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Living With Severe Hearing Loss

Hearing Aids

Hearing aids work by amplifying sounds so they are easier for the inner ear to detect. The greater the hearing loss, the more amplification necessary. There are several styles of hearing aids:

  • Behind-the-ear hearing aids consist of a plastic case worn behind the ear, along with an ear mold worn in the outer ear.
  • Open-fit hearing aids are worn completely behind the ear with only a narrow tube reaching into the ear canal.
  • In-the-ear hearing aids are worn completely inside the outer ear.
  • Canal hearing aids fit inside the ear canal.

Hearing aids can't always help people with severe hearing loss. People who can benefit "will get their best performance from behind-the-ear style hearing aids," says Craig Newman, PhD, Cleveland Clinic's head of audiology. "These are the most flexible in how they can be programmed … and they have more power."

Gordon Hughes, MD, of the National Institute on Deafness and Other Communication Disorders, agrees. "Lighter weight and more versatile styles can't reach the power levels that the other devices can." 

But there are times when no amount of power will be enough. If the inner ear is too damaged, it can't convert sounds into signals the brain can understand. In that case, the person may be a candidate for a cochlear implant.

Cochlear Implants

Cochlear implants offer a way to bypass the damaged hair cells of the inner ear, also called the cochlea. The implant is placed in the cochlea, and an external microphone and speech processor send signals to a device that is implanted under the skin. The cochlear implant delivers impulses directly to the auditory nerve, which carries the signals to the brain. Although the signals are different from normal hearing, they help people recognize speech and other sounds.

Atcherson, who is now an assistant professor of audiology and a fellow of the American Academy of Audiology, says many people with severe hearing loss could benefit from a cochlear implant. He tells WebMD that people with less severe hearing loss may be eligible for cochlear implants in the near future because of the high success rate.

Cochlear implants can treat severe hearing loss in people from infants to older adults. In adults, Hughes tells WebMD, the implants work best when the brain still remembers how to interpret sound signals. The longer a person waits to receive treatment, the less receptive the auditory system becomes. This makes the outcome more difficult to predict.

Atcherson points out that adults need to have realistic expectations about how they will hear with a cochlear implant, especially in the beginning. At first, he had trouble distinguishing voices. "But in those first two months and the next two years, my brain adjusted. Music sounded better, speech was clear, and I got to the point that I use a cell phone."

While cochlear implants are not right for everyone, they have "a lot of potential to make a huge difference in someone's life," Atcherson says. "If someone makes the decision and they are self-motivated to get a cochlear implant, I recommend doing it as early as possible."

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