Index. Note: page numbers followed by f and t represent figures and tables, respectively.

Transcription

1 Index Note: page numbers followed by f and t represent figures and tables, respectively. A Abbreviated Profile of Hearing Aid Benefit, 40 41, 41f, , 170f, 171f, and binaural hearing aid fitting, 211 in communication difficulty assessment, 347 in loudness assessment, 62 for potshot assessment of hearing aids, ABRs (auditory brainstem responses), of middle ear implants, 302, 305f Acclimatization auditory, 245 effect in LDL measurements, Acoustic trauma, 177 Acoustics, real-ear measures with, 85, 86f probe tube positioning method in, 94 Adaptive amplification, in noise-induced hearing loss, Adhesive otitis media, 274 Aging, impact on binaural listening, Aided loudness judgments for speech, 60 62, 61f Air conduction hearing aids, 281f, 282 fitting strategies for, 282 verification strategies for, 282 Ambient noise, in real-ear measure system set up, 85 Amplification adaptive, in NIHL, binaural, in asymmetrical hearing loss. See Asymmetrical hearing loss, binaural hearing aids for in CHL. See Conductive hearing loss, amplification in middle ear implants for. See Middle ear implants in NIHL. See Noise-induced hearing loss, amplification in patient history of, 346 prescriptive targets, outcome measures for evaluation of, 162 Amplitude domain transparency and, 182 in real-ear measure systems, APHAB. See Abbreviated Profile of Hearing Aid Benefit Asymmetrical hearing loss, binaural hearing aids for, acclimatization and, 245 audiologists attitude, changing, 244 auditory deprivation and, 245 binaural advantage, case studies involving, , 235f 238f changing image of, 247 contraindications for, counseling in, efficacy of, 225 in Meniere s disease, objective versus subjective measures in, patient evaluation of, patient expectations and, patient selection guidelines for, performance of assessment, verifying, 239 psychoacoustic assessment of, purpose and definitions, , 227f, 229f single versus multiple-channel, successful, technological advances and, , 233f Atresia, of external auditory canal, 273 Audiologic criteria, for cochlear implants, 336 Audiologic evaluation for binaural hearing aid fitting, for cochlear implants, Audiologist assisting patient decisions, patient education by, 347, 348f, 349f role in hearing orientation and counseling, See also Orientation and counseling, for hearing aid patients Audiologist-driven protocol, in hearing aid fitting strategy, 6 Audiometric data, 4 Auditory acclimatization, 245 Auditory brainstem responses, of middle ear implants, 302, 305f 384

2 INDEX 385 Auditory deprivation, 207, 245 Auditory memory, paired comparison and, 141 Auditory threshold, and loudness discomfort levels predicting, 26f, 27f, relationship between, 26f, 27f, 43 48, 44f, 46f 48f Autoclave sterilization, 376 Average-length method, probe tube positioning in realear measures with, B BAHA (bone-anchored hearing aid), 288 audiologic criteria for, versus bone-conduction hearing aid, 279 for conductive hearing loss, 273 fitting strategies for, , 279f postoperative care, 278 research outcomes using objective, 281 subjective, surgical, 280 surgical considerations for, , 277f, 278f Bandwidth, in real-ear measure test signals, 83 Bass increase at low levels, 187 Batteries, for hearing aids doors for, 359, 360f and physical limitations of user, 352 insertion/removal of, 363 Behind-the-ear (BTE) hearing aid in adults, case studies of, , 319f, 320f, 322f, 323f air conduction, , 281f binaural, 237 bone-conduction, , 283f in children, versus binaural linear, case studies of, , 330t, 331t directional microphones in, 355 fitting of, in unilateral hearing loss, 260, 261f insertion/removal of, 366 in NIHL patients, 193 RECD procedure for, T-coils for, , 356f BICROS. See Bilateral contralateral routing of signals; Bilateral contralateral routing of signals (BICROS) hearing aids Bilateral asymmetric hearing loss, 222 Bilateral contralateral routing of signals, amplification of, in asymmetric hearing loss, 234 limitations of, in unilateral hearing loss, , 262f Bilateral contralateral routing of signals (BICROS) hearing aids fitting of, in unilateral hearing loss, 260, 261f in Meniere s disease and asymmetrical hearing loss, 234 real-ear measures of head-shadow benefit, , 103f insertion-gain, 103 BILL (bass increase at low levels), 187 Binaural advantage, in asymmetric hearing loss, Binaural aided thresholds, , 330t, 331t Binaural amplification, for asymmetrical hearing loss. See Asymmetrical hearing loss, binaural hearing aids for Binaural hearing, 203, 203f advantages of, Binaural hearing aids in adults, case studies of, , 319f, 320f, 322f, 323f for asymmetrical hearing loss. See Asymmetrical hearing loss, binaural hearing aids for in children, case studies of versus cochlear implants, , 332t, 333t versus digital hearing aids, , 330t, 331t fitting of, 5 LDL measurements and, strategies for, 3t, , 214f, 215f NIHL patients and, Binaural listening aging impact on, fitting binaural aids and, 207 impact of directional microphones on, 209 Binaural squelch, 194 in fitting binaural hearing aids, 206 Binaural summation in fitting