Sherlock LaGuinn P, Perry Trevor T, Brungart Douglas S
Army Hearing Program, U.S. Army Public Health Center, Aberdeen, Maryland, USA.
Audiology and Speech Pathology Center, Walter Reed National Military Medical Center, Bethesda, Maryland, USA.
Ear Hear. 2021;42(6):1544-1559. doi: 10.1097/AUD.0000000000001044.
Many individuals with noise-related hearing loss continue working in environments where they are periodically exposed to high levels of noise, which increases their risk for further hearing loss. These individuals often must remove their hearing aids in operational environments because of incompatibility with the mandated personal protective equipment, thus reducing situational awareness. Extended-wear hearing aids might provide a solution for these individuals because they can be worn for weeks or months at a time, protect users from high-level noise exposures, and are compatible with communication headsets, earmuffs, and other types of personal protective equipment. The purpose of this study was to evaluate localization ability and speech understanding, feasibility of fitting and use, and acceptability in terms of comfort in a population of noise-exposed, active duty Service members.
Participants in the study were active duty Service members who were experienced hearing aid users and were currently using standard hearing aids bilaterally. Participants were fitted with extended-wear hearing aids for up to 14 weeks. Laboratory measures included functional gain, sound localization, and speech recognition (in quiet and in noise). Performance was compared between unaided, standard hearing aids, extended-wear hearing aids, and extended-wear hearing aids combined with a tactical communication device (3M Peltor ComTac). In addition, self-perceived benefit between extended-wear hearing aids and standard hearing aids was compared.
The extended-wear hearing aids provided more attenuation of external sound when turned off compared to standard hearing aids. Speech understanding in quiet and in noise was comparable between extended-wear hearing aids and standard hearing aids and was better when a tactical communication device was worn in addition to extended-wear hearing aids. Localization with extended-wear hearing aids was the worst, intermediate with the standard hearing aids, and the best when the ears were unaided. The extended-wear hearing aids and standard hearing aids provided similar self-perceived communication benefits relative to unaided ears. Device failure and issues with extended-wear hearing aids fit and comfort contributed to a high participant withdrawal rate.
Overall, the hearing benefits of extended-wear hearing aids for Service members with hearing loss were comparable to those obtained with standard hearing aids, except for sound localization, which was poorer with extended-wear hearing aids. Extended-wear hearing aids provide the additional benefits of protecting the ears from high-level impulsive noise and being compatible with tactical communication and protection systems and other existing personal protective equipment and communication gear. The withdrawal rate in this study, however, suggests that extended-wear hearing aids may not be suitable for active duty Service members in locations where properly trained hearing professionals are not available to replace or re-insert extended-wear hearing aids when needed due to discomfort or device failure.
许多患有噪声性听力损失的人仍继续在会定期接触高强度噪声的环境中工作,这增加了他们进一步听力损失的风险。由于与规定的个人防护装备不兼容,这些人在工作环境中常常必须摘下助听器,从而降低了情境意识。长佩戴型助听器可能为这些人提供一种解决方案,因为它们可以一次佩戴数周或数月,保护使用者免受高强度噪声暴露的影响,并且与通信耳机、耳罩及其他类型的个人防护装备兼容。本研究的目的是评估在暴露于噪声环境中的现役军人中,长佩戴型助听器的定位能力、言语理解能力、验配和使用的可行性以及舒适度方面的可接受性。
本研究的参与者为有使用助听器经验且目前双侧佩戴标准助听器的现役军人。参与者佩戴长佩戴型助听器长达14周。实验室测量包括功能增益、声音定位和言语识别(安静环境中和噪声环境中)。比较了未佩戴助听器、佩戴标准助听器、佩戴长佩戴型助听器以及佩戴长佩戴型助听器并结合战术通信设备(3M Peltor ComTac)时的表现。此外,还比较了长佩戴型助听器和标准助听器之间的自我感知益处。
与标准助听器相比,长佩戴型助听器关闭时对外部声音的衰减更大。长佩戴型助听器和标准助听器在安静环境中和噪声环境中的言语理解能力相当,并且在佩戴长佩戴型助听器的同时佩戴战术通信设备时言语理解能力更好。长佩戴型助听器的定位能力最差,标准助听器居中,未佩戴助听器时定位能力最佳。相对于未佩戴助听器的耳朵,长佩戴型助听器和标准助听器在自我感知的通信益处方面相似。长佩戴型助听器的设备故障以及验配和舒适度问题导致参与者退出率较高。
总体而言,对于有听力损失的军人,长佩戴型助听器的听力益处与标准助听器相当,但声音定位能力除外,长佩戴型助听器的声音定位能力较差。长佩戴型助听器还具有额外的益处,即保护耳朵免受高强度脉冲噪声的影响,并且与战术通信和防护系统以及其他现有的个人防护装备和通信设备兼容。然而,本研究中的退出率表明,在没有经过适当培训的听力专业人员在需要时因不适或设备故障而更换或重新插入长佩戴型助听器的地点,长佩戴型助听器可能不适用于现役军人。