I have been contacted by a potential client who is seeking an analog hearing aid because she has Tullio's phenomenon and has been advised elsewhere that a digital instruments would not work. Is there some reason this might be so? It defies logic to me.
The Tullio phenomenon consists of the combination of vertigo and abnormal eye and/or head movements provoked by sound. Dehiscence of the superior semicircular canal can also be found in certain patients with the Tullio phenomenon. When you go to PubMed and enter Tullio Phenomenon and Hearing Aids/Amplification, there are no citations from the peer reviewed published literature, which tells us that the relationship between hearing aid signal processing strategies and the Tullio phenomenon has not been studied very extensively.
When you use other search engines, such as Google Scholar and Scirus, you can learn a little more about it. In one particular study, published in the journal Neurology in 2000, five patients experienced the Tullio phenomenon when a relatively low intensity level (55-65 nHL) was used to elicit it. Dr. Timothy Hain, an Otologist in Chicago mentions the Tullio phenomenon on his website. Dr. Hain talks about the various sound generators (including a shower massager) used to diagnose it.
Based on this information, I think you can draw two conclusions:
Hearing aid patients experiencing the Tullio phenomenon need to be referred to an otolaryngologist for monitoring
It's unlikely that switching from a digital to an analog hearing aid is going to make any difference. (There is nothing I could find in the published literature to contradict this statement). Considering that the gain and output of a digital hearing aid can be fine tuned more easily with a digital device, you are more likely to set the output below the threshold in which dizziness is elicited.
Brian Taylor, Au.D., is the Professional Development Manager for Unitron. Brian is responsible for all Unitron initiatives related to enhancing our customer's expertise, professionalism, and effectiveness in the areas of hearing aid fitting, product selection, and practice development. Brian earned his Au.D from Central Michigan University and has over 15 years of clinical and practice management experience.
Brian Taylor, AuD
Director of Practice Development & Clinical Affairs
Brian Taylor is the Director of Practice Development & Clinical Affairs for Unitron. He is also the Editor of Audiology Practices, the quarterly publication of the Academy of Doctor’s of Audiology. During the first decade of his career, he practiced clinical audiology in both medical and retail settings. Since 2003, Dr. Taylor has held a variety of management positions within the industry in both the United States and Europe. He has published over 30 articles and book chapters on topics related to hearing aids, diagnostic audiology and business management. Brian is the co-author, along with Gus Mueller, of the text book Fitting and Dispensing Hearing Aids, published by Plural, Inc. He holds a Master’s degree in audiology from the University of Massachusetts and a doctorate in audiology from Central Michigan University. Brian Taylor is the Director of Practice Development & Clinical Affairs for Unitron. He is also the Editor of Audiology Practices.
1https://www.audiologyonline.com/audiology-ceus/course/audiology-treatment-introduction-to-thieme-32010Current Topics in Audiology Treatment, in Partnership with Thieme PublishersThis course will review current topics in audiology treatment that are detailed in the upcoming book by Thieme publishers. Editor Dr. Jason Galster will provide a tour of content focused on the treatment of hearing loss through amplification, implantable solutions, and a variety of additional techniques.auditory, textual, visual
This course will review current topics in audiology treatment that are detailed in the upcoming book by Thieme publishers. Editor Dr. Jason Galster will provide a tour of content focused on the treatment of hearing loss through amplification, implantable solutions, and a variety of additional techniques.
2https://www.audiologyonline.com/audiology-ceus/course/maximizing-speech-intelligibility-for-open-11955Maximizing Speech Intelligibility for Open Canal FittingsPsychoacoustic models for speech intelligibility and loudness can be used successfully for deriving a prescriptive fitting rule specifically to high frequency hearing losses. This article describes the development of a new prescriptive fitting algorithm for high frequency hearing losses, OPEN, including a detailed rationale and supporting clinical studies.textual, visual
Psychoacoustic models for speech intelligibility and loudness can be used successfully for deriving a prescriptive fitting rule specifically to high frequency hearing losses. This article describes the development of a new prescriptive fitting algorithm for high frequency hearing losses, OPEN, including a detailed rationale and supporting clinical studies.
3https://www.audiologyonline.com/audiology-ceus/course/loud-too-using-ldl-measures-827How Loud is Too Loud? Using LDL Measures for Hearing Aid Fitting and Verification (PART 1)A discussion of LDLs and their clinical use for fitting hearing instruments.auditory, textual, visual
4https://www.audiologyonline.com/audiology-ceus/course/before-hearing-aid-fitting-what-849Before the Hearing Aid Fitting: What Pre-Tests Provide "Bang for the Buck"? (Part 1)This course provides a discussion of various pre-fitting measures that can provide valuable insight to the abilities, preferences and expectations of the wearer.auditory, textual, visual
5https://www.audiologyonline.com/audiology-ceus/course/loud-too-using-ldl-measures-874How Loud is Too Loud? Using LDL Measures for Hearing Aid Fitting and Verification (Part 2)The second installment in LDL measures overview including how these measures will affect the hearing aid fitting. NOTE: The two additional handouts for this course are currently unavailable.auditory, textual, visual