Total Hearing Care

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  • Services

    The physicians and audiologists at Virginia ENT work together to provide comprehensive, total hearing care for all ages. From newborn hearing screenings to hearing aids, we can assist with all of your hearing healthcare needs.

    Diagnostics

    Virginia ENT is an all-encompassing diagnostic audiology facility.  Unlike other hearing health practices, our audiologists work side-by-side with board-certified physicians for a more comprehensive approach to your hearing loss management.

    We perform testing appropriate for all ages.  Our audiologists have extensive education and specialized training in prevention, assessment, and treatment of non-medical hearing disorders. They are the most qualified professionals to evaluate, diagnose, treat, and manage hearing loss and balance disorders in adults and children.

    If you think you might be suffering from hearing loss, contact our office to make an appointment for a hearing evaluation.  During this appointment, one of our expert audiologists will determine if a hearing loss is present, if further medical management is needed and/or if a referral to an otolaryngologist is indicated.  The severity and possible nature of the hearing loss and possible options for management, including amplification if indicated, will be addressed.

    As we work together to learn more about your unique needs, we will guide you in making an informed decision on how to most appropriately manage your hearing loss. With offices throughout the Richmond metro area and Colonial Heights, we are able to perform complete audiologic and vestibular testing in all four of our locations.

    Newborn Hearing Screening

    Early identification and intervention of childhood hearing loss can prevent long-term effects on a child’s development.  Hearing screening programs have been implemented across the U.S. to ensure that all children have their hearing screened at birth.  Virginia ENT is proud to be a referral site for follow-up services for the Virginia Department of Health Early Hearing Detection and Intervention Program.

    For more information go to http://www.vdh.virginia.gov/ofhs/childandfamily/childhealth/hearing

    Hearing Aids

    Learning that you have hearing loss is often an overwhelming and emotional discovery.  Whether you came to us with suspicions about your hearing or have been caught completely off guard by our findings, you may feel unprepared about what your next step should be.  Click here for information on some of the things you should know before purchasing a hearing aid.

    The audiologists at Total Hearing Care understand the complex feelings and questions associated with hearing loss.  We also understand that no two people are affected in the same manner, face the same challenges or will make the same decisions on how to manage their hearing loss.  The technology for hearing aids has truly progressed (click here to learn more).  We have the latest in digital technology and are well equipped to meet your hearing needs. 

    Assistive Listening Devices

    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.  Recent improvements in hearing aid technology provide multiple options for using assistive devices with hearing aids through Bluetooth connectivity or direct audio input.  For more information about how this could change your listening experience, speak with one of our audiologists.

  • Hearing Aids

    While any hearing loss diagnosis can be challenging, working with the audiologists and physicians at Virginia ENT will make finding a viable solution easy and effective

    Because there are different types of hearing loss, hearing aids might not always be the best solution. That’s why a full diagnostic hearing evaluation is critical in identifying and properly diagnosing your specific condition. In the event that your hearing loss requires hearing aids, one of our audiologists can assist you in finding the right device for your specific needs.

    What is a Hearing Aid?

    A hearing aid is a computer chip that processes sound to make it louder. In the past, hearing aids functioned linearly, meaning they amplified all sounds equally. Thanks to the widespread use of digital sound processing, today’s hearing aids can be fine tuned across the entire frequency range. Therefore the hearing aids can be programmed to correct the specific deficit in each ear. Audiologists then have the ability to match patients with the correct type of hearing aids considering their  lifestyle, hearing loss, and price point.

    There is a range of how sophisticated the different kinds of hearing aids are. Some are more adaptive (i.e. they adjust themselves for you based on the sound environment) and others are more manual (i.e. are more basic and give you more control over what sounds are louder than others). The audiologists of Virginia ENT are best able to determine the right option based on each individual patient’s needs.

    Finding The Right Hearing Aid

    At Virginia ENT, helping our patients find solutions to their hearing problems is a big part of what we do. And because getting a hearing aid is a very individualized process, the service and support you receive will help make the transition much easier.

    Hearing aids at their core are pieces of equipment that help you hear better but we focus on the evaluation process and ensuring you feel comfortable while wearing them. Our goal is to connect with each patient and foster a relationship so we can have an open dialog about expectations and options while being part of the planning process for what to do moving forward.

    We begin with an evaluation of your hearing, which includes a full diagnostic evaluation where each ear is tested independently. Beyond just your hearing, we asses your middle ear and your auditory system as a whole to determine if there’s anything else that may be contributing to your hearing loss. You will meet with an audiologist, a professional who is trained to be able to identify your hearing issues and discuss your hearing problems, lifestyle, goals, and what a tailored fitting for hearing aids will include.

