Clin Exp Otorhinolaryngol.  2014 Jun;7(2):94-101.

Advantages of Binaural Amplification to Acceptable Noise Level of Directional Hearing Aid Users

• Kim JH
• Lee JH
• Lee HK

Abstract

OBJECTIVES
The goal of the present study was to examine whether Acceptable Noise Levels (ANLs) would be lower (greater acceptance of noise) in binaural listening than in monaural listening condition and also whether meaningfulness of background speech noise would affect ANLs for directional microphone hearing aid users. In addition, any relationships between the individual binaural benefits on ANLs and the individuals' demographic information were investigated.
METHODS
Fourteen hearing aid users (mean age, 64 years) participated for experimental testing. For the ANL calculation, listeners' most comfortable listening levels and background noise level were measured. Using Korean ANL material, ANLs of all participants were evaluated under monaural and binaural amplification with a counterbalanced order. The ANLs were also compared across five types of competing speech noises, consisting of 1- through 8-talker background speech maskers. Seven young normal-hearing listeners (mean age, 27 years) participated for the same measurements as a pilot testing.
RESULTS
The results demonstrated that directional hearing aid users accepted more noise (lower ANLs) with binaural amplification than with monaural amplification, regardless of the type of competing speech. When the background speech noise became more meaningful, hearing-impaired listeners accepted less amount of noise (higher ANLs), revealing that ANL is dependent on the intelligibility of the competing speech. The individuals' binaural advantages in ANLs were significantly greater for the listeners with longer experience of hearing aids, yet not related to their age or hearing thresholds.
CONCLUSION
Binaural directional microphone processing allowed hearing aid users to accept a greater amount of background noise, which may in turn improve listeners' hearing aid success. Informational masking substantially influenced background noise acceptance. Given a significant association between ANLs and duration of hearing aid usage, ANL measurement can be useful for clinical counseling of binaural hearing aid candidates or unsuccessful users.

Keyword

Acceptable noise level; Binaural amplification; Directional microphone hearing aids

MeSH Terms

Counseling
Hearing
Hearing Aids*
Masks
Noise*

Figure

• 

  Fig. 1 Comparison of mean hearing thresholds (error bars, standard deviation) from 250 to 8,000 Hz at the octave scale between right and left ears.

• 

  Fig. 2 Comparison of the mean Acceptable Noise Levels (ANLs) (error bars, standard deviation) of 14 hearing-impaired listeners obtained with monaural and binaural amplification for five different speech maskers. 1-M, one-male; 1-F, one-female; 2, 2-talker; 4, 4-talker; 8, 8-talker maskers; Avg, averaged across five speech maskers.

• 

  Fig. 3 Comparison of individual and mean Acceptable Noise Levels (ANLs) of 14 hearing-impaired listeners (error bars, standard deviation) obtained with monaural and binaural amplification for each of the five different speech maskers (A: 1-M, one-male; B: 1-F, one-female; C: 2-talker maskers; D: 4-talker maskers; E: 8-talker maskers; Avg, averaged across five speech maskers). The dashed lines at 6-dB and 14-dB ANLs represent low- and high-ANL, respectively.

Reference

1. Taylor B. The Acceptable Noise Level Test as a predictor of real-world hearing aid benefit. Hear J. 2008; 9. 61(9):39–42.

2. Bentler RA, Niebuhr DP, Getta JP, Anderson CV. Longitudinal study of hearing aid effectiveness. II: Subjective measures. J Speech Hear Res. 1993; 8. 36(4):820–831. PMID: 8377494.

3. Nabelek AK, Tucker FM, Letowski TR. Toleration of background noises: relationship with patterns of hearing aid use by elderly persons. J Speech Hear Res. 1991; 6. 34(3):679–685. PMID: 2072693.

4. Nabelek AK, Freyaldenhoven MC, Tampas JW, Burchfiel SB, Muenchen RA. Acceptable noise level as a predictor of hearing aid use. J Am Acad Audiol. 2006; 10. 17(9):626–639. PMID: 17039765.

5. Nabelek AK, Tampas JW, Burchfield SB. Comparison of speech perception in background noise with acceptance of background noise in aided and unaided conditions. J Speech Lang Hear Res. 2004; 10. 47(5):1001–1011. PMID: 15603458.

6. Rogers DS, Harkrider AW, Burchfield SB, Nabelek AK. The influence of listener's gender on the acceptance of background noise. J Am Acad Audiol. 2003; 9. 14(7):372–382. PMID: 14620611.

7. Freyaldenhoven MC, Plyler PN, Thelin JW, Burchfield SB. Acceptance of noise with monaural and binaural amplification. J Am Acad Audiol. 2006; 10. 17(9):659–666. PMID: 17039768.

8. Holmes AE. Bilateral amplification for the elderly: are two aids better than one? Int J Audiol. 2003; 7. 42(Suppl 2):2S63–2S67. PMID: 12918631.

