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1
Q

What is a 2-cc coupler?

A

A standardized 2 cubic centimeter cavity used for hearing aid testing that simulates an average ear canal’s acoustic load.

Coupler measurements provide a consistent baseline for comparing hearing aids and often underestimate real-ear output, especially for small ears.

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2
Q

What does RECD stand for?

A

Real-Ear-to-Coupler Difference

RECD is measured in decibels and is important in pediatric fittings to customize hearing aid settings.
large RECD (due to a smaller ear canal) indicates significantly higher real-ear output than coupler output.

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3
Q

What is the purpose of an ear simulator?

A

To mimic the acoustic impedance of an average human ear and provide output measurements closer to actual real ear experiences.

Unlike the 2-cc coupler, it accounts for ear canal resonance.

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4
Q

What are the two types of test signals used in hearing aid testing?

A

Pure-tone sweeps and broadband (speech-like) signals.

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5
Q

What is OSPL90?

A

Output Sound Pressure Level for a 90 dB input, indicating the maximum output a hearing aid can produce.

It must be set below the user’s discomfort level to prevent discomfort.

Peak OSPL90 should be within +3 dB of the manufacturer’s specification

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6
Q

Define Full-On Gain (FOG).

A

The gain of the hearing aid with all controls set to maximum, typically measured as the High-Frequency Average Full-On Gain (HFA-FOG).

It indicates the maximum amplification for soft sounds.

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7
Q

What is the Reference Test Setting (RTS)?

A

The volume control position used for nominal testing that yields an HFA output 17 dB below the HFA OSPL90. resulting output for a 60 dB input is at a prescribed level

It approximates a typical user volume setting.

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8
Q

What does the frequency response curve represent?

A

A graph showing the hearing aid’s output across frequencies for a given input level.

It indicates how the device amplifies different frequencies.

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9
Q

What is Total Harmonic Distortion (THD)?

A

The percentage of distortion in the output caused by harmonics introduced by the hearing aid.

A low THD indicates a clearer signal.

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10
Q

What does Equivalent Input Noise (EIN) measure?

A

The internal noise generated by the hearing aid expressed as an input level.

A lower EIN is preferable as high internal noise can be audible and annoying.

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11
Q

What is Battery Drain in hearing aids?

A

The electrical current consumption of the hearing aid, measured in milliamps (mA).

It affects how often patients need to change batteries.

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12
Q

Define Real-Ear Aided Response (REAR).

A

The absolute sound level measured in the patient’s ear canal with the hearing aid in place.

REAR shows the output levels across frequencies at the eardrum.

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13
Q

What is Real-Ear Aided Gain (REAG)?

A

The gain of the hearing aid measured in the real ear, calculated as REAR minus the input level.

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14
Q

What does Real-Ear Unaided Gain (REUG) represent?

A

The natural amplification provided by the open ear canal, defined as the difference between sound levels at the eardrum and outside the ear.

It reflects the ear’s resonance characteristics.

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15
Q

What is Real-Ear Insertion Gain (REIG)?

A

The additional gain provided by the hearing aid compared to the open ear, calculated as the difference between aided and unaided ear responses.

It isolates the hearing aid’s contribution to amplification.

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16
Q

What are the steps in the Probe Microphone Measurement Procedure?

A
  1. Place the probe tube in the ear canal near the eardrum. 2. Measure REUR/REUG with no aid. 3. Insert the hearing aid and measure REAR/REAG. 4. Compute REIG.

Proper probe placement is crucial for accurate results.

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17
Q

What are common Real-Ear Measurement Errors?

A

Probe misplacement, blockage, external noise, hearing aid saturation or feedback.

These errors can lead to incorrect REAR/REIG results.

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18
Q

What is Functional Gain in sound-field aided testing?

A

The improvement in hearing thresholds when wearing the hearing aid, measured by comparing aided and unaided thresholds.

It provides a general validation of hearing aid benefit.

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19
Q

What are the styles of earmolds and earshells?

A

Styles include full-concha molds, canal styles, and others.

Each style affects retention and potential venting space.

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20
Q

What are the main functions of ear fittings?

A
  1. Sound delivery to the ear canal via the sound bore
  2. Venting to control ear canal openness
  3. Retention to keep the hearing aid in place comfortably

Understanding these functions is crucial for optimizing hearing aid performance.

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21
Q

What is the impact of earmold style on hearing aids?

A

Earmold style affects comfort, cosmetic appearance, and acoustic seal (feedback prevention)

Different styles include full-concha molds and canal styles, each varying in retention and venting space.

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22
Q

True or False: Larger vents increase low-frequency gain.

A

False

Larger vents reduce low-frequency gain, while occluding fits boost low frequencies.