    Beyond The Hearing Aid Fitting

    Since Virginia ENT is a medical practice, getting fitted for hearing aids is one piece of an all-encompassing service. Our interactions with you don’t end when you have the equipment and walk out of the door. That’s just the beginning.

    Our audiologists understand all of the complex feelings and questions that you may have associated with hearing loss. We also understand that everyone’s experience will be unique: No two people will be affected in the same way, face the same challenges, or will have to make the same decisions on how to manage their hearing loss.  

    We want to not only fit you with the right hearing aids but also educate you on the different hearing aid options prior to choosing and ensure long-term success with your selection.

    Schedule An Appointment

    While any hearing loss diagnosis can be challenging, working with the audiologists and physicians at Virginia ENT will make finding a viable solution easy and effective

    Because there are different types of hearing loss, hearing aids might not always be the best solution. That’s why a full diagnostic hearing evaluation is critical in identifying and properly diagnosing your specific condition. In the event that your hearing loss requires hearing aids, one of our audiologists can assist you in finding the right device for your specific needs.

    What is a Hearing Aid?

    A hearing aid is a computer chip that processes sound to make it louder. In the past, hearing aids functioned linearly, meaning they amplified all sounds equally. Thanks to the widespread use of digital sound processing, today’s hearing aids can be fine tuned across the entire frequency range. Therefore the hearing aids can be programmed to correct the specific deficit in each ear. Audiologists then have the ability to match patients with the correct type of hearing aids considering their  lifestyle, hearing loss, and price point.

    There is a range of how sophisticated the different kinds of hearing aids are. Some are more adaptive (i.e. they adjust themselves for you based on the sound environment) and others are more manual (i.e. are more basic and give you more control over what sounds are louder than others). The audiologists of Virginia ENT are best able to determine the right option based on each individual patient’s needs.

    Finding The Right Hearing Aid

    At Virginia ENT, helping our patients find solutions to their hearing problems is a big part of what we do. And because getting a hearing aid is a very individualized process, the service and support you receive will help make the transition much easier.

    Hearing aids at their core are pieces of equipment that help you hear better but we focus on the evaluation process and ensuring you feel comfortable while wearing them. Our goal is to connect with each patient and foster a relationship so we can have an open dialog about expectations and options while being part of the planning process for what to do moving forward.

    We begin with an evaluation of your hearing, which includes a full diagnostic evaluation where each ear is tested independently. Beyond just your hearing, we asses your middle ear and your auditory system as a whole to determine if there’s anything else that may be contributing to your hearing loss. You will meet with an audiologist, a professional who is trained to be able to identify your hearing issues and discuss your hearing problems, lifestyle, goals, and what a tailored fitting for hearing aids will include.

    Beyond The Hearing Aid Fitting

    Since Virginia ENT is a medical practice, getting fitted for hearing aids is one piece of an all-encompassing service. Our interactions with you don’t end when you have the equipment and walk out of the door. That’s just the beginning.

    Our audiologists understand all of the complex feelings and questions that you may have associated with hearing loss. We also understand that everyone’s experience will be unique: No two people will be affected in the same way, face the same challenges, or will have to make the same decisions on how to manage their hearing loss.  

    We want to not only fit you with the right hearing aids but also educate you on the different hearing aid options prior to choosing and ensure long-term success with your selection.

    Schedule An Appointment

  • Hearing Care FAQs

    Check out some of the most common questions we get asked about hearing aids, affording them, and caring for them.

    Do I need a hearing aid(s)?

    A recommendation for a hearing aid by one of our physicians or audiologists is based on many years of experience helping patients with similar difficulties to the ones you may be facing now.

    Which device and style are right for me?

    Each person’s hearing difficulties are unique.  Our audiologists have a great deal of experience in assisting patients in selecting the proper device to address their specific issues.  We offer many styles including daily and extended wear devices, in the ear style (ITE) devices, and behind the ear (BTE) style devices.

    Does a hearing aid require a lot of maintenance?

    Generally hearing aids require simple daily cleaning and the batteries need to be changed about once a week.  Some hearing aids have rechargeable battery options.

    Are hearing aids waterproof?

    There are several waterproof hearing aid options available to suit patients that have an active lifestyle.  Speak with one of our audiologists to find out more.

    How much do hearing aids cost?

    The cost of hearing aids varies based on the level of technology, which is determined mainly in part by your lifestyle needs.  Hearing aids can average $1000-$3500 per device.

    Does my insurance pay for hearing aids?

