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What Should You Expect from Your Hearing Evaluation?

January 12th, 2012

By: Bettie Borton, Au.D., FAAA
Doctor of Audiology
Doctors Hearing Clinic
7025 Halcyon Park, Suite A
Montgomery, AL 36117
(334) 396-1635
“Like” Doctors Hearing Clinic | Facebook
www.doctorshearingclinic.com

More than 32 million Americans have significant hearing loss, yet only a fraction of that number have ever had their hearing tested by a Board Certified Audiologist. Everyone over 25 should have a baseline audiogram! Consider this fact- 17% of all those involved in motor vehicle accidents will have resultant permanent sensorineural hearing loss. However, if you’ve never had a valid hearing evaluation, you’d be hard pressed to show that your hearing was normal prior to such an accident.

A thorough hearing test is the first step in determining if you do, in fact, have hearing loss. The hearing test results also allow your audiologist to recommend the best treatment options if you do in fact have hearing loss. A hearing test is a quick, painless and non-invasive test, and should always be performed by a licensed, Board Certified audiologist. Ask to see the credentials of those who will be doing your testing! As with most health care  professionals, credentialed individuals have the greatest amount of educational training in diagnosis and treatment of hearing impairment, and will offer you or your loved ones solutions that reflect their knowledge base.

Hearing Test Audiogram

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

The test begins with a thorough case history, which reviews specific health information that may provide insight into hearing loss causes and will assist in determining which tests should be performed. Following the case history, the audiologist will examine your ear canals and eardrums with a special light called an otoscope. Your middle ear function will also be assessed by a test called tympanometry, which offers insight regarding the status of the area behind your eardrum. This area cannot be easily seen, and so the tympangram offers valuable information to the examiner. The test involves a pressure change, and may replicate the feeling you experience while going up in an elevator, but is not painful in any way.

Next, the levels of hearing in each of your ears should be measured in a sound-treated test booth. Some hearing aid technicians don’t use this type of equipment~ but be wary of any hearing test that is not conducted in such a booth, as reliability may be seriously compromised. During this test, a series of tones of different pitches, as well as speech signals, are presented to each ear through headphones. You will be asked to respond to the signals by either pushing a button, raising your hand or in the case of speech signals, repeating what you heard. You will be asked to respond to the lowest level that you can hear which determines your hearing thresholds. Thresholds for each pitch and ear are plotted on a graph called an audiogram. These thresholds indicate the level at which you are just barely able to detect sound. The speech testing yields a word recognition score, which is important in determining in part how well you will perform with hearing aids, which listening situations will be most challenging, etc.

Further tests may be conducted during the hearing test. Your ability to understand words or sentences at different volume levels or in the presence of noise may be assessed to determine how clearly you hear speech in various conditions. Following the tests, the hearing professional will discuss the results with you and may provide further recommendations, including treatment options, like hearing aids.

If you suspect you have hearing loss it is important to have your hearing tested as soon as possible. The use-it or lose-it principle does apply to our hearing; the sooner you treat hearing loss, the better the outcome of treatment. Most people wait an average of seven years from the time they suspect they have hearing loss until they purchase hearing devices. During that time period, the auditory system is at extreme risk for auditory deprivation, or lack of stimulation due to insufficient volume. This can make a difficult situation worse than it really needs to be. So why wait? Have a Board Certified Audiologist evaluate your hearing as soon as you (or others!) suspect there might be a hearing loss.

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Posted in Audiogram, Audiologist, Bettie Borton, Board Certified Audiologist, Doctors Hearing Clinic, Ear Canal, Eardrum, Ears, Hearing, Hearing Aid, Hearing Aid Technician, Hearing Care, Hearing Evaluation, Hearing Impaired, Hearing Loss, Hearing Test, Hearing Tested, Hearing Threshold, Listening Situations, Otoscope, Sensorineural Hearing Loss, Uncategorized

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What’s the Best Hearing Aid?

December 8th, 2011

By: Bettie Borton, Au.D., FAAA
Doctor of Audiology
Doctors Hearing Clinic
7025 Halcyon Park, Suite A
Montgomery, AL 36117
(334) 396-1635
“Like” Doctors Hearing Clinic | Facebook
www.doctorshearingclinic.com

“What’s the best hearing aid?” As an Audiologist, I’ve heard that question so many times. To successfully answer that question, perhaps the very first thing I need to do is modify it slightly ~ “What’s the best hearing aid for you?” An important concept to keep in mind when exploring today’s vast array of options for hearing devices is that what’s right for you may not be right for someone else, and vice reverse. The decision regarding which type of hearing instrument technology will sound and perform the very best will be largely dependent on you, your lifestyle, budget, and listening needs. These parameters tend to be highly variable from person to person, so let’s take a closer look.

