CIC vs MicroBTE

October 19, 2015

Want small? You got it.

There’s an old song that goes, “you’re so vain, you probably think this song is about you.” Although the song’s crooners have long since retired, vanity is alive and well. Everyone is concerned about what hearing aids look like, whether they admit it or not. We’d like to pretend that we’ve moved beyond the stigma, but the truth is, there is still a stigma attached to wearing hearing aids that says, “I’m old” or “I have a handicap.” So, for that style-conscious consumer, there are several choices of small hearing aids that are easily hidden from view.

The completely-in-the-canal (CIC) hearing aid is a small custom-made hearing aid that fits completely inside the ear canal. Besides the benefit of being small in size, the CIC provides a closer proximity to the eardrum which can improve the perceived sound quality and volume. Those who wear the CIC also have less issue with the irritation of wind noise running over the top of the microphone because it is protected by being tucked inside the ear canal. One of the better benefits of the CIC is the ability to use the telephone normally. The completely-in-the canal isn’t for everyone, though. It’s best for those with mild to moderate hearing loss and it requires that the user have good dexterity as the batteries are quite small. Additionally, the hearing aid must be removed from the ear by grasping a small removal strand, making this instrument difficult to use for some. However, the CIC is by far the most aesthetically pleasing hearing aid.

A close second is the micro behind-the-ear (BTE) hearing aid. Research shows that this hearing aid, which sits on back of the ear and has a small, clear tube attached which runs down the side of the ear and into the ear canal to deliver the amplified sound to the ear, is becoming more and more popular. Those who choose the Micro BTE option often prefer the open ear feeling that this style affords. Having an open ear canal means a more natural sound quality and a better physical fit. It’s not uncommon to hear a micro BTE wearer report, “I forget I’m even wearing a hearing aid!” Additional preference for this ultra-small hearing aid stems from the ease of use and significant decrease in the sensation of occlusion (ear canal blockage causing an echo, barrel or tunnel like sensation of sound) and poor sound quality of the wearer’s own voice.

In either case, the miniaturization of hearing aids is making it easier for those with hearing loss to take that first important step toward better hearing. And, those who have worn hearing aids before will enjoy having more choices without sacrificing function, sound quality or ease of use. If you think you might have a hearing loss, a CIC or micro BTE is a great option for just about anyone. Call our office today to see if either of these styles is right for you.

Advances in Hearing Aid Technology

October 12, 2015

Are you experiencing hearing loss but just accept it as an “accumulation of birthdays”? Have others told you it’s something you will have to live with because hearing aids won’t help or are too expensive? While it is true that our hearing diminishes as we age, it doesn’t mean we have to stop communicating or change our lifestyle to avoid the difficult listening situations. If you are at an age in life that you plan to reap the benefits of your hard work, don’t let a hearing loss deprive you of that enjoyment. With a simple test and a quick conversation, your Doctor of Audiology can determine the severity of your hearing loss and give you the solutions to put your life back on track, at any age.

The first step in determining the extent of your hearing loss is to schedule a hearing test with an Audiologist. This simple, non-invasive test will help your Audiologist determine if you need amplification (hearing aids) to correct your problem, and if so, the type of hearing aids that will work best for you. New advancements in technology mean you’ll have several types of hearing aids or manufacturers to choose from. Working with your Audiologist, you’ll be able to find the right solution for your hearing loss and your budget. The majority of hearing aids today are fully digital instruments. Many people do not realize there are two types of hearing aids: analog and digital. Until just a few years ago, all hearing aids were analog, but new technology advancements have provided us with digital hearing aids that have far surpassed their predecessor, the analog hearing aid.

Analog Hearing Aids
Analog hearing aids provide better hearing by using a continuous electrical signal to produce sound, much like a microphone and speaker system you might see at a concert or while singing karaoke. These sounds are then amplified and sent into the ear canal, allowing you to hear the sounds around you. Analog hearing aids are not generally less expensive than digital models but have less features and less adjustability. Analog hearing aids look and feel just like digital hearing aids in every way but are limited in what they can provide the listener at a similar price to the newer digital hearing aids. There really isn’t a good reason to purchase an analog hearing aid any longer.

