Tag: personalized solutions

Earwax – It Deserves a Better Reputation!

By: Crystal L. Chalmers, Au.D.
North State Audiological Services
Chico, CA 95928

www.nsaudiology.com

Audiologist & Ear Doctor, Dr. Crystal Chalmers, Chico, California
Crystal Chalmers, Au.D., is an AudigyCertified™ Doctor of Audiology, the owner of North State Audiological Services in Chico, and a member of AudigyGroup, the nation’s largest member-owned association of independent hearing care professionals.

Though its medical name is cerumen, most of us refer to it as “Earwax”.

While I agree that neither term sounds very attractive, I will argue that earwax has gotten an undeserved bad reputation as something equivalent to dirt that we need to remove from our bodies.

So before reaching for the cotton swabs, you should know that earwax performs several important functions for our ears and hearing system.

That’s right.   Earwax – unless it is in excess and blocking our ear canal(s) or has plugged and disrupted the proper functioning of hearing technology – is a good thing.

Here are some positive functions of earwax:

●  It provides a protective barrier to the skin of the ear canal

●  Assists in lubricating and cleaning the outer portion of the ear canal.

●  Provides protection against insects (it is a natural insecticide), fungi, and bacteria – all of which like to dwell in dark, moist places … just like the ear canal!

So don’t be so quick to want to remove all of your earwax.  Oftentimes, excess earwax will work its way to the outer portion of the ear canal and simply fall out on its own.  To clean your ears, NEVER use cotton swabs as these can push the wax down further into the ear canal.  Simply rinse your ears with warm water while showering and/or use a damp cloth with mild soap to gently wash the exterior of the ear.  In cases where earwax is excessive, it should only be removed by a medical doctor as this is a delicate procedure.  In fact the ear canal is the only place on the body where skin is in direct contact with bone, so improper cleaning of this area could result in infection with serious consequences.

 

New FDA-Approved Tinnitus Treatment Available

The Serenade Tinnitus Treatment System is now available at Advanced Hearing Care!

New customized sound therapy approach with novel treatment sounds

SAN JOSE, California, March 26, 2012. SoundCure Inc., a new tinnitus solution provider, today announced the launch of the Serenade Tinnitus Treatment System at the upcoming American Academy of Audiology Meeting in Boston, March 28 – April 1, 2012. This marks the formal commercial release of a novel advancement in sound therapy based on the development of S-Tones®, customized treatment sounds developed independently by leading hearing researchers at the University of California, Irvine (UCI).

Tinnitus, or “ringing in the ears”, affects approximately 10% of U.S. adults and an estimated 260 million people globally. It can be extremely debilitating, leading to depression, irritability, and difficulty sleeping or concentrating. It is most often related to hearing loss, especially that caused by noise damage.

Serenade is a handheld device that is programmed in the audiologist’s office for each individual patient according to his specific condition. Through the device’s earphones, the patient listens to therapeutic sounds which are designed to address the underlying neurological cause of tinnitus. Four different treatment sounds are available, anchored by advanced, proprietary S-Tones. Long-term relief can be achieved when used in an on-going sound therapy program.

The American Tinnitus Association provided a grant to UCI to develop the technology. Sound therapy as a tinnitus treatment is well-established and effective. S-Tones are low frequency, amplitude modulated tones that are frequency pitch-matched to a patient’s unique tinnitus, representing a significant clinical breakthrough compared to previous approaches. According to Dr. Fan-Gang Zeng, one of the technology inventors, these modulated tones “keep the brain’s interest” thus “inhibiting and reducing the perceived tinnitus sound and bringing relief”. In addition, S-Tones are intended to be “listened to at a volume that is lower than the patient’s tinnitus, reducing the sound burden”, according to Dr. Zeng.

SoundCure CEO Bill Perry states, “This approach was developed by a team with a deep scientific understanding of the neurophysiology of tinnitus and how the brain processes sound. It is an important solution to provide relief to patients and represents a real advance in tinnitus care.”

About SoundCure, Inc.

