Hearing Aids: A Frisco ENT Doctor's Personal and Professional Perspective

Hearing Aids: A Frisco ENT Doctor's Personal and Professional Perspective

As an ENT doctor who has both personally and professionally navigated the complexities of hearing loss for over two decades, I bring a unique dual perspective to the subject of hearing aids. My journey through the evolution of hearing technology—from the analog devices of the past to today's advanced digital solutions, and from the simplicity of over-the-counter aids to the sophistication of prescription models—has given me a deep appreciation for the nuanced choices that can significantly enhance the hearing aid experience. This guide aims to share valuable insights into selecting, fitting, and adjusting hearing aids, underscored by my personal experiences and professional expertise.

From Analog to Digital: The Evolution of Hearing Aids

Initially, hearing aids were analog devices, simple amplifiers that increased the volume of sounds without much refinement. While they provided a basic solution, their one-size-fits-all approach often resulted in a less natural sound experience, amplifying all noises indiscriminately, including background noise. This often made understanding speech in noisy environments challenging. These were the frequently squealing hearing aids we remember our parents and grandparents disliking so much.

In contrast to analog aids, modern digital hearing aids, which were widely introduced in the mid 1990s, represent a significant leap forward. These devices convert sound waves into digital signals, allowing for more complex processing. This means they can be programmed to amplify certain frequencies more than others, tailored to the user's specific hearing loss profile, much like a well made glasses prescription is made to bring clear vision to their wearers. Digital hearing aids can also distinguish between types of sound, enhancing speech while minimizing background noise, and offering features like wireless connectivity, direct streaming from devices, and environment-specific settings for optimal hearing in various situations. Digital aids can even be set to pick up sound from a specific direction, such as a dinner when you are sitting directly across from someone. In this case, the aid can amplify sounds coming from the front but avoid sounds coming from the sides of the room. The most recent generation of hearing aids is now using machine learning and AI to actively interpret the environment around them in real time and adjust to each situation to tune their input to their users benefit.

In-the-Ear vs. Behind-the-Ear Aids

Choosing the right hearing aid style is crucial for comfort, convenience, and effectiveness. In-the-ear (ITE) aids are custom-made to fit entirely within the outer ear or ear canal, making them less visible and very convenient, especially for phone use. However, their small size can make them challenging to handle for some users, particularly those with dexterity issues. More importantly, their small size limits their ability both to analyze and produce quality sound, almost always providing an inferior result to behind-the-ear aids. In addition to these limitations, in-the-canal-aids often distort sound to some degree as they act a bit like an ear plug and block some of the natural sounds that we all like to hear. I have tried and number of these aids but have never found a solution that works nearly as well as a behind-the-ear aid. Most end up with an artificial sound and more drawbacks than benefits. Many patients start hearing aid conversations asking about these aids given their small size. While I have known patients who are happy with these aids, I can say with confidence that more than 95% of patients ultimately choose behind-the-ear aids and these are always my recommended first choice.

Behind-the-ear (BTE) aids rest behind the ear with a very small tube that directs sound into a small speaker inside the ear canal. These aids were once fairly bulky but are now small enough that most people don't notice them to any degree unless they stand directly behind the patient wearing them. The speaker that sits in the ear canal is small enough to allow all normal sound to pass through it, avoiding any sense of wearing an ear plug. After a few minutes of wear, they become invisible to the wearer. These are more powerful, making them suitable for a broader range of hearing losses and allow for much more customization and tuning of sound. BTE aids also tend to have longer battery life and can accommodate larger batteries and now often rechargeable options. Battery operated hearing aids can last from 2-4 days of daily use while rechargeable aids are usually charged daily. Hearing aids are usually taken out at night so the practical difference between battery and rechargeable aids is minimal.

