A person who is unable to hear as well as someone with normal hearing – hearing thresholds of 25 dB or better in both ears – is said to have hearing loss. Hearing loss may be mild, moderate, severe, or profound. It can affect one ear or both ears, and leads to difficulty in hearing conversational speech or loud sounds.
A grandchild’s first word, rustle of leaves in the wind, the clinking of glasses at the table or whispered secrets from your best friend. These are the moments we hold dear. It’s these sensory experiences that enrich our lives.
Hearing enables us to understand other persons and help to interact with the world around us.
Good hearing is so important in our day-to-day lives, yet most people with normal hearing don’t even think about what it means to be able to hear well.
Chatting with friends, listening to sounds of nature, enjoying music or hearing warning signals everything is taken for granted.
It is only when hearing starts to deteriorate noticeably that we realize the importance of good hearing is in our everyday lives. And how much we miss out when we no longer hear well.
Our hearing plays an important role in how we relate to our surroundings.
It helps in forming of relationships, and opens up a wealth of sensory experiences.
How does our ear work?
Need to understand how and why hearing loss happens, it helps to understand how the ear works.
Firstly, I would like to call it the miracle of nature.
The ear is an amazing and incredibly skilled organ that performs the wonderful and highly complex task of hearing.
The ear is made up of three different sections: the outer ear, the middle ear, and the inner ear. These parts work together so you can hear and process sounds.
Outer Ear– The outer ear picks up sound and transmits it to the eardrum via the ear canal.
Middle Ear– The sound makes the eardrum vibrate and is amplified by the three tiny bones of the ears.
Inner Ear– The cochlear converts movements of these 3 tiny bones into electrical signals. The auditory nerve transmits the signal to the brain.
What is hearing loss?
Hearing loss happens when there is a problem with one or more parts of the ear or ears, the nerves coming from the ears, or the part of the brain that controls hearing. “Impairment” means something is not working correctly or as well as it should.
Hearing loss is where the ability to hear is reduced.
It makes you more difficult to hear speech or other sounds.
No two people with hearing loss are the same. However, most often people with hearing loss are unable to distinguish soft sounds and high pitch sounds.
Have difficulty hearing sounds such as whispers, children’s voices or birdsong.
No two cases of hearing loss are the same.
However, most often people with a hearing impairment are unable to distinguish soft tones and high pitches sounds and have difficulties hearing sounds such as whispers, children’s voices or birdsong.
The understanding of speech also suffers because many of the sounds important for understanding speech are soft, high pitch sounds such as “s” or “th”. These are sounds that help us determine the difference “path” or “pass”. And, however, it may sound, increasing the volume is of limited help. Most likely, people with hearing impairment need clarity, not volume.
Hearing impairments can occur in all parts of the ear, dysfunctions of the outer or middle ear can generally be treated with medication or surgery.
However, a good 80 percent of all hearing impairments are caused by dysfunctions of or damage to the inner ear.
Today, modern hearing instruments can compensate for most inner ear damage.
What are the possible impacts of hearing loss?
Diminished understanding of speech
Trouble communicating with others
Less willing to embrace the unknown
Declining job performance
Lack of acknowledgement by others
Irritability, stress, depression
Withdrawal from social life, isolation
What are the signs of hearing impairment?
Hearing loss generally develops slowly over many years, the effects become apparent only gradually.
This makes it difficult for those affected to recognize that they are suffering from hearing impairment.
Relatives, friends or colleagues are often the first to realize that something is wrong.
However, there are clear signs that your hearing is not entirely as it should be.
Perhaps you find it difficult to understand the phone conversation clearly?
Does your family complain about the volume when you are listening to the radio or television?
Do you find it difficult to follow a conversation in a restaurant or when there is a lot of noise in the street around you?
Do you often feel exhausted after family celebrations because listening is such an effort?
Do you hear better when you can look at the person talking to you?
All these are typical signs of a hearing loss. But don’t worry; hearing loss is not something simply to be endured. You can and should do something about it.
Do only old people have a poor hearing? Not true!!
It is not only older people who suffer from poor hearing. Poor hearing is widespread across all age groups. Today, young people increasingly have hearing impairments too excessively due to loud music listened to via headphones, at concerts and discos is having a major impact. Construction workers, ambulance drivers, DJs and factory workers. These are examples of professions where loud noise can have a lasting and damaging an impact on hearing.
Hearing loss can, of course, also be caused by medical, genetic or simply unknown factors. However, one thing is clear: You are not alone in suffering from a hearing impairment. Today, one in six people have some degree of hearing impairment.
If you feel you have hearing difficulty, you should consult an Audiologist as soon as possible
Hearing loss is usually self diagnosable if the person is more self-aware. The chief symptom is the inability to understand speech or hear soft sounds. Some notice a loud, alarming “pop” just before their hearing disappears and few with sudden deafness may also notice one or more of these symptoms: a feeling of ear fullness, dizziness, and/or a ringing in their ears.
Here are some ways you can gain perspective by experiencing what hearing loss sounds like.
People with mild hearing loss have difficulty hearing soft consonant sounds, making words seem incomplete. Noisy environments make hearing more challenging.
For people with moderate hearing loss, hard and soft consonant sounds become inaudible and speech becomes difficult to understand – particularly with background noise.
For people with severe hearing loss, some loud sounds are audible, but communication without a hearing instrument is impossible.
Describing hearing loss
If you want to understand your own hearing loss or anyone else’s hearing, there are a number of questions you need to consider.
How severe is your hearing loss?
This is the simplest and most frequently used way of describing a hearing loss. Audiologists often use the categories ‘mild, moderate, severe, and profound’.
However, there is much more you need to know before you can understand your hearing fully, as it is not simply about hearing individual sounds and tones.
Is your hearing the same all the time?
Your hearing may be exactly the same every day and at all times during the day, or it may fluctuate during the day or from week to week. A fluctuating hearing loss can be quite bewildering if you don’t realize that for reasons outside your control you can hear better on some occasions (this is something other people may find hard to understand).
