Hearing loss and hearing aids

From prevention to testing to hearing devices, we offer everything you need to keep hearing loss from slowing you down.

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Signs of hearing loss

Hearing loss symptoms often appear so gradually that patients are unaware of a problem until a family member or friend points it out:

  • Difficulty understanding words especially when in background noise.
  • Frequently asking others to repeat themselves.
  • Muffled speech.
  • Social withdrawal.
  • Turning up the volume on the television or radio.

Hearing tests may help detect a problem early, improving the chances of successful treatment.

Hearing loss categories: conductive and sensorineural

Hearing loss is divided into two categories: conductive and sensorineural. A third type—mixed hearing loss—occurs when patients experience a combination of the other two categories.

Conductive

This type of hearing loss is the result of problems of the middle ear and may be able to be managed medically. It is caused by ear infections, earwax accumulations, trauma to the ear and abnormalities or growths. Medications, surgery and earwax removal may all be effective, depending on the circumstances.

Sensorineural

This type of hearing loss is a result of damage to the inner ear and, while rarely curable, is often successfully treated with hearing aids (or, in some cases, cochlear implants). It is the result of nerve damage from aging, noise exposure, viruses and diseases and hereditary factors.

Doctor performs conductive hearing loss examination

Tests for hearing loss

You will undergo a hearing evaluation as the first step in diagnosing hearing loss.

A comprehensive evaluation consists of a series of individual tests that will help determine the extent and type of hearing loss. Our audiologists are skilled in conducting a number of tests to help in diagnosis and  treatment.

Hearing tests are completely safe and painless. They are performed in a soundproof booth and results are plotted on a graph that shows the patient’s hearing response at different frequencies. This is called an audiogram, and will help your audiologist determine the best way to treat any hearing loss.

A typical hearing evaluation includes a number of separate hearing tests:

Acoustic reflex test. Measures involuntary muscle contractions of the middle ear, and is used to determine the location of the hearing problem (the ossicles, cochlea, auditory nerve, etc.) as well as the type of hearing loss.

Auditory brainstem response (ABR) testing. Used to determine whether a specific type of hearing loss—sensorineural—exists. It is also frequently used to screen newborns for hearing loss.

Otoacoustic emissions (OAEs). Sounds are generated by vibrations of the hair cells in the cochlea of the inner ear. OAE testing utilizes a tiny probe fitted with a microphone and speaker that is used to stimulate the cochlea and measure its response.

Pure-tone testing, or pure tone audiometry. Uses air conduction to measure your ability to hear sounds of various pitches and volumes.

Bone conduction testing. Another type of pure-tone test that measures the inner ear’s response to sound.

Speech, or word recognition testing. Used to measure the speech reception threshold (SRT), or the faintest speech you can understand 50 percent of the time.

Tympanometry. A test of the middle ear used to detect fluid, wax buildup, eardrum perforations and tumors.

Even individuals who do not suspect hearing loss should consider regular hearing tests once they reach the age of 50. However, they’re not just for older adults. Babies and toddlers too should have their hearing tested in order to prevent delays in speech and language development should a hearing impairment exist.

Hearing aids

UCHealth audiologists are licensed dispensers of hearing aids and accessories, allowing our patients to get a complete range of hearing services.

Once your hearing loss has been assessed and diagnosed, you will work with your audiologist to select the right pair of hearing devices for your needs. The hearing aid style you choose should be based upon your type and degree of hearing loss, lifestyle needs, cosmetic preferences and budget.

In-The-Canal (ITC) style. Worn inside the ear canal, making them nearly impossible for others to see. ITC hearing aids are suitable for patients with mild to moderate hearing loss.

  • Pros: Virtually invisible due to their small size and placement in the ear canal—perfect for those who value discretion.
  • Cons: Small size translates to shorter battery life and limited features; controls are difficult to adjust; earwax can accumulate and clog speaker.

This style also includes CIC (Completely-In-The-Canal) and IIC (Invisible-In-the-Canal) hearing aids, which are even smaller.

In-The-Ear (ITE) style. This device style is a little bit larger than the ITC. In-the-ear hearing aids are appropriate for individuals experiencing mild to severe hearing loss.

  • Pros: Includes additional features unavailable on smaller ITC hearing aids; easier to handle and adjust controls; larger battery means longer battery life.
  • Cons: Susceptible to wind noise; earwax frequently clogs the speaker; more visible to others.

This style also includes RITE (Receiver-In-The-Ear) hearing aids and RIC (Receiver-In-the-Canal) hearing aids.

Behind-The-Ear (BTE) style. This is the most popular style of hearing aid due to its easily navigable controls and longer battery life. BTE hearing aids are great for all types of hearing loss and appeal to children and the elderly.

  • Pros. Helps with all types of hearing impairments; a larger battery means a longer battery life; easy to handle and adjust the controls; provides more amplification than smaller types.
  • Cons: Largest and most visible style; may pick up wind noise.

Open Fit style. A smaller version of the BTE style. Open Fit styles will work for mild to moderate hearing loss.

  • Pros: Less visible than BTE; no occlusion means more natural sound.
  • Cons: Prone to low frequency noise leakage; smaller size makes it more difficult to adjust.

Hearing protection

Taking steps early to protect your hearing can help prevent hearing impairment in the future.

We are exposed to sound on a daily basis. Volume levels vary considerably, and can easily exceed 85 decibels (dB)—the threshold that is considered safe. Any prolonged exposure to noise exceeding this is harmful and can cause permanent, irreversible hearing loss. Noise-induced hearing loss is the most common cause of hearing loss in the U.S. Fortunately, it is easily preventable.

It is essential for those exposed to loud noise to wear hearing protection. Earplugs are a must in noisy environments such as rock concerts and sporting events. They should also be worn when riding a motorcycle or snowmobile, mowing the lawn, using power tools, etc. Workers who are exposed to loud noise in the workplace must be given hearing protection by their employer as mandated by OSHA requirements. Whenever possible, choose quieter products, including quieter power tools and appliances.

When using earphones, remember the “80-90” rule—you can listen at 80 percent of the maximum volume of your music player for 90 minutes per day. Increasing the volume leads to less safe listening time and decreasing the volume results in longer safe listening time.

References

National Institute of Aging (NIA). Hearing Loss: A Common Problem for Older Adults (https://www.nia.nih.gov/health/hearing-loss-common-problem-older-adults)

National Institute on Deafness and Other Communication Disorders. Hearing Aids (https://www.nidcd.nih.gov/health/hearing-aids)

Center for Disease Control and Prevention (CDC). Types of Hearing Loss (https://www.cdc.gov/ncbddd/hearingloss/types.html)