What are hearing aids?
Hearing aids make sounds louder. There are many different styles of hearing aids. And you can add special features to your hearing aids. But almost all hearing aids have these parts:
- A microphone, to pick up sound.
- An amplifier, to make the sound louder.
- A speaker, to deliver the sound into the ear.
What should I do if I think I need hearing aids?
You have some options if you think you have a hearing problem and are thinking about getting hearing aids. You can see your doctor or an audiologist and be fit for prescription hearing aids by a licensed hearing aid provider. But you might consider buying an over-the-counter (OTC) hearing aid.
If you choose to use an audiologist, he or she can help determine what type of hearing aid will work best for you. The audiologist will pick a hearing aid based on the type and how much hearing loss you have and other factors. He or she can help you learn how to get the most out of your hearing aids. In general, it usually is better to wear hearing aids in both ears, even if the hearing loss in the ears is not equal.
Prescription hearing aids need to be fitted by someone trained specifically in hearing problems. An audiologist or licensed hearing aid provider can make sure your hearing aids fit and work for your type and degree of hearing loss.
Over-the-counter hearing aids, which may be called personal sound amplification products, or PSAPs, may be an option if you have mild to moderate hearing loss. These are available without a hearing test. Read reviews of these devices online and choose one with good ratings.Be careful of low-priced OTC hearing aids.
You also need to consider cost. Hearing aids can be expensive, and they are not always covered by insurance. Be sure to ask about a return policy, in case you are not satisfied with the hearing aids, and any warranties.
What are the different types and styles of hearing aids?
Hearing aids differ in how they look, what size they are, where they are placed in the ear, and how much they can amplify sounds.
Most hearing aids use digital technology. They are programmed for your needs using a computer. Very few hearing aids use analog technology.
The size of a hearing aid is not a good indicator of its sound quality.
You can wear hearing aids behind your ear, in your outer ear, in your ear canal, or completely implanted in the ear. The kind of hearing aid you choose depends on many things, including your degree of hearing loss, your doctor or audiologist's advice, and what kind of hearing aid you want. See a picture of different styles of external hearing aids.
- Behind-the-ear (BTE) hearing aids: Most parts of BTE hearing aids are in a case that fits behind the ear. The case is connected to a plastic ear mold by a clear tube that wraps around the top of your ear. BTE hearing aids are used for all degrees of hearing loss, especially very severe hearing loss. BTE hearing aids can be made with special features, such as a telecoil that helps with hearing during phone calls and a directional microphone system that can help you hear voices in a noisy room. They may be better for children because of safety and growth reasons.
- "Mini" BTE (or on-the-ear) hearing aids: The mini BTE is a smaller version of BTE hearing aids. The parts are in a case behind the ear, but the case is smaller. And the tube connecting the case to the earpiece is almost invisible. Some mini BTE aids can have a very small earpiece that doesn't completely fill the ear canal. These are called "open fit" ear pieces. These ear pieces are less visible than the ear molds used with BTE hearing aids. Also, they reduce the feeling of fullness in the ear and can be more comfortable to wear.
- In-the-ear (ITE) hearing aids: The parts of the ITE hearing aid are in a case that fits in the outer part of the ear. It can be used by people who have mild to severe hearing loss. ITE hearing aids can be made with special features, such as a telecoil that improves hearing during phone calls and a directional microphone system that can help you hear voices in a noisy room. ITE hearing aids can be easier to handle than the smaller ITC and CIC hearing aids. Children do not usually use them because the case must be replaced as the child grows. Adults who have a certain type of severe hearing loss in both ears may have the option of a hybrid device that combines a cochlear implant and an ITE hearing aid.
- In-the-canal (ITC) and completely-in-the-canal (CIC) hearing aids: The parts of the ITC and CIC hearing aids are in a case that fits partly or completely into the ear canal. ITC and CIC hearing aids are used by people with mild to moderate hearing loss. They are made to fit the shape and the size of your ear canal. ITC hearing aids can be made with special features such as a directional microphone system that can help you hear voices in a noisy room. Both ITC and CIC hearing aids can be damaged by earwax and fluid draining from the ear, and their small size may be difficult for some people to handle. They are not recommended for children.
