Hearing Aids
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). However, the regulation says that if you are more than 18 years old and are aware of the recommendation to receive a medical exam, you may sign a waiver to forego the exam.
A Harvard Park Hearing otolaryngologist or audiologist can dispense aids. Hearing aids should be custom fitted to your ear and hearing needs. Hearing aids purchased by mail-order typically cannot be custom fitted.
Cost Of Hearing Aids
Hearing aids vary in price according to style, electronic features, and local market conditions. Price can range from many hundreds of dollars to more than $2,500 for a programable, digitalized hearing aid.
Styles Of Hearing Aids
There are several styles of hearing aids:
· Behind-the-ear (BTE)
· In-the-ear (ITE)
· Smaller versions of ITEs are called half-shell and in-the-canal (ITC)
· The least visible aids are completely-in-the-canal (CIC).
Hearing aid options, which are appropriate for your particular hearing loss and listening needs, the size, and shape of your ear and ear canal, and the dexterity of your hands will all be considered in deciding what type of hearing aid is the best for you. Many hearing aids have special telecoil "T" switches to aid in use of the telephone and certain public sound systems. Discuss your need for a T-coil switch while you are considering hearing aid options.
Will I Need A Hearing Aid For Each Ear?
Usually, if you have hearing loss in both ears, using two hearing aids is best. Listening in a noisy environment is difficult with amplification in one ear only, and it is more difficult to distinguish where sounds are coming from. If, however, the quality of hearing in one ear is very different from the other, one hearing aid may be better than two.
What Other Questions Should I Ask?
1. Ask about charges for the hearing evaluation, dispensing fee(s), and future servicing and repair.
2. Inquire about the trial period policy and what fees are refundable if you return the hearing aid(s) during the trial period.
3. Ask about the warranty coverage for your hearing aids and the consumers' protection program for hearing aid purchasers in your state.
What Will Happen At My Hearing Aid Fitting?
1. The hearing aids will be fitted for your ears
2. Then, while wearing your hearing aids, you will be tested for word understanding in quiet and in noise and for improvement in hearing tones
3. Next, you will receive instruction about the care of your hearing aids, the batteries used to power them, a suggested wearing schedule, general expectations, and helpful communication strategies
4. You will also practice properly inserting and removing the hearing aids and batteries
How Should I Begin Wearing The Aids?
Start using your hearing aids in quiet surroundings, gradually building up to noisier environments
Report any concerns on a follow-up appointment.
IMPORTANT THINGS TO DO BEFORE YOU PURCHASE HEARING AIDS
· Make sure there is a contract that both parties sign and that you fully understand the contract before you sign it.
· Make sure a trial period is offered with the hearing aids.
· Ask what manufacturers the dispenser works with. It is advantageous to work with dispensers who deal with most of the major manufacturers.
· Ask how payment is handled. It is best to pay for the hearing aids when you actually leave with them.
· Make sure the hearing aids come with at least a one-year repair warranty.
· Ask about loss and damage coverage on the hearing aids.
Find out what kind of service the dispenser provides. Some good questions to ask:
1. Are there office visit fees?
2. What are the office hours?
3. Will there be a charge for cleaning or checks of the aid?
4. Are there charges for minor repairs done in-office?
5. Are there charges for programming adjustments?
6. Can I walk in for cleaning/adjustment or do I need an appointment?
WHAT CAN I EXPECT FROM HEARING AIDS?
· Hearing in quiet should be improved.
· Hearing in background noise should be easier than without out hearing aids, although you may still experience difficulty.
· Hearing in noise will not be as good as hearing in quiet.
· Hearing in loud noise should be no worse than without hearing aids.
· Soft speech should be audible, conversational speech should be comfortable, loud speech should not be uncomfortable.
· No whistling should occur if the hearing aids are seated properly.
· The fit should be comfortable
· Your own voice, while it may sound different, should be acceptable.
· It takes time to fully realize the benefits of hearing aids.
A REMINDER
· Hearing aids are only part of the process of hearing better again..
· It takes time for me to fully realize my potential.
· Some sounds may be strange tome initially including my voice, footsteps, birds, and rattling papers.
· Other things like FM, speech, reading, and good listening skills will also benefit me.
· Hearing aids will not restore "normal" hearing:
· I may still have trouble hearing in some noisy situations.
· I may have to modify my environment for better hearing.
