Hearing Loss Solutions
Almost everybody knows someone who has been affected by some degree of hearing loss. While hearing impairment can be the result of heredity, it also is a natural and graduated result of the aging process and/or noise exposure.
At Austin ENT Clinic Pediatric & Adult Care, we deal with people of all ages who are interested in finding out more about hearing loss, either for themselves or for a family member. It’s not uncommon for people suffering from hearing loss to be defensive or in denial about it.
Our goal is to help you learn more about the hearing process, hearing loss, and the scientific advances the hearing community has made in the last several years to bring hearing back to the hearing impaired. We foster the tradition of better hearing through education, technology, and customer service.
About Hearing Devices
We are an Austin ENT Clinic is a full-service practice that was founded to help members of our community get more from a local hearing care provider. Our comprehensive services include hearing testing, hearing aid evaluations, and hearing aid sales and repair. We offer an array of hearing aids and devices to fit the needs of all our patients.
How Does a Hearing Aid Work?
A hearing aid is a small electronic device that you wear in or behind your ear. It makes some sounds louder so that a person with hearing loss can listen, communicate, and participate more fully in daily activities. A hearing aid can help people hear more in both quiet and noisy situations. However, only about 1 out of 5 people who would benefit from a hearing aid actually uses one.
A hearing aid has three basic parts: a microphone, amplifier, and speaker. The hearing aid receives sound through a microphone, which converts the sound waves to electrical signals and sends them to an amplifier. The amplifier increases the power of the signals and then sends them to the ear through a speaker.
Digital Hearing Aids
The digital revolution has made a huge impact on the way hearing aids look, feel, and work. They can be so small that they are virtually invisible, so "cool" looking that you will want everyone to see them, and so natural sounding that they mimic the way you used to hear before you experienced hearing loss.
- Dual microphones allow you to hear better in noisy situations. Some can even identify the source of the noise and reduce it.
- Open technology that keeps the ear canal unobstructed eliminates that "talking in a barrel" effect.
- Feedback cancellation does just that... it cancels feedback BEFORE you hear it as an annoying whistle.
- Hands-free technology automatically adjusts to your listening environment... whether you are on the phone, in a crowd, or in wind.
- Your digital hearing aid can be programmed with a computer to meet your individualized needs.
- Wireless technology allows you to hear your cell phone, television, and home phone in stereo, directly through your hearing aids!
There are so many options available - economy, basic, advanced, and best. Each level offers digital hearing solutions based on your level of hearing loss, lifestyle, and budget. Our audiologist will review your choices and help you determine which is best for your lifestyle and budget.
A cochlear implant is a device that restores a sense of sound for people with severe to profound hearing loss. The implant system consists of the internal implant and externally worn equipment. The implant is surgically placed under the skin with an electrode array inserted into the inner ear. The external equipment is worn similarly to a hearing aid and includes a microphone, sound processor, and transmitter.
- The microphone picks up sound from the environment. The sound processor is a tiny computer worn over the ear that takes the sound and converts it into digital information.
- The transmitter receives signals from the sound processor and sends them to the internal implant.
- The implant converts the signal from the transmitter to electric impulses. The electrode array sends the impulses to the auditory nerve.
- The auditory nerve sends the signals to the brain.
Cochlear implants are different from conventional amplification, such as hearing aids. Using state-of-the-art technology, a cochlear implant bypasses the damaged part of an ear and sends electrical signals directly to the brain via the auditory nerve. By bypassing the damaged part of the ear, the cochlear implant is able to provide sound detection across all pitches improving signal clarity.
The use of a cochlear implant alone, bilaterally, or bimodally with a hearing aid in the non-implanted ear, improves speech perception, significantly allowing recipients to become more active participants in their daily activities.
Who is a cochlear implant candidate?
A cochlear implant candidate experiences severe to profound hearing loss bilaterally, and/or significantly impaired speech recognition. Expanding indications for cochlear implantation include ski-slope hearing loss and single-sided deafness. If hearing aids are providing limited benefit, one of our ENT specialists and audiologists can evaluate you to determine if you are a candidate for a cochlear implant.
The evaluation includes a medical assessment, audiological testing with and without amplification, speech perception testing, and CT scan. Speech-language evaluation and psychological evaluation may also be required. A meningitis vaccination is required of all cochlear implant recipients.
Cochlear implants are approved by the FDA for adults and children as young as 12 months of age.
Austin ENT Clinic offers all FDA-approved cochlear implant devices, including electroacoustic stimulation (hybrid) cochlear implants.
Hearing Aid FAQs
Hearing aids are primarily useful in improving the hearing and speech comprehension of people who have hearing loss that results from damage to the small sensory cells in the inner ear, called hair cells. This type of hearing loss is called sensorineural hearing loss. The damage can occur as a result of disease, aging, or injury from noise or certain medicines.
A hearing aid magnifies sound vibrations entering the ear. Surviving hair cells detect the larger vibrations and convert them into neural signals that are passed along to the brain. The greater the damage to a person's hair cells, the more severe the hearing loss, and the greater the hearing aid amplification needed to make up the difference.
