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Amplification I > Lecture 5 > Flashcards

Lecture 5 Flashcards

1
Q

What are the 9 HA styles (smallest to largest)?

A
  1. Extended wear devices (i.e Phonak Lyric)
  2. IIC (invisible in-the-canal)
  3. CIC (completely in-the-canal)
  4. ITC (in-the-canal)
  5. Half-shell
  6. ITE (in-the-ear)
  7. RIC/RITE (receiver in-canal/receiver in-the-ear)
  8. RITA (receiver in-the-aid)
  9. BTE (behind-the-ear)
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2
Q

What is the difference between a half-shell and an ITE?

A

A half-shell doesn’t fill up the whole concha

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3
Q

____ is the largest and most powerful HA

A

BTE

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4
Q

What are 5 differences between hearing aid models?

A
  1. Cosmetic appearance
  2. Different ability to provide gain (more or less power)
  3. Different venting ability
  4. Feedback susceptibility (squeal)
  5. Maintenance (cleaning, care)
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5
Q

Where is the serial number typically located?

A
  • Inside the battery door
  • Underside of the casing
  • Under a colour marking
  • Imprinted on the shell of a custom device
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6
Q

What is feedback?

A

“Feedback” occurs as a result of sound (attempting to be delivered to the ear canal) leaks either around or through the earpiece, gets picked up, and re-amplified by the microphone system, and re-amplified again, and again, and again

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7
Q

How do HAs avoid feedback?

A

Hearing aids often have “feedback management systems” to avoid feedback

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8
Q

We can minimize feedback by doing what 3 things?

A
  1. Coupling: how the HA is put on the ear
  2. Venting: air flow
  3. Physical fitting of device or earmold to the ear
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9
Q

Explain the feedback loop?

A
  • Input coming to microphone
  • Amplifier provides gain
  • Reciever puts sound into canal
  • Output gets re-picked up by microphone
  • Gain keeps increasing in phase which gives us the oscillation of feedback
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10
Q

What 3 ways do we address feedback?

A
  1. Close the canal
  2. Minimize venting
  3. Create a “snug” fit in ear
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11
Q

Why does the occlusion effect happen?

A
  • Low frequency sounds (vowels in particular) have high SPL level (100dB in the back of our throat)
  • Those high intensity sounds conduct through the mandible, and condyle to the cartilaginous portion of the ear, causing vibration in the ear canal itself
  • Without any physical obstruction on the ear canal (i.e. a hearing aid), those sounds would escape through the canal.
  • With a device in place, energy can be trapped, and redirected to the tympanic membrane, and transmit through the auditory system, perceived as a increase in low frequency sounds
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12
Q

The increase the level of sounds in the ____ when the canal is occluded

A

Low frequencies (greatest at 500 Hz and below)

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13
Q

This increase can be between ____dB in an occluded canal vs. “open” canal

A

20-30

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14
Q

What does the occlusion effect result in?

A

Own voice sounds “loud”, “hollow”, “boomy”, chewing becomes aggravating

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15
Q

Why is the occlusion effect and feedback a balancing game?

A

If we open the canal to reduce the occlusion effect, it increases the possibility of feedback

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16
Q

What 3 ways to we address occlusion?

A
  1. Modify to enlarge the vent
  2. “Open” the fitting
  3. Adjust low frequency gain
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17
Q

Explain how HA batteries work?

A
  • Zinc-Air batteries provide power to hearing aids
  • Zinc-air preferred for safety and efficacy
  • Voltage stays consistent over the battery life (1.25 V)
  • Activated by removing tab
  • Capacity (in mAH hours) dependant on the size
  • Typically last 7-10 days (depending on amount of time worn)
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18
Q

Why should you let a battery sit for 2 min after peeling off the tab?

A

Allow the voltage potential to come up

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19
Q

A 675 battery is in a ____ power battery

A

High

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20
Q

The battery door is often the ____ of the HA

A

On/off

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21
Q

Why might a person choose a rechargeable HA?

A
  • Increasing in popularity (ease of use, and minimizing waste in)
  • Designed for “full day of use”, devices to be recharged at night
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22
Q

Pros and cons of disposable batteries

A
  • Good for someone who doesn’t have a power source available (traveling)
  • Can be ingested (cognitive issues)
  • Can they open and close the battery door?
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23
Q

Pros and cons of rechargeable HAs

A
  • Don’t have to worry about batteries
  • A friendlier environment option
  • Ease of use
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24
Q

Mic, amplifier, receiver location - BTE

A
  • The microphones, amplifier, and receiver are in the device sitting behind the ear.
  • The sound is delivered to the ear through an earmold, attached to the device by tubing (either standard or slim tube); No electronics in the earmold
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25
Q

Mic, amplifier, receiver location - RIC/RITE

A
  • The microphones and amplifier in the device sitting behind the ear
  • The receiver ( the speaker ) sits in the ear canal.
  • A custom shell or dome is attached to the end of the receiver
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26
Q

Mic, amplifier, receiver location - custom devices in the ear (IIC, CIC, ITC, ITE)

A

The microphone, amplifier, and receiver are built into a custom shell

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27
Q

How does a standard BTE with earmold work?

A
  • Behind the ear devices with an earmold feature the microphone, amplifier, and receiver is in the device behind the ear
  • Sound is delivered to the ear via a tube with a tube attached to a custom ear piece
28
Q

What different materials can an earmold be made from?

A

Silicone, lucite, polyethylene

29
Q

Why might a different material be chosen for an earmold?

