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ASK YOUR AUDIOLOGIST

1. I am missing sounds in few situations; does that mean I have a hearing Loss?
The first sign of hearing loss is if you are missing out few sounds in certain situations. Hearing Loss is undetectable at early stages as your brain can overcome the challenges of filling in the blanks where you have missed certain sounds. It is always advisable to evaluate your hearing and the situations where you are missing out sounds often. For a confirmation you can visit your Audiologist and take a simple Pure Tone Audiometry Test that will confirm your hearing levels.


2. What are normal Hearing Standards?
The Audiology Standards for normal hearing are obtained across the frequency range of 250Hz to 8Khz. An individual should be able to hear all sounds across this frequency spectrum at or below the level of 25dB to be considered having a normal hearing. Hearing Level of 25dB is the standard hearing level we follow in India for audiological evaluation.


3. What are different types of hearing losses?
There are 3 types of hearing losses. Conductive Hearing Loss, Sensorineural Hearing Loss & Mixed Hearing Loss. Basically there are three parts of the Ear namely: Outer Ear, Middle Ear & Inner Ear. Hearing Loss pertaining to Outer & Middle Part of the Ear is termed conductive Hearing Loss. Hearing Loss pertaining to Inner Ear is termed Sensorineural hearing Loss; and hearing loss corresponding to both middle and inner ear is termed Mixed Hearing Loss.

Conductive hearing loss is a result of pathology of ear or any kind of structural deformity in the outer or middle ear. This type of hearing losses can be treated with medicine or surgical intervention.

Sensorineural Hearing Loss is due to degeneration of hair cells in the cochlea or the inner ear or issues with the nerve which carries signals to brain. Primarily this type of hearing loss is common in the geriatric population where cell degeneration is observed. Hearing Loss due to ageing is called presbycusis.

Mixed Hearing Loss is a mixture of conductive and sensorineural components. If conductive pathology is ignored over a long period of time, it can lead to a mixed hearing loss.


4. What are the treatments available for Hearing Loss?

Treatments are dependent upon the type of hearing loss. Conductive and mixed hearing loss generally requires advice from the ENT Practitioner whereas pure sensorineural hearing losses requires an audiologist to prescribe Hearing Aid for the patient. Hearing Aids can be used for all types of hearing losses as these are alternative or rehabilitative treatments and does not involve any medication; however, in case of Conductive or Mixed Hearing Loss it is also important to understand the cause of the hearing loss and treat the same to avoid progression of the hearing deterioration.


5. What are the different Types of Hearing Aids?

There are two types of hearing aids: Digital hearing aids & Analog Hearing Aids. Digital hearing aids are hearing devices which can be tuned as per the hearing loss of the patient and analog hearing aids are hearing devices which have to be manually set by the patient himself.

Analog Hearing Aids Digital Hearing Aids
Cannot Be Programmed Can be programmed
These Hearing Aids Amplify all sounds hence clarity of speech reduces These hearing aids maintain a Signal to Noise Ratio wherein they filter speech sounds from Noise Sounds
There is no directionality criteria in these hearing aids These hearing aids understand from which direction the sound is coming relative to the position of the head thereby providing benefit in reducing the background noises during a conversation
Analog Hearing aids often damage hearing ability by providing over amplification These hearing aids don’t damage hearing ability as the device is tuned as per the requirement of the individual

6. How to choose the best Hearing Aid for my Hearing Loss?
Choosing the best hearing aids depends upon 4 broad parameters.

  • Hearing Loss of the Individual and discrimination ability
  • Lifestyle of the individual
  • Cosmetic requirements
  • Budget of the individual
Whereas while choosing the correct Hearing aids, the first two parameters are evaluated by the hearing professional, the 3rd & 4th parameters are for the patient to choose.

Before purchasing the hearing aid, one must understand that hearing aids are neither medicines not consumer products; hearing aids are alternative or rehabilitative treatments for the patients who may not get relief from medication or surgery for their hearing loss. Therefore choosing the hearing aids as per the loss and lifestyle of the individual is very important. Also, hearing aids provide stimulation of sound to the auditory part of the brain and help recover the loss of discrimination ability which happens as a result of hearing loss.


7. What are the different styles of hearing aids?
There are two families of hearing aids; Custom Made Hearing Aids and ready-made hearing aids.

    Custom Made Hearing Aids include:
  • IIC- Invisible in the canal hearing aid;
  • CIC- Completely in the canal Hearing Aid
  • ITC: In the Canal hearing Aid
  • ITE: Completely in the Canal Hearing Aid
    Ready Made Hearing Aids include:
  • BTE: Behind the Ear Hearing Aids
  • RIC: Receiver in the canal hearing aids

Custom family of hearing aids are also considered as cosmetic hearing aids because they are less visible to a viewer.


