15). All of the patients were tested using the Hochmaier, Schultz, and Moser Discrimination Test in quiet and noise. The results of the study demonstrate that most of our cochlear implant patients received a substantial benefit from their implant, achieving scores of 70 to 100 per cent (mean, 90 per cent) for the numbers test and 10 to 72 per cent (mean, 43 per cent) for the monosyllable test 1 year after implantation. Even in situations with background noise, scores of 1 to 99 per cent (mean, 45.65 per cent) for a signal to noise ratio (SNR) of +15 dB 1 year following the implantation improved to 7 to 95 per cent (mean, 50.7 per cent) at 2 years and 8 to 99 per cent (mean, 60 per cent) at 3 years after implantation. These results are significantly (p<0.04) superior to the hearing aid patients' scores of 1 to 64.2 per cent (mean, 26.7 per cent) for a SNR of 15 dB. The results of the present study may have clinical implications in regard to selection of candidates for cochlear implantation.

Adult↗
PubMed1987

Speech understanding and directional hearing for hearing-impaired subjects with in-the-ear and behind-the-ear hearing aids.

With respect to acoustical properties, in-the-ear (ITE) aids should give better understanding and directional hearing than behind-the-ear (BTE) aids. Also hearing-impaired subjects often prefer ITEs. A study was performed to assess objectively the improvement in speech understanding and directional hearing afforded by ITE aids versus BTEs. In 28 hearing-impaired subjects, who visited our Centre for a check-up of their ITEs, the following parameters were measured: (a) thresholds for third-octave bandpass noises between 0.25 and 4 kHz, (b) speech reception thresholds for short Dutch sentences in quiet and with background noise, (c) directional hearing. All three experiments were done binaurally with the subjects wearing their ITEs, BTEs, and no hearing aid. With the 2-cc coupler, the gain used by the subject was measured. The SRT values for the ITE were significantly lower than those for BTE. More gain at 2 and 4 kHz in the ITE proved to be a responsible factor for this improvement. Directional hearing was not improved by wearing an ITE. Large interindividual differences were found between functional gain and the 2-cc coupler measurements. The mean functional gain at 4 kHz for an ITE is higher than the gain measured in a 2-cc coupler. For a BTE, the functional gain at 2 and 4 kHz is lower than the 2-cc coupler gain.

Adult↗
PubMed1991

Hearing impairment, coping and perceived hearing handicap in middle-aged subjects with acquired hearing loss.

Coping strategies are presumed to be modifying factors between a hearing impairment and the perceived handicap. The focus of this investigation was to explore audiological and psychological factors affecting the perceived handicap in hearing-impaired middle-aged subjects. The Hearing Measurement Scale, supplemented by a subjective estimation of the perceived handicap, was used as the dependent variable in a study of 62 subjects, heterogeneous as to type and severity of hearing loss and to hearing aid use. In a stepwise regression analysis, maladaptive communication strategies as well as active and constructive coping behaviours were found to increase the self-perception of hearing handicap. Other significant variables were severity of hearing loss and years of education. Tinnitus symptoms did not contribute to the explained variance in the perceived handicap, which was an unexpected finding. A conclusion that may be drawn from the present study is that active coping strategies tend to focus attention on disability and thereby increase perceived handicap.

Adaptation, Psychological↗
PubMed1990

Hearing disability and hearing aid benefit related to type of hearing impairment.

This study was designed to investigate whether patients with a conductive hearing impairment derive more benefit from the provision of a hearing aid than comparable individuals with a sensorineural hearing impairment. A secondary aim was to assess the relative hearing disability of those with each type of impairment. Twenty-eight patients with a bilateral, symmetrical conductive impairment were selected. They were matched for age, sex and speech frequency average to individuals with a bilateral, symmetrical sensorineural hearing impairment. Each patient performed free-field audio and audio-visual tests in noise, both with and without a hearing aid, during which the non-test ear was acoustically occluded. When unaided, individuals with a conductive impairment were more disabled than those with a sensorineural impairment. On the other hand, those with a conductive impairment derived more benefit from an aid than those with a sensorineural impairment.

Adult↗
PubMed1988

Acquisition of spoken and signed English by hearing-impaired children of hearing-impaired or hearing parents.

This study examines the degree to which hearing-impaired children of hearing-impaired parents (HIP) demonstrate an advantage in their acquisition of signed and spoken English over hearing-impaired children of hearing parents (HP). A subset from the normative sample of the Grammatical Analysis of Elicited Language, 50 HIP children and 50 HP children, were matched in terms of their educational program, hearing level, and age. Results indicate that both groups had comparably poor expressive English language ability at 5 and 6 years of age. However, at age 7 and 8 HIP children demonstrated a significant linguistic advantage in both their spoken and signed English over HP children. Because the production of English by HIP children closely resembled that of orally educated hearing-impaired children of hearing parents, consistent language stimulation throughout the child's early years may be a critical factor in the development of English, regardless of the language or mode of expression.

