Identification of Difficulties Experienced With The Physical Application of Behind-the-Ear Hearing Aids and their Association with Auricular Anatomy
A small study aimed to identify more than normal difficulties experienced by a group of Down's Syndrome BTE aid wearers, auricular anomalies and any associations between the difficulties and presence of those anomalies.
Mandy Miller (UK)
Contemporary digital hearing aid technology will significantly reduce concerns about the cost, sound quality and size of hearing aids. However, to gain optimum benefit from this technology issues of cosmetic appearance, physical comfort and stigma should be addressed. Behind-the-ear (BTE) hearing aids often provoke these concerns and despite significant attempts to improve their user satisfaction there is much scope for improvement. There is insufficient data on auricular morphology and specific difficulties experienced by hearing aid wearers but such data could offer solutions that would satisfactorily resolve some problems associated with hearing aid use. BTE aids are an important source of amplification for people with Down's Syndrome among whom hearing loss is prevalent. Characteristic auricular anomalies are present in this population and it has been suggested that they experience significant difficulties with the physical application of their BTE hearing aids.
A small study aimed to identify more than normal difficulties experienced by a group of Down's Syndrome BTE aid wearers, auricular anomalies and any associations between the difficulties and presence of those anomalies. Fourteen Down's Syndrome subjects (males and females aged between 3 and 18 years) were compared to 16 subjects without Down's Syndrome.
Three sets of data were collected from each subject. Firstly, a questionnaire recorded problems experienced with the physical application of the hearing aids. Secondly, anthropometry was employed to measure the angle of protrusion, height and resistance of the upper portion of the auricles. Thirdly, casts were made of the auricles from which 3 contours of the retro-auricular space were recorded and 4 observations were made on the morphology.
The group of people with Down's Syndrome had significantly more problems with the case of the hearing aid pushing down on the upper portion of their auricles and the accidental detachment of the earmoulds. It was concluded that accidental detachment of the hearing aid case was a problem for the Down's Syndrome group but this problem was not significantly more important than for the non-Down's Syndrome group. The upper portion of the Down's Syndrome auricles gave significantly less resistance and were reduced in height. The concha and cymba concha were significantly shallower and the root of the helix within the concha significantly more pronounced. Reduced height in the upper portion of the auricle contributed to the accidental detachment of the hearing aid case and earmould. Improvements in the methodology were proposed that would certainly strengthen the results. The statistical results together with the qualitative data lead to speculation on a number of possible design considerations.
This article first appeared on the site in 2002.