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Aural Rehab Lectures > 1.03 - Hearing Aids > Flashcards

1.03 - Hearing Aids Flashcards

0
Q

What are three examples of Primary Amplification in AR technology?

A

Hearing Aids

Cochlear Implants

Middle Ear Implants

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1
Q

What are the three types of technology in A.R.?

A

Primary Amplification

Hearing Assistive Technology (HAT)

Other hearing assistive technology

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2
Q

What does HAT stand for?

A

Hearing Assistive Technology

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3
Q

What does ALD stand for?

A

Assistive Listening Devices

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4
Q

What are the four goals for patient w/ hearing aids?

A

Make speech audible

Make/keep speech comfortable

Deliver undistorted sound

Provide a range of loudness

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5
Q

What are the three range of loudness goals for patients with hearing aids?

A

More “gain” for soft sounds (Make soft sounds audible)

Less “gain” for moderate sounds (Moderate sounds comfortable)

Even less “gain” for loud sounds (Loud sounds comfortable)

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6
Q

What is a BTE hearing aid?

A

Behind the Ear

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7
Q

How many programs do most BTE hearing aids have?

A

3-4

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8
Q

What are the parts to a BTE hearing aid?

7

A

Battery door

Program button (unless automatic)

Volume control

Amplifier

Microphone (1 or more)

Receiver (speaker)

Custom earmold

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9
Q

What are some of the advanced “options” on BTEs?

A

Multiple programs

Bluetooth capability (connects to second device)

Direct Audio Input

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10
Q

Why might you want a non-occluding hearing aid?

A

High Frequency HL

Chronic otitis media

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11
Q

When might you need to create a new earmold?

A

When fitting hearing aid on children

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12
Q

What does HFHL stand for?

A

High Freq HL

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13
Q

What does RITE stand for?

A

Receiver in the Canal

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14
Q

Where might you see a RITE feature?

A

On a Micro BTE

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15
Q

What are some advantage of Micro BTEs & RITEs?

4

A

Cosmetically appealing

Less “stuff” in the ear canal

Fairly easy to insert and remove

More appealing for the first time hearing aid user

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16
Q

What are some disadvantages of Micro BTEs & RITEs?

A

Smaller design means not all advanced features are available (May not have a T coil. May be limited in power)

May be limited in number of programs and advanced options

May not be compatible with FM systems

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17
Q

It’s all about ______. As the size of the instrument ______, some things have to be ______.

A

“Real estate”

Decreases

Omitted

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18
Q

What are the point of Earmolds in BTEs?

4

A

Deliver sound from receiver to ear

Hold the hearing aid in place

Prevents amplified sound from leaking out of the ear canal

Custom-made to fit the user’s ear canal

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19
Q

What are the steps for creating an earmold?

7

A

Otoscopic exam (looking for blockage, infection, etc.)

Insertion of “otoblock”

Mix silicone material

Inject material into ear canal

Let material harden and set

Remove material

Earmold lab creates earmold

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20
Q

What does ITE stand for?

A

In the Ear

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21
Q

What does FS stand for?

A

Full Shell

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22
Q

What does HS stand for?

A

Half Shell

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23
Q

What is an All-in-the-Ear hearing aid?

A

One that fits in pinna and the ear canal

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24
Q

What are the parts of an all-in-the-ear hearing aid?

5

A

Battery door

Volume control/Program button

Microphone (Can have more than 1)

Vent

Receiver

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25
Q

All-in-the-ear hearing aids require an ______ to determine its ______.

A

Ear mold

Shape

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26
Q

What are some advantages to ITE hearing aids?

3

A

Microphone position reduces wind noise

Microphone position assists in localization

Less affected by sweating

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27
Q

Moisture is ______.

A

Deadly to hearing aids

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28
Q

What are some disadvantages to ITE hearing aids?

4

A

Size of the ear can dictate what features are available

May be limited in power

May be limited in number of programs/advanced options

May not be compatible with FM systems

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29
Q

What does ITC stand for?

A

In the canal

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30
Q

What are the parts of an ITC hearing aid?

5

A

Battery door

Volume/Program control(s)

Microphone

Air vent

Receiver/Sound port

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31
Q

What are some advantages to ITC hearing aids?

A

Cosmetically appealing

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32
Q

What are some disadvantages to ITC hearing aids?

4

A

Sound port can easily become obstructed with wax

Small size can be difficult for patients with dexterity problems to handle

Small battery must be changed often

No T-coil or other assistive devices (advanced options)

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33
Q

What does CIC stand for?

A

Completely in the canal

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34
Q

What does IIC stand for?