binaural hearing aids, loudness, 194 unilateral hearing loss and, 258 biocompatibility, of middle ear implants, 299 Bone-anchored hearing aids. See BAHA (boneanchored hearing aid) Bone-conduction hearing aids versus BAHA, 279 for conductive hearing loss, 273, , 283f fitting strategies for, 284 verification strategies for, 284 implantable, 276, 277f. See also BAHA (boneanchored hearing aid) for unilateral hearing loss, fitting, Broadband signals with bias tones, 84 BTE hearing aid. See Behind-the-ear (BTE) hearing aid C CANS (compromised central auditory nervous system), 203 Centers for Disease Control and Prevention hand washing recommendations, 373 universal precautions, 374, 374t Cerumen and hearing aid selection, 352 infection caused by, 370 management, for hearing aid patients, 364, 364f Channels. See Compression channels Chicken pox, unilateral hearing loss and, 255

3 386 INDEX Children and adults, LDL measurement differences between, 49 50, 50f cochlear implant case study in, , 332t, 333t with hearing aids, case studies of, , 330t, 331t unilateral hearing loss in classroom performance and, neonatal pulmonary hypertension and, 255 CHL. See Conductive hearing loss Cholesteatoma conductive hearing loss and, 274 congenital, unilateral hearing loss and, 255 Chronic otitis media, conductive hearing loss and, 274 Circle of decibels, 72t, , 111f, 112t, 113t Classroom performance, unilateral hearing loss and, Cleaning techniques, in infection control, , 376f Client Oriented Scale of Improvement, 349, 350 for postfit assessment of hearing aids, Clinical trials, of middle ear implants, , 306t CNC words. See Consonant-Vowel-Nucleus-Consonant words Cochlear Implant Association, 342 Cochlear implants audiologic criteria for, 336 candidacy for, case studies of, , f in children, , 332t, 333t findings in, implications of, digital processing capabilities in, 311 goal of, 312 hearing rehabilitation counseling for, 340 MEIs as alternative to, 287 Cold sterilization, , 378f Color, of hearing aids, 359 Comfortable levels, of loudness, 25 Commercial hearing aids, paired comparison of, 133f, wearers complaints and, 127f, 136f, Communication APHAB in difficulty assessment, 347 strategies for hearing impaired, 341 system evaluation, outcome measures for, , 163t clinical implementation, , 165f, 166f Communication Profile for the Hearing Impaired, 167, 168t, 349 cochlear implant evaluation and, 338 Complaints, hearing aid wearers, 144 Compression channels, in NIHL patients, number of, ratio, threshold, 189 time constants, 190 versus peak clipping in maximum output limiting, 56 prescriptive strategies for, 5 Compression hearing aids, real-ear measures and, 98 99, 99f Compression ratio, Compression threshold, 189 Computed tomography for cochlear implant candidates, 338 of temporal bone evaluation, 273 Concurrent equalization, real-ear measure test environment and, 89 Conductive hearing loss, 272 amplification in implantable bone-conduction device for, 276, 277f. See also BAHA (bone-anchored hearing aid) strategies for, surgery to provide, 275 bone conduction hearing aids for, 272 external auditory canal lesions and, 273 hearing aid fitting in, , 281f adjustments for, 5 hearing aid selection in, , 281f air-conduction, 282 bone-conduction, , 283f LDL measurements and, 51 middle ear and mastoid in inflammatory diseases of, 275 lesions of, tumors of, 275 tympanic membrane lesions and adhesive otitis media perforation of, tympanosclerosis, 274 Congenital hearing loss cholesteatoma and, 255 stenosis of external auditory canal and, 273 Consonant-Vowel-Nucleus-Consonant words in binaural hearing aid case study, 318, 320f, , 323f in cochlear implant case study, 328, 328f Contralateral routing of signals, amplification of, in asymmetric hearing loss, 234 limitations of, in unilateral hearing loss, , 262f transcranial, in unilateral hearing loss, verification strategy for, , 269t Contralateral routing of signals (CROS) hearing aids case study of, 235 CROS-Plus, in unilateral hearing loss, 264 fitting, in unilateral hearing loss, , 261f evaluation of, , 266f, 267t probe measures for, , 269t for Meniere s disease and asymmetrical hearing loss, 234 real-ear measures of, head-shadow benefit, 102 insertion-gain, 103 Conversational fluency, 341 CORFIG (coupler response for flat insertion gain), 70 real-ear measures and, , 114f, 115t Corrections, average, LDL and, 51 52, 51t, 52t COSI (Client Oriented Scale of Improvement), 349, 350 for postfit assessment of hearing aids, Counseling, 198. See also Orientation and counseling, for hearing aid patients asymmetric hearing loss and,

