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