Not all hearing losses can be correctly fit with the same style or type of device. This is very evident when fitting those with precipitous loss in the high frequencies.  High frequency deficits are the most common configuration of hearing loss, and respond best to open fit technology. This type of device leaves your ear canal open, ensuring that the sound of your own voice is normal and pleasant. Conversely, fitting those with high frequency loss with conventional “in the ear” devices can have catastrophic results in terms of patient satisfaction. Have hearing instruments that you or your loved one are not using? It may be resultant from the units being the wrong style for the loss! High quality open fit technology has been available for a relatively short period of time, and many of those whose instruments were purchased more than 5 years ago may not have had access to those devices.

What about some of the new “fancy stuff”, like Blue Tooth technology? Is that for you? Many of my patients are not familiar with Blue Tooth, but it can open up a world of ancillary devices and couplings for your hearing devices. For example, if you use Blue Tooth enabled hearing aids, you can wear a “streamer” around your neck, and answer your cell phone hands free through your hearing aids! With the new cell phone use restrictions now in place in Montgomery, that can be a really handy feature. It’s also possible to listen to your TV or IPod directly through your hearing instruments with this technology, or use a special microphone to make conversations with your significant other in a noisy car or restaurant much easier. Other technologies to consider are remote controls, assistive listening devices like amplified phones or doorbell alerts, or FM devices to help with performance in a classroom or job environment. However, if you don’t want or need such technologies, don’t pay for them!

AGX Hearing Lifestyle

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

What kind of lifestyle do you have? If you are still working, it’s likely that you are in highly variable listening environments, or your profession demands auditory accuracy (and most jobs do!). Those who lead very active lifestyles need to consider today’s high end technology, with plenty of noise reduction capability. On the other hand, if you’re retired, living alone, and seldom go to restaurants or parties,  simpler, more basic noise reduction features will suffice – and cost less! If you are the type of person who “wants the best of everything” then there are plenty of high end technologies to wow you (and your friends and family). Don’t overbuy, but do be honest with your Audiologist about your listening needs. If you aren’t you may be disappointed with your hearing devices.

Finally, as self-serving as this might sound, perhaps the only honest and comprehensive answer to the question above is “a hearing device recommended and provided by an exceptionally skilled and dedicated Audiologist.” Sometimes that’s not the answer folks are looking for. I have patients tell me “it’s all about price” or request a specific brand because a friend or relative was successful with a particular device. Hearing aids are a big investment with the potential for providing a big improvement in the quality of your life. People with hearing impairment need a competent and caring Board Certified Audiologist who will go the extra mile to provide them with solutions custom-tailored to their own unique hearing loss and listening situations. As critical as the various aspects of technology may be to the hearing aid industry, it is ultimately the professional who is the decisive factor in guiding patients to satisfaction and benefit with hearing devices.

Note: Doctors Hearing Clinic was recently named Best of 2011 Hearing Healthcare Professionals by The Hearing Review, and was Dr. Borton and her staff were the only clinic in Central Alabama to receive this award. This recognition was provided to only 165 hearing healthcare clinics across the United States.

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Posted in Audiologist, Bettie Borton, Bluetooth, Central Alabama, Doctors Hearing Clinic, Hearing Aid, Hearing Device, Hearing Instruments, Hearing Loss, Hearing Technology, Listening Enviornments, Listening Situations, Listening Tips, Noise Reduction, Uncategorized

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Make the Most of Your Hearing – (re) Train Your Brain!

November 23rd, 2011

By: Bettie Borton, Au.D., FAAA
Doctor of Audiology
Doctors Hearing Clinic
7025 Halcyon Park, Suite A
Montgomery, AL 36117
(334) 396-1635
“Like” Doctors Hearing Clinic | Facebook
www.doctorshearingclinic.com

We hear in our ears, but we process and understand sound in our brain. Hearing aids can help a person detect that are no longer in their range of audibility, but they don’t necessarily provide good listening skills. There is a fundamental difference between hearing and listening, and hearing devices alone do not assure good listening. We all know people who have normal hearing but are poor listeners (ok, ok, don’t reference your spouse’s selective hearing!). Hearing requires a functional auditory system that allows sound to be heard, listening requires specific effort and skill, and that can become more difficult when a hearing loss is present.

