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FREQUENTLY ASKED QUESTIONS
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:
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
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).
WHY TWO EARS ARE "USUALLY" BETTER THAN ONE?
Research indicates that, for most people under 85, binaural hearing (i.e., using both ears) usually helps us:
There are six basic styles of hearing aids:
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.
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.
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:
*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.
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:
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).
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