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Audiology and ENT Yr2 > Hearing Aids > Flashcards

Hearing Aids Flashcards

1
Q

Name some historical hearing aids.

A

sound collectors
chair with insert into ear
hairband
battery pack device - body worn hearing aids

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2
Q

Why do some people not want to wear a hearing aid?

A

There is a stigma surrounding them- however nowadays are hardly noticeable.

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3
Q

What do hearing aids not do?

A

They do not cure hearing loss.

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4
Q

What are the goals of hearing aids?

A

Goal is to amplify sounds thereby increasing the signal to the wearer which provides audibility.

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5
Q

Hearings aids are only an _____ not a cure.

A

aid.

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6
Q

Hearing Aids are not just a mic + amplifier, they have….

A

complex digital signal processors.

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7
Q

Hearing aids are all different _____, _______ and _______.

A

Shapes
Sizes
Colours

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8
Q

What is the most common type of hearing aid?

A

Behind the ear (BTE) (or post aural) Hearing Aid.

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9
Q

How is the behind the ear hearing aid worn?

A

Behind the pinna.

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10
Q

What is the BTE coupled to?

A

Its coupled to the concha (main part of the pinna) via plastic tube and earmold.

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11
Q

Where does the behind the ear hearing aid deliver sound to?

A

It delivers sound to external auditory meatus (ear canal).

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12
Q

What is an alternative to the behind the ear hearing aid?

A

In the ear.

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13
Q

In the ear hearing aids are better________ but have more restricted ________ than BTE.

A

aesthetically, acoustics.

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14
Q

In the ear HA’s can be either…

A
  • full concha
  • half concha
  • ITC (in the canal)
  • CIC (completely in the canal)
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15
Q

What is more discrete, in the concha (ear) or in the canal?

A

in the Canal is more discrete :)

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16
Q

Hearing Aids can be worn on the body, what are these called?

A

Body Worn Hearing Aids.

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17
Q

When are bone conduction (BC) hearing aids used?

A

When there’s problems with the pinna, ear canal and glue ear.

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18
Q

What does the bone conduction hearing aid bypass?

A

It bypasses the outer/middle ear.

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19
Q

What hearing loss can bone conduction hearing aids be used for?

A

Conductive losses.

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20
Q

How does a bone conduction hearing aid work?

A

Sound transmitted through mechanical vibration of cranial bones, to cochlea rather than through outer/middle ear (air conduction).

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21
Q

How is the bone conduction hearing aid worn?

A

On the mastoid process behind the ear and then battery clipped to body (not v. aesthetic).

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22
Q

For babies how is a bone conductor hearing aid worn?

A

It is worn as a headband.

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23
Q

Why is it important for children to wear hearing aids?

A

So the child is exposed to sound as early as possible for language acquisition.

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24
Q

Name some issues with bone conduction hearing aids.

A
  • cosmesis of headband- people don’t want to wear it
  • headband discomfort (headaches, pressure)
  • Restriction of movement
  • Low gain, poor sound quality (worse than air conduction HA) and speech discrimination.
  • Acoustic feedback
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25
Q

What is a bone anchored hearing aid?

A
  • Titanium screw inserted into skull

- Aid is attached to screw

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26
Q

Name the HA that needs a screw inserted into the skull.

A

Bone Anchored Hearing Aids.

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27
Q

What sort of patients would use bone anchored hearing aids?

A

For patients with chronic conductive hearing loss/outer/middle ear pathology.

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28
Q

Bone anchored hearing aids are _______, whereas hairbands are ________.

A

Permanent

Temporary

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29
Q

What are the components of a hearing aid?

A

Microphone
Receiver
Digital Amplifoer

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30
Q

What does the microphone of a hearing aid do?

A

It converts sound energy into electrical energy.

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31
Q

What does a receiver of a hearing aid do?

A

It converts electrical energy back into sound.

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32
Q 
HA process/ feedback loop:
1.
2.
3.
4.\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_\_\_
5.
6.
7.
A 
Sound wave (picked up by microphone)
Voltage wave
Digital signal
Digital Processing
Digital signal
Voltage wave
Sound wave (delivered to patient)
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33
Q

What performs the following function?-

Signal sampled at discrete time intervals and processed as discrete quantities.

A

Digital Amplifier.

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34
Q

In the feedback loop of a HA, what happens at the digital processing stage?

A

Amplified

Manipulated

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35
Q

Define Gain.

A

Measure of amplification applied to signal (at particular frequencies). Difference between input level and output level.

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36
Q

What is gain set according to?

A

Hearing Loss.

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37
Q

What gain would be set for:

A mild/moderate high frequency hearing loss.

A

Mild-moderate gain at high frequencies (presbyacusis)

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38
Q

______ is the most important Hearing Aid (HA) parameter.

A

Gain

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39
Q

Gain is to do with _______.

