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Colorado Springs

Audiology, Inc.


Phone  719.520.1155


Dr. Gene McHugh

Licensed Audiologist

In Colorado




Mountain Time USA



Closed Fridays


 © Copyright 2020








How do I determine if I am a candidate for a hearing aid?

Is it necessary to wear two hearing aids, or can I get by with one?

What determines what style of hearing aid I should wear?

Why does my voice so strange when wearing hearing aids?

Why causes my hearing aid to whistle?

What are digital hearing aids?

What are directional microphones used for?



How do I determine if I am a candidate for hearing aids?

Normal hearing people occasionally misunderstand others and have to have others repeat.  People with hearing problems frequently misunderstand to the degree it becomes quite noticeable to others, particularly one’s spouse and close friends. 

Usually, people with hearing problems are the last to realize it.  Why?  Most can “hear” quite well because of relatively good hearing sensitivity in the lowers pitches, but cannot “understand” because of relatively poor hearing ability in the higher pitches.

Ask yourself these questions

  • Does it seem like everyone “mumbles?”   

  • If someone turns their back while speaking, can you still understand them?   

  • Do you find yourself staring at people’s mouths to better understand what is said? 

  • Do you need the TV turned up in order to understand what is said.   

The critical variable is whether you experience difficulty hearing or are having increased stress and strain in daily function due to hearing problems.  Personal amplification is designed to make speech easier to understand.  Often this involves amplifying only certain regions of the speech spectrum. top

Is it necessary to wear two hearing aids, or can I get by with one?

This depends upon three factors:  Age, “configuration” of hearing loss, and ear symmetry. 

AGE:  Research shows that with increased age, there is reduced acoustic benefit in using two hearing aids.  The reason is probably “central” in nature.  As a general rule, I tend to fit patients over 85 with only one hearing aid.  For those under 85, I encourage patients to try two hearing aids.  There are other more practical reasons for considering using only one hearing aid in patients over 85.  Difficulty learning to operate the hearing aids is confounded using two hearing aids.  Many older first-time users report hearing as well with one as two.

CONFIGURATION OF HEARING LOSS:  Patient with “steeply sloping high frequency” hearing loss tend to gain more benefit using two hearing aids than any other group.  As such they are encouraged to try two hearing aids.  Patients with “flat” hearing losses do not tend to recognize as much benefit.

EAR SYMMETRY (that is, how close in hearing the two ears are):  The closer the two ears are in hearing sensitivity, the better the candidates for using binaural amplification (i.e., hearing aids in both ears).


Research indicates that, for most people under 85, binaural hearing (i.e., using both ears) usually helps us: 

  • Understand better in noisy environments:  The reason we hear better with two ears is not completely understood, but believed to be related to their brain’s ability to better attend with input from both ears.  It is similar to the eyes.  Think of it, we need only one eye to see so why is it so important to have both eyes working together?  With two eyes, we can focus with more precision, . And, there is better depth perception with a wider field of vision.  The ears are no different.  Studies on auditory attention indicate that speech discrimination is better in quiet and with background when we use both ears.

  • Localize sound:  Localization of sound is well understood.  At a very young age, we learn that when sound is coming from our right, there is a slight (very slight!) delay of sound arriving to the opposite (i.e., left) ear.  When this happens, we associate the sound source to our right.  Auditory localization is so precise, that most people can detect a sound source to within 10 degrees of a 360 degree entire circle.   People with more than a 10 decibel difference have a reduced ability to localize sound.  People with no hearing in one ear often have reduced ability to attend.  Therefore, when hearing sensitivity is within 10 decibels, the use of two hearing aids is preferred.  

  • Hear Louder:  With both ears receiving sounds, threshold improve by approximately three decibels with better reception in the important high frequency region.

What determines the style of hearing aids I should wear?

There are six basic styles of hearing aids:  



  • N THE EAR (ITE)  




The decision on which style to use is based upon three factors: 

1.       Degree and slope of hearing loss:

a.      When “degree” of one’s average hearing loss exceeds 70 decibels, behind the ear (BTE) styles hearing aids may be required.

b.      When “slope” of the loss is “flatter,” patients perform better with in-the-ear, in-the-canal, and completely-in-canal models.  Patients with steeply sloping losses are limited to using behind the ear styles coupled to very well ventilated earmolds.  Otherwise, they feel totally plugged up, and gain very little benefit with their hearing aids.

