Effect of Hearing Aids on Phonation and Perceived Voice Qualities.

Problems with own-voice sounds are common in hearing aid users. As auditory feedback is used to regulate the voice, it is possible that hearing aid use affects phonation. The aim of this paper is to compare hearing aid users' perception of their own voice with and without hearing aids and any effect on phonation. Eighty-five first-time and 85 experienced hearing aid users together with a control group of 70 completed evaluations of their own recorded and live voice in addition to two external voices. The participants' voice recordings were used for acoustic analysis. The results showed moderate to severe own-voice problems (OVP) in 17.6% of first-time users and 18.8% of experienced users. Hearing condition was a significant predictor of the perception of pitch in external voices and of monotony, lower naturalness, and lower pleasantness in their own live voice. The groups with hearing impairment had a higher mean fundamental frequency (f0) than the control group. Hearing aids decreased the speaking sound pressure level by 2 dB on average. Moreover, acoustic analysis shows a complex relationship between hearing impairment, hearing aids, and phonation and an immediate decrease in speech level when using hearing aids. Our findings support previous literature regarding auditory feedback and voice regulation. The results should motivate clinicians in hearing and voice care to routinely take hearing functions into account when assessing voice problems.