Do you have Tinnitus?
Tinnitus (noises you can hear that are not caused by sounds in the outside world) can make it much harder to hear with any given level of hearing loss. If your tinnitus changes from time to time it will mean you can sometimes hear better on some occasions, even though your hearing remains the same, because the sound of the tinnitus will block out what you are trying to listen to.
Since when is the hearing issue noted?
If your hearing loss began when you were a baby, you will experience your remaining hearing differently than if you began to lose your hearing much later in life. Your voice may be different, and your emotional relationship with your hearing may be different. If you have been accustomed to hearing all your life and then it changes, there are some difficult adjustments to make.
Don’t delay if you experience a sudden or very rapid loss of hearing. It’s considered a medical emergency and you should seek urgent care at the Accident & Emergency department of your nearest hospital where you should be treated by an ENT doctor.
Much more commonly, the change in hearing takes place over a long period of time, sometimes acquired over many, many years. Under the circumstances, you may find it difficult to know exactly when it started and it can take some time before you realize it is happening. Often, the people around you will notice it before you do for the obvious reason that if you don’t hear something, you usually don’t know you haven’t heard it.
Hearing Loss can adversely affect the mental health
TALKING ON THE PHONE POSITIVELY AFFECTS YOUR MENTAL HEALTH
It’s no secret that talking on the phone with friends and family can be a great source of happiness – and even the most mundane, task-oriented calls give us a sense of connection and control over our lives.
Without this daily social connection, people who are deaf, hard-of-hearing, or speech impaired can be at risk for chronic sadness or depression. They may also experience feelings of irritability, poor self-image, and feelings of inadequacy.
Here are 3 ways relay services can help people live happier, more connected lives.
(1) Connection vs. Isolation
The effects of isolation on the mind are well documented. Relay services are a vital connection for anyone experiencing hearing loss or speech/visual impairment. Imagine if you had to wait until conditions were just right to take or make a call – or worse, had to wait until a friend or family member could assist you. Communication difficulties, if not addressed appropriately, can lead to social withdrawal and self-defeating thoughts. “They can’t understand me, so I might as well quit trying. I’m not really a part of society. What good am I?”
(2) Confidence vs. Anxiety
We all want to feel confident in our abilities and decisions, but struggling to communicate can be a real confidence killer. For example, older adults with hearing loss might feel as if they are to blame for misunderstandings. Many feel apologetic about repeatedly asking for help to understand what is being said. They lose confidence in their abilities, face anxiety in social situations, and worry about personal relationships. “I’m a nuisance. I should quit talking because it just frustrates other people. They must be sick of me.” This can in turn lead to physical symptoms such as tension, exhaustion, and weakened immune systems.
(3) Capable vs. Incompetent
Disability does not mean inability. But to many people, not being able to hear and discern message and meaning can result in feelings of shame, humiliation, and inadequacy. They worry about being seen as incompetent, or even stupid. The feeling of shame linked to hearing loss can be linked to misunderstanding and the resulting social embarrassment of giving the wrong response. People may think “How stupid I must look!” or “What will others think?”
Relay services – and the simple joy of talking on the phone again – can have a major impact on a person’s relationships with family and friends, their happiness, and mental health.
5 TIPS FOR TALKING TO LOVED ONES ABOUT HEARING LOSS
It’s never easy to admit when we have a problem, and that’s especially true when it comes to age-related hearing loss. For those affected, it’s common to experience a wide range of emotions including anger, grief, and denial.
Choose the right place and time.
One of the worst things you can do is blurt out something insensitive in a moment of frustration. Instead, plan ahead and choose a quiet, comfortable location with plenty of privacy. Plan on setting aside at least a few hours for the first discussion – so you and your loved one can have plenty of time to talk without interruption.
Be respectful and positive.
When the conversation begins, emphasize how much you care about your loved one. Explain calmly how you’ve noticed them showing signs of hearing loss. Try phrases such as, “I am concerned about how often you ask everyone to repeat themselves,” and “It would make ME feel better if you had your hearing checked.” To ensure the conversation goes well, they must feel supported – not attacked.
Don’t assume they know.
This may seem hard to believe, but age-related hearing loss can be so gradual that your loved one might not notice they’ve had to turn the TV up louder to hear, or that they’re becoming fatigued from trying to follow conversations. A good conversation starter could be something you’ve noticed. For example, “I’ve noticed that you need the TV on very loud,” or “I’ve noticed that you haven’t been able to hear as well on the telephone lately.”
Do your homework.
Do your homework before the conversation, so you can be prepared with helpful information for your loved ones. Learn more about age-related hearing loss and the emotions and challenges that come with it. Make a list of Audiologists in your area. Read up on other tips for having difficult conversations with loved ones. The more you can prepare yourself, the better your conversation will be.
Offer to help with next steps.
Finally, make a plan for what happens AFTER your first conversation about hearing loss. If the time is right, suggest the next steps – such as making an appointment to see an audiologist. Remember your loved one might be nervous about seeking treatment. Assure them they have nothing to lose and everything to gain.
In today’s world, we are so tempted to buy everything online. Online shopping is not only convenient but also time-saving in the fast lives we live in today. Right from clothes, food, grocery items, gadgets, cosmetics to plants we can buy everything online.
Similarly, would it be a good idea to buy hearing aids online??
Let us consider a few facts about hearing aids first.
Hearing aids are medical devices. They are complex and sophisticated devices- not just amplifiers.
Hearing aids that are fitted without a hearing test may not give you desirable results.
There is a risk associated with Over-amplification – more than necessary power from hearing aids- which can harm your hearing
Everyone’s hearing needs are unique and the selection of hearing aids requires an assessment of a person’s listening needs as any hearing aid cannot be fit anyone. Selecting a model on your own can lead to dissatisfaction with hearing aids.