4 INDEX 387 for binaural hearing aid fitting, 211 on hearing aid options, on hearing rehabilitation for adults, 313, for NIHL patients amplitude failure and, realistic expectations and, 198 Coupler response for flat insertion gain, 70 real-ear measures and, , 114f, 115t Coupler tests, 159, 159f. See also Coupler response for flat insertion gain Couplers, HA 2-cc, 67, , 159f CORFIG responses, 70 history of, 66 CPHI (Communication Profile for the Hearing Impaired), 349 cochlear implant evaluation and, 338 Crest factor, CROS. See Contralateral routing of signals; Contralateral routing of signals (CROS) hearing aids Crosstalk, in microphone real-ear measure systems, 82 D DAI (direct audio input), hearing aids with, 356, 358t Definite discomfort, in LDL measurement, 29 Device-independent fitting strategies, 7 8, 7f Digital hearing aids in adults, case study of, , 322f 323f in children, versus binaural hearing aids, , 330t, 331t NIHL patients and, 188 feedback reduction in, 192 paired comparisons for, 129 Digital signal processing, 188 Digital signal processing (DSP) hearing aids in asymmetric hearing loss, 232, digitally programmable, 354 versus analog, Digitally programmable hearing aids analog versus digital signal processing, fitting and use of, digital signal processing, 354 versus analog, Direct audio input (DAI), hearing aids with, 356, 358t Directional microphones, 355 impact on binaural listening, 209 NIHL patients and, real-ear measures of, , 104f Disability, WHO definition of, 153 Discomfort, extreme, in LDL measurement, 29 Disinfection, of hearing aid, , 365f in infection control, 375 techniques for, 376, 377f, 377t 378t Distortion, saturation-induced, 56 Double-elimination tournament, in paired comparisons, 132, 132f DPOAEs (distortion product otoacoustic emissions), of middle ear implants, 303, 305f DR (dynamic range), 25 Dri-Aid kit, 365, 366t DSL [i/o] hearing aid fitting procedure, 7t, 12 14, 15f, 16f comparison among other strategies, 15 20, 19f DSP (digital signal processing), 188 DSP hearing aids. See Digital signal processing (DSP) hearing aids Dual/multiple microphones, noise-induced hearing loss patients and, E EAC (external auditory canal) lesions, conductive hearing loss and, 273 amplification strategies for, 273 Ear pathology, hearing aid counseling and, Earmold method, in real-ear measures, 81f, 95, 95f Earmolds acoustics of, NIHL patients and, 193 infection control for, , 382t selection of, 359 Earphones ER 3A insert, real-ear measures using, , 106f, 107f in LDL measurements, 32 Ease of listening, fitting binaural aids and, 207 Elderly binaural listening and, decreased memory in, hearing aid selection for, 352 LDL measurement in, and young adult differences, 41f, Electroacoustic measures, of hearing aid performance, 159, 159f Electromagnetic middle ear implants, , f Electromechanical middle ear implants, , 296f 298f Emotional concerns, audiologist counseling to address, 350 Entry-level hearing aids, , 194f Environment audiologist s office, 345 in balanced outcome measures battery, 152t, 155 Environmental Protection Agency, 375, 375t Experimental signals, in real-ear measures, External auditory canal lesions, conductive hearing loss and, 273 amplification strategies for, 273 Extreme discomfort, in LDL measurement, 29 Eyeglass hearing aid, bone-conduction, , 283f F FIG6 fitting strategy, 14, 17f comparison with other strategies, 15 20, 19f Fine motor coordination problems, hearing aid fitting considerations and, 352

5 388 INDEX Fistula, perilymphatic, unilateral hearing loss and, 255 Fitting strategies. See also Asymmetrical hearing loss; Conductive hearing loss; Noise-induced hearing loss; Symmetrical hearing loss; Unilateral hearing loss for air conduction hearing aids, 282 for BAHA (bone-anchored hearing aid), , 279f for binaural hearing aids, 3t, , 214f, 215f for linear hearing aids, 7f, 8 11, 9t, 10f for NIHL patients, 185 adaptive amplification, compression, frequency shaping, user-controlled multiple programs, , 191f for nonlinear hearing aids. See Nonlinear hearing aids outcome measures battery assessment and. See Outcome measures battery paired comparison and, 144. See also Paired comparisons postfit assessment, , 367f practical considerations for, 3t, 4 adjustments for conductive loss, 5 audiometric information in, 4 binaural fitting, 5 channels and, 5 fitting information provides, 4t, 5 individualized hearing aid and earmold fitting data in, 3t, 4 5 prescriptive, for hearing aids, 2 4, 3t device-independent versus proprietary, 7 8, 7f incorporation within fitting protocol, 6 7 linear and nonlinear device, 7f, 8 9 for linear signal processing, 9 11, 9t, 10f for nonlinear signal processing, 7t, comparisons of, 15 20, 19f suprathreshold, 11, 11t using LDL, 51 Fluctuating composite, FM systems, 103 Follow-up care, for hearing aid patients, 366 Frequency compression hearing aid, versus WDRC hearing aid, , 334t Frequency domain, transparency in, 182 Frequency shaping, in noise-induced hearing loss patients, Functional gain assessment, 224 NIHL patients and, G Gender, LDL measurement differences and, 50 Gloves, for infection control, , 381f, 382t 383t Gross motor coordination problems, hearing aid fitting considerations and, 352 H HAE (hearing aid evaluation), 347 options, counseling on, Hand washing, 379, 379f, 380t CDC guidelines for, 373 Handicap, WHO definition of, 153 Hardware development, middle ear implants and, HCL (highest comfortable level), 25 Head shadow effect, 194 in fitting binaural hearing aids, 205, 205f unilateral hearing loss and, 257 Hearing impaired, rehabilitation for. See Hearing rehabilitation loss of. See Hearing loss Hearing aid clinic, infection control protocols in, Hearing aids batteries for. See Batteries BICROS. See