Age Factors↗
PubMed1998

Psychometric evaluation of the Gothenburg Profile for measurement of experienced hearing disability and handicap: applications with new hearing aid candidates and experienced hearing aid users.

The Gothenburg Profile (GP) for measurement of experienced hearing disability and handicap was developed with content partly taken from the shortened Hearing Measurement Scale (HMS25). The GP consists of 20 items divided into two subscales. The first subscale measures Experienced Disability as to hearing speech (items 1-5) and sound localization (items 6-10). The second subscale targets the Experienced Handicap in social settings (items 11-15) and the personal reactions to the experienced handicap (items 16-20). In this study, data are presented for new hearing aid candidates (NewHA) (n=441) and for experienced hearing aid users (ExpHA) (n=476). Principal components factor analyses were conducted and a three-factor solution was obtained, supporting the two factors of the Experienced Disability subscale, but just confirming one factor in the Experienced Handicap subscale. The internal consistency reliability (coefficient alpha) was good (0.85 to 0.95) for the subscales as was the test-retest reliability. The ExpHA group expressed significantly greater disability (first subscale) as well as experienced handicap (second subscale). However, when controlling for hearing level the differences disappeared. The clinical use of the GP for assessment of rehabilitation needs is recommended.

Adolescent↗
PubMed1993

[Studies on screening for hard-of-hearing children by questionnaire. 2. Comparison of response rates to individual questions in 1-year-6-month-old children with normal hearing and hearing loss using a health screening questionnaire].

We report the results of studies on responses to questions on hearing impairment, comparing 165 school children whose hearing was diagnosed as normal at the time of admission to primary school and 37 children with hearing loss attending facilities for children with this disability. These children had been covered by similar surveys as part of the health screening for 1-year-6-month-old infants conducted by municipal authorities. Significant differences between the two groups were noted in the response rates to all questions on hearing. Similar differences were noted in the responses to questions on family history of hearing impairment. There were no significant differences in the incidences of asphyxia and jaundice at birth. The most striking differences were noted in the response rates to questions 6, 7, 8, 10, 11, 16, and 18. Most useful and universally valid in this survey were questions 8, 10 and 18 in addition to the question on whether or not parents suspected infantile hearing loss.

Child, Preschool↗
PubMed1991

Psychological and somatic distress in relation to perceived hearing disability, hearing handicap, and hearing measurements.

Acquired hearing loss has frequently been reported to cause strains in everyday life, but few attempts have been reported where the affliction is related to the concept of stress. In this within-subjects investigation of 48 middle-aged to elderly hearing impaired patients, the relationships between hearing measurements, experienced disability and handicap (HMS), and psychological and somatic distress symptoms (SCL-90(R)) were analyzed. The variations in experienced hearing disability was found to correlate to the occurrence of a few, but more severe distress symptoms, and by loss of hearing for high frequencies. The experienced handicap, defined as emotional responses and personal opinions, was found to correlate to a general level of distress. In particular those distress items expressing insecurity were related to handicap experience. It was suggested that insecurity in social settings, and diminished hearing for contextual sounds, could cause a perceived loss of control, which could induce stress reactions.

Adaptation, Psychological↗
PubMed1980

The hearing performance inventory and hearing aid use in profound hearing loss.

Subjects with profound postlingual hearing loss completed the Hearing Performance Inventory (HPI) during the course of their hearing aid evaluations. Comparisons of responses to the HPI were made for (a) subjects who wore hearing aids versus subjects who did not, and (b) hearing aid users with losses greater than 100 dB versus users with losses between 80-100 dB. The former set of comparisons indicated consistently superior performance for the aided group, and the latter set indicated consistently superior performance for the 80-100 dB group. The HPI may be a valuable tool in hearing aid considerations.

Cues↗
PubMed1999

[Suprasegmental speech in prelingual hearing-impaired children with cochlear implants, hearing-impaired children without implants and normal hearing children].

A review of the relevant literature indicates a lack of knowledge regarding suprasegmental speech characteristics in prelingual hearing impaired children with cochlear implants. This study is aimed at examining certain suprasegmental features in the speech of prelingual hearing impaired children with cochlear implants by perceptual ratings and acoustic analyses, comparing these results to that of prelingual hearing impaired children without implants, and normal hearing children of the same age. Twelve Afrikaansspeaking children between the ages of six and ten years were included in three groups. An integrated view of the perceptual and acoustic results shows that the cochlear implanted children's suprasegmental speech characteristics bear closer resemblance to those of the normal hearing group than those of the hearing impaired group.