Digital hearing aids are programmable and require software for programming which is not accessible and safe to use by non-professionals
The cause of hearing loss is also important. Not all hearing losses can be helped with hearing aids. Some can be corrected medically while some require other hearing devices like BAHA/ Cochlear implants. One needs to consult a Hearing care professional / Audiologist for the same.
Hearing aids are electronic devices and hence are susceptible to damage if not handled well.
Hearing aids are available in different styles and models. Any hearing aid cannot be fitted to anyone. It requires a thorough assessment of your hearing.
Role of Audiologists/ Hearing care professionals in management of hearing loss:
An audiologist is a professional who specializes in the diagnosis, management, and rehabilitation of individuals with hearing loss of all ages. Since hearing aids are medical devices, a thorough understanding of the mechanism of hearing, cause of hearing loss, management options, treatment, and the prognosis is necessary to be guided by an Audiologist.
An Audiologist will conduct a thorough examination of your hearing abilities; access your individual listening needs and specific issues that you face pertaining to your hearing. He/ She will then guide you regarding the management of hearing loss. If aural rehabilitation with hearing aids is indicated, he/she will guide you to choose the hearing aids suitable to your hearing loss type, degree, and your individual listening needs.
Hearing aids are available in different styles and technologies. A hearing aid trial is necessary in order to evaluate which hearing aid gives the best performance and is most suitable. Different hearing aids can be tried during your consultation with an audiologist and this can help greatly in making a decision.
Adaptation to hearing aids takes time. During this time, the audiologist helps you with follow up appointments to help you get better used to hearing aids. Hence, even after purchasing the hearing aids, most often support is necessary to help you use hearing aids comfortably. This is the major disadvantage of purchasing hearing aids online.
Hearing aid settings are to be made tailor-made quite like your garment fitting.
Have you had an experience with online garment shopping that ended up with the return of clothing as it didn’t fit?
Also, did you know that hearing loss can be progressive and regular assessment of hearing is necessary even after hearing aid fitting?
Audiologist helps you with regular Audiological assessment at regular intervals.
Hearing aids are electronic devices. Hence servicing the hearing aids is necessary from time to time. Audiologist helps you with regular servicing so that optimal performance through hearing aids can be maintained. Also, any repair issues also are addressed when hearing aids are purchased from an audiologist.
Custom molds are required for behind the ear hearing aids and also for Receiver in the canal hearing aids in some cases. You can get that done at the audiology clinic. Also, custom hearing aids that fit into the ear canal like in the ear(ITE), In the canal(ITC) hearing aids, Completely in the canal(CIC) and invisible in the canal (IIC) hearing aids are developed after taking your ear impression and then housing the hearing aid components into the shell.
These services are available at the audiology clinic. Audiologists can help you with the pros and cons of different styles and recommend which is most suitable for you. This takes care of your satisfaction while using hearing aids for a longer period of time.
A constant touch-point is necessary for most hearing aid users. Common support needed is for troubleshooting, changing tubing of molds, buying batteries, or any accessories. This becomes difficult when we consider buying hearing aids online.
Also, if you consult an audiologist for programming after you purchase hearing aids online, that would not be the best idea either as that would not guarantee satisfaction since the extent to which hearing aids can be programmed vary model to model. Also, the selected hearing aid may not be suitable for the user. The service provider would likely charge you for every consultation for hearing aids ordered online.
The prices of online hearing aids are appealing to the user. However one needs to understand that Audiologist’s involvement in the process will improve your satisfaction with hearing aids as audiologists not only would help you with the selection but also with all their consultations from time to time, counseling as required, guidance regarding hearing aids usage, care and maintenance and services related to it like programming of the aids, retuning, servicing and repairs.
Hearing aids are not like any other gadgets that you buy without requiring anyone’s consultation. Make sure to take professional advice for getting the most satisfaction with hearing aids.
Dr. Shubham Mittal is a 24 years young aspiring Doctor who has just completed his MBBS and right now working at the hospital as well as preparing for his pg exams.
He has a mild loss which makes it difficult to hear the complaints of his patients at the hospital. His day begins with his patients and night ends with parties. He will be indifferent environmental backgrounds.
Off late, Dr. Shubham is facing problems with changing volume and different programs based on the environment he is being in. At this younger age, he feels awkward every time touches his hearing aids to make necessary changes in the hearing aid manually.
He fails to enjoy the company of other doctors at parties which is also affecting his personal life and also professional.
Then Dr. Mittal consulted the Audiologist at Aanvii Hearing Solutions, she prescribed him a hearing aid which is compatible with the special feature that is Touch Control App.
He is very amused with this app as it’s being very easy to control all the features and volume with just a single tap. Now let’s see how the Touch Control App is helping Shubham.
In today’s world where technology and cosmetic appearance are the main concerns of all the people. If a patient with hearing loss tries to make any changes in the hearing aid in front of others it might turn out to be an awkward situation, yet the patient cannot compromise with the quality of hearing either.
Hence our Signia products solve all these problems, with an application which has also aid the patients to make necessary changes they wish without having to touch the hearing aid or get into an awkward situation.
As we are meeting more patients who need advanced touch control app. Signia has come up with a unique app known as the touch control app. Touch Control App is the most discreet and convenient handling option right at patients’ fingertips.
It offers the most proven functionality for increased usability and is compatible with almost all the Signia products.
Remote support, audio streaming, and remote control are at the tip of the patient’s fingers. Most Signia hearing aids are compatible with useful apps for both Android and iOS smartphones.
The most used and best of them is the touch control app. This app lets you discreetly and conveniently change the hearing programs, volume, bass, and treble via their smartphones without any extra hardware.
What is the need for the Touch Control app?
It is the most discreet and convenient handling options right at your fingertips. The touch control app offers proven functionality for increased usability and compatibility with all Signia products. The spatial configurator function in the touch control app increases usability by allowing wearers to focus on their preferred sound source.
A new additional configurator option via QR code sets all features and program names based on the configured options in Connexx software. This new QR code automatically activates the spatial configurator and battery check options for compatible instruments.
