Hearing aid fitting is an act of repeating adjustment and evaluation of the hearing aid to find out the most appropriate hearing aid and amplification to the hearing aid users. Re-adjustments are made referring to the user's experience of trial use of hearing aids, result of speech discrimination test and questionnaire to the users. However, though they could satisfied with hearting aid's amplification adjusted in relatively quiet environment, it is still difficult for many of hearing aid users to understand speech in everyday life than they expected and they may have doubts on efficiency of hearing aids. In these days, the programmable hearing aids and digital hearing aids have been used like conventional hearing aids, and adjustable range of amplification has been remarkably improved. Those adjustments can be easily saved and also can be reproduced. With a purpose of determining the appropriate programs of hearing aids which are suitable for various environment in everyday life and of their evaluation making a good use of those new functions, we have developoe a fitting support system with virtual environmental sound, called “FiVES”.
We reported a case of Fabry disease in 40-year old man. The patient complained bilateral hearing loss, tinnitus, non-rotational nystagmus. The disease occurred in virtually all areas of the body, including chronic renal insufficiency, simple angioma, angiokeratoma, and left ventricular hypertrophy. Analysis of the clinical data from DPOAE, ABR and nystagmus test revealed cochlear deafness, retrolabyrinthine deafness and peripheral and central imbalance. These findings suggested that the accumulation of glycosphingolipids in the stria vascularis and nerve cell into the brainstem caused deafness. In addition, it is also possible that deposits in glomeruli and tubules of the kidney were secondary to bilateral hearing loss.
Development of communication in a child with congenital profound hearing loss was examined, before and after cochlear implantation. Frequency of imitating the examiner's mouth position without accompanying speech, frequency of mimicking the examiner's speech and articulation were measured. As though the child seldom spoke before the use of cochlear implant, the duration of speech had increased by more than 10 times the level before the use of cochlear implant. All vowels were articulated 6 months after the surgery. The duration of speech decreased temporarily at 7 months after the beginning of using cochlear implant, but this change was accompanied by a remarkable increases, but frequency of imitating the examiner's mouth shap without accompanying speech and the frequency of mimicking the examiner's speech. At 29 months of cochlear implant use, the child could speak 17 consonats. It is noteworthy that the child could articulate unvoiced affricates. This indicates that cochlear implant is useful in promoting the development of articulation.
A group of 154 children (303 ears) with sensorineural hearing impairment were followed up to identify the prevalence and the correlated factors of deterioration of their hearing after long-term follow up. Of 303 ears, ninety-one ears (30%) demonstrated more than 15dB progression in two or more adjacent frequencies. Frequent deterioration was observed at higher frequencies, including 2kHz (30%), 4kHz (25.4%), and 8kHz (26.5%). In audiometric configuration, the patients who showed “abrupt” shape of hearing had higher risk of deterioration although “gradually sloping” audiogram was most common among all study participants. The presumptive etiology of 77 subjects (50%) with sensorineural hearing loss were unknown. The deterioration was most frequent in hereditary and congenital causes, but no specific causes could be related to progressive hearing impairment.
Differences in performance between the digital hearing aid (Phonax Claro 21dAZ) and analogue hearing aids worn by 9 sensorineural hearing-impaired subjects were evaluated. We used objective measurements (speech discrimination tests in quiet and multitalker noise) and subjective assessments (questionnaires). The subjective scores were better for the digital hearing aid than the analogue hearing aids. Performance in a speech discrimination in noise was also better for the digital hearing aid at the noise level of 75dB when speech level was 70dB, but no statistically significant was found. No difference between the digital and analogue hearing aids could be demonstrated in the objective speech discrimination test in quiet. The results may be interpreted as indicating that the digital hearing aid may be preferred for the noisy environments.
Tinnitus retraining therapy is one approach for habituation of tinnitus. It is logically based on the neurophysiological model described by Jasreboff (1990). Since 1999, 39 patients have been seen at Department of Otolaryngology, Nagoya City Universisy, School of Medicine and Sekiya otolaryngology clinic (male 17, female 22). We evaluated changes of tinnitus by questionnaire, visual analogue scale (VAS), tinnitus handicap inventry (THI), aimed at the evaluation of tinnius habituation, the effect of tinnitus on patients' lives, and the level of tinnltus-induced annoyance. Of 26 patients we followed up for 6 months, 100% of them exhibited improvement, 77% with visual analogue scale, 74% with tinnitus handicap inventry. These results suggested that TRT was highly effective for tinnitus.