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Asymmetrical Sensorineural Hearing Loss: Fitting Strategies

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1.  When referring to an "asymmetrical" hearing loss, the asymmetry between ears may be in:
  1. thresholds
  2. word recognition
  3. dynamic range
  4. all of the above
2.  Which of the following statements is true in regard to asymmetrical hearing losses:
  1. If you can obtain hearing thresholds, the ear is aidable.
  2. If the hearing loss is in both ears, both ears should always be fit with hearing aids.
  3. In some cases, you may find that you want to disengage some of the binaural processing features in the hearing aids when fitting an asymmetrical loss.
  4. All of the above statements are true.
3.  What is the best way to predict or decide if an ear is aidable?
  1. If word recognition is 50% or greater the ear is always aidable
  2. Fit the ear with a trial of amplification, finetune as needed and have the patient use the hearing aid in real world conditions
  3. If PTA is 90 dBHL or better the ear is always aidable
  4. As long as the loss is sensorineural, you can always fit successfully with amplification
4.  Etiologies that lead to asymmetrical hearing loss include:
  1. Meniere’s Disease
  2. Noise exposure on the poorer ear side
  3. Both A and B
  4. None of the above
5.  Which hearing aid feature does the author consider a "must" when fitting asymmetrical hearing losses?
  1. frequency lowering technology
  2. binaural coordination (ear to ear linking)
  3. 32 or more channels
  4. a volume control
6.  One approach to hearing aid fitting with asymmetrical hearing losses that the author recommends is:
  1. Rule out cochlear implant candidacy before proceeding with hearing aid fitting.
  2. Serial fitting - fit the better first, and the poorer ear at a later date.
  3. Wait and see - do not fit with amplification until both ears have at least a moderate hearing loss.
  4. Serial fitting - fit the poorer ear first, and then the better ear only if necessary.
7.  Before proceeding with a CROS or Bi-CROS fitting:
  1. have the patient sign a waiver that they understand that amplification will not restore normal hearing
  2. first try ALDs
  3. rule out direct amplification for the poorer ear
  4. None of the above
8.  In addition to verification, which of the following is helpful particularly in asymmetrical hearing loss fittings?
  1. Outcome measures or interviews to determine use of hearing aids, motivation and benefit
  2. Monthly finetuning sessions for the first year
  3. Auditory training for the poorer ear only
  4. All of the above
9.  In order to created a fused, single auditory sensation:
  1. the hearing aids must be the same make/model between ears
  2. aided thresholds must be the same between ears
  3. you must work closely with the patient, finetuning and adapting the settings as needed to achieve a feeling of 'balanced' hearing between the ears
  4. fit to DSL targets for both ears and additional finetuning is not usually needed
10.  A patient with an asymmetrical hearing loss:
  1. may need more time to trial amplification
  2. may be experiencing auditory deprivation in an ear previously unaided
  3. may experience a change in hearing over time
  4. all of the above