FAQ
What are the different kinds of hearing losses?
Hearing voices of family, friends and the sounds of nature are some of life's greatest pleasures. Since hearing plays such a vital role in one's life, we should make every effort to maintain and if necessary, improve our hearing.
Nearly 18 million people suffer needlessly from hearing impairment. Today, virtually all hearing loss can be corrected through medical treatment or surgery, or assisted with amplification.
Three types of hearing loss can occur:
- Conductive hearing loss results from a medical problem in the external ear (ear canal) or middle ear (the air space behind the eardrum). Obstruction of the ear canal by wax accumulation, infection, or bony growths may result in hearing impairment. A hole in the eardrum from injury or infection, diseases involving the middle ear bones, or accumulation of fluid behind the eardrum can also result in hearing loss. Medical intervention is usually successful in correcting the hearing loss. Occasionally, a hearing instrument may also be used to further improve one's hearing.
- Sensorineural hearing loss, also known as nerve loss, occurs when there is a problem with the nerves of the inner ear. There are many causes of sensorineural loss, but the most common are the aging process and exposure to noise. Most of these losses can be assisted by the use of hearing instruments.
- Mixed-type hearing loss is due to a combination of the conductive and sensorineural losses.
Problems associated with hearing loss may include difficulty understanding conversations, especially in the presence of background noise, difficulty locating and detecting environmental sounds, acute or chronic dizziness, pain or discomfort, drainage from the ears, and ringing or other types of head noises.
What can I expect a hearing instrument to do for me?
There are several types of hearing losses. Some people can be treated medically while others may benefit significantly through the use of hearing instruments. Although hearing instruments do help people to hear better, there are some realistic expectations that should be kept in mind. Listed below are a few of the advantages and limitations of amplification.
- Hearing instruments enable those with hearing loss to hear what they have been missing.
- Hearing instruments do enable one to hear communication more comfortably.
- Use of hearing instruments will enable family and friends to more easily communicate with those who have a hearing loss.
- Hearing instruments are easy devices to learn to utilize.
- Utilizing a hearing instrument in only one ear will not necessarily cause the opposite ear to become worse.
- When fitted properly, hearing instruments do not cause one's hearing to become worse.
- A person's hearing loss will not become worse as a result of not using hearing instruments. If it occurs, it is due to other factors.
- No hearing instrument will eliminate all background noise.
- Hearing aids do not make one's hearing normal; there is not yet a substitute for the real ear.
What are some of the signs I have a hearing loss?
- People seem to mumble more frequently.
- You hear but have trouble understanding all the words in a conversation.
- You often ask people to repeat themselves.
- You find telephone conversation increasingly difficult.
- Your family complains that you play the radio or TV too loudly.
- You no longer hear normal household sounds, such as the dripping of a faucet or the ringing of a doorbell.
- You have trouble hearing when your back is turned to the speaker.
- You have been told you speak too loudly.
- You experience ringing in your ears.
- You have difficulty understanding conversation when in a large group or crowd.
If you experience these problems repeatedly or in combination, they may indicate a hearing loss.
Why do most hearing aid wearers have two hearing aids?
Why has nature provided us with two ears when one ear will allow us to hear? Nature has shaped and located our ears in a cleverly calculated manner. The outer part of an ear protrudes from the head at a specific angle collecting sound waves, which enter the ear canal and go directly to the eardrum. These sound waves are carried through the middle ear cavity along three delicately small bones to the hearing nerves of the inner ear. The fluid-filled inner ear is one of the wonders of creation. Packed into a space the size of a large garden pea, in this fluid are found the organs of balance, acceleration and deceleration sensors, and over 20,000 hearing cells each tuned to a different frequency. The sound waves create motion in the inner ear fluid, which causes the tiny cells to generate an electrical impulse, which is carried to the brain. The brain functions to interpret these impulses and gives them meaning. Thus, we hear with our ears, but understanding what is heard takes place in the brain.