8. Are different Styles of Hearing aids for different types of hearing losses?
Yes; some hearing aid styles suit certain types of hearing losses for example for a patient with sloping hearing loss RIC hearing aid is more beneficial as it cancels out occlusion and resound. For a patient with a history of ear discharge it is not advisable to give an intra canal hearing aid as it may spoil the machine if discharge occurs. Also, for old patients with poorer reflexes and motor movements it is advisable to give a BTE hearing aid as it is easier to manage when compared to any custom hearing aid.


9. Should I wear Hearing Aids in Both Ears or only one is sufficient?
It depends on your hearing loss. If you have a hearing loss in both the ears then it is advisable to wear hearing aids on both sides to keep a balance of Right & left and get required amplification and stimulation in different challenging environments. However if you have hearing loss in one ear only then you have to use hearing aid on that side.


10. What is the best solution for unilateral hearing loss?
Unilateral hearing loss or hearing loss only on one side can be dealt with using any digital hearing aid, However if the loss is profound then one can go in for CROS hearing aid which involves a device on both the ears. In this, the signal from the poorer ear is transferred to the better ear and audibility is obtained.


11. Can Hearing Aid be tried before Purchase?
Yes, your hearing professional can arrange for a trial session of the hearing aid; however this hearing aid is often of standard indent. Customized hearing aids have to be ordered and are designed as per the measurement of the ear canal.


12. What is a life of a Hearing Aid?
All hearing aid companies provide a warranty of 2 years from the purchase date however you can easily extend the life of your hearing aid by maintaining them properly. Regular cleaning, safe keeping, using de-humidifier and protection from water are standard maintenance guidelines which need to be followed. The general feedback about the life of any hearing aid goes from 5-7 years.


13. If my Hearing Loss increases, do I need to change my Hearing Aid?
No. In case of a digital hearing aid, if your hearing aid has a maximum output which covers your hearing loss, the same hearing aid can be re-programmed to suit your changed requirement. Your audiologist/hearing professional shall be able to help you out with the same.


14. What is the care and maintenance required for a Hearing Aid?
You are required to clean the hearing aid regularly. Each hearing aid has a set of cleaning procedures which can be explained by your hearing professionals. The hearing aid is an electro-acoustic device, hence you need to protect the same from water; usage of de-humidifier is ideal for this purpose. One must change the battery of the hearing aid from time to time. General servicing of the hearing aid every year can help extend the life of the instrument.


15. How long does a hearing aid battery last?
Different types of hearing aids have different battery life. In general a custom digital hearing aid may have a battery life of 5-7 days and a digital BTE Hearing aid may have a battery life around 15 days.


16. Will use of Hearing Aids damage further reduce my hearing power?
No. A well programmed hearing aid shall help to stimulate your system better thus keeping it healthy, however use of analog or non-digital hearing aids may affect your hearing power adversely. Incase of a digital hearing aid, the progression of your hearing loss can be minimized considerably to several years.


17. I purchased a hearing aid but I am still not able to hear what to do?
You need to look at a few things. Whether the hearing aid is suitable for you as per your hearing loss and lifestyle; is the hearing aid programmed well by your hearing professional or audiologist. Also, you need to understand how well you are able to discriminate speech.

We often confuse our speech discrimination ability with our hearing ability. Although these two are a part of the same system but these may be different. Incase you are suffering from a discrimination loss as well then you need to be patient with the hearing aid as with stimulation over a period of time, the brain will recover its discrimination function.


18. Are Hearing aids water proof?
The industry is still working on the water proofing of the hearing aids. Nano shields for hearing aids are already in the market however these are good when providing resistance against limited water exposure. Prolonged exposure shall for sure spoil the circuitry of the hearing aid.


19. Is CIC Hearing Aid better than a BTE Hearing Aid?
Both CIC hearing aids and BTE hearing Aids have their own advantages and dis-advantages.
The table below shall be able to explain the difference:

CIC Hearing Aids BTE Hearing Aids
Low visibility provides cosmetic advantage This is visible
Sits in the Ear Canal hence you can utilize the Ear Shape which helps funnel sound in the ear Sits outside the ear hence utilizes dual microphone for directionality
Telephone usage is easy Telephone has to be adjusted over the ear near the microphone for better clarity
Lesser battery life More Battery life
Difficult to manage for old age people with poor motor coordination Relatively easy to manage owing to a larger size


20. I am wearing a Hearing Aid but there is no clarity of speech; what should I do?
You must consult your hearing professional for fine tuning your hearing instrument. Clarity in speech can be due to the instrument tuning or due to your own discrimination ability. If the clarity is due to the instrument then it can be easily fixed, however if it is due to your reduced discrimination scores then you need to patiently stimulate your ears with proper sounds for few weeks or months.


