HEARING AIDS

Sound can be measured accurately. The term decibel (dB) refers to an amount of energy moving sound from its source to our ears or to a microphone. A drop of more than 10 dB in the level of sound a person can hear is significant. Sound travels through a medium like air or water as waves of compression and rarefaction. These waves are collected by the external ear and cause the tympanic membrane (ear drum) to vibrate. The chain of ossicles connected to the ear drumthe incus, malleus, and stapes carries the vibration to the oval window, increasing its amplitude 20 times on the way. There the energy causes a standing wave in the watery liquid (endolymph) inside the Organ of Corti. sound energy passes through the air of the external ear, the bones of the middle ear and the liquid of the inner ear. It is then translated into nerve impulses, sent to the brain through nerves and understood there as sound. It follows that there are five steps in the hearing process: air conduction through the external ear to the ear drum bone conduction through the middle ear to the inner ear water conduction to the Organ of Corti nerve conduction into the brain interpretation by the brain.

Conduction of sound
air conduction conduction of sound waves to the inner ear through the external auditory canal and middle ear. bone conduction conduction of sound waves to the inner ear through the bones of the skull.

Hearing loss
Hearing loss is any degree of impairment of the ability to apprehend sound.

depending on which part of the hearing pathway is affected..

Conductive hearing loss Sensorineural hearing loss Central hearing loss Functional hearing loss Mixed hearing loss

Conductive Hearing Loss

Conductive hearing loss is due to any condition that interferes with the transmission of sound through the outer and middle ear to the inner ear. This type of hearing loss can be successfully treated in most cases.

Sensorineural Hearing Loss

In sensorineural hearing loss, the damage lies in the inner ear, the acoustic nerve, or both. Most physicians call this condition "nerve deafness."

Central Hearing Loss

In central hearing loss, the problem lies in the central nervous system, at some point within the brain. Interpreting speech is a complex task. Some people can hear perfectly well but have trouble interpreting or understanding what is being said. Although information about central hearing loss is accumulating, it remains somewhat a mystery in otology (the medical specialty of ear medicine and surgery).

Functional Hearing Loss

Functional hearing loss involves a psychological or emotional problem, rather than physical damage to the hearing pathway. Individuals with this type of hearing loss do not seem to hear or respond; yet, in reality, they have normal hearing.

Mixed Hearing Loss

Frequently, a person experiences two or more types of hearing impairment, and this is called mixed hearing loss. This term is used only when both conductive and sensorineural hearing losses are present in the same ear.

Basic Hearing Aid Structure

Hearing Aid Types

Body Aids Behind-the-ear (BTE) In-the-ear(ITE) In-the-canal(ITC) Completely-in-canal(CIC) CROS and biCROS

BTE
Attached to earmold Powerful Wide range of HL Can have open earmolds Less repair problems Less feedback Telecoils

Disadvantages
Large size Does not take advantage of pinna and concha benefit Vulnerable to scalp perspiration Microphone above pinna

ITE
Fits in concha Microphone at ear canal level Mild to severe HL

Disadvantages
Visible Does not take advantage of pinna and concha One piece design Need some dexterity to insert

ITC
Only face sticks out into concha Wide range of HL Microphone at opening of ear canal Takes advantage of most of the auricle

Disadvantages
Easily dislodged Need dexterity for insertion/removal/adjustment

CIC
Hidden in canal Full effect of auricle Receiver very close to tympanic membrane so requires less amplification

Disadvantages
Patient needs very good dexterity to place and remove Easily lost because of small size Some circuitry not available in this size Feedback can be a problem

CROS
Contralateral routing of signal Use with good hearing ear a bad hearing ear Prevents head shadow effect Microphone at bad ear sends signal to good ear

biCROS
Used with bad hearing ear and poorer hearing ear Same routing of signal from poorer hearing ear Provides amplification to better ear

What is a Cochlear Implant?

A cochlear implant is an electronic device, that bypasses the damaged hair cells of the cochlea and stimulates the auditory nerve directly. It can provide the child with useful hearing and improved communication abilities in the implant user. It is a safe, reliable, and an effective treatment for profound hearing loss in children (and adults).

How do Cochlear Implants Work?

Cochlear implants detect sounds via an ear level microphone that sends these sounds to a wearable sound processor. The processor converts these sounds to tiny digital impulses that provide hearing sensations to the user. Some of the newest sound processors are small enough to fit behind a person's ear.

How do Cochlear Implants Work?

The electronic impulses from the processor are sent to a coil or transmitter (halfdollar sized) worn externally behind the ear over the implant. The coil sends an FM signal to the implant receiver, located under the scalp. The implant then sends these sound impulses to a number of tiny electrodes within the cochlea (inner ear).

How do Cochlear Implants Work?

These signals contain information about the frequency and loudness of speech and other sounds. The responses to these signals are then sent via the auditory nerve to the brain where they are interpreted as sound.