The binaural advantage (two-ear hearing) over hearing with one ear is better for the following reasons:
- Localization
Sound waves do not reach both ears at the same time unless they are coming from directly in front of or directly behind the listener. The ear closest to the sound source will perceive the sound a fraction of a second earlier than the other ear. This tiny time difference is essential to our ability to locate a sound source. Directional hearing, which permits sound localization, is not possible with one ear.
- Speech Intelligibility
It is the high frequency portion of the human speech range, which contributes most to speech intelligibility. Two ears function to collect more high frequency speech information than one ear. Consequently, better speech understanding occurs when both ears are corrected.
- Understanding Speech in Noise
Two-ear hearing is necessary to separate competing sound messages. Two ears function to relegate interfering sound messages to the background of a person’s attention. Thus, the person wearing two hearing aids can focus upon the wanted sound message. Selective hearing is difficult, if not impossible, when only one ear is corrected. It takes two to “tune in”.
- Higher Tolerance to Loud Sounds
The patient who attempts to assist a hearing impairment with one hearing instrument must set the aid at a louder point. Smaller amounts of volume may be used when two hearing aids are employed.
- Relief from Head Noise
The loud ring of a fire bell from the street will drown out the tiny tinkle of a dinner bell. Close the window and you hear the dinner bell. In the same manner, the many small sounds of body function and the ringing and buzzing (tinnitus) of the ears which is often associated with hearing loss is masked for us by the much louder sounds which surround us. A hearing impairment closed the “window” to outside sounds and invites the ringing and buzzing noises to stand out and become annoying. The amplification of hearing instruments often reopens the ‘window” to outside sounds and serves to reduce these distracting head noises. Obviously, when only one ear is corrected, this unhappy condition can remain in the unaided ear.
- The Stereophonic Effect
The world of sound assumes the dimensions of depth and width when our hearing is in proper balance. Patients with two ear correction have described this stereophonic effect as having these important advantages: Better clarity and brilliance –More natural sounding – Greater sound quality – A wider range of hearing – Balanced hearing with no “deaf side”.
- Both Ears Must Remain Active
If a person with hearing loss in both ears wears amplification in only one ear, the aided ear tends to take over all hearing function. Speech understanding is promoted through repetition. Hearing speech over and over again develops good auditory speech memory. However, each ear must independently develop its own memory bank. Therefore, memory speech patterns grow stronger in the aided ear, while in the neglected ear, speech memory is gradually replaced by an inability to recognize and understand words.
What is this ringing/buzzing sound in my ear/head?
Any unwanted sound that is often described as a "ringing”, "roaring", "buzzing”, "pulsating," or "hissing" sound is call tinnitus. Tinnitus most often is a subjective noise heard either in the head or ears. It can occur in one or both ears and can be intermittent or continuous. Tinnitus is a common problem. A National Health Survey conducted by the Public Health Agency estimates that 36 million American adults experience tinnitus.
The causes of tinnitus are numerous and not all are known or fully understood. However, some tinnitus can be attributed to, or associated with, problems of the jaw joint, outer ear canal, eardrum, middle ear, inner ear, hearing nerve, brain or cardiovascular system.
The most common cause is due to deterioration of nerve cells within the inner ear, which is often the result of excessive noise exposure and/or aging.
Many things can aggravate tinnitus, such as:
- Exposure to loud sounds
- Hypertension or stress
- Alcohol
- Nicotine
- Caffeine
- Salicylates
- Excessive use of salt
There is no known medical cure for tinnitus. Many methods have been investigated but, none to date have proven to be consistently effective. Although tinnitus cannot be cured, there are several types of treatment currently available:
- Hearing aids
If tinnitus accompanies a hearing loss, sometimes the use of a hearing aid will reduce or “mask” the tinnitus, making it tolerable.
- Tinnitus masker
These are devices that look like hearing aids but rather than amplifying sound they generate an external band of masking noise in the ear to cover the tinnitus. The purpose is to substitute an external bearable noise for an internal unbearable one. The masker can be combined with a hearing aid when both are needed.
