University Otolaryngology

                                                                                                                              Head & Neck Surgery, Inc.

 \
  • Brian E. Duff, MD
  • Sharon E. Gibson, MD
  • Charles M. Ruhl, MD
  • Jan Groblewski, MD
  • Jules M. Friedman, MD

 

Do I Need Hearing Aids?
Most hearing losses can be treated with hearing aids.  Depending on the degree of your hearing loss, you may be able to benefit from amplification.  There are four general categories or degrees of hearing loss: mild, moderate, severe & profound. Your hearing loss may fall into more than one category.  For instance, you may have a mild hearing loss in the low pitches with a severe hearing loss in the high pitches.  There are three types of hearing loss: conductive, sensorineural & mixed.  Conductive hearing loss results from inefficient transmission of sound from your outer or middle ear to your inner ear.  In conductive hearing losses, the inner ear is healthy.  Ear infections and wax in the ear canal are two of the most common causes of conductive hearing loss.  Hearing can be restored with medical treatment in most cases of conductive hearing loss.  Sensorineural hearing loss involves damage to the inner ear.  This damage and the accompanying hearing loss are generally irreversible, although there are cases where sensorineural hearing loss may be fluctuating or progressive (getting worse over time).  Sensorineural hearing loss can result from noise exposure, certain medications, aging (presbycusis), genetics and so forth.  Finally, in a mixed hearing loss, there is hearing loss that is associated with the inner ear (sensorineural) and the outer/middle ear (conductive).  Your Audiologist will explain your hearing loss in detail and work with you to determine whether you could benefit from amplification.

Do I Need Two Hearing Aids?
Wearing two hearing instruments, or binaural amplification, is usually recommended by hearing health care professionals for the following reasons: 

  1. It has been found that the listener is more relaxed with two instruments because binaural amplification eliminates the need to strain to hear a sound.  If only one instrument is worn, you will continually use the good ear by turning toward the source of the sound.
  2. Wearing two instruments makes it easier to locate the source of a sound-whether it is a nearby ambulance, someone calling your name or the room where the phone is ringing. 
  3. Two instruments help you to better understand speech, especially in a situation where noise is present.
  4. Because you are surrounded by sound, the use of two hearing instruments allows a more balanced sense of hearing and better overall sound quality.    Many try to turn up the volume on their sole instrument in an effort to improve the audibility of the sound, but this may result in increased distortion.  Turning up the volume on a single aid does not necessarily result in improved audibility or enhanced sound quality.

Just as two eyes are necessary to focus on objects and see the complete picture, two good ears are necessary to clearly understand speech, locate the source of a sound, balance incoming noise and deliver a more natural sound quality.  If you wish to decide for yourself whether two ears are better than one, begin by trying two hearing instruments.  You will have a thirty day trial period, during which you can return one or both hearing aids.  Your audiologist will discuss with you the details of our thirty day trial period. 

Alternative Amplification

 

Are There Any Alternatives to Conventional Hearing Aids?

Yes.  Hearing aids are not for everyone.  For some individuals, medical problems such as chronic ear infections, middle ear surgery or complete deafness may prevent them from wearing a conventional hearing aid.  For these individuals, surgically implanted devices such as Cochlear Implants or Bone-Anchored Hearing Aids (BAHA) may be a good alternative.

  

 

These alternative amplification devices involve medical and/or surgical procedures which will be performed by one of our physicians.  Your physician and audiologist will work with you to evaluate your candidacy for alternative amplification.  Our comprehensive care includes evaluation, treatment and follow-up.  Insurance coverage for the above procedures varies.  Please check with your individual insurance carrier for coverage information.  The RetroX is not currently covered by medical insurance.

 

If you think you may be a candidate and are considering any one of these alternative amplification devices, please contact our Waterman Street Location's Audiology Department at (401) 274-3277 for further information.  Simulators for the BAHA are available so you can try them out to see if these medical approaches are right for you.*   

 

 

*There may be a waiting list for these devices.

