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J Am Acad Audiol 2022; 33(05): 277-284
DOI: 10.1055/a-1808-1275
Research Article

Venting Corrections Improve the Accuracy of Coupler-Based Simulated Real-Ear Verification for Use with Adult Hearing Aid Fittings

Susan Scollie
1   National Centre for Audiology, Faculty of Health Sciences, Western University, London, Ontario, Canada
2   School of Communication Sciences and Disorders, Faculty of Health Sciences, Western University, London, Ontario, Canada
,
Paula Folkeard
1   National Centre for Audiology, Faculty of Health Sciences, Western University, London, Ontario, Canada
,
John Pumford
3   Audioscan, Inc., Dorchester, Ontario, Canada
,
Parvaneh Abbasalipour
1   National Centre for Audiology, Faculty of Health Sciences, Western University, London, Ontario, Canada
,
Jonathan Pietrobon
3   Audioscan, Inc., Dorchester, Ontario, Canada
› Author Affiliations Funding Ontario Research Fund, RE08-072
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Abstract

Background Hearing aid responses can be verified with the Real-Ear Aided Response (REAR). Procedures for predicting the REAR from coupler-based verification exist, but have not incorporated corrections for venting, limiting their use and validity for vented and open fittings. A commercially available system for including venting effects in simulated real-ear measurement (S-REM) has recently been developed.

Purpose To evaluate the accuracy of a vent-corrected S-REM for predicting the REAR across test levels, for fittings with a wide range of coupling styles including modular domes.

Research Design This was a within-subject comparison study using technical measures. Retrospective file review was used to obtain previously measured REARs from 104 fittings in 52 adults and three hearing aid styles. Prospective data collection was used to re-measure each fitting at three test levels using S-REM with and without venting corrections. Comparison of differences by frequency band was performed to assess the impact of the venting correction.

Results The vent model reduced low-frequency error by up to 11 dB, and the effects were consistent with the expected effects of venting in hearing aid fitting: fittings with more open dome or tip styles had a larger improvement when the vent model was added. A larger sample of fittings was obtained for dome/sleeve couplings than for custom fittings.

Conclusions The vent-corrected S-REM system evaluated in this study provides improved fitting accuracy for dome or sleeve-fitted hearing aids for adults and supports the use of vented S-REM for open fittings. Further studies to examine a representative sample of custom tip or mold fittings, and fittings for children are future directions.

Keywords

hearing aid - adult - verification - venting - coupler

IRB Approval

Received 20 Dec 2019 (Protocol 114746).


Disclaimer

Any mention of a product, service, or procedure in the Journal of the American Academy of Audiology does not constitute an endorsement of the product, service, or procedure by the American Academy of Audiology.




Publication History

Received: 16 September 2021

Accepted: 17 March 2022

Accepted Manuscript online:
24 March 2022

Article published online:
07 November 2022

© 2022. American Academy of Audiology. This article is published by Thieme.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

