J Korean Med Sci.  2024 Jun;39(23):e179. 10.3346/jkms.2024.39.e179.

Comparative Effectiveness of Personal Sound Amplification Products Versus Hearing Aids for Unilateral Hearing Loss: A Prospective Randomized Crossover Trial

• Kim MS
• Kim KH
• Choe G
• Park YH

• KMID: 2556680
• DOI: http://doi.org/10.3346/jkms.2024.39.e179

Abstract

Background
This study compared hearing outcomes with use of personal sound amplification products (PSAPs) and hearing aids (HAs) in patients with moderate to moderately severe unilateral hearing loss.
Methods
Thirty-nine participants were prospectively enrolled, and randomly assigned to use either one HA (basic or premium type) or one PSAP (basic or high-end type) for the first 8 weeks and then the other device for the following 8 weeks. Participants underwent a battery of examinations at three visits, including sound-field audiometry, word recognition score (WRS), speech perception in quiet and in noise, real-ear measurement, and self-report questionnaires.
Results
Functional gain was significantly higher with HAs across all frequencies (P < 0.001). While both PSAPs and HAs improved WRS from the unaided condition, HAs were superior to PSAPs. The speech recognition threshold in quiet conditions and signal-to-noise ratio in noisy conditions were significantly lower in the HA-aided condition than in the PSAP-aided condition, and in the PSAP-aided condition than in the unaided condition. Subjective satisfaction also favored HAs than PSAPs in questionnaires, Abbreviated Profile of Hearing Aid Benefit, International Outcome Inventory for Hearing Aids, and Host Institutional Questionnaire.
Conclusion
While PSAPs provide some benefit for moderate to moderately severe unilateral hearing loss, HAs are more effective. This underscores the potential role of PSAPs as an accessible, affordable first-line intervention in hearing rehabilitation, particularly for individuals facing challenges in accessing conventional HAs.

Keyword

Hearing Aids; Personal Sound Amplification Products; Unilateral Hearing Loss

Figure

• 

  Fig. 1 CONSORT flow diagram.HA = hearing aid, PSAP = personal sound amplification product.

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  Fig. 2 Comparison of audiometry results between unaided, PSAP-aided, and (HA-aided conditions. Symbols and vertical bars represent means and standard deviations, respectively. (A) Pure-tone thresholds for all 39 participants. (B) Device-specific pure-tone thresholds. (C) Functional gain comparison of PSAP and HA for all 39 participants. (D) Functional gain comparison of groups based on device. (E) Comparison of WRSs for all 39 participants under unaided, PSAP-aided, and HA-aided conditions. (F) Comparison of WRSs among device groups.PSAP = personal sound amplification product, HA = hearing aid, WRS = word recognition score.**P < 0.01, ***P < 0.001, ****P < 0.0001.

• 

  Fig. 3 Comparison of speech perception using the Korean version of the Hearing-in-Noise Test. Symbols and vertical bars represent the means and standard deviations, respectively. (A) SRT in quiet testing environment for unaided condition, PSAPs condition, and the HAs condition. (B) SRT in quite condition for each type of device. (C) SNR in the noisy testing environment for unaided, PSAP-aided, and HA-aided conditions. (D) SNR in the noisy environment for each type of device.PSAP = personal sound amplification product, HA = hearing aid, SRT = speech recognition threshold, SNR = signal-to-noise ratio.*P < 0.05, **P < 0.01, ****P < 0.0001.

• 

  Fig. 4 Real ear insertion gains for each hearing device measured at input levels of 55 dB (A), 65 dB (B), and 75 dB (C). Symbols and vertical bars represent the means and standard deviations, respectively.REIG = real ear insertion gain, PSAP = personal sound amplification product, HA = hearing aid.*P < 0.05, **P < 0.01, ****P < 0.0001.

• 

  Fig. 5 APHAB comparison of the hearing devices for each subscale. Symbols and vertical bars represent the means and standard deviations, respectively. (A) Ease of communication. (B) Reverberation. (C) Background noise. (D) Aversiveness.APHAB = Abbreviated Profile of Hearing Aid Benefit, EC = ease of communication, PSAP = personal sound amplification product, HA = hearing aid, RV = reverberation, BN = background noise, AV = aversiveness.*P < 0.05, **P < 0.01.

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  Fig. 6 Comparison of questionnaires between the unaided, PSAP, and HA conditions. Symbols and vertical bars represent the means and standard deviations, respectively. (A) THI comparison of the unaided, PSAP, and HA conditions for all 39 participants. (B) THI comparison of the groups based on the device. (C–F) VAS for Tinnitus comparison of hearing devices for each subscale. (G) International Outcome Inventory for Hearing Aids by device. Factor 1: use of HA, perceived benefits, satisfaction, and quality of life. Factor 2: residual activity limitation, residual participation restriction and impact on others. (H) Questionnaire developed by the research institution. Symbols and vertical bars represent the means and standard deviations, respectively.THI = Tinnitus handicap inventory, PSAP = personal sound amplification product, HA = hearing aid.**P < 0.01, ****P < 0.0001.

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