- Biofeedback or relaxation therapy
This process has proven, in some cases, to be a useful way of enabling individuals to control their tinnitus. Relaxation can be helpful in dealing with the emotional and physical stress that is often associated with the condition.
- Self help tips
Tinnitus is frequently more noticeable when first going to sleep or upon awakening. To mask or cover the noise at these times, many people use cassette tapes of surf, wind or rain. Tuning the radio between stations to the static hiss of FM bands will provide a masking agent as well.
Your doctor will investigate your problem with tinnitus. This will usually include an examination and hearing tests. The probable cause and treatment will be discussed following your evaluation.
Learn more about tinnitus at www.ata.org.
Why do I sound so strange when I speak while wearing my hearing instruments?
When you wear hearing aids for the first time, you may notice your voice sounds different. Without hearing instruments, our ears are open. The sound of our own voice travels both through the ear canal from outside of our head (air conduction) and through the bones in our skull from the inside of our head (bone conduction). When the ear canal is closed or “plugged” with hearing instruments, we reduce hearing through the ear canal and may enhance hearing through the bones. Some people describe this sensation as feeling "plugged up" or hearing their voice “echoing”. We call this phenomenon, occlusion. This is usually normal and most first time hearing instrument users will adapt to their voice within a few days. There are some adjustments your professional can make to help relieve occlusion, should it persist beyond the first few days. Open fit hearing instruments are often a good solution to the occlusion issue.
Why do my hearing instruments “whistle”?
The high pitched “whistle” or “squeal” that can come from hearing instruments while they are being worn is called feedback. Causes of feedback include:
- Wax blocking the ear canal
- Improperly inserted hearing instrument in the ear
- Poor physical fit of instrument to the ear
- Debris blocking the microphone or receiver of the instrument
- Instrument malfunction
- Weak battery
There are two types of feedback. Normal feedback can occur in some hearing instruments when something is placed close to or over the instrument (cupping your hand over your hearing aid may cause feedback). Abnormal feedback occurs frequently and unexpectedly with normal head and jaw motion, even when the hearing instrument is properly inserted in the ear. If this occurs, see your professional. Your professional will be able to determine the cause of the feedback and provide a solution to the problem.
Why are hearing instruments so expensive?
There are many reasons for the high cost of hearing instruments.
Research and development costs are part of the cost. Manufacturers spend millions of dollars every year on never-ending research and development trying to build the best hearing instruments possible.
The economies of scale; the hearing instrument market is relatively small, with only about 2 million hearing instruments sold each year. While that sounds like a lot it represents only 2% of the population.
Despite what the inter-net may lead one to believe, hearing instruments are not an “off the shelf” consumer product. They are medical devices regulated by the Food and Drug Administration. Hearing health care professionals spend a significant amount of time with each and every individual being fit with amplification. Time is spent testing, during the initial fitting, follow-up visits, verifying benefit, making adjustments and counseling. These services often are provided for the life of the instrument. Equipment needed to properly dispense hearing instruments is also expensive. Unlike inter-net sales of hearing instruments (where legal) most services are provided in an office environment equipped with reception staff that is always available to assist, along with all the other amenities that make the delivery of professional services in a comfortable environment a pleasant experience.
Read more on this issue by clicking here.
What are assistive listening devices (ALDs) and do I need them?
ALDs are special devices made to help in specific situations where the hearing instruments alone may not be enough. Some of these situations may involve listening to the radio, television or on the telephone. Addressing the inability to hear warning sounds like doorbells or alarm clocks is another area where ALDs provide assistance. Assistive listening devices and alerting devices can help you hear a desired sound by making it louder and/or altering the pitch. In some cases, the ALD can transform a sound into a visual alert such as a strobe light. There are a wide variety of ALDs available today, including systems that have been installed in large theaters and auditoriums for use by the hearing impaired. Check with your provider to see if any of these devices would be helpful to you.
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