The effect of remote fitting technology on hearing aid satisfaction

Background: Telemedicine is a method of providing remote healthcare services and consultations to patients using communication technology. Tele-audiology is a sub-branch of telemedicine. It refers to providing audiology services using telehealth strategies. This study aims to compare the satisfaction of patients who come to the hearing aid center and receive device fitting service and patients who have hearing aid fitting using tele-audiology service. For this purpose, hearing aid users were divided into two groups. The study group consisted of 17 participants (10 male, 7 females;mean age 65.17 +/- 13.88) who continued fitting appointments remotely after the first clinic application, while the control group consisted of 23 participants (10 males, 13 females;mean age 62.17 +/- 18.32) who had all hearing aid fittings performed face-to-face in the clinic. The participant's satisfaction was assessed with The International Outcome Inventory for Hearing Aids Turkiye (IOI-HA-TR) questionnaire because it is practical and can be administered over the phone. Result(s): There were no significant differences in hearing aid satisfaction between those who came to the hearing center and filled out the IOI-HA-TR questionnaire personally and those who completed it through the Remote Care application (p < 0.05). In addition, most of the participants stated that using Remote Care solved their problems (35% very good, 24% good) and they were satisfied with the fitting of their hearing aids with this application (35% good, 29% very good). In addition, 13 out of 17 participants stated that they would pay attention to the "remote fitting" feature when purchasing a new hearing aid (76% very good). Moreover, they would like to continue the fitting using the Remote Care application (65% yes). Conclusion(s): Remote fitting technology via smartphone applications can facilitate the lives of hearing aid users and improve their quality of life in cases of risky conditions such as pandemics, various diseases, and physical limitations.Copyright © 2023, The Author(s).

Comparison of speech recognition performance with and without a face mask between a basic and a premium hearing aid in hearing-impaired listeners.

BACKGROUND: The mask mandate during the COVID-19 pandemic leads to communication challenges as sound energy gets reduced and the visual cues are lost due to the face mask. This study examines the impact of a face mask on sound energy and compares speech recognition performance between a basic and a premium hearing aid. METHODS: Participants watched four video clips (a female and a male speaker with and without a face mask) and repeated the target sentences in various test conditions. Real-ear measurement was performed to investigate the changes in sound energy in no mask, surgical, and N95 mask conditions. RESULTS: With the face mask on, sound energy significantly decreased for all types of masks. For speech recognition, the premium hearing aid showed significant improvement in the mask condition. CONCLUSION: The findings emphasize and encourage health care professionals to actively use communication strategies, such as speaking slowly and reducing background noise, when interacting with individuals with hearing loss.

Tele-Audiology: Current State and Future Directions.

The importance of tele-audiology has been heightened by the current COVID-19 pandemic. The present article reviews the current state of tele-audiology practice while presenting its limitations and opportunities. Specifically, this review addresses: (1) barriers to hearing healthcare, (2) tele-audiology services, and (3) tele-audiology key issues, challenges, and future directions. Accumulating evidence suggests that tele-audiology is a viable service delivery model, as remote hearing screening, diagnostic testing, intervention, and rehabilitation can each be completed reliably and effectively. The benefits of tele-audiology include improved access to care, increased follow-up rates, and reduced travel time and costs. Still, significant logistical and technical challenges remain from ensuring a secure and robust internet connection to controlling ambient noise and meeting all state and federal licensure and reimbursement regulations. Future research and development, especially advancements in artificial intelligence, will continue to increase tele-audiology acceptance, expand remote care, and ultimately improve patient satisfaction.

SYNTHESIS AND EVALUATION OF LO-FI LOW-LOAD HEARING AIDS MODULE WITH PIEZO FILM AND CONDUCTIVE POLYMER

We fabricated a capacitor-type actuator with laminated conductive polymer on both sides of the piezoelectric film and evaluated basic acoustic characteristics. This actuator is applied to our new 'Auditory AR (Augmented Reality) device' which enables users to hear both real and virtual sound information. We carried out measurements of those actuator-characteristics in a cylindrical frame with constant curvature, the same with our AR device. The AC (Alternating Current) amplification characteristics simply increase quasi-linearly within the audio band, and saturate at about 10 kHz, near the upper limit of audio frequency. We applied the autocorrelation analysis method to evaluate the verbal speech transmission efficiency, without human examinee, because of the global pandemic of the COVID-19, and successfully estimated the transmission clarity under the "Virus-free" circumstances. We developed a 'vector effective duration model' to evaluate users' verbal cognitive clarity, only with physical measurement without human subjects. In the low-frequency band below 1 kHz and in the ultra-high-frequency band above 10 kHz, beyond auditory bands, the frame-mounted actuator shows conspicuous attenuation. In the mid-frequency band between 1 kHz and 10 kHz, i.e., higher area of the audio band, selectively amplified frequency components are observed. This mid-frequency band primarily conveys the semantic content of spoken language. This area is the band for "whispering". Our actuator amplifies this "whispering band" in harmonic ways effectively and is suitable for a "Lo-Fi auditory module" that cuts off unnecessary low- and high-frequency bands;auditory organs are mostly exhausted with physical impacts conveyed by those low-frequency components, and they transmit more emotional information than verbal meanings. Users can use this module all day long without auditory fatigue. Renewals in hearing aids and welfare technologies are expected. © International Institute of Acoustics and Vibration (IIAV), 2022.