Bilateral contralateral routing of signals (BICROS) hearing aids binaural, for asymmetrical hearing loss. See Asymmetrical hearing loss, binaural hearing aids for bone conduction, , 277f, 283f BTE. See Behind-the-ear (BTE) hearing aid care of cerumen management, 364, 364f disinfectant use, , 365f insertion/removal, moisture and humidity effects, 365, 366f cost of, counseling on. See Orientation and counseling, for hearing aid patients CROS. See Contralateral routing of signals (CROS) hearing aids CROS-Plus, 264 digital and programmable. See Digitally programmable hearing aids DSP. See Digital signal processing (DSP) hearing aids earmold selection and, 359 evaluation of, 347 options, counseling on, fitting strategies for. See Fitting strategies follow-up care for, 366 goals, in hearing rehabilitation, 312 infection control and. See Infection control ITC (in-the canal), 193, , 281f linear, 7f 10f, 8 11 maximum output of. See Maximum output of hearing aids microphones for. See Directional microphones; Dual/multiple microphones; Microphones multichannel, , 99f multiple memory, nonlinear. See Nonlinear hearing aids nonprogrammable, 353 options, counseling on, patient decisions for, performance, paired comparison as predictor of, 139 postfit assessment, , 367f programmable, 129. See also Digitally programmable hearing aids

6 INDEX 389 remote controls in, and physical limitations of user, 352 in sound field, RECD procedure and, styles of, 356, 358t. See also specific styles switches for, patient use of, 363 telephone use and, 357f, volume control in, 357 warranty options and, 359 WDRC. See Wide dynamic range compression (WDRC) hearing aids Hearing Handicap Inventory for adults, 167, 168t for elderly, 167, 168t Hearing Handicap Scale, 167, 168t Hearing in noise, in binaural hearing aid fitting, , 205f Hearing in noise test, , 165f, 166f binaural hearing aid and case study, , 320f fitting, cochlear implants and audiologic criteria, 336 case study, 326f, Hearing loss acquired, 255 asymmetrical. See Asymmetrical hearing loss conductive. See Conductive hearing loss congenital, 255, 273 idiopathic, 255 noise-induced. See Noise-induced hearing loss otitis media causing, 255, 274 otosclerosis, sensorineural, 314 severity of, hearing aid fitting concerns, 351 symmetrical. See Symmetrical hearing loss unilateral. See Unilateral hearing loss Hearing loss lifestyle, 340 Hearing Measurement Scale, 167, 168t Hearing Performanc Inventory, 167, 168t Hearing Performance Scale, 167, 168t Hearing rehabilitation, for adult, counseling on, 313, binaural hearing aids and, , 319f, 320f, 322f, 323f for children with hearing aids, , 330t, 331t cochlear implants and, , 326f 328f evaluation of, findings in, implications of, speech levels and, 26f, 27f, , 316f WDRC versus frequency compression hearing aid case study, , 334t HHIA (Hearing Handicap Inventory for Adults), 167, 168t HHIE (Hearing Handicap Inventory for the Elderly), 167, 168t HHS (Hearing Handicap Scale), 167, 168t High-frequency amplification, and failure for noiseinduced hearing loss patients, HINT. See Hearing in noise test HMS (Hearing Measurement Scale), 167, 168t HPI (Hearing Performance Inventory), 167, 168t HPS [Hearing Performance Scale (HPS)], 167, 168t Humidity, effect on hearing aids, 365, 365f Hyperacusis, 25 Hyperbilirubinemia, unilateral hearing loss and, 255 I ICRA noise, in real-ear measures, 84 IHAFF. See Independent Hearing Aid Fitting Forum (IHAFF) protocol Illnesses, and hearing aid selection, 352 ImpaCt aids, case study using, , 334t Impairment rehabilitation in. See Hearing rehabilitation WHO definition of, 153 Implantable bone-conduction hearing device, 276, 277f. See also BAHA (bone-anchored hearing aid) Implants, middle ear. See Middle ear implants Implex TICA (Totally Implantable Cochlear Amplifier), , 291f In-the-canal (ITC) hearing aids air conduction, , 281f NIHL patients and, 193 In-the-drawer phenomenon, 172 In-the-ear (ITE) hearing aids air conduction, , 281f binaural, case study of, 235 directional microphones in, 355 IROS, noise-induced hearing loss patients and, 193 Staphylococcus infection and, , 372t T-coils for, , 356f Independent Hearing Aid Fitting Forum (IHAFF) protocol, 14 binaural hearing aid case studies using, 317 Infection control, 374, 375t cleaning, disinfecting, and sterilizing processes, , 376f 377f, 377t, 378t custom hearing aids and, , 381t 382t for earmold impressions, , 381t gloves for, , 380f, 381t handwashing and, 377, 378f 379f, 379t in hearing aid clinic, protocols for, infection process and, for listening check, 383, 382t need for, OSHA standards, 369, 370t practices, 373 protective apparel, 380 specific, need for, , 372t universal precautions for, 374, 374t Initial discomfort, in LDL measurement, 29 Initial estimate, in simple up-down paired comparisons, Insertion, of hearing aids, Intensity differences, interaural, 204, 204f Interaural differences intensity, 204, 204f time, , 203f Internal noise, in microphone real-ear measure systems, 82