Prescription vs. Over-the-Counter Hearing Aids

The distinction between prescription and over-the-counter (OTC) hearing aids is pivotal. Prescription hearing aids are customized based on a comprehensive hearing evaluation conducted by an audiologist. This customization ensures the device is precisely tuned to the user's hearing loss pattern, offering the best possible improvement in hearing. Audiologists now even have the ability to tune a hearing aid while it is in the ear, using the patients own ear canal to help resonate sound and tune the aid precisely enough to emphasize specific sounds the patient feels are more challenging. As just one example, my audiologist recently used this technology to help emphasize the sound of the letter "s" in my own hearing aids, as my own hearing has decrease a bit in the last year. The difference was immediate and strikingly better.

OTC hearing aids, while more accessible and often less expensive, are only tailored to the individual users needs from a basic hearing test, often done on a phone-based app. They may offer a range of preset settings that the user can choose from, but this self-fitting approach will simply not provide the optimal hearing improvement that could be achieved with a professional fitting. I have tried a number of OTC devices and, while the quality of some can be excellent, the lack of professional fitting makes a night and day difference.

The Importance of Fitting and Adjusting Hearing Aids

Proper fitting and adjustment of hearing aids are crucial for their effectiveness. Studies have shown that individuals with properly fitted hearing aids report significantly higher satisfaction levels and improved quality of life compared to those using poorly fitted devices. A well-fitted hearing aid will be comfortable, minimize feedback, and be tuned to the wearer's specific hearing loss, ensuring clarity of speech and sound.

Adjustments are often necessary as the user's hearing changes over time or as they become more accustomed to the device. Regular follow-ups with an audiologist ensure that the hearing aid continues to meet the user's needs, adjusting settings as required for optimal performance.

Exploring the Leading Hearing Aid Manufacturers

When selecting a hearing aid, it's beneficial to consider products from the multiple major manufacturers such as Phonak, Oticon, ReSound, Starkey, and Widex. Each brand offers unique features and technologies designed to address different aspects of hearing loss. Conversations with an audiologist about the specific offerings of these brands can guide patients toward the right choice. For instance, some brands excel in noise reduction technologies, while others may offer superior connectivity options or innovative rechargeable solutions. Some brands are best for people who like to frequently adjust their own aids via a phone app while others are best for patient who would simply like to put their aids on in the morning, have them perform throughout the day, and take them out at night.

Patients are advised to seek out audiologists who offer a range of brands. This ensures a broader selection of options, allowing for a more tailored fit to individual hearing needs. An audiologist with access to multiple brands can provide a comparative perspective on the performance and features of different models, facilitating an informed decision that aligns with the patient's lifestyle, preferences, and hearing loss profile.

Lifespan and Adjustability of Hearing Aids

Hearing aids typically have a lifespan of 5 to 7 years, though this can vary based on the model, care, and how often they're used. Advances in technology mean that digital hearing aids can be adjusted over time to adapt to changes in the user's hearing, environment, or preferences, extending their useful life and ensuring they continue to provide benefit.

Battery vs. Rechargeable Hearing Aids

The choice between battery-powered and rechargeable hearing aids is another consideration. Traditional battery-powered models require regular battery changes, which can be cumbersome and costly over time. Rechargeable hearing aids, conversely, offer the convenience of not having to replace batteries, simply requiring the user to charge the device, much like a smartphone. This can be particularly advantageous for users with dexterity issues or those who prefer the ease of charging over changing batteries.

Water Resistance in Hearing Aids

Finally, water resistance is an increasingly common feature in hearing aids, offering protection against moisture, which can damage the device. While most hearing aids are not waterproof, many are water-resistant, capable of withstanding exposure to rain or sweat, which enhances their durability and reliability, especially for active individuals or those living in humid climates.

Conclusion

In conclusion, the journey through hearing loss and the utilization of hearing aids is deeply personal yet universally impactful. As an ENT doctor with personal experience in hearing loss, I can attest to the profound difference that the right hearing aid can make. Whether it's choosing between analog and digital, ITE and BTE, prescription and OTC, the key lies in understanding the options, ensuring proper fit and adjustment, and staying informed about technological advancements. With the right approach, hearing aids can significantly improve quality of life, offering clarity of sound and the joy of connection to those navigating the challenges of hearing impairment.