However, there are practical limits to the amount of amplification a hearing aid can provide. In addition, if the inner ear is too damaged, even large vibrations will not be converted into neural signals. In this situation, a hearing aid would be ineffective.
If you think you might have hearing loss and could benefit from a hearing aid, visit Austin ENT Clinic. One of our otolaryngologists will evaluate the cause of your hearing loss. One of our audiologists will identify and measure your hearing loss to assess the type and degree of loss. She will then select and fit you with an appropriate amplification device or assistive listening device as needed.
There are three basic styles of hearing aids. They differ by size, their placement on or inside the ear, and the degree to which they amplify sound.
Behind-the-ear (BTE) hearing aids consist of a hard plastic case worn behind the ear and connected to a plastic ear mold that fits inside the outer ear. The electronic parts are held in the case behind the ear. BTE aids are used by people of all ages for mild to profound hearing loss.
Open Fit Behind-the-Ear
Open fit behind-the-ear aids fit behind the ear completely, with only a narrow tube inserted into the ear canal, to enable the canal to remain open. For this reason, open-fit hearing aids may be a good choice for people who experience a buildup of earwax, since this type of aid is less likely to be damaged by such substances.
Some people may prefer the open-fit hearing aid because their perception of their voice does not sound “plugged up.” Open Fit BTE aids are used by adults for mild to moderately-severe degree of hearing loss.
Receiver-in-the-Canal (RIC) or Receiver-in-the-Ear (RITE)
Receiver-in-the-canal (RIC) or receiver-in-the-ear (RITE) hearing aids include a hard plastic case worn behind the ear and connected with a thin wire to a small plastic ear piece that fits inside the outer ear. The RIC or RITE aids are sleeker and smaller because the actual receiver of the hearing aid, which sends sounds to the ear canal, sits directly inside of the ear canal with the small ear piece on the end of the thin wire.
RIC or RITE aids are used by adults for mild to severe degree of hearing loss depending on the size of the ear piece that sits in the ear canal. The greater the degree of hearing loss, the thicker and larger the plastic ear piece that sits in the ear canal.
In-the-ear (ITE) hearing aids fit completely inside the outer ear and are used for mild to severe hearing loss. The case holding the electronic components is made of hard plastic. ITE aids usually are not worn by young children because the casings need to be replaced often as the ear grows or changes in shape, for example, if one gains or loses weight.
Canal aids fit into the ear canal and are available in two styles. The in-the-canal (ITC) hearing aid is made to fit the size and shape of a person's ear canal. A completely-in-canal (CIC) hearing aid is nearly hidden in the ear canal. Both types are used for mild to moderately severe hearing loss.
Because they are small, canal aids may be difficult for a person to adjust and remove. In addition, canal aids have less space available for batteries and additional features. They usually are not recommended for young children or for people with severe to profound hearing loss because their reduced size limits their amount of power and volume to help the patient hear.
Hearing aids work differently depending on the electronics used. The two main types of electronics are analog and digital.
Analog aids convert sound waves into electrical signals, which are amplified. Analog/adjustable hearing aids are custom built to meet the needs of each user. The aid is programmed by the manufacturer according to the specifications recommended by your audiologist.
Analog/programmable hearing aids have more than one program or setting. An audiologist can program the aid using a computer, and the user can change the program for different listening environments – from a small, quiet room to a crowded restaurant to large, open areas, such as a theater or stadium.
Analog/programmable circuitry can be used in all types of hearing aids. Analog aids usually are less expensive than digital aids.
Digital aids convert sound waves into numerical codes, similar to the binary code of a computer, before amplifying them. Because the code also includes information about a sound's pitch or loudness, the aid can be specially programmed to amplify some frequencies more than others.
Digital circuitry gives an audiologist more flexibility in adjusting the aid to a user's needs and to certain listening environments. These aids also can be programmed to focus on sounds coming from a specific direction. Digital circuitry can be used in all types of hearing aids.
The hearing aid that will work best for you depends on the kind and severity of your hearing loss. If you have a hearing loss in both of your ears, two hearing aids are generally recommended because two aids provide a more natural signal to the brain. Hearing in both ears also will help you understand speech and locate where the sound is coming from.
You and your audiologist should select a hearing aid that best suits your needs and lifestyle. Price is also a key consideration because hearing aids range from hundreds to several thousand dollars. Similar to other equipment purchases, style and features affect cost. However, don't use price alone to determine the best hearing aid for you. Just because one hearing aid is more expensive than another does not necessarily mean that it will better suit your needs.
A hearing aid will not restore your normal hearing. With practice, however, a hearing aid will increase your awareness of sounds and their sources. You will want to wear your hearing aid regularly, so select one that is convenient and easy for you to use.
Other features to consider include parts or services covered by the warranty, estimated schedule and costs for maintenance and repair, options and upgrade opportunities, and the hearing aid company's reputation for quality and customer service.
Before you buy a hearing aid, ask your audiologist these important questions:
- What features would be most useful to me?
- What is the total cost of the hearing aid?
