Hearing Aids (Mr. Desbel)

Question 1

Who is Mr. Desbel?

Answer 1

• An outgoing 73 year-old retired CIO of a cyber security and technology company who uses an iPhone
• Current BTE hearing aids are 5 years old and he doesn’t use any assistive technology
• No history of noise exposure, tinnitus, aural fullness, dizziness, drainage, and ear surgeries
• Leads an active lifestyle with his husband, 3 children, and 8 grandchildren
• No health conditions, normal cognitive abilities, physically fit
• Activities:
  • Goes to the gym 3x a week
  • Attends grandchildren’s activities
  • Family gatherings and parties
  • traveling with husband and going on tours
  • Sporting events (Maryland Basketball and football, Nats, Caps)
  • Foodie so likes to go to restaurants

In last 6 months:

• no change in health
• Not as outgoing
• Withdrawn and isolated
• Pulling away from family and not socializing like he used to
• No longer eating out as frequently
• Doesn’t attend as many of the larger family gatherings
• Doesn’t travel as much b/c of difficulty hearing tour guide
• Greater difficulty with speech understanding on the phone, TV, and in noise

Question 2

Describe the comprehensive assessment of Mr. Desbel’s communication loss through objective measures.

Answer 2

• Case history
• Otoscopy
• Pure tone air and bone conduction
• Tympanometry (to rule out middle ear dysfunction)
• SRT
• WR in quiet
• EA on hearing aids
• Unaided speech-in-noise using QuickSin

Question 3

Why would you use the QuickSIN over the HINT?

Duncan & Aarts, 2006

Answer 3

• Easier to score
• Easier to administer
• Scoring is relative to performance for normal hearing individuals

Question 4

Describe the comprehensive assessment of Mr. Desbel’s communication loss through subjective measures.

Answer 4

Questionnaire such as Glasgow Hearing Aid Benefit Profile (GHABP)

Question 5

What is the Glasgow Hearing Aid Benefit Profile (GHABP)?

Gatehouse, 1999

Answer 5

• A questionnaire that can be administered by the audiologist in an interview format.
• 6 scales assessing disability, handicap. hearing aid use, hearing aid benefit, hearing aid satisfaction, and residual disability in 8 different circumstances (4 pre-specified ad 4 patient specified)
• Can be answered in terms of his current hearing aids and then re-assessed with new hearing aids following his hearing aid fitting.

Question 6

What are the 4 pre-specified settings on the GHABP?

Answer 6

1) Listening to television with other family or friends when the volume is adjusted to suit others
2) 1-on-1 conversation in quiet
3) Conversation on busy street or in busy shop
4) Conversation with several people in a group

Question 7

What are the expected results of the testing with Mr. Desbel?

Answer 7

• Pure tone audiometry–> stable
• Normal tymps
• WR is fair (R: 68%, L: 72%)
• QuickSIN–> Severe SNR loss of 16 dB
• PTA and SRT are in agreement indicating inter-test reliability
• EA of hearing aids revealed high distortion, high equivalent input noise, and low high frequency average full on gain
• GHABP indicated that he wants to improve in 1.) hearing grandchildren 2.) tours 3.) phone 4.) restaurants

Question 8

Describe a patient-centered treatment plan for Mr. Desbel

Answer 8

1. ) Counseling on results and options
2. ) Recommendation for new hearing aids (ReSound LiNX2 9 BTE hearing aids) based on EA of hearing aids and age of devices
3. ) Assistive technology–> TV Streamer and multi-microphone for tours and in restaurants
4. ) Computer-based auditory training

Question 9

Why aural rehab?

Answer 9

Research has shown that aural rehabilitation following HAF results in decreased subjective hearing handicap, increased hearing aid use, and increased hearing aid satisfaction compared to individuals who don’t receive aural rehabilitation (Sweetow & Sabes, 2006)