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Say What?! A discussion on hearing loss, hearing aids and implant options

Why Talk About Hearing? • Hearing loss is the 3rd most prevalent disabling condition

with advanced age (#1 Arthritis, #2 Hypertension)

• About 20% of adults in the U.S. (48 million) report some degree of hearing loss

• 60% of the people with hearing loss are either in the workforce or in educational settings

• In older people, a hearing loss is often confused with, or complicates, conditions such as dementia.

• About 2-3 out of every 1,000 children are hard of hearing or deaf

• Some hearing loss can be PREVENTED.

Available from Internet on January 21: http://www.hearingloss.org

Why Talk About Hearing?

“Blindness separates us from things, but hearing loss separates

us from people” – Helen Keller

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Overview

1. How the ear works

2. Hearing evaluation process

3. Interpretation of the hearing evaluation

4. Current hearing aid technology

5. Communication strategies

6. Community resources

HOW THE EAR WORKS

Two Systems Peripheral System consists of:

– The Outer Ear

– The Middle Ear

– The Inner Ear

The Central System

– Brainstem

– Auditory Cortex (Temporal Lobe)

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Three Parts of the Peripheral System

Available from Internet on January 21: http://enriquem12bio.wikispaces.com/5.+THE+STRUCTURE+AND+FUNCTION+OF+THE+HUMAN+EAR

Peripheral Auditory System

Available from Internet on January 21: http://enriquem12bio.wikispaces.com/5.+THE+STRUCTURE+AND+FUNCTION+OF+THE+HUMAN+EAR

Systems of the Inner Ear

Available from internet on January 21: http://hyperphysics.phy-astr.gsu.edu/hbase/sound/eari.html

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Normal & Abnormal Outer Hair Cells

Available from internet on January 21: http://www.pnas.org/content/97/13/6939/F1.expansion.html.

Primary Auditory Cortex

Available from internet on January 21: http://dspace.jorum.ac.uk/xmlui/bitstream/handle/123456789/965/Items/SD329_1_section17.html Available from internet on January 21: http://en.wikipedia.org/wiki/File:Primary_auditory_cortex.PNG

HEARING EVALUATION

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Warning Signs of Hearing Loss

• Asking for repetition

• Turning up the TV

• Tinnitus that is constant or occasional

• Slight muffling of sound

• Speech is difficulty to hear in noisy social environments

Complete Hearing Evaluation Tests often included:

– Collection of case history

– Otoscopy

– Immittance testing

– Pure tone testing

– Speech testing

Immittance Testing

• Used to test the status of the middle ear system

• This is NOT a hearing test!

• Three measurements:

– Tympanometry

– Acoustic reflex

– Acoustic reflex decay

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Pure Tone & Speech Testing • Conducted in the sound booth

• Air Conduction vs. Bone Conduction

• Several beeps will be presented at varying pitches and volume levels

• Goal: find the softest level that you can hear at each pitch

• Speech Testing

• Repeat a list of words for each ear

• Goal: understand the difficulties experienced by the patient when understanding speech

Classification of Hearing Loss

Types of Hearing Loss

Three types of loss

– Sensorineural

• Cause of loss is located in the inner ear or 8th nerve

– Conductive

• Cause of the loss is located in the outer or middle ear

– Mixed

• Cause of the loss is both a conductive and sensorineural

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Causes of Conductive Hearing Loss

• Fluid in the middle ear from colds

• Allergies

• Impacted earwax

• Foreign body in the ear canal

• Otosclerosis

Causes of Sensorineural Hearing Loss

• Noise (exposure to loud noise)

• Aging (presbycusis)

• Genetic hearing loss

• Head trauma

• Virus or disease

• Combination of causes

Degree of Hearing Loss

Mild Hearing Loss 26-40 dB

Moderately Severe 56-70 dB

Normal Hearing 0-25 dB

Moderate Loss 41-55 dB

Severe 71-90 dB

Profound > 90 dB

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Configurations of Hearing Loss

• Shape of the hearing loss

• Types of configurations

http://hubpages.com/hub/The-Best-Hearing-Loss-Simulations-Understanding-Audiograms-and-the-Impact-of-the-Speech-Banana

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Current Hearing Aid Technology

Hearing Aid Styles

Behind the Ear Receiver in the Ear

Half Shell ITE Completely in Canal Full Shell ITE

Lyric

Available from internet on May 20: http://www.phonak.com/

Different Levels of Technology

Economy Basic Advanced Premium

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Current Implant Technology

Types of Implants • Middle Ear Implants

• Moderate to severe sensorineural hearing loss

• Auditory Brainstem Implant • Typically used for patients with neurofibromatosis 2

(NF2)

• Bone Anchored Hearing Aids (BAHA) • Adults or children with conductive hearing loss

• Cochlear Implants • Adults or children with severe to profound

sensorineural hearing loss

Available from internet on May 20: www.hearlifeclinic.ae

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Available from internet on May 20: speech-language-pathology-audiology.advanceweb.com & sciteech.com

Available from internet on May 20: umm.edu, ais.southampton.ac.uk, www.midwesthearingconsultants.com, www.audiologyonline.com

Available from internet on May 20: mommyspeechtherapy.com, gigaom.com

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Community Resources

Utilize Community Resources Places that offer Assistive Listening Devices:

• Movie theaters

• Churches

• Century Link Center

• Orpheum Theater

Available from internet on May 20: https://marcustheatres.com/Movie/Captions/

Other Assistive Technology • Alarm Clocks

• Fire/CO Alarms

• Weather Alert

• Television

• TV Ears, Closed Captioning,

Amplifiers

• Telephones/Cell Phones

• Amplified ringers, visual alerts, vibrating alerts, amplified phones, Bluetooth connections

Available from internet on January 21: http://www.harriscomm.com/equipment.html

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Community Organizations

Other Resources:

• Nebraska Commission for the Deaf and Hard of Hearing (NCDHH)

• Nebraska Department of Education Vocational Rehabilitation (VR)

• Assistive Technology Partnership

• Local Hearing Aid Banks

• Sertoma, Lion’s Club, HearU

Questions?

Ashton Lampe, Au.D.

Phone: (402) 559-5208

Email: alampe@nebraskamed.com