Hearing Aids FAQs

A hearing aid is an electronic, battery-operated device that amplifies and changes sound to allow for improved communication. Hearing aids receive sound through a microphone, which then converts the sound waves to electrical signals. The amplifier increases the loudness of the signals and then sends the sound to the ear through a speaker.

Approximately 30 million Americans have a hearing impairment. Hearing loss is one of the most prevalent chronic health conditions in the United States, affecting people of all ages, in all segments of the population, and across all socioeconomic levels. Hearing loss affects approximately 17 in 1,000 children under age 18. Incidence increases with age: approximately 314 in 1,000 people over age 65 have hearing loss. Hearing loss can be hereditary, or it can result from disease, trauma, or long-term exposure to damaging noise or medications. Hearing loss can vary from a mild but important loss of sensitivity, to a total loss of hearing.

Hearing depends on the following series of events that change sound waves in the air into electrical impulses that the auditory (hearing) nerve carries to the brain. The ear has three major parts, described as the outer ear, middle ear and inner ear.

Sound waves enter the outer ear (pinna) and travel through a narrow tube (ear canal) that leads inside the ear to the eardrum (tympanic membrane). The eardrum vibrates from the incoming sound waves and transmits these vibrations through three tiny bones called the ossicles (the malleus, incus and stapes) in the middle ear. They amplify the sound and send it through the entrance to the inner ear (oval window) and into the fluid-filled hearing organ (cochlea). The vibrations create ripples in the fluid that bend projections from tiny hair cells in the cochlea, causing electrical impulses that the auditory nerve, or eighth cranial nerve, sends to the brain.

The brain translates these impulses into what we experience as sound.

There are different types of hearing loss. Conductive hearing loss occurs when sound waves are prevented from passing to the inner ear. This can be caused by a variety of problems including buildup of earwax (cerumen), infection, fluid in the middle ear (ear infection or otitis media) or a punctured eardrum. Sensorineural (nerve) hearing loss develops when the auditory nerve or hair cells in the inner ear are damaged by aging, noise, illness, injury, infection, head trauma, toxic medications or an inherited condition. Mixed hearing loss is a combination of both conductive and sensorineural hearing loss. A conductive hearing loss can often be corrected with medical or surgical treatment, while sensorineural hearing loss usually cannot be reversed.

People with hearing loss may experience some or all of the following problems:

• Difficulty hearing conversations, especially when there is background noise
• Hissing, roaring or ringing in the ears (tinnitus)
• Difficulty hearing the television or radio at a normal volume
• Fatigue and irritation caused by the effort to hear
• Dizziness or problems with balance

If you think you might have hearing loss, you should consult with an otolaryngologist (ENT physician) 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. There are five ENT physicians and four audiologists that practice at Alamance Ear, Nose & Throat.

On the basis of the hearing test results, the audiologist can determine whether hearing aids will help. Hearing aids are particularly useful in improving the hearing and speech comprehension of people with sensorineural hearing loss. When choosing a hearing aid, the audiologist will consider your hearing ability, work and home activities, physical limitations, medical conditions and cosmetic preferences. For many people, cost is also an important factor. Hearing aids are available in different levels of technology and prices.

There are several types of hearing aids. Each type offers different advantages, depending on its design, levels of amplification, and size. There are three basic styles of hearing aids for people with sensorineural hearing loss:

• Behind-the-Ear (BTE) hearing aids are worn behind the ear and are connected to an earmold that fits inside the outer ear. The components are held in a case behind the ear. Sound travels through the earmold into the ear. BTE aids are used by people of all ages for mild to profound hearing loss. They are much smaller now, and have become the most popular choice of our patients at Alamance Ear, Nose & Throat.
• In-the-Ear (ITE) hearing aids fit completely in the outer ear and are used for mild to moderately-severe hearing loss. The case, which holds the components, is made of hard plastic. ITE aids can accommodate added technical mechanisms such as a telecoil, a small magnetic coil contained in the hearing aid that improves sound transmission during telephone calls. ITE aids can be damaged by earwax and ear drainage, and their small size can cause adjustment problems and feedback. They are not usually worn by children because the casings need to be replaced as the ear grows.
• Completely in the Canal hearing aids fit into the ear canal and are available in two sizes. A Completely-in-Canal (CIC) hearing aid is largely concealed in the ear canal and is used for mild to moderately severe hearing loss. Because of their small size, completely-in-the canal aids may be difficult for the user to adjust and remove, and may not be able to hold additional devices, such as a telecoil. CICs can also be damaged by earwax and ear drainage. They are not recommended for children.

Using hearing aids successfully takes time and patience. Hearing aids will not restore normal hearing or eliminate background noise. Adjusting to a hearing aid is a gradual process that involves learning to listen in a variety of environments and becoming accustomed to hearing different sounds.

Before you buy a hearing aid, ask your audiologist these important questions:

• Are there any medical or surgical considerations or corrections for my hearing loss?
• Which design is best for my hearing loss?
• What is the total cost of the hearing aid?
• Is there a trial period to test the hearing aids? What fees are nonrefundable if they 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?

• Become familiar with your hearing aid. Your audiologist will teach you to use and care for your hearing aids. Also, be sure to practice putting in and taking out the aids, cleaning, identifying right and left aids and replacing the batteries with the audiologist present.
• Your own voice may sound too loud. This is called the occlusion effect and is very common for new hearing aid users. Your audiologist may or may not be able to correct this problem; however, most people get used to it over time.
• Your hearing aid may "whistle." When this happens, you are experiencing feedback, which is caused by the fit of the hearing aid or by the buildup of earwax. See your audiologist for adjustments.
• You may hear background noise. Keep in mind that a hearing aid does not completely separate the sounds you want to hear from the ones you do not want to hear, but there may also be a problem with the hearing aid. Discuss this with your audiologist.