Table of Contents
Introduction
New technologies and regulations have made hearing aids more advanced and accessible than ever before. While the basic premise of how a hearing aid works remains the same, recent developments have brought about significant improvements. For those with hearing loss, hearing aids can be life-changing devices, offering improved cognition, better balance as we age, and heightened social engagement. However, the high cost of prescription hearing aids often prevents many individuals from accessing these benefits. On a positive note, recent FDA rules now allow hearing aids to be sold directly to consumers without an exam or fitting by an audiologist, making them more affordable. However, this also means that many people are wearing hearing aids without personalized support from an audiologist. To shed light on this topic, we interviewed James Shehorn, an audiologist from the Americans for Better Hearing Foundation, to learn more about hearing aids, their different styles, and which type might be best suited for specific situations.
How Hearing Aids Work
Hearing aids consist of three main parts: a microphone, an amplifier, and a speaker. Sound is captured by one or more microphones and processed in a microchip. During processing, the sound is analyzed and adjusted based on the individual’s specific level of hearing loss. The amplifier then increases the strength of the digital signal before sending it to the speaker, also known as a receiver, which produces the sound in the ear canal. Individuals with hearing loss at different pitches may require adjustments to amplify specific sounds, as determined by an audiologist.
Types of Hearing Aids
There are two main styles of hearing aids: behind-the-ear (BTE) and in-the-ear (ITE). The choice of hearing aid depends on personal preference, medical needs, and the type of hearing loss.
In-the-Ear (ITE) Hearing Aids
ITE hearing aids come in three sizes:
ITE (in the ear, full shell): This is the largest of the three and fills up the entire opening of the outer ear, known as the pinna and concha.
ITC (in the canal, half shell): Approximately half the size of ITE hearing aids, ITC hearing aids occupy half of the concha.
CIC (completely-in-canal): The smallest of the three, CIC hearing aids sit entirely in the ear canal and resemble a Bluetooth earpiece.
Behind-the-Ear (BTE) Hearing Aids
BTE hearing aids are larger and bulkier but are often the best choice for individuals with more severe hearing loss or physical challenges. Despite their previous reputation for being bulky and highly visible, modern BTE hearing aids feature slim tubing that is barely noticeable from the front. Moreover, their larger size allows for greater volume adjustment by audiologists.
Invisible Hearing Aids
As technology continues to evolve, invisible hearing aids are becoming an increasingly popular choice for individuals seeking a discreet solution to hearing loss. These devices are designed to fit deep within the ear canal, making them virtually undetectable to others, offering a more natural and aesthetic option for wearers. Despite their small size, invisible hearing aids boast impressive sound quality and advanced features, including noise reduction, feedback cancellation, and enhanced speech clarity. For those who value both performance and discretion, invisible hearing aids provide the perfect balance, allowing users to improve their hearing without compromising their appearance. Thanks to ongoing advancements in miniaturization and digital technology, invisible hearing aids are now more comfortable, effective, and accessible than ever before.
Hearing Aid Domes: Choosing the Right Type
Hearing aids are equipped with different types of domes, depending on an individual’s hearing loss. The three main dome types are closed dome, open dome, and power dome.
Closed Dome
Closed domes without holes are designed for individuals with hearing loss in low pitches. Low pitches have long wavelengths that can bend around objects, such as thunder in the distance. When sound is amplified, if the ear canal is not completely sealed, low pitches tend to escape.
Open Dome
People with hearing loss in high pitches benefit from open fit or open dome hearing aids. These domes feature small holes that allow low-frequency pitches to enter and exit the ear canal naturally. This enables the hearing aid to focus on amplifying higher-frequency pitches that have shorter wavelengths and do not leak out.
Power Dome
Power domes consist of double domes, with one larger and one smaller dome. They are best suited for individuals with severe hearing loss.
It is important to note that the effectiveness of a hearing aid is not solely determined by its size or style but by the individualized fitting provided by an audiologist.
Choosing the Right Hearing Aid Fit
Selecting the best hearing aid fit depends largely on the level of hearing loss. While discreet options may be preferred by some, they may not always be the most suitable choice.
The smallest hearing aids, such as CIC, have smaller speakers due to their size. This also means they have a smaller and less advanced computer chip. Consequently, individuals with profound hearing loss are not the ideal candidates for CIC hearing aids. For significant hearing loss, larger hearing aids are recommended to provide more bulk between the speaker in the ear canal and the microphone on the face of the hearing aid.
Elderly patients with cognitive decline or dementia are often better served by behind-the-ear hearing aids, as they are more durable, easier to locate, and simpler to maintain. Additionally, individuals with diabetes may experience numbness in their fingertips or vision loss, making it more challenging to handle smaller hearing aids.
OTC Hearing Aids vs. Prescription Hearing Aids
Over-the-counter (OTC) hearing aids are often considered a more affordable option for individuals experiencing hearing loss, especially for those who previously found licensed clinic hearing aids financially out of reach. However, it’s important to consider whether a higher price always equals higher quality. High-quality premium devices from licensed professionals come with advanced features, personalized fitting, and are designed to last. In contrast, continuously browsing for new OTC devices could waste time, energy, and money~resources that could have already been used to purchase professional hearing aids and receive ongoing support that OTC options don’t have. Therefore, it’s crucial to weigh the pros and cons of both options before making a decision, as the right hearing aid can significantly impact one’s quality of life.
Convenience and Price
While OTC hearing aids offer the convenience of being easily purchased online or from big-box retailers without the need for a professional exam, choosing a licensed clinic provides a significant advantage. When you visit a licensed clinic, you’ll be seen by a qualified professional who will assess your level of hearing loss, provide a comprehensive consultation, and offer expert advice on the best options for you. In some cases, they may even inform you that your hearing loss is not severe and that hearing aids may not be necessary at this stage. If hearing aids are recommended, they come with the benefit of expert fitting by hearing instrument specialist, along with customization options tailored to your needs, and ongoing support throughout your journey.
