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
1
Q
What are the three types of technology in A.R.?
A
Primary Amplification
Hearing Assistive Technology (HAT)
Other hearing assistive technology
2
Q
What does HAT stand for?
A
Hearing Assistive Technology
3
Q
What does ALD stand for?
A
Assistive Listening Devices
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
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)
6
Q
What is a BTE hearing aid?
A
Behind the Ear
7
Q
How many programs do most BTE hearing aids have?
A
3-4
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
9
Q
What are some of the advanced “options” on BTEs?
A
Multiple programs
Bluetooth capability (connects to second device)
Direct Audio Input
10
Q
Why might you want a non-occluding hearing aid?
A
High Frequency HL
Chronic otitis media
11
Q
When might you need to create a new earmold?
A
When fitting hearing aid on children
12
Q
What does HFHL stand for?
A
High Freq HL
13
Q
What does RITE stand for?
A
Receiver in the Canal
14
Q
Where might you see a RITE feature?
A
On a Micro BTE
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
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
17
Q
It’s all about ______. As the size of the instrument ______, some things have to be ______.
A
“Real estate”
Decreases
Omitted
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
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
20
Q
What does ITE stand for?
A
In the Ear
21
Q
What does FS stand for?
A
Full Shell
22
Q
What does HS stand for?
A
Half Shell
23
Q
What is an All-in-the-Ear hearing aid?
A
One that fits in pinna and the ear canal
24
What are the parts of an all-in-the-ear hearing aid?
| 5
Battery door
Volume control/Program button
Microphone (Can have more than 1)
Vent
Receiver
25
All-in-the-ear hearing aids require an ______ to determine its ______.
Ear mold
Shape
26
What are some advantages to ITE hearing aids?
| 3
Microphone position reduces wind noise
Microphone position assists in localization
Less affected by sweating
27
Moisture is ______.
Deadly to hearing aids
28
What are some disadvantages to ITE hearing aids?
| 4
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
29
What does ITC stand for?
In the canal
30
What are the parts of an ITC hearing aid?
| 5
Battery door
Volume/Program control(s)
Microphone
Air vent
Receiver/Sound port
31
What are some advantages to ITC hearing aids?
Cosmetically appealing
32
What are some disadvantages to ITC hearing aids?
| 4
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)
33
What does CIC stand for?
Completely in the canal
34
What does IIC stand for?
Invisible in the canal
35
What are some advantages to CIC/IIC hearing aids?
| 4
Inconspicuous
Microphone location reduces wind noise problems
Can use headphones or phone over HA
Improved sound localization
36
What is the Lyric hearing aid?
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
37
How is the lyric hearing aid sold?
Sold on a prescription basis
Purchase includes a years worth of devices
Runs about $3000
38
How do you change the batteries in a lyric hearing aid?
You don't
When battery dies, need to visit your audiologist to remove the aid and replace with another
39
Is the lyric hearing aid digital or analog?
Analog
40
Can the lyric be programmed to meet specific requirements?
Yes
41
What range of hearing loss is the lyric designed to help?
Mild to moderate loss of hearing
42
What are some disadvantages to the lyric hearing aid?
| 4
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
43
What are Middle ear implants?
A surgically implanted device that increases the mechanical energy used to stimulate the structures of the inner ear.
44
Who might be a candidate for a middle ear implant?
| 4
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
45
What middle ear implant is FDA approved?
Vibrant Soundbridge
46
What does FMT stand for?
Floating mass transducer
47
What are the parts to a middle ear implant?
| 5
Processor (external)
Magnet/internal device
Conductor Link
Attachment
FMT* Body
48
In a middle ear implant, the ______ connects to the ______ via a magnet.
Audio processor (external)
Implanted device
49
How does a middle ear transplant work?
| 6
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
50
What are the advantages to middle ear implants?
| 3
Open ear canal
Great for patients with chronic draining ears!
No “feedback” (or squeal)
51
What are the disadvantages to middle ear implants?
| 4
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
52
What does BAHA stand for?
Bone Anchored Hearing Aid
53
What is a BAHA?
One that conducts sound via bone conduction
54
What are the parts of a BAHA?
| 3
Implant
Abutment
Hearing processor
55
What are the parts to a BAHA hearing processor?
| 3
Battery
Microphone
Signal (hearing) processor
56
In Single sided deafness, to fit a BAHA, you need _________.
