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The Lifespan of a Hearing Aid

How Long Do Hearing Aids Last?

One of the most common questions we hear during a hearing aid consultation is “how long will these devices last?” It’s a smart question to ask given the investment that is required for a new pair of hearing aids. Many long-term hearing aid users will also start to worry that their devices will fail suddenly, leaving them without sound.

The average hearing aid user will upgrade their technology after 5 to 6 years. Some people will continue to use a hearing aid for 8-10 years, while others will choose to buy new technology after just two years. Let’s take a look at what might affect how long someone uses a hearing aid:

  1. Repairs: Like all electronics, hearing aids are more prone to requiring repairs the older they are. After the initial manufacturer’s warranty expires on the hearing aid (typically at 2 to 3 years), all repairs are out-of-pocket costs. Depending on what has gone wrong, repairs can range from $50 to $300+. In most cases, frequent repairs also mean time spent without the hearing aid, which can be very difficult for people who have grown dependent on their amplification. If repairs become too frequent, a person may opt to put their money towards updated technology. Also keep in mind that eventually, a manufacturer will run out of replacement parts for older models of hearing aids, so it become more difficult to get an 8-10 year old hearing aid repaired.
  2. Updates to technology: Hearing aid technology turns over very quickly. Most manufacturer’s release at least one new product every year, if not more often. It usually takes about five years for someone to notice a significant increase in sound quality and functionality of the hearing aid in order to justify upgrading technology.
  3. Loss/Damage: New hearing aids usually have a loss and damage warranty for 1-3 years. During that time, if you lose a device, the manufacturer will replace it with a new one for a small fee. Outside of the warranty, if you lose the hearing aid, you have to purchase a new one to replace it.
  4. Hearing changes: Most hearing aids can be reprogrammed to fit a large range of hearing levels. In rare instances of severe and sudden hearing deterioration, it is possible that someone would need to purchase a power device, which would be a new hearing aid designed to fit worsening hearing.

 

If you are wondering if newer hearing aids are appropriate for you, or you are noticing increased difficulties hearing, it’s a good idea to visit your audiologist. He or she can make recommendations for improving your current devices or moving forward with purchasing new technology. Remember that this is your journey, so don’t be afraid to ask questions and state your preferences. We look forward to helping you along the way.

Types of Hearing Loss: Conductive, Sensorineural, and Mixed

What Kind of Hearing Loss Do You Have?

As described in our last blog post, the human ear can be divided into three general parts: the outer ear, the middle ear, and the inner ear. Hearing loss can occur in any, or multiple, parts of the pathway from the ear to the brain. Depending on where the hearing loss is occurring, hearing loss can be classified into three different types: conductive hearing loss, sensorineural hearing loss, and mixed hearing loss.

Note that in order to determine the type and degree of hearing loss, an audiologist would perform a hearing test and graph the results on an audiogram. In addition, different types of hearing loss require different types of intervention. Make sure to discuss all of your options with a medical provider.

  • Conductive hearing loss occurs when sound cannot be transmitted from the outer ear, to the ear drum, and into the middle ear space (where the smallest bones in the human body, the ossicles, are located). This type of hearing loss can often be corrected medically or surgically. Common causes of a conductive hearing loss may include:
    • Middle ear infection (otitis media)
    • Earwax (cerumen) impaction
    • Fluid or pressure in the middle ear from colds or allergies
    • Poor Eustachian tube function
    • Perforation in the eardrum
    • Head trauma
    • Swimmer’s ear (otitis externa)
  • Sensorineural hearing loss happens when there is damage to the inner ear (the cochlea) or to the nerve pathways from the inner ear to the brain. This is the most common type of permanent hearing loss. And even when speech is loud enough to hear, it may still be unclear or sound muffled. Common causes of a sensorineural hearing loss can include:
    • Aging
    • Exposure to loud noise
    • Genetics (hearing loss that runs in the family)
    • Drugs that are toxic to hearing
  • Mixed hearing loss occurs when a conductive hearing loss happens in combination with a sensorineural hearing loss. In other words, there may be damage in the outer or middle ear as well as damage in the inner ear or auditory nerve. Common causes of a mixed hearing loss can include any combination of the other issues listed above.

