The most common form of hearing loss associated with ageing results from degeneration of a part of the inner ear which contains hair cells. As hearing deteriorates the ability to understand speech becomes more severely affected. Those affected may, as a result, begin to avoid social contact, and therefore become isolated and depressed.
Although the main cause of presbyacusis is ageing, there are other factors to consider. Some people may have a genetic predisposition to presbyacusis, systemic illness like diabetes etc may also have a role to play. Exposure to noise in earlier life will hasten the onset of noticeable hearing loss, and a history of middle ear disease may also contribute.
Most hearing loss occurs very gradually and you may not be aware that your hearing is deteriorating. If you think you might need hearing aids, the first thing to do is visit your ENT doctor.
How to treat
If you or family member suspects you may have a hearing-impairment, you should be transferred to an audiology clinic under the Ear, Nose and Throat (ENT) department for further tests. After examining the ear and doing hearing tests the diagnosis is made. If it is confirmed that you have a hearing loss, the audiologist or consultant will explain what treatment options are available.
Presbyacusis is incurable, but not untreatable. For most it will be a case of appropriate hearing aids.
A hearing aid amplifies sounds so that they are audible but not uncomfortably loud. It should be selected and set up to meet personal needs and degree of hearing loss.
What types of aid are available?
Hearing aids can be either digital or analogue.
Digital hearing aids
In truly digital aids, the sound is converted from analogue to digital form.
Digital hearing aids may include several features that are not found in analogue aids, such as systems for reducing:
and feedback (the annoying whistling sound that occurs when the sound generated by the aid leaks back to the aid microphone)
and the loudness of steady background noises, improving listening comfort
In addition, they may contain more sophisticated automatic gain control systems than analogue aids, and they may have directional microphones with enhanced directionality. Digital aids are also generally highly adjustable to suit the individual.
Analogue hearing aids
“Traditional” hearing aids are of this type. The term “analogue” means that they use conventional electronics. In these aids a microphone picks up sound, which is amplified using transistors, and is then reproduced by a miniature loudspeaker (receiver).
Digital programmable hearing aids
These are analogue aids that use a digital memory to select between various settings. This makes it much easier for the audiologist or dispenser to provide the user with a range of suitable settings for different listening environments. In some models, the user can select settings using a remote control. Programmable aids have a number of advantages. They can be more precisely tailored to the individual’s needs, settings can be changed and then restored and, as more settings may be available than in conventional analogue aids, more appropriate settings may be found for different situations.
Fitting a Hearing Aid
The hearing aid sits behind your ear and the sound is directed into your ear canal via a custom made ear mould.
Canal Aid-In the Ear
In-the-ear (ITE) aids fit entirely into the ear, filling the entire external part of the ear but with no components sitting behind the ear. Smaller versions of these fill only a small part of the external part of the ear, and are known as in-the-canal (ITC) hearing aids. Even smaller versions sit entirely in the ear canal, and are known as completely-in-the-canal (CIC) hearing aids. ITE hearing aids are not suitable for all degrees of hearing loss.
Body-worn (BW) aids consist of a small chest worn unit with a lead connecting this to an earphone and ear mould. Because of their size, these aids are easier to operate than other types, and can provide higher amplification.
A fairly recent development, the bone anchored hearing aid is helpful to patients who are unable to use a conventional aid. This may be for a variety of reasons, such as if the patient’s ears are absent or malformed, or if they have a disease that regularly causes the ears to discharge, clogging up their hearing aid. These types of aids works by transmitting sound through the bones of the skull to the nerves of the inner ear.
The aid is attached to a small titanium screw which is drilled into the mastoid bone behind the ear. The operation is quite simple and is carried out under local anesthetic. It takes about 30 minutes to perform. The screw is then left for three months to allow the bone to grow back, locking the screw firmly into place, after which a plastic socket is attached. The bone anchored hearing aid fits onto this, and can be easily removed for sleeping or bathing.
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