7 390 INDEX Intraventricular hemorrhage, unilateral hearing loss and, 255 IROS in-the-ear hearing aids, noise-induced hearing loss patients and, 193 ITC hearing aids. See In-the-canal (ITC) hearing aids ITD (in-the-drawer) phenomenon, 172 ITE hearing aids. See In-the-ear (ITE) hearing aids L Laser Doppler vibrometry, of middle ear implants, 302 Late-onset auditory deprivation, 207 LDL. See Loudness discomfort level LDV (laser Doppler vibrometry), of middle ear implants, 302 LE (loudness equalization), 5 6 Lead titanate zirconate, for middle ear implants, 290 Linear hearing aids, fitting strategies for independent, 7f, 8 9 signal processing, 9 11, 9t, 10f Listening, binaural aging impact on, fitting binaural aids and, 207 impact of directional microphones on, 209 Listening check, infection control for, 383, 382t LN (loudness normalization), 5 6 Localization, unilateral hearing loss and, Long-term average speech spectrum, 12 Loudness, equalization versus normalization, 5 6 Loudness discomfort level, 24 auditory threshold to predict, 26f, 27f, and relationship to LDL, 26f, 27f, 43 48, 44f, 46f 48f average corrections and, 51 52, 51t, 52t binaural hearing aid fittings and, 50 51, 211 clinically measured, and real-world levels of discomfort, comfortable, 25 conductive hearing loss and, 51 definition of, 25 differences in children versus adults, 49 50, 50f female versus male, 50 young adults versus elderly, exceeding, maladaptive strategies for, 23 hearing aid fitting and, 51 loudness scaling and, maximum hearing aid output measurements and acclimatization, descriptive anchors, 28, 29f earphone, 25 28, 26f, 27f, 32 effect of signal type, 31 32, 31t instructions for, 29 30, 29f psychophysical procedures for, test-retest reliability, training effect, 33 validity of measures in, 34 35, 34t OSPL90 selection and clinically measured, signal processing, uncomfortable, 24, 25 Loudness scaling, LDLs and, assessment scales for, 40 APHAB, 40 41, 41f PAL, 41, 42f Loudspeaker positioning, during real-ear measures, 68f, 69f, 86f, 95 98, 95f, 97f Low birth weight, unilateral hearing loss and, 255 LTASS (long-term average speech spectrum), 12 M Magnetic resonance imaging, middle ear implants and, 301 Mastoid diseases, conductive hearing loss and, 255 cholesteatoma, 274 chronic otitis media, 255 inflammatory, 275 otosclerosis, tumors as, 275 Maximum length sequence, in real-ear measures, 85 Maximum output of hearing aids auditory threshold and, 26f, 27f, and LDL relationship, 26f, 27f, 43 48, 44f, 46f, 48f channels of compression and, LDL measurements, See also Loudness discomfort level, maximum hearing aid output measurements and loudness assessment and, 40 APHAB, 40 41, 41f PAL, 41, 42f OSPL90 considerations, 56 peak clipping versus compression, 56 saturation-induced distortion, WDRC and, 57 real-world levels of discomfort and clinical LDLs, safety considerations in, 26f, 27f, selection of hearing aid in, 34t, 36 40, 37t, 38f 40f methods, 25 RECD in, 52 55, 52t, 54f terminology of, time constants and signal duration, 58 verification/validation methods aided loudness judgments, 60 62, 61f probe-mic assessment, 59 60, 59t self-assessment scales, 62 MCL (most comfortable loudness) levels, 25 suprathreshold method to determine, 1 MCLL (most comfortable listening level), 222 Measles, unilateral hearing loss and, 255 MEIs. See Middle ear implants Memory (hearing aid), Memory (personal), hearing aid selection and, 352 Meniere s disease fitting binaural hearing aids for, unilateral hearing loss and, 255 Meningitis, unilateral hearing loss and, 255 MET (Middle Ear Transducer), 295, 296f, 297t

8 INDEX 391 Microphones directional. See Directional microphones dual/multiple, NIHL patients and, probe, OMB measures for, , 160f, 161f real-ear measures and crosstalk, 82 directional, , 104f internal noise in, 82 probe-tube, calibration for, 90 91, 92f placement of, 92 93, 92f, 93f positioning methods, reference, 80 81, 81f placement of, 81f, 91 92, 92f Middle ear direct stimulation of, 289 diseases of, conductive hearing loss and cholesteatoma, 274 chronic otitis media, 255 inflammatory, 275 otosclerosis, tumors as, 275 implants in. See Middle ear implants Middle ear implants advantages of, , 302f as alternative to cochlear implants, 287 clinical trials for, , 306t design and development of, hardware and software, material and biocompatibility, 299 direct stimulation and, 289 disadvantages of, preclinical research in, , 304f, 305f surgical issues of, types of, 289 electromagnetic, , f electromechanical, , 296f 298f piezoelectric, , 290f 294f Moisture, effect on hearing aids, 365, 365f Most comfortable levels listening, 222 loudness, 25 suprathreshold method to determine, 1 Motivation in audiologist evaluation, lack of, NIHL patients and, 179 Motor coordination problems, hearing aid fitting considerations and, 352 Multichannel compression hearing aids, real-ear measures and, , 99f Mumps, unilateral hearing loss caused by, 255 N Narrow dynamic range, hearing aid systems for, , 233f National Acoustic Laboratories NAL-NL1 (nonlinear fitting procedure, version 1), 12, 12f comparison among other strategies, 15 20, 19f sound pressure level speech spectrum (obsolete), 312 Newborn, pulmonary hypertension of, unilateral hearing loss and, 255 Noise-induced hearing loss (NIHL) amplification in adaptive, candidates for, 