Chapter 4. Longevity and a new fitting model

4. Longevity and a new fitting model  4.1 Introduction Table 2.1 suggested that the only device that enables the full use of the patient’s dynamic range of hearing was the Codacs device. However, the Codacs device has been developed for patients with otosclerosis and is cochlea-invasive. This device is described in more detail in paragraph 5.2 as one of the amplification options for patients with a fixed stapes. Does this mean that we should abandon the other systems? An attempt was made to Read more [...]

Chapter 5. Comparison of interventions in certain groups of patients

5. Comparison of interventions in certain groups of patients 5.1. Congenital middle ear and outer ear anomalies 5.1.1. Surgical repair or amplification? When counselling patients with hearing loss caused by congenital ear anomalies (like aural atresia), firstly, reconstructive surgery should be considered. Congenital ear anomalies might vary from mild (middle ear anomalies) to severe (atresia of the ear canal) with an associated air-bone gap from 40 to 65 dB. Amongst otologists, reconstructive Read more [...]

Chapter 6. Bilateral application should always be considered

6. Bilateral application should always be considered 6.1 Introduction Binaural hearing refers to hearing with two ears. When listening with two ears instead of one, at least four advantages can be distinguished: 1) binaural loudness summation, 2) use of acoustic head shadow to hear better in noisy places, 3) directional hearing and 4) binaural squelch. In normal hearing listeners binaural hearing is obvious, based on accurate processing of bilateral inputs. That is not necessarily the case for Read more [...]

Chapter 7. Challenges in children; critical choices

7. Challenges in children; critical choices 7.1 Introduction; children should not be treated as young adults Counselling adults, who according to their audiogram should profit from amplification, is not always successful. Adults might deny their hearing problems or postpone a hearing aid trial. If their attitude is more positive, they might only be interested in hardly visible devices, even if speech recognition with such devices is not optimal. For children, there is less room to move because Read more [...]

Chapter 8. Sensorineural hearing loss

Part 2. Challenges and limitations of implantable hearing devices (auditory implants) for sensorineural hearing loss  8.  Sensorineural hearing loss  8.1 Auditory implants for moderate to severe sensorineural hearing loss To rehabilitate sensorineural hearing loss, conventional air-conduction hearing aids are the first choice (e.g. behind-the-ear devices or BTEs; Figure 2.1, chapter 2). For patient with severe to profound hearing loss (>80-90 dB HL), such devices might no longer be effective Read more [...]


Appendix 1 About the author: Ad Snik studied physics at the Eindhoven University of Technology and got his master degree in 1976. In 1982, he got the doctor’s degree from the same university. The title of his dissertation was ‘Visco-elastic properties of monomolecular layers”. He started to teach Physics and Electronics at a college for Bachelor students. In 1984, he entered a training to become a medical physicist and he was registered a few years later as medical physicist/ audiologist. Read more [...]

References and Abbreviations

References Aarnisalo AA, Vasama JP, Hopsu E, Ramsay H. Long-term hearing results after stapes surgery: a 20-year follow-up. Otol Neurotol. 2003;24:567-71. Agterberg MJ, Hol MK, Cremers CW, Mylanus EA, van Opstal J, Snik AF. Conductive hearing loss and bone conduction devices: restored binaural hearing? Adv Otorhinolaryngol. 2011;71:84-91 Agterberg MJ, Frenzel H, Wollenberg B, Somers T, Cremers CW, Snik AF. Amplification options in unilateral aural atresia: an active middle ear implant or a bone Read more [...]