Where is it available? The touch control app is easily available at the Apple app store and also in Google play store. It can be used in almost all of the Signia products.
How to download the app?
Make sure you have an Android or iOS smartphone and an account on the Google Play Store or Apple App Store. Log into your account on the above-mentioned store and find the Touch Control App. Follow the instructions until the app is installed on the android or iOS smartphone.
How to pair it with the hearing aid?
Touch control app can be paired both manually and through QR code,
QR code is easily generated in Connexx Eight software.
The code on the printable single-page instruction sheets lets you set up the touch control app in just one step.
They just scan the code and program names and features for the touch control app are configured automatically.
How does it look?
It mainly consists of a main screen which consists of,
Display of current program
Volume up/ down slider
When we open the further option we find battery status check and sound balance options
When we open the spatial configurator we find the spatial configurator direction which can be set and also the spatial configurator span.
What are the features available?
Volume adjustment – which allows to increase or decrease the volume
Program change – which allows changing the program based on the environment patient is in.
Mute option – allows the patient to mute the hearing aid
Sound balance adjustment – helps in balancing sound
Spatial configurator adjustment – the patient can select the direction from which he expects better clarity to cut down the background noise.
Spatial configurator is a feature where the hearing aids automatically focus on the listener, whether to sides or behind, in competing noise situations, like in the car, etc.
In simpler terms based on the direction of the speaker the hearing aid makes necessary changes to focus more on speech and cut down the other noises.
Battery status readout – can check the battery status with the help of beep sounds in terms of 3,2 and 1 beep
Tinnitus volume – can be used to set the volume of the tinnitus program
What is the outcome of the Touch Control app?
Do you know the best part: the Touch Control app can be downloaded on the Google play store and Apple App store completely free of charge.
It provides an added value for the patients and also for the Audiologists. It is delighting wearers and providing the remarkable value which is essential in today’s hearing care market. It’s so simple and for free. It lets you discreetly and conveniently change their hearing programs, volume, bass, and treble via their smartphones – without any extra hardware. It is an easy to read display even gives users with dexterity issues easy access to their hearing instruments.
Which are the Signia products which have this option?
About the Author: Ananya Ajay is an Audiologist & Speech-Language Pathologist, she works at AANVII HEARING SOLUTIONS.
She is extremely passionate about providing exceptional care, warmth & devising treatment for patients with hearing loss through all walks of life.
Watching videos and talking on the phone is a routine in our generations, especially when you are involved in working with the same.
One of my clients of age 47 is a business associate who would attend at least 10-15 calls per day. He rather found it comfortable to remove his hearing aids while talking on the phone, but doing this several times a day and the inability to use headphones or earphones frustrated him. This ended up in abrupt usage of his hearing device and he fancied a better solution.
Similar is another client who is a music enthusiast, she in her retirement loves to listen and watch television during free hours. Since she was accustomed to using headphones while doing the same, it turned out to be a hassle. For not compromising with the lifestyle, both were recommended EasyTek accessory.
The new EasyTek accessory and EasyTek App provides remote control and audio streaming in one device with the experience of the high-quality stereo headset. This accessory permits you to directly stream phone calls, videos, music, or TV show directly to your ears via Bluetooth.
This chargeable device is to be worn around your neck and under the clothing, which makes it effortless and goes unnoticed, which gives you easy to use in the work environment.
All the important settings like picking a call and changing listening programs can be manipulated through a single button. It also lets you control the volume through the device, also all the functions and low battery status is indicated through distinct LED lights. EasyTek is compatible with the following appliances
Bluetooth phones (up to two)
Bluetooth audio devices such as Tablet, PC, Stereo, Laptop, TV…
The standard line-in devices (audio devices with 3.5 mm jack) FM receiver enables you to use
FM systems even if your hearing instruments do not have an audio input
Our transmitters (up to two) enable wireless audio streaming for devices that do not support Bluetooth.
Once the Bluetooth device is turned on, EasyTek is turned on, Neckloop is plugged into both sides and EasyTek is worn around the neck, every Bluetooth device has to be paired once with EasyTek. After that, the connection is automatically established when EasyTek is turned on and the Bluetooth device is within operating distance.
EasyTek app lets’ control your hearing instruments and how they interact with all of your favorite electronic devices, whether it is watching TV, listening to your favorite song, or talking to a friend on your mobile phone right at your fingertips on Android Smartphone, Tablet or iPhone. For using the app you must have an easyTek. Wear it as usual and turn it on and your Smartphone or tablet must be within Bluetooth operating distance (about 10 m or 32 ft).
Mr.Surender Lahoria is my 50yrs old patient, practicing as a businessman.
He has difficulty understanding speech, especially in a noisy environment. He feels he has to put in extra effort to understand speech which in turn makes him frustrated. He consulted me with his concerns.
After a detailed evaluation and understanding of his lifestyle needs. I suggested to him pure px which has the amazing speech master feature.
Now let’s see how is speech master feature is helping Mr Surender Lahoria in his daily life.
What is speech master?
The clearer you understand your conversation partner, the less effort you have to expend listening. Speech master helps you hear your partner clearly.
Primax deploys a range of sophisticated technologies in harmony with one another to ensure effortless hearing in a wide variety of speech environments.
From the lively family breakfast table to the noisy commute, from the bustle at the office to the sounds enveloping a street café on a windy day, this feature helps you to hear the person speaking to you clearly, this feature is known as speech master.
What are the benefits of speech master?
Listening effort is reduced by making speech understanding easier for you.
Helps to reduce listening effort in a wide variety of speech environments.
What are the key technologies for the effortless hearing?
Noise reduction – reduces background noise
Directionality – focuses on the direction of the target speaker
Amplification – elevates the target speaker over all other sounds in the environment
In what situations does the speech master feature help in hearing effortlessly?
These are lists of some of the hypothetical daily situations to help you understand the speech master better,
At the breakfast table
The radio is playing and someone is rustling through the pages of the newspaper.
