[The tasks of the ENT specialist by hearing aid fitting. Part 2: checking the fit, subjective satisfaction, ear mold...

The second part of this series deals with the tasks of the ENT-specialist, who must not endorse the prescription before making sure that the hearing aid recommended by the acoustician will bring sufficient hearing improvement, and that the suggested hearing aid is suitable. The report and audiograms of the acoustician must be compared to his own results, and a check of whether at least three hearing aids from different companies have been compared must be made. The primary aim of patient satisfaction can be checked by means of the "Oldenburger Inventar" (Oldenburg questionnaire), which determines the improvement of hearing ability in quiet and noise, and of auditory localization. Since the otoplastic substantially effects the amplification of the hearing aid, the ENT specialist should make sure that it does not produce feedback, that it has a second boring, and, in case of need, a Libby horn. He should also consider whether an open fitting would be more appropriate. A free-field measurement--with and without noise--shows whether the dB(opt) has been reached. The in situ measurement and the loudness rating by the Würzburger Hörfeld (Wuerzburg auditory field) are of great help in detecting fitting errors. Additional procedures, such as auditory speech training, lip reading, or technical devices, for instance FM-communication or a light alarm clock, are often employed in elderly patients.