The Influence of the COVID-19 Pandemic on the Hearing Impaired.

Background In this study, we aimed to investigate the effect of the coronavirus disease 2019 (COVID-19) pandemic-induced social restrictions, including face masks, on patients with hearing problems. Methodology This cross-sectional survey study was conducted in an ENT tertiary care center. After signing the consent form, we invited study subjects with hearing disabilities who were using unilateral or bilateral hearing aids to participate in filling out the study survey. The study questionnaire was completed by 80 subjects. The questionnaire included various questions about the respondent's demographics, hearing aids, and communication with a face mask during COVID-19 restrictions. All statistical analyses were performed using SPSS version 19 (IBM Corp., Armonk, NY, USA). Results Overall, 40% of the study sample agreed that understanding people wearing face masks is harder because their speech is muffled, whereas 10% disagreed, and 50% were neutral. While 41.3% agreed that understanding is harder because they cannot see their mouth moving, 23.8% disagreed, and 35% were neutral. More than half of the study sample (55%) agreed that they are worried about how they will communicate with others if wearing face masks becomes more common. However, 50% of the participants thought that they can still hear people when they speak to them from a safe distance. Of note, 71.3% of subjects disagreed about tinnitus being worse since the lockdown. Conclusions The widespread use of face masks had a significant impact on the daily communication and interactions of people with hearing impairments. More research is needed to find creative ways to help these patients improve their daily communication and social interactions.

Remote hearing aid renewal using pre-existing audiograms during the covid-19 pandemic.

OBJECTIVE: During the ongoing Covid-19 pandemic, many patients cancelled their scheduled hearing aid renewal. We offered to send them new hearing aids programmed according to the audiometric data on file. In this study we compared remote hearing aid renewal to a conventional renewal with a recent audiogram based on scores from the International Outcome Inventory for Hearing Aids (IOI-HA) questionnaire. We also examined the need for a physical visit for hearing aid adjustment in the remote group and analysed the accuracy of the pre-existing audiogram correction method using data from the control group. DESIGN: Retrospective chart review. STUDY SAMPLE: 51 patients who underwent remote hearing aid renewal and 22 control patients who received office-based hearing aid renewal. RESULTS: IOI-HA scores were lower in the remote fitted group, but comparison with data from a Swedish nationwide database had no clinically significant differences. A follow-up physical appointment was required in only 20% of the remote group. The intraclass correlation coefficient (ICC) between the pure tone averages of the corrected former audiogram and measured audiogram was high. CONCLUSIONS: Remote hearing aid renewal using existing audiometric data is feasible, and most physical visits can be avoided.

eP455: Fetal ultrasound presentation and neonatal diagnosis of Freeman-Sheldon syndrome in son of previously undiagnosed adult male