 

All About Ear Anatomy

Anatomy and Physiology of the Auditory System

The auditory system consists of several main parts that help carry sounds/signals to the brain. Although hearing seems like a simple feat, the transduction of a signal through the auditory system up to the brain is quite complex.

The Outer Ear

Beginning with the outer portion of the ear, the pinna helps pick up sounds and funnel them into the ear canal, anatomically known as the external auditory canal. The pinna helps individuals localize where sounds are coming from. Sound then travels down the ear canal where it eventually reaches the eardrum, or the tympanic membrane. The tympanic membrane is a thin membrane of skin that vibrates with sound stimulation.

The Middle Ear

Once sound vibrates the tympanic membrane, sound is transferred across three bones (ossicles) in the air filled middle ear space. These ossicles are the tiniest bones in the body known as the malleus, the incus, and the stapes. The stapes bone is shaped like a stirrup and has a round footplate. These three bones work together as a lever system to mechanically transduce sound through the middle ear to the inner ear. As sound reaches the stapes, the footplate pushes on what is referred to as the oval window. This window is the beginning of the inner ear system.

The Inner Ear

After sound reaches the oval window, the stimulation causes fluid in the inner ear system to move. The inner ear is a fluid filled space and therefore sound is hydromechanically transduced. Within the inner ear is an important hearing organ called the cochlea. The cochlea is a snail-shaped organ which has many tiny receptor hair cells embedded in a basilar membrane which respond to certain frequencies of sound. This is known as tonotopic organization in which the base of the membrane in the cochlea responds to higher pitches and the apex responds to lower pitches. As the hair cells are stimulated by the fluid moving in the cochlea, neurons attached to the hair cells receive the signal then send the auditory signal along the auditory nerve and up to the auditory cortex in the temporal lobe of the brain. Although we perceive and interpret sound within milliseconds, the pathway that sound travels to get to the brain is very complex, as detailed above.

There is much more detail related to the process of hearing and understanding, but the above is a basic overview of how individuals hear and interpret a signal. For a more in depth explanation, watch the links below.

The Connection between Hearing and Balance

Why Test My Hearing If I Have Vertigo?

As our name suggests, Jacksonville Hearing and Balance Institute helps patients with hearing and balance/dizziness issues. But how are hearing loss and dizziness related? If you have scheduled an appointment because of your dizziness, why would you need to have your hearing evaluated?

The answer to the above questions lies within the anatomy of our inner ear. The hearing and balance organs are both housed in the inner ear. The cochlea is necessary for hearing and the semicircular canals are part of our balance system.

There are multiple disorders that can cause disruptions in our hearing and balance. The type and configuration of hearing loss can help our providers better diagnose your dizziness. Meniere’s disease is one example of a disorder that is defined by the dizziness you are experiencing and the type of hearing loss that you may have. A patient with Meniere’s disease can experience dizziness for 30 minutes to multiple hours and have fluctuations in their hearing accompanied by a roaring tinnitus. Semi-circular Canal Dehiscence is another disorder that can be accompanied with hearing loss. A patient with SCCD may have a slight conductive component present on the audiogram even though they may not perceive a hearing deficit.

Jacksonville Hearing and Balance provides a comprehensive evaluation to help diagnose and treat your hearing loss and/or dizziness. For questions or to schedule an evaluation, you can reach us at (904)351-1904.

I Can Hear My Family, But I Can’t Understand

Hear for the Holidays

As the holidays draw near you may find yourself concerned with your ability to hear family and friends at holiday parties and gatherings. Many people often report that they can hear the conversation around them but can’t understand what people are saying or they state that people often mumble. This may be especially true in a crowded restaurant or room.

If this situation sounds familiar you may have a hearing loss in one or both ears. A type of hearing loss often seen in older adults is known as ‘presbycusis’. Presbycusis describes a pattern of hearing loss that manifests in the high pitch range. This means low pitched sounds (men’s voices etc) are easy to hear but high pitched sounds (women and childrens’ voices, birds, etc) are much more difficult to hear.

Speech is comprised of many different sounds and they all need to be heard well in order to understand conversation clearly. Low pitched speech sounds, such as vowels, bring the volume or the “power” to speech. High pitched sounds, such as consonants, provide the clarity to speech. In the case of presbycusis, an individual can hear the low pitched vowels but are unable to distinguish the high pitch consonants which results in being able to hear that someone is talking but not being able to understand what they are saying. In addition, listening in a noisy environment such as a party or crowded restaurant can be difficult, stressful and exhausting. The volume of the background noise often “washes over” the soft high pitched consonants making them even more difficult to hear. Also, when a hearing loss is present the brain has a harder time teasing out a speech signal from the unwanted background noise.

