I. hearing assessment
1, receiving and archiving
Archive the deaf patients after receiving treatment, including general information and specialized information.
General information includes name, gender, age, occupation, contact information, etc.
Special information includes the collection of medical history and general examination of otology.
The medical history should record the hearing loss of patients and their families in detail, such as the time of hearing loss, whether it is stable, gradual or fluctuating, whether there are accompanying symptoms, the effect of previous treatment and/or intervention, and the ability of speech expression.
In principle, hearing-impaired people will be fitted with hearing AIDS after being diagnosed by a specialist.
2. Listening test
The audiological examination of children under 3 years old includes behavioral audiometry (behavioral observation response audiometry, visual enhancement audiometry or game audiometry), auditory brainstem response, multi-frequency steady-state response, otoacoustic emission and acoustic impedance.
The audiological examination of hearing-impaired people over 3 years old includes pure tone hearing threshold test, discomfort threshold test, speech audiometry, acoustic immittance, otoacoustic emission, mental intelligence evaluation and so on.
Second, pre-selection
1, choose a hearing aid.
For binaural hearing impaired people, binaural fitting is generally carried out, but it can also be fitted with one ear due to conditions, but the shortcomings of monaural fitting should be pointed out.
The selected hearing AIDS shall meet the national or industrial standards.
Hearing AIDS are divided into box type, behind-the-ear type and in-ear type (customized type) according to shape, and analog hearing AIDS and programmable hearing AIDS according to technical principles.
When choosing hearing AIDS, we should recommend two or more hearing AIDS for the hearing impaired to try on according to their hearing level and performance, combined with their economic conditions, working and living environment and personal preferences.
2. Customize the shell of ear mold or in-ear machine (custom machine)
When the ear mould is customized by the behind-the-ear machine or the box machine, the external auditory canal and tympanic membrane should be checked first, then the ear impression should be taken and the customization form should be filled in.
When selecting custom machine, the obtained ear samples should be sent to the manufacturer together with the completed customization form, which should provide the manufacturer with complete information as far as possible.
Ear mold can be divided into soft ear mold, semi-soft ear mold and hard ear mold.
Children often choose the first two ear molds, while adults choose hard ear molds.
The shape of hard ear mold is related to the degree of hearing loss. Generally speaking, for extremely severe and severe hearing loss, shell ear mold with better sealing performance should be selected. For severe and moderate hearing loss, choose frame ear mold; For moderate and severe hearing loss, choose ear canal ear mold.
According to audiogram and patient's subjective reaction, the selection, size and shape of vent and whether to add dampers with different specifications are decided.
Third, debugging
The electroacoustic parameters of the debugging hearing aid mainly include the gain frequency response curve of the real ear and the frequency response curve of the maximum output of the real ear. These parameters can be calculated by POGO, NAL, DSL and other prescription formulas.
When assembling an analog hearing aid, choose compression circuits according to the hearing dynamic range, such as peak clipping (PC), automatic gain control (AGC), wide dynamic range compression (WDRC) and so on.
When fitting programmable hearing AIDS, it is necessary to adjust the gain and compression ratio of different frequency bands, set up multiple programs to adapt to different types of hearing loss, and use hearing AIDS under different acoustic environment conditions.
When fitting, you can also refer to the tips of hearing aid fitting software for selection.
The choice of hearing AIDS for children should consider the matching of various hearing AIDS.
Fourth, hearing aid evaluation
1, hearing aid effect evaluation
Behavioral observation, functional evaluation, Ling's six tones, digital evaluation, speech test, real ear analysis and questionnaire survey were used to evaluate the wearing effect of hearing AIDS, and the effects of different sound intensities, different sound signals and different listening environments on the amplification effect of hearing AIDS were noted.
Hearing aid effect evaluation includes patient's expectation evaluation and satisfaction evaluation.
2. Tracking and evaluation
The working state of the hearing aid may change during use; The user's hearing condition may also be aggravated or alleviated; Users may also have new personalized needs.
Therefore, it is very important to follow up users regularly and make a new evaluation of the wearing effect of hearing AIDS.
The follow-up time is generally every 1 month in the first year of wearing, and then every six months. If the user has special circumstances, he can see a doctor at any time.
Follow-up evaluation not only adopts the method of hearing aid effect evaluation, but also examines the ears and hearing of the hearing impaired.