The speech master engages noise reduction to minimize the rustling of the paper and other noises in the background so that the voice from across the table is singled out for clear and effortless understanding.
At railway station/ metro
If you are chatting with your colleague on the way to work.
In the background, the sound of announcements and trains make this a demanding situation.
Speech master activates speech and noise management to reduce the unwanted sounds and helps to focus on speech coming from the front.
The voices of the speakers around the speaker are also reduced for clear and relaxed conversation.
In an office
At the office, phones are ringing and people are talking across the hall.
For a one-on-one conversation, it’s a distracting situation.
Noise reduction is automatically activated, minimizing unwanted sounds such as phones.
When the people around the wearer start speaking, the speech master also attenuates them and focuses on the main voice, making you understand effortlessly.
At a café
You are with your friends at a café.
Traffic in the background is loud and mingles with the noise of the wind and chatter from the next table, making hearing difficult.
Here, noise reduction are activated, suppressing the traffic sounds.
Speech master also attenuates surrounding sound even further by singling out the main speaker.
Mr. Surender Lahoria is extremely happy as he is now able to take part in his all day to day routines and is able to enjoy the sound of joy without any hassle of having to make extra efforts. “Now I can listen effortlessly in any type of environment I am present in,” he says.
Do you want to experience the sound of joy without any hassle of making extra effort to understand speech in any situation whatsoever? Then check out the list of hearing aids that are compatible with the Speech Master feature;
Single-sided deafness (SSD) is a condition in which a person has lost hearing in one ear, but can still hear with the other ear. It’s also known as unilateral hearing loss, which is prevalent in 40% of the population with hearing impairment.
We are designed to have two ears for a reason—the brain uses both ears to pinpoint the location of a sound and to improve hearing quality and range. This is known as binaural hearing.
Unable to judge the loudness of a sound
Confusions in pinpointing the location of a sounds
Poor understanding of speech/ muffled speech due to the head-shadow effect
Difficulty to filter the noise to understand speech in noisy listening environments
There tends to add up stress, anxiety, and frustration as well
Single-sided deafness can be experienced because of various factors such as-
A patient of age 37yrs suffered from unilateral hearing loss after a head trauma due to an accident. He was a university professor and had an active lifestyle. He used to attend and give seminars, conduct classes, and attend meetings on daily basis.
The hearing loss started causing hindrance in his career as he found it extremely difficult to locate and understand when his students and coworkers communicated with him.
After diagnosis and analyzing all his needs, he was recommended usage of Contralateral routing of sound system (CROS), this system is uniquely made for people with single-sided deafness in one ear and normal hearing in the other.
When you wear a device on either side of the ear, the signal from the non-functional ear is routed wirelessly to the well-functioning ear. The nonfunctioning ear has a transmitter, which only transmits the signals received from the particular side to the receiver that is placed on the functional ear.
With the help of this system, my client did not miss out on any discussions and was completely satisfied with the results. For people who have mild to moderate loss on the functional ear, there is an option called Bi-cros, which works in a similar way, only by providing the necessary amplification through the receiver in the functional ear.
Benefits of using a cros or bi-cros device-
Clearer and easier conversations with precise speech audibility and accurate speech detection in difficult listening situations
A better understanding of speech in noise
Wind, noise, whistling, and feedback management for optimal speech accuracy
Simultaneous processing of multiple sounds for a comfortable listening experience that makes speech crisp and clear while keeping ambient noise natural
Improved phone conversations with ear-to-ear streaming.
Signia hearing aids provide cros and bi-cros fitting accessories called CROS Pure available in two different technologies, Primax (Px) and Nx respectively.
CROS/Bi-Cros Px works on primax technology, compatible hearing aids with this transmitter are
2. CROS/Bi-Cros pure 312 Nx works on Signis Nx technology, compatible hearing aids with this transmitter are
Pure 3Nx /5Nx/7Nx
3. Nx technology also provides CROS/Bi-Cros Silk Nx transmitters on Completely in the Canal (CIC) model. Compatible hearing aids with this transmitter are
4. CROS Pure Charge & Go Nx transmitter is specially made for rechargeable hearing aids. Compatible hearing aids with this transmitter are
Mrs. Minaxi Lahoria is my 48yrs old patient who has a tinnitus problem, she is unable to sleep or concentrate on anything because of this problem. She is feeling it very uncomfortable to carry out her everyday routine. She has already taken a lot of medicines for this problem and nothing seems to work. She consulted me in despair seeking a solution.
After a detailed evaluation and explanation about tinnitus, she was recommended pure 2px hearing aids to solve her concerns.
What is tinnitus?
Our world is alive with sound. Laughter, unforgettable melodies, waves breaking on the shore, all these sounds enrich our lives and are literally music to our ears, lifting our mood, what happens when one sound suddenly takes control?
Tinnitus is the noise that originates from within the ear rather than from the outside environment. This may affect one or both ears. Unfortunately patient often learns from their doctors that their complaint is incurable. This kind of information makes patients feel isolated convinced that no one can understand what they are going through. Because tinnitus has many causes, so far we have no specific medication or patent cure for all types of tinnitus.
How a person does feel with tinnitus?
The noise differs from one person to the next in nature, pitch, and volume. Many describe the noise as a whistling, hissing, roaring, or ringing in the ear.
What are the types of tinnitus?
Acute Tinnitus – If the noise occurs only temporarily and soon disappears again for instance after a loud concert, it is called acute tinnitus.
Chronic Tinnitus – For millions of people, though the noises are permanent (more than six months), thus developing chronic tinnitus.
What are the possible causes of tinnitus?
One of the most common causes of tinnitus is hearing loss. This may be due to blast injury or exposure to exceptionally loud music.
Frequently occurs alongside sudden hearing loss.
Stress is the most commonly quoted cause of tinnitus.
What are the other problems which you can face due to tinnitus?
How can tinnitus be diagnosed?
Doctors may conduct ENT, dental, orthodontic, and orthopedic examinations.
A hearing test can reveal whether the hearing impairment is also involved.