21. My child has a hearing loss; should I go for a hearing aid or should I wait for him to get older?
You must immediately go in for a hearing aid as your child in his/her learning stage must not miss the environmental sounds near him. These are the sounds which help him grow his communication abilities. Moreover, for children with hearing impairment, it is very difficult to follow classroom conversations leading to poorer representation in their grades and overall development. They may start shying away from discussions thereby excommunicating themselves partially from the society. This is a very unhealthy development for your child.


22. I am having a constant ringing sound in my ear, what should I do?
This constant ringing in the ear is called Tinnitus. It is important to evaluate tinnitus carefully as it can get really disturbing. You must consult your ENT doctor for they will be able to evaluate Tinnitus in detail. Audiological evaluation in this case will also be prescribed to determine if there is any understandable reason for tinnitus.

It has been observed that medicines and injections have lesser success rates to treat this constant ringing noise in the ears. In case the disorder is not treated with medicine, your audiologist or hearing professional can start therapeutic treatment known as tinnitus retrenchment therapy. The hearing professional can also help you with Tinnitus maskers which generate white noise to help mask the internal sound thereby re-training the brain to ignore the sound. This rehabilitative process is generally carried on for a few months to get desirable results.


23. I have a discharge from my ear, can I use hearing aids?
Yes you can use hearing aids however you must use BTE hearing aids as these will not be spoilt due to the discharge from the ear. Also, if there is a discharge, you must not ignore the same. Visiting an ENT practitioner can help solve the issue.


24. I have a stigma to use hearing aids, is there any invisible hearing aid option?
IIC or Invisible in the canal hearing aids are the latest hearing aids which can relieve you of all the stigma of a visible hearing aid. These hearing aids go very deep in the ear canal sitting just before the tympanic membrane or ear drum and are invisible from outside. These are easily removable devices and safe to use. You can wear them and forget them!


25. Is it advisable to use ear buds/Swaps to clean ears?
No it is not. There is always an inherent itch to clean the ears by oneself however since you cannot see what you are cleaning, you may push the ear wax further inside rather than taking it out. Ear has got a self-cleaning procedure of its own and you can leave it to that. If there is an ear ache you may consult your ENT for the same. As per olden belief it is not advisable to put any water or oil in the ear canal as you may be at risk of injuring your ear drum. At the max. you can clean the outer part of your ear after bath with a towel.


26. Can mobile phones, Bluetooth or ear-phones damage ears?
Yes. Excessive use of ear phones, head phones as well as mobile phones have shown to induce a temporary threshold shift which can lead to a permanent hearing loss in the long run. Best Avoided! However if you are a regular user of Phone or Bluetooth, it is advisable to take Audiometry test for hearing once in a year.


27. How can I prevent Hearing Loss?
Healthy Diet/Balanced Diet, proper Exercise, no excessive use of mobile phone or ear phone, aural hygiene, use of ear protection devices in challenging environments, regular check-up for monitoring the hearing ability can help prolong the health of your hearing.


28. What are the tests for determining a hearing loss?
Pure Tone Audiometry for adults and Brainstem Evoked Response Audiometry for infants are the two tests which can determine the status of hearing for an individual.


29. I have a normal hearing; can I undergo a hearing test?
Why not! It is always advised as a part of general health check-up that one must undergo a hearing test every year. Hearing loss is seldom detected in the mild stage; doing an audiometry shall confirm exactly your hearing thresholds.


30. I cannot tolerate loud sound, what should I do?
You may be suffering from “Recruitment”. It is advisable to consult an ENT doctor for the same as well as your hearing professional and get your audiometry tests done. For situations in which you are feeling the pinch of loud sounds, you must wear “Customized Ear Plugs” which can only be obtained from you hearing professional.


31. Can I use ready-made use & throw ear plugs?
No, read- made ear plugs are not advisable as they can cause more harm than benefit. Firstly these are not pertaining to your ear size so there is a chance of discomfort or pain. Secondly these may push the ear wax further inside the ear once you try to fit them in the ear canal which can lead to accumulation of ear wax leading to further problems. It is always recommended to use customized ear plugs made of soft biopore material available with your hearing professional.


32. I often get an ear ache and ear blockage while travelling in a flight, what should I do?
Ear blockage and resultant ear ache is due to pressure difference which is caused as a result of the altitude which the air plane ascends to. Chewing, yawning and valsalva manoeuvre are some of the techniques to release the blockage. You can also try customized ear plugs which can occlude the ear canal therefore disallowing pressure difference to some extent thereby reducing the discomfort due to pressure difference.