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The New Hearing Aids

They're sure not what Grandpa wore.

Hearing Aid Styles

Where the hearing aid is worn - behind or inside the ear - is determined by its size. People with more severe hearing loss often need a larger size to accommodate the added circuitry and wires.

In-the-Ear (ITE): These fit completely in the outer ear and are used for mild to severe hearing loss. The case, which holds the circuitry, is made of hard plastic. ITE aids can be damaged by earwax and ear drainage, and their small size can cause adjustment problems and feedback.

Behind-the-Ear (BTE): These are worn behind the ear and are connected to a plastic earmold that fits inside the outer ear. Sound travels through the earmold (which holds the circuitry) and into the ear. BTE aids are used by people for mild to profound hearing loss. If the earmold is not properly fitted, there can be feedback - a whistling sound caused by either the fit or by buildup of earwax or fluid.

BTE hearing aids can be linked with Bluetooth cell phone technology. "The Bluetooth plugs into the ear hearing aid, so you're hearing directly from the phone into the hearing aid. It cuts out background noise," Dibkey says. "It's very cool."

Canal Aids: The in-the-canal (ITC) aid is customized to fit the size and shape of the ear canal. It is used for mild to moderately severe hearing loss. A completely-in-canal (CIC) aid is nearly hidden in the canal and is used for mild-to-moderately severe hearing loss. Because of their small size, canal aids may be difficult for the user to adjust and remove. These aids may be damaged by earwax and ear draining.

The in-canal hearing aids are the most popular, says Dibkey. "They're small-sized and fit into the ear canal - but not so deep that reception is impeded by ear wax."

Hearing Aid Circuitry

A hearing aid's inside mechanisms will vary among the devices. Basically, there are three types of circuitry or electronics that are used:

Conventional: This is the traditional analog hearing aid, offering the least-expensive technology. The computer-programmed analog hearing aids are slightly more sophisticated, since the audiologist can create more than one program - like "all-the-time" and "noisy environment" settings - so you can change it, via a remote control, to suit your environment. Cost: $700 to $1,000.

Digital/Programmable: This is computer-programmed technology and can be set to precisely match a patient's hearing loss and response time. Digital hearing aids use a microphone, receiver, battery, and computer chip to provide the most sophisticated hearing aid. Cost: $900 to $1,500.

New-Generation Digital: These hearing aids offer 16 bands - treble, bass, and mid-levels - for the most precision in sound quality and clarity. "We can computer-program a hearing aid on as many as 16 bands, to match their hearing loss at every pitch. It's tailor-made to match their hearing loss," explains Dibkey. "And the directional microphones are clinically proven to be most effective in improving speech intelligibility in noisy situations." Cost: $1,200 to $3,500.

"The newest technology is definitely worth the expense," says Dibkey. "No hearing aid can eliminate background noise entirely, but they're getting better -- and the newest ones are the best we've ever had. And the clarity is amazing. ... It's like comparing CDs and DVDs with records and video tapes."

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