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 one out of
five 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.
How can hearing aids help?
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.
How can I find out if I need a hearing aid?
If you think you might have hearing loss and could benefit from a
hearing aid, visit your physician, who may refer you to an
otolaryngologist or audiologist. An otolaryngologist is a
physician who specializes in ear, nose, and throat disorders and
will investigate the cause of the hearing loss. An audiologist is
a hearing health professional who identifies and measures hearing
loss and will perform a hearing test to assess the type and degree
of loss.
Are there different styles of hearing
aids?
There are three basic styles of hearing aids. The styles differ by
size, their placement on or inside the ear, and the degree to
which they amplify sound (see figure on page 1). Hearing Aid Types
Behind-the-ear (BTE) hearing
aids consist of a hard plastic case worn behind the ear and
connected to a plastic earmold that fits inside the outer ear.
The electronic parts are held in the case behind the ear. Sound
travels from the hearing aid through the earmold and into the
ear. BTE aids are used by people of all ages for mild to
profound hearing loss.
A new kind of BTE aid is an open-fit hearing aid. Small,
open-fit aids fit behind the ear completely, with only a narrow
tube inserted into the ear canal, enabling 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. In
addition, some people may prefer the open-fit hearing aid
because their perception of their voice does not sound “plugged
up.”
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. Some ITE aids may have certain added
features installed, such as a telecoil. A telecoil is a small
magnetic coil that allows users to receive sound through the
circuitry of the hearing aid, rather than through its
microphone. This makes it easier to hear conversations over the
telephone. A telecoil also helps people hear in public
facilities that have installed special sound systems, called
induction loop systems. Induction loop systems can be found in
many churches, schools, airports, and auditoriums. ITE aids
usually are not worn by young children because the casings need
to be replaced often as the ear grows.
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 devices, such as a
telecoil. They usually are not recommended for young children or
for people with severe to profound hearing loss because their
reduced size limits their power and volume.
Do all
hearing aids work the same way?
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.
Which hearing aid will work best for me?
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.
What questions should I ask before buying a hearing aid?
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 the audiologist make
adjustments and provide servicing and minor repairs? Will loaner
aids be provided when repairs are needed?
What instruction does the
audiologist provide?
How can
I adjust to my hearing aid?
Hearing aids take time and patience to use successfully. Wearing
your aids regularly will help you adjust to them.
Become familiar with your hearing aid’s features. 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.
How can
I care for my hearing 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
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