Total Hearing Care
Audiologists
Types of Hearing Loss
Hearing Aids
Assistive Devices
Audiologic Rehabilitation
Total Hearing Care is the audiology division of the private medical practice Virginia Ear, Nose & Throat Associates. The practice consists of ear, nose and throat doctors (ENTs) or otolaryngologists, audiologists (hearing healthcare professionals), and highly trained clinical staff with a medical and scientific approach to managing hearing loss.
Like a fingerprint, hearing loss is unique for each individual. Treatments are just as unique. At Total Hearing Care, the doctors and audiologists work closely together to ensure all options are explored prior to recommending a hearing loss management plan.
Hearing Loss
Contrary to popular belief, hearing loss is not only found in older adults. It affects over 28 million Americans of all ages and walks of life. Hearing loss ranges from mild to total, and typically develops from:
- exposure to loud noise
- illnesses and infections
- head injuries
- birth defects
- certain medications
- certain diseases
- aging
Take a survey for signs of hearing loss
AUDIOLOGISTS
Audiology is the science of hearing. It encompasses the study of how the hearing mechanism works, hearing disorders, and rehabilitation for individuals who have hearing loss.
Audiologists have extensive education and specialized training in prevention, assessment, and treatment of non-medical hearing disorders. They are the most qualified professionals to:
- conduct specialized hearing assessments for infants, children, and adults
- refer patients for hearing medical treatment
- perform balance evaluations
- recommend hearing aids, assistive listening devices, and personal alerting devices
- make custom ear molds and protection
- provide hearing rehabilitation for patients and loved ones
- educate on prevention of hearing loss
Our audiologists:
- Receive either a Doctorate in Audiology (Au.D.) or a Master's degree from an accredited university graduate program and they pass a national competency examination. They are licensed to practice Audiology and dispense hearing aids.
- Have extensive training and experience in identifying, assessing, and managing hearing loss in adults, infants, and children of all ages.
- Conduct and supervise newborn hearing screening programs.
- Use specialized equipment to accurately determine the nature of hearing problems.
- Refer patients to physicians when their hearing problems need medical or surgical evaluation.
- Select, evaluate, and fit hearing aids to meet the specific needs of each patient. They are knowledgeable about the latest advances in hearing aid technology.
- Present a variety of a treatment options to patients with hearing impairments including assistive listening devices and alerting devices.
- Provide hearing rehabilitation training through special classes and counseling to assist patients and their families/caregivers with the psychosocial adjustment to hearing loss.
- Administer and interpret tests of balance to evaluate dizziness.
- Help prevent hearing loss by providing and fitting special hearing protection devices.
- Educate consumers and professionals on the causes, prevention and rehabilitation of hearing loss.
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TYPES OF HEARING LOSS
Hearing loss is classified as conductive, sensory, neural, or central depending on the location of the defect within the hearing mechanism.
Conductive Hearing Loss
Conductive hearing loss occurs when sound fails to transmit through the outer or middle ear. Common causes of conductive hearing loss are:
- Impacted earwax
- Perforated eardrum
- Middle ear fluid
- Middle ear infections
- Abnormalities involving the middle ear bones
Conductive hearing loss causes a reduction in the loudness of sound and are often medically or surgically correctible. Hearing aids can be helpful in cases where medical or surgical intervention is not preferred.
Sensory Hearing Loss
Sensory hearing loss occurs when there is damage to the receptor hair cells in the inner ear, or "cochlea." When these cells are healthy, they increase the loudness of sound, contribute to the clarity of speech, allow for a separation of speech and noise, and help prevent loud sounds from becoming uncomfortable. A sensory hearing loss therefore results in a loss of loudness, difficulty with speech clarity, trouble separating speech from background noise, and increased sensitivity to loud noises. Sensory hearing losses often are the result of:
- Heredity
- Aging
- Noise exposure
- Certain illnesses
- Some medications
Sensory hearing losses typically are not medically or surgically correctible and are often treated with hearing aids and other assistive devices. Cochlear implants can be used in cases of severe to profound sensory hearing loss. This type is often mistakenly labeled as “nerve loss” and is the most common type of hearing loss.
Neural Hearing Loss
Neural hearing loss results when the auditory nerve fails to accurately transmit impulses from the receptor cells of the inner ear to the brainstem. Another possible cause is a failure in the chemical transmission between intact inner ear receptor cells and the auditory nerve. conditions that result in neural hearing loss are:
- Auditory neuropathy/auditory dyssynchrony
- Auditory nerve tumors
Neural hearing losses are not treatable with hearing aids. Auditory neuropathy is sometimes treatable with cochlear implants.
Central Hearing Loss
Central hearing loss refers to the inability of the brain to make appropriate use of auditory information. It results in difficulty with speech processing and understanding and can interfere with speech development in children. Auditory processing disorders in children may be mistaken for behavioral disorders.
Central hearing losses are not treatable with hearing aids but some may benefit from assistive listening devices that help to separate speech from background noise.
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HEARING AIDS
How do I know if I need hearing aids?
The need for hearing aids in adults is determined primarily by patient perception of difficulty. The hearing test is a critical component in determining how hearing aids are fit, but because patient lifestyles and personal tolerance limits vary widely, the hearing test alone is not enough to determine candidacy. If you are diagnosed with a hearing loss, your audiologist will conduct an evaluation to discuss your options. During that evaluation you and your audiologist will discuss your hearing test results, your lifestyle, your perception of difficulty and your personal preferences, and appropriate recommendations will be made.
Do I need to wear two hearing aids?
