Stanford Ear Institute
Guide to Hearing Devices
Hearing ability is very important for understanding speech and for a wide variety of other functions such as detecting warning alarms and listening to music. When the abnormal or damaged auditory system is not directly reparable through surgical or medical means, a wide variety of advanced hearing devices is available that can improve these functions, very often quite dramatically.
With the proper selected, fitted and adjusted hearing device, patients with any degree of hearing loss from very mild to total deafness can achieve hearing functions that were not attainable previously. Because these devices generally do not restore the underlying abnormal auditory structures, the sense of hearing is not restored to its natural normal state. However, these devices can optimize or even replace the remaining hearing function and improve hearing ability such that significant life style changes often occur.
Patients whose hearing has deteriorated sufficiently to prevent them from easily communicating with others, in particular, family members, can rejoin the world of easy and natural communication often restoring communication ability to its previous functional state. Patients who were deaf now can detect sounds and understand speech once again.
Virtually everyone with a permanent hearing deficit may benefit from the use of advanced hearing devices. If you are not able to hear sounds within the normal range needed to fully hear and understand speech in normal conversational situations, you should consider being evaluated for the benefits of new, high technology advanced hearing devices.
What do I do first?
The first step is to determine the status of your present hearing ability. Many patients experience additional deterioration in hearing within a year time frame so an annual hearing test is very important. Based on your hearing test results and your own assessment of difficulty in communicating, comprehensive evaluation of your hearing status is warranted.
What do I need to do next?
If your hearing problem is the result of an active disease process or a medical problem that requires surgical or medical intervention, this should be evaluated first. If your physician has determined that your hearing problem is not the result of these processes, he or she can sign a medical clearance for the use of hearing aids. Our physicians can also provide this evaluation.
It is very important to be evaluated for and obtain any advanced hearing device from a comprehensive clinic that has qualified and experienced audiologists to work with you in selecting, fitting and purchasing your hearing aids. It also is very important that this clinic also be able to provide the most comprehensive lines of advanced hearing devices.
How much do hearing aids cost?
Hearing aid prices vary depending upon the style and the circuitry that would best accommodate your hearing loss. Basic hearing aids are less expensive but they are limited in the features. More advanced hearing aids are more expensive but they offer features that benefit you the most.
Discuss the financial aspects of your hearing aids with your audiologist. Remember, you are purchasing your hearing aids to enhance your hearing and your enjoyment of day-to-day communication with your family and friends.
Can I purchase my hearing aids at Stanford?
Yes, you can purchase hearing aids through Stanford Audiology. Please call (650) 736-4351 to make an appointment for a hearing aid evaluation.
What are the different kinds of hearing aids?
Hearing aids come in several different styles, most of which are either completely visible, or barely visible and invisible. These styles vary from devices that are completely-in-the-canal (CIC) and therefore completely invisible to those that are positioned at the entrance to the ear cal and are therefore barely visible.
Current devices that are located behind-the-ear (BTE) that used to be quite visible are now much less visible because of their very small size and the fact that the components that direct the sound to the ear canal themselves are not very visible. Each style has its advantages and disadvantages.
Hearing aids also have several different types of circuitry or electronics that process the sound for your ear. There are "conventional" circuits that have limited programmability. There are also "digital advanced" circuits that offer many features that are custom fitted for your hearing loss.
You should discuss the different styles and types of circuitry that would best benefit your hearing loss and suit your life style. This is why it is important to be seen by experienced and fully trained audiologist in a clinic that has a full and comprehensive line of devices available.
The Food and Drug Administration (FDA) enforces regulations that deal specifically with the manufacture and sale of hearing aids.
According to the FDA, the following conditions must be met before a hearing aid is dispensed: First a written statement signed by a licensed physician that the patient is cleared for fitting with a hearing aid is necessary. The statement must be dated within the previous six months and state that the patient's ears have been medically evaluated.
