Implantable devices for aural rehabilitation are widely developed worldwide. In the manuscript, we review the implantable middle ear hearing devices currently in use, such as the Vibrant Soundbridge system (Med-El Corporation), the MAXUM system (Ototronix LLC), the fourth-generation of Carina prosthesis (Otologics LLC), and the Esteem device. Implantable hearing aids will unquestionably be the major drivers of advancement in otologic practice in early future, improving the quality of life of an increasingly aged population, which will consequently require increased levels of hearing support.
Correction of Hearing Impairment ; Ear, Middle* ; Hearing ; Hearing Aids ; Ossicular Prosthesis* ; Prostheses and Implants ; Quality of Life

As people age, structural as well as neural degeneration occurs throughout the auditory system. Many older adults experience difficulty in understanding speech especially in adverse listening conditions although they can hear speech sounds. According to a report of the Committee on Hearing and Bioacoustics and Biomechanics of the National Research Council, peripheral, central-auditory, and cognitive systems have long been considered major factors affecting the understanding of speech. The present study aims to review 1) age-related changes in the peripheral, central-auditory, and cognitive systems, 2) the resulting decline in the understanding of speech, and 3) the clinical implication for audiologic rehabilitation of older adults. Once the factors affecting the understanding of speech in older adults are identified and the characteristics of age-related speech understanding difficulties are examined, clinical management could be developed for prevention and treatment. Future research about problems related to the understanding of speech in older adults will help to improve the quality of life in the elderly.
Adult ; Aged ; Aging* ; Cognition ; Correction of Hearing Impairment ; Hearing ; Humans ; National Academy of Sciences (U.S.) ; Phonetics ; Quality of Life

BACKGROUND AND OBJECTIVES: This study was designed to identify whether canal type hearing aids can be used by the patients who have undergone epitympanoplasty with mastoid obliteration for postoperative rehabilitation of hearing impaired and also to investigate the advantages of the complete in the canal (CIC) hearing aid for the postoperative rehabilitation of hearing impaired. SUBJECTS AND METHOD: Fourty-three ears belonging to 40 adults, who were treated by epitympanoplasty with mastoid obliteration for cholesteatoma from April 1995 to May 1999 were involved in this study. The impressions were taken and measured postoperatively by Vernier calipers anteroposteriorly (AP) and superoinferiorly (SI). It is well known that the size of the external auditory canal (EAC) should be over 7 mm in diameter and over 2 cm in length to be able to wear the CIC type hearing aid. The shape of the EAC was also taken into consideration. RESULTS: Thirty-five out of 43 ears were large enough to wear CIC hearing aids and all 43 for the canal (ITC) hearing aids. No ears were excluded from being able to wear a CIC or ITC hearing aid with respect to the shape of the EAC. CONCLUSION: Canal type hearing aides can be used after epitympanoplasty with mastoid obliteration which is used as a treatment of cholesteatoma.
Adult ; Cholesteatoma ; Correction of Hearing Impairment* ; Ear ; Ear Canal ; Hearing Aids ; Humans ; Mastoid* ; Rehabilitation*

BACKGROUND AND OBJECTIVES: Speech discrimination testing has been used to evaluate the communication disability, select hearing aid candidacy and appropriate amplification, plan and evaluate aural rehabilitation programs and assist in the determination of the site of lesion. Since the words of speech discrimination tests were made on the basis of the linguistic aspects and used till now, they underestimate the disability of high frequency hearing loss (HFHL). To ameliorate this problem, we analysed the words which were difficult to discriminate in FHL in a commonly used speech testing material using the acoustic analysis method. Also, the words were assorted to establish a basic data for a new speech material which could estimate the disability of HFHL. METHODS: 20 HFHL subjects (age 20-70), selected on the basis of pure tone audiometry, were found to be the descending type. They were tested to repeat the monosyllabic words at 10-15dB HL above the puretone threshold of 1000Hz and checked with the error responses. These words were sorted out according to the error response or the confusion rate and analyzed by consonants and vowels. The words were recorded with an audiologist's voice using a GSI 10 audiometer connected to the personal computer. This was analyzed by the acoustic analysis program that has the MATLAB function. With this program, a word was analyzed by an initial consonant, a vowel, and a final consonant for the intensity, the formant peak frequency and the time course. RESULTS: The words which were difficult to discriminate for HFHL were sorted out by the confusion rates. The words of articulation score 15-50% were revealed to have low intensity with short duration, and the peak frequency spectrum above 3 kHz. Also the consonant-vowel transition frequency was located above 3 kHz. CONCLUSION: These results could be used as a basic clinical data to make a new speech discrimination material which evaluates the disability of HFHL more accurately.
Acoustics* ; Audiometry ; Communication Disorders ; Correction of Hearing Impairment ; Hearing Aids ; Hearing Loss* ; Hearing* ; Linguistics ; Microcomputers ; Speech Discrimination Tests ; Speech Perception ; Voice