Additionally, government subsidies are available, which can help offset the cost of professional devices, making them cost you pennies, there are also installment plans if necessary. You’ll also have access to premium devices from trusted, high-quality brands like Widex, Oticon, Phonak, Signia, and others—brands that are proven to last and provide exceptional performance. Investing in a professional hearing aid ensures you get the right solution for your hearing needs, supported by expertise that OTC options simply can’t match.
Customization
Hearing aids from licensed clinics offer the highest level of customization and personalized care, making them especially important for individuals with severe or complex hearing loss. Unlike OTC hearing aids, which generally offer a one-size-fits-all solution, professional devices are tailored to meet your unique hearing needs. A licensed hearing instrument specialist works closely with you to create a custom fit, adjusting settings to match the specific frequencies and levels of hearing loss you experience. This personalized approach ensures the best possible hearing experience, improving both comfort and clarity. For those with more significant hearing challenges, this level of customization is essential, as it helps ensure that the hearing aids provide the most effective support, something that OTC hearing aids do not come with.
Hearing Tests
OTC hearing aids lack the comprehensive and precise audiograms (hearing tests) provided by professional hearing instrument specialists. These detailed tests assess the full spectrum of your hearing abilities and allow for a tailored approach to your treatment. While some direct to consumer hearing aid companies offer online tests, these tests are often inaccurate and fail to capture the nuances of your individual hearing loss. In reality, they do not provide the level of detail needed to ensure the best possible fit and performance. It is the wild truth that we tell our patients, Online hearing Tests simply don’t work. Without a professional evaluation, you risk relying on a solution that may not fully address your hearing needs, which can lead to frustration and less-than-optimal results.
Level of Support
One of the key advantages of choosing hearing aids from a licensed clinic is the ongoing, personalized support you receive throughout your hearing journey. From the initial consultation to expert fitting and fine-tuning, hearing instrument specialists are there to guide you every step of the way. This level of support extends well beyond the purchase, whether you need adjustments, troubleshooting, or advice on how to get the most out of your hearing aids, you’ll have access to a team of professionals ready to assist. In contrast, OTC hearing aids typically lack the same level of customer support, leaving you to navigate challenges on your own. Having a professional support system ensures that your hearing aids continue to meet your needs, helping you enjoy clearer hearing and a better quality of life.
In the end, while OTC hearing aids may seem like an affordable and convenient option, they often fall short in delivering the personalized care, professional support, and long-term value that licensed clinic hearing aids provide. From comprehensive hearing tests to customized fitting and expert guidance, premium devices from a licensed clinic are designed to offer a solution that truly meets your unique needs. With access to top-quality brands, ongoing support, and the possibility of government subsidies, investing in professional hearing aids ensures you’re not just purchasing a device, but enhancing your overall quality of life. Choosing the right hearing aid is an important decision—one that should prioritize your hearing health, comfort, and long-term satisfaction.
When to Wear Hearing Aids
It is recommended to wear hearing aids all day, even when not engaged in conversations. Initially, wearing hearing aids may cause individuals to notice background noises they were not accustomed to hearing before. This adjustment period is crucial for the brain to adapt to the new soundscape. Wearing hearing aids in a quiet environment at home allows for practice and acclimatization.
Many people make the mistake of only wearing their hearing aids when going out, resulting in a sudden increase in noise levels, which can be disorienting. Therefore, it is advisable to wear them throughout the day and remove them only during bedtime and showering.
CROS and BiCROS Hearing Aids: Who Should Use Them?
CROS and BiCROS hearing aids are designed for individuals with asymmetrical hearing loss, where one ear has significant hearing loss or the degree of hearing loss varies between ears.
CROS Hearing Aids
Contralateral Routing of Signals (CROS) hearing aids are suitable for individuals with hearing loss in only one ear. A microphone or transmitter is placed in the ear with impaired hearing, which then routes the sound to a hearing aid in the better ear. This allows individuals to hear sound better from the side with hearing loss, eliminating the need to turn or twist to hear.
BiCROS Hearing Aids
Bilateral with contralateral routing of signal (BiCROS) hearing aids are ideal for individuals with total hearing loss in one ear and some hearing loss in the other. These hearing aids reroute sound from the impaired ear to the better ear, amplifying it in the process.
The main difference between CROS and BiCROS hearing aids lies in the amount of amplification provided on the hearing aid side of the device.
For individuals with suspected unilateral or asymmetrical hearing loss, it is recommended to consult a licensed audiologist for a comprehensive assessment. While OTC hearing aids may provide some assistance, they may not be the ideal solution.
Conclusion
Hearing aids have evolved significantly with advancements in technology, offering greater accessibility and affordability for individuals with hearing loss. When selecting a hearing aid, it’s essential to consider factors such as personal preference, medical needs, and the type of hearing loss. The fit and type of hearing aid dome also play a crucial role in achieving the best hearing experience. While OTC hearing aids can be an okay option for individuals with early symptoms of hearing loss, hearing aids from licensed professionals are better suited for individuals with mild-to-moderate loss and offer greater customization and personalized care. Consistent use of hearing aids throughout the day is important to help the brain adjust to the new sound environment. For individuals with asymmetrical hearing loss, solutions like CROS and BiCROS hearing aids can be highly effective. While OTC devices may seem convenient, consulting with a licensed audiologist ensures a comprehensive assessment and tailored recommendations for your hearing needs.
