Assessment of Hearing Aid Maximum Output A person who was fitted with a hearing aid returns for a 1-year follow-up visit and you find 20 dB threshold shifts in the aided ear. Any audiologist who has experienced this situation knows the concern and apprehension that emerge. Questions immediately come to mind: “Could I have overampli-fied ... Edge Report
Edge Report  |   March 01, 1993
Assessment of Hearing Aid Maximum Output
 
Author Affiliations & Notes
  • David B. Hawkins, PhD
    Department of Speech-Language Pathology and Audiology, University of South Carolina, Columbia, SC 29208
Article Information
Hearing Disorders / Hearing Aids, Cochlear Implants & Assistive Technology / Edge Reports
Edge Report   |   March 01, 1993
Assessment of Hearing Aid Maximum Output
American Journal of Audiology, March 1993, Vol. 2, 13-14. doi:10.1044/1059-0889.0201.13
 
American Journal of Audiology, March 1993, Vol. 2, 13-14. doi:10.1044/1059-0889.0201.13
A person who was fitted with a hearing aid returns for a 1-year follow-up visit and you find 20 dB threshold shifts in the aided ear. Any audiologist who has experienced this situation knows the concern and apprehension that emerge. Questions immediately come to mind: “Could I have overampli-fied this person? Where did I set that output control? How much SPL was that hearing aid putting out? Will I be liable if this shift was caused by the hearing aid I selected and fitted?”
Knowledge of the maximum output in the ear canal at the hearing aid fitting may not totally eliminate these situations, but it will provide valuable information to the audiologist. The real-ear maximum output of the hearing aid is important because it can be quite different from the SSPL90 curve generated in a 2-cm3 coupler. The real-ear coupler difference (RECD) can be quite large and variable, but the output is nearly always greater in the real ear than in the 2-cm3 coupler (Fikret-Pasa & Revit, 1992; Hawkins, Cooper, & Thompson, 1990). In the higher frequencies, the SSPL90 may be 110 dB SPL in the 2-cm3 coupler and exceed 120 dB SPL in the ear canal of the hearing aid user. These differences may be even greater for children (Feigin, Kopun, Stelmachowicz, & Gorga, 1989) due to the smaller residual volume between the tip of the earmold and the tympanic membrane.
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