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Aural Rehabilitation > Lecture 2.1 > Flashcards

Lecture 2.1 Flashcards

1
Q

What are the components of all hearing aids?

A

microphone - picks up the sound
amplifier - increases the gain
battery - power source
signal processor - computer within the aid
receiver - sends amplified sound to the ear

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2
Q

What is the best way to treat most hearing loss?

A

amplification

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3
Q

How do hearing aids work?

A

sound picked up by microphones

sent to amplifier and then signal processor

amplified signal transferred to receiver to be delivered to ear

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4
Q

What are some factors that contribute to candidacy for hearing aids?

A

age
type and degree of hearing loss
monoaural vs. binaural
needs and lifestyle
technology level
dexterity
physical and or psychological factors

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5
Q

What is binaural squelch/squelch effect?

A

aka cocktail party effect

a signal in the presence of noise is more easily detected when the signal and noise are presented to both ears rather than one ear alone
- benefit of adding the ear with the poorer signal to noise ratio

binaural listener can attend to a conversation in the presence of background noise

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6
Q

What is the head shadow effect?

A

attenuation of sound that occurs as it passes through the head

when hearing on side of poor ear it reduces the loudness of sound as it passes through the head to reach the better ear

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7
Q

What is the localization effect?

A

the ability to know the direction of the sound and to orientate in an environment

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8
Q

What is the summation effect?

A

a boost in perceived loudness when both ears hear a signal

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9
Q

Are 2 hearing aids always better than one?

A

yes unless only single sided deficits

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10
Q

Who uses BTE hearing aids?

A

all ages, mild to profound degree of hearing loss

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11
Q

What are the types of BTE hearing aids?

A

open fit
receiver in the canal

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12
Q

What are open fit hearing aids?

A

thin tube is attached to the device and a dome is used along with it, allows ear canal to remain open

suitable for individuals with excessive wax build up

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13
Q

What are receiver-in-the-canal hearing aids?

A

has an external receiver which goes into the ear canal

for mild-severe hearing loss

no “plugged up” feeling

minimizes amplification of own voice by allowing sounds to escape through ear canal

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14
Q

What are the types of custom hearing aids?

A

in the ear (ITE)
in the canal (ITC)
completely in the canal (CIC)

all made using ear mold impression of the patient’s ear

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15
Q

What is an in-the-ear hearing aid?

A

molded and fits the outer ear

suitable for mild-severe hearing loss

not recommended for children because the casing would need to be replaced often as the child’s ear keeps growing

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16
Q

What is an in-the-canal hearing aid?

A

molded and fits partly in the ear canal

for mild to moderately severe hearing loss

not suitable for children, individuals with severe to profound hearing loss, or individuals with poor dexterity (harder to insert and remove device)

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17
Q

What is a completely in the ear hearing aid?

A

molded to fit full inside the ear canal

smallest type, nearly invisible

not recommended for children or individuals with severe-profound hearing loss

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18
Q

What is the hearing aid fitting process?

A

assessment of hearing loss
selection of hearing aid
verification of hearing aid
outcome validation

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19
Q

Why is hearing aid fitting important?

A

hearing aids fit comfortably

output of hearing aid meets specific hearing needs and lifestyle needs

speech is audible and comfortable across a broad range of frequencies

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20
Q

What occurs during a hearing assessment?

A

case history
- medical, hearing, family, noise exposure, etc.

otoscopy

audiologic assessment
- acoustic immittance procedures (ex. tympanometry)
- OAEs
- pure-tone audiometry (air and bone conduction)
- ABR

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21
Q

What is acoustic immittance?

A

measure of air pressure flow

useful in assessing anatomy of the middle ear and then function of the tympanic membrane and muscle reflexes

22
Q

What do OAEs measure?

A

the responses from hair cells in the inner ear

23
Q

What is pure tone audiometry?

A

behavioural test that measures hearing thresholds through air and bone conduction

using in hearing aid programming when available

24
Q

What is ABR?

A

auditory brainstem response

records evoked potentials from auditory nerve and brainstem structures

25
Q

What are the physical features to be considered during selection of hearing aids?

A

style of hearing aids (depends on type and degree of loss, age, appearance, etc.)
binaural vs. monaural
ear mold/shell type and configuration
number and size of user controls
compatibility with other technologies

26
Q

What are some electroacoustic characteristics to be considered during hearing aid selections?

A

microphones
noise reduction
binaural processing
program options

also:
digital feedback control
frequency lowering
telecoil sensitivity

27
Q

What is the role of microphones in hearing aids?

