Hearing Aids
Why should you see a physician for your hearing aid? The knowledge and expertise of a physician will assure that your problem is truly one that is hearing related and not of another origin or disease process. It is crucial to insure the health and welfare of all patients seeking proper diagnosis and treatment of their problem. Proper fitting is essential to the excellent treatment of the problem and can be aptly done so in a physician's office. Additionally, physicians are able to diagnose and treat all within one visit and under one roof making it a simple and convenient experience. For an in depth discussion about the specifics on hearing aid technology, please continue to read further.
Which Hearing Aids Are Best for You
Over the past few decades, technology has evolved at a rapid pace. In this great explosion of technological advances, hearing aids have also undergone several transformations. With the latest advancements in technology and surgical technique, you as the consumer now have a unique opportunity to benefit from either the BAHA, a bone anchored hearing aid, or from many of the traditional hearing aid options.
To decide which hearing aid technology is best for you, an audiologist, in conjunction with a physician, has the education and clinical training to serve as a guide to help determine what will best meet your needs. Our audiologists hold Doctor of Audiology (Au.D.) degrees and are certified as clinically competent by the American Speech, Language, and Hearing Association (ASHA). The clinical team at Arizona Hearing and Balance Center is best qualified to serve your needs and help you make a decision that best suits your lifestyle.
BAHA (Bone Anchored Hearing Aid) - Implantable Hearing Aids
Bone Conduction vs. Air Conduction: We receive sound in two ways: by air conduction, via the ear canal, eardrum, and middle ear bones; and by bone conduction where sound is transmitted directly through the skull, bypassing the outer and middle ear. Conventional hearing aids operate on the principal of air conduction and are appropriate for a large majority of hearing impaired people. Some individuals, however, are unable to benefit from air conduction hearing aids and may benefit significantly from a BAHA.
What is a BAHA?: A BAHA, or Bone Anchored Hearing Aid, is a surgically implantable hearing device. It consists of 2 parts: the surgically implanted abutment in the skull and the external speech processor which snaps onto the abutment and allows the patient to hear. The microphone on the external processor picks up acoustic sound and converts it to vibrations which are then conducted, via the abutment, to the inner ear which enables the patient to hear. The sound is routed either to the inner ear on the same side as the BAHA (in individuals with chronic middle ear dysfunction or outer ear deformities) or to the inner ear on the opposite side of the BAHA (in individuals with single-sided deafness the BAHA is placed on the deaf side and routs sound from that side of the head over to the still-hearing ear).
Who Can Benefit: The BAHA is currently FDA approved for 3 distinct populations: those with chronic middle ear dysfunction (i.e. chronic drainage from the ears from ear infections), those with deformities of the outer ear (i.e. no functioning ear canal in which to wear a conventional hearing aid), and those with single-sided deafness. Certain audiologic criteria must be met in order to be a candidate; your audiologist will be able to determine if you meet audiologic criteria with a simple hearing test. BAHAs are FDA approved for surgical implantation in children as young as 5 years; however, infants and toddlers can still benefit from the BAHA worn on a soft headband until they reach the age when surgery can be performed.
BAHA Surgery: Surgery is completed under IV sedation for adults and general anesthesia for children. A 1 to 2 inch incision is made above or behind the ear through the soft tissue. A small hole is then drilled into the skull. This hole is widened and a titanium flange fixture is inserted and twisted into place. Between the flange fixture and the external sound processor is the abutment. The abutment is a cup-shaped structure that protrudes through the skin. The BAHA operation is either completed in one stage or two stages, depending on a variety of factors your surgeon will discuss with you. Risks following BAHA surgery may include infection, bleeding at the surgery site, soft tissue issues, cerebrospinal fluid leak, and post rejection. All of these potential risks will be discussed in detail prior to your procedure.
Recovery: Typically, adult patients are allowed 3 months to heal before attaching the external speech processor. In children, healing time is closer to 6 months. Once the healing process is deemed successful by the surgeon, the audiologist will instruct you on attaching and removing the speech processor, as well as proper use and maintenance.
Insurance Coverage: Arizona Hearing and Balance Center contacts insurance providers to determine benefits and obtain authorization prior to all surgical procedures.