Established in 2009 to commercialize the technology developed for years at the University of California, Irvine, SoundCure, Inc. is a privately held medical device company whose mission is to revolutionize the treatment of tinnitus and provide relief to the millions of people suffering its effects. SoundCure is an Allied Minds company.

Serenade Tinnitus Treatment System at Advanced Hearing Care!

Advanced Hearing Care is proud to be the first provider in Oklahoma to offer the Serenade Tinnitus Treatment System! This groundbreaking technology has recently received FDA approval for the treatment of ringing in the ears.  Studies are beginning to show that Serenade can offer immediate relief from the annoyance of tinnitus symptoms.  For more information on the Serenade system, contact our office to schedule a consultation appointment!

BHI Raises Awareness of Hearing Aids as Potential Therapy to Help Quiet “Ringing in the Ears”

Ringing in the Ears
Tinnitus is the perception of a sound that has no external source.

Washington, DC, May 3, 2012—The Better Hearing Institute is joining the American Tinnitus Association (ATA) in recognizing National Tinnitus Awareness Week (TAW), May 13 to 19, 2012, and is raising awareness of hearing aids as a potential therapy to help quiet chronic “ringing in the ears.” According to a BHI study published in Hearing Review, 43.5 percent of people with tinnitus were helped at least mildly with hearing aids. And 3 out of 10 were helped moderately-to-substantially. For those whose audiologists used best practices in fitting hearing aids, the figure jumped to 50 percent. There currently is no known cure for tinnitus.

Often referred to as “ringing in the ears,” tinnitus is the perception of a sound that has no external source. Tinnitus sufferers commonly describe the noise as a ringing, humming, buzzing, and/or cricket-like. Tinnitus can be constant or intermittent. And it can be heard in one ear, both ears, or in the head. For many who suffer from it, tinnitus can be a source of endless torment and a continual drain on quality-of-life.

Nearly thirty million Americans—almost twice as many as previously believed—suffer from persistent, chronic tinnitus, according to the BHI study. That’s about ten percent of the U.S. population. And for people ages 65 to 84, that number jumps to almost 27 percent. Tinnitus is now the number one service-connected disability of returning military personnel from Iraq and Afghanistan.

“The good news is there are effective therapies available to help people cope,” said Sergei Kochkin, PhD, BHI’s Executive Director. “In particular, we found that a variety of sound  therapies and/or hearing aids in conjunction with counseling can help. But we need to raise awareness that effective therapies are available, including the use of hearing aids.”

Exposure to extreme noise is the leading cause of tinnitus, and people with tinnitus almost always have accompanying hearing loss. In fact, the study found that respondents with more severe hearing loss were more likely to have tinnitus. Yet, more than a third (39%) of people with hearing loss do not seek help specifically because they have tinnitus.

“Persistent, chronic tinnitus is a highly intrusive, increasingly common condition that can interfere with a person’s cognition, ability to interact with family and friends, and basic life functions,” said Jennifer Born, Director of Public Affairs at the American Tinnitus Association (ATA). “Much progress is still needed in understanding tinnitus and finding a cure—which is why Tinnitus Awareness Week is such an important effort.”

As baby boomers age, people listen to portable music players at high volumes, and more soldiers return from combat, the incidence of both hearing loss and tinnitus is expected to grow.

People suffering with tinnitus can find the latest information on their condition and methods for coping with it in an authoritative eGuide, “Your Guide to Tinnitus.” This 14-page guide covers definitions, causes, the impact of tinnitus, treatments, practical tips for managing tinnitus, and good self-help references.

“We are very pleased to join ATA this year in promoting Tinnitus Awareness Week and hope that our efforts bring us closer to finding a cure,” Kochkin said.

More About Tinnitus
Four in ten people experience their tinnitus more than 80 percent of the time; slightly more than one in four describe their tinnitus as loud; and about one in five describe their tinnitus as disabling or nearly disabling, the BHI study found.

People with tinnitus report that it most often affects their ability to hear (39%), concentrate (26%), and sleep (20%). Yet for many, tinnitus is even more pervasive. Twelve percent of respondents—or 3.6 million people when extrapolated to the general population—say their tinnitus affects leisure activities, social life, personal relationships, and emotional or mental health. Seven percent of respondents—or an estimated 2.1 million people nationwide—indicate that tinnitus affects their ability to work.

