Binaural fittings

AVISHEK DUTTADIRECTOR

BENGAL SPEECH AND HEARING PVT. LTD.

Elements of communication

Satisfaction level with hearing aid

•Satisfaction level of person with conductive hearing loss fitted with hearing aid is usually the best.

•Satisfaction level of elderly people fitted with hearing aid is usually poor.

Why???????

• Hearing loss▫ “Although it is true that mere detection of a

sound does not ensure its recognition, it is even more true that without detection the probability of correct identification is greatly diminished”. (Pascoe, 1980)

• Global cognitive decline• Maladaptive compensatory behaviors • Neural plasticity and progressive

neurodegeneration▫Morest, 2004

• Loss of confidence▫Saunders and Cienkowski (2002)

Hearing aid patients by age

0

10

20

30

40

50

60

70

65+ 45-65 30-44 18-29 <18

From Strom, Hearing Review, 2001

Perceptual and cognitive declines (resource limitations) in elderly

•Speed of processing

•Working memory

•Attention difficulties (noise, distraction and executive control)

Wingfield and Tun, 2001- Seminars in Hearing

Impact of ageing on speech perception

•Even in the absence of hearing loss, older subjects require 3-5 dB higher SNR than young listeners (Schneider, Daneman and Murphy, 2005).

•Older subjects with normal hearing perform approximately the same as young hearing impaired subjects (Wingfield and Tun, 2001)

• Perhaps the problem isn’t that older people have true cognitive differences than young. Rather, the need for greater SNR places a greater strain on the cognitive resources. This creates more effortful listening (Pichora-Fuller, 2006).

solution

•Binaural fitting

Advantage of binaural fitting over monoaural fitting

•Better understanding of speech

•Better understanding in group and noisy situations

•Better ability to tell the direction of sound

•Better sound quality

•Smoother tone quality

•Wider hearing range

•Better sound identification

•Keeps both ears active resulting in potentially less hearing loss deterioration

•Hearing is less tiring and listening more pleasant

•Feeling of balanced hearing

•Greater comfort when loud noises occur

•Reduced feedback and whistling

•Tinnitus Masking

•Consumer preference

•Customer satisfaction

Candidacy for binaural fitting

•Symmetry of hearing loss

•Age: Central Processing Ability & Dexterity

•Attitude of the service provider

•Other factors

CASE STUDY Group – I Group – II

No of cases 5 5

Pure tone Average (PTA)

Rt ear : 50.0dB HLLt ear: 51.6 dB HL

Rt ear : 48.3 dB HLLt ear: 50.0 dB HL

Type of hearing loss Sensorineural Sensorineural

SRT Both ears: 50 dB HL Both ears : 55 dB HL

WRS 80 – 85 % 60 – 65 %

Speech in noise 70 – 75 % 30 – 40 %

Satisfaction with hearing aid

Monaural Binaural

Group I Audiogram

Group II Audiogram

THANK YOU