Fitting hearing aids on infants and children: a primer for otolaryngologists
Fitting hearing aids on infants and children: a primer for otolaryngologists
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DOI：
10.1016/s0030-6665(02)00050-6
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发表时间：
2002-08-01
影响因子：
1.7
通讯作者：
Koenig, JA
中科院分区：
文献类型：
--
作者：
Littman, TA;Blankenship, KK;Koenig, JA
随着新生儿听力筛查计划的普及，听力学家和耳鼻喉科医生将发现自己比以前更年轻的孩子进行评估和管理。事实上，现在通常在2到3个月大的时候就决定是否配戴助听器，而过去则是在15到19个月大的时候[1，2]。为这样的幼儿装配助听器提出了一些挑战，这些挑战通常不会遇到较大的儿童和成人。本文将回顾为2 ~ 6个月龄的婴儿验配助听器所面临的挑战，首先是获得准确的、特定频率的阈值测量，不仅用于听力损失的诊断和医疗管理，而且允许准确设置助听器输出。第二，必须就最适合幼儿的援助的特点和方式作出决定。第三，幼儿无法提供行为信息，加上耳道容积小，在适当设置助听器输出方面存在独特的障碍。第四，孩子的小耳廓会使助听器更难固定到位，避免反馈。第五，耳模必须经常重新制作，由于尺寸限制，可能无法提供重要的配件选择。最后，也许也是最重要的一点，给非常小的婴儿安装助听器不能破坏孩子和父母之间关键的早期联系过程。以下各节将更详细地讨论这些挑战中的每一个。
As newborn hearing screening programs become more widespread, audiologists and otolaryngologists will find themselves evaluating and managing much younger children than previously. In fact, decisions about hearing aid fitting are now often made at two to three months of age, as contrasted with approximately 15 to 19 months of age in the past [1,2]. Fitting hearing aids on such young infants presents a number of challenges typically not encountered with older children and adults. This paper will review the challenges involved in fitting hearing aids on young infants, with a focus on the two to six month age range.The first challenge is obtaining accurate, frequency-specific threshold measurements, not only for diagnosis and medical management of the hearing loss, but to permit accurate setting of hearing aid output. Second, decisions must be made regarding the features and style of aid most appropriate for a small child. Third, the young infant's inability to provide behavioral information, combined with a small ear canal volume, present unique hurdles in setting hearing aid output appropriately. Fourth, the child's small pinna can make it more difficult to hold a hearing aid in place and avoid feedback. Fifth, earmolds must be remade at frequent intervals, and because of size constraints, important fitting options may not be available. Finally, and perhaps most important, fitting hearing aids on very young infants must not disrupt the critical early bonding process between child and parents. Following sections will address each of these challenges in greater detail.