Hearing in the contralateral ear better than or equal to 20 dB HL (an average of 500, 1000, 2000, and 3000 Hz)
57
What does SSD stand for?
Single sided deafness
58
In Mixed and Conductive hearing losses, to fit a BAHA, you need ________ for a one ear fitting.
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)
59
In Mixed and Conductive hearing losses, to fit a BAHA, you need ________ for a bilateral fitting.
Symmetric bone conduction thresholds (less than 10 dB difference on average at 500, 1000, 2000 and 3000 Hz)
60
BAHAs in children are approved for ages _______.
5 and up
61
How much does a BAHA cost?
Around $7500 for each device.
Surgeon and hospital is additional.
Some insurance companies do not pay for this.
62
What are the four basic hearing aid components?
Microphone
Amplifier
Receiver/ speaker
Power supply/battery
63
What does a microphone do in a hearing aid?
Picks up audio signal and converts it into an electrical signal
64
What are some types of microphones available in hearing aids?
Omnidirectional
Directional
65
What are some types of DIRECTIONAL microphones available in hearing aids?
(3)
Dual- and tri-microphone
Automatic
Adaptive directional
66
What does the amplifier do in a hearing aid?
| 3
Increase sound intensity - “gain”
Provides a “ceiling”
Controls maximum power output (MPO)
67
What types of amplifiers are available in hearing aids?
| 3
Analog
Programmable analog
Digital
68
How are Analog amplifiers adjusted?
Trimpots adjusted via small screwdriver
69
How are Digital amplifiers adjusted?
Have AD converter
Amplification controlled through software
70
What does the receiver do in a hearing aid?
Converts the signal from the amplifier back to acoustic energy
Largest component within most hearing aids
A mini loudspeaker
71
What is the most frequently damaged component in a hearing aid? Why?
Receiver
Damage from ear wax, moisture, cleaning
72
What is the power supply of a hearing aid?
The battery
73
What are the 5 sizes of batteries used in hearing aids?
5A
10A
312
13
675
All are 1.4 volt button type
74
How long do batteries tend to last in hearing aids? Which lasts longer: analog or digital?
1-4 weeks
Analog lasts longer than digital
75
Is more precise programming an advantage to digital hearing aids?
Yes
76
Are more parameters under audiologist’s control an advantage to digital hearing aids?
Yes
77
Is a more complex automatic signal processing an advantage to digital hearing aids?
Yes
78
Is better sound quality an advantage to digital hearing aids?
Yes
79
Is higher fidelity an advantage to digital hearing aids?
Yes
80
Is less distortion an advantage to digital hearing aids?
Yes
81
Is good loudness comfort an advantage to digital hearing aids?
Yes
82
Is better control of feedback an advantage to digital hearing aids?
Yes
83
Are quieter circuits an advantage to digital hearing aids?
Yes
| Meaning you can't hear the computer running
84
What are the signal processing options available on hearing aids?
Analog signal processing (Rarely used today)
Digital signal processing (Mathematical with numerical coding)
85
What is the signal pathway for analog hearing aids?
Mic -> Amp -> Filter -> Receiver
86
What is the signal pathway for digital hearing aids?
Mic -> Digital Signal Processor -> Amp -> Receiver
Computer controls what components are activated
87
What happens to the sound signal in digital hearing aids?
Sound is converted into a digital signal and then modified
88
When did the first 100%, completely digital hearing aid become available? Who made it?
1996
Widex/Oticon
89
The advent of the digital hearing aid allowed for a more ______ in a ______ hearing aid unit.
Advanced signal processing
Smaller
90
What are two stages to Digital Speech Processing?
Analog to Digital Converter:
Digital to Analog Converter
91
What does an Analog to Digital Converter do?
| 3
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
What is a Digital to Analog Converter?
The manipulated signal is now converted back into an analog signal
93
What is the flow to digital speech processing?
| 3
Analog to Digital Converter
Mathematical Signal Processing
Digital to Analog Converter
94
What is the most difficult state for using hearing aids?
Hearing in Noise
95
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?
Yes
Due to frequency and temporal resolution problems
These create poor word recognition.
96
Can the use of directional mics assist in creating better sound sensitivity?
