How Hearing Aids Work
Hearing aids play a big role in hearing health. While there are different levels of sophistication, design, and customization, they all use the same basic hearing aid parts to accomplish the same ultimate goal: amplify sounds going into the ear.
All hearing aids have at least one microphone that picks up sound, a computer chip to amplify and process the sound picked up by the microphone, and a speaker that sends the processed and amplified signal to your ear. Hearing aids are powered by a traditional or rechargeable hearing aid battery.
Continue reading to see how different models of hearing aids use this same basic process to be effective for people with a variety of types and levels of hearing loss.
Hearing Aid Styles
As you can imagine, hearing aids come in many different sizes with numerous features and therefore price levels vary. Hearing aids vary in style, size, technology, and purpose; there are hearing aids for babies, hearing aids for kids, and hearing aids for adults.
Depending on the type of hearing aid, these devices are placed in the ear in different ways.
As far as style goes, the main hearing aid styles include:
Completely-In-The-Canal (CIC).
In-The-Canal (ITC)
In-The-Ear (ITE)
Behind-The-Ear (BTE)
Receiver-In-The-Canal (RIC), Receive-In-The-Ear (RITE)
Open Fit
CROS and BiCROS
Bone anchored hearing aids
Bone conduction hearing aids
While many people may desire smaller hearing aids, smaller designs do not always have the power to give you the improved hearing that you need. There are pluses and minuses to each hearing aid style and they will be discussed below. It is important to not get too hung up on any particular feature, even size, but to find the style that works for you in terms of function and comfort.
Completely In The Canal
The CIC hearing aids are molded to fit inside your ear canal and are the smallest and most discreet hearing devices available. They work better for people with mild to moderate hearing loss. Because of where they are placed, they are less likely to pick up wind noise and have good sound quality, but they can also be difficult to get in and out of your ear and are more susceptible to ear wax clogging the speaker. People like them because of their size and because they are less noticeable, but it is their size that can make them more difficult to handle. The size also means they have smaller batteries with less life and certain features like volume controlsevere hearing loss or a directional microphone are often not available.
In The Canal
ITC hearing aids are also molded and fit partially in the ear canal and partially in the outer ear. Similar to CIC, ITC are best for mild to moderate hearing loss, but they are larger in size than the CIC style. They are still discreet, and their slightly larger size gives them more battery life and more potential features such as volume control and a directional microphone. Their size and where they are placed can sometimes make the ears feel “plugged up” and they are also susceptible to ear wax clogging. ITC hearing aids are easier to work with however, particularly putting them in and taking them out, when compared to the CIC hearing aids.
In The Ear
ITE hearing aids sit completely in the outer ear and are housed in a custom fit shell. The shell designs are classified as either a half shell that fills only the bottom half of the ear, or a full shell that fills most of the bowl-shaped area of the outer ear. ITE hearing aids are made for people with mild to severe hearing loss and are available with multi-directional microphones. Some of the features you can find in ITE hearing aids include volume control, longer lasting hearing aid batteries with rechargeable options, ease of use, and the multi-directional microphones. Sitting on the outer part of the ear, they tend to pick up more wind noise, they are susceptible to wax clogging the speaker, and they are definitely more noticeable in the ear than some of the smaller options.
Behind The Ear
A BTE hearing aid hooks over the top of your ear and rests behind your ear while a tube connects the hearing aid to a custom earpiece, called an ear mold, that fits into your ear canal. These hearing devices are generally appropriate for any age group and any level of hearing loss. BTE hearing aids are, traditionally, the largest of the hearing aid styles though there are some new “mini” versions that are less visible. Some features found in BTE hearing aids include directional microphones, higher levels of sound amplification, improved sound quality, and multiple battery options. They are also great for children because they can be reprogrammed and the ear mold can be replaced as the child grows. They are however, generally larger and more noticeable than other styles, they pick up more wind noise, and they can be a challenge for eyeglass wearers. BTE hearing aids also have available wireless connectivity and advanced technology in some models.
Receiver In Canal or Receiver In The Ear
The RIC and RITE hearing aids are similar to the BTE hearing aid styles in how they look and operate, but instead of a tube connecting the hearing aid and earmold, it is a tiny wire. In general, this style of hearing aid has most of the benefits of the BTE style but has smaller parts and are less noticeable.
Open Fit
An open fit hearing aid is another variation of the BTE hearing aid style. The open fit hearing aids keep your ear canal as open as possible so that low frequency sounds enter your ear naturally while higher frequency sounds are amplified through your hearing aid.
