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Hearing Aid
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Hearing Aid
See Also
Hearing Loss
Sensorineural Heaing Loss
Presbycusis
Home Adaptations for the Elderly
Background
OTC Hearing Aid
s will be available in U.S. in 2023
Evaluation
Available Features When Purchasing a Hearing Aid
Digital noise reduction (most modern Hearing Aids)
Reduces
Ambien
t common noises such as wind
Tinnitus
Masking (most modern Hearing Aids)
External noise volume adjusted to mask the specific
Tinnitus
frequency
Feedback Suppression
Prevents squealing sound (microphone feedback)
Directional Microphones
Sound directly in front of patient is amplified, and sounds from other directions are reduced
Automatic noise level adjustments
Newer Hearing Aids adjust volumes to optimize speech understanding given
Ambien
t noise
Multiple Pre-Programmed Settings
Audiologist can setup multiple different modes for specific listening needs and environments
Rechargeable Batteries
No need to replace batteries (every 1-2 weeks, ~30 per year) eases maintenance (esp. low dexterity,
Vision
)
Smartphone Integration
Newer Hearing Aids connect to smartphones to adjust volumes and listening profiles via manufacturer apps
Wireless or Bluetooth Connectivity
Newer Hearing Aids may connect to phones, computers, televisions either directly or via secondary device
Telecoil (T-Coil)
T-Coil compatible devices (phones) and facilities (e.g.
Hearing
loop theaters) improve sound quality
Types
Location
Hearing Aid behind the ear (mild to severe
Hearing Loss
)
Classic Hearing Aid with the electronics in a small case behind the ear
Sound tube exits the Hearing Aid and is placed inside the ear
Largest Hearing Aids, but easier to use, with volume control and some are rechargeable
Mini Hearing Aid external and receiver in ear canal (mild to severe
Hearing Loss
)
Ear canal receiver connects via a thin wire to a small Hearing Aid behind the ear
Typically rechargable devices with many added modern features, and less visible than behind the ear
Manual dexterity needed to position, and susceptible to earwax clogging
Hearing Aid completely In the ear canal (mild to moderate
Hearing Loss
)
Custom made Hearing Aid that completely sits within the ear canal (Least externally visible Hearing Aid)
Batteries are small, with short lives, difficult to handle, and not rechargeable
Lack added features (e.g. volume control, directional microphone, T-Coil) and susceptible to earwax clogging
Full Ear including bowl/concha (moderate to severe
Hearing Loss
)
Largest devices that are the easiest to manipulate by those with decreased dexterity
Hearing Aid fills the external bowl of the ear (antihelix, concha) and canal
Available as full shells or half shells (fill only part of the ear bowl)
Types
Conventional Analog Hearing Aids
Cost: ~$900 per ear
Components
Battery
Microphone transduces sound into electrical energy
Receiver changes electrical energy into sound
Most Hearing Aids can adjust volume
May be a problem with background noise
Sub-Types
Linear (Simple Hearing Aid)
Amplifies loud and soft sounds equally
Non-Linear
Varied amplification for loud and soft sounds
Decreased recruitment (increased loudness)
Types
Programmable Hearing Aids
Programmable by audiologist
Sound levels adjustable for audibility and comfort
Volume per frequency
Intensity
Microphone power output
Compression Ratios
Some available with multiple programs
(e.g. telephone, music)
Types
Digital Hearing Aids
Cost: ~$2900 per ear
Digital signal processor samples incoming signals
Adjusts in different sound environments
Can reduce background noise from non-speech source
Enhances speech understanding
Programmable by audiologist
See Above
Management
Hearing Aids amplify many sounds including background noise
Expect a time to adjust to Hearing Aids, and tuning out background noise (e.g. footsteps)
Proficiency with Hearing Aids requires a training period with frequent, continuous Hearing Aid use
Start with less noisy
Gene
ral measures
Ears should be dry before inserting Hearing Aids
Turn off Hearing Aids when not in use
Removing ear wax with cotton swabs is not needed and may cause ear
Trauma
Remove Hearing Aids when sleeping, bathing, swimming, applying hair care products or instilling ear medications
Light rain and mild sweating is not typically a problem
Clean Hearing Aids daily with a soft cloth
Button Batteries
May need changing as every week or more
Button batteries are dangerous if swallowed (keep away from pets and young children)
Ear
Pruritus
or Irritation
Causes
Over-cleaning (e.g. wax removal decreases ear canal protection)
Dry Skin
Mal-fitting Hearing Aid
Reaction to Hearing Aid material (uncommon)
Approach
Expect irritation and itching to improve over time
Consider
Skin Lubricant
(skin
Moisturizer
) application overnight while Hearing Aids are out of the ear
Recheck with Hearing Aid specialist if persists
Resources
Hearing Aid Styles (Cleveland Clinic)
https://my.clevelandclinic.org/health/articles/5122-hearing-aid-styles
Best Hearing Aids (NCOA)
https://www.ncoa.org/adviser/hearing-aids/best-hearing-aids/
References
(2022) Presc Lett 29(9): 52
Michels (2019) Am Fam Physician 100(2): 98-108 [PubMed]
Unwin (2024) Am Fam Physician 109(3): 279-83 [PubMed]
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