II. Precautions

  1. Strongly consider consulting Audiology before any Hearing Aid purchase
    1. Formal Hearing Tests are often covered by insurance
    2. Many Hearing Aid resellers (including prescribed Hearing Aids, e.g. costco) offer free Hearing evaluation
      1. Performed prior to purchase of Hearing Aid
    3. Most Hearing Aid companies offer a trial period during which product returns are allowed
      1. Shop for devices that offer at least 30 day trial period and clearly stated return policy
      2. Also look for products with an adequate warranty and good customer support policy
    4. Online and mobile phone Hearing Tests are also available
      1. HearWho
        1. https://www.who.int/teams/noncommunicable-diseases/sensory-functions-disability-and-rehabilitation/hearwho
      2. Mimi Hearing Test
        1. https://mimi.health/hearing-test
  2. Evaluate Hearing Loss in clinic
    1. Consider Hearing Loss red flags (e.g. associated Vertigo, chronic Ear Drainage, Sudden Sensorineural Hearing Loss)
    2. Consider reversible Hearing Loss causes (e.g. impacted cerumen, Medication Causes of Hearing Loss)

III. Indications

  1. Mild to Moderate Hearing Loss
    1. Patients who turn up the television volume higher than others, or frequently ask others to repeat themselves

IV. Contraindications

  1. Complex Hearing needs
  2. Limited technological knowledge
  3. Severe Hearing Loss
    1. Patients unable to hear loud sounds (power tools) or to hear conversations in a quiet room

V. Background

  1. Various Hearing Aid products have been available OTC
  2. FDA Reauthorization Act (2017) allows for direct-to-consumer sales of Hearing Aids
    1. Indicated for mild Hearing Loss
    2. Best outcomes with a complete audiology evaluation and rehabilitation
  3. Contrast with Hearing amplifiers used by hunters and bird watchers (e.g. iHEAR TReO)
  4. As of 2022, many new OTC Hearing Aids (e.g. Lexie, Jabra Enhance)
  5. Crystal Ear was available as a mail order product from TechnoBrands (Comtrad) in the 1990s
    1. Linear conventional analog Hearing Aid (most simple Hearing Aid type_
    2. Weak amplification in speech range (200-6000 Hz)
    3. One-size-fits-all device (came with 2 sleeves to help fit to ear canal)
    4. Court settlement regarding false advertising
    5. Was not recommended by Medical Letter
    6. (1998) Med Lett Drugs Ther 40(1028): 62 [PubMed]

VI. Types

  1. Personal sound amplification device (e.g. Pocket Talker)
    1. Low cost, handheld device with headset (e.g. $20) available at retail stores
    2. Provides only amplification without noise cancelling or other features
  2. Preset Over-the-Counter Hearing Aids
    1. Easy set-up, easy use devices with limited features
    2. Available in retail stores at moderate cost (e.g. $200)
  3. Self-Fitting Over-the-Counter Hearing Aids
    1. Customizable OTC Hearing Aids (via smartphone app), and more difficult to setup
    2. Available in retail stores and relatively expensive for OTC devices (e.g. $700)
      1. However, prescription, standard Hearing Aids may cost up to $6000

VII. Advantages

  1. Inexpensive ($200-$1000 in contrast to $1000-$6000)

VIII. Disadvantages: Direct-To_Consumer Hearing Aids

  1. May be difficult to handle and place in ear canal
    1. May not prevent acoustic feedback (occurs when air escapes ear canal)
  2. Inadequate in noisy environments
  3. Helps only a minority of persons with Hearing Loss
    1. Those with mild, flat Hearing Loss
  4. Requires proper selection and setting
    1. Contrast with prescribed Hearing Aids which are typically managed by an audiologist
    2. Multiple size ear tips
    3. Volume settings
    4. Noise reduction settings
  5. Hearing Aid batteries may not be rechargeable
    1. Disposable, replaceable batteries last 3 to 20 days (depending on usage, battery size, noise cancellation)
    2. Hearing Aid batteries are hazardous waste and requires special disposal

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