What is a hearing aid and how does it work?
• A hearing aid (HA) is any device that amplifies sound or assists the hearing impaired person (generally considered electroacoustic devices).
• Consider when hearing loss (HL) ~≥30 dB, though may be suitable for minimal losses with tinnitus, or for listening in specifi c circumstances.
• For asymmetric hearing loss generally fit poorer-hearing ear, although binaural fitting usually preferable.
• Glasgow benefit scale and Belfast rule of thumb can be considered for HA application as well as surgery.
What are the Conventional Nonimplanted Hearing Aids?
Hearing Aids: provide differential amplification of frequencies to adjust for specific frequency losses, less background and circuit noise, allow compression (non linear relationship between input and output level, for patients who have limited recruitment or dynamic range ) and the possibility of programmability (different optimal programs for different listening situations).
Air conduction aids are commonly used in adults and children to treat sensorineural, mixed or conductive losses as well as tinnitus.
These have the advantage that that they are readily available, inexpensive and easy to repair and replace.
Contraindications include the absence of a pinna or canal, recurrent infections when wearing aids, or thresholds too low to be helped.
What are the types of hearing aids?
- Behind the ear : most commonly; best for more severe losses as less issues of feedback compared with in-the-ear aids.
- Open fit: avoids problems of occlusion caused by conventional aids, helping with lowfrequency noise appreciation, quick fi tting (no mold required), and allows better ear canal ventilation; generally good for high-tone losses (>1 kHz); better cosmetically.
- In the ear : fi lls concha; suitable for mild, severe loss.
- In the canal: more diffi cult to insert (relevant if patient has arthritis, for example).
- Completely in the canal.
- Bone conductor: suitable when no ear canal or pinna, or chronic discharge; body-worn and bone-anchored types.
- CROS: contralateral routing of signal.
- Implantable devices: middle ear transducers, cochlear implants, and auditory brainstem implants.
What are the best types of hearing aids?
What conservative measures should be discussed with patients who have hearing impairment?
Strategic seating at meetings or events (better ear toward speaker, sitting close to the front), making eye contact with speakers, reducing competing background noise.
What are the parts (the basic components) of a hearing aid?
Microphone, amplifier, receiver, power supply.
What accessories are available to enhance the benefits of digital air conduction hearing aids?
Streaming accessories which connect to Bluetooth devices, such as mobile phones, allow a listener to send the audio signals to their hearing aids.
This creates a hands-free headset for phone calls and eliminates the need for headphones when listening to videos and music. Remote microphones are also available and enable a listener to better hear someone who is at a distance or in poor listening environments.
Remote microphones work by placing a microphone on the speaker’s collar; their voice is picked up by the microphone and sent to the hearing aid either directly or via the streamer.
What are the benefits of ventilated hearing aids?
Decrease in external auditory canal moisture, decrease in occlusion effect, dissipation of low frequency input (advantageous in patients with primarily high-frequency hearing loss).
What is the defenition of gain as it pertains to conventional hearing aids?
Gain is the difference between the level of input and level of output at any given frequency.
What factors should be considered in predicting patient satisfaction with traditional hearing aids?
The best candidates are motivated patients who are receptive to the idea of hearing aid use.
Those with predominantly high-frequency hearing loss generally do better than those with low-frequency hearing loss.
Severe to profound hearing loss is often difficult to aid.
Suprathreshold speech and speech recognition performance is important; patients with good word recognition when amplification is provided are more likely to report satisfaction and continued device use.
What' s the difference between the speech reception threshold and the speech discrimination score?
Speech reception threshold is the quietest volume (in dB) at which presented spondaic words can be identified at least 50% of the time, whereas the speech discrimination score is the percentage of time that a presented word is correctly identified.
What's the advantages and disadvantages of the completely-in-canal and the in-the-canal hearing aid?
Advantages: Discreet size offering enhanced cosmesis; takes advantage of the ear’s innate shape assisting with natural sound amplification and limiting undesirable wind noise.
Disadvantages: Power limitations, cerumen clogging, aural fullness and occlusion effect, difficult fit, fine dexterity requirements, cost, and external ear canal irritation.
What's the advantages and disadvantages of the in-the-ear hearing aid?
Advantages: Delivers adequate power to rehabilitate mild to moderately severe losses, more powerful, and easier to manipulate than in-the-canal models.
Disadvantages: Require some manual dexterity for placement and volume control. Less discreet than in-the-canal models.
What's the advantages and disadvantages of the behind-the-ear hearing aid?
