Common Questions and Answers About Hearing Loss and Hearing Aids

Questions about Digital Hearing Aids

Q. Why does my hearing aid squeal ?

A. Squealing from a hearing aid is called Feedback. It can result from sound leaking around the hearing aid and getting re-amplified. Wax in the ear can also cause feedback. With a hearing aid behind the ear instrument, cracked tubing in the ear mold can also cause feedback.

Q. Can digital hearing aids can eliminate feedback?

A. Yes, in many cases digital instruments can eliminate feedback. This is accomplished by comparing the returning signal to a static filter set that is stored in the hearing aid chip. If the returning signal is different from that stored image, a phase shifting of the signal occurs which stops the whistling. Different manufacturers have different methods for reducing the feedback.

Q. How do I know if I need a hearing aid?

A. Make an appointment to see an ear specialist or an audiologist. Your hearing will be evaluated and then you will be told if you could benefit from a hearing aid. Then a hearing aid evaluation might be set up where you could try a hearing aid for one month to determine if it would benefit you. Several counseling sessions are needed during that adjustment period to make sure the hearing instrument is adjusted properly and that you are doing what you are supposed to do.

Q. Can digital hearing aids help me hear better?

A. In most cases, patients report better understanding in noise with digital hearing instruments. The main reason is that digital products have the ability to continuously analyze the incoming sound signal and try to differentiate between noise and speech signals. Also units equipped with two or more microphones can also improve the signal to noise ratio, especially in noisy environments. The result is typically clearer speech.

Q. How much do digital hearing aids cost?

A. There are basically two factors that affect the cost..size and level of sophistication of the circuit. The smallest in the hearing aid is called a completely in the canal (CIC) and it is designed to fit deep in the ear canal and not be noticeable. It is the most expensive style of hearing aid because it is the hardest to build. Then there are varying degrees of sizes that get little bigger. The largest in the ear size is called a full shell in the ear (ITE). It fills the entire outer ear. Then there are of course behind the ear units that can accommodate more severe losses. Price can also be driven by the type of digital circuit ordered. The top of the line digital circuit has all of the bells and whistles included to try and help the user hear better in quiet and noisy listening environments. Then as you go down to the two other classes of digital hearing instruments, certain features like directional microphones (and some programming abilities) are eliminated to help hold down costs. Bottom line, what you need is determined by your listening environments and your personal desires. The price range can be from $2900 each for the top end digital CIC unit to $850 for older style in the ear (ITE) analogue (non digital) device with volume control.

Q. How do I pay for my digital hearing aids?

A. We do have financing available now that will allow you to pay for your digital hearing aids in two different ways. You can pay same as cash over 90 days, or finance them over 48 months. We can see if you qualify for financing immediately when you come into our office. If you would rather pay cash, we ask that you pay half of the total price at the time the hearing instrument order is placed, and then the other half when you are fitted with the devices. You of course have a 30-day trail period to decide if you like you're new hearing instruments.

SoundRecover – Add Understanding to Speech

SoundRecover is a proprietary Phonak (major manufacturer of hearing instruments) algorithm which compresses frequencies above a pre-calculated cut-off frequency and shifts them to a lower frequency range, thereby enhancing high-frequency audibility.

The proprietary algorithm which was initially developed in 2008,effec¬tively extends the audible range without creating annoying artifacts. Frequencies below the compres¬sion sensitivity point are amplified conventionally while only the high frequencies are compressed.

The overall benefits of SoundRecover algorithm should be increased detection, distinction and recognition of sounds. Patients should also experience a significant improvement in intonation, overall voice quality, improved hearing of high pitched sounds, and better speech understanding. Also most modern hearing instruments have a wide-band frequency response. However, due to receiver limitations, achieving audibility at frequencies above 6000Hz is very difficult even for milder hearing losses. SoundRecover technology technology helps overcome the industry wide receiver limitations by extending the audible range.