178 failure of, , 180f considerations in, , 194f counseling of patients with, 198 course of, , 177f 179f definition of, 177 digital feedback reduction and, 192 directional and dual/multiple microphones for, etiology of, 176 fitting strategies for patients with, 185 adaptive amplification, compression, frequency shaping, real-ear insertion assessments, subjective scaling in, terminology of, , 177f 179f user-controlled multiple programs and, , 191f Noise reduction, clinical real-ear measures and, 88 Nonlinear hearing aids, fitting strategies for independent, 7f, 8 9 signal processing, 7t, comparison of, 15 20, 19f DSL [i/o], 7t, 12 14, 15f, 16f FIG6, 14, 17f NAL-NL1, 12, 12f VIOLA, 14 15, 18f Nonprogrammable hearing aids analog, 353 digital, 353 O Objective measures in BAHA use, 281 in binaural hearing aid fitting, Occlusion effect, f Occupational Safety and Health Administration, 369, 370t OMB. See Outcome measures battery Operator, positioning during real-ear measures, 86f, 98 Orientation and counseling, for hearing aid patients amplification history in, 346 audiologist s role in, care of, , 364f case history in, communication and hearing loss, 347, 348f, 349f evaluation for hearing aid options, and follow-up care, 216, 366 initial contact for, 345 patient decisions for, patient motivational assessment in, postfit assessment in, , 367f

9 392 INDEX Orientation and counseling, for hearing aid patients, (continued) selection options and direct audio input, 356, 358t directional microphones, 355 multiple memory, telephone coils, , 356f, 357f styles of, 356, 358t CROS/BICROS, , 360f technology, use of, 357f, OSHA (Occupational Safety and Health Administration), 369, 370t OSPL90 (output sound pressure level), 25 signal processing of hearing aid and, 56 peak clipping versus compression, 56 saturation-induced distortion, 56 WDRC and, 57 Otitis media adhesive, 274 chronic, 274 conductive hearing loss and, 274 unilateral hearing loss and, 255 Otologics MET, 295, 296f, 297f Otosclerosis, conductive hearing loss and, Otoscopic inspection, real-ear measures and, 90, 91f probe tube positioning, 94 Outcome measures, , 152t description of, , 152t meeting clinical goals and expectations with, 152t, patient s perspective on, 152t, testing environment in, 152t, 155 timing of, 152t, types of, 152t, 153 Outcome measures battery, 152t, for communications systems, , 163t clinical implementation of, , 165f, 166f examples of, for physiologic system, , 158t, 159f 161f for psychological system, , 168t clinical implementation of, , 170f, 171f Output limiting, in real-ear measure systems, 90 P Paired comparisons, in hearing aid fittings advantages of, definition of, , 127f history of, , 128f integration of in clinical hearing aid fitting, , 147f with other measures, 148 need for, technique of, double-elimination tournament, 132, 132f modified simplex procedure, , 136f round-robin tournament, , 130f simple up-down procedure, , 133f single-elimination tournament, 131, 131f PAL (Profile of Aided Loudness), 41, 42f, 62 Patient counseling for. See Counseling; Orientation and counseling, for hearing aid patients education of, after diagnosis, 347, 348f, 349f expectations of binaural hearing aids in asymmetric hearing loss, hearing aid selection and, motivational assessment of, perspective of outcome measures battery for, 152t, in unilateral hearing loss, 259 and real-ear measures instructions for, 100 positioning during, 68f, 69f, 86f, 95 98, 95f, 97f Patient-driven protocol, in hearing aid fitting strategy, 6 7 Peak clipping, 56 Perforation, of tympanic membrane, conductive hearing loss and, Performance Inventory for Profound and Severe Loss, , 168t Perilymphatic fistula, unilateral hearing loss and, 255 PHAB (Profile of Hearing Aid Benefit), 349 Phenome identification, 162 Physiologic system, OMB to measure, , 158t, 159f 161f Piezoelectric middle ear implants, , 290f 294f PIPSL (Performance Inventory for Profound and Severe Loss), , 168t PORP (Partial Ossicular Replacement Prosthesis), 294, 294f Postfit assessment, of hearing aids, , 367f PPHN (pulmonary hypertension of the newborn), unilateral hearing loss and, 255 Prescriptive amplification targets, outcome measures for evaluation of, 162 Prescriptive formulas for hearing aids. See also Fitting strategies, prescriptive fitting protocol, fitting strategy within, 6 7 historical perspective of, 1 2 loudness normalization versus loudness equalization, 5 6 theoretical considerations for, 5 Prescriptive speech recognition targets, 164 Probe measures, for CROS fittings, Probe-microphone assessment, 59 60, 59t in hearing aid performance, , 160f, 161f REOR/G as, 75 76, 76f Probe-tube microphone measurements with, 66 in real-ear measure systems, calibration for, 90 91, 92f methods of positioning, placement of, 92 93, 92f, 93f Profile of Aided Loudness, 41, 42f, 62 Profile of Hearing Aid Benefit, 349 Programmable hearing aids. See also Digitally programmable hearing aids paired comparisons for, 129 Proprietary fitting strategies, 7 8, 7f