Digital Hearing Aids

Digital hearing aids are increasingly popular on the market now with many different makes and models available. Their popularity has increased in the last few years because of design and size, as well as advantages not seen in the analog hearing aids. Some of these advantages are feedback suppression, noise reduction and wireless connectivity.

Digital hearing aids have eliminated most of the noise generated by the instrument when sound gets trapped or squeezes around the instrument and is then reamplified. We call this noise “feedback.” Feedback can occur with jaw movement or getting too close to an object. Advancements in hearing aid technology have also been able to significantly reduce the background noise that was so annoying to users when out in a crowd. A common complaint of a person with hearing loss is not being able to determine the direction of a sound they hear. With the directional microphone system available in some digital hearing aids this is no longer an issue. Digital hearing aids are now available in extremely small models, making them much less obvious when worn in or behind the ear. Digital hearing aids can be customized to your specific needs, based on your Doctor of Audiology’s evaluation of your hearing loss. Newer technology also allows for Bluetooth connectivity to systems that have an audio output, such as your TV and cell phone.

Exciting new technology advancements have brought us a long way from the first hearing aids, worn over the ear and attached by wire to a box on your chest, to the tiny hearing aids of today. There are choices for every lifestyle and budget. Working alongside your Doctor of Audiology, you will be able to find the instrument that works best for you.

Give us a call today, and let our Audiologists introduce you to the newest, state-of-the-art digital hearing aids.

Accessories That Connect To Hearing Aids

October 5, 2015

One of the few down sides to wearing most hearing aid styles is that you can’t put anything ELSE in your ears at the same time. This means no ear-level Bluetooth pieces, no iPod or MP3 player earbuds, and often no headsets for listening to TV. Consumers have been asking for a solution, and finally manufacturers are listening. Now there are ways to connect to the audio gadget of your choice without first having to remove your hearing aid. Most use Bluetooth® technology or in some way connect via Bluetooth.

What is Bluetooth?
Put simply, Bluetooth technology is a short-range wireless radio technology that allows electronic devices to securely connect to one another without wires.

How Does Bluetooth Work With Hearing Aids?
Bluetooth allows hearing aids to communicate with hands-free devices, such as a music player and cell phone. It can also be used with accessories that act as transmitters to take information from non-Bluetooth audio devices, such as a TV or stereo system, and send it to the hearing aids using the same Bluetooth technology. These accessories are manufacturer-specific and are an optional extra accompanying the hearing aid purchase. Accessories range in price from $100 to $400 each. In addition, Bluetooth allows the audio signal to be altered through the hearing aid programming to better suit the listeners hearing needs, while also allowing the two hearing aids to communicate with one another, permitting a more “hands free” hearing experience.

What Are Some Examples?
The hearing aid manufacturer Oticon uses Bluetooth in their Streamer device. The Streamer, worn around the neck, is paired with the hearing aids and then the audio devices you want to use. The Streamer is not a true Bluetooth system in that it uses the hearing aid’s internal T-coil to communicate with the hearing aids. This requires that the Streamer be worn around the neck to pick up the audio signal. Although this means the wearer is essentially tied to the accessory device, the Streamer allows for direct streaming of a Bluetooth audio signal to the hearing aids without first removing the hearing aids. Oticon also sells a line of products under their ConnectLine brand, which includes an adapter for non-Bluetooth audio signals from televisions and landline phones.

Phonak uses a device called the iCom, which operates similarly to the Streamer. It also uses induction to the hearing aid T-coil with a device that is worn around the neck. The iCom allows for connection of up to five different audio devices. This allows the listener to listen to the TV, using the Phonak TV accessory, switch easily to an incoming cell phone call, then resume with the TV audio after the call is finished. Seimens uses Tek Connect, which is similar to the Streamer and iCom accessories.

The next generation of truly wireless connectivity is now available in several hearing aids. ReSound’s Alera hearing aids can use the Unite accessories to connect to TV and cell phone without the use of a neck-worn accessory. The Alera and Unite accessories are the first truly hands-free Bluetooth hearing aid devices.

