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Q: How do I know which hearing aid is best for me?
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A: Several things need to be consider when selecting hearing aids:  style and size, circuitry (analog or digital), features (type of microphone, telephone switches, assistive device couplers), and whether binaural (two hearing aids) or monaural (one hearing aid) is most beneficial.   An individual’s type and degree of hearing loss, ear canal shape, and other medical factors are used to determining the most appropriate fitting.  For example, certain styles are more appropriate than others when an individual has chronic draining ears or certain skin sensitivities.
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Q: What are the various styles of hearing aids?
     
A: Behind-the-ear hearing (BTE) aids are worn behind the ear and require the use of a custom fit ear mold.  Behind-the-ear hearing aids can be worn by individuals with nearly all types of hearing loss and are often the choice for children.  BTEs are available with all types of circuits.  Severe-to-profound hearing loss may require the use of BTE aids.  Those with less significant hearing loss may be candidates for the other styles.

In-the-ear (ITE) hearing aids are custom made for each individual ear and are appropriate for individuals with mild to moderately severe hearing loss.  This style may also be more appropriate than the smaller hearing aids, for those with manual dexterity problems such as arthritis.  Depending on an individual’s ear size, this style may be less desirable for those with moderately severe hearing loss.  They are available in all types of circuits.

In-the-canal (ITC) hearing aids are custom-designed for individual ears.  They fit deeper into the ear canal and are smaller in overall size.  The ITC is most appropriate for milder to moderate hearing loss.  All types of circuits are available in this size hearing aid.  Because they are smaller than ITE aids, certain special features and options may not be available due to size limitations.

Among the smallest of hearing aids are the completely-in-the-canal (CIC) hearing aids, which fit deeply in the ear canal.  Individuals with mild to moderate hearing loss can be fit with  CIC hearing aids.  The shape and size of the individual ear canal assists in determining if this style is appropriate.  Although they have removal wires that are used to remove them from the ear canal, their size is quite small and may pose problems for individuals with hand dexterity problems such as arthritis.

             
     
Q: What are the various circuits and how do they differ?
     
A:

There are primarily two type of circuits:  a. Analog (conventional non-programmable) and b. Digital (programmable).

Analog or “conventional” circuits were among the first types of electronic circuits used in hearing aids.  They have some controls that are built into the hearing aids, which can be used to make certain adjustments.  Although there are controls (potentiometers), which can be used to improve the incoming signals, these aids have limited flexibility and are not programmable.  Some circuit adjustments must be made by the manufacturer.  Analog hearing aids are the least expensive but vary in cost depending on the style, circuitry, and controls.

Digital (programmable) hearing aids are programmed using computer software and offer a wide range of listening options to users.  Most digital hearing aids have individual memories that can be activated by small user-operated controls buttons.  For instance, one memory might be used for everyday conversation, another for listening when there are high levels of background noise, and possibly another for listening to music or telephone use.  Individuals who were formerly analog hearing aid users frequently report that digital circuits offer a more “natural” sound quality.  Depending on the programming done, they may also provide improved speech understanding.  Because they are programmable and use digital technology, digital hearing aids can be adjusted over several visits to meet the needs of an individual who has to listen in a variety of conditions.   If a patient has changes in hearing ability, programmable hearing aids can be adjusted to help meet many of those needs.

     
     
Q: What are the features that are available in hearing aids?
     
A:

With the advancements in hearing aid research, and the need to help individuals with varying degrees of hearing loss, there are several features to consider, such as whether to include a telephone coil; whether to use omni directional, directional or multiple microphones; and whether the individual needs couplers that enable the use of assistive listening devices. 

Microphones vary in their function.  Omni directional microphones are those which pick up sounds that originate in almost any direction around the individual.  Directional microphones are those that are specifically designed to amplify signals that are in front of the individual and are often enabled by a user push-button.  This can improve listening in noisy settings.  Some more sophisticated hearing aids use more than one microphone that can better help differentiate speech from surrounding noise.  While one sees advertisements of hearing aids that “block background noise”, these are misleading and have become the target of the Food and Drug Administration scrutiny.  Microphone technology and digital circuitry such as described above may help enhance speech understanding in noise, but results may vary depending on the type and degree of hearing loss.

           
     
Q: Do I need one or two hearing aids?
     
A: Individuals with normal hearing hear equally well in both ears providing good discrimination in quiet and noisy environments.  Those with hearing loss in both ears may be candidates for two hearing aids.  Some individuals have a hearing loss in only one ear in which case one hearing aid may be appropriate.  While it is recognized that the majority of hearing impaired individuals could benefit from the use of two hearing aids, some may do well or even better with one.  Individuals who have binaural hearing loss but who use only one hearing aid may experience some problems with sound localization.  In some individuals the degree of hearing loss is so severely profound that the use of a hearing aid may be contraindicated.  Factors to consider when deciding on one or two hearing aids include, but are not limited to the following:   a) degree of hearing loss, b) listening demands, c) hand dexterity and limb movement, d) overall life style.  Wearing two hearing aids may, according to some literature in audiology enhance speech understanding in noise, particularly when directional microphones are considered.  Children with binaural hearing loss need, in most cases, two hearing aids.  It is important that they hear sounds originating from all directions and that the brain gets as much auditory and language input as possible to help them develop speech and language.
             
       
Q: What are the different types of hearing loss?
       
A: There are basically three types of hearing loss:  a) “nerve” hearing loss, termed sensorineural hearing loss; b) conductive hearing loss in which the auditory nerve functions within the range of normal but the physiology of the middle ear system is abnormal, c) mixed hearing loss that involves the auditory nerve and the middle ear, and d) central processing disorder which primarily refers to some difficulty processing sounds in the brain in addition to hearing loss at the level of the ear. In most cases, the use of hearing aids and/or amplification devices will help an individual with communication.  While hearing loss may be more commonly attributed to senior citizens, hearing loss affects individuals of all ages.  With advances in newborn hearing screenings, hearing impaired infants can be fit with hearing aids shortly after birth.
             
       
Q: Can anyone with hearing loss benefit from using hearing aids?
       
A: Most individuals with hearing loss can be helped with hearing aids and devices.  It is important, however, to understand that hearing aids can help an individual hear, but that they do not restore hearing loss to “normal hearing”.    Many individuals wear eyeglasses due to some problems with the lenses of the eyes (near- or farsightedness, etc.), They may experience normal vision while wearing them.  However, individuals with optic (visual) nerve involvement may derive some benefit from using glasses, yet still experience some vision problems because of nerve damage or pathology in the visual system.  By comparison, the majority of individuals with hearing loss have some sensorineural (nerve) involvement.  This type of hearing loss is, for the most part, “permanent” and may not respond to nor require medical intervention.  Yet individuals with nerve hearing loss usually experience improvement in communication when using amplification.
             
     

 

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