Assistive Listening Devices

 

Although hearing aids can be very useful in helping individuals with hearing impairment in daily activities, there are many situations in which the hearing aids alone do not provide sufficient help.  Such instances include hearing in background noise, on the telephone or at the theater and listening to your TV.  Some people with hearing loss also have difficulty hearing alarms (i.e. smoke detectors), door bells or telephone ringing unless they are close to the unit.  Assistive Listening Devices (ALDs) are products that are designed to help in all of these situations.  ALDs help individuals with hearing impairment to improve communication and increase environmental awareness.  They can be used to supplement hearing aids and cochlear implants to give the hearing impaired listener access to sounds that are otherwise unavailable to them therefore overcoming even the most challenging listening situations.  ALDs can also help people who have normal hearing or very mild hearing loss that have trouble hearing in noisy environments but are not considered candidates for hearing aids.  ALDs are sometimes stand-alone products or they can be hardwired to televisions, telephones, answering machines, radios, and so forth.  Many are wireless and use infrared, FM signals, or loop systems to bring the sound to the individual.
 
ALDs fall into two general categories:

 

1.

Personal systems that aid in communication, as well as telephone, TV, radio & stereo use.

2.

Alerting devices for awareness of environmental sounds and warning signals such as smoke alarm, doorbells, and baby crying.


By bringing the speakers voice directly to the ear of the listener, ALDs help to solve communication difficulties through:

1.

Reduction of interference of background noise.  Anyone with hearing loss or who uses a hearing aid is at a considerable disadvantage in background noise.  Noise masks or blocks out much of the speech information, especially the high frequency information so important for understanding speech.  ALDs help by bringing the sound directly to the ear of the listener.

2.

Reduction of the effects of distance between the sound source and the listener.  As distance form the sound source increases, loudness decreases.  Also, distance takes away important visual cues from the listener, and gives noise more opportunity to garble the message.

3.

Reduction of the effects of poor acoustics, such as reverberation.  Some rooms, especially meeting rooms, churches, synagogues and auditoriums are highly reverberant.  Reverberation occurs when sound bounces off of hard surfaces, sometimes sounding like an echo.

How Common is Hearing Loss?
 
About 28 million people in the U.S. have some degree of reduced hearing sensitivity. Of this number, 80% have irreversible hearing loss. (NIDCD, 1989)

Over 1 million children in the U.S. have a hearing loss. (U.S. Public Health Service, [1990]. Healthy People 2000. Washington, DC: Government Printing Office.)
 
5% of children 18 years and under have hearing loss. (US Dept of Health and Human Services, [1991]. Healthy people 2000: National health promotion and disease prevention objectives. DHHS Publication No. 91-50121. Washington, DC: US Government Printing Office, Superintendent of Documents.)

 
How Do I Know if I Have a Hearing Loss? 
Below are some general guidelines that may indicate a possible hearing loss. The presense of one or more of these conditions does not necessarily confirm hearing loss, but may prompt you to schedule a hearing evaluation.  We provide comprehensive hearing evaluations for all ages.

Adults:

  • You often complain that people mumble or do not speak clearly.
  • You frequently ask people to repeat what they've said.
  • Your friends or family members tell you that they suspect you have hearing loss.
  • Looking at people when they talk to you makes it somewhat easier to understand, especially when there is a lot of background noise.
  • You find yourself missing parts of conversations.
  • you cannot ehar the doorbell or the telephone ring.
  • Others say that your preferred volume on the TV is too loud.

Children:

  • Your child inconsistently responds to sound.
  • Your child's speech or language development is delayed.
  • Your child's speech is unclear or difficult to understand.
  • The volume on the TV is turned up too loud.
  • Your child does not follow (or misunderstands) directions.
  • Your child frequently says, "what?" or asks for repetition.
  • Your child does not respond when called.

What are My Choices?

There are several sizes or styles of hearing aids, as well as a multitude of technology options.  We offer a full range of custom hearing aid size options, ranging from completely in the canal (CIC) to full in-the-ear (ITE) models, as well as the latest in "open fit" and standard behind-the-ear (BTE) options.  All of the hearing aids we offer are fully digital and programmable with technology ranging from basic digital to the state-of-the-art premium digital technology. It is important to remember that no one hearing aid is appropriate for all hearing losses.  Amplification needs vary from person to person depending upon a number of factors (e.g. hearing loss, age, activity level, lifestyle, speech discrimination ability, manual dexterity, etc...). Your audiologist will work with you to determine which size and technology best meets your needs. We offer a wide range of hearing aid technologies and styles from the major hearing aid manufacturers. 

How Do I Get Hearing Aids?

In order to receive hearing aids a medical clearance is generally recommended, but may be waived under certain circumstances.  Also, a current hearing test (performed within the past six months) is required.  Our board certified otolaryngologists and audiologists are available to help you with this process.

