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Review
. 2017 Dec 18:16:Doc08.
doi: 10.3205/cto000147. eCollection 2017.

Hearing aids: indications, technology, adaptation, and quality control

Ulrich Hoppe  1 , Gerhard Hesse  2
Affiliations
Review

Hearing aids: indications, technology, adaptation, and quality control

Ulrich Hoppe et al. GMS Curr Top Otorhinolaryngol Head Neck Surg. .

Abstract

Hearing loss can be caused by a number of different pathological conditions. Some of them can be successfully treated, mainly by surgery, depending on the individual's disease process. However, the treatment of chronic sensorineural hearing loss with damaged cochlear structures usually needs hearing rehabilitation by means of technical amplification. During the last two decades tremendous improvements in hearing aid technology led to a higher quality of the hearing rehabilitation process. For example, due to sophisticated signal processing acoustic feedback could be reduced and hence open fitting options are available even for more subjects with higher degrees of hearing loss. In particular for high-frequency hearing loss, the use of open fitting is an option. Both the users' acceptance and the perceived sound quality were significantly increased by open fittings. However, we are still faced with a low level of readiness in many hearing impaired subjects to accept acoustic amplification. Since ENT specialists play a key-role in hearing aid provision, they should promote early hearing aid rehabilitation and include this in the counselling even in subjects with mild and moderate hearing loss. Recent investigations demonstrated the benefit of early hearing aid use in this group of patients since this may help to reduce subsequent damages as auditory deprivation, social isolation, development of dementia, and cognitive decline. For subjects with tinnitus, hearing aids may also support masking by environmental sounds and enhance cortical inhibition. The present paper describes the latest developments of hearing aid technology and the current state of the art for amplification modalities. Implications for both hearing aid indication and provision are discussed.

Keywords: audio therapy; hearing aid; hearing loss; rehabilitation; tinnitus.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Figure 1
Figure 1. Relationship between hearing aid indication and hearing aid usage [42]
Figure 2
Figure 2. Functional principle of modern digital hearing devices
Figure 3
Figure 3. Output level of a hearing aid as curve of the input level with non-linear amplification (thick line) in comparison to the unamplified signal (dotted line). The amplification below the knee-point is 20 dB, above the knee-point of 60 dB it decreases linearly. Above 100 dB, even signal attenuation occurs. The whole amplification process may be described by the initial amplification, the knee-point, and the compression.
Figure 4
Figure 4. Example for typical hearing aid care. The figure shows the understanding of monosyllabic words without (circles) and with hearing aid (rectangles) in dependence from the speech level. For everyday speech, the speech intelligibility was improved from 10 to 75%. The average understanding of monosyllables of 90% is only merely achieved with hearing aids. The standard curve for normally hearing people is significantly better. In the level area, the discrimination curve is shifted of 20–25 dB to the lower values.
Figure 5
Figure 5. Questions on hearing aid use with the purpose of listening to music [120]
See this image and copyright information in PMC

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