PP1019 - Optimizing Care with Low-Gain Hearing Aids for Patients with Normal Hearing but Auditory Challenges

Abstract:
Low-gain hearing aids (LGHAs) are gaining traction as a management option for individuals with normal hearing thresholds, an area where research and clinical practice remain limited. This study explores the benefits of LGHAs, comparing use and outcomes based on individual history and hearing. Results demonstrate higher LGHA usage and benefit among groups with auditory injury and significant difficulties. Two case studies provide further support for LGHAs as a valuable intervention for patients with auditory deficits. These findings contribute to advancing clinical practice and addressing the unmet needs of individuals without measurable hearing loss.

Summary:
Rationale
Low-gain hearing aids (LGHAs) are increasingly considered for individuals with normal hearing thresholds (NHTs) who report significant self-reported hearing difficulties (SHDs). Despite normal audiometric thresholds, these individuals often experience challenges that affect communication and quality of life. Traditional hearing aids are typically prescribed for individuals with measurable hearing loss, leaving those with SHDs underserved. This study seeks to evaluate the efficacy of LGHAs as a management option for this population, addressing an unmet need in clinical practice and providing new insights into managing SHDs. The study also compares LGHA use and benefit in individuals with peripheral hearing loss to understand the broader applicability of this intervention.

Design
A sample of service members undergoing annual hearing tests was surveyed, and individuals who self-identified as hearing aid users were selected for further analysis. Participants were divided into groups based on their self-reported hearing difficulties and other auditory injury history. The Tinnitus and Hearing Survey-Hearing Subscale (THS-H) was selected as the validated tool for quantifying subjective hearing difficulties. Questionnaires addressing auditory injury history, hearing aid usage, benefit, hearing difficulties, and tinnitus were administered to assess the effectiveness of LGHAs. In addition to the quantitative analysis, two case studies of individuals with SHDs and auditory processing deficits were presented to provide a more detailed examination of LGHA benefits.

Results
The findings indicate that individuals with auditory injuries, SHDs and NHTs reported significantly higher LGHA usage and benefit than individuals without such history and difficulties. Importantly, comparable levels of hearing aid use and benefit were observed between individuals with SHDs, regardless of whether they had peripheral hearing loss or normal hearing thresholds. This suggests that the perceived benefit of LGHAs is linked more closely to self-reported difficulties than to audiometric results, supporting the notion that LGHAs can be an effective treatment option even in the absence of measurable hearing loss. The case studies further illustrate that individuals with significant auditory processing deficits experienced notable improvements following LGHA use, reinforcing the broader applicability of this treatment.

Conclusions
This research highlights the potential of LGHAs as a viable management option for individuals with normal hearing thresholds but auditory injuries and significant self-reported hearing difficulties. These findings challenge the conventional approach of reserving hearing aids for individuals with measurable hearing loss, suggesting that SHDs alone may warrant intervention. The results also emphasize the value of using tools like the THS-H to identify patients who may benefit from LGHAs, thereby expanding clinical practice to better serve those with auditory processing deficits. Given the high reported usage and benefit, LGHAs represent a promising, timely intervention that addresses an important gap in current audiological care. Further research is needed to optimize patient selection criteria and evaluate the long-term outcomes of LGHA use in this population, but this study marks a critical step toward advancing audiology practice and improving patient outcomes for those with normal hearing thresholds.

Brief Summary of Clinical Takeaways:
The clinical takeaway for this session is that low-gain hearing aids are a viable treatment option for patients with normal hearing thresholds but significant self-reported hearing difficulties, leading to reduced auditory challenges and improved overall outcomes in daily communication.

Assumptions
A foundational understanding of diagnostics and hearing aid fitting principles, familiarity with patient-reported outcome measures and experience managing patients involving both normal hearing thresholds and hearing aid interventions is recommended.