- Do the benefits of newer technologies outweigh the higher costs?
- Is there a trial period to test the hearing aids? (Most manufacturers allow a 30- to 60-day trial period during which aids can be returned for a refund.)
- What fees are nonrefundable if the aids are returned after the trial period?
- How long is the warranty?
- Can it be extended?
- Does the warranty cover future maintenance and repairs?
- Can you make adjustments and provide servicing and minor repairs?
- Will loaner aids be provided when repairs are needed?
- What instruction do you provide?
Hearing aids take time and patience to use successfully. Wearing your aids regularly will help you adjust to them.
Become familiar with the features of your hearing aid. With your audiologist present, practice putting in and taking out the aid, cleaning it, identifying right and left aids, and replacing the batteries. Ask how to test it in listening environments where you have problems with hearing. Learn to adjust the aid's volume and to program it for sounds that are too loud or too soft. Work with your audiologist until you are comfortable and satisfied.
You may experience some of the following problems as you adjust to wearing your new aid:
- My hearing aid feels uncomfortable. Some individuals may find a hearing aid to be slightly uncomfortable at first. Ask your audiologist how long you should wear your hearing aid while you are adjusting to it.
- My voice sounds too loud. The “plugged-up” sensation that causes a hearing aid user's voice to sound louder inside the head is called the occlusion effect, and it is very common for new hearing aid users. Check with your audiologist to see if a correction is possible. Most individuals get used to this effect over time.
- I get feedback from my hearing aid. A whistling sound can be caused by a hearing aid that does not fit or work well or is clogged by earwax or fluid. See your audiologist for adjustments.
- I hear background noise. A hearing aid does not completely separate the sounds you want to hear from the ones you do not want to hear. Sometimes, however, the hearing aid may need to be adjusted. Talk with your audiologist.
- I hear a buzzing sound when I use my cell phone. Some people who wear hearing aids or have implanted hearing devices experience problems with the radio frequency interference caused by digital cell phones. Both hearing aids and cell phones are improving, however, so these problems are occurring less often. When you are being fitted for a new hearing aid, take your cell phone with you to see if it will work well with the aid.
Proper maintenance and care will extend the life of your hearing aid. Make it a habit to:
- Keep hearing aids away from heat and moisture.
- Clean hearing aids as instructed. Earwax and ear drainage can damage a hearing aid.
- Avoid using hairspray or other hair care products while wearing hearing aids.
- Turn off hearing aids when they are not in use.
- Replace dead batteries immediately.
- Keep replacement batteries and small aids away from children and pets.
Although they work differently than the hearing aids described above, implantable hearing aids are designed to help increase the transmission of sound vibrations entering the inner ear. A middle ear implant (MEI) is a small device attached to one of the bones of the middle ear. Rather than amplifying the sound traveling to the eardrum, an MEI moves these bones directly. Both techniques have the net result of strengthening sound vibrations entering the inner ear so that they can be detected by individuals with sensorineural hearing loss.
A bone-anchored hearing aid (BAHA) is a small device that attaches to the bone behind the ear. The device transmits sound vibrations directly to the inner ear through the skull, bypassing the middle ear. BAHAs are generally used by individuals with middle ear problems or deafness in one ear.
Because surgery is required to implant either of these devices, many hearing specialists feel that the benefits may not outweigh the risks.
Hearing aids are generally not covered by health insurance companies, although some do. Financing is usually available. For eligible children and young adults ages 21 and under, Medicaid will pay for the diagnosis and treatment of hearing loss, including hearing aids, under the Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) service. Also, children may be covered by their state's early intervention program or State Children's Health Insurance Program (SCHIP).
Medicare does not cover hearing aids for adults; however, diagnostic evaluations are covered if they are ordered by a physician for the purpose of assisting the physician in developing a treatment plan. Since Medicare has declared the BAHA a prosthetic device and not a hearing aid, Medicare will cover the BAHA if other coverage policies are met.
Researchers are looking at ways to apply new signal processing strategies to the design of hearing aids. Signal processing is the method used to modify normal sound waves into amplified sound that is the best possible match to the remaining hearing for a hearing aid user. Researchers funded by the National Institute on Deafness and Other Communication Disorders (NIDCD) also are studying how hearing aids can enhance speech signals to improve understanding.
In addition, researchers are investigating the use of computer-aided technology to design and manufacture better hearing aids. Researchers also are seeking ways to improve sound transmission and to reduce noise interference, feedback, and the occlusion effect. Additional studies focus on the best ways to select and fit hearing aids in children and other groups whose hearing ability is hard to test.
Another promising research focus is to use lessons learned from animal models to design better microphones for hearing aids. NIDCD-supported scientists are studying the tiny fly Ormia ochracea because its ear structure allows the fly to determine the source of a sound easily. Scientists are using the fly's ear structure as a model for designing miniature directional microphones for hearing aids. These microphones amplify the sound coming from a particular direction (usually the direction a person is facing), but not the sounds that arrive from other directions. Directional microphones hold great promise for making it easier for people to hear a single conversation, even when surrounded by other noises and voices.