There are two methods for adjusting the characteristics of hearing aids for individuals with impaired hearing: a comparative procedure and a prescriptive procedure. In practice, these two procedures are usually combined at hearing aid clinics. At present, the NAL-NL (National Acoustic Laboratory-nonlinear) and the DSL (Desired Sensation Level) procedures are generally used worldwide. Although no significant differences in speech perception have been seen between the NAL-NL and the DSL in several investigations, the DSL results in a loud sensation more often than the NAL-NL. The prescriptive target indicated by these procedures should be accomplished at the end stage of fitting, rather than at the start. For new hearing aid users, a procedure that starts with less acoustic gain and gradually reaches the final prescriptive target gain has been proposed. Investigating whether these prescriptive processes developed in English-speaking countries are valid for use in Japan will be important.
Abstract: In a profoundly-hearing-impaired child wearing a hearing aid, we followed up and analyzed, from the age of 3 to 15 years, the development of the articulation ability and progress of articulation training with the development of speech perception ability, language ability and communication medium. Our findings were as follows. 1) The patient's speech perception score improved to the 60% range in early childhood, but began to decrease gradually with school age, becoming 25% at 15 years old. Her speech perception score with the use of lip reading was maintained in the 80% range after school age. Her language ability became age-appropriate after upper-grade elementary school. 2) Her speech intelligibility score improved to the 80% range during school age, and was maintained at the same level thereafter. Her acquisition order of articulation was similar to that of normal children, although she still had not acquired the ability to perceive fricative and affricate sounds at 15 years old. 3) The factors responsible for articulation development in profoundly-hearing-impaired children, like in this case, include not only improvement of the speech perception ability, but also formation of phonological representation using visual communication modes such as lip reading, finger spelling or written words, sustenance of the language ability at a certain level with language training, and daily use of spoken language.
Objective: To evaluate the clinical usefulness of the MAICO MB11 BERAphone® equipped with CE-Chirp® as a screening device.
Methods: A total of 599 healthy newborns were screened with the MB11 BERAphone® at our hospital from December 2014 to April 2016. The infants with a “refer” result were examined by auditory brainstem response and auditory steady state response using the Interacoustic Eclpipse®.
Results: Out of the 599 babies examined, the result was “passed” in 587 cases and “refer” in 12 cases representing a “pass” rate and “refer” rate of 98.0% and 2.0%. The mean test time was 322.3±220.1 sec. The specificity was 97.8%, and the false-positive rate was 2.0%.
Conclusions: CE-Chirp® is an optimized chirp stimulus designed to compensate for the time delay in the auditory periphery in an attempt to increase temporal synchrony. The detection algorithm using the CE-Chirp® stimulus in the MB11 BERAphone® allowed a decrease of examination time. The device is useful for newborn hearing screening, not only because of the short examination time, but also because of the low costs and easy operation. However, further investigation and improvement in the accuracy of the device are necessary.
The natural history of vestibular schwannoma (acoustic neuroma, AN) has been reported in a number of published studies. However, there are few reports about long-term conservative management of AN. We conducted a retrospective chart review of the hearing changes and tumor growth in patients with AN who were managed conservatively for more than 5 years at the Department of Otorhinolaryngology, Mitsui Memorial Hospital, from 1996 through 2015. Sixteen patients were included in this study, and the average follow-up period was 9.9 years, ranging from 5.0 to 19.5 years. Of the 16 patients, 1 presented with total deafness at his first visit. Among the remaining 15, 12 patients (80.0%) presented with progressive hearing loss, 2 patients (13.3%) had fluctuating hearing function, and in 3 patients (20.0%), the hearing function was retained. In regard to the hearing preservation rate, hearing preservation surgery needs to be considered as one of the treatments for small tumors in patients with serviceable hearing. Patients should be informed about the long-term natural course of AN, because some may choose conservative management, based on personal preference, situation, and background.
This study examined hearing aid usage time and other factors which correlated with the consistency of early hearing aid use by infants. The participants included twenty seven (27) 0- to 1-year children (four-frequency pure-tone average=73.7dBHL, SD24.0). These results were then compared with nineteen 2- to 6-year children (PTA-4=64.5dBHL, SD16.4). Hearing aid usage time was calculated by means of the device's built in data-logging capability, as well as through parents' self-reporting of the number of times the infants removed their own hearing aid. The study found that children with milder hearing losses wore their hearing aids less consistently than children with more severe hearing losses. Multiple regression analysis indicated that hearing aid usage time was a significantly correlated predictor with the PTA-4, the mean age at fitting of amplification, and with the parents' efforts at consistency of hearing aid use. The study suggests the importance of consistent support in medical treatment and education of the parents of 0- to 1-year children with mild to moderate hearing loss. The study found this to be due to both lower parental motivation regarding hearing aid use and the natural proclivity by infants to use the device in comparison to children with severe to profound hearing loss.
The current criteria for adult cochlear implantation in Japan are based on the hearing level. However, in other countries, such as the United States, they are based on word recognition scores. In Japan, there are individuals who have difficulty in communication, even when their hearing level is less than 90dBHL. In the current study, we evaluated the results of speech perception following cochlear implantation in nine subjects who had had poor word recognition, but a hearing level of less than 90dBHL in the better hearing ear before cochlear implantation. The average postoperative word recognition scores of these nine subjects was almost equal to the average postoperative word recognition scores of other adult subjects with a bilateral hearing level of more than 90dBHL. The postoperative speech recognition scores of the four subjects who received the cochlear implant in the ear with a hearing level of less than 90dBHL were generally good. However, there was variability in the results of the five subjects who received the cochlear implant in the ear with a hearing level of greater than 90dBHL. These results indicate that Japanese individuals with poor word recognition scores and a hearing level of less than 90dBHL are candidates for cochlear implantation.