Background: Freeman-Sheldon syndrome [distal arthrogryposis type 2A (OMIM #193700), DA2A, Freeman-Burian syndrome] is a rare autosomal dominant multiple pterygium syndrome caused by alterations in MYH3. The phenotypic features, particularly of the face, are distinct and easily recognizable, and the diagnosis can be confirmed with molecular gene analysis. Fetal ultrasound imaging may provide important diagnostic clues to facilitate the diagnostic process. Informed consent and parental permission were provided by the parents. Case presentation: The infant’s mother presented for a Maternal Fetal Medicine genetic counseling telehealth appointment (due to COVID-19 pandemic restrictions) as a G7P2132, 32-year old female who had insulin-dependent diabetes and thrombocytosis. Her partner was a 24-year old male with a history of hearing loss, a V-shaped palate, and a lower lip cleft. Gestational age was 14 4/7 weeks and the indications were: increased nuchal translucency, paternal complex medical history, maternal G6PD heterozygote, and recurrent pregnancy loss. During the genetic counseling session, the following were addressed: 1) Maternal heterozygote status for G6PD indicated that if the fetus was male, there was a 50% chance he would be affected with G6PD-deficiency;2) Increased nuchal translucency on fetal ultrasound (US) with measurement at 98th percentile is associated with an increased risk of chromosomal abnormalities, microdeletion/duplications, and Noonan syndrome. The patient reportedly had low risk cell-free DNA but results were not available to the counselor at the time of consult. The option for additional genetic screening and diagnostic testing was declined;3) Three first trimester pregnancy losses with the father of this baby (FOB) were addressed, and parents deferred chromosome analyses at the time;4) Mother shared FOB’s complex history of bilateral sensorineural hearing loss, V-shaped cleft palate, lower lip cleft, and micrognathia. However, father was not present during the telehealth encounter. Mother was counseled regarding the possibility of an autosomal dominant condition with the potential risk to the pregnancy of up to 50%. It was recommended that the FOB have a clinical genetics evaluation, which could potentially provide a specific diagnosis and inform recurrence risk and management guidance. Follow-up MFM genetic counseling telephone visit occurred with the mother at 31 6/7 weeks gestation due to multiple congenital anomalies evident on fetal ultrasound. A 25 week fetal ultrasound revealed hypotelorism and a thickened nuchal translucency. A repeat study at 29 weeks revealed a V-shaped palate with a possible cleft, micrognathia, and midline mandibular cleft. FOB’s history was revisited. It was determined that he had 3 previous “no shows” to Genetics clinic appointments and did not pursue evaluation after the last counseling appointment. Again, it was emphasized that in order to best make a diagnosis for the family, an affected person would need to undergo a thorough evaluation, including medical and family history review, physical examination, and any indicated genetic testing. The parents were comfortable with the likelihood that the baby had the same condition as the father, but variable expressivity and broad range pf phenotypic presentation were explained. Recommendations for postnatal evaluation of the infant and pertinent genetic testing were provided. Consultative Genetics evaluation of the infant at 2 days of age revealed a short, broad forehead with supraorbital fullness leading to a horizontal brow indentation;mask-like facial appearance;hypotelorism;very deep set eyes with blepharophimosis;deep, creased nasal bridge;small, upturned nose with hypoplastic alae and narrow nares;microstomia with pursed lips;glossoptosis;micrognathia;2 deep vertical chin creases;short neck with excess nuchal skin;inverted and wide spaced nipples;clenched hands with 5th digits overlying 4th and 2nd overlying 3rd, bilaterally;bilateral vertical talus;2nd toes longer and overlying rd toes;clinodactyly of 4th and 5th toes bilaterally;and deep gluteal crease with no visible sinus. There were no evident contractures. The father has a complex history with no medical assessments prior to age 18. He reported that he did “not look like anyone else” in his family. He has a diagnosis of autistic spectrum disorder, a submucous cleft, vision issues, hearing loss necessitating a hearing aid on the left, and a history of cholesteatomas and of mastoidectomy. On brief examination, he had a mask-like face, blepharophimosis, left microphthalmia, left esotropia, narrowing of his midface, deep vertical crease on the mandibular region, microstomia, broad great toes, single flexor creases on the thumbs, and contracture of right thumb. Maxillofacial CT of the infant revealed hypoplastic mandibular body, ramus, and condyles bilaterally with micrognathia and retrognathia;hypoplastic maxilla bilaterally;and enophthalmos with retracted appearance of globes in the bony orbits bilaterally. Multiple facial bone abnormalities were seen, including microsomia, micrognathia, retrognathia, orbital hypotelorism and enophthalmos Genetic testing was performed via a custom Whole Exome Slice at GeneDx laboratories and included the MYH3 and TNNI2 genes. Results revealed a heterozygous pathogenic change in MYH3 (c.2015 G>A;p. R6724) consistent with the diagnosis of Freeman-Sheldon syndrome. Conclusion: The presentation of “midline mandibular cleft” on fetal ultrasound was the most specific prenatal finding. This is a very rare fetal finding. Thus, it should prompt further evaluation to assess for true clefting versus ridging or creasing. Additionally, targeted assessment for other findings or clinical clues for Freeman-Sheldon syndrome, such as contractures, “windmill vane” hand, and mouth size, could aid in the differential diagnosis considerations and the diagnostic process. Admittedly, these are position and quality dependent, and are challenging to assess even in ideal situations. The phenotype of the father was immediately recognizable. However, due to COVID-19 pandemic restrictions, prior to the infant’s birth, only telehealth visits were conducted and the father’s participation was by telephone. This limited the ability to narrow the differential diagnosis without visualization of his distinct phenotypic features. Finally, missed opportunities to diagnose the father prior to this pregnancy occurred. Many clinics send “no show” letters to referring providers and patients, as we do. Emphasizing the importance of diagnosis prior to pregnancy for individuals concerned about having a genetic disorder should be considered as part of the information shared in these letters.