As technically advanced as modern hearing aids might be, these devices alone cannot ensure listening skills needed for communication. Listening integrates a number of skills including attending, understanding, and remembering. Unfortunately, many of these cognitive skills deteriorate as we age. This may show up as a worsening of short-term memory, or increasing difficulty understanding rapid speech. Modern hearing aids have certainly improved the quality of sound in noisy environments, but they do not eliminate background sounds. People with sensorineural hearing loss have disproportionately difficult time understanding speech in noise. In addition, research shows that a loss of hearing produces physical changes in the auditory pathways of the brain. We now know that when hearing loss deprives parts of the brain of auditory stimulation, neural pathways actually degrade. The old adage of “use it or lose it” is very true with regard to hearing loss- waiting to get hearing aids when you know you have hearing loss is problematic because your brain may not be receiving the kind of stimulation it needs to maintain speech understanding.

Bettie Borton, Au.D. Doctor of Audiology AudiologistWhen people lose confidence in their ability to communicate in noisy social situations, they simply drop out and avoid those environments. While this may save them effort and embarrassment, it ultimately costs them important personal and social contact. Some individuals utilize compensatory strategies that may result in successful hearing aid use. Others, however, are not so fortunate. The need for additional therapy beyond that provided by devices alone is becoming increasingly evident, and is underscored by the fact that individuals with similar hearing loss frequently report a wide range in satisfaction and benefit from their hearing aids.

The good news is a Board Certified Audiologist can optimize your hearing aid hearing experience using a number of methods, strategies and techniques. The hearing healthcare professionals at Doctors Hearing Clinic specialize in developing individualized treatment plans for those struggling with hearing impairment, and can offer the very latest in technologies, as well as the time required to successfully implement them! Have realistic expectations for hearing aids – they’re wonderful devices, but not new ears. Join a self help group to share methods and techniques that are successful for you and others (Montgomery has a Hearing Loss Support Group that meets the second Thursday of each month at the First Methodist Church, 4 PM, free of charge!). And consider new computer software to “train your brain” to listen more effectively!

The great news is that with the help of a skilled Audiologist who routinely offers programs in aural rehabilitation, you or your loved ones can keep listening skills from deteriorating and improve ability to function in noisy situations. When a person injures an arm or leg, everyone recognizes the importance of physical therapy to strengthen adjacent muscles and instruction to optimize function. Similarly, it is likely that hearing devices alone will not produce optimal communication skills unless accompanied by counseling and training.

There are many exercises you can try on your own. Here are three examples:

• Use closed- captioned TV, or record programs using a DVR or TIVO. Watch the show live. Then replay it with closed captioning or by slowing it down.

• Listen to, while reading, audio books.

• Buy two copies of the newspaper. Have your spouse or colleague read the newspaper aloud while you are listening only, and then go ahead and read it yourself. Try this in quiet at first, and then proceed to noisier listening environments.

• Try self-help computer assisted training programs

One such auditory training therapy program designed to help the brain listen, Listening and Communication Enhancement (LACE) uses a computer or DVD. LACE is designed to enhance listening and communication skills, improve confidence levels, and provide communication strategies. The program consists of a variety of interactive and adaptive training tasks for listening to speech in noise, rapid speech, and auditory memory. Besides the immediate feedback given for each task, LACE provides you with a graph depicting daily improvement from the start of the training.

LACE training is conducted in the privacy of your own home at a pace comfortable to you; Doctors Hearing Clinic also offers a computer lab where you can take all or part of the training in their office. Research on thousands of people with hearing loss demonstrates that you can expect on average a 40% improvement of speech comprehension in noisy situations, if you complete the training program.

So if you or someone you love uses hearing devices, take the important step of seeking help from a Board Certified Audiologist to help you develop a comprehensive strategy for hearing and communication skills – train your brain for listening!

References: Robert W. Sweetow, Ph.D., Professor of Otolaryngology, University of California, San Francisco and the Better Hearing Institute

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Posted in Audiologist, Communication, Communication Strategies, Hearing Aids, Hearing Loss, LACE, Listening Tips, Sensorineural Hearing Loss, Uncategorized

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Can I Prevent My Hearing Loss From Getting Worse?

November 10th, 2011

By: Bettie Borton, Au.D., FAAA
Doctor of Audiology
Doctors Hearing Clinic
7025 Halcyon Park, Suite A
Montgomery, AL 36117
(334) 396-1635
“Like” Doctors Hearing Clinic | Facebook
www.doctorshearingclinic.com

Bettie Borton, Au.D. Doctor of Audiology AudiologistWhen I diagnose patients with a loss of hearing, they usually want to know if there is any way they can stop the progression of the loss. Common sense (and a large body of research) tells us that hearing loss tends to get worse as we get older, but each case is unique. In many cases, hearing is stable for many years. In others, the hearing loss progresses relatively rapidly.