How Hearing Aids Help
In addition to improving hearing and communication, hearing aids amplify background sound, so the loudness or prominence of the tinnitus is reduced. Simply taking the focus off the tinnitus means relief for many people. Hearing aids also reduce the stress associated with intensive listening by improving communication, which in turn help relieve tinnitus symptoms.

About Tinnitus Awareness Week
Each year, a week is set aside during Better Hearing Month to focus specifically on increasing public awareness about tinnitus and most importantly the need for increased funding for tinnitus research. This year, ATA is “going for gold” in its efforts to raise awareness and encourage people across the United States and around the world to help educate people about “ringing in the ears.” The premiere TAW 2012 event is the Tour de Tinnitus, a new bike ride fundraiser for the organization that was started last year by long time ATA member Mark Church. His efforts last year spawned great interest and the ride has grown to incorporate five new teams that will participate in four separate rides to raise money to support tinnitus research.

ATA has developed a TAW 2012 section on their website at ATA.org/TAW2012. From requesting proclamations from locally and nationally elected officials, to contacting your local media outlets, sharing tinnitus-related crosswords and posters, ATA has all the information you’ll need to get started in raising some serious tinnitus-awareness!

About BHI
Founded in 1973, BHI conducts research and engages in hearing health education with the goal of helping people with hearing loss benefit from proper treatment. For more information on hearing loss, visit www.betterhearing.org. To take the BHI Quick Hearing Check, visit www.hearingcheck.org. To participate in the discussion forum, visit www.betterhearing.org, click on “Discussion Forum,” and go to “Welcome!” to register.

4 Reasons to Make a Hearing Test Part of Your Yearly Check-up Routine

There are many reasons why having a regular hearing test is a good idea, even if you have normal hearing.  Hearing is our most important social sense; it is what allows us to communicate with one another and connect with our friends, families, and loved ones.  A yearly test is particularly important if you have other disorders which have been identified as possible causes of hearing loss, such as diabetes, high blood pressure, heart disease, and a history of certain infections, particularly in childhood.

As more research is conducted into the impact of hearing loss, we learn about exactly how insidious the disorder can be.

Hearing loss has also been identified as a risk factor for other disorders, particularly disorders that affect cognitive health.  Four of these disorders are particularly important as a person continues to age:

  1. Dementia – Researchers at Johns Hopkins University recently found that individuals who have untreated hearing loss are significantly more likely to develop dementia time than those people who seek early treatment for their hearing loss.  This relationship could be due to a number of factors, such as social isolation, increased cognitive strain or a similar underlying pathology.
  2. Brain Atrophy – This study was released by the Perelman School of Medicine at the University of Pennsylvania. Researchers found that brain volume decreased among patients with untreated hearing loss, a condition that made it more difficult for those particular subjects to understand complex sentences.
  3. Depression – In 1999, a National Counsel on Aging survey of 2,300 hearing impaired adults age 50 and older found that those with untreated hearing loss were more likely to report depression, anxiety, and paranoia and were less likely to participate in organized social activities, compared to those who wear hearing aids.
  4. Risk of Falling – Though some people have issues with their hearing that involve their vestibular (balance) function, this study looks more at the direct nature between even a so-called mild hearing loss and fall risk.   All other risk factors aside, a person with hearing loss is three times more likely to fall, and that risk increases dramatically as the hearing loss progresses.

These are just a few of the ways in which even a so-called mild hearing loss can affect a person’s lifestyle on a larger scale.  A yearly hearing test, particularly for those patients with risk factors for hearing loss, can help insure that treatment is sought for the hearing loss when it is needed.  Also, yearly tests can serve as valuable tools to monitor the progression of hearing loss over time, allowing any hearing aid prescribed to be appropriately fit to an individual’s hearing needs.

To schedule your yearly or baseline hearing test, call us today for an appointment.  Our Four-Step Process is centered around discovering your individual hearing and listening needs, even if you just need a baseline examination.  We have appointment times available Monday thru Friday, so we’re sure to have one that’s perfect for your busy schedule.  Let us help you keep on top of your hearing health needs!