A

Invisible in the canal

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35
Q

What are some advantages to CIC/IIC hearing aids?

4

A

Inconspicuous

Microphone location reduces wind noise problems

Can use headphones or phone over HA

Improved sound localization

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36
Q

What is the Lyric hearing aid?

A

A waterproof hearing aid that can be used for 24 hrs./day for about 120 days

It must be removed by a trained professional using an operating microscope

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37
Q

How is the lyric hearing aid sold?

A

Sold on a prescription basis

Purchase includes a years worth of devices

Runs about $3000

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38
Q

How do you change the batteries in a lyric hearing aid?

A

You don’t

When battery dies, need to visit your audiologist to remove the aid and replace with another

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39
Q

Is the lyric hearing aid digital or analog?

A

Analog

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40
Q

Can the lyric be programmed to meet specific requirements?

A

Yes

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41
Q

What range of hearing loss is the lyric designed to help?

A

Mild to moderate loss of hearing

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42
Q

What are some disadvantages to the lyric hearing aid?

4

A

When battery dies, must return to dispenser for replacement

Cost

Is not compatible with FM or other assistive devices

Overall power of the device is limited by the size of the components

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43
Q

What are Middle ear implants?

A

A surgically implanted device that increases the mechanical energy used to stimulate the structures of the inner ear.

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44
Q

Who might be a candidate for a middle ear implant?

4

A

Moderate to severe sensorineural hearing loss

Cannot tolerate anything in the ear canal for medical reasons (chronic ear canal inflammation)

Require an open ear canal for personal or professional reasons ( musicians, singers, or physicians

Rely on good high frequency hearing

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45
Q

What middle ear implant is FDA approved?

A

Vibrant Soundbridge

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46
Q

What does FMT stand for?

A

Floating mass transducer

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47
Q

What are the parts to a middle ear implant?

5

A

Processor (external)

Magnet/internal device

Conductor Link

Attachment

FMT* Body

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48
Q

In a middle ear implant, the ______ connects to the ______ via a magnet.

A

Audio processor (external)

Implanted device

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49
Q

How does a middle ear transplant work?

6

A

Sounds are picked up by the microphone of the audio processor.

The audio processor converts sounds into electrical signals.

The electrical signals are transmitted across the skin to the implanted part.

The implant relays the signal down to the FMT (Floating Mass Transducer).

The FMT converts the signal into mechanical vibrations that directly stimulate the ossicular chain causing it to vibrate.

These vibrations then conduct sound to the inner ear

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50
Q

What are the advantages to middle ear implants?

3

A

Open ear canal

Great for patients with chronic draining ears!

No “feedback” (or squeal)

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51
Q

What are the disadvantages to middle ear implants?

4

A

Surgical procedure (Always carries the risk of hearing loss)

Cost (~$15,000)

Some insurance companies will not pay for the device

Hearing loss can change outside the recommended range

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52
Q

What does BAHA stand for?

A

Bone Anchored Hearing Aid

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53
Q

What is a BAHA?

A

One that conducts sound via bone conduction

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54
Q

What are the parts of a BAHA?

3

A

Implant

Abutment

Hearing processor

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55
Q

What are the parts to a BAHA hearing processor?

3

A

Battery

Microphone

Signal (hearing) processor

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56
Q

In Single sided deafness, to fit a BAHA, you need _________.

A

Hearing in the contralateral ear better than or equal to 20 dB HL (an average of 500, 1000, 2000, and 3000 Hz)

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57
Q

What does SSD stand for?

A

Single sided deafness

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58
Q

In Mixed and Conductive hearing losses, to fit a BAHA, you need ________ for a one ear fitting.

A

Average bone conduction threshold of the indicated ear should be better than or equal to 45–55 dB HL (average at 500, 1000, 2000 and 3000 Hz)

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59
Q

In Mixed and Conductive hearing losses, to fit a BAHA, you need ________ for a bilateral fitting.

A

Symmetric bone conduction thresholds (less than 10 dB difference on average at 500, 1000, 2000 and 3000 Hz)

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60
Q

BAHAs in children are approved for ages _______.

A

5 and up

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61
Q

How much does a BAHA cost?

A

Around $7500 for each device.

Surgeon and hospital is additional.

Some insurance companies do not pay for this.

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62
Q

What are the four basic hearing aid components?

A

Microphone

Amplifier

Receiver/ speaker

Power supply/battery

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63
Q

What does a microphone do in a hearing aid?

A

Picks up audio signal and converts it into an electrical signal

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64
Q

What are some types of microphones available in hearing aids?

A

Omnidirectional

Directional

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65
Q

What are some types of DIRECTIONAL microphones available in hearing aids?