One of the most important things that all adults over the age of 50 need to do is to have an audiological evaluation that will establish their baseline hearing, and keep that on file with their primary care physician and with their health records kept at home. Getting a comprehensive audiometric  by a Board Certified Audiologist ensures that you have been evaluated by a professional who has the most training for this purpose, and ascribes to the highest ethical, practice,  and continuing education requirements available. Why is it so important to have this baseline? Well, if your hearing changes, it will be much easier to gauge the rate of progression of the loss if you have clearly established a “starting point”, and have annual re-evaluations to document any shift in thresholds. And remember, documenting that starting point could be very important –No one wants to borrow trouble, but  don’t forget that  17% of all of those involved in motor vehicle accidents with air bag deployment have permanent sensorineural hearing loss as a result! That could be difficult to prove in a court of law if you haven’t had a recent hearing test.

Noise is a leading cause of hearing loss, and hearing loss from noise exposure is usually preventable. Both the level of the noise and the length of time you’re exposed to it determine if a noise will cause damage to your hearing. A good rule of thumb is: if you have to raise your voice to be heard by someone standing three feet away, the noise around you could be damaging.  Everyday sounds, such as music, power tools, or a lawn mower, have been shown to cause hearing damage.

Visit a local hearing center for advice regarding the best options for ear plugs or other noise protection to wear during these activities and get your hearing checked on a a regular basis.  Your hearing professional can compare your exams over time to determine if your hearing loss is worsening. If a significant change is noted, your hearing professional may refer to you to an ear doctor for further evaluation.

 

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Posted in Audiological Evaluation, Audiometric, Baseline Hearing, Bettie Borton, Board Certified Audiologist, Doctors Hearing Clinic, Hearing Center, Hearing Damage, Hearing Loss, Hearing Professional, Hearing Test, Loss of Hearing, Noise Exposure, Sensorineural Hearing Loss, Uncategorized

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You bought new hearing technology, but, you still have difficulty hearing in noise. What’s going on??

November 3rd, 2011

By: Amit Gosalia, Au.D., FAAA
Board Certified Doctor of Audiology
Audiology Clinic, Inc.
505 NE 87th Ave., #150
Vancouver, WA 98664
(360) 892-9367
Follow Audiology Clinic | Facebook | Twitter
www.audiologyclinic.com 

“Dr. Gosalia, I just bought a pair of $8500 hearing aids from XYZ in Portland. I was told that I would hear normally in all environments, including restaurants and ball-games. I am less than pleased because I still can’t hear or understand in noise. Did I waste my money?”

Amit Gosalia, Au.D. - Doctor of Audiology, Vancouver, WAThis was a case I dealt with a few months ago. This patient went to a business to purchase hearing aids, and this franchise/chain location set some lofty expectations for the patient. As hearing instrument technology improves, so do patient expectations. Terms such as noise reduction, noise management & directional hearing (along with many other proprietary terms) give the perception that the end-user will not hear background noise, and only hear the person in front of them. Unfortunately and fortunately, this is not true. Below I’ve touched the surface of noise, noise reduction and directivity.

Let’s start with noise. Noise is any disrupting event (in this case, sound) that impedes one’s ability to sense (in this case, hear) a signal (in this case, speech). For the purpose of this post, we’ll concentrate on hearing speech within a noisy environment. A general term and formula that is used in hearing healthcare is Speech-to-Noise Ratio (SNR) which tells us how loud speech is in relation to noise. For example, average speech is 45-55 decibels (dB) hearing speech in a basketball stadium where the crowd is cheering over 90 dB is difficult because the speech is 35-45 dB lower than the noise. This is considered a very low SNR; now compare this to speaking at a normal volume in a quiet library, the SNR will be high making speech much easier to understand. When someone has a hearing loss things change. Without amplification important parts of speech are not heard well, making understanding the person next to you difficult, if not impossible. The natural ability of any person to hear through noise decreases as hearing loss increases. This is a fact that has been well established in research on the human auditory system. Thus, a hearing aid can help make missing pieces of speech more easily heard but it cannot repair one’s ability to hear through noise and find valuable pieces of speech. For this reason, modern hearing aids focus on managing noise and amplifying clean speech.

Hearing instruments can come with or without venting. Vents are holes that are drilled through either the hearing instrument or the earmold for the purpose of letting air and sound travel in and out of the ear canal. The larger the vent, the closer you get to a more natural, open ear. Newer technology has allowed us to keep the ear open with small hearing instruments that rest behind the ear and even some custom molded devices (please see other postings for detailed descriptions of hearing technology). As cute as they may be, if your hearing is not within or near normal limits in the lower frequencies, an open ear device may not be for you.

