The Effects of Receiver Placement on Probe Microphone, Performance, and Subjective Measures with Open Canal Hearing Instruments

Abstract

Background: Open canal hearing instruments differ in method of sound delivery to the ear canal, distance between the microphone and the receiver, and physical size of the devices. Moreover, RITA (receiver in the aid) and RITE (receiver in the ear) hearing instruments may also differ in terms of retention and comfort as well as ease of use and care for certain individuals. What remains unclear, however, is if any or all of the abovementioned factors contribute to hearing aid outcome. Purpose: To determine the effect of receiver location on performance and/or preference of listeners using open canal hearing instruments. Research Design: An experimental study in which subjects were exposed to a repeated measures design. Study Sample: Twenty-five adult listeners with mild sloping to moderately severe sensorineural hearing loss (mean age 67 yr). Data Collection and Analysis: Participants completed two six-week trial periods for each device type. Probe microphone, objective, and subjective measures (quiet, noise) were conducted unaided and aided at the end of each trial period. Results: Occlusion effect results were not significantly different between the RITA and RITE instruments; however, frequency range was extended in the RITE instruments, resulting in significantly greater maximum gain for the RITE instruments than the RITA instruments at 4000 and 6000 Hz. Objective performance in quiet or in noise was unaffected by receiver location. Subjective measures revealed significantly greater satisfaction ratings for the RITE than for the RITA instruments. Similarly, preference in quiet and overall preference were significantly greater for the RITE than for the RITA instruments. Conclusions: Although no occlusion differences were noted between instruments, the RITE did demonstrate a significant difference in reserve gain before feedback at 4000 and 6000 Hz. Objectively; no positive benefit was noted between unaided and aided conditions on speech recognition tests. These results suggest that such testing may not be sensitive enough to determine aided benefit with open canal instruments. However, the subjective measures (Abbreviated Profile of Hearing Aid Benefit [APHAB] and subjective ratings) did indicate aided benefit for both instruments when compared to unaided. This further suggests the clinical importance of subjective measures as a way to measure aided benefit of open-fit devices.