(3)

A

Dual- and tri-microphone

Automatic

Adaptive directional

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66
Q

What does the amplifier do in a hearing aid?

3

A

Increase sound intensity - “gain”

Provides a “ceiling”

Controls maximum power output (MPO)

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67
Q

What types of amplifiers are available in hearing aids?

3

A

Analog

Programmable analog

Digital

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68
Q

How are Analog amplifiers adjusted?

A

Trimpots adjusted via small screwdriver

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69
Q

How are Digital amplifiers adjusted?

A

Have AD converter

Amplification controlled through software

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70
Q

What does the receiver do in a hearing aid?

A

Converts the signal from the amplifier back to acoustic energy

Largest component within most hearing aids

A mini loudspeaker

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71
Q

What is the most frequently damaged component in a hearing aid? Why?

A

Receiver

Damage from ear wax, moisture, cleaning

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72
Q

What is the power supply of a hearing aid?

A

The battery

73
Q

What are the 5 sizes of batteries used in hearing aids?

A

5A

10A

312

13

675

All are 1.4 volt button type

74
Q

How long do batteries tend to last in hearing aids? Which lasts longer: analog or digital?

A

1-4 weeks

Analog lasts longer than digital

75
Q

Is more precise programming an advantage to digital hearing aids?

A

Yes

76
Q

Are more parameters under audiologist’s control an advantage to digital hearing aids?

A

Yes

77
Q

Is a more complex automatic signal processing an advantage to digital hearing aids?

A

Yes

78
Q

Is better sound quality an advantage to digital hearing aids?

A

Yes

79
Q

Is higher fidelity an advantage to digital hearing aids?

A

Yes

80
Q

Is less distortion an advantage to digital hearing aids?

A

Yes

81
Q

Is good loudness comfort an advantage to digital hearing aids?

A

Yes

82
Q

Is better control of feedback an advantage to digital hearing aids?

A

Yes

83
Q

Are quieter circuits an advantage to digital hearing aids?

A

Yes

Meaning you can’t hear the computer running

84
Q

What are the signal processing options available on hearing aids?

A

Analog signal processing (Rarely used today)

Digital signal processing (Mathematical with numerical coding)

85
Q

What is the signal pathway for analog hearing aids?

A

Mic -> Amp -> Filter -> Receiver

86
Q

What is the signal pathway for digital hearing aids?

A

Mic -> Digital Signal Processor -> Amp -> Receiver

Computer controls what components are activated

87
Q

What happens to the sound signal in digital hearing aids?

A

Sound is converted into a digital signal and then modified

88
Q

When did the first 100%, completely digital hearing aid become available? Who made it?

A

1996

Widex/Oticon

89
Q

The advent of the digital hearing aid allowed for a more ______ in a ______ hearing aid unit.

A

Advanced signal processing

Smaller

90
Q

What are two stages to Digital Speech Processing?

A

Analog to Digital Converter:

Digital to Analog Converter

91
Q

What does an Analog to Digital Converter do?

3

A

The signal is changed to a sequence of 1s and 0s.

This sequence is sent to the “core” where it is filtered into bands and channels,

This manipulated according to the programmed settings for the hearing loss.

92
Q

What is a Digital to Analog Converter?

A

The manipulated signal is now converted back into an analog signal

93
Q

What is the flow to digital speech processing?

3

A

Analog to Digital Converter

Mathematical Signal Processing

Digital to Analog Converter

94
Q

What is the most difficult state for using hearing aids?

A

Hearing in Noise

95
Q

Do people with the most up-to-date, “fancy” and expensive hearing aids (fit binaurally), still have trouble understanding speech in the presence of background noise? Why?

A

Yes

Due to frequency and temporal resolution problems

These create poor word recognition.

96
Q

Can the use of directional mics assist in creating better sound sensitivity?

A

Yes

97
Q

In BTE hearing aids, directional microphones can be ______.

In smaller hearing aids, directional microphones may actually be ______.

A

2 physical microphones interacting together.

2 ports to a single microphone with advanced signal processing

98
Q

What is the purpose of directional microphones?

A

To reduce the interference of background noise

99
Q

Can hearing aid algorithms or processing detect the intent of the user?

A

No. This can varied the success of directional microphones.

100
Q

The challenge to engineers is to provide a product that will ______ without the user needing to do this manually (automatic).

A

Switch between different patterns

101
Q

A directional microphone with a free-field cardioid pattern is ______.

A

Most sensitive to sounds in front of the user

102
Q

A directional microphone that is omnidirectional has ______.