  • References

  • 1 AAA. Clinical Practice Guidelines: Pediatric Amplification (pp. 1–60) [Clinical Practice Guidelines]. 2013 . American Academy of Audiology. Available at: https://www.audiology.org/wp-content/uploads/2021/05/PediatricAmplificationGuidelines.pdf
    PubMedGoogle Scholar
  • 2 Valente M, Abrams H, Benson D. et al. Guidelines for the audiologic management of adult hearing impairment. Audiol Today 2006; 18: 32-36
    Google Scholar
  • 3 Almufarrij I, Dillon H, Munro KJ. Does probe-tube verification of real-ear hearing aid amplification characteristics improve outcomes in adults? A systematic review and meta-analysis. Trends Hear 2021; 25: 2331216521999563
    Google Scholar
  • 4 Amlani A, Pumford J, Gessling E. Improving patient perception of clinical services through real-ear measurements. Hear Rev 2016; 23 (12) 12
    Google Scholar
  • 5 Boymans M, Dreschler WA. Audiologist-driven versus patient-driven fine tuning of hearing instruments. Trends Amplif 2012; 16 (01) 49-58
    CrossrefPubMedGoogle Scholar
  • 6 Ledda KT, Valente M, Oeding K, Kallogjeri D. Difference in speech recognition between a default and programmed telecoil program. J Am Acad Audiol 2019; 30 (06) 502-515
    Article in Thieme ConnectPubMedGoogle Scholar
  • 7 McCreery RW, Walker EA, Spratford M, Kirby BJ, Oleson JJ, Brennan M. Stability of audiometric thresholds for children with hearing aids applying the american academy of audiology pediatric amplification guideline: implications for safety. J Am Acad Audiol 2016; 27 (03) 252-263
    Article in Thieme ConnectPubMedGoogle Scholar
  • 8 Munro KJ, Puri R, Bird J, Smith M. Using probe-microphone measurements to improve the match to target gain and frequency response slope, as a function of earmould style, frequency, and input level. Int J Audiol 2016; 55 (04) 215-223
    CrossrefPubMedGoogle Scholar
  • 9 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 (08) 706-721
    Article in Thieme ConnectPubMedGoogle Scholar
  • 10 Moodie S, Rall E, Eiten L. et al. Pediatric audiology in North America: current clinical practice and how it relates to the american academy of audiology pediatric amplification guideline. J Am Acad Audiol 2016; b 27 (03) 166-187
    Article in Thieme ConnectPubMedGoogle Scholar
  • 11 Bagatto M. Providing hearing aids to infants and young children. J Am Acad Audiol 2016; 27 (03) 164-165
    Article in Thieme ConnectPubMedGoogle Scholar
  • 12 Bagatto M, Moodie S, Brown C. et al. Prescribing and verifying hearing aids applying the American Academy of Audiology pediatric amplification guideline: protocols and outcomes from the ontario infant hearing program. J Am Acad Audiol 2016; 27 (03) 188-203
    Article in Thieme ConnectPubMedGoogle Scholar
  • 13 Seewald RC, Moodie KS, Sinclair ST, Scollie SD. Predictive validity of a procedure for pediatric hearing instrument fitting. Am J Audiol 1999; 8 (02) 143-152
    CrossrefPubMedGoogle Scholar
  • 14 Bagatto M, Moodie S, Scollie S. et al. Clinical protocols for hearing instrument fitting in the Desired Sensation Level method. Trends Amplif 2005; 9 (04) 199-226
    CrossrefPubMedGoogle Scholar
  • 15 Moodie S, Pietrobon J, Rall E. et al. Using the real-ear-to-coupler difference within the American Academy of Audiology pediatric amplification guideline: protocols for applying and predicting Earmold RECDs. J Am Acad Audiol 2016; a 27 (03) 264-275
    Article in Thieme ConnectPubMedGoogle Scholar
  • 16 Folkeard P, Pumford J, Abbasalipour P, Willis N, Scollie S. A comparison of automated real-ear and traditional hearing aid fitting methods—Audioscan. Hear Rev 2018; 25 (11) 28-32
    Google Scholar
  • 17 Munro KJ, Hatton N. Customized acoustic transform functions and their accuracy at predicting real-ear hearing aid performance. Ear Hear 2000; 21 (01) 59-69