If you find yourself struggling to hear loves ones this holiday season call 904-399-0350 to schedule an appointment for a comprehensive hearing evaluation with an audiologist. You will be able to learn more about your hearing and the steps you can take to communicate more easily with friends and family.

WJCT Speaker Series: Hearing Loss & Cognition

WJCT Speaker Series

Jacksonville Hearing and Balance Institute (JHBI) is excited to partner with WJCT to host a speaker series this Friday, November 3rd, on hearing loss, cognition, and navigating the complicated world of hearing aids.

The event starts at 10:30am with an hour of free hearing screenings provided by two members of JHBI’s audiology staff. Hearing screenings are provided on a first come, first served basis so arrive early if you’re interested! Registration is open from 11:30am-12:00pm. The main speaking event, including a presentation and a question and answer session, will run from noon until 1:00pm. Complimentary lunch is provided.

Dr. Douglas Green Jr., the founder of JHBI and the practice’s neurotologist, will be speaking on the connection between hearing loss and cognitive decline. Dr. Kristen Edenfield, a clinical audiologist that has been with JHBI for over three years, will be discussing hearing aids as a treatment for hearing loss and how to navigate the world of amplification.

If you are interested in attending, please RSVP by November 1st at 5pm by calling 904-358-6322 or visiting wjct.org/jhbi.

October is National Protect Your Hearing Month!

This October is National Protect Your Hearing Month!

Over 12 million Americans have hearing loss as a result of exposure to noise, or noise-induced hearing loss. The audiologists here at Jacksonville Hearing and Balance Institute as well as audiologists across the country are encouraging individuals to protect their hearing by:

  • Wearing hearing protection when around sounds louder than 85dB for 30 minutes or more.
  • Turning down the volume when listening to the radio, the TV, MP3 player, or anything through ear buds and headphones.
  • Walking away from loud noise.

How Does NIHL Occur?

Noise-induced hearing loss is caused by damage to the microscopic hair cells which are found in the inner ear. They are small sensory cells that convert the sounds we hear into electrical signals that travel to the brain. Once damaged, our hair cells cannot be repaired or grow back, causing permanent hearing loss.

How Loud is Too Loud?

The loudness of sound is measured in units called decibels (dB). Noise-induced hearing loss is caused by prolonged exposure to any loud noise over 85 dB, such as concerts, sporting events, lawnmowers, fireworks, MP3 players at full volume, and more. A brief exposure to a very intense sound, such as a gun shot near the ear, can also damage your hearing.

An environment is too loud and considered dangerous if you:

  • Have to shout over background noise to be heard.
  • It is painful to your ears.
  • It makes your ears ring during and after exposure.

If you have decreased or “muffled” hearing for several hours after exposure, that is a sign of a temporary change in hearing, which can possibly lead to permanent hearing damage.

What Kind of Hearing Protection Does JHBI Offer?

To prevent noise induced hearing loss, the Hearing Center at Jacksonville Hearing and Balance offers a wide range of hearing protection devices that are custom-made to fit the unique curvature of an individual’s ear. These devices attenuate loud sounds and can be used in any environment that can potentially damage hearing sensitivity; from concerts, to sporting events, and even to the firing range.

If you are interested in meeting with an audiologist to discuss custom hearting protection options to fit your lifestyle, contact the Hearing Center at 904-399-0350 to make an appointment.

Noise-Induced Hearing Loss in the Military: A History

A Brief History

The introduction of the jet engine aircraft in the late 1940s and early 1950s raised concerns about hazardous noise and was one of the most important occurrences to the subsequent development of hearing conservation programs (Nixon, 1998). No sound of the jet engine’s magnitude had ever been routinely experienced in the military or by civilians. In 1952, the Navy conducted a study to evaluate the effects of the jet engine noise on personnel aboard the aircraft carrier USS Coral Sea. The study verified the seriousness of the high-intensity noise problem. In response to the problem, the NAS-NRC Armed Services Committee on Hearing and Bioacoustics (CHABA) was established in 1952 (Nixon, 1998). It was their job to examine the areas of (a) effects and control of noise, (b) auditory discrimination, (c) speech communications, (d) fundamental mechanisms of hearing, and (e) auditory standards. CHABA members were at the forefront of hearing conservation program (HCP) development. They began sponsoring and publishing reports related to noise in the military. They went on to publish a Memorandum No. 2 on “Hearing Conservation Data and Procedures” in 1956. The Memorandum described components of a hearing conservation program and provided recommendations for their implementation.

