I don't hear well. What should I do? What should I expect?
First, visit a physician who can refer you to an otolaryngologist (an ear, nose, and throat specialist), because many hearing problems can be corrected medically. If you have ear pain, drainage, excess earwax, hearing loss in only one ear, sudden or rapidly progressive hearing loss, or dizziness, it is especially important that you see an otolaryngologist, as these may be symptoms indicating a serious medical problem. After your exam, the otolaryngologist will help you obtain a hearing assessment from an audiologist (a nonphysician healthcare professional). A screening test from a hearing aid dealer may not be adequate. Many otolaryngologists have an audiologist in their office to assess your ability to hear pure tone sounds and to understand words. The results of these tests will indicate the degree of hearing loss, the type of loss (conductive or sensorineural) and other medical information about your ears and health.
Conductive Hearing Loss: A hearing loss is conductive when there is a problem with the ear canal, the eardrum, and/or the three bones connected to the eardrum. This causes a mechanical (conductive) blockage, preventing the full energy of the sound from reaching your inner ear. Two common reasons for this type of hearing loss are excess wax in the ear canal or fluid behind the eardrum. Medical treatment or surgery may be available for these and other forms of conductive hearing loss.
Sensorineural Hearing Loss: A hearing loss is sensorineural when it results from damage to the inner ear (cochlea) or auditory nerve, often a result of the aging process and/or noise exposure, but also may be secondary to head trauma, systemic illness or infection, or inheritance. Sounds may be unclear or too soft. Sensitivity to loud sounds may occur. Medical or surgical intervention cannot correct most sensorineural hearing losses, but hearing aids may help you reclaim some sounds you are missing as a result of nerve deafness.
Where do I purchase hearing aids?
Federal regulation prohibits any hearing aid sale unless the buyer has first received a physicians evaluation, so you will need to see your doctor before you purchase a hearing aid. However, the regulation also says that if you are over 18 and aware of the recommendation for a medical exam, you may sign a waiver to forego it.
An otolaryngologist, audiologist, or independent dispenser can dispense aids. Hearing aids should be custom-fit to your ear and hearing needs. Mail-order hearing aids typically cannot be custom-fit.
What are costs and styles of hearing aids?
Hearing aids vary in price according to style, features, and local market prices. Price can range from hundreds of dollars to more than $2,500 for a programmable, digital hearing aid. Purchase price should not be the only consideration in buying a hearing aid. Product reliability and customer service can save repair costs and decrease frustration of a malfunctioning hearing aid.
There are several styles:
- Behind-the-ear (BTE) aids go over the ear and are connected with tubing to custom-fitted earpieces.
- Open fit receiver-in-the-ear (RITE) aids are a newer design, and while still placed over the ear, they are extremely small and nearly invisible.
- In-the-ear (ITE) hearing aids fill the entire bowl of the ear and part of the ear canal.
- Smaller versions of ITEs are called half-shell and in-the-canal (ITC).
- The least visible aids are completely-in-the-canal (CIC).
The best hearing aid for you depends upon your particular hearing loss and listening needs, the size and shape of your ear and ear canal, and the dexterity of your hands. Many hearing aids have tele-coil "T" switches for telephone use and public sound systems.
Other options, such as FM systems and Bluetooth devices in conjunction with hearing aids, may provide the best benefit for some patients.
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.
What other questions should I ask?
Ask about future service and repair. Also inquire about the trial period policy and what fees are refundable if you return the hearing aids during that period. And ask about 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?
The hearing aids will be fitted for your ears. Then, while wearing them, you will be tested for word understanding in quiet and in noise, and for improvement in hearing tones. Real ear measurements may also be done, which determine how much gain your hearing aids give you.
Next, you will receive instruction about the care of your hearing aids and other helpful strategies.
How should I begin wearing the aids?
Start using your hearing aids in quiet surroundings, gradually building up to noisier environments. Then eventually work up to wearing your hearing aids all waking hours. Keep a diary to help you remember your experiences and report them accurately to your dispenser for adjustments as needed. Report any concerns on a follow-up appointment. Be patient and allow yourself to get used to the aids and the "new" sounds they allow you to hear.
Copyright © 2014 American Academy of Otolaryngology–Head and Neck Surgery. Reproduction or republication strictly prohibited without prior written permission.