Ask the Audiologist
Have you ever wanted to ask the audiologist? Joe Baker answers your questions about ear health, hearing aids, and tinnitus.
The perception of ringing or buzzing (tinnitus) is a sign that you have experienced noise loud enough to damage your inner ear, the cochlea. Sounds may seem muffled and your own voice sounds distant, along with ringing or humming noise. Usually, this will subside in a few hours, or within 24 to 48 hours as long as you aren’t exposed to more high noise levels. If it does not, schedule an appointment with your audiologist.
We suggest you use hearing protection when attending live events. Hearing protectors can be earmuffs or ear plugs. Many people find earmuffs easy to use, but can be bulky and uncomfortable to wear for extended periods of time. Ear plugs are smaller, more comfortable, and can be either custom made or purchased off the shelf. The best hearing protectors for live events have filters that evenly block noise to maximize sound quality and fidelity. These filters can be part of custom fit ear plugs and are now even available at our office as an off-the-shelf option made to fit most ear sizes.
We’ve all experienced unusual sensations or sounds in our ears from time to time. Some examples include muffled hearing, buzzing, hissing, or even ringing.
What could be causing this?
- Eustachian tube dysfunction
- Middle ear infection
- Ear wax (cerumen) buildup
- Temporomandibular joint (TMJ) disorders
We are all tempted to save money when we can, especially on a major purchase like hearing aids. Sometimes, if our budget leaves us no other option, going the “cheaper” route is better than doing nothing. But, I don’t say that without warnings.
- First, you should understand the difference between actual hearing aids and amplifiers. Many online retailers even claim they are selling FDA “registered” devices when they actually are basic amplifiers not designed to meet specific hearing needs–which brings me to my next warning.
- Have an audiologist test your hearing. Audiologists have the academic and clinical training to know when you have age-related hearing loss or something more serious, such as a hearing nerve tumor, a damaged eardrum, or other medical issue that should be addressed before proceeding with hearing aids.
- Understand your needs, especially for service after receiving the hearing aids. Big box stores and online retailers are in the business of “selling units.” They are happy to sell a product to you, but follow-up care and servicing your hearing aids does not fit their model for making money. An audiologist will provide a sensible service plan to ensure your hearing aids are well taken care of to maximize their life and usefulness–which brings me to the last point.
- Hearing aids must be programmed to address your specific hearing needs (that’s why you need a hearing test). At least 90% of new hearing aids need adjustments after the initial fitting. Your audiologist is able to do this during follow-up care and can make physical changes to the hearing aids if there is an issue with fit or size.
Be a wise consumer and advocate for yourself. Always remember, if it seems too good to be true, it probably is.
If you suspect that you have a hearing loss, consult with an audiologist. An audiologist is trained to identify whether a hearing loss requires medical or non-medical treatment, so will know when to refer you to the appropriate medical specialist. The audiologist will identify, diagnose, treat, and manage your hearing loss.
Yes, especially if you have a family history of hearing loss or you’ve been exposed to loud noise, such as at work, recreational activities, or shooting firearms. Another good reason to have annual hearing tests is if you have experienced recurring ear infections or other ear-related medical conditions. But, if none of these apply to you, it is usually safe to wait until age 50.
There are many brands and types of hearing aids today. The best hearing aids those that are properly fit based on your most recent hearing test results. The style or performance level depends on your lifestyle, budget and hearing loss needs. Today’s hearing aids are even equipped with Bluetooth connectivity to work with wireless technology like a cell phone, tablet computer, or television.
Which is best?
Five major hearing aid companies dominate the global market, with Sonova (make of Phonak and Unitron hearing aids) being the leader holding over 30% market share. Other major players produce brands such as Oticon, Signia, Widex, and ReSound.
The hearing aids most consistently rated best by audiologists and consumers are Phonak and Signia. As of early 2021, our best experiences have been with:
- Phonak Audéo Paradise Rechargeable
- Signia Pure Charge&Go X
- Widex Moment Rechargeable
Medicare will usually cover a physician-ordered hearing test or treatment of a hearing-related medical condition, but will not pay for hearing aids. You are responsible for 100 percent of these costs unless you have a Medicare Advantage Plan or other insurance with hearing aid coverage.
Prices will vary from one place to another. Because our hearing aids span from about $2,000 per pair to $6,000 per pair, most of our patients usually end up in about the middle of that range.
The difference in price is indicates how automatic the hearing aids are, and how well they adapt to changing environments (like background noise, music, etc.). Less expensive hearing aids will certainly help many people, but require more manual adjustments by the user and aren’t as effective in background noise.
Price is an important consideration, but the expertise with which the hearing aids are fit is crucial. The most expensive hearing aids in the world will not help you if they are not well fit!
At our hearing aid center, we offer unmatched expertise and the most up-to-date fitting methods. We verify with real ear measurements (REM) to ensure you get the most from your hearing devices. Every patient has a 45-day trial period so that you know the hearing aids will work for you before you are committed to making this significant investment.
The majority of major insurers who offer Medicare Advantage plans have at least one plan that covers hearing aids. These insurers include United Healthcare, Humana, Aetna, and Anthem BCBS. Hearing Science is a participating provider with most insurance plans.