Because of this, an open fit hearing aid is generally preferable for people with better low frequency hearing and mild to moderate overall hearing loss. This hearing aid style does not plug your ear like others which makes your voice more pleasing to hear, but because it is not as customized, it can be more difficult to fit and to maneuver.
CROS and BiCROS
Hearing aids can accommodate unilateral hearing loss (hearing loss in one ear) and bilateral hearing loss. CROS hearing aids are designed for single-sided or unilateral hearing loss, while BiCROS hearing aids are recommended for individuals who have some level of hearing loss in their “good” ear as well.
In some cases where an individual cannot seem to benefit from hearing aids, cochlear implants or surgically-implanted hearing devices may be recommended.
Bone-anchored Hearing Aids
Bone-anchored hearing aids (also known as osseo-integrated devices or “BAHA” devices) are surgically implanted devices. Unlike traditional hearing aids, they bypass the middle ear, sending vibrations through the bone straight to the cochlea transmitting sound.
Bone Conduction Hearing Aids
Bone-conduction hearing aids work by amplifying sound via bone conduction, also known as vibrations through the bone. Similar to bone-anchored hearing aids, bone-conduction hearing aids are an excellent choice for people with collapsed ear canals, frequent ear infections, or some kind of malformation of the outer or middle ear.
Additional Features of Hearing Aids
The first priorities when choosing a hearing aid are comfort and effectiveness. In addition, there are other optional features available in some hearing devices that can improve your ability to hear in specific situations. These features may make a certain hearing aid product more desirable for you. The following are some of those features with a brief description of each:
Noise reduction
There are several ways digital hearing aids adapt to noise, and all hearing aids have some level of noise reduction. Noise reduction is the feature that allows the unit to increase and decrease the volume in noisy situations so that you can hear conversations and other important things more easily above background noise. There are also feedback reduction and wind noise reduction features in some hearing aids.
Directional microphones
One of the most difficult situations for people with hearing loss is trying to understand conversations in noisy environments. To combat this difficulty, hearing aids can have directional microphones which means that there are two microphones in each ear. One microphone picks up sounds in front of you while the other picks up sounds behind and beside you. In a noisy environment, the processor automatically reduces the sensitivity of the rear microphone and then reverses the process when the noise is reduced.
Rechargeable batteries
Some hearing aids have rechargeable batteries, and the benefits are obvious. With rechargeable batteries you do not have to swap out those tiny button batteries every few days or weeks making maintenance much easier.
Telecoils
Telecoils enable hearing aids to pick up sound directly from compatible phones or sound systems in public places like churches or theaters. When this technology is available, your hearing aid usually has a “T” setting that you can switch to so that sound is picked up directly by the unit’s processor.
Wireless connectivity
Many hearing aids today can connect to tablets, phones, and other Bluetooth devices wirelessly so that your device can act almost like a personal headset.
Remote controls
Some hearing aids have handheld remote controls so that you do not have to touch or mess with the device itself to adjust it. In some of today’s hearing aids, the remote control could be your phone, if the hearing aid has wireless technology that connects the two together.
Direct audio input
With direct audio input, your hearing aid may be able to plug directly into a television, speaker or other music device with a cord.
Variable programming
Some hearing aids can store pre-programmed settings for different environments and situations that can be accessed by a remote control or a simple push of a button. These settings can come in handy for various listening needs and situations.
Synchronization
If you have two hearing aids, they can be synched together so that changes made to one are automatically made to the other. This allows for simpler control and more consistent hearing.
Although currently there is no cure for tinnitus, it can be managed in several ways. The most successful and researched method is by using a tinnitus masking device. Some hearing aids are created with tinnitus-friendly features, offering tinnitus masking technology or white noise.
Things To Know Before Buying Hearing Aids
Choosing a hearing solution is not as simple as buying hearing aids on Amazon – placing an order, and getting it delivered to your home the next day. Yes, there may be over-the-counter hearing aids available that you can buy without a prescription from an audiologist or getting a hearing test.
However, for medical grade hearing aids, there is a process involved, and the first step should always be speaking to an audiologist and letting them help you choose the right device for your situation.
You do not want to make guesses with your hearing, so we would suggest taking all of these things into account prior to buying a hearing aid.
Keep in mind that you should mention any other symptoms you are experiencing with hearing loss such as dizziness, tinnitus (ringing in the ears), etc.
