Hoppe Ulrich, Hesse Gerhard
Audiologische Abteilung, Hals-Nasen-Ohrenklinik, Kopf- und Halschirurgie, Universitätsklinikum Erlangen.
Tinnitus-Klinik am Krankenhaus Bad Arolsen, Universität Witten-Herdecke.
Laryngorhinootologie. 2017 Apr;96(S 01):S43-S65. doi: 10.1055/s-0042-120046. Epub 2017 May 12.
Hearing loss can be caused by a number of different pathological conditions. Some of them can be successfully treated, mainly by surgery, depending on the individual's disease process. However, the treatment of chronic sensorineural hearing loss with damaged cochlear structures usually needs hearing rehabilitation by means of technical amplification. During the last 2 decades tremendous improvements in hearing aid technology led to a higher quality in the hearing rehabilitation process. For example, due to sophisticated signal processing the acoustic feedback path could be reduced and hence open fitting options are available for even more subjects. In particular for high-frequency hearing loss the use of open fitting is an option. Both the users' acceptance and the perceived sound quality were significantly increased by open fittings.However, we are still faced with a low level of readiness in many hearing impaired subjects to accept acoustic amplification. Since ENT specialists play a key-role in hearing aid provision, they should promote early hearing aid rehabilitation and include this in the counselling even in subjects with mild and moderate hearing loss. Recent investigations demonstrated the benefit of early hearing aid use in this group of patients since this may help to reduce subsequent damages as auditory deprivation, social isolation, development of dementia, and cognitive decline. For subjects with tinnitus, hearing aids may also support masking by environmental sounds and enhance cortical inhibition.The present paper describes the latest development of hearing aid technology and the current state of the art for amplification modalities. Implications for both hearing aid indication and provision are discussed.
听力损失可由多种不同的病理状况引起。其中一些可以通过手术成功治疗,这主要取决于个体的疾病进程。然而,对于耳蜗结构受损的慢性感音神经性听力损失,通常需要通过技术放大手段进行听力康复。在过去20年里,助听器技术取得了巨大进步,使得听力康复过程的质量更高。例如,由于先进的信号处理技术,声反馈路径得以减少,因此更多的受试者可以选择开放式验配。特别是对于高频听力损失,开放式验配是一种选择。开放式验配显著提高了用户的接受度和感知音质。然而,我们仍然面临着许多听力受损受试者对接受声音放大的意愿较低的问题。由于耳鼻喉科专家在助听器提供方面起着关键作用,他们应该促进早期助听器康复,并将其纳入咨询内容,即使是对于轻度和中度听力损失的受试者。最近的研究表明,这组患者早期使用助听器有益,因为这可能有助于减少后续损害,如听觉剥夺、社会隔离、痴呆症的发展和认知能力下降。对于耳鸣患者,助听器还可以通过环境声音来辅助掩蔽,并增强皮层抑制。本文描述了助听器技术的最新发展以及放大模式的当前技术水平。还讨论了对助听器适应证和提供的影响。