Selection and Adjustments

Question 1

Why do we care about selection?

Answer 1

degree/type of HL, audiometric confirguation, lifestyle, preference, monetary considerations

Question 2

Why do we care about adjustments?

Answer 2

gain, feedback/occlusion adjustments, programs

Question 3

What HA style is the easiest insertion and removal?

Answer 3

ITE > ITC > CIC

single unit, do not interfere with eyeglasses, may have removal strings

Question 4

What HA style is the easiest on aid user control manipulation?

Answer 4

large BTEs > ITE > ITC

larger - more visible, can be located by touch, ease of volume control - AGC or remote control 4. Can always change volume and program through the app as well

Difficulty manipulating, wide dynamic, largest HA style, aid with a remote control, easily located tactually.

Question 5

What HA style is the most invisibile?

Answer 5

deeply-seated CICs > CICs > RICs

solution to make larger HAs invisibile is to hide them with the hair. Grow out the hair if possible

Question 6

HIgh gain and maximum o/p 2 principles

Answer 6

the farther the mic away from the ear canal entrance, the greater can be the gain without feedback and the larger the reciever and battery the greater the OSPL90 can be

Question 7

RIC HAs (as compared to tradional BTEs) lack of tubing resonacnes result in

Answer 7

higher gain and OSPL90 in the very HFs
smoother shape across the high freqs
preferred over BTEs (when appropriate)

Question 8

What HA style is the least sensitivt to wind noise (turbulence created by the head and pinna)?

Answer 8

deeply-seated CIC (would be least sensitivty) > CIC > ITC > ITE > BTE

best for joggers, people outside in the winter alot

Question 9

Which HAs can have directional microphones?

Answer 9

BTEs, ITES, and larger ITCs (need larger HAs than smaller)
b/c directivity requires two microphones to create directionality, so not all HAs can have directional microphones. The smaller the HA, the fewer microphones can fit.

Question 10

what are the greatest threats to reliability? What are the other threats?

Answer 10

moisture and cerumen

are parts that move or have electrical contacts (switchs, volume controls, battery contacts)

Question 11

what HA style will be the least reliable?

Answer 11

anything inside the canal will be most susceptible: CIC, ITC, ITE

Question 12

What solutions are possible for other threat to reliability?

Answer 12

nano-coating for waterproofing (almost all hearing aids do this) and chargers that take out the moisture when in the charger

Question 13

What HA style is easiest to switch to the telecoil mode?

Answer 13

BTEs with manual switches or RICs with remote/app control (larger HAs will have)

Question 14

What could we do about more difficult, smaller sized styled HAs (ITE and ITC) solution for telephone compatibility?

Answer 14

remote control and automatic switching, telephone- bluetooth- streaming interface device- wireless reciever- HA, acoustic signals can also be picked up

Question 15

What HA style is easiest to clean for pateint with chronic ear infections?

Answer 15

CIC, ITC, ITE, and RIC are unsuitable.
Would want an alternate type if HA: BTE with a mold or a BAHA
dust- and water resistant coating

Question 16

How could u solve avoidance of occlusion and feedback issues? What HA style is easiest to accomplish this task?

Answer 16

increase distance between mic and receiver.

RIC

Question 17

What HA style is easiest to same day assess and fit?

Answer 17

non-custom > custom

Question 18

What HA style is most expensive?

Answer 18

CIC b/c fitting smaller components is more labor-intensive and they have a higher return rate

Question 19

Battery size is directly proportional to ….

Answer 19

battery life

Question 20

Battery size is inversely proportional to ….

Answer 20

handling difficulties

Question 21

when is volume control mostly not needed

Answer 21

if WDRC with low Compression threshold and high compressin ratio; if sound is too loud HA will automatically lower it for patient instead of patient manually changing it

Question 22

What populations may benefit with having a volume control rather then on smartphone controls?

Answer 22

Those for whom WDRC does not achieve acceptable loudness

Those who strongly desire to control their HAs

Experienced HA wearers who are used to a volume control

Question 23

Disadvantage of having a volume control?

Answer 23

Can be moved accidentally

Children or little dexterity who might accidentally switch

Inexperience: might turn it down when they shouldn’t because they should be hearing sounds, but they do not want to hear it (they should get the full experience)

Question 24

Telecoil disadvantage

Answer 24

Size; if someone needs a small HA: could also take away a function to fit it in?

Solution is an automatic telecoil selection

Question 25

DAI or Wireless I/p helpful for:

Answer 25

People who use a wireless transmission system that is electrically coupled to their HAs to improve SNRs e.g. FM People who watch tv in a noisy place – mic placed near the tv, receiver in the HA

Question 26

Who are telecoils essential for?

Answer 26

those with severe-profound HL Helpful for people with moderate HL for telephone conversations Reduces noise and reverberation for all degrees of HL

Question 27

Advantages of fixed directional microphones?

Answer 27

improve SNR in noisy situation

Question 28

disadvantages of fixed directinal microphones?

Answer 28

Even more prone to wind-noise than omni-directional mics Special scenarios e.g. driving a car and listening to passengers Students trying to listen to other students sitting behind them

Question 29

fixed directional microphones does what

Answer 29

as you move, the beam finder will move focus with you

Question 30

What is multichannel compression helpful for:

Answer 30

Moderately-steeply sloping HL because a different of compression can be used for different frequencies will divide the freq range

Question 31

What is the criterion for multichannel compression?

Answer 31

if 2kHz threshold exceeds 500 Hz threshold by more than 25 dB

Question 32

Fast acting compression

Answer 32

those who frequently need to use their HAs in situations where sound level changes rapidly by vast amounts. Fast is better when loudness changes suddenly Speech will get distorted with fast-acting time and release time therefore best option is a mix of slow and fast.

Question 33

slow acting compression

Answer 33

those who use their HAs in a range of environments where sound levels change more slowly. Speech is smooth, less number of distortions, but is lower

Question 34

Adaptive noise reduction

Answer 34

gain is automatically decreased in those freqs regions which have the pooerest SNRs

Question 35

Feedback Management Schemes

Answer 35

easiest way to reduce the gain

Question 36

Feedback Management Schemes most helpful for:

Answer 36

Those with severe-profound HL Good low-freq with poor but useable HF hearing Open canal HAs

Question 37

Frequency lowering most helpful for:

Answer 37

Greatest hearing loss at 3-6kHz Patients with known dead regions (regions where the hair cells are completely gone) TEN test is used to confirm dead region areas.

Question 38

Explain frequency lowering

Answer 38

HL is steeply sloping and no responses at 4k-8k Hz (you want responses/stimulation here so takes this region and transports them to a lower freq area). ANALOGY copy and paste; or cut the nothing there and paste it where there is something; take the hf no response and compress them into the lower frequency region where there is stimuli). – takes brain some time to get used to this sound quality of sounds. Sometimes this could be too aggressive.

Question 39

Cut-offs and bandwidth (how wide is the region you are compressing) for frequency lowering solutions

Answer 39

if pt can differentiate between s and sh, it good; if they can you’ve gone too far.

Question 40

Summary of this topic

Answer 40

1. put audiogram data in programming tool 2. open software from potential manufacturer 3. select fitting method if offereed 4. select earmold options if offered 5. select a potential HA 6. evaluate likely fit to prescription target 7. order chosen HA 8. retrieve client data 9. program HA 10. measure response in the pateint's ear 11. adjust HA setting to meet prescription 12. re-mearue response in pt's ear 13. evaluate pt's reaction to the fiting