Choosing Hearing Aids
After a complete audiological evaluation, your audiologist may recommend
hearing aids. The audiologist will guide you to the most suitable amplification
choice. Hearing aid technology, like all computer-related technologies, is
rapidly advancing. The many recent improvements are exciting, offering greater
fitting flexibility than ever, but the ever-increasing array of options can
make selection a challenge. It is our job to help you make the most appropriate
choice in light of your hearing loss, life style factors, and personal preferences.
Hearing aids are available in a variety of styles and in a range of sound
processing technologies.
Hearing aids styles refer to the "packaging" of the technology:
what does the hearing aid look like? The tiniest hearing aids are called "completely-in-the-canal" (CIC)
and are barely visible. Slightly larger are the canal and half-shell sizes,
still small, but visible. Full shell (in-the-ear) hearing aids fill the bowl
of the ear. Behind-the-ear instruments house the components in a unit that
sits over the ear, and the sound is delivered to the ear through an ear mold
or a narrow tube.
Hearing aid technologies
Most hearing aids fit today have digital technology. Digital hearing aids
function as miniature computers. This is a major breakthrough because much
more sound processing is possible within a small space. The newer hearing
aids offer far greater programming flexibility, and produce a crisper, cleaner
sound. These hearing aids have the ability to analyze the acoustic environment
and adjust the amplification accordingly. Speech is perceived more comfortably
and clearly for many patients in a variety of sound environments.
Over the past few years, product lines have been expanded. Most manufacturers
now offer a range of products from high end feature-rich hearing aids to
mid-line instruments to entry level hearing aids that meet more basic needs.
Some of the features encountered in current hearing aids include:
Open fittings: These tiny behind-the-ear instruments with a narrow tube for
bringing sound to the ear are a great new development for patients with mild
or moderate high frequency hearing loss. They are cosmetically appealing,
and acoustically ‘transparent' so that sound is heard especially naturally
with less perception of occlusion than traditional hearing aids. Digital
technology's advances in feedback (acoustic whistle) management makes this
type of fitting possible.
Multiple memory: This feature allows the user to opt for different listening
strategies optimized for a variety of listening situations. This feature
is beneficial for people with active lifestyles who regularly encounter varying
acoustic environments.
Directional microphones: Newer hearing aids may offer "multi-channel
adaptive directionality" which means that the hearing aid microphones
continually respond to the speech and noise sources in the environment to
provide the best possible signal-to-noise ratio for the listener. The goal
of this feature is to preserve speech understanding in the presence of background
noise.
Feedback management: Hearing aid users may now expect less likelihood of
feedback (whistling). This is important because newer hearing aids can provide
more audibility of soft sounds without feedback. Open fittings, which provide
relief for occlusion, are also possible because of digital advancements in
feedback management.
Noise management: The newest algorithms for processing speech in the presence
of noise not only promote more comfortable listening, but aim to preserve
speech intelligibility.
Wide dynamic range compression: Our goal with amplification is to bring soft
sounds into the audible range, while loud sounds are maintained at a comfortable
level; at the same time moderate conversational levels should be perceived
as comfortable. Digital hearing aids allow a complex relationship between
sound coming into the hearing aids and sound coming out in order to accomplish
this goal. Because the amount of amplification is related to the level of
the incoming sound, volume control is usually automatic.
Mini/micro options: There are more options than ever for patients who prefer
tiny or stylish hearing aids. In addition to the completely-in-the-canal
(CIC) aids, there are new very small over-the-ear aids which couple the sound
to the ear through a vary narrow tube. These sleek little aids are available
in a wide range of high-tech colors, so the look can be either discreet or
fashion/fun.
As hearing aid technology continues to improve, hearing aids make better
decisions in amplification to optimize comfort and speech audibility and
intelligibility.
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