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23
Q

What is the occlusion effect?

A

The phenomenon where a plugged ear causes a booming voice quality

Proper venting can mitigate this effect.

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24
Q

What are the characteristics of the sound bore in earmolds?

A

The shape and diameter of the sound bore affect high-frequency amplification

Acoustic horns can amplify high pitches by gradually widening the bore; can provide up to 10–12 dB more gain in the 2–5 kHz range.

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25
What do dampers do in hearing aids?
Dampers add resistance to smooth out the frequency response and attenuate mid-frequency peaks ## Footnote They improve sound quality and reduce feedback risks.
26
Fill in the blank: _______ is used to avoid amplifying very soft ambient sounds.
[Expansion] ## Footnote Expansion reduces gain for sounds below a certain threshold.
27
What is Wide Dynamic Range Compression (WDRC)?
A compression method that uses a low threshold and compresses a wide span of input levels to improve audibility of soft sounds ## Footnote It helps maintain comfort for louder sounds.
28
What does the Compression Threshold (TK) indicate?
The input level at which compression begins ## Footnote A high TK means compression starts only for loud sounds.
29
What is the difference between high and low Compression Ratios (CR)?
High CR limits output growth significantly, ideal for preventing loudness discomfort; low CR gently compresses, ideal for improving audibility ## Footnote CR is defined as the change in input required for a 1 dB change in output.
30
What are attack and release times in compression?
Attack Time (AT) is how quickly gain is reduced; Release Time (RT) is how quickly gain is restored ## Footnote Fast AT prevents output overshoot; RT can be adjusted for smoother sound.
31
What is the purpose of earmold venting?
To connect the ear canal to outside air, allowing low-frequency sounds to escape and reducing amplified bass buildup ## Footnote Proper venting can also provide pressure relief.
32
What materials are commonly used for earmolds?
Materials range from hard acrylics to soft silicone and vinyl ## Footnote Softer materials provide better seals but can wear out faster.
33
What is the function of acoustic horns in earmolds?
To increase high-frequency gain by acoustically amplifying high pitches ## Footnote A Libby horn tube can provide significant gain in the 2–5 kHz range.
34
What is the trade-off when using dampers in hearing aids?
While dampers improve sound quality, they can slightly reduce overall output ## Footnote They are essential for managing feedback and harsh sounds.
35
Fill in the blank: A _______ vent can reduce occlusion effects.
[larger] ## Footnote Larger vents allow more natural sound entry and reduce the 'boomy' voice quality.
36
What is the role of ear impressions in creating earmolds?
They ensure a good fit and seal for the finished mold, preventing sound leakage ## Footnote Accurate impressions are crucial for effective hearing aid performance.
37
True or False: Compression limiting is used for soft sounds.
False ## Footnote Compression limiting is designed to protect against loud sounds.
38
What is the purpose of using multi-stage compression in hearing aids?
To employ multiple TKs and CRs to tailor the hearing aid response for different input levels ## Footnote This allows for better management of both soft and loud sounds.
39
What is the effect of a fast release time in hearing aids?
A fast release will turn the gain back up quickly, aiding audibility of soft sounds after loud sounds but may cause audible pumping.
40
What is the downside of a slow release time in hearing aids?
A slow release may cause a brief undershoot where a soft sound after a loud one remains too quiet until gain readjusts.
41
Define overshoot in the context of hearing aids.
Overshoot occurs if attack is not fast enough, allowing the initial part of a loud sound to slip through at a higher level before compression kicks in.
42
Define undershoot in the context of hearing aids.
Undershoot occurs if release is too slow, resulting in the beginning of a soft sound after a loud sound being under-amplified.
43
What is AGC-I?
AGC-Input (AGC-I) means the level detector is placed before the volume control, with compression driven by input level.
44
What is AGC-O?
AGC-Output (AGC-O) means the detector is after the volume control, monitoring the output and shifting the compression threshold with volume changes.
45
How does AGC-I differ from AGC-O?
In AGC-I, user volume adjustments do not change the compression point or amount, while in AGC-O, user volume changes affect compression.
46
What is the primary advantage of multi-channel compression?
Multi-channel compression allows frequency-specific amplification, preserving speech clarity by preventing loud noise in one band from compressing others.
47
What is a disadvantage of single-channel compression?
Single-channel compression treats the input as a whole, which can lead to gain reduction affecting the entire signal, compromising clarity.
48
What does fast-acting compression do?
Fast-acting compression adapts quickly to level changes, improving the audibility of soft syllables immediately following loud sounds.
49
What is a downside of fast-acting compression?
