Implantable
Devices
Devices
This type of bone-anchored hearing aid uses a magnet to hold the external processor.
Transcutaneous bone-anchored hearing aid
Why might a patient want to use a directional microphone over an omnidirectional microphone?
Focused on speech in front of the listener
Air bone gaps greater than 10 dB are observed for which type(s) of hearing loss?
2. Mixed hearing loss
1. Noise-induced hearing loss
2. Meniere's Disease
3. Acoustic neuroma
1. Audiologic evaluation
2. Trial period with a hearing aid
3. At least unilateral hearing loss
4. Good health
5. Realistic expectations
Based solely on degree of loss, what type of hearing aid would you recommend for a patient with severe to profound hearing loss?
Behind-the-ear hearing aid
Calculate the word recognition score for a patient who missed 4 words out of a 50 word list.
92%
(50-4 = 46/50 = 0.92*100)
Describe "listening effort" in the context of hearing loss.
What factors contribute to hearing aid selection for a patient?
Degree of hearing loss, patient's preferences, other physical/cognitive limitations, device cost, user's age, lifestyle
What management options are available for a patient with single-sided deafness?
1. CROS hearing aid
2. Bone-anchored hearing aid
3. Cochlear implant
Classroom setting; Theatre/show setting
*Basically any setting where you want to overcome noise and distance*
Distortion product otoacoustic emissions are a measure of what inner ear structures?
Outer hair cells
Describe the difference between a top-down focused auditory training paradigm and a bottom-up focused auditory training paradigm.
Top-down = focused on global structure of sentence; learning to use context
Bottom-up = focused on fine-grained acoustic differences that make up the building blocks of speech (e.g., "phonemes")
Right ear = pure tone via inserts or supra-aural headphones
Left ear = masking noise
What kind of device would you recommend for a patient with anotia?
Bone-anchored hearing aid
Anotia = absent pinna
Why are peak-clipping and compression used in a hearing aid AND what is the primary difference between them?
They are both used as ways to manage the maximum power output in a hearing aid.
Peak-clipping = provides a constant amount of gain (linear) before reaching a specified saturation point where the hearing aid no longer increases the output
Compression = provides varied amounts of gain (non-linear) depending on the input level. (Ex. more gain for lower intensity sounds compared to higher intensity sounds)
Left Ipsilateral: Present
Right Contralateral: Present
Left Contralateral: Absent/Elevated
What factors predict lipreading ability?
1. Cognitive skill (spatial working memory; processing speed)
2. Age (young adults > older adults)
3. Congenital hearing loss
Lipreading = using only the visual speech signal and related gestures to recognize speech (visual only!)
Speechreading = using the visual signal and auditory signal to recognize speech (audiovisual)
Name two similarities and two differences between a hearing aid and a cochlear implant?
Similiarities:
1. Both require external components
2. Both can be appropriate for patients with sensorineural hearing loss
Differences:
1. CI's require surgery; hearing aids do not
2. CI's use an internal component; hearing aids do not
3. CI's require poor speech performance; hearing aids do not
Describe the components of a hearing aid and how sound is transformed in the hearing aid.
2. Amplifier takes converted electrical signal and increases the intensity of the sound based on prescribed settings
3. Receiver takes the re-amplified electrical energy and converts it back to acoustic energy and sends that signal to the listener
If a patient's air conduction thresholds are at 70 dB across the frequency range and the bone conduction thresholds are at 30 dB across the frequency range, what is the degree and type of hearing loss?
Moderately-severe mixed hearing loss.
How would you customize auditory training differently depending on if a patient was prelingually deafened or if the patient was postlingually deafened?
Prelingual = language not yet acquired. Bottom-up approach to build up the building blocks first
Postlingual = language previously acquired. Top-down approach to capitalize on context information
What communication strategies would you recommend to the family of a patient with a hearing loss? (e.g., what can the family do to better support the individual's listening)
spotlight face, use pauses, good lighting, rephrase/repeat, access to visual cues, speak slowly and clearly, minimize noise, empathize