ear, nose, and throat disorders
Management of Hearing Loss
Hearing Aids
Sound amplification with a hearing aid helps people who have either conductive or sensorineural hearing loss. Unfortunately, a hearing aid does not restore hearing to normal. A hearing aid should, however, significantly improve a person's ability to communicate and enjoy sounds. Many people are reluctant to wear hearing aids because of cost, comfort issues, and for some, social stigma. Doctors should discuss such issues and encourage people to meet with an audiologist to evaluate the array of different hearing aid designs available. Some older people and those with arthritis or neurologic problems find it difficult to manipulate the smallest hearing aids and should consider slightly larger devices. The behind-the-ear hearing aid is the most powerful but least attractive hearing aid. The in-the-ear hearing aid is the best choice for severe hearing loss. It is easy to adjust but is difficult to use with telephones. The in-the-canal hearing aid is used for mild to moderate hearing loss. This aid is relatively inconspicuous. The completely-in-the-canal hearing aid is used for mild to moderate hearing loss. This aid has good sound, is nearly invisible, and can be easily used with telephones. It is removed by pulling on a small string. However, it is the most expensive and hard to adjust. All hearing aids have a microphone to pick up sounds, a battery-powered amplifier to increase their volume, and a means of transmitting the sound to the person. Most hearing aids transmit the sounds through a small speaker placed in the ear canal. Other hearing aids, which require surgical implantation, transmit sounds directly to the bones of the middle ear (ossicles) or the skull instead of through a speaker. Hearing aids differ in how big the components are and where they are located. As a general rule, hearing aids with higher quality sound outputs may be more noticeable but are easier to adjust and offer listening advantages. Larger hearing aids can often accommodate features of assisted listening that are not available in small ones. Hearing aids have different electronic characteristics that are chosen to suit the person's particular type of hearing loss. For example, people whose hearing loss affects mainly higher frequencies do not benefit from simple amplification, which merely makes the mumbled speech they hear sound louder. Hearing aids that selectively amplify the high frequencies markedly improve speech recognition. Other hearing aids contain vents in the ear mold, which facilitate the passage of high-frequency sound waves into the ear. Many hearing aids use digital sound processing with multiple frequency channels so that the amplification can even more precisely match the person's hearing loss. People who cannot tolerate loud sounds may need hearing aids with special electronic circuitry, which keeps the maximum volume of sound at a tolerable level. Telephone use can be difficult for people with hearing aids. With typical hearing aids, placing the ear next to the phone handle causes squealing. Some hearing aids have a phone coil. With the flip of a switch the microphone is turned off, and the phone coil links electromagnetically to the magnet in the phone handle. As long as the hearing aid has the proper features, this setup can be arranged by the phone company with simple changes to the phone. Hearing aids with complex features tend to be the most expensive but are often essential to meet hearing needs. 