It can reduce natural intensity differences in speech and may introduce noticeable pumping in background noise.
50
What does slow-acting compression maintain?
Slow-acting compression maintains the inherent loudness variations within speech, providing a more natural listening experience.
51
What is binaural hearing?
Binaural hearing is enabled by neural pathways that carry signals from both ears to the brain, facilitating sound localization and understanding.
52
What is binaural loudness summation?
Binaural loudness summation refers to the increased loudness perception when a sound is heard with two ears versus one, adding roughly 3 dB near threshold.
53
What is the Masking Level Difference (MLD)?
MLD is the improvement in detecting a signal in noise when binaural phase differences are introduced, yielding up to ~15 dB improvement at low frequencies.
54
What is the head shadow effect?
The head shadow effect is the physical attenuation of sound, especially high frequencies, as it travels around the head, reducing speech intelligibility.
55
What is binaural squelch?
Binaural squelch refers to the central auditory system's ability to improve speech understanding in noise by combining different signals from each ear.
56
What is auditory deprivation?
Auditory deprivation refers to the decline in speech understanding ability in an ear that does not receive adequate stimulation, often from lack of amplification.
57
How can bilateral hearing aids help with tinnitus?
Bilateral hearing aids can help manage tinnitus by providing enriching sound, partially masking tinnitus and improving overall auditory input.
58
What factors influence candidacy for binaural fitting?
Factors include significant hearing loss in both ears, the potential for auditory deprivation, and exceptions like severe asymmetry or unaidable ears.
59
What are common objections to binaural fittings?
Common objections include cost, handling two devices, and cosmetic concerns.
60
What is a key benefit of fitting two hearing aids?
Patients fitted with two hearing aids generally report higher satisfaction, better benefit, and improved quality of life.
61
Fill in the blank: Binaural fittings are considered the ______ of care for significant hearing loss in both ears.
standard
62
What is the preferred approach for individuals with bilateral hearing loss?
Binaural fitting ## Footnote Binaural fitting is recommended to prevent loss of speech clarity in the unaided ear.
63
What are some benefits of using two hearing aids?
Improved everyday hearing including: * Noise reduction * Localization * Sound quality ## Footnote Using two hearing aids helps in better understanding speech in various environments.
64
What is the purpose of the Communication Needs Assessment (CNA)?
To define residual auditory function and prioritize goals ## Footnote CNA tools include subjective scales like COSI, HHIE-S, CSOA, SAC/SOAC.
65
What are some subjective scales used in Communication Needs Assessment?
* COSI * HHIE-S * CSOA * SAC/SOAC ## Footnote These tools help in setting individualized goals for patients.
66
What tests are included in Pre-Fitting Speech Discrimination Testing?
* AB word lists * BKB sentences * QuickSIN * HINT ## Footnote These tests help assess hearing aid candidacy and expected benefit.
67
What factors influence the Hearing Aid Selection Process?
* Audiogram * Lifestyle * Dexterity * Finances * Cosmetic preferences * Motivation ## Footnote This process involves shared decision-making and accessible explanations.
68
What is the role of non-audiological factors in technology selection?
They assess readiness and preference, covering: * Motivation * Expectations * Cosmetic concerns * Financial concerns ## Footnote Tools like COAT can guide technology recommendations.
69
What are the technical tasks involved in the fitting appointment?
* Electroacoustic checks * Listening checks * Otoscopy * Physical fit * Initial programming ## Footnote Using prescriptive targets is crucial for a successful fitting.
70
What does Verification Using Real-Ear Measures (REM) aim to achieve?
Match gain targets within ±5–8 dB ## Footnote REM helps ensure that hearing aids provide the expected amplification across different input levels.
71
What should be included in Hearing Aid Orientation for Patients and Families?
* Device use * Battery management * App usage * Phone pairing * Care and maintenance ## Footnote Hands-on training enhances patient and family confidence.
72
What is the follow-up protocol after fitting hearing aids?
Initial follow-up in 1–2 weeks, then 4–5 weeks to reassess: * Fit * Comfort * Benefit * Use patterns * Aided speech testing ## Footnote Datalogging and tests help in optimizing hearing aid settings.
73
What is the purpose of auditory training and long-term maintenance?
Supports long-term use through: * Auditory training (e.g., LACE) * Group AR therapy * Communication strategy coaching ## Footnote Maintenance includes accessories, repairs, and periodic reevaluation.
74
True or False: Counseling should empower the patient to make an informed decision about their hearing aids.
True ## Footnote Patients should understand the reasons for recommendations to ensure informed consent.
75
Fill in the blank: The appointment for hearing aid fitting should set the tone for a ________ approach.
holistic ## Footnote This approach emphasizes that hearing aids are part of a broader communication enhancement plan.

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