UNDERSTANDING HEARING AID TECHNOLOGY
LEVEL I STANDARD CONVENTIONAL INSTRUMENTS AND ENTRY LEVEL PROGRAMMABLE AND DIGITAL INSTRUMENTS
· People who currently wear this level of technology and are happy with it
· Individuals who do not have a sensitivity to loud sounds
· People who are usually in quiet listening situations
· Directional technology is available on some models
LEVEL II PROGRAMMABLE AND DIGITAL INSTRUMENTS
· People who have loudness tolerance issues
· More active individuals who may be in noisier listening situations
· People with poorer speech discrimination ability
· Directional technology is available on some models
LEVEL III HIGH END DIGITAL INSTRUMENTS
· People who are often in noisy situations and need improved hearing in noise
· Achieving the most natural sounding reproduction of signals
· Individuals who require automatic hearing aid functioning
· Individuals with difficult to fit hearing loss configurations
· Comfortable listening in a wide variety of situations
· Directional technology is available on some models
DISPOSABLE INSTRUMENTS
These instruments come in three stock sizes and several pre-set amplification levels. It is not possible to fine-tune these instruments and there are no user controls. They are appropriate for:
· People with hearing loss within the prescriptive range
· Individuals who are not ready to purchase a custom instrument
· People who do not require a custom fit
Cochlear Implants
205A cochlear implant is an electronic device that restores partial hearing to the deaf. It is surgically implanted in the inner ear and activated by a device worn outside the ear.
How Is Hearing Impaired?
If you have disease or obstruction in your external or middle ear, your conductive hearing may be impaired. Medical or surgical treatment can probably correct this.
An inner ear problem, however, can result in a sensorineural impairment or nerve deafness. In most cases, the hair cells are damaged and do not function. Although many auditory nerve fibers may be intact and can transmit electrical impulses to the brain, these nerve fibers are unresponsive because of hair cell damage. Since severe sensorineural hearing loss cannot be corrected with medicine, it can be treated only with a cochlear implant.
How Do Cochlear Implants Work?
Cochlear implants bypass damaged hair cells and convert speech and environmental sounds into electrical signals and send these signals to the hearing nerve.
The implant consists of a small electronic device, which is surgically implanted under the skin behind the ear and an external speech processor, which is usually worn on a belt or in a pocket. A microphone is also worn outside the body as a headpiece behind the ear to capture incoming sound. The speech processor translates the sound into distinctive electrical signals. These 'codes' travel up a thin cable to the headpiece and are transmitted across the skin via radio waves to the implanted electrodes in the cochlea. The electrodes’ signals stimulate the auditory nerve fibers to send information to the brain where it is interpreted as meaningful sound.
Read more about cochlear implants and meningitis.
Cochlear Implant Benefits And Testing For Candidates
Implants are designed only for individuals who attain almost no benefit from a hearing aid. They must be 12 months of age or older (unless childhood meningitis is responsible for deafness).
Your evaluation will include:
1. Ear (otologic) evaluation
2. Hearing (audiologic) evaluation
3. X-ray (radiographic) evaluation
4. Psychological evaluation
5. Physical examination
Cochlear Surgery
Implant surgery is performed under general anesthesia and lasts from two to three hours. An incision is made behind the ear to open the mastoid bone leading to the middle ear. The procedure may be done as an outpatient, or may require a stay in the hospital, overnight or for several days, depending on the device used and the anatomy of the inner ear.
About one month after surgery, your team places the signal processor, microphone, and implant transmitter outside your ear and adjusts them.
There are many factors that contribute to the degree of benefit a user receives from a cochlear implant, including:
· how long a person has been deaf
· the number of surviving auditory nerve fibers
· a patient’s motivation to learn to hear
Is There Care And Training After The Operation?
About one month after surgery, your team places the signal processor, microphone, and implant transmitter outside your ear and adjusts them. They teach you how to look after the system and how to listen to sound through the implant. Some implants take longer to fit and require more training. Your team will probably ask you to come back to the clinic for regular checkups and readjustment of the speech processor as needed.
What Can I Expect from An Implant?
Cochlear implants do not restore normal hearing, and benefits vary from one individual to another. Most users find that cochlear implants help them communicate better through improved lipreading, and over half are able to discriminate speech without the use of visual cues. There are many factors that contribute to the degree of benefit a user receives from a cochlear implant, including:
* how long a person has been deaf,
* the number of surviving auditory nerve fibers, and
* a patient’s motivation to learn to hear.
Your team will explain what you can reasonably expect. Before deciding whether your implant is working well, you need to understand clearly how much time you must commit. A few patients do not benefit from implants.
FDA Approval For Implants
The Food and Drug Administration (FDA) regulates cochlear implant devices for both adults and children and approves them only after thorough clinical investigation.
Be sure to ask your Harvard Park Hearing otolaryngologist for written information, including brochures provided by the implant manufacturers.
Costs Of Implants
More expensive than a hearing aid, the total cost of a cochlear implant including evaluation, surgery, the device, and rehabilitation is around $40,000. Most insurance companies provide benefits that cover the cost.