How can you cope with tinnitus? What are the treatment options available?
Even if there is no specific cause is determined, tinnitus can be treated. There are many possibilities to help patients find ways to cope with their condition. This means changing habits and attitudes so that tinnitus no longer controls your everyday life.
How can you manage tinnitus?
Learning relaxation methods
Practicing imaginary journeys to elicit positive emotions
Transforming negative thoughts and attitudes into a helpful mindset
Weaning off habits that encourage tinnitus
Training for use of hearing instruments, noisers, combined devices, or other audio sources to deflect attention away from tinnitus.
Tinnitus noiser is one of the popular and most effective ways of tinnitus management.
Modern technology can help subdue tinnitus. The main principle is allowing your brain to hear and therefore focus on external sound rather than tinnitus.
What are noisers?
Noisers are for people without hearing loss.
They look like hearing instruments but do not amplify the sounds in the environment.
They generate a soft murmur that is mixed in with the tinnitus to distract the patient from the tinnitus.
Noisers generally offer considerable relief from tinnitus.
What are hearing instruments?
Sometimes wearing hearing instruments both improves hearing and alleviates tinnitus.
The reason being that if you can hear better, you can also ignore tinnitus better.
Hearing instruments pick up ambient sound over a microphone and amplify it before passing it onto the ear.
This enables wearers to better focus on the noises, sounds, and tones around them.
The rustle of leaves in the forest, friendly conversation, or beautiful music restore the emphasis on pleasant hearing impressions and narrow the scope of tinnitus.
In many cases, users scarcely or don’t hear the tinnitus at all as soon as the hearing instrument is switched on.
What are tinnitus combined devices?
Some hearing instruments also feature a noiser function.
As hearing instruments can only amplify noises actually present around us, they are of little use as tinnitus therapy tools in very quiet hearing environments.
This is when the noiser function can be helpful.
In these situations, the noiser can generate a soft noise to distract the patient from the tinnitus.
In modern hearing instruments, like those from Signia Seimens, various hearing programs can be selected at the touch of a button: pure hearing instrument function, purely noiser function, or the combination of two.
What are the tips for living with tinnitus?
Relearning how to hear
Have a good night sleep
Get active, stay on the move
Promote physical fitness
Learn to relax effectively
Mrs. Minaxi Lahoria is very happy and contented after resolving all her problems, she has been using hearing aids for the past 6 months and has found a considerable amount of relief from tinnitus. She is comfortable in carrying on with the daily routine and she feels that the tinnitus is subsided.
List of hearing instruments which has a tinnitus option in it are as follows,
Mr. Nitish of age 42yrs visited our clinic a week back with a complaint of reduced understanding of speech for a year. When we were reviewing the history, it was found that he was identified as having Mild to moderate sensorineural hearing loss in both ears in 2017.
When enquired, he said that he had not had a trial with hearing aids before and currently he felt that this was gradually worsening. He also mentioned that he was feeling anxious at work because it was a noisy environment and that he had stopped watching TV as he no more understood the dialogues.
Another audiometry was done and he was diagnosed as having moderate sloping sensorineural hearing loss in both ears. Test findings were shared with him and he was counseled regarding how important usage of hearing aids is for him.
Trial with Pure Charge and GO 5NX was done for both his ears and he seemed to be most comfortable and delighted. He took them for a 3 day home trial and then purchased them the same week. His major concern was that he was working in a place where there were many people and he was unable to focus and understand conversations in group meetings or conversations at home over the dining table.
Let’s see how noise plays a role in speech understanding
It’s a noisy world, and the noise continues to be a major issue for hearing aid users. Let us take a look at Noise management strategies, general guidelines for assessing patients hearing abilities in noise, the intended applications for the various noise reduction strategies, as well as when and how to implement them.
Let’s face it, our environment is noisy.
Noise is the 1st main complaint of all participating consumers when eating at restaurants. Individuals cannot even escape from the noise in their own homes, as noise is the number-one neighborhood complaint. Since normal-hearing people are subjected to considerable amounts of noise on a daily basis, it is not surprising that the number-one complaint of all hearing aid users is difficulty hearing in noise; almost half (49%) of those who return their hearing aids reportedly do so because of problems with background noise.
Normal-hearing people also encounter difficulty hearing in noise but are better able to recognize or discriminate speech than those with hearing impairment. However, as the background noise or when the distance is increased or when unfamiliar topics are introduced, the natural discrimination of speech decreases.
The discrimination capacity in speech is often lost when someone has hearing loss and parts of phonemes might not be audible. Auditory coding (frequency resolution) also might not be as precise, which can result in stimulation of additional frequency areas within the cochlea, making it more difficult to differentiate among the sounds being heard.
A second problem for those with hearing impairment is the ability to detect changes in the duration of sounds (temporal gap discrimination).
Older adults with hearing impairment often face other difficulties in addition to the above-mentioned problems. Given the same hearing loss configuration, studies have shown that older adults perform worse on speech recognition measures in quiet than younger adults. In addition, older adults might experience more difficulty processing language in the presence of competing speech due to cognitive involvement.
With all of these factors that can contribute to hearing in noise problems, what approach are most clinicians taking, and is there more that could be done?
Most clinicians are using audiograms and speech discrimination measures in quiet on a routine basis as assessment tools for their hearing aid clients.
Results indicate that less than half of the hearing instrument specialists were routinely performing some type of speech in noise test, although hearing in noise has consistently been the number-one complaint from hearing aid users for years.
Addressing Noise Issue(s)
It is important to Identify the Source of the Hearing in Noise Problem
Although audibility can easily be predicted from an audiogram, speech recognition ability in quiet is a poor predictor of speech recognition ability in noise. Furthermore, significant differences have been reported in the ability to understand speech in noise among hearing-impaired listeners with similar audiograms.
