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Laryngorhinootologie 2017; 96(S 01): S43-S65
DOI: 10.1055/s-0042-120046
Referat
© Georg Thieme Verlag KG Stuttgart · New York

Hörgeräte: Indikationen, Technologie, Anpassung und Qualitätskontrolle

Hearing Aids: Indications, Technology, Adaptation and Quality control
Ulrich Hoppe
1   Audiologische Abteilung, Hals-Nasen-Ohrenklinik, Kopf- und Halschirurgie, Universitätsklinikum Erlangen
,
Gerhard Hesse
2   Tinnitus-Klinik am Krankenhaus Bad Arolsen, Universität Witten-Herdecke
› Author Affiliations
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Publication History

Publication Date:
12 May 2017 (online)

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Zusammenfassung

Da nach wie vor eine kausale Behandlung von Schwerhörigkeiten, die durch Schädigungen der Strukturen des Innenohres bedingt sind, nicht verfügbar ist, steht für die Therapie von Schwerhörigkeit die apparative Hörrehabilitation im Vordergrund. Gleichzeitig haben sich die Qualität und technische Möglichkeiten der Hörgeräteversorgung in den letzten 10–15 Jahren deutlich verbessert. Besonders die moderne „offene Anpassung“ hat die Akzeptanz für Hörgeräte, vor allem aber die Rehabiltation von Hochtonhörschwerhörigkeiten entscheidend verbessert. Dennoch sind die Bereitschaft der Betroffenen, sich versorgen zu lassen, aber auch der HNO-Ärzte, möglichst frühzeitig zu versorgen, sicher noch verbesserungsfähig. Aktuelle Forschungen machen jedoch deutlich, dass es sinnvoll ist, Schwerhörige bereits sehr früh und auch bereits mittelgradige Hörverluste apparativ zu versorgen. Dies beugt einer kortikalen auditiven Deprivation und damit auch drohenden sozialen Isolationen bis hin zu Demenzentwicklungen und Intelligenzverlusten vor, ist aber auch zugleich eine sinnvolle Therapie, um Begleitsymptome wie Tinnitus und Geräuschüberempfindlichkeiten lindern zu können. Dieses Referat soll die Indikationen, die technischen Möglichkeiten und den aktuellen Forschungsstand zur Hörgerätetechnologie, -akzeptanz und zu Besonderheiten in der Versorgung Schwerhöriger aufzeigen.

Abstract

Hearing loss can be caused by a number of different pathological conditions. Some of them can be successfully treated, mainly by surgery, depending on the individual’s disease process. However, the treatment of chronic sensorineural hearing loss with damaged cochlear structures usually needs hearing rehabilitation by means of technical amplification. During the last 2 decades tremendous improvements in hearing aid technology led to a higher quality in the hearing rehabilitation process. For example, due to sophisticated signal processing the acoustic feedback path could be reduced and hence open fitting options are available for even more subjects. In particular for high-frequency hearing loss the use of open fitting is an option. Both the users’ acceptance and the perceived sound quality were significantly increased by open fittings.However, we are still faced with a low level of readiness in many hearing impaired subjects to accept acoustic amplification. Since ENT specialists play a key-role in hearing aid provision, they should promote early hearing aid rehabilitation and include this in the counselling even in subjects with mild and moderate hearing loss. Recent investigations demonstrated the benefit of early hearing aid use in this group of patients since this may help to reduce subsequent damages as auditory deprivation, social isolation, development of dementia, and cognitive decline. For subjects with tinnitus, hearing aids may also support masking by environmental sounds and enhance cortical inhibition.The present paper describes the latest development of hearing aid technology and the current state of the art for amplification modalities. Implications for both hearing aid indication and provision are discussed.

 

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