Hearing Aid

From Anvita Health Wiki

Contents 1 More Specific Terms 2 Introduction 3 Notes 4 More General Terms 5 Additional Terms 6 References

More Specific Terms

• bone-anchored hearing aid (BAHA)
• Inteo hearing aid

Introduction

• An electronic amplifying device worn in the ear designed to provide assistance for patients with hearing impairment. It consists of a receiver, an amplifier & a microphone.

• Advantages:

• improved social function
• improved emotional well-being
• improved communication function
• diminished depression
  

• Helpful: understanding speech, listening to television, movies
  
• Not helpful: in noisy or crowded situations
  
• Types of hearing aids:

• behind the ear
• completely in the canal
• in the ear
• body worn
• hand-wired system such as Pocket Talker*
• 1st completely implanted hearing system (Esteem) [4]
  

• * least expensive
  
• Hearing aid selection:

• based on formula that uses threshold measurements
• considerations

• gain averages across all frequencies, selected to match degree of loss
• frequency response chosen to differentially amplify specific frequency regions which may be differentially impaired
• maximum output should be chosen according to the of the patient's dynamic range
  

• Barriers to successful hearing aid use:

• cost (largest obstacle $700-2500 in 2001)*
• lesser self- perceived handicap
• higher levels
• older age
• greater speech recognition threshold gains
• worse vision
• social stigma from wearing hearing aids
  

• * Medicare does NOT cover hearing aids
  
• Additional potential barriers:

• difficulties with the small controls due to arthritis
• excessive feedback from earmold fittings
  

• Characteristics of patients more likely to use a hearing aid:

• those who have hearing difficulty with background noise
• those who assess their hearing as < 70% of normal
  

• Adjustment may take weeks to months & is motivation-dependent. Involvement of a hearing aid specialist for identification of appropriate equipment & training & counseling.
  
• Physician-patient interaction:

• minimize background noise
• use good lighting
• face the person at eye level
• encourage patient to wear their hearing aid to office visits
• speak clearly, rather than shouting
• use gestures & write down important instructions
  

• Expected lifetime of a hearing aid is 3-5 years, although some hearing aids may last longer [3]
  

Notes

• best functional communication with hearing aids is facilitated by 3-6 counseling sessions with the patient & partner/ caregiver

• caregiver alone may be adequate if patient is cognitively impaired
• sessions cover personal adjustment, operation & use of the device
• sessions establish realistic expectations
• instructional brochures that accompany the device are generally not helpful [3]

• the FDA requires that hearing specialists obtain a written statement from the patient confirming that his/her ears have been medically evaluated & that the patient is approved for fitting of a hearing aid

• the statement mus be signed by a licensed physician at dated within the previous 6 months
• most diseases of the middle ear that result in conductive hearing loss may be treated medically or surgically

• stapedectomy for otosclerosis
• ear irrigation for impacted cerumen
• antibiotics for chronic otitis media

• patients >= 18 years of age may sign a waiver for medical evaluation, but this is to be discouraged [3]

More General Terms

• device (medical device)

Additional Terms

• cochlear implant
• hearing loss (hearing impairment, hard of hearing, HOH)

References

1. Stedman's Medical Dictio&nary 26th ed, Williams & Wilkins, Baltimore, 1995
2. Mangione C. In: UCLA Intensive Course in Geriatric Medicine & Board Review, Marina Del Ray, CA, Sept 12-15, 2001
3. Geriatrics Review Syllabus, American Geriatrics Society, 5th edition, 2002-2004; 7th edition 20102
4. FDA NEWS RELEASE March 17, 2010 FDA Approves First Totally Implanted Hearing System Esteem approved to treat sensorineural hearing loss [1]
5. Hearing Aids [2]

hearing aid