One advantage of an open ear hearing aid is to allow low frequency sound to escape the ear canal, keeping the user’s voice more natural. When the user complains of hearing their own voice in their head or sounding as if they are speaking in a barrel, it’s usually a phenomenon called occlusion (or ampclusion). Keeping an ear canal open minimizes this effect but also introduces two detrimental issues. First, low frequency environmental sounds will bypass the hearing aid and travel into the ear naturally through the vent. These sounds that bypass the hearing aid are often heard naturally because most hearing losses are minimal in the low-frequencies and greater in the high-frequencies. This also means that the hearing aid is not able to process the sound before it’s heard, so technologies such as noise reduction do not affect low-frequency sounds in the open ear hearing aid.

Secondly, directional microphones will prove less beneficial in the open-ear fitting.2 What this means is that the more open the ear canal, the harder it becomes to hear what’s in front of you. So, theoretically, if our goal is to have the instruments focus more front-facing, the ear canal should not be very open. Note that normal low frequency hearing will be affected by closing the ear canal, and opening the canal with moderate to profound low frequency hearing will result in less hearing in those frequencies.1,2

So, what does this tell us about hearing in noise with amplification? You will hear background noise in noisy environments. You will most likely hear the kids screaming four tables away. You may still have difficulties hearing the person across the table from you. The good news is that with proper hearing aid selection and the correct technology that meets your lifestyle and budget, you’ll hear much better. Only a well trained hearing care professional can make these choices and help you to establish reasonable expectations for better hearing.

“Ms. XX, although the level of technology you purchased is consistent with an Active Lifestyle (in our clinic approx $7500 – $1000 less than the chain!!), you should know that hearing aids only supplement your hearing in those difficult environments. In fact, with normal hearing, I have difficulty hearing at basketball games and certain restaurants as well. Although we can not restore normal hearing, we can help you hear much better in more environments. You will still have some difficulty hearing and understanding in certain environments, but, with some realistic expectations, expert advice, and some auditory retraining, you will find greater success.”

 

1 What is the Effect of Venting on Directivity? Audiology Online 10/2009; Todd A. Ricketts, Ph.D., CCC-A, FAAA

2 Efficacy of an Open-Fitting Hearing Aid; Hearing Review February 2005; Francis Kuk, Phd, et al

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Posted in Audible, Audiologist, Audiology, Directional Hearing, Doctor of Audiology, Ear Canal, Earmolds, Hearing Aids, Hearing Care, Hearing Healthcare, Hearing Instruments, Hearing Loss, Hearing Technology, Human Auditory System, Open Fit Hearing Aids, Uncategorized

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Stop Transactional Hearing Care!

September 21st, 2011

By: Dr. Helen Hallenbeck
Board Certfied Audiologist
Vibrant Hearing
601 South Orange Street
Missoula, MT 59801
(406) 549-1951 
www.myvibrantsound.com

A gentleman called yesterday and wondered if one of our audiologists would please make an impression of his ear. He found a hearing aid and wanted to “whittle on it” to make it fit his ear better. My first reaction (after “YUCK!”) was Why in the world would anyone want to wear a hearing aid that was customized for another person’s ear and hearing loss?!?!

Helen Hallenbeck, Audiologist Missoula, MTWas it a fundamental lack of understanding of the complexities of hearing loss and the insidious impact that loss has on relationships, communication patterns and lifestyle? Was it financial limitations? It takes an average of 7 years from the moment a person realizes they have a hearing loss until that person decides to get help. Throughout that period of emerging awareness, the person with a hearing loss is bombarded with mixed marketing messages. “Our Amazing Hearing Aids get rid of ALL unwanted background noise!” “Our Amazing Hearing Aids are INVISIBLE!” Our Amazing Hearing Aids will let you hear ONLY what you want to hear!”. In addition to the inexcusable exaggeration of the capabilities of any hearing technology, the hearing aid companies lure people in with FREE! everything.

Is it any wonder, when a person is finally ready to make the deeply personal and incredibly important  investment, that they fundamentally misunderstand what it is they are investing in and who it is they are investing with? The gentleman’s request for an ear impression so he could make his own hearing aid should not come as a surprise. The  hearing industry has painted themselves into a corner with salesmanship and bottom-dollar marketing. As a result the industry has devalued it’s very existence.

The truth is, hearing loss is complicated, frustrating and has a profound negative impact on the lives of the people that are affected. It is time the industry began to address the PERSON with the hearing loss. Today’s hearing technology is truly amazing and an appropriate solution can be found to fit within virtually any budget. But unless that technology has been chosen specifically for the individual, with all of his needs, desires, concerns, question and fears having been accounted for and carefully considered, then the technology has been wasted.