    Some insurance policies do have a benefit that may cover some of the cost for your hearing aid(s).  We will be more than happy to check your benefit for you and inform you of that benefit if it’s available.

    Are there financing options available?

    Virginia ENT is proud to offer financing options available with approved credit.  Speak with one of our audiologists for further information.

    How long will it take for me to get my new hearing aids?

    There are several factors involved in scheduling a fitting appointment; however, we should be able to have you fit with your new device(s) within 2 to 3 weeks depending on the type of device and customization needed.

    So, now what?

    If you are ready to start the process or if you simply just want to learn more, we encourage you to make an appointment with one of our audiologists for a hearing aid evaluation.

    Hyperlinks/Resources

    1. Alexander Graham Bell Association for the Deaf and Hard of hearing
    2. American Academy of Audiology
    3. American Association of the Deaf-Blind
    4. American Athletic Association of the Deaf
    5. American Deafness & Rehabilitation Association
    6. American Hearing Research Foundation
    7. American Society for Deaf Children
    8. American Speech-Language-Hearing Association
    9. Phonak Hearing Aid Manufacturer
    10. Siemens Hearing Aid Manufacturer
    11. Widex Hearing Aid Manufacturer
    12. Oticon Hearing Aid Manufacturer
  • Patient Education

    What is an Audiologist?

    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 patients on prevention of hearing loss

    How the Ear Works

    The ear is divided into three major parts:  the outer ear, the middle ear and the inner ear.

    The outer ear works like a sound funnel to capture sound and channel it down the ear canal.  At the end of the ear canal the sound strikes the eardrum and causes it to vibrate like the head of a drum.

    The eardrum is attached to the first of three bones (ossicles) in the middle ear.  The sound vibrations of the eardrum are passed to this chain of bones known as the malleus (hammer), incus (anvil) and stapes (stirrup).  The footplate of the stapes (stirrup) rests in the oval window which leads into the hearing portion of the inner ear, the cochlea.  The cochlea is shaped like a snail shell and is filled with fluid. The movement of the footplate of the stapes sets the fluid of the cochlea in motion, which in turn creates movement in tiny haircells located along the entire length of the cochlea.  This haircell movement is then converted into neural impulses that travel from the haircells up the auditory nerve to the brain where they are perceived as sound.

    Hearing Loss in Children/NB Screening

    Newborn screening allows children with hearing loss to be identified as early as possible. Early identification and intervention can help a child with hearing impairment to develop speech and language alongside their hearing peers.

    There are two tests used for newborn screening: Otoacoustic Emissions (OAEs) and Auditory Brainstem Response (ABR). Both are safe and reliable. For OAEs, a small probe is placed into the ear. Sounds are played and a response is measured. An “echo” is reflected back into the ear canal and measured by the microphone. OAEs will be present or absent. For the ABR, sounds are presented into the ear and recorded using electrodes. This test measures how the hearing nerve responds to sounds and can identify degrees of hearing loss.

    If a hearing loss is identified, the audiologist, ENT physician, pediatrician and an early intervention program will work together to help your child with their hearing needs. After medical evaluation, the child will be fit with hearing aids. The audiologist will monitor the progress with regular visits. Parents also need to watch for progress and encourage the use of the hearing aids. Research has found that the one common denominator among successful hearing-impaired children is the parent’s willingness to help the child throughout their lifetime.

    Hearing Screening vs. Diagnostic Testing

    A hearing screening is a quick test which gives the audiologist basic information about your hearing. A screening generally gives a pass/fail score. A passing score indicates hearing is within normal limits. A failing score indicates hearing is outside of the normal range. While a screening will determine whether or not you have hearing loss, it will not provide detailed information (such as the degree of hearing loss).

    Common methods of hearing screening include:

    1. Pure tone screening: The audiologist presents beeps across a few pitches at a volume within the normal range of hearing. If you hear the beeps, a passing score is given. If you do not hear the beeps, a failing score is given.
    2. Otoacoustic Emissions (OAEs): The OAE test is performed on an individual who is resting quietly or in a sleep state. A small tip is placed in the patient’s ear. A tone is presented through the tip to stimulate the auditory system. Once the sound reaches the inner ear, hair cells become stimulated and reflect a sound back out of the ear. This response is then recorded onto a computer and analyzed by an audiologist.

