Hearing Aids

 

Treatment of  Sensori-Neural (“Nerve deafness”)  and  The hope for  Deafness due to ageing

An initial hearing loss manifests when people begin to notice a reduction in their hearing ability.

1. It becomes difficult to understand what is being said, when three or more people are talking together.

2. It seems that others – especially young people – have begun to mumble.

3. Background noise can make it difficult to understand what is being said.

4. Other sounds, such as bird song, doorbells or a ringing telephone, can recede or simply disappear.

5. Family and friends of people who have a hearing loss, due to advancing age, also notice this

It can be a difficult and confusing time for the hearing affected person, as a simple conversation becomes a struggle and they begin to blame others for mumbling. So it may take some time to realise that hearing capacity is decreasing.

When the High tones are affected in the range where the important speech sounds, usually the consonant sounds, such as “s”, “t” and “f”, can no longer be clearly heard. This causes speech to sound muddy and slurred, so even though we can hear we are being spoken to, we cannot understand what is being said.

When our hearing fails us, it can be difficult or impossible to perceive all of the rich nuances of life’s many sounds: the clock ticking, foot­steps, water running, food sizzling in a pan. The world around us goes quiet – the melody is lost.

While many of us will have to accept impaired hearing as part of the ageing process, there is absolutely no reason to accept a poorer quality of life as well. The worst thing we can do, when faced with a hearing loss, is to ignore or try to hide the fact. Those around us will quickly suspect that something is wrong, as we become less and less able to communicate normally.

People with a hearing loss are often treated as if they were less intelligent than those with normal hearing.

Their hearing difficulty can put them in situations where, for example, they do not hear a question correctly and consequently give an unrelated answer. Or perhaps they do not hear the question at all. This can be misun­derstood and interpreted as a sign of stupidity.

While a hearing aid is an effective help – it is not a cure for hearing impairment.

Hearing aids can not restore our original hearing ability, but they can help us to make the very most of the hearing ability we have left. Today’s hearing aids are intricate technical instruments, which are individually adjusted to the user’s own specific hearing loss. Even so, it takes time to become used to all the new, amplified sounds ­especially if we have lived with a hearing loss for some time and have forgotten how noisy buses and cars sound.

Age-related hearing loss is neither an illness nor something to be embarrassed about, but rather a completely natural result of advancing age. Fortunately, this is a problem we can do something about!

Most individuals with hearing loss can bene­fit from amplification. The goal of amplification is to make speech audible. The most common types of hearing aids range in size from fitting behind the ear (BTE), in the ear (ITE), and in the canal (ITC) to completely in the canal (CIC), the small­est. The style of hearing aid can be limited by the degree of loss. For example, an individual with severe to profound hearing loss will require a BTE. A lesser hearing loss should benefit from the smaller styles such as ITE or CIC.

Audiogram and Impedance testing determines the levels of hearing for hearing aid can be selected.

The most common types of hearing aids range in size from fitting behind the ear (BTE), in the ear (ITE), in the canal (ITC) and completely in the canal (CIC), the small­est. The style of hearing aid is limited by the degree of loss. For e.g., an individual with severe to profound hearing loss will require a BTE. A lesser hearing loss should benefit from the smaller styles such as ITE or CIC.

Guidelines for choice of a Hearing Aid

 

 

Normal hearing like every other human faculty is taken for granted. It is only when one is deprived of it does the realization and handicap for this is appreciated.

When considering  the hearing faculty, one has to consider the problem from 3 aspects

 

Relation to one self –

• Pleasure aspect – awareness and enjoyment of environmental sounds – rustle of leaves, chirping of birds, enrich many important elements in life – talking to children, socializing with friends.- an overall improved quality of life

• Listening to music (Entertainment aspect)–

• Safety aspect – Not hearing approaching traffic when crossing the street

Not hearing approaching cars when one is driving.

Not hearing the door bell for people living alone.

• Isolation factor – People around the deaf person do not like to strain their voices to communicate with him leading subsequently to psycho social problems Not being able to listen to the telephone conversation or telephone ring from the same room or other room.