A

Amplification.

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40
Q

How is amplification/gain set?

A

By applying PTA thresholds to the prescription formula.

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41
Q

Name the 2 types of amplification.

A

Linear

Non-Linear.

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42
Q

In Linear Amplification, Gain is…

A

constant for all levels of input.

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43
Q

Linear amplification is ____ input:___ output. (45 degrees)

A

1:1

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44
Q

Name the amplification:

As the input increases, the output increases at the same rate.

A

Linear Amplification.

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45
Q

In linear amplification, would a 70dB sound be amplified at the same level as a 40dB sound?

A

Yes.

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46
Q

What type of amplification is used in modern hearing aids?

A

Non-linear Amplification.

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47
Q

In non-linear amplification, the gain…

A

Varies according to input level.

48
Q

Non-linear amplification:

_____ input: ______ output

What shape is the line and what is this known as?

A

<1:1

<45 degrees, known as compression.

49
Q

Name the type of amplification:

70dB sound is amplified at different levels to a 40 dB sound.

A

Non-linear amplification

70dB would be amplified at a reduced level compared to 40dB.

50
Q

In non-linear amplification, what does compression do?

A

Makes sounds more comfortable.

51
Q

People with ___________ hearing loss have raised hearing thresholds but often their uncomfortable loudness levels remain unchanged (the same as a normal listener).

A

Sensorineural.

52
Q

Non-linear amplification performs loudness recruitment, what is this?

A

Less gain is needed as the input signal increases.

53
Q

What do we use compression for?

A

To avoid overamplifying sounds.

54
Q

We _______ larger input signals to make the output more comfortable.

A

Compress

55
Q

What on a HA is useful for different acoustical environments e.g. restaurants, pubs?

A

Directional microphone.

56
Q

What assesses input signals and reduces gain in frequencies dominated by noise?

A

Noise Reduction Algorithms.

57
Q

What does modulation detection assume?

A

Assumes noise is more stationary than speech- less gain for stationary inputs.

58
Q

What does synchrony detection do?

A

It identifies the presence of speech (harmonics) and rejects other noise.

59
Q

What can be used in lecture halls that can be connected with a HA?

A

An Induction Loop

A telecoil pickup - The Loop System

60
Q

What does an induction loop do?

A

Inductive pickup in HA picks up signal from induction room around the room and removes background noise by cutting out HA mic.

61
Q

An ______ loop improves signals to noise ratio and completely removes background noise.

A

Induction.

62
Q

Other devices may help patient’s needs better than a hearing aid. What is the proper name for these?

A

Assisted Listening Devices.

63
Q

Assisted listening devices can improve _____________ ratio by transmitting amplified sound ____ to the HI listener.

A

Signal to Noise ratio

Directly

64
Q

What can assisted listening devices do? give an example :)

A

Convert sound into a visual or tactile signal.

e.g. vibrating alarm clock.

65
Q

What are used in hearing impaired schools where the teacher is connected up to a mic and the kids all have headphones?

A

FM systems.

66
Q

The patient can use _______ audio streaming that they can ________.

A

Bluetooth

Control.

67
Q

What are technology advancements working towards?

A

Being able to connect HA with smartphones.

68
Q

Name the 2 parts of fitting a hearing aid.

A
  • Physical and electroacoustical fit

- Follow up and counselling

69
Q

What provides interface between the HA and the user?

A

Earmould.

70
Q

Why is the physical fit of a HA important?

A

-To facilitate efficient transfer of sounds from receiver to the external auditory meatus.

71
Q

Physical features can significantly affect the _______ of the hearing aid.

A

electroacoustics.

72
Q

What is custom made to suit the individual’s ears?

A

Earmould.

73
Q

Why are earmoulds custom made?

A
  • Everyone’s ears are different shapes and sizes

- Poor fit can drastically affect the benefit of the HA

74
Q

An Earmould should be…

A
  • Comfortable
  • Easy to fit and remove
  • Cosmetically Acceptable
  • Easy to clean
  • Good contact for acoustic fit.
75
Q

Sometimes earmoulds are _______ to help old people to know what ear i’s for (Left and Right are different colours).

A

colour coded
red- R
blue - L

76
Q

Why must earmolds must have good contact with the ear?

A

For a good acoustic fit, otherwise if it didn’t fit properly, sound would leak from the ear.

77
Q

How do they get the shape of your ear to custom make the earmold?

A

They put impression material in the ear and leave it to set for 5-10m mins.

78
Q

What is an open fit alternative to an earmould?

A

Slim tube and dome.

79
Q

What are the benefits of the slim tube and dome?