Why Do Hearing Aids Cost So Much?

The following article was originally posted on the Hearing Care Blog.  We’re reposting it today because it is a great explanation of the costs associated with getting new hearing technology.

Bettie Borton, Au.D. Doctor of Audiology AudiologistBy: Bettie Borton, Au.D., FAAA
Doctor of Audiology
Doctors Hearing Clinic
7025 Halcyon Park, Suite A
Montgomery, AL 36117
(334) 396-1635
“Like” Doctors Hearing Clinic | Facebook
www.doctorshearingclinic.com

When I talk with patients or family members who have hearing loss, I hear a lot of grousing about the cost of the hearing aids purchased. I mean, those hearing aids are so TINY, they look so fragile… and you’re telling me they will cost HOW much?? Sound familiar?

Consumers seeking hearing healthcare help are often surprised at the cost of today’s sophisticated hearing technology. And that’s understandable. A high quality digital hearing aid usually costs between $1000 and $3000, sometimes more when paired with sophisticated bluetooth technology or other assistive listening devices. And in Alabama, hearing devices are also subject to sales tax.

So, is this investment “worth it” ? When assessing the value of hearing aids, it’s important to consider the many market variables inherent to pricing, including the following:

  • Hearing aids are medically regulated devices. As such, the manufacturers who produce these devices are subject to regulation by many organizations, including the FDA, FTC, and FCC. Like many other products in the U. S. marketplace, having to meet regulation specifications by governmental agencies seldom lowers costs, and almost assuredly raises them. As regulated devices, the cost of the research and development (AKA “R & D”) required to bring these products to market is significant, and results in products being more pricey.
  • What does R & D cost, and why is it so important? Consider that the “Big Six” (or the top 6 hearing aid manufacturers in the United States today) spend roughly $500,000,000 annually on R & D, which is quite a lot. To be precise, that figure is 14% of their combined budgets. To put this into perspective, let’s do a percentage comparison.  All of us would concede that Apple is certainly cranking out state of the art technology, and undoubtedly this costs the company in terms of product research and development  – but by comparison,  Apple expends only 2% of its total budget for R & D.
  • Remember that to date, hearing aids are the only medical devices that involve coupling an electronic device to a sensory organ. This is not an easy task. Today’s instrumentation is incredibly sophisticated, with increased chip speed and capability. Today’s hearing devices are certainly not your grandmother’s hearing aid! Nevertheless, this type of electronic capability comes with a price… it’s expensive to bring these products to market, and market share remains limited.
  • Hearing aids still have a fairly low market penetration. Of the 37 million Americans who might benefit from amplification, only about 1 in 5 actually utilize the available hearing technology.  We have not seen the same price reductions that are inherent to widely used electronic devices like TV’s, computers, cell phones, etc., found in virtually every household. So, what’s the result? Without sufficient market penetration, the product pricing remains higher for everyone.
  • The price you are quoted for hearing aids is seldom “unbundled” – this means that the cost for services of the audiologist or hearing healthcare provider, warranties, repair coverage, etc. is usually “bundled” into the price. Consumers often forget that there are dispensing fees inherent to well fit hearing devices. Are these fees “worth it”? To answer that question, we need only consider success rates (or lack thereof) for some of the “unbundled” personal sound amplification products or hearing aids such often sold on the internet, whose return for credit rate is upwards of 60%!
Oticon Intiga Hearing Aid
Today's extraordinary technology can come with a hefty price tag. The essential question is: what is my hearing worth to me?

Is the price tag for quality hearing devices worth it? Let’s consider the alternative…

Untreated hearing loss results in billions (that’s right… I said BILLIONS) of dollars in lost productivity in the U.S. workforce today. To be exact, unaddressed hearing loss results in 23 billion dollars of lost efficiency/productivity, which costs all of us in the long run. And of course, without today’s sophisticated hearing device capability, the loss in communications ability, life style preservation, and a myriad of other quality of life issues, even for those not employed, costs our society a great deal indeed.  There is also a significant body of research that suggests that if you have hearing loss,  waiting to get hearing aids can actually compromise word recognition ability.  As this data indicates,  delaying amplification is not without its own inherent cost.