Let us each  work to make rigorous diagnostics, counseling, education, prevention and rehabilitation the expectation of the consumer.  Let’s stop the transactional process of hearing care that so dominates this industry and start humanizing what is truly a disability.

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Posted in Hearing Aid, Hearing Aids, Hearing Care, Hearing Loss, hearing needs, Hearing Problem, Helen Hallenbeck, Missoula, Uncategorized, Vibrant Hearing

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Sharpen Your Listening Skills

August 3rd, 2011

By: Suzanne Yoder, Au.D.
Doctor of Audiology
HearWell Center
2400 Ardmore Blvd., Suite 401
Pittsburgh, PA 15221
(412) 271-3002
Follow HearWell Center | Facebook | Twitter
www.hearwellcenter.com

Auditory training is a term you will probably only hear in an audiology office or perhaps a school. But it is important for people with hearing loss to know that they can train their brain to hear and listen. Our brain is always searching for sounds whether or not we focus on the sounds and this is called “hearing”. Attending to and focusing on a sound, causing more parts of the brain to react is called “listening.” People who have hearing loss often stop working at listening because it is too difficult and causes fatigue or frustration. Unfortunately this leads to more communication problems due to the combined effect of hearing loss and diminished listening skills. Though anyone can benefit from the practice of using and strengthening listening skills it is more important for those who are hard of hearing.

When it comes to hearing loss and hearing aids, most hearing aid users look to the device to make communication better and though hearing aids can improve hearing, they cannot improve listening. Instead, hearing aid users should strive to be “patients of hearing health care” and look for solutions to improve hearing and listening. This can be accomplished by using any and all devices needed to support hearing as well as therapy and exercises for listening. The highest level of satisfaction with hearing aids comes from following the audiological recommendations in full and accepting that learning to hear and listen again is a process that requires motivation and time. Research in audiology reveals over and over again that hearing care is not a simple thing. The audiology degree is a testament to this fact. For example, an audiology student will spend 8 years in college, earn two or more higher education degrees and perform thousands of clinical hours with patients. Still many people price check for hearing aids believing they are making a technology purchase instead of looking at the professional behind the technology and the service that comes with learning to hear and listen.

Dr. Suzanne Yoder, Au.D. | Doctor of Audiology | Pittsburgh, PAAUTHOR’S NOTE
I’ve been on both “sides of the fence” so to speak. I am a hard of hearing consumer and user of hearing aids. I grew up with hearing loss in both ears and have used hearing aids in both ears as long as I can remember. I am also a doctor of audiology and the owner of HearWell Center in Forest Hills (independently owned private practice). Educating patients is very important to me and I invite you to visit our website for more information.

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Posted in Uncategorized

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Hearing with Only One Ear (Unilateral Hearing Loss)

July 27th, 2011

By: Joan D’Alessandro, Au.D.
Doctor of Audiology
Advanced Hearing & Balance Care
30 South Valley Rd., Ste. 208
Paoli, PA 19301
(610) 296-5857
www.hearingcare4u.com

Hearing loss in one ear can result from several disorders or injuries:

  • Bacterial  infections
  • Head injury
  • Vascular (blood supply) problem
  • Meniere’s disease
  • Viral infection (herpes)
  • Acoustic or 8th nerve tumor
  • Acoustic trauma (sudden loud noise to one ear)

Patients who suffer a severe to profound hearing loss in one ear report no comprehension difficulty in quiet, one-one-one conversations.  However, understanding conversation in less than ideal listening situations is severely compromised.  These include noisy areas such as restaurants,  group conversations and reverberant areas such as churches, gyms, and indoor swimming pools.

Why are these areas so challenging for those with unilateral deafness?  Your ears individually and collectively gather acoustic information and relay those signals to the auditory reception centers in your brain.  With only one ear collecting information, the auditory centers are starved for the complete acoustic picture normally provided by two ears.  When this information is lacking, a number of things  happen that impair your ability to organize and make sense of speech.

Joan D'Alessandro, Au.D. - Doctor of Audiology, Paoli, PennsylvaniaHead Shadow Effect

When a sound occurs toward the deaf ear, the arrival of that sound at the hearing ear is partially blocked by your head, commonly known as the head shadow effect.  The sounds most easily blocked are the higher pitches which are absolutely  necessary for accurate perception of the voiceless consonant sounds of speech, the s,c,f,t,p,ch and  sh sounds.  These consonants allow us to tell the difference between words like teach versus feast and distillery versus facility. This word discrimination ability is compromised by hearing with only one ear because of the head shadow effect.