More Information: More information on BAHA may be found on the manufacturer’s website at http://www.cochlearamericas.com/Products/2013.asp
Traditional Hearing Aids
There are two major decisions in selecting the hearing aid that will best meet your communication needs: 1) the size of the hearing aids and 2) the special features in the hearing aids. Both of these will affect the cost and capabilities of the hearing aids.
Hearing Aid Style and Size: Hearing aids come in five basic styles. The size and style of the hearing aid depends on factors such as degree of hearing loss and types of special features.
- Behind-the-Ear (BTE): This hearing aid fits above your ear and has a custom-made ear piece (an “earmold”) that directs the amplified sound into your ear. This style of hearing aid is appropriate for any degree of hearing loss.
- In-the-Ear (ITE): This is the most common sized hearing aid and fills up most of the external portion of your outer ear. This size of hearing aid is also appropriate for most hearing losses.
- In-the-Canal (ITC): This size hearing aid is smaller than the ITE and extends slightly from your ear canal. This style is commonly used for milder degrees of hearing losses.
- Completely-in-the-Canal (CIC): This is the smallest style of hearing aid and fits entirely in the ear canal. It is used for very mild hearing losses.
- Open Ear or Receiver-in-the-Ear (RITE): This hearing aid is designed for people with fairly good hearing in the low- to mid-pitches who have a mild-to-severe hearing loss in the high pitches. The electronics of the hearing aid are worn behind the ear and sound is directed into the ear via a very thin tube or wire, allowing the ear canal to remain more open than a conventional ITE, ITC, or CIC hearing aid.
Your hearing test results (the “audiogram”) will largely determine the appropriate size and style. With greater degrees of hearing loss, smaller sized hearing aids usually do not provide the appropriate gain or benefit. Additionally, many special features are not available in the smaller sizes. Your audiologist will discuss in detail which size and style would be best for you based on your hearing test results and types of special features you may want.
Hearing Aid Circuitry: Today’s digital hearing aids contain a small computer chip that analyzes, processes, and amplifies sounds. Because these aids can be computer programmed, digital hearing aids offer more options and special features than previous generations of hearing aids. Whereas older hearing aids amplified all sounds by the same amount regardless of a patient’s hearing loss, digital hearing aids analyze and amplify sounds based on each individual patient’s needs.
Special Features on Hearing Aids: Hearing aids of any size and circuitry type may have a number of special features that are designed to improve hearing in specific situations. For example, some hearing aids are designed to control volume automatically rather than manually by the patient. Some hearing aids can be adjusted to have one setting for quiet situations, like watching television alone, and another setting for noisy situations, such as a noisy restaurant or cafeteria with friends. Some hearing aids will actually control this feature automatically by sensing the environment you are in. There are a variety of other features, such as a special telephone setting, circuitry that limits feedback (the loud squealing sound that can come from a hearing aid), and circuitry that attempts to reduce steady noise signals to make speech more audible.
Cost of Hearing Aids: When you purchase hearing aids, not only are you purchasing a healthcare device, but also the professional services that assist you in the selection, fitting, and maintenance of the hearing aids. The cost of a hearing aid varies depending upon the style, size, circuitry, and features that will best fit your needs. Digital hearing aids range in price from $900-$3000 (roughly twice this amount for two). The range in prices reflects the different sizes and features that are available. Our hearing aids come with a two year repair warranty, a two year loss and damage warranty, and a two year professional service warranty. There is also a 30 day trial period on all hearing aids.
Hearing Aid Manufacturers: There are over 80 companies that make hearing aids. Arizona Hearing and Balance Center has chosen to dispense hearing aids from several of the top-tier companies to provide our patients with the most options and to better meet individual needs. The companies that we use regularly are the following: Oticon, Phonak, Widex, Siemens, and Resound. As new products enter the market, we may add manufacturers if they offer unique and special services.
Summary: Choosing the correct hearing aid to best meet your needs involves an in-depth discussion and consultation with your audiologist. To determine the appropriate hearing aid for you, you and your audiologist will discuss your hearing test, your size and style preferences, communication situations, and listening needs. After careful evaluation and consideration, you and your audiologist should be able to determine which hearing aid is most appropriate for you and will meet your expectations. The ultimate goal of the hearing aid program at Arizona Hearing and Balance is to improve your communication by improving the gift hearing.
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