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Audiology & ENT > Hearing Aids > Flashcards

Hearing Aids Flashcards

1
Q

What is the goal of a hearing aid?

A

amplify sounds thereby increasing the signal to the wearer: provide audibility

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2
Q

What a hearing aid not?

A

A cure for hearing loss

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3
Q

What is the hearing aid made up of?

A

mic+amplifier and complex signal processors

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4
Q

How many people in the UK are affected by hearing loss?

A

1 in 6

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5
Q

How many people in the UK would benefit from hearing aids?

A

1 in 10

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6
Q

What are the 2 types of HA?

A

Behind the ear (post-aural)

In the ear

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7
Q

Describe the BTE

A

• Worn behind pinna
• Coupled to concha via plastic tube and earmold
• Delivers sound to external auditory meatus (ear canal)

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8
Q

Describe the ITE

A

• More restricted acoustics • Aesthetics

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9
Q

What ate the types of ITE?

A

Full concha
Half concha
In the canal
Completely in the canal

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10
Q

How do bone conduction hearing aids work?

A

• Sound transmitted through mechanical vibration of cranial bones, to cochlea rather than through outer/middle ear (air conduction)
• Bypasses the outer/middle ear: for conductive losses

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11
Q

What are the issues of BC HA?

A
  • Cosmesis of headband
    • Headband discomfort (headaches, pressure)
  • Low gain, poor sound quality
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12
Q

What is the difference between Bone anchored and bone conduction?

A

Bone anchored the bone vibrator implanted directly into patient

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13
Q

How is a bone anchor fitted?

A

• Titanium screw inserted into skull
• Aidattachedtoscrew
• For patients with chronic conductive hearing loss/outer/ middle ear pathology

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14
Q

What are the components of hearing aids?

A

air conduction receiver (speaker)
Microphones- two or more to reduce background noise
Mechanical potentiometer for volume controls
Mechanical switch for program switching
Battery
Telecoil- converts electromagnetic fields to electrical energy (phones)

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15
Q

What is the change in a microphone

A

Converts sound into electrical

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16
Q

What is the change in a receiver?

A

Converts electrical back into sound

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17
Q

What is the process in a digital amplifier?

A

Sound- Voltage- Digital signal- digital processing- digital signal- Voltage- Sound

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18
Q

What is gain in terms of amplification?

A

measure of amplification applied to signal (at particular frequencies): difference between input level and output level

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19
Q

What is amplification set according to?

A

Hearing loss

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20
Q

What are the two types of amplification?

A

Linear

Non-linear

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21
Q

Describe Linear amplification

A

• Gain constant for all levels of input
• 1:1 ip/op slope
• 70 dB sound amplified same level as 40 dB sound

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22
Q

Describe non-linear amplification

A

Gain varies according to input level • <1:1 ip/op slop

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23
Q

When in non linear amplification commonly used?

A

Modern hearing aids

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24
Q

What does non linear amplification do?

A

Makes sound comfortable

Allows us to avoid overamplifying louder sounds

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25
Q

What happens in non linear amplification?

A

We compress (squeeze down) larger input signals to make
the output more comfortable

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26
Q

What are directional and omni directional microphones good for?

A

Directional microphones useful for different acoustical environments

27
Q

What is modulation detection/ amplitude modulation noise reduction?

A

Noise more stationary than speech, less gain for stationary inputs

28
Q

What is synchrony detection?

A

Identifies presence of speech (harmonics) and rejects other (noise)

29
Q

What are the two types of noise reduction algorithms?

A

Modulation detection and synchrony detection

30
Q

What do Noise reduction algorithms do?

A

Asses input

Reduce gain in frequencies dominated by noise

31
Q

What is telecoil pickup more commonly known as?

A

The loop system

32
Q

Describe the loop system

A

• Inductive pickup in HA housing picks up
signal from induction loop around room/area
• Removes background noise by cutting out HA mic

33
Q

What do assisted listening devices improve?

A

signal to noise ratio by transmitting amplified sound directly to HI listener

34
Q

What do assisted listening devices target?

A

Typically target a single problem: TV, phone, signalling/alerting/lecturing

35
Q

What does the physical fit of an earmould provide?

A

Interface between HA and user

36
Q

What does the physical fit of a hearing aid facilitate?

