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 who were deaf now can detect sounds and understand speech once again. Others whose hearing has deteriorated sufficiently to prevent them from easily communicating with others, in particular, family members, now rejoin the world of easy and natural communication often restoring communication ability to its previous functional state.
Virtually everyone with a permanent hearing deficit may benefit from the use of an advanced hearing device. If it has been determined that 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, an comprehensive evaluation of your hearing status is warranted.
What do I need to do next?
It should be determined if your hearing problem is the result of an active disease process or a medical problem that requires surgical or medical intervention. 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. Conventional hearing aids are less expensive but they are limited in the features. The digital hearing aids are more expensive but they offer features that would benefit you the most.
Discuss the financial aspects of your hearing aids with your dispensing 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 now purchase hearing aids (PDF) through the Hearing Device Center. Please call (650) 736-4351 to make an appointment for digital hearing aids and assistive listening devices.
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. 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) which used to be quite visible are now much harder to detect 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 are based analog processing that have no or limited programmability. There are also “digital” circuits that are programmable and 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.
FDA Regulations
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.
Twelve 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. Old fashioned analog models are usually less expensive - $800 to $1,600 is normal - but the difference in sound quality is like the difference between a microphone and a bullhorn.
Analog models simply make sounds louder. Digital models make them clearer, sharpening speech and other noise that can get muddled in an older ear. Digital models also offer more flexibility, faster processing, and better hearing in noisy places-key reasons that they make up 90 percent of hearing aid sales. Best of all, prices for digital hearing aids are dropping.
The Perfect Fit
Hearing aids that fit in your ear canal are popular because they're hard to see. 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 new class of hearing aids introduced in 2005 called open-ear fittings, which 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, and they're particularly good for severe hearing loss because they provide the strongest amplification. But these new 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). Open-fitting models tend to cost $1,800 to $3,000.
Open fittings are a new consideration. 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 most exciting new advances is fully adaptive directional microphones, available in both behind-the-ear and in-the-ear models. These microphones pickup speech no matter where it comes from. In the past, directional microphones only amplified sounds in front of you.
Though some models are operated manually; others are automatic: if someone is speaking on your left the hearing aid "knows" and adapts so you can hear more dearly. 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. The price for hearing aids with this technology is typically $2,000 to $2,500.
Many new hearing aids provide different settings for different environments. You can choose one setting for a quiet room, another for listening to music, and yet another 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 manipulates the microphones so the wearer always has the best understanding of speech. Such programmable models range from $2,000 to $3,500.
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 a hearing aid helps.
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. Implants cost between $3,500 and $30,000 for the device alone; many patients, however, say they're worth every penny.
Bone Anchored Hearing Aids (BAHAs) work for those with one-sided deafness. Sound is picked up by a transmitter attached to a titanium screw Implanted on the deaf side and then conducted via the skull bone to the "good" side,
Middle ear implants, used for people with mild to moderate hearing loss, attach directly to the middle ear bones and amplify sound signals to the brain. A behind-the-ear component houses the microphone, sound processor, and battery.
Cochlear implants help with severe 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.