Advantages: Most adaptable hearing aid option; delivers enough power to rehabilitate moderately severe to severe hearing loss; generally offers more signal processing features; and is easier to handle than smaller devices in patients with poor manual dexterity.
Disadvantages: Larger size, less discreet, pinna irritation.
What is the primary advantage of a body of hearing aid device?
With severe-to-profound hearing loss, feedback problems occur with ear-level devices because of the close proximity of the microphone to the receiver.
The body aid places the microphone at a distant site from the amplifier, typically on a belt or in a pocket.
With regard to hearing aid technologies, what are the primary advantages of digital processing compared with analogue processing?
Beyond affording multiple programs, digital signal processors can selectively amplify specified frequencies, reduce acoustic feedback and background noise, automatically detect changes in hearing environments to dynamically optimize signal, and offer enhanced connectivity to external sound sources.
What are directional microphones, and what advantages do they have over standard omnidirectional technologies?
Directional microphones selectively amplify sounds located in front of the listener, improving the signal-to-noise ratio.
Adaptive directional microphones go one step further and are able to vary the direction of maximal amplification.
I have severe hearing loss in one ear and mild in the other ,what type of heariong aid shoud i use?
In this case we can discuss the utility of a CROS and BiCROS aid.
The CROS (contralateral routing of signal) aid takes sound from the poorer ear and relays the signal to the better, contralateral ear.
The BiCROS (bilateral contralateral routing of signal) aid similarly "throws" sound to the good ear but also amplifies sound in the receiving ear.
Which patients are candidates for bone-anchored hearing aid placement?
Currently, bone-anchored hearing aids are approved for children 5 years of age or older, patients with conductive or mixed hearing loss who can derive benefit from sound amplification, and patients with single-sided deafness and normal hearing in the contralateral ear.
MORE
Hearing interventions to prevent dementia
Hearing loss is a risk factor for mental dysfunction and dementia. Age-related hearing loss is associated with cognitive decline and predisposing dementia.
Tinnitus is also a chronic hearing disorder, the rate of growth of which increases with age.
Bothersome tinnitus is linked to impairments in working memory and executive control of attention.
Hearing aids and cochlear implants can improve the cognitive decline and mental dysfunction associated with presbycusis.
In conclusion
This is the important benefits that a hearing aid implant can have:
1. Improved sound quality and clarity.
2. Increase the strength of sound, as the implant allows sound waves to travel naturally and freely through the ear canal.
3. Better understanding of audible speech in different noise situations. One of the problems with hearing systems is the difficulty in understanding speech accompanied by noise.
VSB - Vibrant Soundbridge technology allows the auditory bones to function normally and perform appropriately. Its presence in the immediate vicinity of the inner ear allows a better understanding of speech, in different environments.
3. Avoid the annoying feedback that accompanies hearing aids and is a nuisance. This sound is caused by sound waves leaking out and increasing their power. This sound is heard in the patient's environment, making them vulnerable to remarks and embarrassment. Since VSB - Vibrant Soundbridge is not synthesized inside the ear canal, this phenomenon is avoided.
5. The installation of the VSB - Vibrant Soundbridge device is easy, as it is comfortable and aesthetically free (it can be hidden by the hair of the head) which allows its users to wear it more easily. most hours. the day.
6. Increased sound power at high frequencies compared to normal hearing aids. Most hearing impairments are characterized by a decrease in the power of sound at high frequencies and therefore sounds must be reinforced at these frequencies.
The VSB device causes vibrations in the auditory bone chain directly and more quickly, which increases the power of sounds in general, especially at high frequencies, which is a great advantage, as it improves the patient's ability to understand the sound. audible speech, and allows him to hear better.
7. Prevent sensation embolism (occlusion) - all ear headphones must enter the medical, including the most advanced and smallest ones, into the external auditory canal, which often causes a feeling of embolism, that cannot be ignored. While VSB devices keep the external ear canal open and ventilated.
Today, more than ten thousand people suffer from hearing loss and benefit from the properties of VSB - Vibrant Soundbridge devices.
This device has been approved by the United States Food and Drug Administration (FDA) and has received the CE safety mark.
References:
Jafari Z, Kolb BE, Mohajerani MH. Age-related hearing loss and tinnitus, dementia risk, and auditory amplification outcomes. Ageing Res Rev. 2019 Dec;56:100963. doi: 10.1016/j.arr.2019.100963. Epub 2019 Sep 23. PMID: 31557539.