A

efficient transfer of sounds from receiver to the
external auditory meatus

37
Q

What can the poor fit of an earmould affect?

A

The Benefit of the hearing aid

38
Q

List 5 things that the earmould should be.

A

• Comfortable
• Easy to fit and remove
• Cosmetically acceptable
• Easy to clean
• Good contact for acoustic fit

39
Q

List 6 benefits of the slim tube and dome

A

• Low visibility
• Improved ear ventilation
• Natural low freq sounds can enter ear
• Reduce occlusion effect (head in a barrel)
• Comfortable
• Same day fitting

40
Q

What are slim tube and dome not suitable for and why?

A

not suitable for more severe losses. High gain=leakage and feedback

41
Q

How does an electro acoustic fit happen?

A

Programming the hearing aid parameters via hearing aid fitting software

42
Q

What is gain?

A

Level of amplification

43
Q

Describe setting gain.

A
  • Most important parameter (gain=level of amplification)
  • Fit gain in range between hearing thresholds and
    uncomfortable loudness levels
    • This area is known as the dynamic range
  • Area reduced with hearing impairment
44
Q

What is NAL formula fitting gain?

A
  • One example of prescription formula
    • Mathematical formula for generating gain values
  • Average based on 1000s of data
    • Thresholds+ULLs+formula=GAIN CURVES
45
Q

For real ear measurements what must we measure?

A

The levels of gain reaching the tympanic membrane

46
Q

What is the purpose of real-ear measurements?

A

to acoustically verify that the correct, prescribed amount of gain is reaching the ear drum

47
Q

Why do we do real-ear measurements?

A

Everyone’s ears are different shapes and sizes
• Is the software accurate in its gain measures?
• Could be under- or over-fitting gain

48
Q

What are REMs a crucial part of?

A

hearing aid fittings and its benefits is widely proven scientifically

49
Q

What is the method of real-ear measurements?

A
  • Place small probe microphones in ear (6 mm from TM)
  • Measure level differences with and without hearing aid
  • Match up measured gain curve to prescribed target
50
Q

What must a patient do after the HA is fitted?

A

Build up use

51
Q

Why must patient build up use of HA?

A

• HA requires acclimatisation. Patient hears sounds not heard
in years, this can feel odd, sound internalized. But good!
• Eg, fridge noise. Great that patient hearing such low sounds, but not nice! Brain acclimatises and filters out

52
Q

What happens at follow up appointments after HA is fitted?

A
  • Fine-tuning and troubleshooting

* Outcome measures

53
Q

What are common problems of HA?

A 
Poor fitting - pain 
HA whistling
Blocked mould-wax
Blocked tubing- condensation 
Sweaty ear canal 
Aid too loud 
Aid too noisy 
Aid to tinny 
Background noise
54
Q

What happens if the HA is poorly fitted/ hurting the patient?

A
  • Check patient is inserting earmould correctly

* Make new earmould
• Shave off parts of earmould

55
Q

What must we do is the HA is whistling?

A
  • Check mould to see how fits and contacts with ear
  • Make new softer mould with greater contact
    • Increase feedback suppression parameter
  • Turn down gain slightly
56
Q

How does whistling in the HA occur?

A

Feedback caused by amplified sound escaping from the ear and is re-amplified by the HA

57
Q

What do you do if the mould is blocked by wax?

A

Wash or remove wax

58
Q

What do you do if there is condensation in the tube?

A
  • Insert small vent into air mould to improve air circulation
  • Replace tubing
59
Q

What do you do if there is a sweaty ear canal?

A

Narrow bore vent into mould to allow better air circulation

60
Q

What do you do if the aid is too loud?

A
  • Reduce overall gain below recommended levels

* Once patient has acclimatised then increase

61
Q

What do you do if the aid is too noisy?

A
  • Reduce low frequency gain

* Add vent to mould

62
Q

What do you do if the aid is too tinny?

A

Reduce high frequency gain

63
Q

What do you do if there is a problem with background noise in the HA?

A

Program hearing aid to allow for directional microphone and
increase noise reduction algorithm strength

64
Q

How does the counselling process occur with HA problems?

A
  • Discuss problematic situations
    • Recommend ALDs
    • Explain acclimatisation to patient
  • Manage expectations

Audiology & ENT (7 decks)

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