For chil¬dren, SoundRecover is designed to ensure that a greater number of high frequency cues are avail¬able thus aiding in the development of speech and language skills and continued audibility of important speech sounds in the classroom setting. To read about the most research studies on SoundRecover. There you will find a wealth of information to support this innovative technology.

Click here for SoundRecover Newsletter Summer 2011

Signs of Hearing Loss

It is easier to identify hearing loss in others than in yourself. People often blame their hearing difficulty on the speaker or the listening situation. However, if you can honestly look at your behavior, you can gain valuable insight.

Read through these questions to determine if you may have a hearing problem:

  • Do you frequently ask for words or sentences to be repeated?
  • Do you strain to understand conversation?
  • Do you often turn up the television or radio louder than others would prefer?
  • Do people often sound as though they're mumbling or speaking to softly?
  • When you are socializing, does background noise bother you?
  • Do you misunderstand what others are saying or answer questions inappropriately?
  • Do you remove yourself from conversations or social situations because it is difficult to hear what is being said?
  • Do you need to ask others about details of a meeting that you just attended?
  • Do you have difficulty hearing the doorbell or telephone?
  • Has someone close to you mentioned that you might have a problem with your hearing.

If you answered yes to any of these questions, you may have a hearing problem. The next step is to have your hearing evaluated by a hearing care professional.  An audiogram and medical examination of your ear(s), can explain your type of hearing loss and also determine if it can be helped medically, surgically, or possibly with hearing aids. 

Sudden Sensorineural Hearing loss (SSNHL)

By: Ellen R. Wilson, AuD, CCC-A, F-AAA

I remember the first time I saw the phenomenon of “sudden” sensorineural (nerve) hearing loss as a graduate student at UNC – Chapel Hill. The patient, a very pleasant 50-something lady, came into the clinic reporting she had become suddenly “deaf” in one ear. Thinking this was not probable, I immediately thought maybe she had a severe wax impaction or fluid behind the eardrum, but when I peered into her ears with my otoscope, both ears were completely clear. As I proceeded with my tests, she indeed did have an almost total loss of hearing for tones and no word recognition ability at all in that ear. Her other ear was normal.

I knew that differentiation between a conductive hearing loss and a sensorineural hearing loss was critical to her treatment and potential outcomes, so I rechecked my results thoroughly. I approached my supervisor with a bit of hesitancy as this was the first time I had seen this happen in a patient with no significant health history and with normal hearing a few days before. Indeed, it was a sudden sensorineural hearing loss and after her workup with ENT, radiological imaging, and course of treatment, she was just as she had initially stated, “deaf” in one ear and it had happened in a matter of days.

Fast forward 30 years later and this phenomenon is still one of the hardest hearing diagnoses to deliver, yet alone for the patient to receive, especially when the patient had normal or at least symmetrical hearing between ears just a few days before. Therefore, I wanted to revisit the topic because it is important to recognize and get medical care immediately. What follows is a typical scenario of “sudden” hearing loss, but as with other pathologies, there are variables as to onset, degree, and outcome.

You awake one morning and something doesn’t seem quite right. It may take you awhile to discern what the problem is. You realize that one of your ears seems blocked or stopped up and as you attempt to use the telephone on that ear, realize you are not hearing anything clearly. You may hear pronounced distortion, garbled speech, or hear nothing at all. This may or may not be accompanied by a feeling of aural (ear) pressure, tinnitus (ringing or roaring in the affected ear) and/or imbalance, dizziness, or actual vertigo.

Sudden sensorineural hearing loss is a MEDICAL EMERGENCY. “SUDDEN” is defined by an onset of 3 days or less. While varying degrees of hearing loss are reported in the literature, at least a 30 dB deficit or decline from previous hearing threshold levels across 3 octaves is the general definition. In most cases, it is a unilateral (one ear) phenomenon, but about 2 - 5% of cases are bilateral (both ears). There are no true gender differences. IMMEDIATE medical consultation is imperative to rule out potentially life threatening conditions (stroke, tumor), examine the possibility other medical conditions (Meniere’s, Multiple Sclerosis, Lupus, viral infections, etc.), and begin treatment RIGHT AWAY.

