CoDAS
https://codas.org.br/article/doi/10.1590/2317-1782/20212020310
CoDAS
Artigo Original

Comparison of performance with hearing aid programmed to NAL-NL1 first-fit and optimized-fit

Sreena Ediyarath Narayanan; Puttabasappa Manjula

Downloads: 1
Views: 892

Abstract

Purpose: The initial-fit provided by the hearing aid manufacturer’s software is generally a display of measurement done in the ear simulators. The need for verification of hearing aid output and gain in the real ear using probe-microphone measurement to match the prescriptive target is highlighted. The objective of the study was to evaluate the difference in real-ear aided response (REAR), real-ear insertion gain (REIG), aided thresholds, articulation index (AI) and word recognition score (WRS) in quiet, with hearing aid programmed to NAL-NL1 first-fit and NAL-NL1 optimized-fit using the probe-microphone technique. Methods: In a repeated measure experimental design, 11 participants with a mean age of 41.09 (SD=±9.95) years having moderate and moderately-severe sensorineural hearing loss were tested monaurally in two aided conditions, with a 16-channel hearing aid programmed for manufacturer’s NAL-NL1 first-fit and optimized-fit to NAL-NL1 using probemicrophone verification. The REAR, REIG, aided threshold, articulation index and word recognition scores in quiet were obtained for both aided conditions. Results: The REAR, REIG, aided threshold, AI and WRS in quiet were significantly better with the NAL-NL1 optimized-fit compared to manufacturer’s NAL-NL1 first-fit. Conclusion: The optimized-fit yields better audibility and improved word recognition in quiet. This supports best practice guidelines of many professional organizations regarding the use of probe-microphone measurement as the “Gold standard” for verification of hearing aid fitting, thereby providing better satisfaction and quality of life to hearing aid users.