    A diagnostic evaluation gives the audiologist a wide range of information about your hearing. Results from a diagnostic evaluation allow the audiologist to determine not only if you have hearing loss, but to what degree and at which pitches or frequencies. Common tests performed during a full diagnostic hearing evaluation include:

    1. Otoscopy: The audiologist looks into your ear canal.
    2. Tympanometry: A pressure test which gives information about eardrum movement.
    3. Pure tone audiometry: The audiologist presents beeps across a wide range of pitches; the lowest volume that you can hear the beeps is found at each pitch (commonly referred to as threshold).
    4. Speech testing
    • Speech Reception Threshold: The lowest volume where you can correctly repeat words.
    • Word Discrimination: How many words you can correctly repeat at a comfortable volume.

    Noise and Hearing Loss

    Noise Induced Hearing Loss (NIHL) is a preventable type of inner ear hearing loss and can affect people of all ages and backgrounds.  NIHL occurs when very loud sounds are transmitted through the auditory system, causing damage to the sensitive inner ear hair cells.   These loud sounds may come from occupational, or work-related, noise exposure, or they may come from recreational noise exposure.  NIHL can gradually worsen over time, or it can be a result of a single traumatic noise exposure.

    The Occupational Safety and Health Administration (OSHA) requires that workers exposed to excessive noise levels be enrolled in a hearing conservation program, which includes monitoring of hearing levels as well as the use of hearing protective devices (HPDs).  Recreational noise also can cause NIHL.  Shooting, power tools, motorsports, loud music through earphones or earbuds, and many other recreational sounds may result in NIHL.  If a sound is loud enough that you feel you need to speak up to be heard over it, the sound is loud enough to potentially damage your hearing.

    The good news is that NIHL is preventable.  When possible, reduce your exposure to excessive noise levels by reducing the volume of toys and personal music players, and by reducing the amount of time you are exposed to noise.  When volume reduction is not possible or practical, make use of HPDs, which come in a variety of styles to best meet your needs.  Existing hearing loss is NOT protective against noise damage.  Even people with existing hearing loss can further damage their hearing with noise exposure.

    Hearing Protection

    There are many different types of hearing protection available, in both non-custom and customized options.  Over the ear earmuffs and foam insert plugs are common non-custom hearing protectors.  The Noise Reduction Rating (NRR) for each type of hearing protection will be expressed on the packaging.  The higher the NRR, the more noise reduction that type of protective device will afford when worn correctly.   Custom hearing protection is available through your audiologist.  The main benefit to customized hearing protection is that with a custom fit, the potential for improper use is practically eliminated.  Custom hearing protection can truly be customized, not only to the individual fit of each ear, but to the noise applications in which the earplugs may be used.  Solid earplugs, filtered earplugs, and electronic shooters protection are all types of custom plugs available.  Ask your audiologist which type of custom protection may be right for you.

    Tinnitus

    As many as 50 million people experience tinnitus, or head/ear noises; only about 10 million seek help with diagnosis and possible treatment. Tinnitus may be intermittent or continuous in one or both ears and may often be described as “ringing,” “roaring,” “hissing,”  “clicking,” etc. In most cases, it is certainly a real occurrence but is termed “subjective,” only heard by the individual.  Tinnitus may or may not be associated with hearing loss.

    The exact physical mechanisms behind tinnitus are unknown and are, most likely, numerous. Potential causes include conditions of the outer, middle, and inner ear; effects of some medications; trauma to the head or neck, cervical neck problems, and jaw joint misalignment; and systemic medical conditions. Some people experience tinnitus for which no exact cause can ultimately be determined.

    Because of this complexity, careful assessment by the otolaryngologist/audiologist  team is needed to ensure that the medical history is explored in detail, that all necessary diagnostic measures are completed, that treatment options are explored, and that counseling strategies are provided to both minimize the tinnitus and to explore the associated stress that may arise.

    Do I need a Hearing Aid?

    This is a question commonly asked by many first time hearing aid wearers. If you are considering whether you need hearing aids, the first step is to schedule an appointment for a hearing evaluation with an audiologist (a hearing health care professional). Once the hearing evaluation is complete, your audiologist can determine if you have hearing loss and will recommend hearing aids if appropriate.

    Warning signs of hearing loss include:

    1. Everyone sounds like they are mumbling.
    2. You can hear, but not understand speech.
    3. Frequently asking others to repeat what they have said.
    4. Difficulty understanding others when in a group of people or in noisy environments, such as restaurants.
    5. Social situations are no longer of interest, as you feel you are unable to participate in or follow conversations.
    6. You prefer the television volume set louder than others watching with you.

    Hearing loss may not be recognized because it often occurs gradually. Individuals with hearing loss do not necessarily know what is being missed. Family members and friends may be the first to point out hearing problems. High-pitched hearing loss is common and leads to difficulty hearing speech clearly.