So, despite the fact that the price for hearing aids may be steep at first glance, there are some very good reasons why costs may be higher than we’d like to see. If cost of recommended hearing technology is a concern for you or your family member, talk to your audiologist and explore possibilities for financial assistance or alternative technologies.

About the Author: Dr. Bettie B. Borton is a licensed audiologist in Alabama, and was the first audiologist in Montgomery to hold certification by the American Board of Audiology, and is the only audiologist with such certification in private practice in this area. Dr. Borton holds a BS degree with CED Certification in Education of the Deaf from the University of Texas, a Masters degree in audiology from the Louisiana State University Medical Center, and a Doctor of Audiology degree from the the University of Florida. She was a clinical audiologist in the Department of Surgery at UAB between 1990 and 1995, and provided patient care services in The Kirklin Clinic.

She has served as a Visiting Professor, teaching associate and Supervising Clinical Audiologist at Auburn University, as well as a Supervising Clinical Audiologist at Auburn Montgomery. Dr. Borton was a charter member of the Alabama Academy of Audiology (ALAA), and served as President of this organization. She has also served on the Board of Governors for the American Board of Audiology (ABA), and is the former National Chair of the ABA. Dr. Borton is currently the CEO and Director of Doctors Hearing Clinic, a full service private practice in Audiology. In April of 2010 Dr. Borton was elected to the Board of Directors of the American Academy of Audiology, and will serve a three year term in that capacity. She is the first (and to date, only) audiologist from Alabama to have been elected to the Academy Board. Dr. Borton was honored as a 2010 recipient of the prestigious Oticon “Focus on People”€ award, which annually recognizes 12 individuals across the nation for their dedication to helping those with hearing impairment.

Constant Ringing in Your Ears? – From the Hearing Care Blog

By: Bettie Borton, Au.D., FAAA
Doctor of Audiology
Doctors Hearing Clinic
7025 Halcyon Park, Suite A
Montgomery, AL 36117
(334) 396-1635
“Like” Doctors Hearing Clinic | Facebook
www.doctorshearingclinic.com

If it seems like your ears ring constantly, it’s probably not crickets, your imagination or the economy . . . and you’re not alone. You may have tinnitus, an inner ear ailment that affects between 25 million to 50 million Americans — with about 12 million people experiencing such severe symptoms it affects their daily lives. The good news is treatment, including hearing aids, can offer relief to some from the persistent ringing, buzzing or humming associated with tinnitus, according to the Better Hearing Institute.

Tinnitus can be intermittent or constant. Causes range from ear infections and exposure to extremely loud noises, to underlying health problems like allergies or heart and blood pressure problems. Often, sufferers are unable to pinpoint the cause of their tinnitus. “Tinnitus can have a direct impact on a person’s emotional well being,” says Dr. Sergei Kochkin, BHI’s executive director. “Not only can their hearing be affected but also their ability to sleep or concentrate.”

Tinnitus Treatment, Ringing in the Ears CausesKochkin and Dr. Richard Tyler, professor and editor of The Consumer Handbook on Tinnitus (Auricle Ink, 2008), published a survey of 230 hearing health professionals in the United States and Canada. Their survey found that six out of 10 patients reported some tinnitus relief when using hearing aids and two out of 10 reported major relief. The symptoms of tinnitus “influence basic life functions such as socialization and relaxation,” the duo wrote. “In severe cases it can interfere with the individual’s ability to perform adequately on the job, or contribute to psychological disorders such as depression, suicide ideation, posttraumatic stress disorder, anxiety and anger.”

Although tinnitus is actually common and can cause major life disruptions, the number of sufferers who seek treatment for tinnitus is relatively small. One reason may be that they mistakenly believe their condition is untreatable. Unfortunately, many doctors are also unaware of the latest treatment options, and as a result patients may think they simply have to learn to live with the noise.