A

Based on skin condition, ear texture, comfort, and sensitivity

30
Q

Earmold styles have both ____ and ____ properties

A

aesthetic, acoustic

31
Q

____ refers to the channel through the earmold which allows ____ between the medial and lateral side of the mold

A

Venting, airflow

32
Q

A hard ear typically needs a ____ earmold

A

Soft

33
Q

A soft ear typically needs a ____ earmold

A

Hard

34
Q

How does a BTE with a slimt tube (RITA) work?

A
  • Behind the ear devices with a slim tube feature the microphone, amplifier, and receiver in the device behind the ear
  • Sound is delivered to the ear via a thin tube attached to a non-custom dome (*in many cases)
35
Q

Who are the 5 ideal candidates for a BTE?

A
  1. Pediatrics* (earmolds, robustness, retention)
    • Earmolds need to be changed every 4-6 weeks
    • Robust = can hold up to their lifestyle
    • These devices stay the best on the ear
  2. Adults with configurations up to profound hearing losses
  3. Patients who require more of a physical device to “handle”
  4. Patients with excessive moisture and cerumen (electronic are not in the ear, earmold can be cleaned)
  5. Molds can be made from a variety of material for optimal comfort
36
Q

BTE earmolds - landmarks & coupling to the ear

A
37
Q

____ are the most powerful HA option

A

BTEs

38
Q

Why are BTEs less susceptible to feedback?

A
  • Separation of sound outport and microphone
  • Tubing and earmolds can be modified to further separate this
39
Q

What range of HL can use a BTE?

A

Mild - profound

40
Q

How do RICs work?

A
  • RIC/RITE boast the microphones and amplifier in the device sitting behind the ear
  • The receiver (the speaker) sits in the ear canal
  • A custom shell or dome is attached to the end of the receiver
41
Q

What are the 7 HA components of a RIC?

A
  1. Optional program or volume button
  2. Microphone port 1
  3. Microphone port 2
  4. Battery door
  5. Receiver wire (can occasionally be a thin tube)
  6. Dome (various types)
  7. Receiver
42
Q

Different types of RIC domes

A
43
Q

Custom RIC molds

A
44
Q

RIC - Pick receiver size depending on the ____

A

Power

45
Q

Why are RICs cosmetically appealing?

A
  • Small casing behind the ear
  • Receiver wire is discreet
46
Q

What range can a RIC fit?

A

Generally can fit up to a moderately-severe hearing loss (dependant on the receiver and coupling)

47
Q

RICs - Receivers can be interchanged to accommodate different ____ (or changing hearing thresholds)

A

Configurations

48
Q

RICs can be stocked for ____

A

Same day fitting if custom shell is not required

49
Q

RICs have less gain compared to standard ____

A

BTEs

50
Q

What are the 4 custom HAs?

A
  1. IICs
  2. CICs
  3. ITCs
  4. ITEs
51
Q

What are the 5 components of a ITC/ITE?

A
  1. Earshell
  2. Battery door
  3. Microphone
  4. Removal string
  5. Vent
52
Q

The larger the custom hearing aid, the greater the ____ it can accommodate

A

Hearing loss

53
Q

What range of HL can custom HAs accomodate?

A

Mild-severe (dependent on the receiver power selected)

54
Q

Why might require want a custom HA:?

A
  • Patients who cannot support and aid on the ear, or have a preference for the full device off the pinna (glasses, masks, helmets, etc.)
  • Patients whose dexterity limits them from handing two components
55
Q

Can those with OE abnormalities get a custom HA?

A

Custom hearing aids need to be placed in canals are that of a certain shape, with no abnormalities, and whose shape directs sound towards the TM

56
Q

Custom hearing aid shells must be made from a ____ material

A

Solid

57
Q

What are shells typically made from?

A
  • Acrylic material (sometimes titanium)
58
Q

What are ITE HAs great at reducing?

A

Wind noise

59
Q

What range of HL can ITE HAs accommodate?

A

Mild-severe

60
Q

Does ear canal volume matter with ITE HAs?

A

Yes, residual ear canal volume- depth of device matters

61
Q

What is an extended wear device?

A
  • Phonak Lyric
  • HAs that get placed deep with in the EAC and stay there for a couple of months
  • Sit within 4mm of the TM
  • The device is only 12 mm
62
Q

Ideal candidates for an extended wear device

A
  • Fitting range
  • Contraindications (head/neck surgery cannot)
  • Health considerations (diabetes, regular MRIs cannot)
  • Lifestyle considerations (skydivers cannot)
63
Q

What 4 audiological factors that help select the appropriate style of HA for a patient?

A
  1. Audiogram configuration dictates the amount of amplification required (i.e the amount of gain we require to meet a targets at frequencies to make speech audible and comfortable)
  2. Health of the ear
  3. Cerumen, moisture
  4. Physical shape of the ear
64
Q

What 4 non-audiological factors that help select the appropriate style of HA for a patient?

A
  1. Preference and comfort of the patient
  2. Dexterity of the patient
  3. Other features desired (bluetooth, FM systems, partner microphones, TV connectors, etc.)
  4. Face masks, glasses, helmets
65
Q

Selection of hearing aids is complex, and involves many ____

A

Considerations

66
Q

Some HA selections can be ruled out based on ____ of hearing loss

A

Degree

67
Q

What are OTC HAs?

A
  • OTC (over-the-counter) hearing aids are devices that may be purchased without the oversight of a hearing dispenser, or physician
  • Not available in Canada yet (Health Canada), Federal Drug Administration has approved these devices for those in the USA
  • Over the age of 18
  • “Perceived” mild to moderate hearing loss

Amplification I (14 decks)

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