Audiology

There are three types of hearing loss:

1. Conductive hearing loss affects the outer or middle ear, including the ear canal, eardrum, ossicles or airspace behind the eardrum. Common causes of conductive hearing loss include obstruction of the ear canal by wax accumulation, ear infections, boney growths, holes in the eardrum from injury or infection, diseases involving the middle ear bones and accumulation of fluid behind the eardrum.
2. Sensorineural hearing loss occurs when there is a problem with the inner ear. There are many causes of sensorineural loss, but the most common are the aging process and exposure to loud noise.
3. Mixed hearing loss describes an impairment caused by both conductive and sensorineural problems.

The severity of hearing loss varies from person to person. There are seven degrees of hearing between the two extremes of hearing well and hearing nothing: normal, slight, mild, moderate, moderately severe, severe and profound. Most hearing losses are mild to moderate.

1. Normal hearing loss (-10–15 dB) means your can understand sounds and speech easily in most environments.
2. Slight hearing loss (16–25 dB) slightly impacts your listening abilities but still allows you to hear most soft sound, even in moderate background noise.
3. Mild hearing loss (26–40 dB) means you are unable to hear soft sounds and have difficulty understanding speech clearly in noisy environments.
4. Moderate hearing loss (41–55 dB) means you are unable to hear soft and moderately loud sounds and have considerable difficulty understanding speech, particularly with background noise.
5. Moderately severe hearing loss (56–70 dB) means you are unable to hear most sounds in a normal decibel range and have very limited communication abilities without a hearing device.
6. Severe hearing loss (71–90 dB) means some loud sounds are audible but communication without a hearing instrument is impossible.
7. Profound hearing loss (91+ dB) means you may hear some extremely loud sounds but communication without a hearing instrument is impossible.

Today’s hearing aids use digital technology and cutting-edge features to gather, modify and deliver clear, quality sound. Although hearing instruments help a vast majority of patients hear better, it’s important to have realistic expectations. Some advantages and limitations of hearing devices include:

• Hearing devices allow you to hear speech and sound you’ve been missing.
• Hearing instruments enable you to communicate more comfortably.
• Hearing aids let family and friends communicate more easily with you.
• Understanding and using hearing instruments is simple and straightforward.
• Using just one hearing aid can decrease your understanding but will not necessarily cause the opposite ear’s hearing to worsen.
• When fitted properly, hearing instruments don’t cause further damage to your hearing.
• Hearing loss won’t get worse as a result of not using hearing instruments, though it’s likely to worsen gradually due to other factors.
• No hearing instrument will eliminate all background noise.
• Hearing aids don’t restore natural hearing, as there is not yet a substitute for the real auditory system.

The signs and symptoms of hearing loss are easy to understand, but many patients still struggle to recognize them. Some common signs of hearing loss include:

• Frequently thinking people are mumbling
• Hearing speech but having trouble understanding it
• Asking people to repeat themselves regularly
• Finding telephone conversations increasingly difficult
• Playing the radio or TV too loudly for other family members
• Not hearing normal household sounds you once noticed (e.g. a dripping faucet or the doorbell)
• Having trouble hearing when you’re not facing the speaker
• Being told you speak too loudly
• Experience ringing in your ears (tinnitus)
• Struggling to understand conversation in large groups or crowds

Protecting your ears is the key to hearing loss prevention. If your job exposes you to hazardous noises, make sure proper safety equipment is provided, and that it meets state and federal regulations. Hearing protection – earplugs and earmuffs – is essential when working around loud equipment. It’s always a good idea to bring along earplugs if you’re participating in a noisy recreational activity (e.g., a football game or rock concert), as well.

At home, limit your exposure to noisy activities, and keep the volume down – on the television, stereo and especially when it comes to personal music players. Prevent other types of hearing loss by refraining from inserting cotton swabs or other objects into your ears, blowing your nose gently through both nostrils and quitting smoking. Studies show those who use tobacco are more likely to suffer from hearing loss.

Regardless of your age, have your hearing tested regularly. Early detection is key. While noise-related hearing loss can’t be reversed, you can still take steps to avoid further damage to your hearing.

Persistent, unwanted, subjective sound in your ears or head is a common symptom called tinnitus. It’s often described as a ringing, roaring, buzzing, pulsating or hissing sound. Tinnitus can occur in one or both ears and can be intermittent or continuous.

The causes of tinnitus are numerous and not all are known or fully understood. However, some cases of tinnitus can be attributed to problems of the jaw joint, outer ear canal, eardrum, middle ear, inner ear, hearing nerve, brain or cardiovascular system.