In order to address the hearing in noise complaints, it is important to measure hearing in the various auditory domains that can contribute to hearing in noise difficulties. In general, there are three domains for assessing these difficulties:
Basic auditory function or the audiogram
Speech discrimination ability in quiet
Speech discrimination ability in noise
Addressing the Noise issues
Audibility. Current American Academy of Audiology (AAA) guidelines recommend performing real-ear measurements (REM) as a tool for verifying hearing aid gain in adult patients. REM can be used to provide objective information regarding whether an incorrect gain is a contributing factor in a reported hearing in noise problems.
The gain values that the manufacturer recommends for a given hearing aid user in the fitting software assume the patient has an average-size ear canal.
Therefore, if a given patient has a larger-than-average ear canal, they may not receive enough gain and could complain that speech is not loud enough or that noise is too loud due to a primary audibility issue. Likewise, if the patient has a smaller-than-average ear, the hearing aids may provide too much gain, resulting in everything being too loud, including noise.
In addition, audibility—especially in noise—can generally be improved by fitting hearing-impaired patients with two hearing aids instead of only one, when possible. Such benefits include better hearing in quiet and noise, better sound quality, better localization of sounds, and higher listening comfort in various situations.
Although some studies have shown an improvement in the ability to understand speech in noise when fit binaurally, there may not be an improvement in the actual acceptance of noise. Studies also have shown there is a small segment of the elderly population who may actually perform better on speech recognition in noise tests when fitting monaurally due to possible binaural interference.
Overall background noise. If your patient is complaining about the overall level of background noise, the problem could be due to noise that is mixed in with the signal of interest or noise that is being amplified in other areas along with the signal of interest.
The noise that is embedded in the signal of interest. It is extremely difficult to develop a hearing aid algorithm that removes all of the noise embedded in speech without eliminating or distorting a portion of the desired speech signal.
Most hearing aids on the market today have a noise reduction algorithm that uses modulation rate/depth or spectral subtraction to eliminate unwanted noise from the signal. Enabling noise reduction or increasing the noise reduction gain for the environment(s) in which the patient is experiencing difficulty hearing in noise can be especially helpful in improving listening comfort.
A noise that is separated from the signal of interest. Directional processing can be helpful when a patient complains that he/she is having difficulty hearing in noise, and the speaker or signal of interest is separated out from the unwanted noise. Directional microphones are the most effective noise reduction strategy in hearing aids and are reported to provide a 3 to 4 dB SNR improvement in real-world environments with low reverberation.
There are several basic directional technology schemes that can be selected for a given hearing aid user. Fixed directionality is best at canceling noise located behind the hearing aid user when the speaker or signal of interest is located in front of the user.
Adaptive directional processing can be helpful when a hearing aid user is confronted with multiple noise sources. With adaptive directionality, multiple noise sources in different locations can be canceled out at the same time. There are several different ways in which hearing aid users can access the directional programs within their hearing aids. Users can change the programs manually by using a button located on the hearing aids or by using a remote control device.
Wind noise. Wind noise generated by random turbulent flow across the hearing aid microphone(s) can be a mere annoyance or a debilitating interference for hearing aid users. Research has shown that wind noise interference can vary based on the style of hearing aid, the processing is used, and the direction of the wind flow.
As a general rule, the best way to reduce the annoyance of wind noise is to prevent it from entering the hearing instrument in the first place. Some custom device styles, such as CICs that fit deeper into the ear or remote microphone instruments in which the placement of the microphone lies within the contours of the ear, offer natural wind noise protection. Other hearing aid styles, such as BTEs, are more susceptible to wind noise.
The microphone mode is also important. With a directional microphone, the interfering wind noise that is generated very close to the microphone is sensed with high sensitivity while the desired sound from the far-field is sensed with low sensitivity.
Whenever there is a choice, the directional microphone on a hearing aid should not be used when wind noise is present. Thus, fitting a patient with a single microphone hearing instrument or utilizing a program with omnidirectional processing can reduce wind noise complaints.
In addition to the above options, many manufacturers offer software-based wind noise programs that are designed to reduce gain in the frequencies in which wind noise is detected. Possible issues with such wind noise reduction features are that they may detect wind noise when it is not actually present, or they may fail to detect wind noise when it is. The result can be annoying gain reductions at unwanted times or lack of comfort in windy conditions.
Ambient noise. Although wide-dynamic range compression (WDRC) and/or directionality can be quite beneficial, they also can create a problem: ambient noise.
WDRC is used to restore audibility for weak sounds and simultaneously restore some of the normal loudness perceptions that are lost with recruitment. In order to accomplish this, more gain is applied to low-level input sounds than high-level input sounds, with input signal levels below the threshold of compression typically receiving linear amplification.
Loud sounds. If loud noises are intolerable, but all other sounds are okay, it is likely that the patient’s UCLs for at least some of the frequencies have been exceeded. Real-ear and coupler verifications of loud sounds are excellent ways to verify that loud sounds are tolerable to the patient. Measured results can be compared to the patient’s actual or predicted UCLs to adjust hearing aid gain and output.
Counseling and Setting Realistic Expectations
The main goals when fitting amplification are
to improve audibility and to increase the signal-to-noise ratio resulting in an overall improvement in speech understanding.
Even with amplification, some patients will still encounter significant hearing problems due to a damaged auditory system, reduced cognitive ability, and/or difficult auditory environment.
Therefore, it is important to use the subjective and objective test results to counsel the patient about realistic expectations. If the patient demonstrates a significant SNR loss, he/she might benefit from assistive listening devices (ALDs), aural rehabilitation/counseling, or computer-based auditory training programs in addition to amplification.
With all of the wireless hearing aids in the market today, many new ALDs have been introduced that can improve the SNR by offering direct connectivity to TVs, phones, iPods, or remote microphones.
In addition, studies have shown that when hearing aid users attend group support programs on average they have fewer return visits and report their hearing aids to be beneficial in more listening environments than those who do not attend a group. Computer-based auditory programs also can be helpful in improving speech understanding ability in noise.
