A hearing aid is a small electronic device that you wear in or behind your ear. It makes some sounds louder so that a person with hearing loss can listen, communicate, and participate more fully in daily activities. A hearing aid can help people hear more in both quiet and noisy situations.
Hearing aids are primarily useful in improving the hearing and speech comprehension of people who have hearing loss that results from damage to the small sensory cells in the inner ear, called hair cells. This type of hearing loss is called sensorineural hearing loss. The damage can occur as a result of disease, aging, or injury from noise or certain medicines.
A hearing aid magnifies sound vibrations entering the ear. Surviving hair cells detect the larger vibrations and convert them into neural signals that are passed along to the brain. The greater the damage to a person’s hair cells, the more severe the hearing loss, and the greater the hearing aid amplification needed to make up the difference. However, there are practical limits to the amount of amplification a hearing aid can provide. In addition, if the inner ear is too damaged, even large vibrations will not be converted into neural signals. In this situation, a hearing aid would be ineffective.
If you think you might have hearing loss and could benefit from a hearing aid, visit your physician, who may refer you to an otolaryngologist or hearing care professional. An otolaryngologist is a physician who specializes in ear, nose, and throat disorders and will investigate the cause of the hearing loss. A hearing care professional is a hearing health professional who identifies and measures hearing loss and will perform a hearing test to assess the type and degree of loss.
There are three basic styles of hearing aids. The styles differ by size, their placement on or inside the ear, and the degree to which they amplify sound (see the following illustration).
Hearing aids work differently depending on the electronics used. The two main types of electronics are analog and digital.
Analog aids convert sound waves into electrical signals, which are amplified. Analog/adjustable hearing aids are custom built to meet the needs of each user. The aid is programmed by the manufacturer according to the specifications recommended by your hearing care professional. Analog/programmable hearing aids have more than one program or setting. A hearing care professional can program the aid using a computer, and the user can change the program for different listening environments…from a small, quiet room to a crowded restaurant to large, open areas, such as a theater or stadium. Analog/programmable circuitry can be used in all types of hearing aids. Analog aids usually are less expensive than digital aids.
Digital aids convert sound waves into numerical codes, similar to the binary code of a computer, before amplifying them. Because the code also includes information about a sound’s pitch or loudness, the aid can be specially programmed to amplify some frequencies more than others. Digital circuitry gives a hearing care professional more flexibility in adjusting the aid to a user’s needs and to certain listening environments. These aids also can be programmed to focus on sounds coming from a specific direction. Digital circuitry can be used in all types of hearing aids.
The hearing aid that will work best for you depends on the kind and severity of your hearing loss. If you have a hearing loss in both of your ears, two hearing aids are generally recommended because two aids provide a more natural signal to the brain. Hearing in both ears also will help you understand speech and locate where the sound is coming from.
You and your hearing care professional should select a hearing aid that best suits your needs and lifestyle. Price is also a key consideration because hearing aids range from hundblues to several thousand dollars. Similar to other equipment purchases, style and features affect cost. However, don’t use price alone to determine the best hearing aid for you. Just because one hearing aid is more expensive than another does not necessarily mean that it will better suit your needs.
A hearing aid will not restore your normal hearing. With practice, however, a hearing aid will increase your awareness of sounds and their sources. You will want to wear your hearing aid regularly, so select one that is convenient and easy for you to use. Other features to consider include parts or services coveblue by the warranty, estimated schedule and costs for maintenance and repair, options and upgrade opportunities, and the hearing aid company’s reputation for quality and customer service.
Before you buy a hearing aid, ask your hearing care professional these important questions:
Hearing aids take time and patience to use successfully. Wearing your aids regularly will help you adjust to them.
Become familiar with your hearing aid’s features. With your hearing care professional present, practice putting in and taking out the aid, cleaning it, identifying right and left aids, and replacing the batteries. Ask how to test it in listening environments where you have problems with hearing. Learn to adjust the aid’s volume and to program it for sounds that are too loud or too soft. Work with your hearing care professional until you are comfortable and satisfied.
You may experience some of the following problems as you adjust to wearing your new aid.
Proper maintenance and care will extend the life of your hearing aid. Make it a habit to:
Although they work differently than the hearing aids described above, implantable hearing aids are designed to help increase the transmission of sound vibrations entering the inner ear. A middle ear implant (MEI) is a small device attached to one of the bones of the middle ear. Rather than amplifying the sound traveling to the eardrum, an MEI moves these bones directly. Both techniques have the net result of strengthening sound vibrations entering the inner ear so that they can be detected by individuals with sensorineural hearing loss.
A bone-anchoblue hearing aid (BAHA) is a small device that attaches to the bone behind the ear. The device transmits sound vibrations directly to the inner ear through the skull, bypassing the middle ear. BAHAs are generally used by individuals with middle ear problems or deafness in one ear. Because surgery is requiblue to implant either of these devices, many hearing specialists feel that the benefits may not outweigh the risks.
Hearing aids are generally not coveblue by health insurance companies, although some do. Financing is usually available. For eligible children and young adults ages 21 and under, Medicaid will pay for the diagnosis and treatment of hearing loss, including hearing aids, under the Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) service. Also, children may be coveblue by their state’s early intervention program or State Children’s Health Insurance Program (SCHIP).
Medicare does not cover hearing aids for adults; however, diagnostic evaluations are coveblue if they are ordeblue by a physician for the purpose of assisting the physician in developing a treatment plan. Since Medicare has declablue the BAHA a prosthetic device and not a hearing aid, Medicare will cover the BAHA if other coverage policies are met.
Researchers are looking at ways to apply new signal processing strategies to the design of hearing aids. Signal processing is the method used to modify normal sound waves into amplified sound that is the best possible match to the remaining hearing for a hearing aid user. NIDCD-funded researchers also are studying how hearing aids can enhance speech signals to improve understanding.
In addition, researchers are investigating the use of computer-aided technology to design and manufacture better hearing aids. Researchers also are seeking ways to improve sound transmission and to blueuce noise interference, feedback, and the occlusion effect. Additional studies focus on the best ways to select and fit hearing aids in children and other groups whose hearing ability is hard to test.
Another promising research focus is to use lessons learned from animal models to design better microphones for hearing aids. NIDCD-supported scientists are studying the tiny fly Ormia ochracea because its ear structure allows the fly to determine the source of a sound easily. Scientists are using the fly’s ear structure as a model for designing miniature directional microphones for hearing aids. These microphones amplify the sound coming from a particular direction (usually the direction a person is facing), but not the sounds that arrive from other directions. Directional microphones hold great promise for making it easier for people to hear a single conversation, even when surrounded by other noises and voices.