Yes
97
In BTE hearing aids, directional microphones can be ______.
In smaller hearing aids, directional microphones may actually be ______.
2 physical microphones interacting together.
2 ports to a single microphone with advanced signal processing
98
What is the purpose of directional microphones?
To reduce the interference of background noise
99
Can hearing aid algorithms or processing detect the intent of the user?
No. This can varied the success of directional microphones.
100
The challenge to engineers is to provide a product that will ______ without the user needing to do this manually (automatic).
Switch between different patterns
101
A directional microphone with a free-field cardioid pattern is ______.
Most sensitive to sounds in front of the user
102
A directional microphone that is omnidirectional has ______.
Equally sensitivity in all directions
103
A directional microphone with a hypercardioid pattern is ______.
Most sensitive to sounds in front and at 90 degrees to the listener (directly behind the head)
104
A directional microphone with a bidirectional cardioid pattern is ______.
Most sensitive to sound in front and in back of listener
105
Why are there not directional microphones on all hearing aids?
It's an issue of space
106
What are the benefits to Binaural Amplification?
| 4
Elimination of head shadow effect
Loudness summation
Binaural squelch
Localization
107
Does Binaural Amplification benefit both adults and children?
Yes
108
What is the head shadow effect?
Sound is louder on the side of the head closest to the signal
The head acts to “dampen” the sound.
109
What frequencies do head shadows mostly affect?
High frequencies.
Low frequencies are almost unaffected due to the long wavelength.
110
What is Loudness Summation?
That a sound heard with 2 ears is usually judged to be louder than the SAME sound heard with 1 ear.
111
What is the Binaural Squelch?
Our ears and brain receive both speech and environmental sound/noise and suppresses those sounds that we are not interested in.
112
What are four things to consider when deciding whether an adult is a good candidate for hearing aids?
Listening demands/difficulties
Lifestyle, occupation, communication mode, age
Financial aspects
Degree of which sound is used to communicate
113
What are two factors that affect whether someone actually uses their hearing aid?
The perception of benefit
Reality vs. Expectations
114
The actual benefit of hearing aids is maximal in ______ conditions.
The desired benefit of hearing aids is greatest for ______ conditions.
Quiet
Noisy
115
Who are the AAA?
American Academy of Audiology
116
According to the AAA Pediatric Guidelines:
“[Hearing aids] should be considered for a child who demonstrates a ______, including ______, _______, or ______ of any degree.”
Significant hearing loss
Sensorineural
Conductive
Mixed losses
117
Children are now being fit with hearing aids as early as ___ months of age.
6 months
118
Infants should be _______, diagnosed by ______, and fit with hearing aids within ______ of diagnosis but no later than ______.
Screened at birth
3 months
1 month
6 months
119
Children should receive hearing aids if they have ______ whether or not it is ______ or _______.
Mild hearing loss and greater
Unilateral
Bilateral
120
Why is it so important to put children in hearing aid?
Essentially any degree of HL can affect the acquisition of speech and language
121
When fitting a child with hearing aids, should we consider safety features?
Yes
122
When fitting a child with hearing aids, should we consider the growth of ear?
Yes
123
When fitting a child with hearing aids, should we consider HAT/ALD capability?
yes
124
When fitting a child with hearing aids, should we consider hearing assistive technology/assistive listening devices?
Yes
125
When fitting a child with hearing aids, should we consider protection of device?
Yes
126
When fitting a child with hearing aids, should we consider the child tolerance of device in ear?
Yes
127
When fitting a child with hearing aids, should we consider programming w/limited audiometric data?
Yes
128
When fitting a child with hearing aids, should we consider the need for family/teachers to monitor device function?
Yes
129
When fitting an adult with hearing aids, should we consider the patient's age?
Yes
130
When fitting an adult with hearing aids, should we consider the patient's degree and configuration of HL?
Yes
131
When fitting an adult with hearing aids, should we consider the patient's preferences?
Yes
132
When fitting an adult with hearing aids, should we consider the cost of the device?
Yes
133
When fitting an adult with hearing aids, should we consider the patient's lifestyle?
Yes
134
When fitting an adult with hearing aids, should we consider the patient's health status?
Yes
135
What are two aspects of a patient's health status we should consider before fitting them with hearing aids?
