Introduction: Hearing loss (HL) strongly impacts communication abilities and impairs social interactions. Moreover, it modifies the vocal parameters of affected patients. The effects of hearing rehabilitation through hearing aids (HA) on the vocal production of patients suffering from HL have not been thoroughly analyzed in the literature. The aim of this study was to use the ambulatory phonation monitor (APM), a portable vocal dosimeter, to evaluate the variations in the vocal production of a group of patients suffering from moderate-to-severe HL treated with HA and the relationship between such modifications and quality of life (QoL). Materials and Methods: Twenty-six patients suffering from a variable degree of HL and treated with HA have been enrolled. Each of them underwent an evaluation before and 4 months after rehabilitation with HA. The analysis of daily voice production was carried out with the APM, while subjective QoL data were collected through the Speech, Spatial, and Qualities questionnaire (SSQ) and the International Outcome Inventory for Hearing Aids (IOI-HA). The differences in phonatory measurements and subjective evaluations before and after HA rehabilitation were assessed using Wilcoxon signed rank test. The Spearman correlation test was used to analyze the correlation between phonatory measurements, auditory measurements, and SSQ scores. Results: Significant differences in the APM parameters before and after HA rehabilitation were found. After 4 months of HA use, we recorded a significant increase in phonation time and percentage of phonation time and a significant decrease in average amplitude in dB SPL. We also found a significant increase in the SSQ scores after HA rehabilitation. Finally, we were able to detect low but significant correlations between phonatory measurements and SSQ results. Conclusions: The APM proved to be a useful instrument in the evaluation of the benefits of HA and its measurements can be used as indicators of the participation in communication and social life of patients with HL, which are strongly related to QoL.

1.
Lopez-Poveda EA, Johannesen PT, Pérez-González P, Blanco JL, Kalluri S, Edwards B. Predictors of hearing-aid outcomes. Trends Hear. 2017;21:233121651773052.
2.
Gao J, Hu H, Yao L. The role of social engagement in the association of self-reported hearing loss and health-related quality of life. BMC Geriatr. 2020;20(1):182.
3.
Kivimäki M, Singh-Manoux A. Prevention of dementia by targeting risk factors. Lancet. 2018;391(10130):1574–5.
4.
World Health Organization. World report on hearing. Geneva: World Health Organization; 2021. [cited 19 january 2022]. Available from: https://apps.who.int/iris/handle/10665/339913.
5.
Selleck MA, Sataloff RT. The impact of the auditory system on phonation: a review. J Voice. 2014;28(6):688–93.
6.
Mora R, Crippa B, Cervoni E, Santomauro V, Guastini L. Acoustic features of voice in patients with severe hearing loss. J Otolaryngol Head Neck Surg. 2012;41(1):8–13.
7.
Dehqan A, Scherer RC. Objective voice analysis of boys with profound hearing loss. J Voice. 2011;25(2):e61–5.
8.
Hamzavi J, Deutsch W, Baumgartner WD, Denk DM, Adunka O, Gstoettner W. [Cochlear implantation and auditory feedback]. Wien Klin Wochenschr. 2000;112(11):515–8.
9.
Ubrig MT, Goffi-Gomez MVS, Weber R, Menezes MHM, Nemr NK, Tsuji DH, et al. Voice analysis of postlingually deaf adults pre- and postcochlear implantation. J Voice. 2011;25(6):692–9.
10.
Mozzanica F, Schindler A, Iacona E, Ottaviani F. Application of Ambulatory Phonation Monitoring (APM) in the measurement of daily speaking-time and voice intensity before and after cochlear implant in deaf adult patients. Auris Nasus Larynx. 2019;46(6):844–52.
11.
Medved DMS, Cavalheri LMR, Coelho AC, Fernandes ACN, Silva EMD, Sampaio ALL. Systematic review of auditory perceptual and acoustic characteristics of the voice of cochlear implant adult users. J Voice. 2021;35(6):934.e7–934.e16.
12.
Lee GS, Liu C, Lee SH. Effects of hearing aid amplification on voice F0 variability in speakers with prelingual hearing loss. Hear Res. 2013;302:1–8.
13.
Hillman RE, Heaton JT, Masaki A, Zeitels SM, Cheyne HA. Ambulatory monitoring of disordered voices. Ann Otol Rhinol Laryngol. 2006;115(11):795–801.
14.
Cheyne HA, Hanson HM, Genereux RP, Stevens KN, Hillman RE. Development and testing of a portable vocal accumulator. J Speech Lang Hear Res. 2003;46(6):1457–67.
15.
Cantarella G, Iofrida E, Boria P, Giordano S, Binatti O, Pignataro L, et al. Ambulatory phonation monitoring in a sample of 92 call center operators. J Voice. 2014;28(3):393.e1–393.e6.
16.
Mozzanica F, Selvaggio A, Ginocchio D, Pizzorni N, Scarponi L, Schindler A. Speech and language pathologists’ voice use in working environments: a field study using ambulatory phonation monitoring. Folia Phoniatr Logop. 2016;68(6):268–73.
17.
Lyberg Åhlander V, Pelegrín García D, Whitling S, Rydell R, Löfqvist A. Teachers’ voice use in teaching environments: a field study using ambulatory phonation monitor. J Voice. 2014;28(6):841.e5–15.