10 INDEX 393 Proprietary versus device-independent fitting strategies, 7 8, 7f Protocols, in hearing aid fitting strategy audiologist-driven, 6 patient-driven, 6 7 Pseudo-REIG, real-ear measures and, , 122t Psychoacoustic assessment, of hearing aid utility, Psychological evaluation, for cochlear implant candidates, 338 Psychological system, outcome measures for evaluation of, , 168t clinical implementation of, , 170f, 171f Psychophysical procedures, in LDL measurement, Pulmonary hypertension of the newborn, unilateral hearing loss and, 255 R RCL (range of comfortable loudness), 25 REAG (real-ear occluded gain), 75 Real-ear aided response/gain, 5, 74 binaural hearing aids, case study using, , 322f measures in CROS fittings, 268 transcranial, , 269t real-ear measure system and, 101 Real-ear insertion gain, 5, 74, 75f assessment and NIHL patients, measures in CROS fittings, real-ear measure system and, 101 Real-ear measures application of, 72 73, 73f. See also specific real-ear measures of BICROS, , 103f insertion-gain measures for, 103 circle of decibels in, 72t, , 111f, 112t, 113t clinical reality in, 86 90, 87f CORFIG and, , 114f, 115t of CROS, 102 insertion-gain measures for, 103 directional microphones in, , 104f FM systems and, 103 general considerations in, 87f, , 116f, 117f history of, 66 72, 67f 71f, 72t in insertion-gain applications, , 122t instrumentation used in, 80 85, 81f, 86f occlusion effect by, 78 80, 79f patient hazards in, preparations for choosing tests, 100 loudspeaker positioning, 68f, 69f, 86f, 95 98, 95f, 97f operator positioning, 86f, 98 otoscopic inspection, 90, 91f patient instructions, patient positioning, 68f, 69f, 86f, 95 98, 95f, 97f probe-tube microphone, 81f, 90 91, 92 95, 92f, 93f, 95f reference microphone placement, 81f, 91 92, 92f signal type and amplitude, , 99f pseudo-reig in, rationale for, , 122t RECD in, for BTEs, using ER 3A insert earphone, , 106f, 107f using hearing aid in sound field, REDD in, 110 variability in, sources of, 118, 118t WDRC instruments in, 104 Real-ear occluded response/gain, 75 76, 76f real-ear measure system and, 101 Real-ear saturation response, 25, 59 60, 59t, 76 77, 76f, 77f real-ear measure system and, 102 Real-ear-to-coupler difference, 52 55, 52t, 54f, 71f, in fitting hearing aids, 3t, 4 5 occluded, standard deviations in, 67, 70f real-ear measure procedures for, for BTEs, using ER 3A insert earphone, , 106f, 107f using hearing aid in sound field, Real-ear-to-dial difference, 34, 34t, 78 real-ear measure procedure for, 110 Real-ear unaided response/gain, 67f, 68f, measures in CROS fittings, Real-ear unaided response/or gain, real-ear measure system and, , , 122t Real-world levels of discomfort, clinical LDLs and, REAR. See Real-ear aided response/gain RECD. See Real-ear-to-coupler difference Recruitment, 25 REDD. See Real-ear-to-dial difference Reference Equivalent Threshold Sound Pressure Levels, 51, 51t Reference microphones, in real-ear measure systems, 80 81, 81f Rehabilitation, hearing. See Hearing rehabilitation REIG. See Real-ear insertion gain Reliability, of paired comparison, REM. See Real-ear measures Remote controls, for hearing aids, and physical limitations of user, 352 Removal, of hearing aids, REOR/G. See Real-ear occluded response/gain RESR. See Real-ear saturation response RETSPLs (Reference Equivalent Threshold Sound Pressure Levels), 51, 52t REUR/G. See Real-ear unaided response/gain Room acoustics, in real-ear measure system set up, 85, 86f Round-robin-tournament, in paired comparisons, , 130f Roving warble tones, in real-ear measures, 84 S Safety considerations, for LDL assessment, 26f, 27f, Safety glasses, for infection control, 381 St. Croix Envoy, , 292f Saturation-induced distortion, LDLs and, 56

11 394 INDEX Saturation response assessment, noise-induced hearing loss patients and, Scores on Speech Tests, case studies using, , 331t Self-assessment scales to assess loudness, 62 NIHL patients and, Self-help for Hard of Hearing People, 342 Sensorineural hearing loss, 314 Sentence identification, in communication evaluation, 164 Signal-to-noise ratio in fitting hearing aids, HINT case study measuring, 323f, 324 Signals time constants and duration of, 58 types of affecting LDL measurements, 31 32, 31t and amplitude, real-ear measure systems and, Simple up-down procedure, in paired comparisons, , 133f choice of initial estimate in, step size in, 135 termination rule in, Simplex procedure, modified, in paired comparisons, , 136f SIN (Speech in Noise) test, and binaural hearing aid fitting, 210 Single-elimination tournament, in paired comparisons, 131, 131f Smoothing, real-ear measures and, 86 88, 87f SNR. See Signal-to-noise ratio Software development, middle ear implants and, Sound quality judgments about, noise-induced hearing loss patients and, source of locating, in fitting binaural hearing aids, 203 real-ear measure system and, 80 Sound-field equalization, real-ear measure test environment and, evaluation for CROS, , 266f, 267t outcome measures for evaluation of, 158t, , 161t RECD using hearing aid in, SoundTec Direct Drive Hearing System, 294, 295f surgical approach for, 299 Spectrum, in real-ear measure test signals, 83 Speech aided loudness judgments for, 60 62, 61f levels in everyday life, 26f, 27f, , 316f perception-in-noise, 180 recognition-in-noise, Speech in