In some cases, the cause of the hearing loss cannot be determined, therefore deemed “idiopathic”. Idiopathic means "without explanation".
For most patients, this diagnosis is hard to take. If this happened so suddenly, there has to be a reason. How could I hear so well just a few days ago and now it is gone? While viral infections, autoimmune/immunologic conditions, vascular compromise, neurological entities, cochlear leaks/rupture, fistulas, and neoplasms (tumors) have been attributed, at times, it is impossible to pinpoint precisely what lead to this event. Whole chapters have been written on each of these categories, but less has been written on the nature of “idiopathic” hearing loss. Furthermore, sensorineural means just that, affecting the sensory hair cells in the cochlea or the neural fibers of the 8th nerve (cochlear nerve). This may be/become a permanent hearing loss.

Bloodwork, endocrine studies, and radiologic/nuclear imaging are performed to rule out threatening medical conditions. A complete audiological evaluation is necessary to determine type, degree, and prognosis of the hearing loss. Tapered steroid therapy seems to be most common and most reported treatment in the literature. “Shotgun” therapies (several systemic medications taken simultaneously such as steroid, anti-viral, and diuretic) address decreasing inflammation, fighting possible viruses, improving vascular circulation, and re-establishing the cochlear potentials in the endolymph, a fluid filling the inner ear. There seems to be a time window to the success of any treatment approach, therefore, it is imperative to get to an ear, nose and throat doctor (ENT) immediately, not waiting weeks to see if it gets better on its own. The best prognosis comes from starting treatment as close to the onset of the hearing loss as possible and as time progresses, there is less chance of recovery. This window of time closes by about four weeks. Also, while spontaneous recovery is possible, this is not the general rule with severe/profound sudden sensorineural hearing loss.

Possible outcomes are full recovery, partial recovery, or sustained/residual hearing loss of varying degrees. Regardless of the amount of recovery, it prudent to recheck the hearing in three months, six months and a year to monitor affected ear as well as the good ear. If there is partial recovery, hearing aid amplification may be beneficial to improve hearing in that ear. If the hearing loss is severe/profound or total, there are rehabilitative options: 1) CROS (contralateral routing of signal) hearing aid amplification - a hearing aid that transmits by a microphone worn on the deaf ear wirelessly to the good ear or 2) BAHA (bone anchored hearing instrument) for single sided deafness - a surgically implanted bone conduction device that transmits sound through the skull to the good ear. These options will only be discussed after all medical concerns are addressed and proper time allotted for recovery.

In sum, sudden sensorineural hearing loss is a medical emergency. The best hope for recovery of this hearing loss is immediate medical attention and treatment. Waiting to see if it clears up on its own may waste valuable treatment time and affect your longtime prognosis.

Tips For The Family Of Someone With Hearing Loss

A member of your family has a hearing loss. Here are some suggestions that may help you and your family member communicate better.

Should I shout?

No, this distorts your voice. Face your family member and talk in a normal or slightly louder speaking voice.

What about speaking from different rooms?

Your family member probably cannot hear you, and most likely cannot understand you when you are at a distance. DON'T TALK TO YOUR FAMILY MEMBER FROM ANOTHER ROOM! Remember to get their attention before you start talking.

Can people with hearing loss tell the direction of sound?

Some hearing-impaired people cannot tell the direction of a sound or voice. This is especially true when the two ears are very different or not balanced. When your family member calls you and asks "Where are you?" state the specific room instead of answering "here".

How should I repeat myself when I am not understood?

A hearing-impaired person has difficulty in understanding words. Your voice may be audible, but separate words may sound blurred. Rhyming words such as: cat/cap, bread/thread, etc. are extremely difficult to distinguish. When your family member does not understand you the first time you say something, do not repeat the same words. Instead, rephrase the sentence so that you may be more easily understood.

How does hearing loss affect the volume of sound?

A hearing loss changes the relative loudness of sound. Your family member may not hear things that are soft to you. Sounds that are comfortable to you may be soft for your family member. Loud or sudden noises, however, may be more uncomfortable or unsettling than for you.

