Hearing Aids and Cochlear Implants

A well-fitted and perfectly working hearing aid is the single most important tool in helping people with a hearing loss to stay communicating, working, socialising and enjoying life as before.

A little History

Hearing aids began crudely as large trumpets and horns. Later they became transistor radio-style devices but were still bulky and uncomfortable to wear. Next they became smaller behind the ear (BTE) devices, still available today. Then they shrank again, becoming in-the-ear (ITE) and in-the-canal (ITC) devices. Some modern hearing aids are even implanted and therefore invisible.

Hearing aids have been around for decades, yet they were given a bad rap from the very start. Instead of being viewed as the useful devices they were meant to be, they became the butt of jokes.

What are hearing aids?

Hearing aids are electro-acoustic devices which amplify sound so that the wearer can hear significantly better with than without the aid. All hearing aids have a microphone, an amplifier, a speaker and a battery.

For hearing aid choice, there are a wide  range of options other than the basics. These include volume controls, directional microphones, inbuilt loop coils, ability to receive FM transmission and bluetooth signals. Hearing aids are also available with remote control devices.

Your choice will depend on many factors, the most important being your hearing loss. There are many other contributory factors including – unfortunately – cost.

Hearing Aid types

Generally, the more traditional hearing aids use analogue technology while the more modern types are digital. the following  definitions may help you decide which type may be the most suitable for you.

Basic analogue: This conventional technology amplifies all sounds equally. Your audiologist sets the amplification level, though it can be adjusted later. Loud sounds might require you to manually turn down the volume on your hearing aid. This type of technology is best for people who do most of their communicating in relatively quiet situations. Basic analogue is the least expensive technology but is slowly being phased out.

Programmable analogue: The programmability of this technology means your audiologist can adjust the hearing aids to amplify sounds differently. Softer sounds can be amplified more and loud sounds  amplified less, or not at all. If you have this type of technology in your hearing aid, you might not need to adjust the volume in loud situations, as you would with basic analogue electronics. Some of the programmable analogue hearing aids allow you to have multiple settings. This may allow you to switch settings according to your situation either with a remote control or by pushing a small button on the hearing aid. More flexible digital instruments are now replacing these hearing aids.

Digital: With this type of technology, a computer chip converts the incoming sound into digital code, then analyses and adjusts the sound, based on your hearing loss and listening needs. The signals are then converted back into sound waves and delivered to your ears. The result is sound that’s more finely tuned to your hearing loss. Digital hearing aids are available in various styles and the price you pay will depend on the features you choose. More advanced digital signal processing capabilities tend to translate into higher cost.

Hearing aids come in all shapes, sizes and colours. There are 5 broad categories

• Behind-the-ear (BTE) hearing aids are placed over the ear and connected with tubing to custom-fitted earpieces (moulds)

• In-the-ear (ITE) hearing aids fill the entire bowl of the ear and part of the ear canal

• Smaller versions of ITEs are called half-shell and in-the-canal (ITC)

• The least visible aids are completely-in-the-canal (CIC)

• The latest type are open-fit, where the receiver is in the ear

Unfortunately, you will have less choice the greater the degree of your hearing loss.

Getting a Hearing aid

Having gone through the investigative process (see our web page) and deciding that a hearing aid is needed, it is now time to acquire one.

It is not a simple process, it takes time and there are many pitfalls.

There are a few generals rules that we can advise you on:

Use a highly qualified audiologist with a good reputation. Seek advice from other hard of hearing people you know or from your doctor. Your relationship will be  long-term,  so the decision is important.

Try to stay objective, identifying the hearing aid features that  you want and a budget (net of any PRSI entitlement you may have and tax relief) that you can afford.

Make sure that you get an adequate trial period – including one or two adjustments – before paying for the aid. Make the most of this period.

Beware of misleading claims. A hearing aid can be of great benefit to you but while it will improve your listening ability, there are many situations where the benefits will be severely restricted. Make sure that you get a warranty and that you understand the repair service provided. There are consumer protection issues – rogue hearing aid suppliers (who are more interested in profits than your hearing) have taken advantage of many people over the years.