Starkey also has a hands-free Bluetooth device in its Wi line. At the moment, the Bluetooth technology is only available for streaming TV audio through its SurfLink accessory. The streaming rate, however, is extremely fast which means there is no lag-time between what the viewer sees on screen and what is heard at ear-level, which is often noticeable in some of the other products.

The newest wireless hearing aid on the market is the Widex Clear. Currently it is only available in the standard Behind-The-Ear and Receiver-In-The-Canal styles. WidexLink is used to transmit sound from external devices to the hearing aids when watching TV, talking on the mobile phone or listening to music. This is done by way of an external transmitting device. The TV-DEX is used for TV streaming and the M-DEX is used for streaming cell phone audio to the hearing aids.

Other companies are getting into the Bluetooth accessory race, as well. For example, Nokia has introduced a wireless loopset that allows users with T-coil equipped hearing aids to have a connection to their cell phones. The loopset allows for a wide range of control from control of volume and also volume range and frequency. Many cell phone carriers are now offering Bluetooth accessories for hands-free cell phone use. Check with your carrier’s website for availability.

What Should I Think About Before I Buy?
First, talk things over with your audiologist. By working together, you can determine whether or not new hearing aids would be a good fit for you.

Also, consider your lifestyle. Are you a gadget person? Is music a big part of your life or would you like to enjoy music more often? Does your state require hands-free cell phone use? Is the TV volume too loud for others? If so, Bluetooth accessories are a great way to combat these listening issues.

Be aware that there are a few downsides to Bluetooth accessories: You’ll need to keep track of not only the hearing aids, but also another accessory in most cases. You’ll also need to remember to keep the accessory charged. In addition, you may need to upgrade your gadgets (cell phone and music player) for Bluetooth compatibility. Remember that your audiologist is your best ally. You may need to make a few extra visits to ensure everything is properly paired and that you understand how everything works, but ultimately, a hands-free experience can give you a new-found freedom for listening to the sounds of life that you may have been missing.

A new twist on an old solution for single sided deafness

September 28, 2015

Total hearing loss in only one ear is one of the least common types of hearing loss. Surveys estimate that 60,000 people per year acquire this condition1. Most cases of this type of hearing loss are permanent. The causes of single-sided deafness, also known as SSD, range from a congenital defect to trauma or illness. Congenital defects cause hearing loss before or just after birth due to a malformation of the mechanical, working portion of the ear or of the acoustic nerve itself. SSD can also be acquired. Idiopathic hearing loss or hearing loss of sudden onset with no known cause is the most common cause of total loss of hearing in one ear and can be caused by ototoxic medications or by a virus2. Another common cause of SSD is a slow growing tumor on cranial nerve VIII (acoustic nerve) which relays information from the inner ear to the brain.

Total hearing loss in one ear can have a profound impact on those who experience it. Single sided deafness can affect communication in social and work environments and can reduce the ability to determine where sounds are coming from in the environment and will reduce the listener’s ability to understand conversational speech in the presence of background noise4. Rarely is there a medical solution for SSD. In most cases, the best option is to transmit sound from the bad ear to the good ear with a specialized hearing aid called a CROS (Contralateral Routing of Signal) system.

The manufacturer Phonak has developed a new CROS system that is small, stylish and completely wireless. Previous CROS systems required a transmitter be worn on the bad ear and a wire then transmitted sound from the bad ear to the receiver, worn on the better hearing ear. The digital technology in the wireless Phonak CROS offers fast transmission of the sound and excellent sound quality due to its revolutionary noise reduction and digital sound processing. It is available in either a behind-the-ear or in-the-ear style. The BTE CROS has a variety of retention choices to hold it securely in place, offering flexibility to its wearers. If there happens to be hearing loss in the better hearing ear, the system can be adapted as a BiCROS (Bilateral Routing of Signal) system, which amplifies the sound received in the better ear, augmenting the sound specifically for the hearing loss in that ear.