Why does hearing loss cause one to speak louder?

Hearing loss can make it difficult for your family member to judge the volume of his/her own voice. Let your family member know when their voice may be too loud or too soft.

How do room acoustics affect someone with hearing loss?

Some rooms have better acoustics than others. Empty rooms with hard walls may cause speech to echo, thus making it more difficult to hear and understand what is being said. Your family member also may have difficulty when out-of-doors, where the sound is dispersed in the air or wind noise affects the use of hearing aids.

Do fatigue or illness affect hearing?

Yes, your family member may not hear as well as usual when tired or ill. This is because it may be difficult to put as much effort into attempting to understand speech.

Should lip-reading be used?

Even if you do not have formal training in lip-reading, we all make use of lip-reading (speech reading). This is by watching the speaker’s face and picking up on the visual cues. Try to converse in well-lit rooms. If glasses are needed, make sure they are used.

What about background noise?

Background noise almost always interferes with the understanding of speech. For people with hearing loss, it probably is the most difficult situation. Try to reduce the level of avoidable background noise when conversing. When in a restaurant, the person with a hearing loss should sit with their back against the wall; this helps reduce the interference of background noise. Also, sit at a table away from the kitchen or heavy traffic area.

Assistive Listening Devices

Assistive listening devices also cover such products as amplified telephones, alarm and alerting devices (alarm clocks, smoke detectors, doorbell alerts). ALDs have a primary goal of improving your ability to hear by making the desired sound stand out from the background noise.

Many new digital hearing instruments now come with Bluetooth™ capability. Bluetooth™ is an open wireless protocol for exchanging data over short distances from fixed and mobile devices, creating personal area networks (PANs). It is a short-range communication system intended to replace the cables connecting portable and/or fixed electronic devices. It allows the hearing aid users to stream audio signals straight to their digital devices from such items as cell phones, MP3 players, and televisions. In fact, most any device that is Bluetooth™ compatible can be paired with their hearing instruments. A recent Internet search, brought up a set of cordless V-Tech lanline phones (base station plus 3 handsets)for around $100 and a set of Motorola cordless handset phones (base station plus 2 handsets) for under $65.

Assistive listening devices also cover such products as amplified telephones, alarm and alerting devices (alarm clocks, smoke detectors, doorbell alerts).  ALDs have a primary goal of improving your ability to hear by making the desired sound stand out from the background noise.

If you are interested in ordering an assistive listening device, call one of the audiologists.  Central Carolina ENT has many different suppliers for ALD’s.

Hearing Aid Evaluation

The hearing aid evaluation appointment takes an hour and is mainly an information sharing session.  After a brief review of your hearing test, the various styles of hearing aids will be discussed and shown to you.  Normally you will then be given an actual hearing aid demonstration with an over the ear hearing aid.  This type of aid is used because it usually can be programmed to your hearing need and fitted to the ear immediately with a stock tip that fits into the ear canal. 

This experience will give you an idea of how amplification sounds in your ear(s) and how much clearer the speech can sound.  Family members may be asked to talk to you in a normal voice so that you can experience first hand how well your hearing has been improved with hearing aids.  You can also see how the audiologist uses the computer to program your hearing aids to your specific needs.

You might be asked to tell us about your listening needs.  This information is helpful in determining which type of digital processor you might need.  The most sophisticated digital processor will be needed to handle the most difficult listening situations.  But if you are not in a lot of noise, then a less costly and less sophisticated digital aid might be recommended for you.  There are normally four different priced hearing aids and our goal is to find one that will meet your hearing needs and budget.

Once it has been determined which style and level of technology you want, an earmold impression will be taken of your ears.  The impressions will then be sent to the manufacturer or earmold lab for processing.  In about two weeks, you will be called to return to our office for the fitting of the hearing aid(s).  You will be given a copy of the hearing aid payment policy which outlines the terms of the 45 day hearing aid trial period.  It is a company policy that the hearing aids are paid for in full at the time of the fitting.  Financing options can be checked out if you think you’ll need more time to pay for your hearing aids.