In some cases, tinnitus can be relieved by successfully treating the underlying condition causing it. In most cases, though, there is no cure. However, there are several tinnitus treatments currently available. To determine the right treatment plan for your needs, your doctor will investigate your problem by performing an examination and hearing tests.

Feedback is a high-pitched whistle or squeal that can come from hearing instruments while they’re being worn. There are two types of feedback: normal feedback, which can occur in some hearing instruments when something is placed close to or over the instrument, and abnormal feedback, which occurs frequently and unexpectedly with head and jaw motion, even when the hearing instrument is properly inserted in the ear. If this occurs, see a professional audiologist.

Common causes of feedback include:

• Wax blocking the ear canal
• An improperly inserted hearing aid
• Poor physical fit in your ear
• Debris blocking the device’s microphone or receiver
• Instrument malfunction
• A weak or dead battery

There are many reasons for hearing devices’ high price tag:

• Research and development. Manufacturers spend millions of dollars every year trying to build the best hearing instruments possible using the latest technologies.
• Limited market. The hearing instrument industry is relatively small, with only about two million hearing aids sold each year. While that sounds like a lot, it represents only 2% of the population.
• Medical precision. Hearing instruments are not an “off the shelf” consumer product. They are medical devices regulated by the Food and Drug Administration that are prescribed by an audiologist.
• Features and functions. Modern hearing aids are laden with programming and features. Hearing health care professionals spend a significant amount of time fitting, programming, adjusting and testing during the initial fitting and follow-up visits.
• Dispensing services. Equipment needed to properly dispense hearing instruments is also expensive. Hearing aid dispensers must have a fully staffed and equipped office along with all the other amenities that make the delivery of professional services in a comfortable environment a pleasant experience.

Assistive listening devices (ALDs) are special instruments that help in specific situations where hearing aids may not be enough. ALDs can be helpful in many settings, such as when you’re watching a movie, attending a church service, participating in a conference, talking on the phone or listening to the radio or television.

Alerting devices can help you hear important sounds like the phone ringing, your alarm going off or the doorbell buzzing. They make sounds like these louder and can also be programmed to alter the pitch for your individual hearing needs. There are also visual alerting devices such as strobe lights and messaging systems.

There is an old saying, “when you are ready, you will know.” Unfortunately this often doesn’t apply to hearing aids. Hearing loss occurs slowly and is painless so the hearing loss may not be obvious to the person in question. Hearing aids often retain a stigma that a person is “old” or somehow “disabled” if they are used. This certainly is not true but people will often resist wearing a hearing aid because of this. Compound these factors with the number of complaints offered by disgruntled hearing aid users (or ex-users), and we can readily understand why only 10% of the hard-of-hearing population are fit with hearing aids.

There is another old saying that “a hearing aid is less conspicuous than your hearing loss.” We believe this is quite true. Encourage your family member to have his/her hearing tested without any discussion of hearing aids. Perhaps he/she will become more interested in his/her type and degree of hearing loss if he/she is assured that no one will be delivering a “sales pitch.” Hearing aid trials are generally possible at a minimal cost. If the person continues to resist testing, the family may have few options other than allow him/her to experience the consequences and frustrations of hearing loss.

There are many self assessment items to determine your level of hearing effectiveness. Having your hearing tested by a hearing instrument specialist is a great starting point. If hearing aids are recommended, make sure there is a trial period offered which allows you to return the hearing aids at a low cost if the performance of the hearing aids is less than satisfactory.

Discuss styles and circuitry options with your hearing instrument specialist. Have the hearing instrument specialist explain the advantages and disadvantages of each type. Together agree on a course of action. Comparison shopping can be a good idea. However, make certain that you are comparing the same styles and types of circuitry. This can be very misleading.

Regular maintenance can help keep them in great working condition, but once in a while, they may need servicing or repair. If you have tried the troubleshooting tips below and still can’t get your hearing aids to work properly, please contact us to schedule an evaluation.

If your hearing aids aren’t working properly, try the following techniques for a quick fix.

If there is no sound:

• Make sure the battery is inserted correctly
• Replace the battery if you suspect it is dead or weak
• Remove excess earwax from earmold or replace wax guard
• Check tubing for wax buildup or moisture; clean with blower tool
• Make sure hearing aid isn’t accidentally set to telecoil mode

If you are experiencing feedback or whistling:

• Remove and reinsert your hearing aids
• Turn down the volume
• Make sure there is nothing blocking or covering your hearing aids
• Have your doctor check your ears for excess wax and remove if necessary

If the sound is weak or distorted:

• The battery may be dead or weak; replace it
• Open the battery compartment and clean the contacts with a dry cloth
• Clean the earmold or tubing with wax removal tools; replace wax guard