Noise test, and binaural hearing aid fitting, 210 Speech recognition tests improved sensitivity, paired comparisons of hearing aids and, 138 prescriptive targets in, 164 SPIN (speech perception in noise), 180 Squelch effect binaural, 194 in fitting binaural hearing aids, 206 unilateral hearing loss and, 257 St. Croix Envoy, , 292f Staphylococcus, 371, 372f Step size, in simple up-down paired comparisons, 135 Sterilization, in infection control, 375 techniques of, , 378f, 378t Stored equalization, real-ear measure test environment and, 89 Strategies for hearing aid fitting. See Fitting strategies for verification/validation. See Verification strategies Styles of hearing aids, 356, 358t Subjective measures in BAHA (bone-anchored hearing aid) use, in fitting binaural hearing aids for asymmetrical hearing loss, versus objective measures, 230 Subjective outcomes, for BAHA (bone-anchored hearing aid), Subjective preference, to amplified sound in asymmetrical hearing loss, 222 Subjective scaling, noise-induced hearing loss patients and, Suprathreshold fitting strategies, for hearing aids, 11, 11t Suprathreshold method, for gain and frequency response, 1 Surgery for amplification in conductive hearing loss, 275 BAHA and. See BAHA (bone-anchored hearing aid) for middle ear implants, Switches, for hearing aid, patient use of, 363 Syllable identification, 162 Symmetrical hearing loss, fitting hearing aids for, aging impact on, audiologic evaluation in, binaural advantage in, directional microphones and, 209 goals of, binaural hearing, 203, 203f binaural summation, hearing in noise, , 205f interaural time differences, , 203f, 204f listening ease, 207 locating sound source, 203 preservation of hearing, sound quality and, 207 orientation and follow-up, 216 precounseling for, 211 preselection decisions in, strategies for, 3t, , 214f, 215f verification considerations in, Symphonix Vibrant, 287, 298f

12 INDEX 395 T T-coils (telephone coils), , 356f, 357f TD (threshold of discomfort), 25 Technology, hearing aid, patient education and, Telephone coils, , 356f, 357f Telephone use, 357f, Temporal bone, computed tomography of, 273 Temporal properties, in real-ear measures, 84 Termination rule, in simple up-down paired comparison, Test-retest reliability, in LDL measurements, Test signals, in real-ear measure equipment, See also specific signals TILL. See Treble increase at low levels Time constants compression, and NIHL, 190 and signal duration, 58 Time differences, interaural, , 203f TORP (Total Ossicular Replacement Prosthesis), 294, 294f Training, effect in LDL measurements, 33 Transcranial CROS, fitting of, in unilateral hearing loss, verification strategy for, , 269t Transparency, in amplitude frequency domain, 182 Trauma, unilateral hearing loss and, 255 Treble increase at low levels, 187 Tumors, of middle ear and mastoid, conductive hearing loss and, 275 Tympanic membrane lesions, conductive hearing loss and adhesive otitis media and, 274 perforation and, tympanosclerosis and, 274 Tympanosclerosis, causing conductive hearing loss, 274 U UCL (uncomfortable level), 24 ULC (upper level of comfort), 25 ULCL (upper level of comfortable listening), 25 ULL (uncomfortable loudness level), 25 UltraVac, for hearing aid cleaning, 367, 367f Uncomfortable levels, of loudness, 24, 25 Unilateral hearing loss classroom performance and, definition of, 253 etiology of, , 256t fitting strategies for patients with, 253 bone conduction, case history and referral, fitting options, , 261f incidence and prevalence of, patient s perspective of, 259 problems associated with, 257 binaural summation, 258 head shadow effect, 257 localization, squelch effect, 257 verification strategies CROS fittings, probe measures for, transcranial, , 269t sound field evaluation, , 266f, 267t Universal precautions, 374, 374t Upper level of comfort, 25 Upper level of comfortable listening, 25 V Validation methods. See Verification strategies VCWs (volume control wheels), 23 Verification strategies, 230 for air conduction hearing aids, 282 binaural considerations in, for bone-conduction hearing aids, 284 maximum output of hearing aids and aided loudness judgments, 60 62, 61f probe-mic assessment, 59 60, 59t self-assessment scales, 62 in unilateral hearing loss CROS fittings, probe measures for, transcranial, , 269t sound field evaluation, , 266f, 267t VIOLA. See Visual input-output locator algorithm Visual acuity, hearing aid fitting considerations and, 352 Visual input-output locator algorithm, 14 15, 18f comparison with other strategies, 15 20, 19f Volume control wheels, 23 Volume controls, of hearing aids, 357 W Warranty options, on hearing aids, 359 WDRC hearing aids. See Wide dynamic range compression (WDRC) hearing aids WHO (World Health Organization), 153 Wide dynamic range compression (WDRC) hearing aids and BTE hearing aids, case study of, versus frequency compression hearing aid case study, , 334t loudness discomfort levels and, 57 real-ear measures and, 104 Word identification, in communication evaluation, NIHL patients and, World Health Organization, 153 Z Zerlin s method, of paired comparisons, 128

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