“No one should ever ignore persistent tinnitus,” Kochkin says. “Not only is every individual entitled to a chance to regain his or her quality of life, but in rare cases tinnitus also can be a symptom of a more serious health issue that could demand medical intervention. What’s more, nearly everyone with tinnitus has hearing loss as well.”

In a recent large-scale survey of the American hearing impaired population, 39 percent (more than 9 million adult Americans) indicated they had not sought help for their hearing loss specifically because they also had tinnitus. “Research shows that untreated hearing loss has its own negative social, psychological, cognitive and health effects on the individual suffering from it,” Kochkin adds. “So those with both untreated tinnitus and untreated hearing loss suffers an even more diminished quality of life than individuals with just tinnitus or just hearing loss alone.”

While hearing aids are not a cure for tinnitus, they may be able to help tinnitus patients by:

  1. Improving communication and reducing stress, which makes it easier to cope with the condition.
  2. Amplifying background sounds, which can make tinnitus seem less prominent.

A new type of hearing aid, called the open fit hearing aid, may be particularly useful in alleviating tinnitus. The open fit hearing aid can reduce the effects of the tinnitus ringing sensation while still allowing sounds from the outside to pass into the ear. If you think you have tinnitus have your hearing evaluated by an audiologist and to explore the use of hearing aids to alleviate tinnitus. The American Academy of Otolaryngology (AAO-HNS) and the American Tinnitus Association recommends these additional tips for minimizing the effects of tinnitus on your health:

  1. Avoid exposure to loud sounds and noises.
  2. Get your blood pressure checked. If it is high, get your doctor’s help to control it.
  3. Decrease your intake of salt. Salt impairs blood circulation.
  4. Avoid stimulants such as coffee, tea, cola, and tobacco.
  5. Exercise daily to improve your circulation.
  6. Get adequate rest and avoid fatigue.
  7. Eliminate or reduce some stress in different parts of your life; stress often makes tinnitus worse.
  8. Experiment by eliminating other possible sources of tinnitus aggravation, e.g. artificial sweeteners, sugar, alcohol, prescription or over-the-counter medications. (Do not stop taking medications without consulting with your health care professional about the possible ototoxic impact of your medications.)

Dr. Bettie B. Borton is a licensed audiologist in Alabama, and was the first audiologist in Montgomery to hold certification by the American Board of Audiology, and is the only audiologist with such certification in private practice in this area. Dr. Borton holds a BS degree with CED Certification in Education of the Deaf from the University of Texas, a Masters degree in audiology from the Louisiana State University Medical Center, and a Doctor of Audiology degree from the the University of Florida. She has served as a Visiting Professor, teaching associate and Supervising Clinical Audiologist at Auburn University, as well as a Supervising Clinical Audiologist at Auburn Montgomery. Dr. Borton was a charter member of the Alabama Academy of Audiology (ALAA), and served as President of this organization. She has also served on the Board of Governors for the American Board of Audiology (ABA), and is the former National Chair of the ABA. Dr. Borton is currently the CEO and Director of Doctors Hearing Clinic, a full service private practice in Audiology. In April of 2010 Dr. Borton was elected to the Board of Directors of the American Academy of Audiology, and will serve a three year term in that capacity. She is the first (and to date, only) audiologist from Alabama to have been elected to the Academy Board. Dr. Borton was honored as a 2010 recipient of the prestigious Oticon “Focus on People” award, which annually recognizes 12 individuals across the nation for their dedication to helping those with hearing impairment.

New Research Links Hearing Aid Use to Improved Self-Esteem

Better hearing can make a big difference in your overall mental fitness.

Last year was a big year for hearing studies, particularly as hearing health relates to mental health.  We saw multiple studies that linked untreated mild hearing loss to disorders such as dementia and brain atrophy.  A new study was just released that offered a bit of positive news: hearing aid use may actually increase self-esteem.

The study, conducted by Hear the World, showed that a majority of hearing aid users experience better overall mental fitness than people who allow their hearing loss to go untreated.  Quality of life, intimacy, personal confidence, even insomnia tend to improve for people who wear hearing aids.  And when you think about it, this makes a lot of sense.  Our hearing is our most important social sense; it’s the principle component of how we communicate with one another.  To quote Helen Keller, hearing loss “means the loss of the most vital stimulus — the sound of the voice that brings language, sets thoughts astir and keeps us in the intellectual company of man.”