2.       Practicality of the hearing aid style:

a.      Younger, that is under 85, individuals can use the smaller, less visible hearing aids.  They tend to hear better with the smaller CIC hearing aids (unless they have steeply sloping losses) and usually have little difficulty operating them.  The smaller CIC hearing aids work well with the telephone.

b.      Older patients (on the other hand) usually have much more success with the larger in-the-ear styles.  They are easier for older persons to handle.  If others are required to assist, the larger ITE styles are the easiest for others operate.

3.       Cosmetics:

a.      When acoustic factors allow, smaller hearing aids or receiver in the ear (RITE) are a wonderful option.  However, I counsel new patients that if he or she is not a good candidate for the smaller hearing aid, I will not provide it. 


Why does my voice so strange when wearing hearing aids? 

With amplification, the ear canal is somewhat occluded and sounds generally made louder.  Often, the result is that our voice sounds unnatural.  Most new hearing aid users consider the increased loudness of one's own voice a very negative factor.  Many equate the sound of their own voice similar to having one's head in the barrel.  Audiologists refer to the problem as "occlusion" or "the occlusion effect."  While this is a significant problem that cannot be solved for every patient, fortunately most patients learn to gradually adapt to the unnatural sound within three weeks. 

Prospective users should be aware of the potential "occlusion effect" problem.  Three modifications can be employed to reduce its adverse effects of occlusion and should be discussed with your audiologist prior to selecting your hearing aid(s).  They include: 

  • Venting (acoustic modification).  The most effective way to relieve the feeling of ear canal occlusion when using hearing aids is through using ventilation ducts (referred to as a "vent").  A vent is a simply an air channel in the earmold or hearing aid shell.  It reduces the feeling of fullness in the ear canal, and makes sound quality more natural. As a general rule, the larger the vent, the less the occlusion effect.

  • Canal length (acoustic modification).  Another effective way to relieve ear canal occlusion is by extending canal length.  The ear canal is about 1" long.  Studies show that if the length of the hearing aid or earmold extends beyond two-thirds of the canal, the occlusion effect is greatly reduced.*     

  • Reducing low and mid-frequency response (electrical modification).  The frequency range between 750-1200Hz is the primary source of the occlusion effect.  Reducing amplification is this range will usually make sound quality more natural.  top

*I recently evidenced this in a case where a 40 year old man was fit in one ear with a CIC with long canal in 2002.  In late 2003, he was fit with a CIC for the other ear, but the canal length was not as long.  He could not tolerate the occlusion effect.  The hearing aid was remade with a long canal and occlusion problem was solved.

What causes my hearing aid to whistle?

When amplified sound exiting the hearing aid is routed back to microphone, a hearing aid will whistle.  This is referred to as "acoustic feedback."  Nearly all hearing aids have the potential for feedback (whistle) if the volume is turned up high enough.  Feedback problems are worsened there is leakage around the earmold or hearing aid.  Your hearing aid should not feedback when volume is set at a normal listening level.  If it does, the reasons may include the following problems:

  • Poorly fitting earmold or hearing aid:  If your earmold or hearing aid does not fit correctly, sound may be  leaking out.  In some cases, your hearing loss may be so severe that even at normal volume levels, feedback still exists.  To solve the problem, a tighter fitting earmold or hearing aid may be necessary.  This may include reducing the size of any vents which are a common source of feedback.  In some cases, a new earmold may be necessary

  • Too much high frequency response:  Today's hearing aids have extended frequency responses.  Unfortunately, the range around 6000 Hertz has been problematic insofar as feedback is concerned.  When possible, the 6000Hz is reduced and feedback usually goes away. top

What are digital hearing aids? 

Just about all of today's electronics (TV, radios, telephones, etc.) as well as today's hearing aids use digital circuits.  As with other electronics, digital hearing aids are becoming more common, being more flexible than traditional analog circuits.  It is important to know that digital hearing aids are not inherently better, or have better sound quality than older analog circuits.  Both types of hearing aids utilize the same microphones and speakers (receivers).    


What are directional microphones used for?

Directional microphones tend to provide more clarity in noisy surroundings. Studies show that directional microphone technology is the MOST effective means of controlling background noise for persons wearing hearing aids.  However, not all styles can incorporate directional microphones - this is especially true for the smallest completely in canal (CIC) styles.  The most effective style for directional microphones is behind-the-ear (BTE).  If you need a hearing aid that uses a directional microphone, they only come in behind-the-ear (BTE), in-the-ear (ITE) and ITC (in the canal).  Swallow your pride and ego -- if you want to hear and understand better, especially in background noise, you'll need a somewhat larger hearing aid.    top