Types of Hearing Aids

CIC (Completely in the Canal)

This is the smallest type of hearing aid made and in some ears, is almost invisible.  All the components are housed in a small case that fits down into the ear canal.  People often like this style because it is less visible and “hides” in the ear canal. 

The advantages of this style is that the hearing aid utilizes the ear’s own natural sound collecting design (Pinna or outer ear) to collect and  funnel the sound down to the hearing aid.  The CIC aid also allows for normal telephone use most of the time and protection from wind noise as the microphone is recessed in the ear canal.

Because of its size, the CIC devices have a limited fitting range.  They can not be fitted on all ranges of hearing loss.  The person using this type of unit must have fairly good dexterity with their hands and fingers.  The CIC hearing aid is also more fragile and prone to getting plugged up with ear wax.  It also may not be able to be fitted in some ear canals that are extremely small or have severe bends or angles. 

ITC (In the Canal)

A little bigger than the CIC, the ITC hearing aids also fit far into the ear canal. Canal hearing aids use a slightly larger battery than the CIC style. This style is used for mild to moderate hearing losses.  It has the advantage of fitting deeply into the ear canal but may be more manageable by someone with reduced hand and finger dexterity.

These sizes can also accommodate directional microphones (in most cases) which help focus the sound in front of the patient and minimize the noise along side or behind the patient.  No volume controls are necessary in the ITC unit and different noise programs can be accessed by pushing a small button on the faceplate of the device.

ITE (in the Ear, Full Shell or Half Shell)

These hearing aids can be used for a wider range of hearing losses. Due to their larger size, ITEs can accommodate larger sound amplifiers and more features such as directional microphones and a memory program button. 

Directional microphones help the patient focus on the sound  in front and minimize the sound on the sides and behind the hearing aid listener. The memory button allows the hearing aid user to access multiple memories that process the incoming sound differently. They are also easier to handle.

BTE (Behind the Ear)

In BTE hearing aids, the electronics are housed in a case that fits behind the ear. Tubing and a custom made earmold direct the sound to the ear canal. Due to its robust design, this style is especially recommended for children.

BTE hearing aids can provide more amplification than smaller devices due to the stronger amplifier and the larger battery. This style is available in several colors for hair and skin tone matching.  The behind the ear unit can also be equipped with directional microphones to help focus the sound in front of the person and minimize the sound beside and behind the person.  The units also can have multiple memories included in the design, so that the user can go to a different noise program (via a button on the unit) that reduces background noise and makes speech easier to understand in certain listening environments.

Body Aid

Body aids are the strongest of any hearing aids.  A separate amplifier is clipped to a belt or shirt pocket and then a cord leads to a button type receiver in the ear.  The separation of the microphone and receiver allows the user to turn up the unit a lot higher before feedback (whistling noise) occurs. 

Open Ear Technology

For millions of Americans with mild to moderate high frequency hearing loss, new “open Ear” technology offers many advantages over traditional hearing aid fitting approaches. Typically older technology would block the normal hearing ranges while trying to boost the high frequency regions (2 to 6kHz).  The result left the hearing aid user with a plugged up sensation that made wearing hearing aids almost intolerable.

Thanks to advances in digital processing of sound, like the Resound Pulse hearing aid, sound can now be delivered to the ear at prescribed levels without the occlusion effect.  In the world of open fittings, true useable gain is the foundation of speech intelligibility.  A very small thin tube delivers digitally processed sound to the eardrum from a small processor located behind the ear.  This type of fitting, keeps the ear open to lower-pitched sounds that don’t need amplification.  Help can be delivered to the high frequency consonant regions because acoustic feedback can now be better controlled by digital feedback suppression routines that are the hallmark of “open fitting” technologies. The small processor and thin tubing is cosmetically appealing and the improved clarity, especially in the presence of background is a welcome benefit.  Learn More

Open Fit Hearing Aids

Open Fit Hearing Aids are called Open-Fit because they leave the ear canal open. They do not block or occlude the ear canal. This technology has become more popular because of the advancements in feedback cancellation. With Open Fit hearing aids, you eliminate the plugged up sensation. You’ll be able to hear the sounds that you hear now the way you’ve always heard them. These small devices are nearly invisible as the processor hides behind the ear and a small SLIM tube delivers the sound to the ear. The Open Fit technology allows for a clear, natural sound and only amplifies the sounds or frequencies that you have trouble hearing.