18.
Švec JG, Titze IR, Popolo PS. Estimation of sound pressure levels of voiced speech from skin vibration of the neck. J Acoust Soc Am. 2005;117(3 Pt 1):1386–94.
19.
Kodera K, Hosoi H, Okamoto M, Manabe T, Kanda Y, Shiraishi K, et al. Guidelines for the evaluation of hearing aid fitting. Auris Nasus Larynx. 2016;43(3):217–28.
20.
Gatehouse S, Noble W. The speech, spatial and qualities of hearing scale (SSQ). Int J Audiol. 2004;43(2):85–99.
21.
Cox RM, Stephens D, Kramer SE. Translations of the International Outcome Inventory for Hearing Aids (IOI-HA): traducciones del Inventario Internacional de Resultados para Auxiliares Auditivos (IOI-HA). Int J Audiol. 2002;41(1):3–26.
22.
Cox RM, Alexander GC, Beyer CM. Norms for the international Outcome inventory for hearing aids. J Am Acad Audiol. 2003;14(08):403–13.
23.
Kozlowski L, Almeida G, Ribas A. Level of user satisfaction with hearing aids and environment: the international Outcome inventory for hearing aids. Int Arch Otorhinolaryngol. 2014;18(3):229–34.
24.
Hinkle DE, Wiersma W, Jurs SG. Applied statistics for the behavioral sciences. Boston, Mass, London: Houghton Mifflin; 2003. [Hi Marketing] (distributor); [Cited 6 July 2022]. Available from: http://catalog.hathitrust.org/api/volumes/oclc/50716608.html.
25.
Remacle A, Morsomme D, Finck C. Comparison of vocal loading parameters in kindergarten and elementary school teachers. J Speech Lang Hear Res. 2014;57(2):406–15.
26.
Szabo Portela A, Hammarberg B, Södersten M. Speaking fundamental frequency and phonation time during work and leisure time in vocally healthy preschool teachers measured with a voice accumulator. Folia Phoniatr Logop. 2013;65(2):84–90.
27.
Buckley KL, O’Halloran PD, Oates JM. Occupational vocal health of elite sports coaches: an exploratory pilot study of football coaches. J Voice. 2015;29(4):476–83.
28.
Brumm H, Zollinger SA. The evolution of the Lombard effect: 100 years of psychoacoustic research. Beyond Behav. 2011;148(11–13):1173–98.
29.
Franca MC, Wagner JF. Effects of vocal demands on voice performance of student singers. J Voice. 2015;29(3):324–32.
30.
Debruyne F, Buekers R. Interdependency between intensity and pitch in the normal speaking voice. Acta Oto-Rhino-Laryngol Belg. 1998;52(3):201–5.
31.
Noble W, Gatehouse S. Effects of bilateral versus unilateral hearing aid fitting on abilities measured by the Speech, Spatial, and Qualities of Hearing scale (SSQ): efectos de la adaptación uni o bilateral de auxiliares auditivos en las habilidades medidas la escala de cualidades auditiva, espacial y del lenguaje (SSQ). Int J Audiol. 2006;45(3):172–81.
32.
Pennini PTM, Almeida K. Speech, spatial and qualities of hearing scale in assessing the benefit in hearing aid users. CoDAS; 2021 [citato 17 gennaio 2023]. Available from: http://www.scielo.br/j/codas/a/fFRyYhxQNXZ9qqF7TCZZw7n/citation/?lang=en.
33.
Maruthy M, Maruthy S, Kumar UA, Gnanateja GN. Auditory and cognitive attributes of hearing aid acclimatization in individuals with sensorineural hearing loss. Am J Audiol. 2019;28(S2):460–71.
34.
Cox RM, Alexander GC. The international Outcome inventory for hearing aids (IOI-HA): psychometric properties of the English version. Int J Audiol. 2002;41(1):30–5.
35.
Holman JA, Drummond A, Naylor G. Hearing aids reduce daily-life fatigue and increase social activity: a longitudinal study. Trends Hear. 2021;25:23312165211052786.
36.
Fisher DE, Li CM, Hoffman HJ, Chiu MS, Themann CL, Petersen H, et al. Sex-specific predictors of hearing-aid use in older persons: the age, gene/environment susceptibility: reykjavik study. Int J Audiol. 2015;54(9):634–41.
37.
Sawyer CS, Armitage CJ, Munro KJ, Singh G, Dawes PD. Correlates of hearing aid use in UK adults: self-reported hearing difficulties, social participation, living situation, health, and demographics. Ear Hear. 2019;40(5):1061–8.
38.
Most T, Adi-Bensaid L, Shpak T, Sharkiya S, Luntz M. Everyday hearing functioning in unilateral versus bilateral hearing aid users. Am J Otolaryngol. 2012;33(2):205–11.
39.
Banh J, Singh G, Pichora-Fuller MK. Age affects responses on the speech, spatial, and qualities of hearing scale (SSQ) by adults with minimal audiometric loss. J Am Acad Audiol. 2012;23(2):081–91; quiz 139-40.
40.
Bottalico P, Ipsaro Passione I, Astolfi A, Carullo A, Hunter EJ. Accuracy of the quantities measured by four vocal dosimeters and its uncertainty. J Acoust Soc Am. 2018;143(3):1591–602.
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