Approximately 5% to 10% of hearing problems in adults are medically or surgically treatable. This percentage is higher in children especially if a middle ear disease, such as ear infection, is the cause. If your hearing evaluation indicates that your condition cannot be medically or surgically treated, additional testing may be done to determine if hearing aids will be beneficial. If you think you might need a hearing aid or to visit a hearing doctor in NY or NJ, contact an ENT specialist at ENT and Allergy Associates.
If you have hearing loss in both ears, the audiologist may recommend that you use two hearing aids. In most instances, wearing two hearing aids helps in localizing the direction of sounds, improves listening in noisy situations, and provides better overall hearing. The audiologist will provide you with the recommended hearing aid(s) and/or other hearing assistive devices and will instruct you in their use.
Where To Buy A Hearing Aid
Buying a hearing aid can be a challenging process. Because some hearing problems can be medically corrected, having a full evaluation by an ENT physician will help put you on the right track.
Once the audiological and medical evaluations have been completed, and your needs evaluated, we will then help you to determine if hearing aids would be beneficial. In our consultation with you, our patient some of the following items will be discussed: Hearing test results describing the type and degree of hearing loss, one versus two hearing aids, style of hearing aid, and your lifestyle communication demands.
Fortunately, our licensed audiologists can recommend and dispense the latest hearing technology. Because federal regulation prohibits any hearing aid sale unless the buyer has first received a medical evaluation from a physician, you will need to see your physician before you purchase a hearing aid(s).
To read an article published by Consumer Reports, click on the following link on purchasing a hearing aid .
Hearing Aids Technology Overview
Reasons to consider Two versus One Hearing Aid
For more information on purchasing a hearing aid (from the AAO-HNS) and the types of technology, click here.
NY Times Article on Hearing Aid Loop technology.
NY times Article on Hearing Aid Quality of Life, Alzheimer's and Dementia
Types of Hearing Loss
Hearing loss can be categorized by where or what part of the auditory system is damaged. There are three basic types of hearing loss: conductive hearing loss, sensorineural hearing loss and mixed hearing loss.
Conductive Hearing Loss
Conductive hearing loss occurs when sound is not conducted efficiently through the outer ear canal to the eardrum and the tiny bones, or ossicles, of the middle ear. Conductive hearing loss usually involves a reduction in sound level or the ability to hear faint sounds. This type of hearing loss can often be medically or surgically corrected.
Examples of conditions that may cause a conductive hearing loss include:
Conditions associated with middle ear pathology such as:
- Fluid in the middle ear from colds
- Allergies (serous otitis media),
- Poor eustachian tube function
- Ear infection (otitis media)
- Perforated eardrum
- Benign tumors
- Impacted earwax (cerumen)
- Infection in the ear canal (external otitis)
- Presence of a foreign body
- Absence or malformation of the outer ear, ear canal, or middle ear
Sensorineural Hearing Loss
Sensorineural hearing loss occurs when there is damage to the inner ear (cochlea) or to the nerve pathways from the inner ear (retrocochlear) to the brain. Sensorineural hearing loss cannot be medically or surgically corrected. It is a permanent loss.Sensorineural hearing loss not only involves a reduction in sound level or ability to hear faint sounds, but also affects speech understanding, or ability to hear clearly. Sensorineural hearing loss can be caused by diseases, birth injury, drugs that are toxic to the auditory system, and genetic syndromes. Sensorineural hearing loss may also occur as a result of noise exposure, viruses, head trauma, aging, and tumors.
Mixed Hearing Loss
Sometimes a conductive hearing loss occurs in combination with a sensorineural hearing loss. In other words, there may be damage in the outer or middle ear and in the inner ear (cochlea) or auditory nerve. When this occurs, the hearing loss is referred to as a mixed hearing loss.
Causes of Hearing Loss in Adults
Hearing loss in adults has many causes such as disease or infection, ototoxic drugs, exposure to noise, tumors, trauma and the aging process. This loss may or may not be accompanied by tinnitus, ringing in the ears.Tinnitus can occur by itself without any hearing loss.
Otosclerosis is a disease involving the middle ear capsule, specifically affecting the movement of the stapes (one of the three tiny bones in the middle ear).
Meniere's disease affects the membranous inner ear and is characterized by deafness, dizziness (vertigo) and ringing in the ear (tinnitus).
Medications used to manage some diseases are damaging to the auditory system (ototoxic) and cause hearing loss. Some of the specific drugs known to be ototoxic are aminoglycoside antibiotics (such as streptomycin, neomycin, kanamycin), salicylates in large quantities (aspirin), loop diuretics (lasix, ethacrynic acid), and drugs used in chemotherapy regimens (cisplatin, carboplatin, nitrogen mustard).