However, hearing aid coverage varies widely between plans and most have limited service agreements that only provide three office visits in the first 6 to 12 months before you have to start paying for follow-up care. The third-party administrators (TPA) that manage hearing aid benefits for insurers add a layer of bureaucracy that limits choices and your autonomy to work with your hearing healthcare provider as you see fit.
Assistive listening devices (ALDs) and personal sound amplifiers (PSAPs), are available to help people hear better in specific situations. ALDs are available to improve hearing while watching television or for group listening situations such as movies, lectures, or religious services. Other devices are available for individuals who have difficulty hearing the doorbell, car signals, or emergency alarms. Captioned telephones are for individuals who experience difficulty understanding speech while using the telephone.
Speak with your audiologist concerning other ALDs that may be beneficial for you.
Hearing aids can last anywhere from three to seven years. We have seen hearing aids, still in use, that were over 20 years old–but that is an exception. Factors influencing lifespan include how well the instrument is built, how well it’s maintained, and how much wear and tear it experiences being worn in your ear for many hours a day for 3+ years.
Most patients coming to Hearing Science for replacement hearing aids have had theirs an average of for four to six years. Our Five-Year Comprehensive Care Plan helps ensure you get maximum life and use from your hearing aids.
If you’re concerned you or a loved one may be experiencing hearing loss, you are not alone. Because hearing loss can come on gradually, it’s often the people around you who notice your hearing problems before you do. Surprisingly, it takes people an average of seven years after they know they have hearing loss before seeking treatment! So, if you exhibit the following symptoms, consider visiting an audiologist.
Symptoms of Hearing Loss
- People sound like they are mumbling when talking to you
- You have to ask people to repeat what they said
- You laugh at jokes even though you may not have heard the details
- Spouse, friends, or relatives say you play the TV or radio too loud
- Looking at people when they speak to you makes it easier to understand
- Environmental sounds, such as birds chirping or rustling leaves are no longer audible
- You find yourself avoiding certain restaurants because they are too noisy
- There is a ringing sound in your ears, especially when it is quiet.
Tinnitus is a common disorder affecting over 50 million people in the United States. It is often referred to as “ringing in the ears,” although some people hear hissing, roaring, whistling, buzzing or clicking. Tinnitus is not a disease, but a symptom of another condition of the ear, auditory nerve or other influencing factor. Tinnitus can be intermittent or constant, with single or multiple tones. The perceived volume can range from very soft to extremely loud and may be recurrent or constant. The American Tinnitus Association is a valuable resource for tinnitus providers and sufferers.
The exact cause of tinnitus is not known in every case. However, there are several likely factors that may worsen tinnitus. These include:
- Noise-induced hearing loss
- Wax build-up in the ear canal
- Certain medications
- Ear or sinus infections
- Age-related hearing loss
- Ear diseases and disorders
- Jaw misalignment
- Cardiovascular disease
- Certain types of tumors
- Thyroid disorders
- Head and neck trauma
Depending on the severity and underlying condition causing tinnitus, there are several treatments available to improve the perception of unwanted noise. The most common treatments for tinnitus include:
- Hearing aids with tinnitus-masking features
- Tinnitus retraining therapy
- Sound therapy
- Avoidance measures
- Avoidance of certain medications
- Behavioral therapy
Tinnitus maskers produce a variety of noises either through hearing aids or a tinnitus masking unit. As a result, this noise makes the tinnitus inaudible.
There are different hearing healthcare professionals available, but each has different education and training requirements. An audiologist and a hearing instrument specialist (HIS) are two of the most common professionals when seeking treatment for hearing loss. So you can better understand which professional is best for you, it’s important to distinguish the differences between the two.
Audiologist
Audiologists are trained to diagnose, treat and monitor disorders of the hearing and balance system. They are trained in anatomy and physiology, amplification devices, cochlear implants, electrophysiology, acoustics, psychoacoustics and auditory rehabilitation.
Audiologists complete at least a masters degree in audiology as well as a supervised externship prior to state licensure and national certification. And, upon completion of training, audiologists must also pass a national standardized examination to be eligible for state licensure. Continuing education requirements must be met in order for an audiologist to maintain state licensure and their national certifications. In short, for individuals with hearing loss, auditory issues, or balance problems, an audiologist is the most qualified professional to assist with diagnosis and treatment.
Hearing instrument specialist (HIS)
Hearing instrument specialists are licensed by their state to perform audiometric testing only for the purpose of selling and fitting hearing aids. In order to obtain a license in Ohio, a HIS has to pass a written and practical exam. Hearing instrument specialists are able to fit and repair hearing aids, however, they cannot diagnose a hearing loss.
There is a relationship between hearing loss and cognitive decline. But, having hearing loss hasn’t been shown to be the sole cause of Alzheimer’s or dementia. Studies suggest that older people with hearing loss are more likely to develop Alzheimer’s disease and dementia, and hearing loss can be associated with a faster rate of cognitive decline. Why is this?
Researchers have several theories:
1. One has to do with cognitive load. With untreated hearing loss, the brain gets overworked by constantly straining to understand speech and sound. An overworked brain doesn’t work efficiently.
2. Another has to do with brain structure. Brain cells can shrink from lack of stimulation, including the parts of the brain that receive and process sound.
3. The last theory is social isolation. When a person has trouble hearing conversations and socializing, they may prefer staying home instead. However, the more isolated a person becomes, the less stimuli their brain receives.
For more insight, start here with Dr. Frank Lin’s original report in 2011.