Typical Hearing aid Experiences in the Beginning

Depending upon your hearing loss, you may be hearing all sorts of sounds you have not heard for a long time. This can be somewhat overwhelming at first until your brain “toughens up” to certain types of sounds. Luckily digital hearing aids can be adjusted in many ways to keep loud sounds from not being too loud but keep soft sounds audible.

So it is important to report your initial hearing aid experiences (good and bad) to your audiologist so that proper adjustments can be made through the early stages of hearing aid adaptation.
Even the best digital hearing aids will not solve all of your understanding problems. Once the sounds leave the digital processor and pass through the middle ear and then on to the inner ear, hearing problems may still exist. This can be caused by the extent of your hearing loss. We have no control over how your inner ear processes incoming sounds. All the audiologist can do is to fit the hearing aids to the best possible settings for you and then review realistic expectations. We want you to understand what the hearing aids can do but also what they can’t do.

When you speak your own voice may sound quite different with hearing aids in place. In certain fittings, the Occlusion Effect, can cause your voice to sound like you are in an echo chamber. The reason for this is that some parts of your voice are trapped in the ear canal which in turn can cause the cartilage to vibrate.

This sensation often goes away in a short time after your brain adjusts to amplification. But it may persist if there are fitting issues that need to be resolved. For example, the air vent hole in the hearing aids may need tobe enlarged to help offset the occlusion effect. The units may need to be recased so that the tip can be shortened. There are many things that can affect the way your own voice sounds to yourself. Again, excellent communication with your audiologist is critical in making you a successful and happy hearing aid user.

Even after your initial trial period, it is most important to stay in touch with your audiologist. We recommend that you are seen every three months. These checkup appointments are very important so that your aid(s) can be cleaned and programs changed or adjusted if necessary. Also every year the hearing aids can be reprogrammed to account for changes noted in the annual hearing test. These type of services are free if your hearing aid is in warranty.

Digital Hearing Aids

Digital hearing aids boast today's most advanced technology. Digital hearing aids are programmable hearing instruments with digital circuits. These digital circuits are more flexible than analog circuits. The analog circuits increased the volume of all incoming sounds and sometimes made loud sounds too loud and soft sounds too soft. These types of circuits were also prone to feedback (whistling noise) and distortion. Digital circuits can be precisely programmed to match the patient's individual hearing loss, sometimes at each specific frequency/pitch. Digital circuits offer improved clarity of sound, less circuit noise, faster processing of sound, and improved listening in noise when compared to analog circuits. Digital hearing aids are easy to use because they adjust volume automatically.

Digital hearing aids represent the most advanced technology available today allowing the most precise prescriptive fitting available. Older analog hearing aids turned everything up, but digital hearing aids focus on clarity and comfort through sophisticated control of the sound signal inside the hearing aid.

If you think about the sounds that you can hear and sounds that you cannot hear, these sounds differ in pitch (ex. keys on a piano) and they differ in volume/loudness. Digital processing can shape your amplification (volume and clarity of signal which you hear through the aid) by changing pitches and changing volumes.

Digital hearing aids also offer many other feature like directional microphones and multiple programmable memories to enhance the user’s benefit in different listening environments. The key is the tiny computer chip that manipulates the incoming soundwaves according to logic principles supplied by the various manufacturers. The modern digital hearing aid can provide a hearing-impaired person with an improved and more pleasant sound picture. But it cannot bring back normal hearing. Even digital hearing aids are limited by many factors of hearing loss such as speech understanding abilities, extent of damage to the inner ear and entire auditory pathway. Like many other high-tech devices, high expectations can accompany digital hearing aid devices. Counseling patients as to the realistic expectations of digital amplification will continue to be most important. But the future looks bright as technology and processing schemes continue to improve.