    Hearing Aid Styles

    Most hearing aid manufacturers only manufacture digital hearing aids, which allow better sound quality and improved clarity.  Digital hearing aids can be finely tuned to any degree of hearing loss and can help to reduce surrounding background noise for better speech understanding in demanding listening environments.

    Do I need one or two hearing aids?

    The recommendation for two hearing aids is not made to all patients.  Some people may have normal hearing in one ear or have one ear that may not be able to be helped by a hearing aid.  Your audiologist will help determine whether one or two aids are most appropriate.  If both ears need amplification, your audiologist will recommend two aids.  Two aids provide superior benefit for most people.  They provide better speech understanding in background noise, better sound localization and better quality of sound.

    Hearing Aid Options

    Directional microphones:  these microphones are designed to help detect sound from all directions and help reduce background and other surrounding extraneous noises.  Directional microphones are not available on completely-in-the-canal or extended wear hearing aids but come standard in all other styles.

    Telephone options:  a telecoil, which is the most common telephone option, is designed to detect the signal from your telephone without also detecting surrounding noise.  This feature is only available in larger custom hearing aids as well as most behind-the-ear hearing aids.

    Bluetooth compatibility: many newer hearing aids can detect and receive sound from Bluetooth devices, such as cell phones, televisions, mp3 players and other audio devices.  This feature requires the use of an interface that detects the signal from a Bluetooth device and transmits it directly to the hearing aid(s).  The use of this feature allows the user to be hands-free, without requiring use of an additional headset or receiver.  This feature is only available in larger custom hearing aids as well as most behind-the-ear hearing aids.

    Hearing aids are available in different style options.  Selecting a style that is right for you depend on several factors:

    • The degree of hearing loss
    • The configuration of 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 the options with you and decide which is best for your hearing loss and personal needs.

    Each style has its advantages and limitations.  The options are as follows:

    Behind-the-ear (BTE)

    Behind-the-ear (BTE) aids are the most versatile aids due to their size.  The electronics are housed in a casing behind the top of the ear and are held into the ear by a custom made ear piece.  BTE aids can be worn by a wide variety of people, those with mild to profound hearing losses.

    • Best durability as the components are placed outside of the ear
    • Larger batteries (longer battery life)
    • Water resistance available
    • Telephone and Bluetooth compatibility

    Open fit behind-the-ear (BTE)

    Open fit behind-the-ear aids are less visible than the standard BTE style aid.  Their electronics are also housed in a casing that sits behind the top of the ear but are held into the ear by thin tubing with a soft tip.  These aids keep the ear canal open and avoid the occlusion or “plugged up” feeling that users sometimes notice.  These are appropriate for users with normal to near normal hearing in the low frequency range.

    • Mild to severe high frequency hearing loss
    • Best durability
    • Cosmetically appealing
    • Can have larger batteries
    • Water resistance available
    • Telephone and Bluetooth compatibility

    Receiver-in-canal (RIC)

    Receiver-in-canal aids are a BTE style aid with most of the electronics housed in a casing behind the ear.  They are attached to and held into the ear by a receiver (loudspeaker) and thin tubing.

    • Mild to severe hearing loss
    • Cosmetically appealing
    • Can have larger batteries
    • Water resistance available
    • Telephone and Bluetooth compatibility

    In-the-ear (ITE)

    In-the-ear hearing aids are the largest custom aid available.  It fills most of the bowl-shaped part of the ear.  All of the electronics are housed in a plastic shell.

    • Mild to severe hearing losses
    • Larger batteries
    • Great for those with poor dexterity
    • Telephone and wireless capability available

    In-the-canal (ITC)

    In-the-canal hearing aids are smaller custom aids.  They fit into the ear canal and fill part of the bowl-shaped part of the ear.

    • Mild to moderate hearing losses
    • Smaller batteries (shorter battery life)
    • Good dexterity required
    • No telephone and Bluetooth compatibility available

    Completely-in-the-canal (CIC)

    Completely-in-the-canal aids are the smallest custom aids that fit into the ear canal.  Due to their small size, they are appropriate for mild to moderate hearing losses.

    • Less visible than ITC aids
    • Cosmetically appealing
    • Smaller batteries
    • Good dexterity required
    • No directional microphones
    • No telephone and Bluetooth compatibility available

    Extended wear

    Extended wear hearing aids are non-custom aids that are placed in the ear canal by an audiologist and can be worn 24/7 for up to 4 months.  Due to their size and deep insertion, these aids can only be worn by a small number of patients.

    • Mild to severe hearing loss
    • Completely invisible
    • No battery replacement required
    • Analog technology
    • No directional microphones
    • No telephone and Bluetooth compatibility available