Hearing Aid

Aka: Hearing Aid

1. See Also
   1. Hearing Loss
   2. Sensorineural Heaing Loss
   3. Presbycusis
   4. Home Adaptations for the Elderly
2. Background
   1. OTC Hearing Aids will be available in U.S. in 2023
3. Types: Location
   1. Hearing Aid behind the ear
      1. Classic Hearing Aid with the electronics in a small case behind the ear
      2. Sound tube exits the Hearing Aid and is placed inside the ear
   2. Hearing Aid receiver in canal
      1. Receiver moved from within case, to within the ear
      2. Receiver connects to Hearing Aid via thin wire
   3. Hearing Aid completely In the ear
      1. Custom made Hearing Aid that completely sits within the ear canal
4. Types: Conventional analog Hearing Aids
   1. Cost: ~$900 per ear
   2. Components
      1. Battery
      2. Microphone transduces sound into electrical energy
      3. Receiver changes electrical energy into sound
      4. Most Hearing Aids can adjust volume
         1. May be a problem with background noise
   3. Sub-Types
      1. Linear (Simple Hearing Aid)
         1. Amplifies loud and soft sounds equally
      2. Non-Linear
         1. Varied amplification for loud and soft sounds
         2. Decreased recruitment (increased loudness)
5. Types: Programmable Hearing Aids
   1. Programmable by audiologist
      1. Sound levels adjustable for audibility and comfort
      2. Volume per frequency
      3. Intensity
      4. Microphone power output
      5. Compression Ratios
   2. Some available with multiple programs
      1. (e.g. telephone, music)
6. Types: Digital Hearing Aids
   1. Cost: ~$2900 per ear
   2. Digital signal processor samples incoming signals
   3. Adjusts in different sound environs
      1. Can reduce background noise from non-speech source
      2. Enhances speech understanding
   4. Programmable by audiologist
      1. See Above
7. Management
   1. Hearing Aids amplify many sounds including background noise
      1. Expect a time to adjust to Hearing Aids, and tuning out background noise (e.g. footsteps)
      2. Proficiency with Hearing Aids requires a training period with frequent, continuous Hearing Aid use
      3. Start with less noisy
   2. General measures
      1. Ears should be dry before inserting Hearing Aids
      2. Turn off Hearing Aids when not in use
      3. Removing ear wax with cotton swabs is not needed and may cause ear Trauma
      4. Remove Hearing Aids when sleeping, bathing, swimming, applying hair care products or instilling ear medications
         1. Light rain and mild sweating is not typically a problem
      5. Clean Hearing Aids daily with a soft cloth
      6. Button Batteries
         1. May need changing as every week or more
         2. Button batteries are dangerous if swallowed (keep away from pets and young children)
   3. Ear Pruritus or Irritation
      1. Causes
         1. Over-cleaning (e.g. wax removal decreases ear canal protection)
         2. Dry Skin
         3. Mal-fitting Hearing Aid
         4. Reaction to Hearing Aid material (uncommon)
      2. Approach
         1. Expect irritation and itching to improve over time
         2. Consider Skin Lubricant (skin Moisturizer) application overnight while Hearing Aids are out of the ear
         3. Recheck with Hearing Aid specialist if persists
8. References
   1. Michels (2019) Am Fam Physician 100(2): 98-108 [PubMed]
   2. (2022) Presc Lett 29(9): 52