How digital Hearing Aids work

In a very rough sense, the digital hearing aid has five major components: the microphone, the analog to digital converter, the core, the digital to analog converter, and the receiver. Sound waves hit the hearing instrument microphone where they are converted to an electrical signal (analog). The signal then passes through an Analog to Digital converter (A/D converter) where it is changed to a sequence of 1s and 0s. This sequence is sent to the "core" where it is filtered into bands and channels, then manipulated according to the programmed settings for the specific hearing loss. Each hearing aid manufacturer may have its own proprietary set of rules that it applies to the digital speech envelope. The manipulated signal is then channeled through a Digital to Analog converter (D/A) where the end result is an analog signal that has been manipulated according to the hearing loss and proprietary chip logic. This signal then travels to the receiver where it is converted back to an acoustic signal that the user then hears. In other words, the digital hearing aid has a tiny computer chip in it that can manipulate the sound according to specific frequency (pitch) and specific volume level to deliver a clear sound set precisely to the user's hearing loss. The dispenser or audiologist then has the ability to manipulate many aspects of the digital processor, like gain, compression (control the loudness of sounds), and acoustical feedback (whistling noise) through the computer interface. The result is a more precisely fit hearing instrument and a happier hearing aid user.

Cost of Digital Hearing Aids

People often ask why hearing aids are so expensive. One reason is that manufacturers put a great deal of time and money into research and development of the digital products. Another reason is that hearing aid industry is relatively small and a great majority of their products are custom made.

Prices for digital units can very from $1000 to $3000 each depending upon the processor selected You also must realize that the price includes the services of a highly qualified audiologist who will program and service your hearing aid(s) for the life of the warranty and beyond. What type of digital aid you might need might be determined by your listening needs. If you need to hear in crowds and in lots of demanding listening situations, the best noise reduction processor is what you may need. However if you have a fairly quiet life style, then perhaps a less sophisticated processor might be all you’ll need to hear better. Your audiologist will help determine which digital processor is best for you.

Custom Earmold Products

DOCS (pre-form)

DOCS Pro-plugs are used to help keep water out of your ears. They are also used to help decrease the amount of trauma to the eardrum for water skiers. They come in a variety of sizes.

Swimmer’s Ear Plugs

Floatable Swimmers Ear Plugs are custom made for your ears. They help keep water out of your ears and come in a variety of colors

Musician’s Ear Plugs and Monitor molds

Musician’s Ear Plugs are custom made ear plugs which reduces sounds equally across the frequency range. These are ideal for musicians who want to protect their hearing, but do not want the music to be distorted. Custom molds can be made for Monitors used by musicians to help them monitor their voice during a performance or rehearsal.

Noise Protection Ear Plugs

Noise Protection Ear Plugs are used to protect your hearing from exposure to loud sounds. Noise Induced Hearing Loss (NIHL) occurs in individuals who are exposed to loud sounds and do not protect their hearing. This damage to your hearing is irreversible. Ear Plugs help reduce the affects of noise on your hearing. They are recommended for anyone who is exposed to loud sounds in their environment, whether it is hunting, mowing the lawn, use of chain saws, target shooting, or working around loud machinery. They are custom made for your ears and are usually more comfortable than foam earplugs.

Custom Earpieces for Cellular Phones

Custom earpieces allow people to talk on their cellular phone while driving without putting themselves at risk for an accident or while working at your desk. They also improve the clarity by decreasing background noise. They are very lightweight and comfortable to wear.

Repairs and Supplies

Hearing Aids come with standard warranties and loss and damage coverages. The length of the warranty often is determined by the model of hearing aid that is purchased. When your initial warranty is about to expire, you can elect to extend that warranty for a certain fee. Sometimes you can also extend the loss and damage coverage. Be sure and check with your audiologist regarding the details in your particular case.