9. Freyaldenhoven MC, Nabelek AK, Burchfield SB, Thelin JW. Acceptable noise level as a measure of directional hearing aid benefit. J Am Acad Audiol. 2005; 4. 16(4):228–236. PMID: 16050333.

10. Ricketts T. The impact of head angle on monaural and binaural performance with directional and omnidirectional hearing aids. Ear Hear. 2000; 8. 21(4):318–328. PMID: 10981608.

11. Ricketts TA. Directional hearing aids: then and now. J Rehabil Res Dev. 2005; Jul-Aug. 42(4 Suppl 2):133–144. PMID: 16470469.

12. Hornsby BW, Ricketts TA. Effects of noise source configuration on directional benefit using symmetric and asymmetric directional hearing aid fittings. Ear Hear. 2007; 4. 28(2):177–186. PMID: 17496669.

13. Shin JB, Lee JH. Effects of the target talker gender and the number of competing talkers on Acceptable Noise Level (ANL) of Korean normal-hearing adults. Audiology. 2010; 6(2):146–152.

14. Baek EJ, Lee JH. Measurement of acceptable noise level and self-reported subjective disability in adult cochlear implant users. Audiology. 2012; 8(2):196–203.

15. Alexander JM, Lutfi RA. Informational masking in hearing-impaired and normal-hearing listeners: sensation level and decision weights. J Acoust Soc Am. 2004; 10. 116(4 Pt 1):2234–2247. PMID: 15532655.

16. Kidd G Jr, Arbogast TL, Mason CR, Walsh M. Informational masking in listeners with sensorineural hearing loss. J Assoc Res Otolaryngol. 2002; 6. 3(2):107–119. PMID: 12162362.

17. Erdman SA, Sedge RK. Subjective comparisons of binaural versus monaural amplification. Ear Hear. 1981; Sep-Oct. 2(5):225–229. PMID: 7297789.

18. Noble W, Gatehouse S. Effects of bilateral versus unilateral hearing aid fitting on abilities measured by the Speech, Spatial, and Qualities of Hearing Scale (SSQ). Int J Audiol. 2006; 3. 45(3):172–181. PMID: 16579492.

19. Gatehouse S, Noble W. The Speech, Spatial and Qualities of Hearing Scale (SSQ). Int J Audiol. 2004; 2. 43(2):85–99. PMID: 15035561.

20. Stephens SD, Callaghan DE, Hogan S, Meredith R, Rayment A, Davis A. Acceptability of binaural hearing aids: a cross-over study. J R Soc Med. 1991; 5. 84(5):267–269. PMID: 2041002.

21. Boymans M, Goverts ST, Kramer SE, Festen JM, Dreschler WA. A prospective multi-centre study of the benefits of bilateral hearing aids. Ear Hear. 2008; 12. 29(6):930–941. PMID: 18998242.

22. Ricketts T. Impact of noise source configuration on directional hearing aid benefit and performance. Ear Hear. 2000; 6. 21(3):194–205. PMID: 10890727.

23. Gordon-Hickey S, Moore RE. Acceptance of noise with intelligible, reversed, and unfamiliar primary discourse. Am J Audiol. 2008; 12. 17(2):129–135. PMID: 18840706.

24. Durlach NI, Mason CR, Kidd G Jr, Arbogast TL, Colburn HS, Shinn-Cunningham BG. Note on informational masking. J Acoust Soc Am. 2003; 6. 113(6):2984–2987. PMID: 12822768.

25. Lee JH, Humes LE. Effect of fundamental-frequency and sentence-onset differences on speech-identification performance of young and older adults in a competing-talker background. J Acoust Soc Am. 2012; 9. 132(3):1700–1717. PMID: 22978898.

26. Freyman RL, Balakrishnan U, Helfer KS. Effect of number of masking talkers and auditory priming on informational masking in speech recognition. J Acoust Soc Am. 2004; 5. 115(5 Pt 1):2246–2256. PMID: 15139635.

27. Donaldson GS, Chisolm TH, Blasco GP, Shinnick LJ, Ketter KJ, Krause JC. BKB-SIN and ANL predict perceived communication ability in cochlear implant users. Ear Hear. 2009; 8. 30(4):401–410. PMID: 19390441.

28. Vaughan-Jones RH, Padgham ND, Christmas HE, Irwin J, Doig MA. One aid or two? More visits please! J Laryngol Otol. 1993; 4. 107(4):329–332. PMID: 8320520.

29. Walden TC, Walden BE. Unilateral versus bilateral amplification for adults with impaired hearing. J Am Acad Audiol. 2005; 9. 16(8):574–584. PMID: 16295244.

30. Van den Bogaert T, Klasen TJ, Moonen M, Van Deun L, Wouters J. Horizontal localization with bilateral hearing aids: without is better than with. J Acoust Soc Am. 2006; 1. 119(1):515–526. PMID: 16454305.