Hearing Aids

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Hearing Aids

Hearing loss cannot be discussed without mentioning hearing aids. When the ENT specialist tells the patient that everything has been done from a medical point of view to restore natural hearing as much as possible, the patient depends on a hearing aid to amplify whatever hearing is left or to simply accept the amount of hearing that is left.

Every case is different and I can only give a brief overview here. However, the ENT specialist will also advise you whether you could be helped by a conventional hearing aid or a cochlear implant. The technology has improved vastly in the 1990's when there was a switch from analog to digital technology for conventional hearing aids.

Hearing aids

Conventional hearing aids

Cochlear implants

Also, at the same time there has been a downsizing of both conventional hearing aids, which is used for 10 to 40 decibel hearing loss, and cochlear implants, which is used for deaf persons with 40 decibel hearing loss or worse.

There has been a silent revolution regarding hearing aids and cochlear implants in the 1990's because of new technology. People who used to be deaf can now hear! Old age deafness can now mostly be remedied with conventional hearing aids and severe hearing loss can be solved with cochlear implants. Ask your physician and get a referral to an ENT specialist.

[edit] Conventional hearing aids

Most patients with mild to severe conductive hearing loss and many patients with sensorineural hearing loss will benefit fom one or two conventional hearing aids that can be molded into the ear canal.

Most patients with high frequency hearing loss and those with hearing loss only on one ear will benefit from the conventional hearing aid. Here is a link to a site that has a detailed description of this technology and pictures of some of the devices (use the return key in the left upper corner of your screen to return to this page). It is important that both ears hear about equally well as this enables a person to have directional hearing. The human ear is very sensitive in discriminating millisecond time differences, which is processed subconsciously and tells the person from which direction the sound originated. This is taken into consideration when the hearing aid is fitted.

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Ear problems

[edit] Cochlear implants

This newer technology has revolutionized the treatment of deaf people. A picture of this can be found under this link as well as a more detailed description (use the return key in the left upper corner of your screen to return to this page).

Here I am merely mentioning that there is a microphone that is usually located behind the ear, from which sound is translated into electric current modulations. This is sent through two induction coils into an internal electrode that is connected to a branch of the 8th cranial nerve (the hearing nerve) and the brain can process this signal as a sound. By way of the outside induction coil and the inside induction coil it is possible to have the two parts of technical equipment separated so that infections of the implanted elctrode will not occur. The surgery for the cochlear implant is only one part of the overall process. The other part is the work with a knowledgeable speech pathologist to relearn language skills and sounds. Those who had good hearing in the past are able to utilize their past audiology knowledge and learn much faster than those who have been congenitally deaf. Cochlear implants are truly one of he greatest achievements of modern technology!

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References:

1. The Merck Manual, 7^th edition, by M. H. Beers et al., Whitehouse Station, N.J., 1999. Chapter 84.

2. Noble: Textbook of Primary Care Medicine, 3rd ed.,2001, Mosby Inc.

3. The Merck Manual, 7^th edition, by M. H. Beers et al., Whitehouse Station, N.J., 1999. Chapter 85.

4. Rakel: Conn's Current Therapy 2001, 53rd ed.,2001, W. B. Saunders Company

5. Goldman: Cecil Textbook of Medicine, 21st ed.,2000, W. B. Saunders Company

6. Mandell: Principles and Practice of Infectious Diseases, 5th ed.,2000, Churchill Livingstone, Inc.

7. The Merck Manual, 7^th edition, by M. H. Beers et al., Whitehouse Station, N.J., 1999. Chapter 265.

8. MF Williams: Otolaryngol Clin North Am; Oct1999; 32(5): 819-834.

9. The Merck Manual, 7^th edition, by M. H. Beers et al., Whitehouse Station, N.J., 1999. Chapter 106.

10. Ferri: Ferri's Clinical Advisor: Instant Diagnosis and Treatment, 2004 ed., Copyright © 2004 Mosby, Inc.

11. Rakel: Conn's Current Therapy 2004, 56th ed., Copyright © 2004 Elsevier