Child↗
PubMed1996

An improvement in hearing sensitivity following hearing-aid fitting in a child with an apparent sensorineural hearing impairment.

This case describes an apparent improvement in hearing sensitivity in a young girl over a period of 12 months, after she was fitted with binaural hearing-aids. Discrepancies between objective and subjective test results are highlighted. Even if the underlying reason for the conflicting test results was due to poor listening skills or test error, this child behaved like a hearing-impaired child and her performance improved after hearing-aid use. The case also illustrates the application of earphone testing from six months of age. The importance of closely monitoring all children who are fitted with hearing-aids is highlighted.

Female↗
PubMed1991

Hearing instruments for the elderly hearing impaired. A comparison of in-the-canal and behind-the-ear hearing instruments in first-time users.

The purpose of this investigation was to compare negative and positive experiences between two matched groups of elderly first-time users of hearing instruments (HI). One group had been supplied with behind-the-ear hearing instruments (BTE), the other with in-the-canal hearing instruments (ITC). There were 20 persons in each group. All were visited in their homes. Those who needed extra help were offered follow-up at the Hearing Centre. ITC were found to be superior to BTE as regards time-of-use, operational difficulties and undesirable sound experiences. ITC were also used in more difficult listening situations. Successful instruction and follow-up was more easily achieved with ITC users than with BTE users. ITC are recommended as the preferred instrument for elderly first-time HI users, at least for hearing losses not exceeding 60 dB PTA, provided the subject's dexterity and anatomical conditions permit fitting of ITC.

Acoustic Stimulation↗
PubMedDate not supplied

Vestibular findings in sensorineural hearing disorders. Results of caloric, oculomotor and hearing tests in 205 patients with unilateral hearing dysfunction.

In 205 patients with unilateral hearing loss, 117 of cochlear and 88 of retrocochlear origin, thorough audiovestibular examinations were performed to establish the occurrence and severity of vestibular dysfunction. The results were also analysed with the aim of determining the relationships between the severity of the hearing loss, the etiology and the topical location of the hearing disorder, on the one hand, and vestibular dysfunction, recorded as reduced caloric sensitivity and occurrence of oculomotor disturbances, on the other. No correlation was found between severity of hearing loss and recordable vestibular dysfunction, in either the cochlear or retrocochlear group of patients, or in the etiological subgroups of these main groups. With respect to the relations between the topic locations of the lesions and the results of vestibular tests, distinct characteristics were observed. In the affected ears, totally extinguished caloric reactions were more than six times as frequent in the retrocochlear group as in the cochlear group and appeared as a specific but rather insensitive sign of acoustic neurinoma. Oculomotor disturbances were only exceptionally observed in patients with cochlear lesions, but were noted in nearly half of the retrocochlear group; when only those patients with lesions of the brain stem or cerebellum were considered, all were found to exhibit such disturbances. The relations between audiometric hearing test pattern, caloric sensitivity and oculomotor disturbances seem to form interesting diagnostic paradigms of great value for the topical localization of audiovestibular disorders.

Auditory Pathways↗
PubMed1997

[Principle requirements of an electromechanical transducer for implantable hearing aids in inner hearing hearing loss. II: Clinical aspects].

In cases of sensorineural hearing loss, an electromechanical transducer of implantable hearing aids should partially or completely compensate for the cochlea amplifier (CA) failure that occurs in most of these patients. CA failure can be clinically identified by a positive recruitment and amplitude loss in otoacoustic emissions (OAE). In a healthy ear, the basis of the CA is the motility of the outer hair cells. A transducer that replaces functions of the CA can be termed CAI (cochlea amplifier implant). A CAI should fulfill five requirements: (1) production of a vibratory output signal, (2) reinforcement of the travelling wave in the inner ear, (3) imitation of the physiological, nonlinear behavior of the CA, (4) reinforcement without distortion, and (5) steady amplitude at rising frequencies. Compensation of frequency selectivity of the CA would also be desirable; however, this can hardly be expected from an implant. If the requirements are fulfilled, one can expect superior sound and hearing quality compared to a conventional hearing aid. Frequency should range from 50 to 10,000 Hz and have an increasing transfer function beyond 1000 Hz. Equivalent levels in the high frequency range should clearly exceed 100 dB SPL. Total distortion should at best amount to 1%. The CAI should function as a totally implantable hearing aid requiring minimum energy. The outer ear canal has to remain open so that occlusion cannot occur; the ossicular chain should be kept intact or repairable, and the implantation technique should allow explantation. The quality of the implant should make possible a CE approval in Europe and an FDA approval in the USA. Furthermore, there should be no risks involved if computer tomography, MRI, or PET examination are undertaken. Underwater diving to a depth of 2-3 m should also be permissible. Minimization of risks that occur near strong magnetic fields or high frequency fields is of great practical importance.

Cochlear Implants↗