Dexterity
Vision
136
What is Feedback?
A high pitched squealing sound heard by anyone near the hearing aid
137
Are hearing aid users always aware of feedback?
Nope. Sometimes the wearer does not hear this because their hearing loss is severe enough that they are not aware of this.
138
What causes feedback?
Feedback occurs as amplified sound leaks out of the ear and is re-routed back into the hearing aid microphone.
139
What are some conditions that can create feedback?
| 3
When hearing aid out of ear but turned on
Close physical proximity to another surface
When earmold is loose or inserted wrong
140
What current technology has made a serious dent in feedback occurances?
Digital feedback canceling circuits in today’s digital hearing aids
141
What is a tele-coil (or T-coil)?
| 4
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
Where can you find T-coils?
Specially equipped telephones
Some assistive listening devices
143
What are 5 common hearing aid options?
Program button (Mute the HA, switch to telecoil, change programs)
Volume control
DAI capabilities (direct audio input)
Remote Controls
“Streaming” devices
144
“The good news is that we have ______. The bad news is that we have ______.” (Cunningham, 1997)
More options
More options
145
What are streaming devices?
Bluetooth streaming from TV, telephone, etc.
This is then transmitted to the hearing aid using the T-coil of the hearing aid.
146
What does DAI stand for?
Direct Audio Input
147
Are cell phone t-coil rated?
Yes
148
What is Verification/Validation?
Making sure the hearing aid is properly fit
149
Why is Verification/Validation important?
Hearing aids MUST be fit properly to work properly
Objective verification/validation measures ensure accurate fitting
150
Recent Consumer Reports test found that ______ of hearing aids were misfit; They amplified ______.
2/3
Too much or too little
151
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 ______.
Actual measurements in the ear
Inaccurate fittings
152
Do most hearing aid dispensers use real ear measurements to fit a hearing aid?
Nope
153
What does a Phonak 8000 box do?
A hearing aid test analyzer
Tests the functionality of hearing aids
154
Are telecoils an advantage to Typical BTEs?
Yes
155
Is Lots of Power an advantage to Typical BTEs?
Yes
156
Is Flexibility an advantage to Typical BTEs?
Yes
157
Is the ability to easily remake the earmold an advantage to Typical BTEs?
Yes
158
Is less problems w/ Feedback an advantage to Typical BTEs?
Yes
159
Is sturdiness an advantage to Typical BTEs?
Yes
160
Is non-occlusion an advantage to Typical BTEs?
Yes
161
Are advanced “options” an advantage to Typical BTEs?
yes
162
Is the inability to change volume/programs a disadvantage to CIC/IIC Hearing Aids?
Yes. The patient will need a remote control or this may not even be available
163
Is the lack of T coil availability a disadvantage to CIC/IIC Hearing Aids?
Yes
164
Is the fact that CIC/IIC Hearing Aids cannot be paired with FM systems a disadvantage?
Yes
165
Is the fact that CIC/IIC Hearing Aids may increase occlusion (feeling “plugged up”) a disadvantage?
Yes
166
Is higher maintenance due to earwax a disadvantage to CIC/IIC Hearing Aids?
Yes
167
Is the fact that CIC/IIC Hearing Aids must be fit perfectly critical or FB occurs a disadvantage?
Yes
168
Is improved directionality and localization an advantage to the Lyric hearing aid?
Yes
169
Is a reduced sense of occlusion and feedback an advantage to the Lyric hearing aid?
Yes
170
Is high frequency gain an advantage to the Lyric hearing aid?
Yes
171
Is reduced wind noise an advantage to the Lyric hearing aid?
Yes
172
Is less distortion due to less gain required an advantage to the Lyric hearing aid?
Yes
173
Is normal telephone use (don’t need a T coil) an advantage to the Lyric hearing aid?
Yes
174
Is comfort an advantage to the Lyric hearing aid?
Yes
175
Is 100% invisiblity an advantage to the Lyric hearing aid?
Yes
176
Real ear measurements are ______.
The coolest tool ever
177
What do real ear measurements do?
Allow us to measure how the sound has been processed through the hearing aid in the ear canal
178
What is the name of the dummy in the real ear measurements slide?
KEMAR
179
Is ease of maintenance an advantage to the Lyric hearing aid?
Yes