One of the most important things that we do at Advanced Hearing is work with our patients to restore their quality of life where their hearing loss interferes.  It isn’t a surprise for us to see the results of this study.  We see the importance of better hearing everyday in our patients.  It’s our biggest passion and our greatest privilege.  To experience the difference better hearing can make, call us today.

 

Why Can’t I Hear In Background Noise, Even With My Hearing Aids?

Amit Gosalia, Au.D. - Doctor of Audiology, Vancouver, WA

Originally posted on the Hearing Care Blog
By: Amit Gosalia, Au.D., FAAA

Board Certified Doctor of Audiology

Audiology Clinic, Inc.
505 NE 87th Ave., #150
Vancouver, WA 98664

(360) 892-9367
Follow Audiology Clinic | Facebook | Twitter
www.audiologyclinic.com 

Dr. Gosalia, I just bought a pair of $8500 hearing aids from XYZ in Portland. I was told that I would hear normally in all environments, including restaurants and ball-games. I am less than pleased because I still can’t hear or understand in noise. Did I waste my money?”

This was a case I dealt with a few months ago. This patient went to a business to purchase hearing aids, and this franchise/chain location set some lofty expectations for the patient. As hearing instrument technology improves, so do patient expectations. Terms such as noise reduction, noise management & directional hearing (along with many other proprietary terms) give the perception that the end-user will not hear background noise, and only hear the person in front of them. Unfortunately and fortunately, this is not true. Below I’ve touched the surface of noise, noise reduction and directivity.

Let’s start with noise. Noise is any disrupting event (in this case, sound) that impedes one’s ability to sense (in this case, hear) a signal (in this case, speech). For the purpose of this post, we’ll concentrate on hearing speech within a noisy environment. A general term and formula that is used in hearing healthcare is Speech-to-Noise Ratio (SNR) which tells us how loud speech is in relation to noise. For example, average speech is 45-55 decibels (dB) hearing speech in a basketball stadium where the crowd is cheering over 90 dB is difficult because the speech is 35-45 dB lower than the noise. This is considered a very low SNR; now compare this to speaking at a normal volume in a quiet library, the SNR will be high making speech much easier to understand. When someone has a hearing loss things change. Without amplification important parts of speech are not heard well, making understanding the person next to you difficult, if not impossible. The natural ability of any person to hear through noise decreases as hearing loss increases. This is a fact that has been well established in research on the human auditory system. Thus, a hearing aid can help make missing pieces of speech more easily heard but it cannot repair one’s ability to hear through noise and find valuable pieces of speech. For this reason, modern hearing aids focus on managing noise and amplifying clean speech.

Hearing instruments can come with or without venting. Vents are holes that are drilled through either the hearing instrument or the earmold for the purpose of letting air and sound travel in and out of the ear canal. The larger the vent, the closer you get to a more natural, open ear. Newer technology has allowed us to keep the ear open with small hearing instruments that rest behind the ear and even some custom molded devices (please see other postings for detailed descriptions of hearing technology). As cute as they may be, if your hearing is not within or near normal limits in the lower frequencies, an open ear device may not be for you.

One advantage of an open ear hearing aid is to allow low frequency sound to escape the ear canal, keeping the user’s voice more natural. When the user complains of hearing their own voice in their head or sounding as if they are speaking in a barrel, it’s usually a phenomenon called occlusion (or ampclusion). Keeping an ear canal open minimizes this effect but also introduces two detrimental issues. First, low frequency environmental sounds will bypass the hearing aid and travel into the ear naturally through the vent. These sounds that bypass the hearing aid are often heard naturally because most hearing losses are minimal in the low-frequencies and greater in the high-frequencies. This also means that the hearing aid is not able to process the sound before it’s heard, so technologies such as noise reduction do not affect low-frequency sounds in the open ear hearing aid.

