Differences in Force Levels, Word Recognition in Quiet, Sentence Reception Threshold in Noise, and Subjective Outcomes for a Bone-Anchored Hearing Device Programmed Using Manufacturer First-Fit, Aided Sound-Field Thresholds and Programmed to DSL-BCD Using a Skull Simulator

Abstract

Background Best practice guidelines for verifying fittings of bone-anchored hearing devices (BAHD) recommend using aided sound-field thresholds (ASFT), but express caution regarding the variables impacting obtaining valid and reliable ASFTs.[1] Recently, a skull simulator was introduced to facilitate programming BAHD devices in force level (FL) to desired sensation level-bone conduction devices (skull simulator/DSL-BCD)[2] [3] targets in a hearing aid analyzer. Currently, no evidence is available reporting if differences in measured FL using the manufacturer first-fit (FF) and word recognition in quiet, sentence reception threshold in noise, and subjective outcomes are present for a BAHD programmed using ASFT versus programmed using skull simulator/DSL-BCD targets.

Purpose The aim of this study was to examine if significant differences were present in FL using the FF and word recognition in quiet at 50 and 65 decibel of sound pressure level (dB SPL), sentence reception threshold in noise and subjective outcomes using the abbreviated profile of hearing aid benefit (APHAB), and speech, spatial, and qualities of hearing (SSQ) between a BAHD fit using ASFT or skull simulator/DSL-BCD targets.

Research Design A double-blind randomized crossover design with 15 adults having unilateral sensorineural hearing loss. All participants were successful users of the Cochlear America Baha 5.

Data Collection and Analysis Baha Power 5 devices were fit using FF, ASFT, and skull simulator/DSL-BCD targets. Order of the three fitting strategies was randomly assigned and counter-balanced.

Results No significant differences were found for a BAHD device programmed using ASFT versus skull simulator/DSL-BCD targets for consonant-nucleus-consonant words in quiet at 50 or 65 dB SPL, sentence reception threshold in noise, the APHAB or SSQ. There were, however, significant differences, at primarily 500 to 2,000 Hz in measured FLs between the FF, ASFT, and skull simulator/DSL-BCD targets at 50 and 65 dB SPL.

Conclusions There were no significant differences in subject performance with two speech measures and subjective responses to two questionnaires for BAHD fittings using ASFT versus using skull simulator/DSL-BCD targets. Differences in FL between the three fitting strategies were present primarily at 500 to 2,000 Hz. Limitations of the study are highlighted along with situations where the skull simulator can play a significantly beneficial role when fitting BAHD devices.

Keywords

bone-anchored hearing device - Baha Power 5 - skull simulator - DSL-BCD

Disclaimer

Any mention of a product, service, or procedure in the Journal of the American Academy of Audiology does not constitute an endorsement of the product, service, or procedure by the American Academy of Audiology.

Publication History

Received: 17 November 2020

Accepted: 08 March 2021

Article published online:
30 November 2021

• References

• 1 Hodgetts WE, Scollie SD. DSL prescriptive targets for bone conduction devices: adaptation and comparison to clinical fittings. Int J Audiol 2017; 56 (07) 521-530
• 2 Hodgetts W, Scott D, Maas P, Westover L. Development of a novel bone conduction verification tool using a surface microphone: validation with percutaneous bone conduction users. Ear Hear 2018; 39 (06) 1157-1164
• 3 Tharpe AM, Fino-Szumski MS, Bess FH. Survey of hearing aid fitting practices for children with multiple impairments. Am J Audiol 2001; 10 (01) 32-40
• 4 Moodie S, Rall E, Eiten L. et al. Pediatric audiology in North America: current clinical practice and how it relates to the American Academy of Audiology pediatric amplification guideline. J Am Acad Audiol 2016; 27 (03) 166-187
• 5 Holube I, Fredelake S, Vlaming M, Kollmeier B. Development and analysis of the international speech test signal (ISTS). Int J Audiol 2010; 49 (12) 891-903
• 6 Stenfelt S. Transcranial attenuation of bone-conducted sound when stimulation is at the mastoid and at the bone conduction hearing aid position. Otol Neurotol 2012; 33 (02) 105-114
• 7 Peterson GE, Lehiste I. Revised CNC lists for auditory tests. J Speech Hear Disord 1962; 27 (01) 62-70
• 8 Nilsson M, Soli SD, Sullivan JA. Development of the Hearing in Noise Test for the measurement of speech reception thresholds in quiet and in noise. J Acoust Soc Am 1994; 95 (02) 1085-1099
• 9 Cox RM, Alexander GC. The abbreviated profile of hearing aid benefit. Ear Hear 1995; 16 (02) 176-186
• 10 Gatehouse S, Noble W. The speech, spatial and qualities of hearing scale (SSQ). Int J Audiol 2004; 43 (02) 85-99
• 11 Valente M, Barninger K, Oeding K, Smith S, Snapp H, Sydlowski S. AAA Clinical practice guidelines-adult patients with severe-to-profound unilateral sensorineural hearing loss. 2015: 1-49 www.audiology.org . Accessed April 1, 2021
• 12 British Society of Audiology. Guidance on the use of real-ear measurements to verify the fitting of digital signal processing hearing aids. 2007 . Accessed April 1, 2021 from: http://www.thebsa.org.uk/wp-content/uploads/2014/04/REM.pdf
• 13 Bianchi F, Wendt D, Wassard C. et al. Benefit of higher maximum force output on listening effort in bone-anchored hearing system users: a pupillometry study. Ear Hear 2019; 40 (05) 1220-1232
• 14 Koehler E, Kulkarni S. Fast and easy fitting and verification with integrated real-ear measurement. Hear Rev 2014; 21 (10) 36-40
• 15 Baumann J, Powers T, Branda E. Validity, reliability and efficiency if the Signia auto fit procedure. Hear Rev 2018; 25 (09) 26,28,30
• 16 Denys S, Matthias L, Francart T, Wouters J. A preliminary investigation into hearing aid fitting based on automated real-ear measurements integrated in the fitting software: test–retest reliability, matching accuracy and perceptual outcomes. Int J Audiol 2019; 8 (03) 132-140
• 17 Folkeard P, Pumford J, Abbasalipour P, Willis N, Scollie S. A comparison of automated real-ear and traditional hearing aid fitting methods. Hear Rev 2018; 25 (11) 28-32
• 18 Pumford J, Mueller HG. Using autoREMfit for hearing aid fitting and verification: evidence of accuracy and reliability. Hear Rev 2020; 27 (08) 24-27
• 19 American Academy of Audiology. Clinical practice guideline for fitting adult patients with severe-to-profound unilateral sensorineural hearing loss. 2015. American Academy of Audiology; www/audiology.org . Accessed April 1, 2021
• 20 Stenfelt S. Bilateral fitting of BAHAs and BAHA fitted in unilateral deaf persons: acoustical aspects. Int J Audiol 2005; 44 (03) 178-189
• 21 Verstraeten N, Zarowski AJ, Somers T, Riff D, Offeciers EF. Comparison of the audiologic results obtained with the bone-anchored hearing aid attached to the headband, the testband, and to the “snap” abutment. Otol Neurotol 2009; 30 (01) 70-75
• 22 Acoustical Society of America. American national standard specification for audiometers. 2018. American National Standards Institute, Inc.;