When hearing loss exists in both ears, hearing aids in both ears are extremely important for several reasons.
- Wearing just one hearing aid makes it very difficult to separate speech from background noise.
- Wearing just one hearing aid creates difficulty with sound localization.
- Auditory deprivation in one ear can result in deterioration in that ear. It’s important to remember that we don’t hear with our ears. Our ears are just a means of getting sound to the brain where hearing takes place. Without sound stimulation, the areas of the brain that receive and interpret sound can lose their ability to process auditory information.
Will hearing aids make my hearing normal?
No. Hearing loss results from damage in the hearing mechanism that cannot be reversed by wearing hearing aids. Patients with sensory hearing loss will always have more difficulty understanding speech in competing noise and will always experience some distortion of sounds. In particularly difficult listening situations, speech understanding may not be attainable through auditory means alone.
Why do hearing aids amplify background noise?
Any sounds in the environment that don’t interest the listener are defined as background noise. Hearing aids have no means of determining what you are and are not interested in at any given moment, so they will necessarily amplify background noise. However, digital hearing aids equipped with directional microphones can significantly help improve speech understanding in background noise.
Why does my voice sound so funny through hearing aids?
Often patients report an echo effect, or a sensation of having their head “in a barrel” when wearing hearing aids. This phenomenon is known as the “Occlusion Effect”, and it results from having the ear canals blocked with the hearing aids or earmolds. When the ear canals are open, our voices are heard both through the air traveling to the ear canal (air conduction) and through vibrations in the bones of the skull (bone conduction). When the ear canals are partially closed, the bone conduction perception is enhanced, creating a reverberation when we speak. The same effect can be created by closing the ear canals with your fingers.The occlusion effect is a normal side effect of most hearing aid fittings, but in some cases can be reduced by opening the ear canal or through programming changes.
Why do hearing aids whistle (feedback)?
Whenever amplified sound gets back into the microphone of the hearing aid, it will create a “feedback loop” and cause the hearing aid to whistle. This is a normal occurrence in any amplification system but is more likely in powerful hearing aids, open canal fittings, and very small hearing aids. Sophisticated digital hearing aids are often equipped with feedback reduction algorithms that decrease the likelihood and duration of feedback.
What determines the style of hearing aids I should wear?
Hearing aids typically come in 4 basic styles:
1) behind-the-ear (BTE)
2) full shell in-the-ear (ITE)
3) in the canal (ITE)
4) completely in-the-canal (CIC)
The appropriate style for a given patient is determined by:
- The degree of hearing loss
- The configuration of the hearing loss
- The size and shape of the ear and ear canal
- Patient preferences
- Patient lifestyle
- Desired hearing aid options
- Patient dexterity
Your audiologist will discuss your options with you and help you determine the best style for your particular needs.
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Sensory hearing loss results in deficits that cannot always be addressed using hearing aids alone. In some cases a patient may not be a good candidate for hearing aids but can obtain benefit from assistive devices. In children especially, assistive devices such as FM listening systems are critical in the classroom. If you have a hearing loss and cannot wear hearing aids or do not obtain sufficient benefit from hearing aids alone, ask your audiologist about appropriate assistive devices.
Assistive listening devices have the advantage of improving the listener’s ability to hear the desired signal in background noise or at a distance. Most hearing impaired people experience most of their difficulty in background noise, so assistive listening devices are useful for the majority of hearing aid patients.
- FM Systems transmit the speaker’s voice via FM from a remote microphone directly to the listener’s ear. They can couple directly to hearing aids or can be used on their own without hearing aids.
- Infrared Devices also transmit the desired signal directly to the listener’s ear using infrared light. Infrared technology is often used in TV listening devices and public theaters.
- Hard wired devices are useful for improving signal to noise ratio at close distances. They’re a good choice for patients with relatively inactive lifestyles who cannot use hearing aids due to poor speech understanding ability. They can also be used with television.
- Telecommunication Devices include amplified, hearing compatible telephones, portable telephone amplifiers, telecoil-equipped hearing aids, neckloops, TTYs, and Bluetooth couplers for cellular telephones.
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AUDIOLOGIC REHABILITATION
At Total Hearing Care at Virginia Ear, Nose and Throat Associates we understand that patients do not come to us because they have a desire to wear hearing aids. Patients seek out our expertise to help solve communication problems and improve quality of life issues that result from hearing loss. Hearing aids are often an important tool in addressing those problems, but hearing aids alone may not provide a satisfactory resolution to all of the negative impact resulting from hearing loss. For that reason, we are unique in offering a comprehensive program of audiologic education and rehabilitation that will enable our patients and their friends, family, and significant others to successfully communicate. At the conclusion of the program, our patients are asked to provide us with constructive feedback that will enable us to continue to improve our services to the hearing impaired population.
Here are some comments provided by our patients:
“These classes are a wonderful public service. I learned a great deal.”
“Great program! I have had hearing aids for over 10 years but I found it extremely helpful.”
“Thank you for including my husband. You have helped us both.”
“This was an extremely helpful class and helped me think through a lot of issues and gave me new information on my hearing aid, assistive devices and ways of helping people hear me better. Thank you for offering it.”
“Fantastic – The Greatest. This puts my past hearing aid experience to shame. You are the greatest.”
“These classes need to be mandatory. I felt so much better knowing things weren’t always my fault and how to control a situation. Having a source to go on information is great. Very informative.”
“This course should definitely be offered if not required to be taken by people who are considering hearing aids for the 1st time. This course is so very good and informative it helps the hard of hearing know and understand what to expect and NOT to expect – which can eliminate disappointment.”
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