[Hearing care aspects in universal face mask use during the COVID 19 pandemic]. / Motivirovannost' k slukhoprotezirovaniyu v usloviyakh masochnogo rezhima pri pandemii COVID-19.

BACKGROUND: Typical cloth and medical masks, which are mandatory to wear during the COVID 19 pandemic, create visual barrier, obscure linguistic and nonverbal communication and interaction. Ski-slope hearing loss patients often don't admit their auditory insufficiency and do not use hearing aids due to acceptable speech intelligibility by using visual access to the mouth and other potential facial cues. PURPOSE: To assess the impact of universal face medical masks in public places on motivation to using hearing aids of patients with ski-slope hearing loss. PATIENTS AND METHODS: All the 504 patients (18-65 years old), who applied for < hearing care assistance and for the first time bought hearing aid were included. 266 patients (group A) applied from June to November 2020, when wearing facial masks was mandatory; 238 patients (group B) applied from June to November 2019, when wearing facial masks wasn't required. In both groups patients, who fulfilled the following criteria, were selected: 1) binaural mild to severe sensorineural ski-slope hearing loss lasting more than 3 years; 2) no progression of hearing loss within the last 3 years; 3) pure tone audiometry <20 dB HL at 125-1000 Hz frequencies; 4) hearing care with mono- or binaural hearing aids with the receiver-in-the-canal open-type. Questionnaires were administered to eligible patients in group A to assess the motivational components of acquiring hearing aids. RESULTS AND DISCUSSION: In group A, 74 (28%) patients received hearing aids according to the inclusion criteria, and in group B, 46 (19%) patients received hearing aids (p=0.033). Significant factors determining hearing aid acquisition were lack of visual contact when wearing a mask, communication difficulties in noisy environments and lack of intelligibility in a concert hall or lecture. CONCLUSION: Patients' motivation to hearing care grows in mandatory wearing facial masks conditions during the COVID-19 pandemic leading to an increase in patients using hearing aids.

The impact of COVID-19 on provision of UK audiology services & on attitudes towards delivery of telehealth services.

OBJECTIVE: To (i) identify the impact of COVID-19 on provision of UK audiology services across sectors (ii) compare teleaudiology service provision between private and public sectors before and after the introduction of restrictions and (iii) identify barriers to teleaudiology delivery amongst UK hearing care professionals in both sectors. DESIGN: A mixed-methods cross-sectional survey study design. Responses to the structured questionnaire were analysed using descriptive and non-parametric statistics. STUDY SAMPLE: UK based hearing care professionals (HCP) (n = 323) completed the survey (218 public sector; 89 private sector). RESULTS: Changes in working patterns varied greatly between different sectors, with 61% of national employed and 26% of independent HCPs being furloughed, compared with 1% in the public sector. Use of telehealth was under-utilised across all sectors and groups in UK hearing healthcare, despite 92% of public and 75% of private HCPs reporting feeling comfortable conducting remote consultations. CONCLUSION: This study highlights a variation in teleaudiology adoption and key barriers across sector in the UK. A collaborative approach between hearing device manufacturers, research centres, HCPs and professional bodies is required for the creation of targeted guidance and training materials according to sector, to support clinicians in effective teleaudiology provision.

Audiological practice and COVID-19: recommendations that audiological centers can use to maintain the safety and quality of service-expert opinion.

PURPOSE: Audiology is an essential service for some patient groups and some interventions. This article sets forth experience-based recommendations for how audiological centers can continue to safely and effectively function during COVID-19. METHODS: The recommendations are the result of panel discussion and are based on the clinical experience of the panelists/authors. RESULTS: The recommendations cover which patient groups and which interventions should be treated when and whether this can be performed in the clinic or remotely; how to maintain the safety of workplace via optimizing patient flow within the clinic and the sanitation of rooms and equipment; and overcoming communication challenges that COVID-19 intensifies. CONCLUSION: For essential audiological services to continue under COVID-19, safety measures must be implemented and maintained, and treatment and communication strategies must be adapted to offset communication difficulties due to personal protective equipment (PPE) and social distancing and to bolster patient confidence. In short, it is vital that staff feel safe, that patients either feel the clinic is safe enough to visit or that remote treatment may be an option, and that clinics and patients have a broad agreement on the urgency of any needed service. We hope that these recommendations help clinics effectively accomplish these goals.