I don’t hear well. What should I do? What should I expect?
First, visit a physician who can refer you to an otolaryngologist (an ear, nose, and throat specialist), because many hearing problems can be corrected medically. If you have ear pain, drainage, excess earwax, hearing loss in only one ear, sudden or rapidly progressive hearing loss, or dizziness, it is especially important that you see an otolaryngologist, as these may be symptoms indicating a serious medical problem. After your exam, the otolaryngologist will help you obtain a hearing assessment from an audiologist (a nonphysician healthcare professional). A screening test from a hearing aid dealer may not be adequate. Many otolaryngologists have an audiologist in their office to assess your ability to hear pure tone sounds and to understand words. The results of these tests will indicate the degree of hearing loss, the type of loss (conductive or sensorineural) and other medical information about your ears and health, which will then determine hearing aids cost and style.
Conductive Hearing Loss: A hearing loss is conductive when there is a problem with the ear canal, the eardrum, and/or the three bones connected to the eardrum. This causes a mechanical (conductive) blockage, preventing the full energy of the sound from reaching your inner ear. Two common reasons for this type of hearing loss are excess wax in the ear canal or fluid behind the eardrum. Medical treatment or surgery may be available for these and other forms of conductive hearing loss.
Sensorineural Hearing Loss: A hearing loss is sensorineural when it results from damage to the inner ear (cochlea) or auditory nerve, often a result of the aging process and/or noise exposure, but also may be secondary to head trauma, systemic illness or infection, or inheritance. Sounds may be unclear or too soft. Sensitivity to loud sounds may occur. Medical or surgical intervention cannot correct most sensorineural hearing losses, but hearing aids may help you reclaim some sounds you are missing as a result of nerve deafness.
Where do I purchase hearing aids?
Federal regulation prohibits any hearing aid sale unless the buyer has first received a physician’s evaluation, so you will need to see your doctor before you purchase a hearing aid. However, the regulation also says that if you are over 18 and aware of the recommendation for a medical exam, you may sign a waiver to forego it.
An otolaryngologist, audiologist, or independent dispenser can dispense aids. Hearing aids should be custom-fit to your ear and hearing needs. Mail-order hearing aids typically cannot be custom-fit.
How much do hearing aids cost?
Hearing aids vary in price according to style, features, and local market prices. Price can range from hundreds of dollars to more than $2,500 for a programmable, digital hearing aid. Hearing aids cost should not be the only consideration in buying a hearing aid. Product reliability and customer service can save repair costs and decrease frustration of a malfunctioning hearing aid.
There are several styles:
- Behind-the-ear (BTE) aids go over the ear and are connected with tubing to custom-fitted earpieces.
- Open fit receiver-in-the-ear (RITE) aids are a newer design, and while still placed over the ear, they are extremely small and nearly invisible
- 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 best hearing aid for you depends upon your particular hearing loss and listening needs, the size and shape of your ear and ear canal, and the dexterity of your hands. Many hearing aids have tele-coil “T” switches for telephone use and public sound systems.
Other options, such as FM systems and Bluetooth devices in conjunction with hearing aids, may provide the best benefit for some patients.
Will I need a hearing aid for each ear?
Usually, if you have hearing loss in both ears, using two hearing aids is best. Listening in a noisy environment is difficult with amplification in one ear only, and it is more difficult to distinguish where sounds are coming from.
What other questions should I ask?
Ask about future service and repair. Also inquire about the trial period policy and what fees are refundable if you return the hearing aids during that period. And ask about warranty coverage for your hearing aids and the consumers’ protection program for hearing aid purchasers in your state.
What will happen at my hearing aid fitting?
The hearing aids will be fitted for your ears. Then, while wearing them, you will be tested for word understanding in quiet and in noise, and for improvement in hearing tones. Real ear measurements may also be done, which determine how much gain your hearing aids give you.
Next, you will receive instruction about the care of your hearing aids and other helpful strategies.
How should I begin wearing the aids?
Start using your hearing aids in quiet surroundings, gradually building up to noisier environments. Then eventually work up to wearing your hearing aids all waking hours. Keep a diary to help you remember your experiences and report them accurately to your dispenser for adjustments as needed. Report any concerns on a follow-up appointment. Be patient and allow yourself to get used to the aids and the “new” sounds they allow you to hear.
Frequently Asked Questions
If you experience hearing difficulties, the first step is to visit a physician who can refer you to an otolaryngologist (ear, nose, and throat specialist). This specialist can identify whether your hearing problem is medical and may be corrected. After assessment, you might be referred to an audiologist for a detailed hearing test to understand the type and degree of your hearing loss.
Conductive hearing loss occurs due to problems with the ear canal, eardrum, or middle ear bones that block sound from reaching the inner ear, often treatable with medical or surgical interventions. Sensorineural hearing loss results from damage to the inner ear or auditory nerve and is usually caused by aging, noise exposure, or other factors; it is generally not medically treatable but can be helped with hearing aids.
Hearing aids can be purchased from otolaryngologists, audiologists, or independent dispensers. Federal regulations require a medical evaluation by a physician before purchase; however, adults over 18 may waive this requirement by signing a waiver if they are aware of the recommendation. Custom fitting is essential, so mail-order hearing aids usually are not recommended.
Hearing aid prices vary widely, ranging from a few hundred dollars to over $2,500 depending on style, features, and local market prices. While cost is important, reliability and customer service are crucial as well, as they reduce repair needs and frustration from malfunctions.
There are several hearing aid styles, including behind-the-ear (BTE), receiver-in-the-ear (RITE), in-the-ear (ITE), half-shell, in-the-canal (ITC), and completely-in-the-canal (CIC). The right choice depends on your hearing loss, ear shape, manual dexterity, and listening needs. Many have tele-coils for phone use, and some work with Bluetooth or FM systems for enhanced benefit.
If you have hearing loss in both ears, it is usually best to use two hearing aids. Amplifying sound in both ears improves understanding in noisy environments and helps you localize sounds more effectively than using a single hearing aid.
During a hearing aid fitting, the devices are custom-fitted to your ears, and your hearing is tested with the aids in place to evaluate word understanding and sound improvement. Real ear measurements may be taken to verify proper amplification. You’ll also receive instructions on care and usage strategies.
Begin wearing hearing aids in quiet environments and gradually move to louder settings, building up to all-day use. Keeping a diary to track experiences helps you communicate needs for adjustments with your dispenser. Patience is important as your brain adapts to new sounds, and follow-up visits ensure proper function and comfort.