A

Equally sensitivity in all directions

103
Q

A directional microphone with a hypercardioid pattern is ______.

A

Most sensitive to sounds in front and at 90 degrees to the listener (directly behind the head)

104
Q

A directional microphone with a bidirectional cardioid pattern is ______.

A

Most sensitive to sound in front and in back of listener

105
Q

Why are there not directional microphones on all hearing aids?

A

It’s an issue of space

106
Q

What are the benefits to Binaural Amplification?

4

A

Elimination of head shadow effect

Loudness summation

Binaural squelch

Localization

107
Q

Does Binaural Amplification benefit both adults and children?

A

Yes

108
Q

What is the head shadow effect?

A

Sound is louder on the side of the head closest to the signal

The head acts to “dampen” the sound.

109
Q

What frequencies do head shadows mostly affect?

A

High frequencies.

Low frequencies are almost unaffected due to the long wavelength.

110
Q

What is Loudness Summation?

A

That a sound heard with 2 ears is usually judged to be louder than the SAME sound heard with 1 ear.

111
Q

What is the Binaural Squelch?

A

Our ears and brain receive both speech and environmental sound/noise and suppresses those sounds that we are not interested in.

112
Q

What are four things to consider when deciding whether an adult is a good candidate for hearing aids?

A

Listening demands/difficulties

Lifestyle, occupation, communication mode, age

Financial aspects

Degree of which sound is used to communicate

113
Q

What are two factors that affect whether someone actually uses their hearing aid?

A

The perception of benefit

Reality vs. Expectations

114
Q

The actual benefit of hearing aids is maximal in ______ conditions.

The desired benefit of hearing aids is greatest for ______ conditions.

A

Quiet

Noisy

115
Q

Who are the AAA?

A

American Academy of Audiology

116
Q

According to the AAA Pediatric Guidelines:

“[Hearing aids] should be considered for a child who demonstrates a ______, including ______, _______, or ______ of any degree.”

A

Significant hearing loss

Sensorineural

Conductive

Mixed losses

117
Q

Children are now being fit with hearing aids as early as ___ months of age.

A

6 months

118
Q

Infants should be _______, diagnosed by ______, and fit with hearing aids within ______ of diagnosis but no later than ______.

A

Screened at birth

3 months

1 month

6 months

119
Q

Children should receive hearing aids if they have ______ whether or not it is ______ or _______.

A

Mild hearing loss and greater

Unilateral

Bilateral

120
Q

Why is it so important to put children in hearing aid?

A

Essentially any degree of HL can affect the acquisition of speech and language

121
Q

When fitting a child with hearing aids, should we consider safety features?

A

Yes

122
Q

When fitting a child with hearing aids, should we consider the growth of ear?

A

Yes

123
Q

When fitting a child with hearing aids, should we consider HAT/ALD capability?

A

yes

124
Q

When fitting a child with hearing aids, should we consider hearing assistive technology/assistive listening devices?

A

Yes

125
Q

When fitting a child with hearing aids, should we consider protection of device?

A

Yes

126
Q

When fitting a child with hearing aids, should we consider the child tolerance of device in ear?

A

Yes

127
Q

When fitting a child with hearing aids, should we consider programming w/limited audiometric data?

A

Yes

128
Q

When fitting a child with hearing aids, should we consider the need for family/teachers to monitor device function?

A

Yes

129
Q

When fitting an adult with hearing aids, should we consider the patient’s age?

A

Yes

130
Q

When fitting an adult with hearing aids, should we consider the patient’s degree and configuration of HL?

A

Yes

131
Q

When fitting an adult with hearing aids, should we consider the patient’s preferences?

A

Yes

132
Q

When fitting an adult with hearing aids, should we consider the cost of the device?

A

Yes

133
Q

When fitting an adult with hearing aids, should we consider the patient’s lifestyle?

A

Yes

134
Q

When fitting an adult with hearing aids, should we consider the patient’s health status?

A

Yes

135
Q

What are two aspects of a patient’s health status we should consider before fitting them with hearing aids?

A

Dexterity

Vision

136
Q

What is Feedback?

A

A high pitched squealing sound heard by anyone near the hearing aid

137
Q

Are hearing aid users always aware of feedback?

A

Nope. Sometimes the wearer does not hear this because their hearing loss is severe enough that they are not aware of this.

138
Q

What causes feedback?

A

Feedback occurs as amplified sound leaks out of the ear and is re-routed back into the hearing aid microphone.

139
Q

What are some conditions that can create feedback?

3

A

When hearing aid out of ear but turned on

Close physical proximity to another surface

When earmold is loose or inserted wrong

140
Q

What current technology has made a serious dent in feedback occurances?