While technology and training can help improve the SNR for hearing-impaired people, the noise will always be an issue that even normal-hearing people have to contend with on a daily basis. The best option continues to be starting out with a good SNR by being selective about the environment when possible and manipulating the environment when necessary.
Clinicians can be most beneficial to their hearing-impaired patients by providing them with hearing tools—not just hearing aids—and these tools should include ALDs, counseling, and listening strategies.
Speech and Noise management is compactible with the following hearing aids:
Intuis 3 products
RIC/BTE/Custom 1PX ,2PX ,3PX,5PX and 7PX products
RIC/BTE/Custom NX Products
Pure Charge and GO NX/Motion Charge and GO NX Products
Mr. Sen is a retired Bank officer who has been facing difficulties in hearing for the last 4-5 years. He has used hearing aids in the past however he finds it difficult to follow telephone conversations and has clarity problems while watching TV.
He also likes to hear debates, listen to old Hindi songs and speeches on his phone, but reported that he often misses words due to reduced clarity. He is an iPhone user.
Mr sen approached Aanvii Hearing Solutions to get a solution for his problems. We proceeded with his testing. After assessing his listening needs and problems, he was recommended Pure Charge & Go 5Nx hearing aids in both ears which are Made for iPhone hearing aids.
What are ‘Made for iPhone’ hearing aids??
These are hearing aids with Bluetooth compatibility for iPhone. There is a special Bluetooth low energy protocol that is used which reduces the battery drainage of both the devices without compromising the quality of streaming.
What is the use of this feature? How does it help to hear better?
This feature can be used for direct streaming of phone calls, music, or videos through iPhone, iPad, or iPod touch devices. It works on Bluetooth technology using which your hearing aids would work like wireless stereo earphones. The clarity of phone calls or music or anything you stream is crystal clear when streamed through Bluetooth.
Can these Hearing aids be used if I do not have an iPhone?
Yes. For using the streaming feature, you would need to use a streaming accessory called ‘Streamline Mic’ which will pair your android phone to your Made for iPhone(MFI) hearing aids.
How to pair these hearing aids to your iPhone?
Step 1: Switch on the Bluetooth by going to General setting on your iPhone
Step 2: Go to iPhone SETTINGS>>GENERAL>>ACCESSIBILITY>>MFI Hearing devices
Step 3: Ensure that hearing aids are completely charged and switch ON the hearing aids near your iPhone
Step 4: When you press on MFI hearing aids, the iPhone would begin scanning for hearing aids and display it on the screen once detected.
Step 5: Press on the hearing aids displayed. The pairing option will pop-up for both the hearing aids. Press on ‘Pair’ for both the hearing aids and YOU ARE DONE!
Can I control the hearing aids’ volume or settings through my iPhone?
Yes, You could increase or decrease the volume or change programs by going to Settings on iPhone. Settings>> General>> Accessibility>>MFI devices
An easier option would be using an App to control your hearing aids. The name of the app is the MyControl App. You could download the app from the App Store and the app provides easy access to the settings of your hearing aids.
Which iOS devices are compatible with Made for iPhone hearing aids?
iPhone 5 or later
iPad Pro (all models)
iPad Air (all models)
iPad(4th generation ) or later
iPad Mini (all models)
iPod touch(5th generation) or later
What happens if I receive calls once the hearing aids are paired to my iPhone? What do I need to do if someone else wants to talk from my phone?
Once the hearing aids are paired to the iPhone, the default mode would be through the hearing aids’ Bluetooth. In that case, you would hear in both ears and don’t even need to hold the phone on-ear you. You could talk hands-free.
If someone else wants to talk from your phone, press on ‘AUDIO’ option on your screen after connecting the call. Then select ‘iPhone’ to enable iPhone’s speaker. One can then hold the iPhone on-ear and talk like we normally do. You also have the ‘SPEAKER’ option which can be used to put the iPhone on speaker mode which will be a hands-free option when all of you can hear it.
Can I pair hearing aids to two iOS devices at the same time?
No, if the hearing aids are paired to one of your iOS devices, they need to be disconnected before pairing it to other iOS devices. You cannot stream through two iOS devices at the same time.
Can MFI hearing aids stream audio through TV?
Yes. You would have to use an accessory for TV streaming called ‘Streamline TV’ using which you can stream TV audio directly into your MFI hearing aids.
If I watch something on my iPhone, will it be heard only by me or by others as well?
When you stream audio to Made for iPhone hearing aids, it will be heard only by you. When iPhone’s Bluetooth is switched off, it would not be streamed to your hearing aids anymore. So everyone around would be able to hear what you play.
How are MFI hearing aids different than other Bluetooth headphones/earphones?
When streaming through Bluetooth headphones/earphones, the ambient noise is suppressed and you can hear the audio that is streamed. Attending to other environmental sounds can be difficult. However, when streaming from MFI hearing aids, you can also hear other sounds in your environment enabling you to be more alert of other sounds in the environment. Headphones are external accessories that are often bulky and heavy on the ears, while made for iPhone hearing aids act as Bluetooth stereo headphones without any extra weight on your ears. Also wearing over the ear Bluetooth headphones /earphones can get uncomfortable if used for longer periods of time. Hence it is more convenient to use MFI hearing aids than headphones/ earphones as the audio is not only streamed but also enhanced based on your hearing loss.
If I want to use streaming feature, it is preferable to used rechargeable hearing aids or battery operated hearing aids?
It is preferable to use rechargeable (Charge & Go) hearing aids than battery operated (Battery 13 and 312) hearing aids as when the streaming feature is active, the zinc-air batteries tend to drain out very soon and would need replacement often. Instead, if you use rechargeable hearing aids, the Lithium-ion batteries are more durable. Hence it is advisable to go for Charge & Go hearing aids if you intend to use the streaming feature for a considerable time in a day.
Mr. Sen can hear phone conversations seamlessly now. He can also enjoy listening to debates on his phone & enjoys listening to old Hindi songs through his Made for iPhone hearing aids.
Following is the list of Made for iPhone hearing aids: