Ask Your Audiologist
How Do We Hear?
Can mild hearing losses be helped by hearing aids?
Why Do I need two hearing aids?
What Can I Do About Excessive Noise Exposure?
What Type of Improvement Can I Expect From Hearing Aids?
When should I have my hearing tested?
How often do I need to have my hearing tested?
What Do I Need To Know About My Child's Hearing Loss and Hearing Aids?
What Are The Signs of Hearing Loss?
What Are The Types of Hearing Loss?
How Does Hearing Loss Affect Speech Understanding?
What is a Hearing instrument?
What Is Involved in the Maintenance of Hearing Aids?
What is an Audiologist?
Where do audiologists work?
Why should someone with hearing loss be evaluated by an audiologist?
How long will my batteries last?
How Do We Hear?
The way we hear is complex and fascinating. We do not hear or perceive sound until sound reaches the brain. Sound has to make many stops along the way to the brain and hearing loss can occur at different points along the pathway. First, sound waves enter the ear canal, which is part of the "outer ear" and gets naturally amplified due to the resonating factors of the canal. Then, sound hits the eardrum and is sent mechanically through the bones of the middle ear (malleus, incus, stapes) where another natural amplification process occurs. After this, the sound enters the inner ear, specifically the cochlea. Tiny cells, termed hair cells vibrate according to the pitch or frequency of the sound. There are thousands of hair cells. They are responsible for, again, amplifying sound and for connecting sound to the hearing nerve. Sound is then converted to electrical energy and sent along the hearing nerve through the brainstem and into the brain. Once the signal enters the hearing center of the brain, sound is perceived. Back to Top
Can mild hearing losses be helped by hearing aids?
Hearing loss can often go undetected for years. Unfortunately, comprehensive hearing evaluations are often not included as part of the annual health care routine. Frequently, hearing loss can be in the moderate and sometimes severe range before the first full hearing evaluation is ever performed. In addition, many of our patients report that they perceived and/or their family noticed their difficulty hearing several years prior to scheduling a hearing evaluation. One of our goals is to increase the awareness and the importance of annual hearing evaluations. The earlier the hearing loss is discovered, even if the hearing loss is in the mild range, the sooner we can provide intervention. Until recently, we had few options to help a mild hearing loss. One option was trying "traditional" hearing aids, but patients with mild hearing loss often rejected them. Rejection of traditional style hearing aids usually stems from a change in sound quality of the patient's own voice called the occlusion effect. For example, the patient's voice may sound hollow or it may sound as if talking in a barrel. The other option was to wait until the hearing loss progressed to a more severe level. However, mild hearing loss typically results in difficulty understanding soft speech, women and children's voices, and difficulty hearing in background noise. With today's technological advances, we are now better equipped to provide intervention to the majority of hearing losses, including mild hearing loss. Several manufacturers now offer hearing aids specifically designed for early hearing loss. These "high frequency," open-canal hearing aids are designed to minimize the occlusion effect and amplify the high frequencies. By reducing the occlusion effect patients report greater comfort, a more natural sound quality and are more likely to accept the devices rather than reject them. Back to Top
Why Do I need two hearing aids?
Many patients state that it can be overwhelming to learn for the first time that they are candidates for hearing aids. Because of the insidious nature of hearing loss, patients may not seek professional care until the hearing loss is in the moderate to severe range. Adjusting to hearing aids and hearing sounds that have not been heard for many years can be a significant lifestyle change. A common question that patients ask is why are you recommending two hearing aids rather than just one?
The question is best answered by explaining why we have two ears. The hearing center in the brain is designed to receive information from both ears. Differences in volume and timing of sounds between each ear help us to localize sound, to hear at greater distances and to hear better in background noise. For instance, if you are in a crowd of people and a friend calls out to you the brain can almost immediately detect where your friend is standing, and which direction you need to turn to acknowledge the call. When you start conversing with your friend the brain uses information from both ears to help separate speech from the background noise. The volume level of speech in relation to the volume level of noise is referred to as the signal to noise ratio. The brain naturally provides a better signal to noise ratio by receiving input from both ears. As hearing loss progresses, it becomes increasingly difficulty to understand speech in noisy environments, partly because the loss of hearing does not allow for one to hear soft level speech sounds. If you have hearing loss in both ears, you will receive the greatest benefit for speech understanding if both ears are amplified. Remember the brain is designed to work best with input from two ears. Back to Top
What Can I Do About Excessive Noise Exposure?
Exposure to noise is one of the leading contributors to hearing loss. Whether it is music, loud equipment or exposure to gunfire, the short and long term effect is most likely hearing loss. OSHA National guidelines have been set forth requiring employees who are exposed to loud levels of noise 85db or above to use hearing protection. In other words any exposure to sound levels 85dB or higher can result in hearing loss. To Give you an idea of how loud sounds are Whisper: 30dB
Normal Conversation 3-5ft : 60dB
Lawn Mower: 90dB
Rock Concert: 100dB
Ambulance Siren: 120dB
Airplane jet engine at 100ft: 140dB
12 guage Shotgun 165dB Earmold companies have spent a great deal of time manufacturing a variety of different type of sound plugs to protect hearing and are custom made to fit the shape of your ear canal. For instance, there are an assortment of ear plugs that are specifically designed for musicians, dentists, hunters, construction workers and pilots to name just a few. If you are concerned about missing speech, musician ear plugs using special noise reduction filters offer protection against damaging noise levels while allowing speech to be audible. Does your bedmate's snoring keep you awake at night?
Custom made earmolds can be designed to help those who have bedmates who snore get a restful night's sleep. Back to Top
What Type of Improvement Can I Expect From Hearing Aids?
At Professional Audiology Associates, Inc. our goal is to give our patients the best hearing possible, but it is extremely important to have reasonable expectations of hearing aids. Hearing aid technology has improved significantly over the past 10 years helping patients to hear better while delivering a more natural sound quality. However, it is impossible for hearing aids to bring your hearing back to normal. Hearing aids do an excellent job of amplifying sound, but results can vary depending on the type and severity of the hearing loss. There are 3 types of hearing loss: conductive, sensorineural and mixed. Hearing aids are usually prescribed for patients with sensorineural hearing loss, the most common of the three. Sensorineural hearing loss is associated with damage to the tiny hair cells inside the cochlea (hearing organ in the inner ear). These hair cells amplify sound and are vital in transmitting sound along the neural pathway, which takes this information to the area of the brain that interprets it. Hearing aids are designed to improve your hearing. They amplify sound at the level of the ear canal. This means that after the sound leaves the hearing aid and enters your ear canal, the sound still needs to be transported through the middle ear, the inner ear and along the hearing nerve before it gets to the hearing center of the brain. The more severe the hearing loss, the further the destruction of hair cell damage and with greater hair cell damage there is more potential for speech distortion. If any of the hair cells that connect to the hearing nerve are damaged, (which is seen in moderately-severe to profound hearing losses), there will still be a loss of connection even with the hearing aid. In other words, a hearing aid is an amplifier only. It does not correct for the loss of clarity due to excessive hair cell damage. It is important to understand that realistic expectations are different for everyone because the severity of hearing loss can be different for everyone. So, people with mild to moderate hearing losses may perform better with hearing aids than those with more severe losses. Back to Top
When should I have my hearing tested?
As audiologists, we often hear that the last time people can remember having a hearing test was in elementary school. It is quite common for people to go their entire adult life without having a hearing test. Even if you think your hearing is fine, it is a good idea to establish a baseline graph of your hearing to keep in your medical file. Because hearing loss can be such an insidious process, it is easy to be unaware that you may be losing hearing until the people around you start to notice. In this article we offer our readers some general guidelines on when it is necessary to have your hearing tested. If you experience any of the following, it is recommended that you have your hearing tested. - Ear Fullness
- Tinnitus (ringing/noises in your ears)
- Increased difficulty hearing in background noise
- Family member complaints (volume of TV is common)
- Asking for people to repeat themselves
- Sudden change in your hearing
- You have reached the golden age
- Noise exposure (current or prior)
- Curiosity Having worked many years in an ENT office, we often tested patients who reported sudden changes in their hearing. Many of these patients reported that they waited before having their hearing tested because they thought they had wax or fluid in their ears. Unfortunately, for some of these patients, by the time they came in to the office the sudden hearing loss is irreparable. If you experience a sudden change in your hearing, the sooner you have your hearing tested and medically treated, the greater your chances are for recovering your hearing. Back to Top
How often do I need to have my hearing tested?
Your audiologist will recommend how often you should be tested. Generally, if your hearing is symmetrical, meaning you have the same amount of hearing in both ears, and there are no apparent medical issues that need to be treated by a physician, you should have your hearing tested once a year. If you are being treated medically, usually the physician will order testing to be completed prior to and following the treatment. If there is asymmetry, different hearing levels in both ears, the audiologist and/or physician may recommend monitoring your hearing every 3 months. Back to Top
What Do I Need To Know About My Child's Hearing Loss and Hearing Aids?
We know that you have a lot of questions about hearing aids and hearing loss. While we are not a pediatric audiology center at this time, we put together this article to provide you with general information about hearing aids and children. Learning that your child has hearing loss can be overwhelming and can bring about many emotions. We want you to know that you are not alone. At least 1.4 million children in the U.S. have hearing loss. There are a lot of resources available to you through the internet and organizations at the local and national level. At the end of this article, some of these resources are listed. One of our roles as audiologists is to rehabilitate hearing loss using hearing aids or other assistive listening devices. Speech and language development relies heavily on the ability to hear. Also, hearing ability plays a large role in performance in school. Research has shown that even children with minimal or mild hearing loss can have difficulty in school. Research has also shown that the earlier children with hearing loss are amplified, the greater the possibility will be for successful communication. Hearing aid technology is constantly improving and research is focusing on effective ways to amplify speech. While hearing aid technology has improved tremendously in the last 10 years, it is still not perfect and does not restore hearing to normal. This means that there still may be situations where your child misses parts of a conversation. The most important thing to know is how to control the environment in which you want your child to hear and how to communicate effectively with your child so that the entire conversation is understood. Children's speech and language development also will rely heavily on the way their caregivers communicate with them. Most importantly, you want to be communicating at a close distance, face to face, and in a quiet environment. Some of the websites listed at the end of this article offer excellent communication strategies for auditory training. The purpose of hearing aids is to make sound louder. Sound is everywhere - leaves crunching, paper crinkling, dogs barking, cars driving, waves crashing, birds singing, fingers typing, basketballs bouncing, people talking, etc. All of these types of sounds occur at different volume levels. Some sounds are soft like a whisper and some sounds are loud like a jet airplane. Noise is also sound. Examples of different types of noises are refrigerator noise, wind noise, restaurant noise, computer noise, etc. While speech is the most important sound that we want to amplify, it is not the only sound that the hearing aid will amplify. Noise will also be louder. Hearing aids are designed to focus most of its attention on speech sounds, meaning that they try to provide more volume to speech sounds and less volume to noise and loud sounds that may interfere with speech communication. Hearing aids come in many shapes and sizes. Some hearing aids fit in the ear (ITE) while others fit behind the ear (BTE). ITEs are custom fitted to the shape of your child's ear and BTEs fit over the top of your child's ear and attach to an earmold that fits into the ear canal. Behind the ear (BTE) style hearing aids are usually recommended for young children and infants due to the rapid growth of the ear canal. It is much easier and more cost effective to replace the earmolds every so often than to replace the entire hearing aid. Replacing earmolds is dependent on the age and growth rate of your child.
www.oticon.com
BTE w/ earmold
How Hearing Aids Work:
There are three basic parts to hearing aids • Microphone - its job is to pick up sound
• Amplifier - this is where the sound is made louder
• Speaker - this is where the amplified sound comes out of the hearing aid and is sent into the ear canal The way in which the sound is processed varies from hearing aid to hearing aid. Most hearing aids today are digital and have many options in how they treat sound. Most of these options revolve around how the hearing aid controls noise. Other options include different types of microphones and feedback (whistling) control. You and your audiologist will sit down and discuss all the available options and what is the best selection for your child.
www.phonak.com
Caring for Hearing Aids:
Your audiologist will show you how to care for and maintain the hearing aid in detail. The following are some general guidelines:
• The hearing aid circuit is electronic so the hearing aid should not be exposed to excessive heat, moisture or water.
• Daily cleaning will be necessary. This involves wiping and brushing off wax and debris from the hearing aid.
• Daily inspection of the tubing and earmold is necessary. Check the tubing for debris, moisture, flexibility, security. Check the earmold debris.
• Check the microphones to make sure there is no blockage.
• Batteries need to be changed every so often. It is important that the battery is checked or tested daily with a battery tester.
• Before inserting the hearing aids in your child's ears, a listening check should be performed with a listening stethoscope (provided in your hearing aid kit). Check the volume control if applicable.
• Nightly use of a dry aid kit is recommended to remove moisture from the hearing aids.
Internet Resources:
The Listen-Up Web - - http://www.listen-up.org/ - This website has a large database of resources.
My Baby's Hearing - http://www.babyhearing.org/ - "Babyhearing.org is brought to you by a team of professionals at Boys Town National Research Hospital. We are: Audiologists, Speech-Language Pathologists, Teachers of the Deaf Geneticists, Doctors and Parents of Deaf and Hard of Hearing Children." This site has an excellent in depth glossary of hearing aid terms - http://www.babyhearing.org/HearingAmplification/Glossary/index.asp
Beginnings for Parents of Children Who Are Deaf or Hard of Hearing - http://www.beginningssvcs.com/ - "A non-profit agency providing an objective approach to meeting the diverse needs of families with children who are deaf or hard of hearing and professionals who serve them."
Laurent Clerc National Deaf Education Center - http://clerccenter.gallaudet.edu - "Gallaudet University's Laurent Clerc National Deaf Education Center shares the concerns of parents and professionals about the achievement of deaf and hard of hearing students in different learning environments across the country. We all know that deaf and hard of hearing students can and do excel, but we also know that not all deaf and hard of hearing students are achieving their full potential. The Clerc Center has been mandated by Congress to develop, evaluate, and disseminate innovative curricula, instructional techniques and strategies, and materials. The aim of the Clerc Center is to improve the quality of education for deaf and hard of hearing children and youth from birth through age 21."
Florida Resource:
Children's Medical Services - http://www.cms-kids.com/InfantHearing.htm - "CMS is a program of the Florida Department of Health (DOH) and is directed by the Deputy Secretary for CMS. The Children's Medical Services (CMS) program provides children with special health care needs with a family centered, managed system of care." This organization also includes information on financial assistance programs locally and nationally.
Local Contact Office for CMS - West Palm Beach
5101 Greenwood Avenue
West Palm Beach, FL 33407
(561) 881-5040
1-877-822-5203 Back to Top
What Are The Signs of Hearing Loss?
This article is courtesy of GN Resound www.resound.com Many people have a difficult time believing, or accepting, that they have a hearing loss. Part of the reason is that hearing loss often occurs gradually, and it's not always easy to notice at first. Often, people discover their hearing loss from the reactions of others. The following questions may help you decide whether you should have your hearing tested:
• Do you frequently ask for words to be repeated?
• Do you often turn up the television or radio louder than others like?
• Does speech sound muffled to you, or do people sound as though they're mumbling when they speak to you?
• Do you have ringing in your ears?
• Do you have trouble hearing over the telephone?
• Do you find it difficult to follow a conversation in a noisy restaurant or crowded room?
• Have you had any significant noise exposure at work?
• Do you find men's voices easier to understand than women's?
• Does a hearing problem cause you to feel embarrassed when meeting new people?
• Does a hearing problem cause you to visit friends, relatives, or neighbors less often than you would like?
• Does a hearing problem cause you to talk to family members less often than you would like?
• Does a hearing problem cause you to feel depressed? If you answered yes to any these questions, you may have a hearing problem. Answering yes to several of the questions, suggests that it might be time to have your hearing tested by a hearing care professional.
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What Are The Types of Hearing Loss?
This article is courtesy of GN Resound www.resound.com To understand hearing loss requires a basic understanding of how we hear.