Localization Ability

Your brain needs well-balanced sound information from both ears for you to be able to easily pick out the direction from which a sound originates.  Both a sound’s time of arrival (it arrives a few milliseconds faster at the ear closest to the sound) and its intensity or loudness (louder for the ear closest to the sound) are cues that your brain uses to locate the source of a sound.  When you have only one ear, all sounds seem to be coming from the side of the  good ear, even when originating from the bad ear side.  So someone with hearing in only one ear lacks the instantaneous locating cues of time and intensity.  If someone calls your name outdoors, you have to turn your head around to locate the source and it may take several repetitions to accurately pinpoint the source.

Sound Summation and Noise Squelch

To your brain, one ear + one ear = three!  A sound which is barely audible at 20 feet away with only one ear, is easily audible at 30 feet when two ears are listening.  This is called the binaural summation effect and is the result of the two hearing nerves crossing many hundreds of times before the information reaches the cortex.  This crossing or decussation results in the enhancement of sound, so softer sounds become audible.

In addition, this neural sharing contributes to an advantage, known as binaural squelch, when listening in background noise.  This ‘squelch’ provides 3 decibels more signal than noise, also known as the signal –to- noise ratio or SNR.  Even though three  decibels may not seem like much, the decibel is a logarithmic function much like the Richter scale for earthquake measurement.   For every 3 decibels, sound power actually doubles. So three decibels extra is a significant amount and allows for easier understanding in noisy situations.

Solutions for Those with Only One Hearing Ear

The traditional hearing aid solution for unilateral hearing loss has been the use of a CROS hearing aid. The acronym stands for Contralateral Routing of Sound and employs a unit on the dead ear which contains a microphone to pick up sounds arriving on that dead side.  Those sounds are then transmitted wirelessly to a receiver unit on the good side. The sounds from the dead side are then routed into the good ear.

This CROS type aid prevents the head shadow effect but does nothing for localization ability and does not provide binaural summation or squelch.

If the hearing loss is in the  severe category, a traditional hearing aid either in a behind-the-ear(BTE) or in-the-ear style  can be fit.  As with all hearing aids fittings there is an accommodation period during which the patient learns to use the acoustic information from the damaged ear.  The sooner the fitting is done, the more likely the patient will be a successful hearing aid user.

A fairly recent surgical solution for single-sided deafness (SSD) is the implantation of a BAHA or Bone-Anchored Hearing Aid.  This surgical implant uses bone conduction to send sounds from the bad ear side to the good ear via an implant with a microprocessor that adheres to a magnet under your scalp.  The processor is detachable for showering, etc., and is easily hidden underneath your hair.  Again, the BAHA does not accomplish true binaural hearing but does lessen the head shadow effect and some recipients do notice improved localization ability after use of the BAHA for some time.

Our brains are wired to receive information from both ears. Loss of hearing in one ear is a significant handicap with which many people cope through the use of CROS type hearing aids, BAHA implant and positioning themselves  to maximize the best sound reception to the hearing ear.

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Posted in Advanced Hearing & Balance Care, Audible, Binaural, Binaural Hearing, Deaf Ears, Decibles, Ears, Hearing Aid Compatible, Hearing Aid Styles, Hearing Aid Technology, Hearing Aids, Hearing Ear, Hearing Loss, Joan D'Alessandro, Listening Situations, Listening Tips, Paoli, Pennsylvania, Uncategorized, Unilateral Deafness

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Musically Trained Ears & Learning to Hear with Hearing Loss

July 21st, 2011

By: Suzanne Yoder, Au.D.
Doctor of Audiology
HearWell Center
2400 Ardmore Blvd., Suite 401
Pittsburgh, PA 15221
(412) 271-3002
Follow HearWell Center | Facebook | Twitter
www.hearwellcenter.com

Professional and highly skilled musicians have taught researchers in audiology and hearing science that the ear can be trained with practice. The studies have uncovered that musical training creates more activity in the brain of the listener to help sort wanted sounds from unwanted sounds. Research further demonstrated that musicians have a listening skill that is helpful not only in musical applications but in other real world listening situations such as hearing in noise. Noisy environments are challenging for every listener. Normal hearing individuals will understand between 60-70 % of speech in the presence high noise levels. Good listeners will employ a number of skills in order to understand speech in noise including filling in the blank when a word is not heard, watching for visual input (lipreading and gestures), standing closer and leaning in towards the speaker. With these skills a good listener, even in noise, will be able to follow conversations fairly well.