Hearing Aid Evaluation:The hearing aid evaluation is a no obligation one hour consultation appointment.  Family members are always encouraged to attend.  At this appointment, the audiologist will review your hearing loss, discuss style/technology options and make recommendations.  If you would like to proceed with a custom order, an impression of the ear(s) will be taken and an order will be placed. For standard devices (non-occluding or "open fit"), no impression is necessary.  The audiologist will make a few simple measurements to ensure the right size selection is made.  Depending upon the device (i.e. standard vs. custom), it may take one to two weeks to receive the order.  There is no charge for this appointment.

Fitting:  Family members are once again encouraged to attend the fitting.  The fitting is appoitment is where you will be receiving your new hearing aid(s).  The audiologist will provide appropriately detailed instruction with regard to hearing aid use, care and maintenance, as well as offer demonstrations and allow time for practicing new skills, such as insertion and battery changing.  The audiologist will also discuss with you what should be expected as you adjust to amplification and how your hearing aids will account for this.  Preliminary customized hearing aid settings will be programmed into the hearing aid and adjustments to these settings may be made if the audiologist determines it is necessary.  The fitting will initiate a thirty-day trial period, the terms of which will be discussed at this time.  Your hearing aid(s) will come with a two year comprehensive manufacturer warranty, the terms of which will also be discussed.  Payment in full is due at the time of the fitting appointment (We accept cash, personal/bank checks, Mastercard, Visa and American Express).

Follow-up: You will be scheduled for at least one to two follow up visits, generally at two week intervals during your trial period.  Follow up visits are one half an hour in duration.  Your audiologist will tailor your follow-up schedule to your unique needs.  These appointments are essential to ensure that you are getting the most out of your hearing aid(s).  Your audiologist uses this time to review instructions, fine tune your hearing aid(s) and to determine the level of benefit you are receiving.  At the conclusion of your trial period, you may continue to schedule regular follow ups, based upon your individual needs.  Additional appointments may be scheduled on an as-needed basis for adjustments, maintenance or repairs.

Repair Policy: Scheduled appointments are required, as the audiologists will likely be unable to accommodate patients who arrive without an appointment.  You may elect to leave your hearing aid(s) with the receptionist at your convenience.  The audiologist will later determine if the aid can be repaired at our office or if it needs to be sent to the manufacturer for repair and you will be notified accordingly.

Fees: Service during the first year after a new hearing aid purchase is complimentary.  Service fees will apply for hearing aids > 1 year old, as well as for those purchased at another facility.  You will be informed of specific fees prior to service.

We have a variety of accessories, including premium batteries, available for purchase. 

For further information on hearing loss and the hearing aids we offer please visit the following sites:

GN Resound         Oticon, Inc.        Phonak         Siemens Hearing Instruments        Starkey         Vivatone         Widex

 

Hearing Aid Technology

 

At University Otolaryngology our highly skilled Audiologists (What is an audiologist?) perform comprehensive hearing evaluations on both pediatric (6 months +) and adult populations.  During these evaluations, our audiologists will use age-appropriate techniques to assess the patient's ability to hear a variety of sounds, including speech and tones, presented through insert earphones, headphones or speakers.  The audiologist will also check the ears (e.g. for wax, drainage, etc..) and perform testing which evaluates the eardrum and middle ear.  This testing is comfortable and safe.  Total testing takes from fiteen to thirty minutes. 

Our audiologists are skilled in advanced hearing diagnostic testing and will perform further testing as indicated.  Advanced testing is not performed at the initial hearing evaluation, but can be scheduled as needed for subsequent appointments.  For more information regarding Audiology Diagnostic testing services you may download our patient information form.

Tip for parents: Testing is most productive when the infant/toddler is well rested, fed and dry.

Examples of Assistive Listening Devices include:

  • Amplified handsets for the telephone that allow volume adjustment
  • Amplified doorbell ringers or light flashers that will signal if someone is at your door
  • Reomote units that can be set up in any room of your home
  • Headphones that allow you to adjust the volume of your television to comfortable levels for yourself without disturbing others.  Many are wireless and some are bluetoothe compatible
  • Amplified smoke alarms to alert you to danger (Very Important:  A standard smoke alarm may not be loud enough to wake a sleeping individual with a moderate hearing loss or greater at teh pitch of the alarm). Some units have flashing lights to alert you when the alarm sounds.
  • Amplified alarm clocks with adjustable alarm tones and vibrating attachments

There ar many other devices that are available.  Please make an appointment with one of our audiologists to discuss which devices best meet your particular needs.

Hearing Evaluation