Get a checkup
If you suspect that you have any degree of hearing loss (muffled hearing, distorted hearing, difficulty hearing in background noise), it is a good idea to get a diagnostic hearing test. Your doctor can tell you if there is an easily correctable issue such as earwax or infection, or if you need to have your hearing tested by a hearing specialist.
There are various types of hearing loss that are differentiated in various categories. Typically, hearing loss is categorized as central hearing loss (associated with how the brain processes information) and peripheral hearing loss (sensorineural, conductive, and mixed).
An individual can also have:
Depending on the cause, hearing loss may be temporary or permanent. If you experience sudden hearing loss, seek medical attention promptly. Getting a thorough hearing evaluation from an audiologist is necessary to get the most appropriate hearing solution.
Seek a referral to a reputable audiologist
If the issue is neither earwax nor infection, ask your doctor for a referral to a reputable audiologist. They will assess your hearing and if you need a hearing aid, they will be able to walk you through the steps needed to find the right one.
Before recommending a hearing aid, an audiologist will need to carry out tests such as an otoscopic examination (to check the integrity of the ears), and hearing tests such as pure tone test, otoacoustic emissions (OAEs), or auditory brainstem response (ABR) test.
Ask about a trial period
A trial period is important for a hearing aid because it could take a while to get used to the device, both from a comfort and hearing performance level. You should ask the hearing aid dispenser to put the cost of the trial in writing, and also whether or not the cost of the trial could be used for the purchase of the hearing aid. With a trial period, you get the peace of mind that comes with being able to try out the device before making a final purchase.
Think about future needs
Depending on the type of hearing loss you are experiencing and your age, your hearing loss could get progressively worse. If there is a good chance that this could be the case for you, it is important to make sure that the hearing aid you choose is capable of increasing its power in accordance with your future hearing needs.
You may also want to invest in hearing protection to prevent further hearing damage or hearing aid accessories that you can use to maximize or enhance the benefits of your hearing device.
Check for a warranty
Make sure your hearing aid has a warranty that covers parts and labor for at least a specified period of time. Take the strength and length of time of the warranty into account when purchasing a hearing aid.
Beware of misleading claims
If a hearing aid claims that it can “return your hearing to normal” or provides other outlandish assertions that cannot be true, look for another device.
Some private insurance policies will cover all or part of the expenses of hearing aids, but you should check your policy prior to the purchase. Medicare does not cover hearing devices for adults.
Hearing aids are tiny devices and can get dirty easily, especially since they are placed inside the ear. It is important you maintain the physical cleanliness of your devices so the functionality of your hearing aids can keep working in tip-top shape. It is advisable to bring your device to your hearing care provider periodically to have it checked and professionally cleaned. As a hearing aid owner, it is also your responsibility to keep your ears clean for the benefit of your hearing aid and overall hearing health.
Getting Used to Your Hearing Aids
If you are struggling with hearing loss then it is probably easy to see all of the benefits that a hearing aid could bring. It is true, hearing aids can make a world of difference, but wearing one is also unlike anything you have experienced, and it may take time to get used to.
You may experience noise sensitivity, find your own voice weird-sounding, or experience some occasional bouts of whistling or feedback. Make sure to take note of any concerns and get in touch with your hearing care provider so that these issues may be addressed promptly.
If you know what to expect, and follow some of these tips, it could make your transition easier.
The biggest change could be your own voice
At first, your voice may sound funny or even unfamiliar. It may even sound louder than what you are used to, even if you are talking at a normal level. Even chewing and swallowing may seem louder or feel strange as you get used to your hearing aid. While annoying at first, they become the new normal and you will notice these differences less and less as time goes on.
Your hearing will not return to normal
Hearing aids cannot restore your hearing to “normal.” They can improve your hearing by amplifying sound, but your hearing will be different and will not return to what it was before your hearing loss.
For babies and kids with congenital hearing loss, early detection and intervention will play a big role in their learning and development. Kids with congenital hearing loss may not experience normal hearing, but they will be able to experience the world the best way they could through hearing aids or cochlear implants.
Learn the basics
The specialist, who fits you with the hearing aid, will also teach you how to use them and give basic hearing aid troubleshooting tips. Do not assume you can just learn on your own at home.
Audiologists can help you use and adjust to your hearing aids, including how to take it out/put it in, clean it, change hearing aid batteries, and operate all of the features that you are paying for. Learning how to use and maximize the benefits of your hearing aid will play a big role in your journey to hearing success.
Tips
Wear the hearing aids at home first before you ever wear them out in public.
Wear them for short periods of time with breaks in between until you are used to them.