A
  • Low visibility aka. can’t notice it
  • Improves ear ventilation (into the eat canal)
  • Natural low frequency sounds can enter ear
  • Reduces occlusion effect (head in a barrel)
  • Comfortable
  • Same day fitting
80
Q

What is a slim tube and dome not suitable for?

A

Not suitable for more severe losses.

High gain= leakage (sound leaks back out of ear) which causes feedback (whistling).

81
Q

What do they do for a good electroacoustic fit?

A

They programme the hearing parameters via hearing aid software which then gives the best HA options.

82
Q

Level of amplification is also known as _______.

A

Gain.

83
Q

What is the most important HA parameter?

A

Setting Gain.

84
Q

What should gain be fitted inbetween?

A

Inbetween hearing thresholds and uncomfortable loudness levels.

85
Q

The range of sound one can hear is known as the..

A

dynamic range.

86
Q

The dynamic range is reduced with __________ _________.

A

Hearing Impairment.

87
Q

________ formulas are used to fit HA gain.

A

Prescriptive.

88
Q

______ ______ to set gain ares based on real worls data and research.

A

Mathematical formulas.

89
Q

Formulas generate __________ ___________of gain required across _______ for a specific set of hearing ________.

A

target levels
frequencies
hearing thresholds

90
Q

Formulas are applied using what?

A

A computer with HA fitting software.

91
Q

What does the NAL-NL 1 formula aim to do?

A

Aims to maximise speech intelligibility and restore loudness perception.

92
Q

The NAL_NL 1 is based on __________________ to predict HI performance.

A

Loudness models and speech intelligibility index.

93
Q

Less _______ for loud sounds.

A

Gain.

94
Q

What does REM stand for?

A

Real-ear measurements.

95
Q

We need to measure the levels of gain reaching the ________ ________.

A

Tympanic membrane.

96
Q

What is the purpose if Real-ear measurements (REM)?

A

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

97
Q

Why must we do REMs after using our formulas and setting the gain accordingly?

A

-Everyone’s ears are different shapes and sizes but the prescriptions (formula) only provide an initial estimate based on average.

98
Q

What checks if we are over or under fitting gain?

A

REM (Real Ear Measurement).

99
Q

___________ are a crucial part of hearing aid fittings.

A

REMS.

100
Q

What is the method describing:

  • small probe placed in ear
  • measure level differences with and without hearing aid
  • match up measured gain curve to prescribed target
A

Real Ear Measurements.

101
Q

What are the 2 main things that should happen post fitting of a HA?

A
  • Patient should build up the use of the HA

- Should attend follow up appointments

102
Q

Why does the patient need ti build up the use of a HA?

A

It requires acclimatization, may hear sounds they haven’t heard in years- strange, annoying eg. fridge noise.
Takes time for brain to adjust.

103
Q

What happens in a follow up appointment?

A
  • Fine-tuning and troubleshooting (making adjustments)

- Outcome measures eg. GHBP- is HA helping? (questionnaire)

104
Q

A common problem is a poor fitting ________ hurting.

A

Earmould.

105
Q

How is the earmould hurting solved?

A
  • make new earmould
  • check patient inserting it correctly
  • shave bit off earmold
106
Q

Another common problem is HA whistling, what causes this?

A

Feedback caused by amplified sound escaping from the ear and is re-amplified by the HA (heard as whistle).

107
Q

How can HA whistling be stopped?

A
  • earmould not fitting correctly- fit new one, make softer mould to enhance contact with ear
  • turn down gain slightly
108
Q

What can block the earmould and stop/reduce amplified sound being presented to the ear? How is this solved?

A

Wax

Wash earmould or remove wax if necessary.

109
Q

Another common problem is ___ tubing/ _______ in the tube- how is this solved?

A

Blocked
Condenstaion
Insert small vent into earmould to improve air circulation. Or replace tubing.

110
Q

Why would a narrow bore vent be created in the mould to allow better air circulation?

A

If the user complains of blocked, sweaty ear canals.

111
Q

A common problem is that the aid can be too ______.

A

Loud.

112
Q

If the aid is too loud, how is it solved?

A

Reduce overall gain below recommended levels

Once patient acclimitised then increase.

113
Q

If the hearing aid is too noisy, how is it solve?

A
  • Reduce Low frequency gain (eg. fridge noise)

- Add vent to mold.

114
Q

When would we reduce high frequency gain?

A

If aid too tinny.

115
Q

How are problems with background noise solved?

A

program HA to allow for directional microphone and increase noise reduction algorithm strength.

116
Q

What is also important when going through the HA process?

A

Counselling.

117
Q

What does counselling involve?

A
  • discuss their problems + problem solve
  • we can give them info
  • help them deal emotionally
  • explain they have to acclimitise to HA
  • Manage expectations (its not a cure)
  • Set Goals (realistic!)
  • Motivation

Audiology and ENT Yr2 (21 decks)

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