Hearing Aid Style Breakdown:Behind the Ear

Hearing aids come in a variety of styles. My upcoming posts will breakdown the advantages and limitations of a popular styles of hearing aids. Selecting a style that is right for you depends on a number of factors. You will need to consider the severity of your hearing loss, the size and shape of your ear, and your personal preferences.
The Behind the Ear (BTE) hearing aids are housed in a curved case that fits neatly and comfortably behind your ear. The hearing aid picks up sound, amplifies it and carries the amplified sound to an ear mold that fits inside your ear canal. A custom ear mold is made to the exact shape of your ear. The custom ear mold directs the sound from the hearing aid into your ear and secures the hearing aid in place.

A Behind the Ear hearing aid is the largest, most visible type of hearing aid. This could be seen as a draw back for some. Many of our patients prefer their hearing aids to be barely visible. They are also particularly vulnerable to sweat and wax build up. It is important to keep your hearing aids clean to have them run properly. I have also heard some complain of feeling "plugged-up" from the earmold. If this is a concern for you, ask about having your BTE vented.

As the world's most popular style, there are some clear advantages to this hearing aid. For many, versatility makes it a popular choice. This style is appropriate for a wide range of hearing losses and age groups. They are even a good fit for children. Because the main components are housed outside of the ear, these aids tend to be more durable. With that, they need less repairs and have a longer life expectancy. Traditionally, their size has allowed them to provide the most amplification. With ever-changing technology, other options have been developed which allow similar styles to surpass the BTE in power. This is accomplished through purchasing additional power molds that can be added onto a similar style of hearing aid: Receiver in the Canal. We will take a closer look at this style next post.

What Is a Hearing Evaluation?

A hearing evaluation is essential to understanding and diagnosing your hearing loss. During your evaluation, a licensed hearing instrument specialist or audiologist will conduct a series of tests to access how well you hear. I get asked often about the cost of such an exam. House of Hearing Orem provides everything mentioned in this post completely free of charge. We simply want to help you hear, and a proper hearing evaluation will provide us with valuable insight to your loss.

1. Patient Paperwork
Before proceeding, you will be asked to fill out basic contact information and answer questions about your medical history. At our office, we use these questions to pinpoint your specific needs. Maybe you have been exposed to excess noise at work, or have suffered physical damage to your ears. It is important for us to know about past illnesses and any other basic medical history that may have had an impact on your hearing. Once you have filled out our paperwork, your actual hearing exam will begin.

2. Looking Into Your Ears
At the beginning of your hearing exam, we will ask to look into your ears with an Otoscope. This helps us see into your ears and determine if there are any abnormalities in the ear canal or maybe if you are plugged up with wax. If your loss is just from wax, we will give you a free cleaning kit to take home with you.

3. The Pure Tone Test
The next step is conducted in a quiet room. We try to keep our front room as quiet as possible to ensure outside noises will not interfere with test results. For a Pure Tone Test, you will be asked to insert a small set of earplugs into your ears. Testing each ear individually, we will play tones of different frequencies one at a time. When you hear the sound, we ask that you raise a finger. Each tone is played at softer and softer levels until you no longer respond consistently. The softest level you can hear is your threshold for that particular frequency. Your responses are charted on an audiogram, and the resulting graph indicates how well your outer and middle ear structures are processing sound. The various frequencies played represent the range of sounds you commonly hear in the world.

4. The Speech Test
The Speech Test is broken down into two parts. The first part requires you to repeat a series of two-syllable words that are played at successively lower levels. This test helps to determine the level at which you can detect speech. You will then be asked to repeat one syllable words set at a comfortable listening level, to see how well you understand speech. Identifying these levels helps to further determine your hearing aid candidacy. If your hearing exam shows you could benefit from hearing aids, these speech tests help customize your hearing devices so it is easy to comprehend conversation in multiple listening environments.

5. Results
From all of this, we will sit down and analyze your results. It is important to us that you understand these. We are happy to take as much time as you need to explain and go over everything. If you have a question, or simply do not understand something, please ask! It is possible to be tested and have no hearing loss. If your results do indicate a loss, we will provide free demonstrations of a variety of hearing aid brands and styles that will suit your lifestyle. We believe no two hearing losses are the same. At our office, we aim to give you a customized, personal fitting experience. We look to be the best at fitting hearing aids that are comfortable for your ears, your price range, and your lifestyle.

Can One Restore Their Hearing?

Be it naturally, surgically, or with the help of hearing aids, many wonder if their hearing can be restored after a loss. The simple answer is, it depends. You first need to identify what caused your loss. In our previous post, we focused on noise-induced hearing loss. While that may be one of the more popular causes, there are a variety of factors to consider. Some others include genetics, injury, ear infections, tinnitus, wax, and obviously age. Recognizing the contributing factors for your loss is essential to finding the solution. Below are ways in which you may be able to improve your hearing.