Outer ear
Your outer ear acts like a dish that collects sound waves. These sound waves travel along the ear canal and vibrate against the ear drum. Middle ear
In the middle ear, three tiny bones (the smallest in the body) transfer vibrations to the fluid-filled cochlea in the inner ear. This creates ripples in the fluid, which bend the hair cells in the cochlea.
This movement, in turn, is converted into electrical impulses that are carried through the auditory nerve to the brain, where they are translated into meaningful information. As you can see, hearing is a complex process. As with any such process, things can go wrong.
The most common types of hearing loss are:
Sensorineural loss, is the most common type of hearing loss, occurs when the nerve endings in the inner ear are not transmitting sound properly, often as a result of damage to the hair cells in the cochlea. This damage can by caused by a number of things, including noise, or a natural withering of the cells (presbyacusis) that comes with age. Sensorineural loss cannot be cured medically, but it can usually be improved through the use of hearing instruments. Conductive loss occurs when sound is not being sent properly to the inner ear due to some "mechanical" problem. Conductive loss is often the result of damage or blockage in the middle ear. In most cases, conductive hearing problems can be corrected medically. Mixed loss is a combination of sensorineural and conductive. Back to Top
How Does Hearing Loss Affect Speech Understanding?
This article is courtesy of GN Resound www.resound.com
Speech can be loud enough to be heard and yet remain difficult to understand. It is a rapid stream of sounds varying in intensity. For example, vowels are strong while consonants are weaker and often harder to recognize.
Normally, strong sounds are perceived as loud, while weak sounds are perceived as soft. When each speech sound is perceived at its normal loudness, words are easily recognized and it is possible to carry on a conversation even in the presence of background noise.
With hearing loss, strong intensity sounds are still perceived as loud, but medium intensity sounds seem very soft instead of "comfortable". The weak consonants, instead of being very soft, are often inaudible. When some sounds are too soft or inaudible, speech becomes "jumbled" and difficult to understand especially in noise. Back to Top
What is a Hearing instrument?
This article is courtesy of GN Resound www.resound.com
At the most basic level, a hearing instrument is a miniature sound amplifier. It receives sounds through a microphone, converts them to electrical impulses, amplifies the impulses, and converts them back into sound.
Different kinds of hearing losses:
But if a hearing instrument were to do only that, it would be of very limited use. It would simply amplify all incoming sounds equally. This would be ineffective, because all hearing losses are different. Some people lose hearing in the high frequencies, some in the middle or low frequencies - hearing loss patterns are as unique as thumbprints. People with hearing loss also have widely varying comfort levels when it comes to the loudness of various sounds. That's why a hearing instrument must be highly selective in how it amplifies sound for its user.
Digitally programmable instruments:
Today, the most advanced hearing instruments use digital technology. Hearing test results are fed into a computer, and the hearing care professional uses the computer to adjust the hearing instrument for the user's particular needs. These hearing instruments are called "digitally programmable."
Fully digital instruments:
Even more advanced are the new generations of instruments called "fully digital" or simply "digital." Not only are these instruments fine-tuned by a computer, they actually contain a computer - a tiny microprocessor with enormous processing power. Digital hearing instruments convert sounds into digital code, manipulate the code according to the user's needs, and re-convert it into sound. Not only does this provide "CD" sound quality, it also opens the door to sound processing capabilities that were impossible before. Back to Top
What Is Involved in the Maintenance of Hearing Aids?
This article is courtesy of GN Resound www.resound.com Proper care and maintenance is essential to the life and function of your hearing instruments. A hearing aid is a big investment and is it imperative that you take the necessary steps to keeping it functioning properly. Your audiologist may have given you information on when to bring the instruments in for a professional cleaning but there are a few things that you can do at home to keep your hearing aid working its best all the time.
Batteries:
It is important to use fresh batteries in your hearing aids. Batteries should be stored properly - kept out of reach of children and pets as well as not stored with medication. When a battery is dead it should be disposed of properly too. At night the battery door should be opened on the hearing aid. This ensures that the hearing aid is turned off and not draining the battery. If you use a dry aid kit, remove the battery from the aid as the dry aid kit will drain the battery. More on batteries...