The Phonak CROS system offers many features designed to improve the listening experience of the CROS wearer. One of those features, called SoundFlow, is an automatic feature that seamlessly adapts to changing environments to ensure optimal listening. If there are certain listening environments that need specific attention, such as listening in church or for TV listening, customizable manual programs can be added to the settings to better accommodate the listening environments of each individual CROS wearer. Another feature is Real Ear Sound. Being able to determine where sounds are coming from (localization) is a necessity in order to feel comfortable in all listening environments. The Phonak CROS is equipped with technology to improve the localization capability of the wearer as well as an improvement in speech understanding in noisy environments. Finally, the QuickSync feature offers a one-touch user control, allowing the wearer to change the volume or rotate between programs with a touch of a button on either the CROS transmitter on the bad ear or the receiver on the better hearing ear. There are also remote control options for manipulating volume and programs, if the wearer so chooses.

Single sided deafness poses a different set of issues to be resolved than the typical bilateral hearing loss. With Phonak’s CROS system, those who have acquired or congenital complete loss of hearing in one ear can now expect better hearing in varying listening environments, all packaged in a discreet, stylish and wireless instrument. If you have SSD, talk with your hearing healthcare provider to determine if the Phonak CROS system is right for you.

1, Single Sided Deafness: Issues and Alternatives, 5/31/2004, by Teri Sinopoli, M.A., CCC-A, AAA, and BBC News, 13 June, 2003.
2 Fayad et al. 2003. Etiologies and Treatment Options for Sudden Sensorineural Hearing Loss. Hearing Review.
3 Fritsch et al. 2003. Sudden Hearing Loss: A Team Approach to Assessment, Treatment, and Rehabilitation. Hearing Review.
4 Baguley et al. 2006. The evidence base for the application of contralateral bone anchored hearing aids in acquired unilateral sensorineural hearing loss in adults. Clin. Otolaryngol. 31, 6–14

Learning to Listen Just Got Easier

September 21, 2015

When you have trouble hearing, the trouble doesn’t just stem from hearing loss or damage to the actual mechanical parts of the ear – the outer, middle and inner ear. Instead, for most people who have hearing loss, there can also be a loss of the cognitive (brain) function due to the old adage, “if you don’t use it you lose it.”

When you have hearing loss, there can be changes that occur in the auditory processing center of the brain because it isn’t receiving the full stimulation that it would have if the system was working normally. So, even with a very good hearing aid that reduces noise and improves the clarity of speech, it’s possible to feel like you still have more trouble understanding a conversation in a restaurant or at a dinner party than others seem to be having. To cope, you may find yourself doing the “smile and nod,” pretending you understood when in actuality, you missed the majority of the conversation.

It would be easy to be upset at your audiologist for selling you a shoddy pair of hearing aids or convincing yourself that “hearing aids just don’t work.” The truth is, hearing aids don’t solve the trouble of hearing in noise. Don’t get me wrong, it certainly helps, but hearing aids are a tool. When used correctly and when programmed appropriately, they are a fantastic tool. But the other part of the equation is working on the way the brain uses the information coming through the system. Making the brain a more effective listener and learning other tools to help you listen more efficiently is really the key to benefiting the greatest from better hearing.

In order to train the brain to be a more efficient listener, audiologists have used auditory training programs with their patients. These programs can be time consuming and not cost effective. But one program, called Listening and Communication Enhancement Training (LACE), developed at University of California, San Francisco by Dr. Robert Sweetow, is a home-based training program that is less costly and easily completed on your home PC. It has had great success in the past few years, helping those with hearing loss, with and without hearing aids, learn to listen with their brains.

Just recently, Neurotone, the producers of LACE have developed an on-line version of the program. Now, this easy-to-use auditory training program can be accessed from any PC with internet access or from any smart phone, iPad or tablet. The internet version isn’t as extensive as the regular LACE program, but it’s less expensive and may be a better choice for the person who travels or may have difficulty accessing the same computer on a regular basis.

The research is clear – hearing aids aren’t the only answer. They ARE a good way to make hearing easier and speech more clear. But alongside a good auditory training program, such as LACE, the hearing aid wearer can dramatically improve their ability to hear in a noisy situation. One research article suggests that the improvement in speech understanding in noise can be as much as 40%!

If you haven’t tried LACE training, talk to your Audiologist about the program. You can’t go wrong. The investment will be worth it and you’ll be happier with your hearing aids in the long run.