    CrossrefPubMedGoogle Scholar
  • 18 Munro KJ, Millward KE. The influence of RECD transducer when deriving real-ear sound pressure level. Ear Hear 2006; 27 (04) 409-423
    CrossrefPubMedGoogle Scholar
  • 19 Munro KJ, Toal S. Measuring the real-ear to coupler difference transfer function with an insert earphone and a hearing instrument: are they the same?. Ear Hear 2005; 26 (01) 27-34
    CrossrefPubMedGoogle Scholar
  • 20 American National Standards Institute, R2018, ANSI_S3.46. Methods of measurement of real-ear performance characteristics of hearing aids. Acoustical Association of America.
    Google Scholar
  • 21 Blau M, Sankowsky T, Stirnemann A, Oberdanner H, Schmitt N. Acoustics of open fittings. J Acoust Soc Am 2008; 123 (05) 3011-3011
    CrossrefGoogle Scholar
  • 22 Carporali S, Cubick J, Catic J, Damsgaard A, Schmidt E. The vent effect in instant ear tips and its impact on the fitting of modern hearing aids. Proceedings of the International Symposium on Auditory and Audiological Research, 7, 205–212
    Google Scholar
  • 23 Kuk F, Keenan D, Lau CC. Comparison of vent effects between a solid earmold and a hollow earmold. J Am Acad Audiol 2009; 20 (08) 480-491
    Article in Thieme ConnectPubMedGoogle Scholar
  • 24 Zachman TA, Studebaker GA. Investigation of the acoustics of earmold vents. J Acoust Soc Am 1970; 47 (4, 4B): 1107-1115
    CrossrefPubMedGoogle Scholar
  • 25 Winkler A, Latzel M, Holube I. Open versus closed hearing-aid fittings: a literature review of both fitting approaches. Trends Hear 2016; 20: 233121651663174
    CrossrefPubMedGoogle Scholar
  • 26 Winther Balling L, Jensen NS, Caporali S, Cubick J, Switalski W. Challenges of instant-fit ear tips: What happens at the eardrum? Hear Rev. 2019; 26 (12) 12-15
    PubMedGoogle Scholar
  • 27 Pumford J, Scollie S, Folkeard P, Pietrobon J, Abbasalipour P. Vent corrections for simulated real-ear measurements of hearing aid fittings in the test box. AudiologyOnline. 2021 . Accessed April 6, 2022 at: https://www.audiologyonline.com/articles/audioscan-vent-corrections-27884
    PubMedGoogle Scholar
  • 28 Scollie S, Seewald R, Cornelisse L. et al. The desired sensation level multistage input/output algorithm. Trends Amplif 2005; 9 (04) 159-197
    Google Scholar
  • 29 Scollie SD, Seewald RC, Cornelisse LE, Jenstad LM. Validity and repeatability of level-independent HL to SPL transforms. Ear Hear 1998; 19 (05) 407-413
    CrossrefPubMedGoogle Scholar
  • 30 Vaisberg JM, Folkeard P, Pumford J, Narten P, Scollie S. Evaluation of the repeatability and accuracy of the wideband real-ear-to-coupler difference. J Am Acad Audiol 2018; 29 (06) 520-532
    Google Scholar
  • 31 Hoover BM, Stelmachowicz PG, Lewis DE. Effect of earmold fit on predicted real ear SPL using a real ear to coupler difference procedure. Ear Hear 2000; 21 (04) 310-317
    CrossrefPubMedGoogle Scholar
  • 32 Johnstone PM, Yeager KR, Pomeroy ML, Hawk N. Open-fit domes and children with bilateral high-frequency sensorineural hearing loss: benefits and outcomes. J Am Acad Audiol 2018; 29 (04) 348-356
    Article in Thieme ConnectPubMedGoogle Scholar
  • 33 Bentler R, Mueller HG, Ricketts T. Modern Hearing Aids: Verification, Outcome Measures, and Follow-Up. San Diego, CA: Plural Publishing; 2016
    Google Scholar
  • 34 Agnew, J. (1996). Acoustic Feedback and Other Audible Artifacts in Hearing Aids, Trends in Amplification: 1(2): 45-82. doi: 10.1177/108471389600100202.
  • 35 Vogl, S., & Blau, M. (2019). Individualized prediction of the sound pressure at the eardrum for an earpiece with integrated receivers and microphones. The Journal of the Acoustical Society of America, 145(2), 917-930. https://doi.org/10.1121/1.5089219.