Secondly, directional microphones will prove less beneficial in the open-ear fitting.2 What this means is that the more open the ear canal, the harder it becomes to hear what’s in front of you. So, theoretically, if our goal is to have the instruments focus more front-facing, the ear canal should not be very open. Note that normal low frequency hearing will be affected by closing the ear canal, and opening the canal with moderate to profound low frequency hearing will result in less hearing in those frequencies.1,2

So, what does this tell us about hearing in noise with amplification? You will hear background noise in noisy environments. You will most likely hear the kids screaming four tables away. You may still have difficulties hearing the person across the table from you. The good news is that with proper hearing aid selection and the correct technology that meets your lifestyle and budget, you’ll hear much better. Only a well trained hearing care professional can make these choices and help you to establish reasonable expectations for better hearing.

“Ms. XX, although the level of technology you purchased is consistent with an Active Lifestyle (in our clinic approx $7500 – $1000 less than the chain!!), you should know that hearing aids only supplement your hearing in those difficult environments. In fact, with normal hearing, I have difficulty hearing at basketball games and certain restaurants as well. Although we can not restore normal hearing, we can help you hear much better in more environments. You will still have some difficulty hearing and understanding in certain environments, but, with some realistic expectations, expert advice, and some auditory retraining, you will find greater success.”

Footnotes:
1 What is the Effect of Venting on Directivity? Audiology Online 10/2009; Todd A. Ricketts, Ph.D., CCC-A, FAAA
2 Efficacy of an Open-Fitting Hearing Aid; Hearing Review February 2005; Francis Kuk, Phd, et al

4 Reasons to Hear Better in 2012

SoundVoids™ can cause unnecessary frustration in visiting with your loved ones.

It’s coming.  2011 is almost over and 2012 is on its way.  As the new year approaches, it’s a great time to begin the journey toward better hearing.  Here are four great reasons to start today:

  1. If you don’t use it, you’ll lose it. A common phenomenon, especially among those who let their hearing loss go untreated, is called phonemic regression. Simply put, phonemic regression is when we find a loss of speech discrimination that isn’t proportional to the person’s pure tone thresholds. The most common symptom of this is being able to hear that someone is speaking but simply not being able to understand what is being said, something we call a Sound Void. This is a very frustrating situation, as the problem is not a simple matter of volume. In some cases, phonemic regression could have been prevented simply by wearing hearing aids earlier.
  2. Keep your brain sharp! In February, John’s Hopkins University released a startling study that linked untreated hearing loss to the development of dementia in elderly populations. While the exact nature of this link remains a bit of a mystery, it is well known that social isolation contributes to dementia.  One of the biggest contributing factors to this kind of isolation is the inability to hear well enough to enjoy getting out and being active.
  3. New technology provides superior sound quality and satisfaction.  The king of hearing aids is no longer that big ear plug that your father or grandfather wore (or refused to wear, as the case may have been).  There are many styles available for nearly every budget that are designed to treat nearly every type of hearing loss.  The possibilities are all but endless, and so is our ability to help people with many different kinds of hearing loss.
  4. Better hearing has never been easier!  Our ultimate goal as hearing professionals is to reintroduce you to a world of sounds that you haven’t been hearing.  Our Service Excellence Guarantee provides you with peace of mind knowing that we’ll have your back and make sure that you get the full value of your investment in better hearing.  We offer a 75-day trial period, well beyond the 30 days required by state law, with a 100% refund if you’re not completely satisfied.  We also offer extended warranties, in-office repairs and service, manufacturer repair if needed, and a wealth of knowledge to customize hearing solutions for every patient, all as part of our Service Excellence Guarantee.  We will support you every step along your journey to better hearing.

To start your journey toward better hearing, call us to schedule an appointment for a hearing test.  Through our 4-step process, we’ll learn about you and your better hearing goals, examine your ears for any defects or blockages, diagnose your hearing loss, and show you what we can do to help you hear better.  Don’t wait to hear what you’ve been missing!  Early treatment can make all the difference!

In observance of New Year’s Day, Advanced Hearing Care will be closed on Friday, December 31. We will return for normal office hours on Monday, January 2. Have a safe and happy New Year!