No abstract

The purpose of this study was to examine telephone use among cochlear implant recipients. A questionnaire was constructed and mailed to 803 adults who received a Clarion cochlear implant system manufactured by Advanced Bionics Corporation. Questionnaire recipients were implanted at least 12 months prior to receiving the questionnaire (i.e., they were implanted in 1998 or 1999). Approximately 60% (n = 478) responded, of whom 70% (n = 336) were considered "telephone users" (i.e., they answered the telephone and/or initiated calls). Telephone users were significantly younger and had significantly more daily hours of cochlear implant use than nonusers. Not surprisingly, there were differences between groups with respect to method of communication (i.e., more users employed oral communication, while more nonusers employed both oral and manual communication) and ability to understand words without lipreading (i.e., more users were able to understand). Thirty-seven percent of the telephone users were male, and 63% were female. The average age was 51.8 years (SD = 15.5). Ninety-five percent of users initiated calls to family and friends, 65% made appointments by phone, and approximately 50% asked for information about a product or service and conducted business over the phone. Over 95% of users could identify a dial tone, a busy signal, and voices. The average telephone use per week was 5.4 hr. Approximately 85% indicated that they were able to interact with strangers on the telephone within 5 months of receiving the sound processor. Approximately 30% communicated via a cellular phone for personal use. The findings of this survey suggest an increase in cochlear implant users' telephone use relative to a decade earlier. Advances in cochlear implant and telephone technologies are 2 of several factors that may contribute to the changes observed.

This 4-year project investigated the pass/refer rates of preschool children in a hearing screening program. Three- and 4-year-old children who attended Head Start centers in rural, traditionally medically underserved, eastern North Carolina participated (n = 1,462). Screening procedures and pass/refer criteria were based on the Guidelines for Audiologic Screening (American Speech-Language-Hearing Association [ASHA], Panel on Audiologic Assessment, 1997). Only 54% (n = 787) of children passed the initial screening (i.e., passed all three of the screening components, which included pure-tone audiometry, tympanometry, and otoscopy), and an additional 22% (n = 323) passed the rescreening, for an overall pass rate of 76%. The initial pass rate was 90%, 71%, and 71% for otoscopy, tympanometry, and pure-tone audiometry, respectively. After the initial screening, 675 children were referred (i.e., 83%, 2%, and 15% for audiologic rescreening, medical evaluation, or both, respectively). About 71% (n = 478) received the recommended evaluation. Follow-up assessment compliance after the rescreening was poor. Slightly more than 10% of children were evaluated. The hearing status of 267 (i.e., 18.3%) children was never determined. Six (i.e., 0.5%) of the 1,195 children who completed the audiologic screening and/or received diagnostic audiologic assessment were confirmed to have hearing loss. Methodological factors that may have contributed to this high refer rate include the use of all screening techniques (pure tones, tympanometry, and otoscopy), procedural considerations in testing protocol and pass/refer criteria, and the demographic characteristics of the children screened.

When taking an impression of the external ear canal and ear, the audiologist is engaged in an invasive procedure whereby a foreign body is first placed into the ear canal and then removed. There is always an element of risk for significant medical problems when a clinician is performing an invasive procedure. Although some minor patient discomfort and, at times, some slight trauma to the ear canal occur when taking ear impressions, the incidence of significant trauma to the external or middle ear appears to be low. The purpose of this report is to provide some illustrative cases of significant external and middle ear trauma as a result of taking impressions of the external ear. Audiologists are advised to develop and implement an appropriate risk management program for taking ear impressions to reduce the potential risks associated with this procedure to their patients and to their practices. Abbreviations: CIC = completely in the canal, HPD = hearing protection device, OR = operating room, PROS = pressure relief oto-dam system

The acoustic effects of 1-, 2-, and 3-mm vents were investigated with in-the-ear, in-the-canal, and completely-in-the-canal hearing aid shells. Real-ear sound pressure level measures were obtained from unvented and vented shells with 12 adults. In general, with increasing vent size, a statistically significant (p < .05) increase in the amount of low-frequency reduction, an upward shift in vent cutoff frequencies, and an upward shift in vent-associated resonances occurred for all hearing aid shell styles. There was no significant change in the slope of the low-frequency reduction across all hearing aid shell styles (p > .05), albeit the frequency response curves were shifted upward in frequency with increasing vent diameters. Only with the in-the-ear and completely-in-the-canal hearing aid shells were statistically significant (p < .05) differences found with the magnitude of vent-associated resonance as a function of vent diameter, and these differences were not consistent across the different styles. These findings suggest that venting may be used effectively to tune low-frequency responses in custom in-the-ear hearing instruments.