Step 2: Know Your Treatment Options
The type and degree of your hearing loss will determine which treatment your audiologist or ENT recommends. Here are some of your options.
Hearing aids are devices that fit inside or behind your ear. They don't restore hearing, they just electronically amplify the sounds going into your ear. "A hearing aid will never bring their hearing back to normal, but it will improve their ability to understand speech and to hear the sounds their hearing loss is masking," says Hull Bell.
Your audiologist will use the information from your audiogram to choose the best hearing aid for you. Then the hearing aid will be programmed to accommodate your type and degree of hearing loss. Some hearing aids amplify the higher frequencies to improve speech recognition. Other hearing aids can be programmed to accommodate for specific situations, such as noisy or quiet environments.
Lastly, your audiologist will test the hearing aid in your ear to make sure the amplification works for you. You can also customize your hearing aid further by adding one of these options:
- Directional microphones boost the sound coming straight at you so that you have an easier time hearing conversations.
- A telephone switch ("T" setting) filters out background noise while you're on the phone. You can also use the "T" setting with the listening systems available in many public facilities to help you hear plays, concerts, meetings, and worship services.
Cochlear implants are electronic devices that create the sensation of sound by directly stimulating hearing nerves in the inner ear.
The benefits of cochlear implants can be dramatic, but they're not for everyone. "It's for those people who really cannot get good benefit from hearing aids," says Hull Bell.
It's important to remember that a cochlear implant isn't like a hearing aid. It doesn't amplify what your ears are hearing. Instead, it bypasses your ears and directly stimulates the auditory nerve, which sends the signal straight to your brain. Although cochlear implant surgery is considered to be safe, it is still a surgical procedure. So be sure to talk with your doctor about the risks.
A new technology that combines a cochlear implant with a hearing aid in the same ear is being tested in clinical trials. This technology may help certain patients with high-frequency hearing loss and some residual hearing in the low frequencies. Researchers are still testing these devices with the goal of improving hearing across the spectrum.
The sound you hear with a cochlear implant is not the same as normal hearing. However, with time and practice a person's performance ability improves. Many cochlear implant users report being able to hear very well in quiet environments. They also show significant improvement in hearing in noisy environments. Many use landline and cellular phones, and enjoy music again.
Performance with cochlear implants improves with time and practice. At first, someone might perceive that voices are present but may not be able to understand those voices very well. The brain will adapt, and this adaptation may improve if the user participates in aural rehabilitation.
Although there is a wide range of performance, most people with cochlear implants are satisfied with the results and can actively participate again in the hearing world.
To determine if you qualify for cochlear implants, you'll undergo a thorough hearing loss evaluation. Your ENT will also examine you to make sure you're healthy enough to go through the implant surgery.
Middle ear implants are an option for people who either can't tolerate or don't benefit from hearing aids, but whose hearing loss isn't severe enough for a cochlear implant.
Here's how it works: You wear an external microphone above your ear that picks up sound. The sound is converted into electrical signals, which travel through the skin to an implant that is attached to the tiny bones of the middle ear. The implant enhances the vibration of the middle ear bones and sends those amplified vibrations to the inner ear. Finally, the nerve signal is sent to the brain, where it is recognized as sound.
You can adjust the middle ear implant much like you would program a hearing aid or cochlear implant.
Middle ear implants may not be covered by insurance and can be quite expensive. Once the implant is placed, a person cannot have an MRI scan without removing the implant.
Auditory brain stem implants (ABIs) are different from cochlear implants. Instead of placing the stimulator in the cochlea, an ABI is placed directly on the surface of the brain.
Right now, ABIs are only being used in a small group of people who have a missing or nonfunctioning cochlear nerve. This is usually the case for people who have a rare inherited disorder called neurofibromatosis type II (NF-2). Outside the U.S., auditory brain stem implants are being placed in both adult and pediatric patients without NF-2.