1. Naturally
New research shows that certain supplements, vitamins, and minerals can be used to improve hearing. While this is not my area of expertise, let me clarify this statement. There is a difference between improving and curing hearing loss. Once you have damaged hair cells, those are not regenative. If you are looking to use natural methods to improve your hearing, the sooner you start the better. Note that supplements are not an instant cure. The most common, and possibly easiest, way that I recommend to improve your hearing is to remove ear wax. If you suffer from muffled hearing, the culprit could simply be wax. Q-tips are not recommended for removing wax as they can puncture your eardrum. We give out free wax cleaning kits to our patients to use at home. You can purchase them about anywhere!

2. Surgerically
If the loss is conductive, that is, caused by a problem with the ear canal, ear drum, bones behind the ear or middle ear cavity, there is a good chance that it could be treated surgically. Conductive hearing loss is caused by a problem with sound waves getting from the air around us to the cochlea. A sound wave travels through the ear canal, eardrum, and middle ear bones before going to the cochlea. Any problem along that pathway will dampen the sound wave and cause hearing loss. A long list of problems can cause conductive hearing loss, ranging from the above mentioned earwax impaction to a tumor behind the eardrum. Popular surgical treatments, either tympanoplasty or mastoidectomy, involve removing a cyst from the ear and rebuilding the eardrum. A stapedotomy is another surgical procedure in which the stapes and incus, both bones in the middle ear, are separated. A hole is made in the footplate of the stapes. Through this hole an artificial prosthesis called a stapes piston is inserted and connected to the incus, thus restoring the transmission of sound waves to the cochlea.

What about a cochlear implant? As opposed to the above treatments for conductive hearing loss, cochlear implants restore hearing to people with severe to profound sensorineural hearing loss who do not achieve benefit from hearing aids. They can be performed in patients ranging from adults down to children. Cochlear implants are devices that have an external processor connected to a coil of electrodes which are surgically implanted directly into the cochlea. The external processor converts sound waves into electrical impulses and sends them to the coil within the cochlea. Directly stimulating the cochlear nerve, sound is now produced.

3. Hearing Aids
As you have probably noticed, hearing loss is categorized into two main types:conductive and sensorineural. A conductive hearing loss is caused by a barrier or hiccup in the transporting of sound waves. On the other hand, if the hearing loss is due to changes in the nerves it is a sensorineural hearing loss. With this, there is no surgical, medical or alternative treatment that will improve the hearing once it is lost. This is the most common type of loss, often associated with aging, and most cases are compensated well by hearing aids. Now you might groan at the idea of hearing aids. Maybe you think they are too expensive, they hurt, do not work well, or maybe you dislike how they look. Hearing aids have changed drastically over the past decade, and I guarantee the technology is only getting better. Researchers are always finding ways to improve. In the coming weeks I will be putting together multiple posts to address these concerns. Additionally, I would like to do a couple posts about specific brands and styles of hearing aids that may interest you. In the mean time, if you have any questions you would like to see addressed, feel free to leave them in the comments below!

How Loud is Too Loud?

I am a self-professed loud music listener. I use my iPod at the gym, and I love it. Ever wonder how loud is too loud? Ever wonder how much hearing loss your iPod is causing? Music has evolved. Loud gets attention, and sells records. How this is associated with hearing loss depends on the person. It depends on how long you are listening, and it depends on the level at which you are setting your iPod. There is huge variation in how people are affected by loud sound. Certainly a huge part of this is underlying genetics. Put that aside and physiologically, noise-induced hearing loss is caused by damage deep inside the ear. The primary area where the ear is damaged is not the eardrum, not the part of the ear that you can see and not the bones that make up the middle ear — it is actually even deeper inside. It is where the nerve that brings the sound message up to the brain connects with the inner ear, and it involves some very specialized cells. These are hair cells, and specifically we are looking at the outer hair cells. When they are overexposed or stimulated at too high a level for too long a duration, they end up being metabolically exhausted. They are simply overworked. Once fatigued, they temporarily lose their function. What do we do to compensate? We turn up the volume. Sound has to be made louder in order for you to hear it. Ever got into your car and immediately had to turn the radio down? This is the perfect example of hair cell fatigue. In your prior car ride, you had become use to the volume of the radio and did not perceive it as loud anymore. After letting your hair cells rest, re-visiting that level of volume was startling, even uncomfortable. Your hair cells can recover after a single exposure, but if you overexpose them often enough, they end up dying. Once this happens you lose that functional ability inside your inner ear. The cells that die are not replaceable.

As far as a rule of thumb goes, the figures show that people using their iPod could listen at about 80% of maximum volume for 90 minutes per day or less without increasing their risk for noise-induced hearing loss. But the louder the volume, the shorter your duration should be. At maximum volume, you should listen for only about 5 minutes a day. Below is a chart which visually illustrates this relationship.