Hearing Aids

What are hearing aids?

Nearly 36 million adults in the U.S. have some degree of hearing loss. Hearing aids can help improve hearing and speech especially in persons with sensorineural hearing loss (hearing loss in the inner ear due to damaged hair cells or a damaged hearing nerve). Sensorineural hearing loss can be caused by virus or bacteria, noise, injury, infection, aging, certain medications, birth defects, tumors, problems with blood circulation or high blood pressure, and stroke.

Hearing aids are electronic, battery-operated devices that can amplify and change sound. A microphone receives the sound as sound waves. The sound waves are then converted into electrical signals.

What are the different types of hearing aids?

The type of hearing aid recommended for the individual depends on the person's home and work activities, his or her physical limitations and medical condition, and personal preference. There are many different types of hearing aids on the market, with companies continuously inventing newer, improved hearing aids every day. However, there are 4 basic types of hearing aids available today. Consult your health care provider for additional information on each of the following types:

In-the-ear (ITE) hearing aids	These hearing aids come in plastic cases that fit in the outer ear. Generally used for mild to severe hearing loss, ITE hearing aids can accommodate other technical hearing devices, such as the telecoil, a mechanism used to improve sound during telephone calls. However, their small size can make it difficult to make adjustments. In addition, ITE hearing aids can be damaged by ear wax and drainage.
Behind-the-ear (BTE) hearing aids	Behind-the-ear hearing aids, as the name implies, are worn behind the ear. This type of hearing aid, which is in a case, connects to a plastic ear mold inside the outer ear. These hearing aids are generally used for mild to severe hearing loss. Poorly fitted BTE hearing aids can cause feedback, an annoying "whistling" sound, in the ear. However, all hearing aids can have feedback.
Canal aids	Canal aids fit directly in the ear canal and come in two sizes: in-the-canal (ITC) aid and completely-in-canal (CIC) aid. Customized to fit the size and shape of the individual's ear canal, canal aids are generally used for mild to moderate hearing loss. However, because of their small size, removal and adjustment may be more difficult. In addition, canal aids can be damaged by ear wax and drainage.
Body aids	Generally reserved for profound hearing loss, or if the other types of hearing aids will not accommodate, body aids are attached to a belt or pocket and connected to the ear with a wire.

Who may be a candidate for hearing aids?

Anyone who has hearing loss that may be improved with hearing aids can benefit from these devices. The type of hearing aid recommended may depend on several factors, including, but not limited to:

• The shape of the outer ear (deformed ears may not accommodate behind-the-ear hearing aids)

• Depth or length of the ear canal (too shallow ears may not accommodate in-the-ear hearing aids)

• The type and severity of hearing loss

• The manual dexterity of the individual to remove and insert hearing aids

• The amount of wax buildup in the ear (excessive amounts of wax or moisture may prevent use of in-the-ear hearing aids)

• Ears that require drainage may not be able to use certain hearing aid models

Wearing a hearing aid

Once the hearing aids have been fitted for the ears, the individual should begin to gradually wear the hearing aid. Because hearing aids do not restore normal hearing, it may take time to get used to the different sounds transmitted by the device. The American Academy of Otolaryngology-Head and Neck Surgery recommends the following when beginning to wear hearing aids:

• Be patient and give yourself time to get used to the hearing aid and the sound it produces.

• Start in quiet surroundings and gradually build up to noisier environments.

• Experiment where and when the hearing aid works best for you.

• Keep a record of any questions and concerns you have, and bring those to your follow-up examination.

Taking care of hearing aids

Hearing aids need to be kept dry. Methods for cleaning hearing aids vary depending on the style and shape. Other tips for taking care of hearing aids include:

• Keep the hearing aids away from heat and moisture.

• Batteries should be replaced on a regular basis.

• Avoid the use of hairspray and other hair products when the hearing aid is in place.

• Turn off hearing aids when they are not in use. 

Considerations when purchasing a hearing aid

A medical examination is required before purchasing a hearing aid. Hearing aids can be purchased from an otolaryngologist (a doctor who specializes in disorders of the ear, nose, throat, and related structures of the head and neck), an audiologist (a specialist who can evaluate and manage hearing and balance problems), or an independent company. Styles and prices vary widely. The National Institute on Deafness and Other Communication Disorders recommends asking the following questions when buying hearing aids:

• Can the hearing loss be improved with medical or surgical interventions?

• Which design will work best for my type of hearing loss?

• May I "test" the hearing aids for a certain period?

• How much do hearing aids cost?

• Do the hearing aids have a warranty and does it cover maintenance and repairs?

• Can my audiologist or otolaryngologist make adjustments and repairs?

• Can any other assistive technological devices be used with the hearing aids?