Care and maintenance of hearing aids

Day-to-day care is very important for short term and long term performance of your hearing aids.  Here are some useful tips. (This list is taken from a Phonak user manual)

1. Avoid getting your hearing aids dirty. Always make sure your fingers are dry and clean before handling your hearing instruments. The microphone inlet is only a few tenths of a millimetre (1/16 to 1/8 inch) wide and can become blocked easily.

2. Avoid sharp knocks and impact. Insert and remove your hearing aid over a soft surface (a bed or sofa).

3. Protect your hearing aid from heat. Never leave your hearing instruments where they may be affected by extreme heat. Protect them from direct sunlight (at home and in a parked car) and do not leave them near radiators.

4. Protect your aids from dampness. Remove instruments from your ears before showering, bathing or swimming. Do not leave them in the bathroom where they could suffer water damage. Dry any perspiration inside and around the ears regularly. Dampness and condensation can damage the circuitry in your hearing instruments. We recommend that you leave the battery compartments open overnight and use the special drying kit available from your hearing care professional.

5. Keep your hearing aids out of the reach of children and pets
Dogs are irritated by the feedback (whistling) sound and attracted by the owner’s scent. Often the result is a chewed up hearing instrument. The hearing aid battery can be dangerous if swallowed. Consult a medical professional immediately if the battery is accidentally ingested.

6. Avoid contact with make-up or hair spray. The fine particles produced by make-up or hair spray can easily block a microphone inlet. Always remove hearing aids before using such products.

7. Clean your aids carefully. Clean your aids using a soft, dry cloth. Alcohol, solvents and cleaning fluids can damage electronic circuitry.

8. Ear hygiene. Always make sure that the ear is clean. If your aid sounds weak, it may be due to the sound outlet or the cerumen filter being blocked with wax or dirt. You can obtain special cleaning products from your hearing care professional.

9. Note in the case of BTE aids, sound weakness could be due to a blockage in the tubing or mould.

10. Keep your aids in a safe place. When your aids are not in use, always keep them in the presentation case or in a special drying box. Remove the batteries if the aids will not be used for some time.

11. Always have repairs carried out by a specialist. Screwdrivers and oil can be fatal for hearing aids. Merely touching the electronics or micro-mechanics can lead to irreparable damage. See your hearing care professional for service of your hearing aid.

12. For BTE aids, always separate the earmold from the hearing aid before you wash it. The hearing instrument should never come into contact with water. Before putting the two back together, make sure that they are both completely dry.

13. For ITE, ITC and CIC aids, remove anyaccumulated cerumen daily. When using a cerumen removal tool, e.g. a brush, always clean the aid from below. This will prevent particles of wax or dirt from getting inside the instrument.

Cochlear Implants

Cochlear implants are an option for people with a very severe hearing loss. They might be regarded as the ultimate hearing aid for a small minority of people.

A cochlear implant (CI) is a surgically implanted electronic device that provides a sense of sound to a person who has a very severe or profound loss. Unlike hearing aids, the cochlear implant does not amplify sound, but works by directly stimulating any functioning auditory nerves inside the cochlea with an electric field. External components of the cochlear implant include a microphone, speech processor and an RF transducer or primary headpiece coil. A secondary coil is implanted beneath the skull’s skin and inductively coupled to the primary headpiece coil. The headpiece coil has a magnet by which it attaches to another magnet placed on the secondary coil often beside the cochlear implant. The implant relays the incoming signal to the implanted electrodes in the cochlea. The speech processor allows an individual to adjust the sensitivity of the device. The implant gives recipients additional auditory information, which may include sound discrimination fine enough to understand speech in quiet environments. Post-implantation rehabilitative therapy is often critical to ensuring successful outcomes.

Click HERE above to view a video of an Operation (Not for faint hearted)

Click  to view an Adult switch on or a Child