Exposure to harmful levels of noise results in noise-induced hearing loss . The prolonged exposure causes damage to the hair cells in the cochlea and results in permanent hearing loss. The noise-induced hearing loss usually develops gradually and painlessly. Hearing loss can also occur as a result of an acoustic trauma, or a single exposure or very few exposures to very high levels of sound.
An acoustic neuroma is an example of a tumor that causes hearing loss. Acoustic neuromas arise in the eighth cranial nerve (acoustic nerve). The first symptom is reduction of hearing in one ear accompanied by a feeling of fullness.
Trauma can also result in hearing loss. Examples include fractures of the temporal bone, puncture of the eardrum by foreign objects, and sudden changes in air pressure.
Loss of hearing as a result of the aging process is called presbycusis. The process involves degeneration of the inner ear (cochlea). Presbycusis can also involve other parts of the auditory system. The hearing loss is progressive in nature with the high frequencies affected first. While the process begins after age 20, it is typically at ages 55 to 65 that the high frequencies in the speech range begin to be affected.
Hearing Aid FAQ's
Question: What happens when I want to have my hearing checked?
Answer:Hearing screening tests provide a quick and cost effective way to separate people into two groups: a pass group and a fail group. Those who pass hearing screening are presumed to have no hearing loss. Those who fail are in need of an in-depth evaluation by an audiologist and may also need follow-up care from other professionals. Hearing screening occurs from birth throughout the adult years when requested, when conditions occur that increase risk for hearing loss, or when mandated by state and local laws or practices. It is recommended that all hearing screening programs be conducted under the supervision of an audiologist holding the American Speech-Language-Hearing Association's (ASHA) Certificate of Clinical Competence (CCC).
Question: Are all hearing aids the same?
Answer: Hearing aids differ in design, size, the amount of amplification, ease of handling, volume control and availability of special features. But they do have similar components that include:
- a microphone to pick up sound,
- amplifier circuitry to make the sound louder,
- a receiver (miniature loudspeaker) to deliver the amplified sound into the ear,
- batteries to power the electronic parts.
Some hearing aids also have earmolds (earpieces) to direct the flow of sound into the ear and enhance sound quality. Based on your listening needs, type of hearing loss, and lifestyle, your audiologist will advise you on which of the basic hearing aid styles and features best meet your communication needs and their related costs.
Question: What are the different styles of hearing aids?
In-the-canal and completely-in-the-canal aids: These aids are contained in a tiny case that fits partly or completely into the ear canal. They are the smallest aids available and offer cosmetic and some listening advantages.
In-the-ear aids: All parts of the aid are contained in a shell that fills in the outer part of the ear. These aids are larger than canal aids, and for some people may be easier to handle than smaller aids.
Behind-the-ear aids: All parts are contained in a small plastic case that rests behind the ear, the case is connected to an earmold by a piece of clear tubing. This style is often chosen for young children for safety and growth reasons.
Receiver-in-The-Ear (RITE): These are probably the most popular type of hearing aids in today's market. Cosmetically excellent, with state-of-the art technology.
There are hearing aids available that can accommodate virtually any kind of hearing loss!
Question: Will hearing aids help me hear better on the telephone or in public places?
Answer: Depending on your hearing loss, hearing aids typically help make speech over the telephone clearer. If you are on the telephone a lot, consider getting hearing aids with the "T", (telecoil) circuits described above. Telephone sounds are amplified more efficiently and background noises are better eliminated with this kind of circuit. [Only some cordless telephones work well with hearing aids]. People with hearing loss may also benefit from a telecoil to use with some of the special assistive listening sound systems available in many auditoriums, theaters and other public places as required under federal law. Discuss your option of a "T", switch with your audiologist.
Question: Will hearing aids eliminate all my communication problems?
Answer: With hearing aids, you will hear some sounds you have not heard previously or sounds you have not heard in a long time. At first, background noise may seem loud and distracting. Your own voice may sound louder. It can take several weeks to months to become adjusted to listening with your hearing aids. Your audiologist will provide hearing aid orientation for you as well as audiologic rehabilitation as needed, which will enable you to communicate more effectively with your hearing aids.
Question: Will my health insurance pay any of the costs of acquiring a hearing aid?
Answer: Some private health care plans cover the costs of audiologic tests, a hearing aid evaluation, and even partial or full coverage of a hearing aid. Check with your health insurance company or your benefits manager to find out exactly what audiology services your policy covers. You may wish to advocate for inclusion of audiology services in your plan if not included. At this time, Medicare does not cover hearing aids, Medicaid often does and must for children.
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