A

Digital feedback canceling circuits in today’s digital hearing aids

141
Q

What is a tele-coil (or T-coil)?

4

A

It is a small coil of wire designed to pick up a magnetic signal

It is located inside a hearing aid or speech processor

This coil can pick up an electromagnetic signal

It was designed to help eliminate all other sources of sound from entering the hearing aid (a.k.a., background noise)

142
Q

Where can you find T-coils?

A

Specially equipped telephones

Some assistive listening devices

143
Q

What are 5 common hearing aid options?

A

Program button (Mute the HA, switch to telecoil, change programs)

Volume control

DAI capabilities (direct audio input)

Remote Controls

“Streaming” devices

144
Q

“The good news is that we have ______. The bad news is that we have ______.” (Cunningham, 1997)

A

More options

More options

145
Q

What are streaming devices?

A

Bluetooth streaming from TV, telephone, etc.

This is then transmitted to the hearing aid using the T-coil of the hearing aid.

146
Q

What does DAI stand for?

A

Direct Audio Input

147
Q

Are cell phone t-coil rated?

A

Yes

148
Q

What is Verification/Validation?

A

Making sure the hearing aid is properly fit

149
Q

Why is Verification/Validation important?

A

Hearing aids MUST be fit properly to work properly

Objective verification/validation measures ensure accurate fitting

150
Q

Recent Consumer Reports test found that ______ of hearing aids were misfit; They amplified ______.

A

2/3

Too much or too little

151
Q

A common approach to fitting hearing aids is to rely on the hearing aid fitting software to perform the fitting without ______ — this will result in ______.

A

Actual measurements in the ear

Inaccurate fittings

152
Q

Do most hearing aid dispensers use real ear measurements to fit a hearing aid?

A

Nope

153
Q

What does a Phonak 8000 box do?

A

A hearing aid test analyzer

Tests the functionality of hearing aids

154
Q

Are telecoils an advantage to Typical BTEs?

A

Yes

155
Q

Is Lots of Power an advantage to Typical BTEs?

A

Yes

156
Q

Is Flexibility an advantage to Typical BTEs?

A

Yes

157
Q

Is the ability to easily remake the earmold an advantage to Typical BTEs?

A

Yes

158
Q

Is less problems w/ Feedback an advantage to Typical BTEs?

A

Yes

159
Q

Is sturdiness an advantage to Typical BTEs?

A

Yes

160
Q

Is non-occlusion an advantage to Typical BTEs?

A

Yes

161
Q

Are advanced “options” an advantage to Typical BTEs?

A

yes

162
Q

Is the inability to change volume/programs a disadvantage to CIC/IIC Hearing Aids?

A

Yes. The patient will need a remote control or this may not even be available

163
Q

Is the lack of T coil availability a disadvantage to CIC/IIC Hearing Aids?

A

Yes

164
Q

Is the fact that CIC/IIC Hearing Aids cannot be paired with FM systems a disadvantage?

A

Yes

165
Q

Is the fact that CIC/IIC Hearing Aids may increase occlusion (feeling “plugged up”) a disadvantage?

A

Yes

166
Q

Is higher maintenance due to earwax a disadvantage to CIC/IIC Hearing Aids?

A

Yes

167
Q

Is the fact that CIC/IIC Hearing Aids must be fit perfectly critical or FB occurs a disadvantage?

A

Yes

168
Q

Is improved directionality and localization an advantage to the Lyric hearing aid?

A

Yes

169
Q

Is a reduced sense of occlusion and feedback an advantage to the Lyric hearing aid?

A

Yes

170
Q

Is high frequency gain an advantage to the Lyric hearing aid?

A

Yes

171
Q

Is reduced wind noise an advantage to the Lyric hearing aid?

A

Yes

172
Q

Is less distortion due to less gain required an advantage to the Lyric hearing aid?

A

Yes

173
Q

Is normal telephone use (don’t need a T coil) an advantage to the Lyric hearing aid?

A

Yes

174
Q

Is comfort an advantage to the Lyric hearing aid?

A

Yes

175
Q

Is 100% invisiblity an advantage to the Lyric hearing aid?

A

Yes

176
Q

Real ear measurements are ______.

A

The coolest tool ever

177
Q

What do real ear measurements do?

A

Allow us to measure how the sound has been processed through the hearing aid in the ear canal

178
Q

What is the name of the dummy in the real ear measurements slide?

A

KEMAR

179
Q

Is ease of maintenance an advantage to the Lyric hearing aid?

A

Yes

Aural Rehab Lectures (8 decks)

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