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 Hearing Loss Facts Hearing loss affects the communication ability of at least 24 million Americans – over half of whom are over the age of 65 – causing loneliness, anxiety and isolation. Yet, it is estimated that only 4 to 5 million people wear hearing aids to help overcome their hearing problems. One reason is that hearing loss is invisible and almost gradual and painless. There are no physical warning signs, except in some cases where ringing in the ears (tinnitus) may be present. It is typical for a person with a mild to moderate hearing loss to be unaware of their problem, even though family and friends may be aware of the problem. Hearing loss ranks third among disabilities in older Americans. This rate is increasing at a faster rate due to the aging of the U.S. population. The causes of hearing problems vary greatly according to age. Some hearing problems are due to genetic factors, while others are caused by infectious diseases, excessive noise exposure, ototoxic drugs, presbycusis (aging process) and trauma. Sound waves are collected by the outer ear and channeled along the ear canal to the eardrum. When sound hits the eardrum, the impact creates vibration, which in turn causes the three bones in the middle ear to move. The smallest of these bones, the stirrup, fits into the oval window between the middle and inner ear. When the oval window vibrates, fluid in the inner ear transmits the vibrations into a delicate, snail-shaped structure called the cochlea. In the inner ear, thousands of microscopic hair cells are bent by the wave-like action of fluid inside the cochlea. The bending of these hair cells sets off nerve impulses that are passed through the auditory nerve to the hearing center of the brain. The center translates the impulses into sound memories that the brain can recognize. Approximately 10 percent of all hearing losses may be helped medically or surgically. The remaining 90 percent may find help in the form of hearing aids or assistive listening devices. Conductive loss is produced by injury to or problems with the bones, eardrums and membranes that carry sound from the external ear through the middle ear to the inner ear. Generally, conductive disorders affect children and can medically or surgically treated by an otolaryngologist or ear, nose and throat specialist (M.D.). Sensorineural is also known as nerve deafness, and is a loss in which all the mechanisms (outer and middle ear) are intact but a deterioration of the inner ear is present (specifically the hair cells). This may be caused by the natural aging process or degeneration of the nerves leading from the inner ear to the brain. Sensori-neural losses cannot be surgically or medically repaired. Mixed is a loss that contains elements of both a conductive and sensorineural hearing loss. What You Should Know Before Buying a Hearing Aid Hearing loss is a medical problem, and, as a result, you should seek a complete medical and audiological examination from a competent physician or audiologist. Your family physician or otolargyngologist can give qualified medical opinions and treatment either medically or surgically regarding your loss of hearing. An audiologist is a professional who is certified or licensed to provide assistance concerning communication problems associated with hearing impairment. An audiologist specializes in preventing, identifying and assessing hearing impairment, rehabilitating the hearing impairment, and fitting hearing aids and training individuals in their use. Some hearing aid dealers use the title “Certified Hearing Aid Audiologist.” This title is given to them by their national trade association, the National Hearing Aid Society (NHAS), after completing several weeks of study, and passing state licensure. Hearing aid dealers are sales personnel who can fit hearing aids, help you understand how to use a hearing aid and can explain problems associated with hearing aids. But, remember they are not professionals who can diagnose and solve hearing impairments. A hearing aid is an electrical device designed for one purpose – to increase the sensitivity of the sound being delivered to the ear. It cannot select the particular sounds you want to listen to, nor can it interpret sounds for you. Therefore, during the first few weeks that you are a hearing aid owner, you will have the responsibility of learning to become a hearing aid user. To ensure satisfaction and adjustment to your aid, make sure your dispenser offers a 30-day trial period, allowing for the return of an unsatisfactory product. The capabilities of some hearing aids have been clearly oversold. Some hearing aid manufacturers have been accused of misleading advertising regarding the benefits of their products. This has resulted in the negative emotions some hearing-aid consumers have. Hearing aids themselves are not the problem. Hearing aids – if they fit and are worn properly – can have a profoundly positive effect on people’s lives. Hearing aids help people, but those seeking amplification need to be told the truth about what to expect from hearing aids and they need to be properly evaluated. It has been estimated that over one half of all people with hearing aids have not been properly evaluated (including a medical evaluation) before the fitting. No wonder the success rates of hearing aids are so low. As a result, it is in the person’s best interest to seek qualified professional help in seeking proper hearing healthcare, and audiologists are uniquely qualified to this end. Audiologists can give complete and accurate information on hearing impairment and provide a full range of hearing healthcare services. Hearing aids vary widely in price and function. Aids may cost from $700 each up to $3,000 each and may contain electronic circuitry ranging from linear to computerized digital sound. Superior sound quality may be realized from any level of hearing aid circuitry if fitted and counseled properly. Sometimes a hearing aid is not appropriate for certain losses. When this is the case, assistive hearing devices are a viable alternative.
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