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Understanding Your Hearing Loss
University Ear, Nose, and Throat Specialists
Center for Audiology and Hearing Aids
Eye and Ear Institute
3 Primary Divisions
Ultimately, we hear with our brain
Conductive Hearing Loss
-Occurs when sound waves cannot reach the inner ear.
-Usually due to earwax, foreign object, tumor, or ear infection
-Generally treated by a physician with medicine or surgery
Sensorineural Hearing Loss
-The sound reaches the cochlea, but it is either processed improperly or the nerve signals do not make it to the brain
-Usually due to aging, exposure to loud noise, infection or disease, drugs, or it may be inherited
-Usually occurs in both ears
-Generally treated with amplification devices and communication therapy
Mixed Hearing Loss
-Has both a conductive and a sensorineural component to it
-May need to be treated by a physician first and then also be fit for amplification by an audiologist
Damage can cause
Inability to hear sounds Inability to discriminate sounds
– Pitch perception is compromised Tinnitus (ringing)
Measuring Hearing
What to expect– Seated in a sound proof booth– Wearing earphones– Hearing tones at specific frequencies
(pitches)– Hearing speech in quiet and noise
For your hearing test to be covered by insurance…
Currently you will need a script (prescription) or order for the hearing evaluation from your primary care physician
Test your hearing over the phone!
Dial 412-647-2400
Communicating with people with hearing loss
Face the individual Speak slightly louder than normal, but not a
shout Do not speak from another room Speak slowly Keep hands and objects away from your face Re-phrase sentences Write key pieces of information down Verify information
The Importance of Protecting your Hearing
Over-the-counter and custom hearing protection are available
Musicians, hunters, construction workers all need to be aware of potential harm to their hearing
Understanding Hearing Aid Technology and other Assistive
Listening Devices
University Ear, Nose, and Throat Specialists
Center for Audiology and Hearing Aids
Eye and Ear Institute
We hear for…
Communication Safety Enjoyment
Individuals involved in hearing health care…
Medically treatable hearing loss– ENT– Otolaryngologist– Otologist
Choose your hearing health care provider carefully: Nonmedically treatable hearing loss Audiologist
– 2-4 years post-graduate work– Masters or AuD (clinical doctorate)– Licensed by the state– Required continuing education
Hearing Aid Dealer– High school education– No criminal record– Registered by the state
State Laws regulating hearing aid provision
30 day adjustment period Ability to return the devices with your money
returned (minus $150.00 per device) State form to be signed at the time the
hearing aids are ordered and when they are delivered
No money is to be collected until the hearing aids are delivered
Process
Full, diagnostic hearing evaluation (you need an order or script from your PCP for this to be covered by your insurance)– including ability to hear in noise
Medical referral if needed
Hearing Aid Discussion– Discuss test results– Examination of the size and shape of ear canal– Communication needs assessment and
expectations– Matching style and technology to hearing loss,
communication needs, environment, ear size, and financial considerations
– Earmold impression
Hearing Aid Fitting– Physical Fit– Programming/Adjusting the hearing aid response
based on measures of the output of the hearing aid in the ear canal (the hearing aid is connected to the computer and there is a small, soft microphone placed in your earcanal with the hearing aid)
– Soft, moderate, and loud sounds are mapped against your hearing thresholds to return correct loudness (it will not sound correct on the first day)
– Test of tolerance for loud sounds
Hearing Aid Orientation– Insertion and removal of the hearing aids– Insertion and removal of the batteries– Manipulation of the controls– Care and cleaning of the hearing aids– Use with the telephone– Warranty information (1 year loss/damage/repair
at a minimum)– Wearing schedule to get used to fit and new
sounds
Keep in mind…
If the hearing aid is tuned correctly, you will not like it for the first week or so…
We know that the brain must adapt to the new input and the only way to adapt is to be exposed to the sound
The brain is not good at trying to hear two different ways. Individuals who try to wear hearing aids part time are not successful (they continually have difficulty in noise and other more difficult listening situations).
Follow-up (3 weeks)– Fine-tuning based on patient perceptions after full
time use for at least 2 weeks– Discussion of residual difficulties, identifying other
solutions if needed
Future appointments– Based on patient need– Change in hearing– Prior to end of warranty (insurance)
Price of Hearing Aids
Bundled price includes the device and all services for a year.
The device is useless without an expert to program it for your hearing loss and communication needs.
Hearing aids range from approximately $900 to $3000 per aid depending on technology and style
Insurance
Many insurances do not cover hearing aids
Security Blue (a few other High Mark products as well)
UPMC for Life
Programs for free hearing aids
Lion’s Foundation HEAR NOW
Hearing Aid Considerations
One ear vs. two ears
Need to choose a style
Need to then choose what technology will be inside the hearing aid
Before you choose a style
Degree of hearing loss Special features needed Ear size Lifestyle needs Manual dexterity Cosmetic preferences Daily care Telephone needs Cost
Hearing Aid Styles
Behind the ear
In the ear
In the canal
Completely in the ear
Behind the ear style
Fits snugly behind your ear Can fit any degree of hearing loss
Attached to a custom earmold
Fewest repairs due to wax
May be connected to assistive devices via telephone switch
Hearing Aid Types
New…
Slim tube Open canal Mini BTE
In the ear style
One-piece instruments custom designed to fit within the bowl of outer ear
Fits mild to moderate degrees of hearing loss
Some repairs due to wax
Can also be connected to assistive devices via telephone switch
In the canal style
Custom instrument that fit almost entirely in the canal of the ear.
Fits mild to mildly-moderate degrees of hearing loss
Many more repairs due to wax
Cannot be connected to assistive devices due to size limitations
In-the-Canal
More discrete Often cannot fit a
telecoil Requires
finger/hand
dexterity
Completely in the canal style
The smallest, most cosmetically appealing hearing instrument
Fits mild to moderate hearing degrees of loss, especially for high-frequency losses
Greatest number of repairs due to wax
Works well with phone due to deep insertion, no need for T-coil
Completely in the Canal (CIC)
Currently very popular virtually invisible can’t have T coil use on phone normally high maintenance takes advantage of
natural gain from auricle and EAM
Hearing Aid Technologies
All Hearing Aids now use Digital Technology
Advanced feedback solutions– Feedback is when amplified sound can
leak out of the ear canal and reach the hearing aid microphone
Processes speech and noise differently(helps with comfort, not understanding in noise)
Fully Digital Technology
Do you want to hear in noise?
Solution: Wear your hearing aids full time
Wear 2 hearing aids
Multiple microphones (Directional Mics)
Assistive Listening Devices (ALD’s)– Put the microphone near the thing you want to
hear, the signal is sent to a receiver attached to your hearing aids
Matching the technology to your needs
You do not want to over purchase The clinic should be using evidence
based practice and therefore be able to explain the technology level choice based on your test results
Safety/Alerting Devices
Telephone Communication Telephone ring Door bell/door knock Hearing a dependent individual calling Alarm Clock Smoke detector
Other helpful solutions
Moisture problems Retention problems Insertion challenges Cleaning products
Remember
You need to wear the new hearing aids for two full weeks, full time
You need to be a full time user of amplification; part-time users are rarely successful