When a loss occurs, you might be asked to bring in a notarized statement. This document describes when and where the loss occurred and is submitted to the hearing aid manufacturer for processing. Normally there will be a deductible charge that ranges around $200. The replacement hearing aid will continue with the warranty terms of the lost hearing aid but it will no longer have loss coverage. You can obtain loss coverage again from a third party vendor if desired. Earmolds are not covered by loss and damage claims.

Most hearing aids can be repaired. However some units more than five years old, may be more expensive to repair. A standard repair warranty is typically one year long. With some custom in the ear aids, remakes may or may not be covered by a typical repair. With changes in technology, it is wise to have your hearing checked yearly to see if you could be better served with a newer hearing aid.

Central Carolina ENT sells batteries and other hearing aid supplies. Assistive listening devices (ALD’s) can often help individuals who can’t or won’t wear hearing aids. ALD’s, like FM systems, can often be coupled to current hearing aids and help pickup and focus in on sounds in noisy environments. Check with the audiology staff to see if we can find certain products that will enhance your listening experience.

Warranty and Service

All hearing aids come with at least a one year warranty and one year loss and damage coverage.  Many of the higher priced units will have a longer warranty and loss and damage coverage.  There is never a charge to be seen in the Audiology department if your aid is under warranty.  But we ask you to call first becoming in to the office as we want to take care of your needs promptly.   

When your initial warranty is about to expire, you do have the opportunity to extend the warranty and loss coverage for a certain period of time depending upon the make of your hearing aid.  Sometimes extended warranties will only cover repair services and not remakes of in the ear hearing aids.  Check with your audiologist to find out what coverage you have on your digital unit. 

How can I hear better in noisy environments with my hearing aids?


I wear a hearing aid, and I hear pretty well with it in quiet settings, however, I cannot hear well with it in noisy environments.  Given the high level of technology available today, as well as the cost of my device, shouldn't I be able to hear well with my hearing aid?


There are many factors which will affect how much benefit you derive from your hearing device(s), especially in challenging listening environments.  These would include the severity of your hearing loss, the audiometric configuration (the "shape" of your loss by frequency/pitch), your ability to discern the sounds of speech, your listening demands/lifestyle, your level of motivation, etc.

First and foremost, if you have hearing loss in both ears, it is crucial  (with very few exceptions)  that two hearing instruments be worn.   Hearing in noise involves auditory processes which occur when  input from both ears  is received. When only one ear is aided, these processes are hindered.  Hearing aid manufacturers are very aware of this, and they incorporate features in their technology which capitalize on the benefits of binaural hearing.  As an aside, binaural hearing is also necessary for determining where a sound is coming from, which can be pretty important in everyday situations, such as crossing the street!

Hearing aids typically also have multiple "programs" which can be tailored to your specific listening needs.  Some devices offer compatibility with your "smart" phone, which then allows you to use your phone to control program switching, bass/treble emphasis, volume, and even allow you extra help in a noisy restaurant by "zooming in"  on speech within a specified width in front of you.  Some devices allow you to a direct connection to your smart phone so that you can hear the caller in both ears, wirelessly, with no additional device to be worn around your neck, etc.

Other hearing aid compatible accessories can allow you to hear your television  via wireless transmission to your devices.  “Remote” microphone accessories and FM devices can improve the signal to noise ratio to allow for significant improvement in hearing in adverse listening conditions.

Lastly, there are some basic listening strategies you can employ to aid in speech understanding:

  • Face the person you are listening to, and utilize nonverbal cues
  • Ask for rephrasing, not just repetition of words missed.
  • When dining out, chose a table in a corner, if possible.
  • Chose restaurants with favorable room acoustics; avoid very high ceilings, lots of  glass and hard, uncarpeted surfaces.  These increase reverberation, which sounds like distortion.

Purchasing quality hearing technology is very important, as is appropriate follow up with an Audiologist you trust.  Don't forget to be patient with yourself as you acclimate to hearing better.  

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