Relation to other human beings –

Since hearing is basic to communication, its loss can have a strong impact on human relations.  Hearing others in everyday situations – One to one conversation at home, in groups of people as at a home family get together, both of the above situations in a quiet situation as at home or office, interaction with other human beings in a noisy environment as when there’s a TV in the background, family get togethers, at a market place,  conversation in the street, in  a noisy restaurant.

Relation to the environment –

Hearing keeps us in contact with life. Losing it means entering a world of silence and loneliness.

When you miss  out on these  things. you feel an irritation, frustation or even anger.

Matching Hearing demands with Degree of Hearing Loss & Hearing Aid types available

 

Consideration of  the age factor

Hearing demands

Lifestyle (cosmetic aspect)

Personal preferences

Economic status (Affordability)

Who is complaining   Patient  OR   relatives

Category of hearing loss (Type of hearing loss)

 Moderate to severe

 Severe to profound

 If not severe, H Aid can help enjoy sounds – rustle of leaves, chirping of birds, talking to children,

socializing  better with friends. enjoying music – an overall improved quality of life

 

 

Type of Aid (According to size & Amplification [Power])

 Pocket (Body worn) (Upto 135 dB) No directionality

 BTE [Behind the Ear] (Upto 120 dB)

 ITE  [In the Ear] (Range upto 90 dB)

 ITC  [In the Canal] (Upto 90dB)

 CIC  [Completely in the Canal] (Upto 70dB)

 

 

Choice of Microphone – 3 generations

 1st generation  – Single Microphone that amplifies all sound signals

 2nd generation   2 Microphones –

1 Microphone –Uni directional, usually forward pointing e.g. lawyer, office etc

2nd  Microphone – Omni / Multi directional for groups, meetings, crowds, while driving

 3rd generation Microphone– Intelligent H. Aids. Speech waves are different from Noise waves.

The microphone distinguishes and separates background noise and speech noise and amplifies only

the speech signals

 

Restriction of  impact noise

Diwali crackers, Vehicle horns, clatter of dishes at a dinner party, traffic, sudden loud noises,

people talking at the next table are firmly suppressed.

Directional technology

2-channel high level compression or 3-channel enhanced dynamic range compression

Combines Adaptive Directionality with Active Microphone Matching to ensure optimum speech

clarity in  background over the instrument’s entire lifetime.

Automatic volume control

Adjusting volume immediately every time your environment changes.

 

Type of Aid (According to price) (Cost factor)

 

Each of the above have:-

 Basic economic category

  Moderate category

  Advanced category (Good compression system  to take care of UCL (Uncomfortable level) and not only HTL (Hearing threshold level) data

 

Monoaural (Aid used in one ear)    Binaural (In both ears)

Open fitting hearing aids

“Open” hearing instrument that amplifies hard-to-hear high pitched sounds while allowing all other sounds to enter the ear naturally. Useful in patients whose low frequency hearing is normal.

No feeling of having a plug in the ear.

That demands heavy telephone use Wearer should be able to use telephones and mobile phones normally  without having to first remove the instrument and with a minimum of bothersome feedback squeal or radio frequency interference.

Background noise reduction

 

Locates and reduces unwanted noise, helping you …. to hear conversions more clearly.

Comfortable listening in both noisy and quiet environments. The instrument continually identifies sounds in the user’s environment whether they are speech or  background noise and quickly-reduce background noise before, during and after the speech signal and letting the wearer hear the full message, no matter how brief.

Some Manufacturers (Brands)

Oticon       Widex      Starkey     GN Resound     Siemens – Rexton,   Novax,     Phonak      Arphi

Alps     Danavox   etc.

Identification of patient’s demands

(Situations to consider while going in for a Hearing Aid)


*  Pleasure aspect – awareness and enjoyment of environmental sounds – rustle of leaves, chirping of
birds, enrich many important elements in life – talking to children, socializing with friends.- an overall  improved quality of life.
*   Listening to music (Entertainment aspect)–*    Safety aspect – Not hearing approaching  trafficwhen                               crossing the street