Objectives: To examine the effects of an auricular prosthesis on sound levels at the entrance of the ear canal by measuring the auricular prosthesis transfer function (APTF) and to determine the effect of the prosthesis on speech recognition in noisy hearing conditions. Methods: Eight prostheses were used to measure the APTF. A microphone at the entrance of the ear canal measured sound pressure levels with the prosthesis present or absent while the head was rotated 360° at 30° increments. The Hearing in Noise Test was modified by the APTF to simulate the absence of an auricular prosthesis. Speech recognition was measured by testing 11 subjects with the unmodified Hearing in Noise Test and the modified Hearing in Noise Test. Results: The APTF changed with the head's position relative to the speaker. The mean (SD) maximal gain provided by an auricular prosthesis was 8.1 (2.7) dB at 4.6 (1.0) kHz and 9.7 (1.7) dB at 11.5 (0.9) kHz at 0° rotation. During speech testing, the auricular prosthesis improved the mean (SD) signal to noise ratio by 1.7 (1.7) dB at 0° (P< .001), 0.9 (2.2) dB at 90° (P=.04), and 0.5 (2.3) dB at 180° (P=.52). Conclusions: The acoustic gain provided by an auricular prosthesis increases speech recognition in noisy environments. Auricular prostheses not only restore aesthetics but also improve hearing.
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