In 1956, the Air Force was the first to establish a comprehensive hearing conservation program. The Regulation was revised in 1973. Both were model programs after which many organizations within and outside the government were created (Nixon, 1998). In 1978, the Department of Defense Instruction (DODI) 6055.3 was published and contained requirements that attempted to make all hearing conservation programs uniform across services. By 1980, the three branches (Air Force, Army, and Navy) had established hearing conservation programs in compliance with DODI (Nixon, 1998). In 1987, the DODI was revised. The most current DODI is 6055.12, and ensures that all services have a hearing conservation program implemented and these programs should include: a) sound measurements, b) engineering control measures, 3) noise labels in hazardous areas/on equipment, d) issuance of hearing protective devices, e) appropriate education to all personnel working around hazardous noises, f) routine audiometric testing which is to be stored in the Defense Occupational and Environmental Health Readiness System (DOEHRS), g) access to materials, h) record keeping through DOEHRS, and i) program performance evaluations (DOD, 2010).

NIHL in the Military

Northeast Florida is home to many military installations, including Naval Air Station Jacksonville, Naval Station Mayport, Kings Bay Naval Base, Camp Blanding Joint Training Center, Naval Aviation Depot Jacksonville, and Marine Corps Blount Island Command, which together provide employment to more than 50,000 active duty, reserve, and civilian men and women. As of 2011, there were 2,226,883 military members in the United States serving (including active duty, National Guard, Air National Guard, and reserves). Within the military population, an estimated 60% of veterans returning home from war have a hearing loss (CDC, 2013). Disabilities of the auditory system, including hearing loss and tinnitus, are the third most common injury experienced by veterans (Helfer, Canham-Chervak, Canada, & Mitchener, 2010). As far back as World War II, handguns, rifles, artillery rockets, ships, aircraft carriers, vehicles, communications devices, and many more, have been sources of potentially damaging noise levels (Humes et al., 2006, p. 201). Hearing is critical to the performance of military personnel, and noise-induced hearing loss (NIHL) is a severe impairment that can potentially reduce military effectiveness.

Several studies have been conducted to document reports of military hearing loss and tinnitus and effects due to noise. Results from a study conducted in 2010 using data between 2003-2005, found that a total number of 88,285 hearing impairment and noise-induced hearing related injuries (NIHI) were documented—unspecified hearing loss, tinnitus, perforations of tympanic membrane, acoustic trauma, impairment of auditory discrimination, etc. (Helfer et al., 2010). Overall, NIHI visits were reported for 9.6 per 1000 personnel.

How Does NIHL Occur? How Can It Be Prevented?

            The How

Loud noises destroy the ear’s special cells, called “hair cells.” They lie within the sensory organ of the ear, called “the cochlea”. The cochlea cannot regrow new hair cells. Once they have become permanently damaged, they are no longer a useful part of the cochlea. Hair cells are important because they help translate sound into a signal the brain interprets, or “hears.” The hair cells can be damaged significantly by a single impulse sound — gunfire, for example, or by prolonged noise exposure at levels that are harmful to healthy hair cells (greater than 85 dB).

            Prevention

Prevention is key in helping to reduce the number of military members and veterans with NIHL. Hearing conservation programs are a step in the right direction. Hearing protection devices, such as passive and active earplugs and earmuffs will also aid in prevention when used properly. Engineering controls to help reduce excessive noise levels should also be implemented. Most importantly, education about the dangers of hazardous noise levels is paramount to further reducing the incidence of NIHL in military members and veterans. Over the past several years, all branches of the military have been making strides towards better education about hearing loss and taking steps towards providing the best hearing protection for soldiers.

