The influence of progress in information science on audiology over the past three decades was discussed from the point of view of my personal experience. These experiences were categorized as i) computer model simulations, ii) the rapid analysis of signals and images, and iii) the refinement of implantable devices. The great contribution from the progress of computing capabilities to basic and clinical sciences was re-confirmed. However, future issues to be addressed were also raised, the solutions for which will require further progress in information science.
We investigated 79 infants diagnosed as having bilateral hearing impairment according to further evaluation after newborn hearing screening (NHS) between 2000 and 2013. We categorized the infants into three groups according to the hearing threshold of the better ear by auditory; brainstain response evaluation. The distribution of the infants according to the severity of hearing loss was as follows: mild hearing loss, 3 infants; moderate hearing loss, 35 infants; severe hearing loss, 41 infants. Of 79 infants, 63% visited to the hospital before the age of one month. In 77% of the 79 infants, the diagnosis was made by audiologic and medical evaluation before the age of 3 months. Of 74 infants, 68% received intervention, and of 68 infants, 54% received fitting of hearing aid before the age of 6 months. There was no difference in the average age at their first visit to the hospital or the age at diagnosis of the hearing level, however, infants with severe hearing loss received intervention or fitting of hearing aids earlier than those with moderate hearing loss. Ten infants with severe hearing loss received cochlear implants. These results indicate early detection, intervention and fitting of hearing aid undergo appropriately. It is important to make the appropriate judgment in a timely manner to allow hearing-impaired children to receive appropriate interventions, including fitting of hearing aids.
Newborn hearing screening (NHS) has been enforced since the year 2001 in Japan. So, over 13 years have passed since NHS was first implemented in Akita prefecture. The rate of NHS reached 100% in this prefecture in 2010. The cooperative framework of the first screening in newborns at general hospitals and complete hearing examinations at university hospitals increased the impact of NHS. We report a general overview of NHS (rate of complete hearing exam, positive-predictive value, rates of pursuits and analysis of hearing changes after the diagnosis of hearing loss) during the last 13 years at our university. The positive-predictive value of NHS was 61.0%. Our 13-year data did not differ from the report of a national investigation published in the year 2013. In this study, 143 patients were continuously followed up from the first diagnosis of the auditory brainstem response (ABR) to the present. We compared the ABR thresholds at the first diagnosis and the final hearing levels in patients over 3 years old. We recognized that the hearing levels have the possibility of changing after determination of the ABR. Therefore, long-term hearing management is necessary to evaluate the accurate hearing levels in children.
We examined whether subjects with unilateral hearing loss (UHL) have any difficulties of dairy life, and how these subjects recognize their hearing difficulty and deal with problems, using the evaluation of hearing difficulty (Okano et al, 2013) and the life stories of the subjects from childhood to the present in 4 people with UHL. Subjects with UHL often found it difficult to hear and localize from the affected side when the ambient noise level was high, but there were individual differences in psychosocial issues. We analyzed their stories; there were 4 categories and 27 concepts, and we attempted to theorize on the process of disorder recognition in the subjects. They became aware of hearing difficulty from experiences of difficulty in hearing during schoolgoing-age; in some cases, they also experienced psychological conflicts in teenage. They accepted their hearing difficulty and used their own ingenious methods for communication until they became adults. Our findings suggested that the parents' negative recognition about UHL might affect their children to accept their hearing difficulty in teenage. Therefore, it is important that we provide support to children with UHL, and also their parents, over the long term according to their psychological state and growth, and we need to provide accurate information about UHL and peer support systems.
Fitting of hearing aids is the most important process towards providing hearing improvement for patients with hearing impairment. However, there is as yet no consensus as to how to manage these patients after the initial fitting process. In our department, since the hearing ability is known to change with time, we carry out regular check-ups every 3 months. However, since there are almost no previous studies investigating the benefits of such periodical check-ups, some patients are not eager to keep their appointments. This study was aimed at examining whether periodical check-ups and long-term management of hearing aids are beneficial, in terms of improving the hearing ability, to the patients. We carried out hearing level tests and speech audiometry after the initial fitting, and compared the results with those obtained after regular, long-term check-ups (average interval, 3 years and 2 months). To focus on the influence of hearing aid management, we limited the subjects to those with moderate hearing loss, whose hearing ability changed little throughout the study. The results revealed that the average hearing thresholds decreased from 34±5dBHL to 30±6dBHL (p<0.001) and speech audiometry results improved from 90±10% to 92±8%(p<0.01). Thus, we think that it is important to continue check-ups and management even after the initial fitting.