Noise is naturally disruptive to understanding speech and more so in individuals with hearing loss. Most hearing disorders are a result of permanent damage to the delicate structures of the inner ear including the cochlear hair cells. The more severe the loss, the more damage there is to these hair cells leading to increasingly distorted and muted sound signals to brain and a loss of specificity for speech. Therefore, individuals with hearing loss who wish to communicate verbally must learn additional coping and listening skills to offset this specificity loss.

Hearing aids and assistive listening devices are very important for treating hearing loss but they are not the only treatment necessary for learning to hear again. Since most people delay getting hearing aids for years the consequence is an under-stimulated auditory system. People with long standing, untreated hearing loss become accustomed to not hearing and consequently, not listening. This is not a surprise since it is hard work to listen when you can’t hear and people with untreated hearing loss often withdraw from communication limiting their opportunities for practice. Wearing hearing aids does not mean the brain will instantly remember how to hear and listen. Hearing aids will return audibility for sound but it takes time to adapt to new sounds and it takes time to learn to listen again. Audiologists are trained to help people in both areas with counseling and follow up being the most important aspects of the hearing aid selection and fitting process. New hearing aid users need to be closely monitored on their progress with hearing devices as well as counseled on auditory training programs when needed.

Hearing aid success varies widely and not all listeners are created equal. The most successful hearing aid wearers are those that educate themselves about the adaptive process behind using hearing devices and take on the task of improving their listening skills by doing auditory training exercises. With all that we’ve learned in research with musicians, it is apparent that the ear can and should be trained to help compensate for loss of hearing sensitivity. Thanks to musicians and the researchers in the field we have the tools and resources to make this possible.

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Posted in Audiologist, Audiology, Auditory, Ears, Hearing Aids, Hearing Device, Hearing Science, Hearing Sensitivity, Listening Situations, Musicians, Normal Hearing, Uncategorized, Untreated Hearing Loss

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You Don’t Have to be Tech Savvy, Just Social.

July 15th, 2011


techsavvy

By: Tom Vandel
Senior Communications Specialist

Once you get the hang of it, social networking is really quite simple. All you need is a computer or mobile device (like a smartphone or a tablet) and a functioning online signal. You may want a decent photo of yourself for your profile, but it’s up to you. Here are the major social media sites that are most popular with older adults.

eonseons.com   Eons is a social networking site designed for “boomers” aged 50 and older. Similar to Facebook, it allows you to post messages and photos, join interest groups, discuss boomer-centric issues, play games, and keep in touch with family and friends.

 

Facebook logofacebook.com   By far the most popular social networking website, Facebook is used by 41% of the population in the U.S. You can create a personal profile for yourself and ask others to become “friends” and link with you. Many people will ask you to be their friend as well. It’s up to you how many people you want to connect with. You and your contacts can share messages, photos, videos and links. Additionally, many businesses have profiles where you can find out about up-to-the-minute news and Facebook-only discounts when you “Like” them.

 

Twittertwitter.com   Twitter is a free social networking site designed for quick, short messages that are shared among your network of contacts. The messages, known as “tweets”, must be no longer than 140 characters and can include links to other messages or online sites. Once you set up a profile, you can “follow” the tweets of others. They can follow your tweets as well if you allow them. Twitter is a great way to stay in touch with family, friends, businesses, and interest groups.

 

YouTubeyoutube.com   As the name implies, YouTube is a website where you can watch videos, TV, movie clips, and home movies—all available for free. You don’t have to be a member. Just go to the website and search for a subject of interest. If you become a registered user, you can post your own videos on the site for anyone to see and comment on. Search for this great YouTube video called “Flintstones Hearing Loss”, which uses The Flintstones to illustrate the different levels of hearing loss.

 

flickrflickr.com   Flickr is an image and video hosting website and online community. It’s a place where you can store, sort, search and display photos for people to see. Once you put the images on the site anyone can view them. If you want to share private photos with family or friends, you send them a message with a Guest Pass link to your page of images. You can upload up to 300 MB of images per month for free.

Groupongroupon.com  Think of Groupon as a “group coupon.” It is a website that offers a deal of the day in various geographic markets in the U.S. and abroad. One deal, such as a discounted restaurant meal, is offered per day. If enough people sign up for it, then the deal goes live and is available to all.

 

foursquarefoursquare.com  Foursquare is a location-based social networking website. This free service is available to people with GPS-enabled mobile devices, such as smartphones. When you “check in” at venues such as restaurants or stores, you earn points that can be redeemed for special discounts and prizes.

Yelpyelp.com  Yelp provides reviews and information on local businesses. Just enter what you are searching for—such as, “hearing care”—and your general location and you get a listing of area businesses with contact information, a map, rankings and reviews (by real people). It’s a great way to share the gift of better hearing!

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Posted in Baby Boomers, Social Media, Uncategorized

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