For the general population, three strategies you can use for prevention are: 1) walk away- at further distances, dangerous noise levels are not as harmful to your ears, 2) turn it down- if you have the ability, make sure you are listening to things at safe levels, reference the dB level above, and 3) protect your ears- always have a pair of earplugs or muffs on hand when you go to concerts, loud sporting events, hit the shooting range, etc. And just remember, currently, there is no cure for hearing loss, so try to protect the healthy hair cells you have!

References:

DoD. 2010. Department of Defense Instruction 6055.12: DoD Hearing Conservation Program. Washington, DC: Department of Defense

Helfer, T. M., Canham-Chervak, M., Canada, S., & Mitchener, T. A. (2010). Epidemiology of hearing impairment and noise-induced hearing injury among U.S. military personnel, 2003-2005. American Journal of Preventative Medicines, 38(1S), S71-S77. doi: 10.1016/j.amepre.2009.10.025

Humes, L. E., Joellenbeck, L. M., & Durch, J. S. (2006) Noise and military service: Implications for hearing loss and tinnitus. Washington, DC: National Academies Press

Nixon, C.W. (1998). A glimpse of history: The origin of hearing conservation was in the military? Wright-Patterson Air Force Base, OH: U.S. Air Force Research Laboratory

 

What’s New With Cochlear Implants?

Advancements in Cochlear Implant Technology

In recent years, technology has become available that has allowed hearing aid users to connect their hearing devices directly to their Apple IPhone. This technology has allowed users to stream phone calls, stream media, and use their phone as a remote control without the need for an extra piece of equipment (neck worn device, etc.). Unfortunately, this option has not been available for cochlear implant users. However, with the release of Cochlear Americas’ Nucleus 7 sound processor, this is now a great option for IPhone and Cochlear Americas implant users.

 

But what about users without iPhones?!

Not to worry, there are still those “in-between” devices that will allow users to connect to their cell phones with Bluetooth. These types of devices are available to users of all three of the cochlear implant companies with which we work (Advanced Bionics, Cochlear Americas, and MED-EL).

If you or a loved one are a cochlear implant user looking to upgrade technology or if you are someone suffering from hearing loss and believe the cochlear implant may be the best solution for your hearing needs, contact our clinic at 904-399-0350.

 

Do I Really Need Two Hearing Aids?

The Benefits of Binaural Listening

The question regarding whether to purchase one or two hearing aids is an important topic to address with your audiologist during a hearing aid consultation. Hearing aids are an investment in your hearing health that can contribute to improved communication with family and friends and lead to better quality of life. Hearing aids are also a financial investment and it makes sense that many people want to weigh the benefits versus the cost.

In some cases one hearing aid truly is the best option. For example, a person may have a hearing loss in only one ear and normal hearing in the other ear. Another example is a person who has very little useful hearing in one ear; in this case a hearing aid may not provide any benefit at all and a cochlear implant may be the better option.  In most other cases if both ears have a hearing loss then two hearing aids are better than one.

Binaural hearing is the term used to refer to hearing with two ears (whether with two normal hearing ears or with two hearing aids). Bimodal hearing applies to people who wear a hearing aid on one side and a cochlear implant on the other ear. Studies have shown that binaural/ bimodal hearing have many benefits and leads to improved communication ability.

Detecting Location of Sound

The ability to detect where sounds are coming from is called “localization” and is a function of the brain that is dependent upon sound being heard well by both ears. The brain uses timing and loudness cues to determine which ear received the sound first and at which ear the sound was louder in order to determine where the sound is located. The brain is unable to detect the location of sound accurately with only one (amplified) ear.

Understanding in Noise

When sound reaches the ears, the signal travels to the inner ear and is then transferred to the hearing never. It then travels up the brainstem to the hearing centers of the brain. The brain analyzes and combines the sound heard from both ears to help “tease out” the speech signal from the unwanted background noise. If the brain only receives sound from one amplified ear it has much more difficulty separating speech from noise.

Louder Volume

When sounds are received by both ears the signal travels through multiple pathways in the brainstem. This double input of information to the brain creates a boost in the volume of the speech signal making it easier to hear. This boost or summation of volume does not occur with one ear.

Easier Listening

Studies have shown that when the brain listens with two ears, less effort is needed to hear and understand speech which helps to reduce fatigue.

For more information about the benefits of listening with two ears or about bimodal benefit for cochlear implant users call Jacksonville Hearing and Balance Institute at 904-399-0350 to set up a hearing aid consultation.