A Continuously Worn Dual Temperature Sensor System for Accurate Monitoring of Core Body Temperature from the Ear Canal.

The objective of this work was to develop a temperature sensor system that accurately measures core body temperature from an ear-worn device. Two digital temperature sensors were embedded in a hearing aid shell along the thermal gradient of the ear canal to form a linear heat balance relationship. This relationship was used to determine best fit parameters for estimating body temperature. The predicted body temperatures resulted in intersubject limits of agreement (LOA) of ±0.49 °C over a range of physiologic and ambient temperatures without calibration. The newly developed hearing aid-based temperature sensor system can estimate core body temperature at an accuracy level equal to or better than many devices currently on the market. An accurate, continuously worn, temperature monitoring and tracking device may help provide early detection of illnesses, which could prove especially beneficial during pandemics and in the elderly demographic of hearing aid wearers.

Improving Speech Understanding and Monitoring Health with Hearing Aids Using Artificial Intelligence and Embedded Sensors.

This article details ways that machine learning and artificial intelligence technologies are being integrated in modern hearing aids to improve speech understanding in background noise and provide a gateway to overall health and wellness. Discussion focuses on how Starkey incorporates automatic and user-driven optimization of speech intelligibility with onboard hearing aid signal processing and machine learning algorithms, smartphone-based deep neural network processing, and wireless hearing aid accessories. The article will conclude with a review of health and wellness tracking capabilities that are enabled by embedded sensors and artificial intelligence.

The Future of Private Practice in Audiology.

Although private practice in audiology has evolved during the past 40 years, hearing aids have remained as a central component to success. This article will discuss present and future trends for the next 40 years, including parallels to other professions and the need to innovate beyond technology.

Secondhand smoke exposure and the risk of hearing loss.

Hearing loss has been associated with tobacco smoking, but its relationship with secondhand smoke is not known. We sought to investigate the association between secondhand smoke exposure and hearing loss in a nationally representative sample of adults. The National Health and Nutrition Examination Survey (NHANES), a nationally representative cross-sectional dataset, was utilised to investigate the association between secondhand smoke exposure and hearing loss. Data collected from non-smoking participants aged 20-69 years were included in the analysis if they had completed audiometric testing, had a valid serum continue value, and provided complete smoking, medical co-morbidity and noise exposure histories (N=3307). Hearing loss was assessed from averaged pure-tone thresholds over low- or mid-frequencies (500, 1000 and 2000 Hz) and high-frequencies (3000, 4000, 6000 and 8000 Hz), and was defined as mild or greater severity (pure-tone average in excess of 25 dB HL). Second-Hand Smoke (SHS) exposure was significantly associated with increased risk of hearing loss for low-/mid-frequencies (adjusted OR=1.14; 95% CI 1.02-1.28 for never smokers and 1.30; 1.10-1.54 for former smokers) and high-frequencies (1.40; 1.22-1.81 for former smokers), after controlling for potential confounders. Findings from the present analysis indicate that SHS exposure is associated with hearing loss in non-smoking adults.

A clinical protocol for predicting outcomes with an implantable prosthetic device (Baha) in patients with single-sided deafness.

BACKGROUND: The Baha implant is increasingly becoming a common form of treatment for individuals with single-sided deafness (SSD). However, evidence-based guidelines for determining candidacy in these patients are not yet established. PURPOSE: The purpose of this study was to investigate the clinical utility of speech-in-noise testing as a part of the preoperative evaluation of the Baha device in patients with SSD. RESEARCH DESIGN: The study design was a prospective cohort of 24 English-speaking adults comparing preoperative results on speech-in-noise measures using the Baha Cordelle II headband stimulator to postoperative results using the patient's external Baha processor. INTERVENTION: Outcome measures included signal-to-noise ratio (SNR) loss as measured by the QuickSIN™ and scores of self-reported disability questionnaires. RESULTS: Wilcoxon signed-rank test resulted in no significant difference between the preoperative and postoperative methods for measuring benefit on listening in noise tasks. Passing Bablok regression analysis showed the preoperative and postoperative results to be statistically equivalent, which suggests that postoperative results can be predicted during preoperative testing. Wilcoxon signed-rank test showed significant improvements in self-reported disability postoperatively. CONCLUSIONS: The results support the use of speech-in-noise measures as an accurate predictor of overall benefit in patients with SSD prior to implantation.

Autoimmune inner ear disease: diagnostic and therapeutic approaches in a multidisciplinary setting.

Autoimmune Inner Ear Disease (AIED) is a clinical syndrome of uncertain pathogenesis. It is associated with bilateral rapidly progressive hearing loss. The hearing loss may be associated with vestibular symptoms. Autoimmunity has been proposed as the pathogenesis of this sort of hearing loss, although the mechanism of the disease is poorly understood. It is well accepted that the endolymphatic sac is an immunocompetent organ and circulating autoantibodies against inner ear antigens have been reported, as have viral antigens in the endolymph, although the sensitivity, specificity, and roles of those antibodies in a disease process are poorly defined. We will describe the clinical aspects of the disease, the histopathology, the immunologic indicators, the types of presentation, both from the audiologic and vestibular point of view, clinical trials for treatment and the follow-up. One of our conclusions is that many of these patients respond favorably to the treatment Methotrexate.

The utility of positron emission tomography in the evaluation of autoimmune hearing loss.

OBJECTIVE: To evaluate positron emission tomography as an imaging tool in the diagnosis, evaluation, and management of autoimmune inner ear disease. BACKGROUND: Autoimmune inner ear disease is a form of cochleovestibular disease associated with variable hearing loss and vertigo for which no reliable diagnostic tests are available. METHODS: Pilot study of 10 patients with autoimmune inner ear disease and 5 sex-matched and age-matched control subjects without any history of autoimmune inner ear disease, who underwent limited positron emission tomography of the inner ear. Five patients with new or active autoimmune inner ear disease underwent serial positron emission tomography before and after 4 to 6 weeks of a high-dose tapering course of prednisone. The subjects had cranial magnetic resonance imagining, audiometric and vestibular studies, and heat-shock protein (HSP-70) measurements. Reading of the positron emission tomography scans was blinded. RESULTS: Positron emission tomography was normal in 4 of 5 normal control subjects and abnormal in 1 with normal audiometric and vestibular studies and positive HSP-70. Of patients with established and stable autoimmune inner ear disease, 4 of 5 had no positron emission tomography abnormalities and negative HSP-70, and the one with abnormal positron emission tomography shortly thereafter manifested clinically active disease. Of the 5 patients with active autoimmune inner ear disease monitored serially, 4 had an initial abnormal positron emission tomography in at least one ear, which became normal in all but 1 patient after therapy. HSP-70 correlated with disease activity. Only 1 patient with clinically active autoimmune inner ear disease had a normal positron emission tomography before and after therapy (the HSP-70 was positive before therapy and negative after the therapy). CONCLUSIONS: Positron emission tomography, especially when combined with HSP-70 determination, may be a useful technique for assessing disease in patients with autoimmune inner ear disease.

Nonlinear hearing AIDS and verification of fitting targets.

This paper addresses the issue of initial verification of hearing aid gain and output for nonlinear hearing aids. Specifically, "urban legend" has it that nonlinear hearing aids with digital noise reduction circuitry may not be accurately measured using functional gain and/or probe microphone measures. Discussed are the advantages and disadvantages of both measurement strategies, and how they may be used to "acoustically match" hearing aids to individual patients. An evaluation protocol that employs both optimal aided thresholds and probe microphone measurements to assess gain, output, and audibility in hearing-impaired patients.