Hearing Loss and Hearing Aids

Sunday, August 01, 2004

Approximately 28 million Americans suffer from some degree of hearing impairment. Hearing loss among seniors is the third most prevalent, but treatable disabling condition, behind arthritis and hypertension.

Hearing loss affects approximately 17 in 1,000 children under age 18. The prevalence of hearing loss increases with age. Up to 1 in 3 over the age of 65 has hearing impairment. Hearing is one of the body’s major senses; therefore, a loss of this sense can create severe obstacles in a person’s life. Hearing loss can lead to isolation, withdrawal, depression, frustration, confusion and stress.

Prejudice against and embarrassment of hearing impairment prevent close to 15 million people from getting help for a condition that is typically treatable through hearing aids. Hearing aids, although not perfect, can help improve the quality of one’s life.

What causes a hearing loss?

Medically, there are two major types of hearing loss:

  • Conductive hearing loss involves the outer and middle ear. This type of hearing loss can be caused by a variety of problems including buildup of earwax (cerumen), a punctured eardrum, ear infections, or birth defects. Typically, a conductive hearing loss can be corrected either medically or surgically.

  • Sensorineural hearing loss develops when the auditory nerve or hair cells in the inner ear are damaged by aging, loud noise exposure, head trauma, viral and bacterial infections, toxic medications, or an inherited condition. Medical or surgical intervention cannot correct most sensorineural hearing losses. However, hearing aids may effectively help reclaim some sounds that a person is missing.

What are some problems that people with hearing loss may experience?

The hearing impaired person may start to exhibit some of the following signs:

  • difficulty hearing conversations, especially in the presence of background noise

  • turning the volume of the television or radio up so high that others complain

  • complaining that everyone mumbles

  • fatigue and irritation caused by the effort to hear

  • ear infections, dizziness, or roaring/ ringing in the ears (Tinnitus)

  • misunderstand what people are saying

If a person has difficulty with one or more of these issues, they should seek a medical and hearing examination performed by an otolaryngologist (ENT) and audiologist, respectively.

What is a hearing aid?

A hearing aid, in the most basic terms, is an electronic device that receives sounds, amplifies it, and transmits this stronger sound down the ear canal into the ear to allow for improved communication. Based on the results of the hearing test, the audiologist can determine whether you may be a candidate for hearing aids.

What is the appropriate hearing aid for me?

Selecting the correct hearing aid for you should reflect your needs, preferences, and budget. The following considerations should be made by the audiologist as well as the individual:

  • the individual’s lifestyle and level of activity

  • the individual’s physical characteristics, limitations and dexterity

  • any medical condition the individual may have

  • the individual’s cosmetic and style preference

  • the individual’s budget

Usually, if the individual has a hearing loss in both ears, binaural amplification (two hearing aids) is recommended. The advantage of two hearing aids is the enhanced ability to localize the sound source, better balance of hearing (stereo hearing) and greater ability to distinguish sounds in the presence of background noise.

There are instances where the quality of one ear may be very different from the other ear; therefore, one hearing aid may be warranted.

What are the different styles and features of hearing aids?

There are several types of hearing aids available today. Each type offers different advantages, depending on its design, levels of amplification and size. There are four basic styles of hearing aids:

  1. Behind-the-Ear (BTE) hearing aid for mild to profound hearing loss is worn behind the ear and is connected to an ear mold that fits into the ear canal.

  2. In-the-Ear (ITE) hearing aid for mild to severe hearing loss fits into the outer ear and extends into the canal. 3. In-the-Canal (ITC) hearing aid is customized to fit into the ear canal for mild to moderately-severe hearing losses.

  3. Completely-in-Canal (CIC) hearing aid suitable for mild to moderate hearing loss concealed in the ear canal and is the smallest hearing aid available.

Thanks to advances in technology, there are several features available on particular hearing aids that can help with a person’s success with a hearing device. Some features include the option of a telecoil (T-coil) which is designed to help those individuals who have difficulty listening on the telephone.

Another optional feature is directional microphones. Hearing aids cannot eliminate the presence of background noise, which is a common complaint among individuals with hearing loss. However, directional microphones have evolved to aid in reducing the amount of background noise present. The option of these features depends on the severity of the hearing loss and style of the hearing instrument selected.

What can I expect from a hearing aid?

Using hearing aids successfully requires patience, time and realistic expectations. Hearing aids cannot restore a person’s hearing to “normal” nor can they cure a hearing problem. Adjusting to hearing aids is a gradual process that involves becoming accustomed to hearing different sounds that you may not have heard in a while and learning to listen in a variety of environments.

It takes effort to learn these new skills, but once mastered, they can help you experience a more active, enjoyable and rewarding life. The person’s family also plays an important role in the hearing impaired person’s adjustment to amplification.

How expensive are hearing aids?

Hearing aids vary in price according to style, technology and electronic features. Prices can range from hundreds of dollars to more than $2,500 per ear for a high end digital hearing aid.

Digital technology is the most advanced and sophisticated technology available today. It allows the hearing aid to be precisely programmed to match the patient’s individual hearing loss at specific frequencies. They also offer improved clarity of sound, less distortion, more flexibility in programming capabilities and adjust automatically for various sounds. Purchase price of a hearing aid should not be the only consideration in buying a hearing instrument.

Product reliability, customer service and the improvement in the quality of one’s life should all play a part in deciding if a hearing aid is suitable for you.

Charlotte Moreau, Au.D., CCC-ACharlotte Moreau, Au.D.
Clinical Audiologist