- Implantable hearing aids: For people with moderate to severe hearing loss who cannot wear an external hearing aid, an implantable hearing aid is an option. Different types of these devices are implanted surgically; others are implanted non-surgically. Because nothing is molded into the ear to block sound, some people say they hear better with implantable devices. Also, implantable devices do not create "feedback" noise. And the batteries tend to last a very long time.
Special features can be added to your hearing aids to help you hear even better.
- Bluetooth: Bluetooth technology allows you to connect your hearing aids to other electronic devices, such as cell phones, computers, and GPS devices.
- Directional microphone: This feature can help you hear better in a noisy place. A directional microphone will make sound coming from one direction louder than other sounds. For example, a directional microphone will make a person's voice coming from in front of you louder than sounds coming from behind you. This can help you have a conversation in a noisy restaurant.
- T-coil: A t-coil lets you switch between normal hearing aid settings and a telephone setting. This will help you hear better on a regular telephone.
- Direct audio input: This feature lets you connect your hearing aid to a TV, radio, or CD player. You plug it directly into your hearing aid.
- Feedback suppression: This feature will control the high-pitched sound some people get with hearing aids (feedback). Feedback happens most when a hearing aid gets close to a telephone or if your hearing aid is loose in your ear.
Disposable hearing aids that you use for a short period of time are also available. They last for 30 to 60 days. They may be an option for those who have mild to moderate hearing loss.
Will it be hard to adjust to hearing aids?
It may take from several weeks to months for you to get used to your hearing aids. You may find that:
- Sounds seem strange. It's good to remember that hearing aids will not make you hear like you used to. And nothing will ever sound completely normal. If noises are so strange or shrill that they are distracting you, tell your hearing aid provider before you leave the office.
- You hear things you haven't heard in a long time. For example, you may hear background noises (rustling papers, clinking silverware) much more clearly.
- You are more aware of sounds close to you. Your footsteps, heartbeat, or car motor may be much more noticeable. With time, your brain will get better at ignoring these sounds.
- Your hearing aids can be uncomfortable. But they should not be painful. Before you leave the hearing aid provider's office with your new hearing aids, make sure they fit. Your hearing aid should not hurt your ear or be loose in your ear.
- Sometimes your hearing aids will make a buzzing noise when you use a cell phone. This noise can be annoying, and it can make it hard to hear the person on the phone. If you use a cell phone, make sure your hearing aid provider knows. He or she can suggest hearing aids that work better with cell phones. And when you buy a new cell phone, buy one that is compatible with hearing aids.
Here are some general tips to help you adjust to your new hearing aids.
- Start by wearing your hearing aids when you are talking to only one person. These are the easiest conversations to understand. Slowly work up to conversations with more than one person.
- Continue to pay attention to people's gestures, facial expressions, posture, and tone of voice. Your hearing aids won't help you catch every word that is said, especially in a loud place.
- Wear your hearing aids. The more you wear them, especially at the beginning, the faster you will get used to them.
Other Works Consulted
- National Institute on Deafness and Other Communicative Disorders (2011). Ten Ways to Recognize Hearing Loss. Available online: http://www.nidcd.nih.gov/health/hearing/pages/10ways.aspx.
- Sweetow RW, Cascia T (2012). Aural rehabilitation and hearing aids. In AK Lalwani, ed., Current Diagnosis and Treatment in Otolaryngology—Head and Neck Surgery, 3rd ed., pp. 721–728. New York: McGraw-Hill.
Current as of: December 2, 2020
Author: Healthwise Staff
William H. Blahd Jr. MD, FACEP - Emergency Medicine
Kathleen Romito MD - Family Medicine
Charles M. Myer III MD - Otolaryngology