Give yourself homework assignments to help you learn how to use them to their full capacity.
Find and attend hearing aid care classes.
Attend follow-up visits to fine-tune your hearing and your hearing aid.
Anticipate some frustration and be ready to overcome it.
Report pain immediately to your doctor.
While there are challenges involved with getting used to hearing aids, they really can change your entire life for the better. The key is to stay positive and to rely on the people in your life that you trust and love to help you through. Practice with your loved ones, ask their advice, and trust them to help you when things are difficult. Also, find a good audiologist who can lead you through the process and make the journey as easy as possible.
FAQs
How much do hearing aids cost?
Hearing aids can range in cost anywhere from around $1,500 to several thousand dollars depending on style, features, brand, insurance, etc. The key is to find the right product for your budget and needs. The best way to do that is to sit down with an audiologist and figure out what you are looking for and what fits within your budget.
Does insurance cover hearing aids?
This is a state-by-state, insurance-by-insurance issue. Many insurance companies do not cover hearing aids, yet some private insurances will cover part of all of the hearing aid related expenses. Check your private health insurance policy prior to shopping. Medicare does not cover hearing devices for adults.
Which is the best hearing aid?
The best and most comfortable hearing aid is the one that fits your needs most optimally. Taking into account your hearing needs, how comfortable the device is in your ears, and your opinion of which hearing aid is the most fashionable, will help you find the ideal hearing aid for you.
Working with an audiologist will allow you to combine the aspects you are looking for with the features you need. Audiologists are trained to diagnose and treat hearing loss, and they are knowledgeable about how the human hearing range works. Finding an audiologist who practices real ear measurement will also ensure that you are getting the golden standard in terms of hearing aid fitting.
There are so many different styles and features available now, you are very likely to find a device that fits your desires.
Bluetooth hearing aids have essentially made headphones unnecessary for hearing aid wearers. Many of the industry’s top hearing aid manufacturers not only produce Bluetooth hearing aids, but they have developed hearing aids that provide the same stereo-quality sound expected from high end headphones.
Do cheap hearing aids work?
The short answer is “yes,” of course cheap hearing aids work, but they might not work for you. Your audiologist should perform a diagnostic screening to understand your hearing needs and then speak with you to understand your hearing goals and what you desire in a hearing device. During the planning phase with your audiologist, you will figure out the best hearing aid at the best price point for you.
Yes, earwax can affect how hearing aids work. If earwax gets stuck in some parts of the hearing aid, it can cause the device to “whistle” or produce feedback. Excessive ear wax can also affect the performance of hearing aids if it enters the tube or receiver. Dirt and debris may also be the culprit as to why your hearing aids don’t work, so make sure to clean your device regularly.
Although using hearing aids will not prevent further hearing loss, it will help to preserve the clarity of your hearing. Hearing aids will keep you connected to the people and activities you love. Hearing aid use will help preserve the clarity of your hearing. This means you will be able to follow conversation more easily when you have been wearing hearing aids.
When you invest in hearing aids, the hope is that they will last indefinitely. But the fact of the matter is they last between three to seven years. This is because the technology nowadays is so advanced it’s almost like having a tiny computer in your ear, and computers need updating often. Contact your audiologist for a consultation to see what option is best for you.
What is the role of hearing aids in aural rehabilitation?
The cause of hearing loss is unique for each individual – some may have occupational hearing loss, some lost their hearing gradually due to aging, while some experienced hearing damage due to exposure to loud, sudden noises. Aural rehabilitation is a broad term that encompasses all of the treatment that can be provided to help people overcome the challenges related to hearing loss. It is important to know that hearing aids are only one piece of the puzzle when it comes to treating hearing loss, and finding an audiologist who provides all of the components of aural rehabilitation will ensure more successful outcomes with the treatment process.
Hearing aids make sounds more understandable, they can filter out background and ambient noises, and they can help with speech comprehension as they separate speech from all other sounds to make it easier to hear. Meanwhile, an amplifier or PSAP has one simple purpose and one simple function – it makes sounds louder. They are not selective in the sounds they amplify but simply make every sound that you would normally hear louder.
Some cheap hearing aids are nothing more than personal sound amplification devices (PSAP) while others are actual hearing aids that you can buy over-the-counter (OTC). The main difference that sets a cheap hearing aid apart is that commonly they are purchased without the assistance of a hearing healthcare professional. When it comes to your ears and hearing health, finding the right hearing aid for your situation and your hearing loss is more important than finding the cheapest option available.
