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Managing Severe Hearing Loss

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1.  Which etiologies can lead to severe hearing loss? Viral or Genetic Sudden or rapidly progressing SNHL Meniere's Disease All of the above

2.  Severe SNHL is characterized by Performance that is completely predictable based on the amount of pure-tone hearing loss Essentially no ability to understand speech in noise Typically well preserved speech understanding in quiet None of the above

3.  Severe hearing loss can be caused by disruptions in The intra-cochlear membranes or Chemical balance in the intra-cochlear fluids Inner hair cells Blood supply to the cochlea or All of the above

4.  Asymmetrical hearing loss can include One aidable ear and one normal ear One dead ear and one aidable ear Two aidable ears with different degrees of loss All of the above

5.  In the presence of asymmetrical hearing loss: The listener can easily make a judgement of the perception in each ear separately The listener will look to achieve one fused auditory image Aiding the poorer ear will not affect the perception in the better ear The better ear will eventually settle at the same level as the poorer ear

6.  If the decision is made to amplify both ears in the presence of a significant amount of asymmetry: A proposed strategy is to fit and adjust the better ear first before adding the second ear A proposed strategy is to fit and adjust the poorer ear first before adding the second ear Both ears should always be fit at the same time The patient should switch between wearing one device versus the other on an ongoing basis

7.  According to the presenter, BiCROS should be considered Anytime there is significant asymmetry between ears Never, it is an outdated technology Only after trial use in the poorer ear, unless you are absolutely sure the ear is truly dead Only for younger adults

8.  For patients with recently acquired severe hearing (from, for example, Menieres Disease) Maximum gain should be provided to stimulate the brain The patient may not be able to tolerate target gain due to instability or extreme sensitivity in the ear Hearing aids should be avoided until thresholds have been stable for a year Strict adherence to target is essential to properly preserve the remaining hearing

9.  Patients with longstanding severe to profound SNHL May be very sensitive to small changes in the frequency response or to the loss of any amount of loudness in the signal May take time to adjust to improvements in the audible bandwidth May need more linearity in the signal All of the above

10.  Patients with severe hearing loss . . . Have a high demand for connectivity solutions and flexible solutions Have a high demand for feedback cancellation Have a demand for improved speech understanding but also auditory scene awareness All of the above