Dr. Allan Ho, MBBS, MSc, FRCS(ORLHNS), FRCSC,¹ Co-author: Brendan McDonald MA, MClSc, R.Aud, ²

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Abstract: Hearing loss has a profound impact on an individual. A hidden disability, hearing loss disrupts the way we communicate and ultimately limits our ability to socialize and engage with others. Hearing loss is the most common communication disorder in the older adult population. Our aim is to update readers about types of hearing loss, and to provide specific information on intervention options for conductive hearing loss. This article will address implantable hearing devices used to correct conductive loss and recent technological advances in these devices.

Key Words: hearing loss, hearing aids, bone-conduction device, hearing implant, osseointegration.

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Any patient with a conductive hearing loss or mixed hearing loss should be referred to an otolaryngologist.

Choosing the right candidate for a bone-anchored hearing system involves a multidisciplinary approach.

Otolaryngology and audiology must work together to evaluate the best surgical and audiological candidates for these devices.

Bone conduction hearing devices are a viable option for patients with conductive and mixed hearing losses where a conventional hearing aid is not a good choice.

Assessment and patient selection for bone-conduction hearing implants require a multidisciplinary approach with otolaryngologists and audiologists. Best candidates meet criteria both surgically and audiologically.

Softband bone-conduction trials with an audiologist can be used to demo and counsel patients on the device and technology. It is non-invasive, only requiring the external processor and a specialized headband to demonstrate its function.

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Christopher Hilton, MD, Instructor, Department of Otolaryngology, University of Minnesota, Minneapolis, MN, USA.
Tina Huang, MD, Assistant Professor, Department of Otolaryngology, University of Minnesota, Minneapolis, MN, USA.

Age-related hearing loss (ARHL) is the most common neurosensory deficit associated with aging. It presents with a predictable pattern of sensorineural hearing loss, causing problems with communication that have been associated with depression and social isolation. Recent studies have improved our understanding of the etiology of ARHL on a molecular level. While treatment options exist with hearing aids and cochlear implants, prevention by identification and avoidance of key risk factors remains the best strategy for dealing with this disease.
Key words: presbycusis, age-related hearing loss, deafness, hearing aids, aging.

Mary Beth Jennings, PhD, Reg. CASLPO, Aud(C), FAAA, Audiologist, Assistant Professor, National Centre for Audiology, Faculty of Health Sciences, University of Western Ontario, London, ON.
Frances Richert, MSc, Reg. CASLPO, Audiologist, H.A. Leeper Speech and Hearing Clinic, School of Communication Sciences and Disorders; National Centre for Audiology, Faculty of Health Sciences, University of Western Ontario, London, ON.

Older adults are the fastest-growing age group in Canada. Hearing loss is highly prevalent among this population. Of those persons who would benefit from the use of hearing aids, only a small number actually own and use them. Digital hearing aids now constitute the majority of hearing aids on the market. Technological advances in hearing aids and hearing assistive technologies have expanded the range of options available to improve the success of device use. Matching the needs and optimizing performance of older adults with the broad range of devices available requires appropriate assessment, selection, verification, and follow-up by the audiologist.
Key words: hearing aids, hearing assistive technologies (HATS), rehabilitation services, older adults.

Jerome D. Schein, PhD, Professor Emeritus, New York University, New York, NY, USA; Adjunct Professor, University of Alberta, Edmonton, AB.
Maurice H. Miller, PhD, Department of Speech-Language Pathology & Audiology Steinhardt School of Education, New York University, New York, NY, USA.

For persons whose hearing does not return in 60–90 days following idiopathic sudden sensorineural hearing loss (ISSNHL), audiologic rehabilitation should be provided. This article describes aspects of audiologic rehabilitation, including counselling, information about lifestyle changes, and techniques (such as amplification) for overcoming the communication handicap ISSNHL imposes. Advantages and limitations of various hearing aids are presented.
Key words: audiology, counselling, hearing aids, otology, rehabilitation, sensorineural, hearing loss.

Maurice H. Miller, PhD, Department of Speech-Language Pathology & Audiology/Steinhardt School of Education, New York University, New York, NY, USA.
Jerome D. Schein, PhD, Professor Emeritus, New York University, New York, NY, USA; Adjunct Professor, University of Alberta, Edmonton, AB.

Hearing loss that occurs instantaneously or over a period of a few days without immediately apparent cause is called Idiopathic Sudden Sensorineural Hearing Loss (ISSNHL). In part 1 of this series, the diagnosis and initial treatment of this condition are described in relation to most patients’ demands for active and aggressive intervention. Part 2 (to follow in the next issue) will address rehabilitation.
Key words: audiology, deafness, diagnosis, hearing aids, idiopathic, otology, rehabilitation, unilateral and bilateral hearing loss, sensorineural.

Hearing Aid Devices are Tiny Yet Offer Greater Sound Amplification & Less Distortion

Cory Soal, RHAD
Registered Hearing Aid Dispenser

Hearing loss is as individual as a fingerprint. Generally, its progression is so slow that it remains undetected until it has become a real concern. Like any other medical problem, early detection of hearing impairment is important. A proper and thorough hearing test is crucial not only for purposes of diagnosis--it is key to determining what type of hearing aid technology will be the most suitable for a patient.

With the advent of micro-technology, hearing aids have become greatly improved. It is now possible to place more circuitry in a smaller package. Hearing aids can be fitted far into the ear canal and have internal controls that automatically adjust in extreme noise conditions.

First and foremost, a successful fitting of a hearing aid is dependent upon a complete hearing evaluation. A proper hearing test consists of the following components: Pure Tone Air and Bone Conduction tests, Speech Reception Threshold tests, and Speech Discrimination testing. The more accurately hearing is evaluated, the more suitable is the prescription for a hearing aid. There are two important concerns when selecting a hearing instrument. Firstly, the patient must be comfortable with the size of the hearing aid chosen: a patient can be fitted with a Behind-The-Ear (BTE), In-The-Ear (ITE), or the smallest hearing aid that fits Completely-In-The-Canal (CIC).