Cleaning Your Hearing Aids:
The microphone and receiver of your hearing aids are susceptible to debris and should be inspected on a regular basis. Your audiologist can provide you with tools to clean you hearing instruments at home. Generally these include a small brush and a wax loop. A clean, dry toothbrush can also be used for daily cleaning. Gently brush over the microphone and receiver to remove any wax or debris. If there appears to be any debris in the receiver tubing the wax loop can be used very gingerly to scoop out the wax. Because the receiver sits down inside this tube you must be very careful not to insert the wax loop too far which would damage the receiver. Your hearing instrument should never be immersed in water. However you can wipe the shell with a soft, dry tissue such as a kleenex or rag to remove any debris.
Earmolds:
Earmolds can be detached from a BTE hearing instrument and cleaned in a mild soap solution. The waxloop can be used to remove any wax that may enter the tubing from the ear canal. The earmold and tubing should be completely dry before reattaching it to the hearing aid as moisture will damage a hearing instrument. If there is wax in the tubing of the earmold that cannot be removed with the wax loop or washed out, the earmold should be taken to your audiologist to have the tubing changed. Earmold tubing should be changed on a regular basis. If the tubing becomes brittle, hard, of starts to change color, this may be a sign that it is time to have the earmold checked by your audiologist for a tubing change.
Moisture:
Moisture can be very damaging to hearing instruments. Hearing aids should be stored in the dry aid storage every night. The battery should be removed before placing the aid in a dry aid kit. Batteries should never be put in a dry aid kit - it will drain the battery's power.
Troubleshooting Problems:
If your hearing aid is not amplifying sounds:
• Is there wax in the hearing aid receiver blocking the sound from reaching your ear?
• Is the battery dead?
• Is the hearing aid turned on?
If you have inspected the hearing aid and the battery and the hearing aid is still dead, call your dispensing office to set up an appointment to have that checked. Your hearing aid should be a comfortable fit both physically and in volume. If at any time the fit of the instrument is uncomfortable, do not hesitate to contact your audiologist to set up an appointment for it to be checked. Back to Top
What is an Audiologist?
An audiologist is a professional who diagnoses, treats, and manages individuals with hearing loss or balance problems. Audiologists have received a master's or doctoral degree from an accredited university graduate program. Their academic and clinical training provides the foundation for patient management from birth through adulthood. Audiologists determine appropriate patient treatment of hearing and balance problems by combining a complete history with a variety of specialized auditory and vestibular assessments. Based upon the diagnosis, the audiologist presents a variety of treatment options to patients with hearing impairment or balance problems. Audiologists dispense and fit hearing aids as part of a comprehensive habilitative program. Audiologists may be found working in medical centers and hospitals, private practice settings, schools, government health facilities and agencies, as well as colleges and universities. As a primary hearing health provider, audiologists refer patients to physicians when the hearing or balance problem requires medical or surgical evaluation or treatment.
This information was retrieved from The American Academy of Audiology's website www.audiology.org. Back to Top
Where do audiologists work?
Audiologists work in private practice offices, hospitals and medical centers, clinics, public and private schools, universities, rehabilitation or speech and hearing centers, health maintenance organizations and nursing homes. Audiologists work closely with government agencies, practicing physicians and hearing aid manufacturers. Audiologists conduct clinical activities with patients, are involved in hearing research, dispense hearing aids and assistive listening devices and teach at universities and medical schools.
This information was retrieved from The American Academy of Audiology's website www.audiology.org. Back to Top
Why should someone with hearing loss be evaluated by an audiologist?
Audiologists hold master's or doctoral degrees from accredited universities with special training in the prevention, identification, assessment and non-medical treatment of hearing disorders. Audiologists are required to complete a full-time internship and pass a demanding national competency examination. By virtue of their graduate education and licensure, audiologists are the most qualified professionals to perform hearing tests, refer patients for medical treatment and provide hearing rehabilitation services.
This information was retrieved from The American Academy of Audiology's website www.audiology.org. Back to Top
How long will my batteries last?
Battery life is determined by the type and amplification of your hearing aid as well as the hours you wear your hearing aid. Your hearing care professional can tell you the battery life you can expect. More on batteries...
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