At Stanford, you may bring this statement with you from your own physician, or if you wish, such an evaluation can be provided by our own physicians. A patient age 18 years or older can sign a waiver for this medical examination.
FDA regulations also require that an instruction brochure be provided with the hearing aid that illustrates and describes its operation, use, and care. The brochure must list sources for repair and maintenance, and include a statement that the use of a hearing aid may be only part of a rehabilitative program.
Over thirty-three million Americans 55 and up have age-related hearing loss, yet people wait seven years, on average, to seek treatment. The reason? Often, it's vanity. There's an everyone-will-stare-at-me stigma that makes us more worried about how we look than how we listen. But current, advanced, high technology hearing aids are less noticeable than ever and more effective than ever. Patients often actually feel younger, smarter, and happier after obtaining a current, properly fitted and adjusted hearing aid.
The price of a hearing aid depends on the type. Medicare and most insurance companies do not cover the costs. The newest high-tech digital models typically cost from $2,000 to $3,500 per ear.
The Perfect Fit
Hearing aids that fit in your ear canal are popular because they're less visible. But wearers often report feeling "stuffed up" because the ear canal is blocked. The blockage also means wearers may not be able to benefit from their residual hearing. The solution: a class of hearing aids introduced in 2005 called open-ear fittings, that are very small and sit behind your ear like a traditional hearing aid.
Behind-the-ear models have always been more comfortable and easier to switch on and off than in-the-ear aids. These open-ear versions are much smaller and have a barely visible thin tube that extends into the ear canal (which is how the sound is transmitted). These devices are physically and acoustically open and comfortable. They are a boon to people with mild to moderate sensorineural hearing loss. One of the newer advances is fully adaptive directional microphones. These and other automated features that do not require pressing buttons. Feedback - the annoying whistle you hear when amplified sounds are picked up again by the hearing aid - has been lessened in most models, as well.
Often, people with hearing loss in both ears would have to adjust their hearing aids by hand, one at a time. But with new wireless technology, hearing aids communicate with each other and operate as one system, even if the user has more hearing in one ear than the other. The technology automatically adjusts the settings in both ears as the listening environment changes.
Many new hearing aids provide different settings for different environments such as a quiet room, for listening to music, or for a noisy restaurant. The options are preprogrammed, so all you do is adjust the aid to the proper setting typically with a remote control. One remote control is also a watch. Some models build in the adjustment capability. The hearing aid 'listens" to the environment and can choose the settings automatically.
Keep in mind that everyone's needs are unique. You should not go to your audiologist and say, "I want this type of device because my friend has one and loves it." Not all features are necessary for all people. This is why working with a licensed and experienced audiologist is so important.
Also, calibrate your expectations. It's unlikely your hearing will return to 100 percent, no matter which device you choose. But you may be surprised how much hearing aids help.
Because most hearing losses come on gradually, the new sound provided by a hearing aid mya take some time to get used to. Stanford provides an unusually long trial periods -- 45 days -- during which you can return the aids for a complete refund. So do not delay if you need adjustments or feel the aids are not helping. But if you just feel awkward, try to relax, give yourself at least six months to get used to having something in your ear.
The Bionic Ear
When it comes to replacement body parts, science hasn't quite caught up to science fiction. But for those with severe hearing loss, surgical implants are steadily improving.
Bone Anchored Hearing Aids (BAHAs) and a dental device work for those with one-sided deafness. Sound is picked up on the deaf side and then conducted via the skull bone to the "good" side. These are considered prosthetic devices and several are available.
Cochlear implants help with severe to profound hearing loss by converting sound Into nerve impulses that are sent to the brain. A transmitter is placed under the skin behind the ear, and electrodes are implanted inside the cochlea (a cone-shaped tube in the inner ear).
Recently smaller more precisely placed version of a standard cochlear implant has been developed and is now undergoing FDA trials. Though cochlear Implants were previously available only to people under 65, the age cutoff has been lifted, and Medicare does provide coverage.