![]() ![]() Yet, even 15 years later, the final 1977 report to the US Federal Trade Commission (FTC) by the Bureau of Consumer Protection was rather equivocal, at best: In particular, a 1961 study by three bona-fide legends in audiology research-Raymond Carhart, James Jerger, and Donald Dirks-published in two papers described their findings as “remarkably unsuccessful in demonstrating objectively that the hearing impaired derive any significant gain in speech intelligibility from binaural as opposed to monaural hearing aids.” 1,2 However, as Mark Ross later pointed out, the word score tests in this early study were performed in monaural direct orientation, a condition we would now expect to differ least from the binaural scores. Several studies using test methods of that time did not support binaural hearing. ![]() Indeed, when looking back, they had some reason for concern. There were some who believed binaural fittings were downright unethical and motivated by profit. This probably added to some “disconnect” between clinical audiology and practical dispensing. Additionally, prior to 1978, the role of the audiologist was to test and recommend hearing aids, but not dispense the devices. It should be acknowledged that monaural eyeglass aids were a very popular style in the 1960s, and may have complicated the debate. Figure 1 shows that fewer than one-quarter of all US hearing aids fit prior to 1980 were binaural, and controversies swirled around the benefit of binaural fittings well into the late-70s. However, the road to this particular “best practice”-with probably around 85% of all of today’s fittings involving two hearing aids-was not a smooth one in the United States. Act 1: Challenges and Questions about Binaural Benefitīinaural hearing aid fittings have completely changed the hearing healthcare landscape for the better. Percentage of binaural (in red) versus monaural hearing aid fittings (in blue) from 1975 to 2016 in the United States, as reported by Hearing Instruments and Hearing Review surveys of hearing care professionals (HCPs). Essentially, it has all (okay, maybe just some!) of the key movie elements found in a science thriller: legendary hearing researchers indicating binaural aids weren’t particularly beneficial leading hearing aid specialists saying they were more legendary researchers and clinicians re-assessing the question and coming to new conclusions-all against a backdrop of finger-pointing and accusations about self-interests and profits, as well as a pivotal ruling by the Supreme Court. If you wanted to produce a movie about a controversy in audiology, then binaural amplification might be the subject with the most plot twists and turns.
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