Aural rehabilitation is defined as a comprehensive service which includes hearing aid fitting, hearing aid orientation, auditory training, and informational/educational counseling for people with hearing loss in order to reduce deficits of auditory function, difficulty in communication, and limited social activity, and ultimately to enhance their quality of life. Although it is well known that auditory training among a large scope of the aural rehabilitation is critical to improve residual hearing of hearing-impaired adults and/or older adults, there are some limitations to conduct it in the clinic in terms of time consuming and individual difference. In this review paper, we introduce two of the most popular web-based auditory training programs, namely Listening and Communication Enhancement And customized learning: Exercises for Aural Rehabilitation. The paper analyzes their purpose, contents, effect (or benefit) of auditory training, and clinical application, while arguing their pros and cons. In conclusion, we discuss a necessary of developing auditory training platforms for the hearing-impaired adults and older adults, and then of forging systematic web-based auditory training tools with a low-cost and high efficiency because aging population is rapidly increasing in Korea.
Adult ; Aging ; Correction of Hearing Impairment* ; Counseling ; Education* ; Exercise* ; Hearing ; Hearing Aids ; Hearing Loss ; Humans ; Individuality ; Korea ; Learning* ; Quality of Life

Patients deafened by a severe head injury are rarely encountered. We report a case of a 65-yr-old man with bilateral transverse temporal bone fractures due to head injury. He underwent cochlear implant and achieved a satisfactory auditory rehabilitation. Imaging studies of temporal bone before performing a cochlear implantation provide important information on a patient with bilateral temporal bone fractures. Cochlear implantations with careful planning in such a patient may be a very effective method for aural rehabilitation.
Cochlear Implantation ; Cochlear Implants ; Correction of Hearing Impairment ; Craniocerebral Trauma ; Hearing Loss, Sensorineural ; Humans ; Skull Fractures ; Temporal Bone

BACKGROUND AND OBJECTIVES: The stimulus signals delivered in cochlear implant (CI) systems are generally derived by sampling the temporal envelope of each channel at some constant rate and using its intensity to control the stimulation current level delivered to the corresponding electrode site. The objective of the study was to investigate speech recognition performance of cochlear implant users in quiet and noisy environments using either moderate or high rates of electrical stimulations. MATERIALS AND METHODS: Six post-lingually deafened adult users of the Nucleus CI24 cochlear implant (Contour(R) electrode array, Cochlear(TM), Macquarie Park, Australia) with the Freedom(R) speech processor participated in the study. Stimulation rates of 900 and 2400 pulses-per-second/channel (pps/ch) were used after both stimulation programs were balanced for loudness. Monosyllabic word and sentence recognition scores in quiet and noisy environments were evaluated for each stimulation program after two months of practice. Subjects were also asked to respond to a questionnaire to examine their preference to any stimulation rate in different hearing conditions. RESULTS: Word recognition scores for monosyllabic words in quiet conditions with the 900 stimulation rate was better than that of the 2400 stimulation rate, although no significant differences between them were found for sentence test in noise. A survey questionnaire indicated that most subjects preferred the 900 stimulation rate to the 2400 stimulation rate, especially in quiet conditions. CONCLUSIONS: Most subjects indicated a preference for 900 pps/ch rate in quiet conditions. It is recommended to remap at 900 pps/ch for those CI users whose performance in quiet conditions is less than ideal.
Adult ; Cochlear Implants ; Correction of Hearing Impairment ; Electric Stimulation ; Electrodes ; Hearing ; Humans ; Noise ; Speech Perception ; Sydnones ; Surveys and Questionnaires

BACKGROUND: Some authors recommend the surgical correction at early childhood in the selected cases of unilateral atresia as well as bilateral atresia. It has been enabled due to the improvement of imaging technique and it gives cosmetic satisfaction and biaural hearing. OBJECTIVES: The authors laid emphasis on the timing of canaloplasty in unilateral atresia, stage of canaloplasty, and postoperaitve hearing results. MATERIALS AND METHODS: A retrospective review of surgical results of congenital aural atresia from 1983 to 1995 in Seoul National University Hospital was performed. RESULTS: Forty four patients had unilateral atresia and 16 patients had bilateral atresia. Age range at the time of surgery was from 5.3 years to 14.6 years: average age was 8.1 years. Otoplasty was performed in 22 ears by plastic surgeons. It took precedence over canaloplasty in 17 ears. The endaural anterior approach through incision from temporal area to cavum cocha was performed in these cases. Meatal stenosis was the most common postoperative complication, but it has been decreased since the introduction of modification of anterior approach. The surgical attempts to improve hearing could not be performed in 14 ears due to various reasons. The audiologic follow-up period in the remaining 60 ears ranged from 1 year 9 months to 8 year 8 months(mean, 3 year 8 months). By analyzing final air conduction level, it was possible to attain 30 dB or better in 18(30%) of 60 cases and 40 dB or better in 36(60%) of 60 cases. CONCLUSION: The authors recommend the surgical correction at early childhood in unilateral atresia. and the otoplasty should be performed at first and it seems to be better in view of early audiologic rehabilitation that canaloplasty would be performed before the stage of elevation of rib cartilage graft. Meatal stenosis can be reduced by modification of anterior approach.
Cartilage ; Constriction, Pathologic ; Correction of Hearing Impairment ; Ear ; Follow-Up Studies ; Hearing ; Humans ; Postoperative Complications ; Retrospective Studies ; Ribs ; Seoul ; Transplants

Social concerns about sensorineural hearing loss have been increasing with the advent of an aging society. As most hearing loss is incurable and permanent, audiologic rehabilitation is the only option for restoring hearing. Sensorineural hearing loss includes both sensory loss of the cochlea and functional loss of the 8th cranial nerve. Because sensorineural hearing loss patients often have difficulty in understanding and locating specific sounds amidst the other ambient noise, functional amplification with hearing aids in sensorineural hearing loss is challenging work. By applying digital signal processing techniques to hearing aids, hearing rehabilitation has undergone remarkable development in recent years. Herein, the basic concepts underlying digital signal processing are reviewed briefly, followed by a short historical background of hearing aid development. The principles of hearing aid selection, counselling, frequent problems encountered in hearing aid fitting and validation are also discussed.
Aging ; Cochlea ; Correction of Hearing Impairment ; Cranial Nerves ; Hearing ; Hearing Aids* ; Hearing Loss ; Hearing Loss, Sensorineural* ; Humans ; Noise ; Rehabilitation* ; Signal Processing, Computer-Assisted

BACKGROUND AND OBJECTIVES: Hearing impairment is a common problem that increases significantly with age and hearing impaired persons need enough and proper medical and social services. We aimed to assess the present status of hearing rehabilitation services and measure the satisfaction of hearing impaired persons in their living. SUBJECTS AND METHOD: We selected a total of 60 persons by stratified randomized systemic sampling from hearing handicapped persons pre-registered with the Ministry of Health and Welfare. There were 32 males and 28 females with the mean age of 54.0+/-17.7 years. We checked the hearing handicap inventory (HHI), articulation index (AI), and visual analogue scale (VAS) of subjects. RESULTS: From 60 subjects, 35 subjects (58.3%) needed hearing aid and 13 subjects (21.7%) needed cochlear implantation. Thirty six subjects (60.0%) were classified into group 4 and 5 in HHI and the mean VAS score was 4.0+/-2.5. Among the 40 subjects with hearing aid, only 7 subjects (17.5%) had a proper device of hearing rehabilitation. In addition, no subjects had cochlear implantation (CI) even though they needed it. CONCLUSION: From this study, most hearing impaired persons had difficulties in every day living and had emotional problems. The low rate of proper hearing rehabilitation suggested that clinicians have to be concerned about providing hearing rehabilitation and expanding social and medical services for hearing impaired persons.
Cochlear Implantation ; Cochlear Implants ; Correction of Hearing Impairment ; Disabled Persons ; Female ; Hearing Aids ; Hearing Loss ; Hearing* ; Humans ; Male ; Persons With Hearing Impairments* ; Rehabilitation ; Social Work