Clin Exp Otorhinolaryngol.  2020 Feb;13(1):23-28. 10.21053/ceo.2019.00402.

Which Patients With a Unilateral Hearing Aid for Symmetric Sensorineural Hearing Loss Have Auditory Deprivation?

• Lee HJ
• Lee JM
• Na G
• Moon YM
• Lee C
• Jung J

• KMID: 2501293
• DOI: http://doi.org/10.21053/ceo.2019.00402

Abstract

Objectives
. The aim of study is to find conditions that aggravate auditory deprivation in patients with symmetric hearing loss after unilateral digital, non-linear hearing aid (HA).
Methods
. In the retrospective case-comparison study, we assessed 47 patients with symmetric sensorineural hearing loss (SNHL), wearing unilateral conventional HAs. Audiological outcomes were assessed >1 year after HA fitting (mean duration, 31.0 months). Pure-tone audiometry in HA-aided and HA-unaided conditions was performed over time. Word recognition score (WRS) was evaluated at the most comfortable listening level.
Results
. The initial pure tone average of four frequency thresholds at 500, 1,000, 2,000, and 4,000 Hz (PTA4) did not show a difference of >5 dB HL between HA-aided and HA-unaided ears. WRS progressively decreased for both HA-aided and HA-unaided ears although the extent of decrease was significantly greater for HA-unaided (7.6%) than for HA-aided ears (5.1%, P<0.05). Notably, auditory deprivation in HA-unaided ears was significantly greater in patients with an initial PTA4 ≥53 dB HL (P<0.001).
Conclusion
. Bilateral HAs are strongly recommended, particularly for patients with moderate to severe SNHL to prevent auditory deprivation in the contralateral ear.

Keyword

Auditory Deprivation; Sensorineural Hearing Loss; Unilateral Hearing Aid; Speech Intelligibility

Figure

• 

  Fig. 1. Pure-tone audiometry and word recognition test for the ear fitted with a hearing aid (HA) and the contralateral unaided ear in a patient with symmetric sensorineural hearing loss. (A) Initial unaided air-conduction audiometry is performed for the HA-aided (ipsilateral) and the HA-unaided (contralateral) ears. (B) The last unaided air-conduction audiometry session is performed for the ipsilateral and the contralateral ears. Aided air-conduction audiometry for the ipsilateral ear is also performed via a sound field test using a loudspeaker. (C) The ipsilateral ear (unaided condition) shows a significantly smaller decrease in the word recognition score (WRS) than the contralateral ear. ΔWRS indicates difference in the WRS between the first and last tests. (D) ΔWRS in the ipsilateral ear (aided condition) more significantly differs from that in the contralateral ear. *P<0.05, ***P<0.001.

• 

  Fig. 2. Assessment of the decrease in the word recognition score (WRS) depending on the initial hearing threshold in patients with symmetric sensorineural hearing loss who had worn a unilateral hearing aid for more than 1 year. Patients are classified according to a mean pure-tone audiometry thresholds (PTA4) of <53 or ≥53 dB HL. There is no difference in ΔWRS between the aided ear and non-aided ear in patients with an initial hearing threshold of <53 dB HL. However, in patients with an initial hearing threshold of ≥53 dB HL, the decrease in WRS for the non-aided ear is significantly larger than that for the aided ear. PTA4, the average threshold at 500, 1,000, 2,000, and 4,000 Hz; ΔWRS, difference in the WRS between the first and last tests; NS, not significant. ***P<0.001.

• 

  Fig. 3. Effects of the initial hearing threshold and duration of hearing aid (HA) use on auditory deprivation in the contralateral ears of patients with symmetric sensorineural hearing loss who had worn a unilateral HA for more than 1 year. Auditory deprivation was defined as the difference in changes in the word recognition score between the ipsilateral and contralateral ears. (A) The initial hearing threshold in PTA4 shows a significant negative association with auditory deprivation. Auditory deprivation in the contralateral ear shows a negatively correlation with the initial hearing threshold in PTA4 (y=−0.3759χ+17.770, R2=0.266, P<0.001, χ=initial threshold). (B) The duration of HA use does not have an effect on the severity of auditory deprivation in the unaided ear (y=−0.069χ–4.765, R2=0.0412, P=0.18, χ=duration of HA use). PTA4, the average threshold at 500, 1,000, 2,000, and 4,000 Hz.

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