Keywords

Hearing Aid; NAL-NL1; First-fit; Optimized-fit; Probe-microphone Verification

Referências

1) Valente M, Van Vliet D. The Independent Hearing Aid Fitting Forum (IHAFF) Protocol. Trends Amplif. 1997;2(1):6-35. http://dx.doi.org/10.1177/108471389700200102
» http://dx.doi.org/10.1177/108471389700200102
2) ISA: International Society of Audiology. Good practice guidance for adult hearing aid fittings and services. 2005 [cited 2020 March 20]. Available from: http://www.isa-audiology.org/members/pdf/gpg-adaf.pdf
» http://www.isa-audiology.org/members/pdf/gpg-adaf.pdf
3) AAA: American Academy of Audiology. Guidelines for the audiologic management of adult hearing impairment [Internet]. 2006. [cited 2020 March 20]. Available from: http://audiology.org/resources/documentlibrary/documents/ haguidelines.pdf
» http://audiology.org/resources/documentlibrary/documents/
4) ASHA Ad Hoc Committee on Hearing Aid Selection and Fitting. Guidelines for hearing aid fitting for adults. Am J Audiol. 1998;7(1):5-13. https://doi.org/10.1044/1059-0889.0701.05 https://doi.org/10.1044/1059-0889.0701.05
» https://doi.org/10.1044/1059-0889.0701.05
» https://doi.org/10.1044/1059-0889.0701.05
5) Dillon H, Keidser G. Is probe-mic measurement of HA gain-frequency response best practice? Hear J. 2003;56(10):28-30. http://dx.doi.org/10.1097/01.HJ.0000292916.91825.6a
» http://dx.doi.org/10.1097/01.HJ.0000292916.91825.6a
6) Mueller HG, Picou E. Survey examines popularity of real-ear probe-microphone measures. Hear J. 2010;63(5):27-32. http://dx.doi.org/10.1097/01.HJ.0000373447.52956.25
» http://dx.doi.org/10.1097/01.HJ.0000373447.52956.25
7) Manjula P. Verification of hearing aid fitting for audibility and speech recognition through behavioural and objective methods. In: Hemanth N, Nambi PMA, editors. Clinical aspects in hearing aids. Mysore, India: Indian Speech and Hearing Association; 2020. p. 91-8.
8) Bentler R. Advanced hearing aid features: do they work? In: Proceedings of the Convention of the American Speech Language Hearing Association; 2004; Washington, D.C. Rockville: ASHA; 2004.
9) Bretz K. A comparison of three hearing aid manufacturers’ recommended first-fit to two generic prescriptive targets with the pediatric population [thesis]. St. Louis: Washington University School of Medicine; 2006.
10) Hawkins DB, Cook JA. Hearing aid software predictive gain values: how accurate are they? Hear J. 2003;56(7):26-34. http://dx.doi.org/10.1097/01.HJ.0000292552.60032.8b
» http://dx.doi.org/10.1097/01.HJ.0000292552.60032.8b
11) Aarts NL, Caffee CS. Manufacturer predicted and measured REAR values in adult hearing aid fitting: accuracy and clinical usefulness. Int J Audiol. 2005;44(5):293-301. http://dx.doi.org/10.1080/14992020500057830 PMid:16028792.
» http://dx.doi.org/10.1080/14992020500057830
12) Aazh H, Moore BCJ. The value of routine real ear measurement of the gain of digital hearing aids. J Am Acad Audiol. 2007;18(8):653-64. http://dx.doi.org/10.3766/jaaa.18.8.3 PMid:18326152.
» http://dx.doi.org/10.3766/jaaa.18.8.3
13) Aazh H, Moore BCJ, Prasher D. The accuracy of matching target insertion gains with open-fit hearing aids. Am J Audiol. 2012;21(2):175-80. http://dx.doi.org/10.1044/1059-0889(2012/11-0008) PMid:22846638.
» http://dx.doi.org/10.1044/1059-0889(2012/11-0008)
14) Leavitt R, Flexer C. The importance of audibility in successful amplification of hearing loss. Hear Rev. 2012;19:20-3.
15) Sanders J, Stoody T, Weber J, Mueller HG. Manufacturers’ NAL- NL2 fittings fail real-ear verification. Hear Rev. 2015;21:24-30.
16) Abrams HB, Chisolm TH, Mcmanus M, Mcardle R. Initial-fit approach versus verified prescription: comparing self-perceived hearing aid benefit. J Am Acad Audiol. 2012;23(10):768-78. http://dx.doi.org/10.3766/jaaa.23.10.3 PMid:23169194.
» http://dx.doi.org/10.3766/jaaa.23.10.3
17) Valente M, Oeding K, Brockmeyer A, Smith S, Kallogjeri D. Differences in word and phoneme recognition in quiet, sentence recognition in noise, and subjective outcomes between manufacturer first-fit and hearing aids programmed to NAL-NL2 using real-ear measures. J Am Acad Audiol. 2018;29(8):706-21. http://dx.doi.org/10.3766/jaaa.17005 PMid:30222541.
» http://dx.doi.org/10.3766/jaaa.17005
18) Keidser G, Dillon H, Flax M, Ching T, Brewer S. The NAL-NL2 prescription procedure. Audiol Res. 2011;1(1):e24. http://dx.doi.org/10.4081/audiores.2011.e24 PMid:26557309.
» http://dx.doi.org/10.4081/audiores.2011.e24
19) American National Standards Institute. ANSI S3.1-1999. Maximum Permissible Ambient Noise Levels for Audiometric Test Rooms. New York: Acoustical Society of America; 2018
20) Carhart R, Jerger J. Preferred method for clinical determination of pure-tone thresholds. J Speech Hear Disord. 1959;24(4):330-45. http://dx.doi.org/10.1044/jshd.2404.330
» http://dx.doi.org/10.1044/jshd.2404.330
21) Rajashekar B. The development and standardization of a picture SRT test for adults and children in Kannada [dissertation]. Mysore, India: University of Mysore; 1976.
22) Yathiraj A, Vijayalakshmi CS. Phonemically-balanced Kannada word identification test for adults. Mysore, India: AIISH. 2005.
23) Ricketts TA, Bentler R, Mueller HG. Behaviroal assessments during clinical fittings. In: Ricketts TA, Bentler R, Mueller HG, editors. Essentials of modern hearing aids: selection, fitting, verification. San Diego: CA Plural Publishing; 2019. p. 559-602.
24) McCreery R. Building blocks: the trouble with functional gain in verifying pediatric hearing aids. Hear J. 2013;66(3):14-6. http://dx.doi.org/10.1097/01.HJ.0000427527.55840.9b
» http://dx.doi.org/10.1097/01.HJ.0000427527.55840.9b
25) Amlani AM, Punch JL, Ching TYC. Methods and application of the audibility index in hearing aid selection and fitting. Trends Amplif. 2002;6(3):81-129. http://dx.doi.org/10.1177/108471380200600302 PMid:25425917.
» http://dx.doi.org/10.1177/108471380200600302
26) American National Standards Institute. ANSI S3.5-1969. Methods for the Calculation of the Articulation Index. New York: Acoustical Society of America; 1969.
27) American National Standards Institute. ANSI S3.5-1997. Methods for the Calculation of the Speech Intelligibility Index. New York: Acoustical Society of America; 1997.
28) Humes LE. Understanding the speech-understanding problems of the hearing impaired. J Am Acad Audiol. 1991;2(2):59-69. PMid:1768875.
29) Amlani AM, Pumford J, Gessling E. Improving patient perception of clinical services through real-ear measurements. Hear Rev. 2016;23:12-2.
30) Amlani AM, Pumford J, Gessling E. Real-ear measurement and its impact on aided audibility and patient loyalty. Hear Rev. 2017;24:12-21.


Submetido em:
29/09/2020

Aceito em:
04/03/2021

619558f2a95395505a5ca123 codas Articles

CoDAS

Share this page
Page Sections