A

pick up sound and send it to processor

have at least one, usually 2 or more

hearing aids that communicate between ears use microphones on both aids to collect sound from specific locations

28
Q

What are the types of microphones used in hearing aids?

A

omni-directional - picks up sound from all around

directional - multiple microphones work to reduce sound from behind the target signal and can be configured in an array to form a directional response

beamforming microphone array - can be designed to be more sensitive to sound coming from one or more specific directions than sound coming from other directions

29
Q

How can hearing aids reduce noise?

A

noise affects fatigue, memory, comprehension, and performance because of an increase in cognitive load

digital noise reduction provides less amplification to noise than speech
- identifies frequencies/times when noise is intense relative to speech and applies less amplification

30
Q

What are the benefits of binaural processing?

A

better hearing in noise
better localization of sound
phone use going to both ears

31
Q

What are hearing aid programs?

A

different settings or configurations of the hearing aid that can be selected based on environment
- vary gain, noise reduction, directionality

number of programs in a hearing aid can vary

32
Q

What are tinnitus programs?

A

hearing aids have specific programs for tinnitus patients - patients with ringing or noises in the ears

33
Q

What is digital feedback control?

A

whistling sound from the hearing aid is automatically cut out

34
Q

What are the components of hearing aid fitting and verification?

A

quality control
electroacoustic analysis
physical fit
fitting approaches

35
Q

What is quality control?

A

before fitting the aid

do a listening check using a stethoscope to rule out noise and check sound quality

36
Q

What is electroacoustic analysis?

A

hearing aid tested and compared to American National Standards Institute (ANSI) to verify if it meets its intended performance measures

37
Q

How is the physical fit of a hearing aid tested?

A

fit of the ear mold or hearing aid is verified with the patient by assessing cosmetic appeal, physical comfort, absence of feedback, ease of insertion, and removal

38
Q

What are fitting algorithms?

A

mathematical models that adjust the amplification and frequency response of a hearing aid to match the specific hearing needs of the user

most common: desired sensation level and NAL-NL2

39
Q

What are real ear measures?

A

measures the actual sound levels delivered to the ear through the hearing aid

used to set hearing aids/verify proper fitting
- proper frequency gain
- ensure audibility/minimize discomfort

a probe microphone measures sound levels in the ear canal while the hearing aid is in use, hearing aid response displayed on SPLogram
- plots dB SPL at each frequency

40
Q

How does the equipment for real ear measures work?

A

place probe tube in ear canal within 5mm of ear drum

measures sound pressure level just before it hits the ear drum, adjust based on target levels
- targets based on hearing loss, hearing aid style, ear shape, etc.

41
Q

What is the goal of hearing aid fitting?

A

adjust hearing aid response (using SPLogram) so that it meets the prescriptive targets

connected to manufacturer’s hearing aid software during the fitting and gain adjustments are made in real time

42
Q

What levels are hearing aid responses calibrated at?

A

soft - 55 dB SPL
average - 65 dB SPL
loud - 75 dB SPL
max power output - 90 dB SPL
- ensures hearing aid does not exceed uncomfortable hearing levels

43
Q

What do we do if we notice hearing aid output does not match prescriptive targets?

A

fine tuning/adjusting the gain to match the targets

can bring gain up at certain frequencies and down at others as necessary

44
Q

What is the importance of real ear verification?

A

provides accurate measure of sound pressure level at ear drum which provides more accurate assessment of hearing aid performance

several standards/guidelines insist on use of real ear verification

45
Q

What are over the counter (OTC) hearing aids?

A

approved by FDA
hearing instrument, OTC hearing aid, personal sound amplification devices, hearables

46
Q

Who are OTC hearing instruments for?

A

for hearing loss treatment
adult and pediatric
mild to severe hearing loss

47
Q

Who are OTC hearing aids for?

A

option for treatment of perceived hearing loss
mild to moderate severity loss
adults, not pediatric

48
Q

What is a PSAP?

A

personal sound amplification device

for adults to use in specific listening situations such as recreational activities like birdwatching or hunting

NOT for hearing loss, for people with normal hearing

49
Q

What are hearables?

A

electronic in-ear devices used for enhanced hearing or as health devices (ex. HR)

for adults, not for children
ear level entertainment, not for hearing loss

50
Q

How has technology expanded for hearing devices?

A

AirPod Pros as hearing devices
smart phones as remote controls for hearing aid and “find my” feature

accessories
- remote mics
- streaming devices

Aural Rehabilitation (11 decks)

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