Open-canal fittings

FigureIn the 16 years I've been covering the hearing industry, I've never seen as much enthusiasm over a new product type as there is today over open-canal hearing aids. Whether I'm speaking with audiologists and hearing instrument specialists who've been fitting patients since the 1970s or young practitioners so new to the profession they've never dispensed an analog device, many are saying that these new mini-BTEs—especially the ones that leave the ear canal open—are generating more user satisfaction than anything they've ever seen. Even better, what I'm hearing and what various surveys are finding is that many dispensers are convinced that OC instruments are bringing a new crop of consumers into the marketplace, younger people with less severe hearing losses. BUT WHAT ARE THE FACTS? Yet, no matter how positive the anecdotal reports may be about any innovation in hearing aids, experience tells us to view them with a healthy dose of skepticism. Sometimes what looked great at the start turns out to be as good as it seemed—or even better. On the other hand, reality often falls short of initial hopes. The goal of this special issue of HJ was to determine the realities of open-canal hearing aids and how to derive optimal patient benefit from them. Obviously, this was a demanding mission—one that would require a lot of work by many people. But first came the easy part—finding the right guest editor. That was my job, and what made it so easy was that the right person to quarterback this issue was none other than our contributing editor, Gus Mueller. He brought to the assignment an extraordinary expertise in amplification combined with an unmatched ability to recruit outstanding contributors. Together, they have conducted a careful, objective, evidence-based analysis of the salient issues related to this emerging category of hearing aid. As most of you know, a key reason that open-canal fittings have become much more viable than they were in the pre-DSP era is the advent of feedback-reduction algorithms. Our first contributing author, Vijay Parsa of the University of Western Ontario, assesses the effectiveness of these algorithms with open fittings. Knowing how to fit OC instruments is essential to providing users with optimal benefit. To that end, Gus Mueller and his Vanderbilt colleague, Todd Ricketts, offer ten “take-home tips” on this subject. Their comprehensive article could serve as a manual to keep handy whenever you do this kind of fitting. Another key question is how well does directional technology perform in open-canal hearing aids. Ruth Bentler and two of her doctoral students at the University of Iowa—Yu-Hsiang Wu and Julie Jeon—present the latest information regarding that issue, including results of their own research. Overcoming the occlusion effect is probably the most-touted benefit of open-canal fittings, but just how well do they do that? Douglas MacKenzie of the State University of New York at Geneseo reports on a study he conducted to find out. By now, there is a great amount of real-world experience with these fittings to draw upon. Several of our authors have done that. Earl Johnson, a PhD student at Vanderbilt, uses the results of a nationwide survey of dispensers to find out how they and their patients feel about these products. David Gnewikow, a Vanderbilt faculty member, and Meredith Moss, an AuD student, unveil the results of a study in which hundreds of subjects were fitted, alternately, with OC and closed-canal instruments and then given various measures of satisfaction. Finally, Brian Taylor of Amplifon USA shares the findings of two surveys—one for new users and one for experienced wearers—that compared the benefits and satisfaction derived from open- and closed-canal fittings. YOU'LL LIKE WHAT YOU READ This special issue offers a comprehensive, up-to-date, and authoritative review of the most exciting development in hearing aids in many years. And, while I don't want to give anything away, I think you'll be pleased to learn that, based on the evidence so far, open-canal hearing aids may be one of the rare developments in which the reality lives up to the hype.

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