An Insight into the World of Hearing Aids

The hearing problem has become a major source of concern today affecting over 11 million people in the UK alone. This figure stands at 1 in every 6 of the population. These figures are expected to rise to 15.5 million by 2030 which is closely tied to the population of the aging people. Hearing loss can be a source of embarrassment and a barrier to smooth communication. It has a social implication as well and can lead to mental illnesses (anxiety and depression).
The mild-to-moderate hearing loss is one of the most prevalent degrees of hearing loss. Among all the adults with hearing loss in the UK, this condition accounts for about 92% of the total numbers.
There are 5 different octave frequencies for accessing hearing sensitivity (0.25, 0.5, 1, 2, 4 kHz). The mild hearing loss is indicated as 20–40 dB HL while 41–70 dB HL stands for moderate in the better hearing ear.
Hearing aid remains the clinical recommendation for the treatment of hearing loss. It is quite unfortunate that up to 60% of the people who require a hearing aid do not have access to it.
One pressing issue remains the fact that most people have this wrong idea that hearing aids are for older adults. A lot of people with hearing problems never took up the hearing aid until in their 70s.

What is a hearing aid?

A hearing aid is a small device designed to improve hearing in people with hearing loss. They are designed to be worn behind the ear or in the ear canal. The core functions of this device are to collect and filter sound. This small device enables people with hearing loss to listen and communicate with people around them. In other words, it helps them participate fully in their daily life and activity. A hearing aid can improve hearing both in noisy and quiet situations. The price of the hearing aid is quite high at the moment with only 2 out of 10 who require being able to purchase.
A hearing aid consists of three basic parts. These include the microphone, the speaker and the amplifier. The hearing aid is designed to receive sound through a microphone. The microphone converts sound into electrical signals and send them to the amplifier. The amplifier increases the power of the signals. These amplified sounds are sent to the ear through the speaker.
Conventional hearing aid does not restore hearing loss, rather they make sound louder through electronic amplification. Hearing aids can be classified as regulated medical devices. Their main duty is to deliver sound directly into the ear canal through air conduction or bone conduction. There are a lot of alternative devices in the market today that are designed to improve hearing. These devices cannot be classified as hearing aid as their core duty is simply to make sound louder.
The more technology continues to advance, we are bound to see more of these devices on the shelves in stores at affordable prices. It is therefore important to understand what your requirements are before throwing your money.

Who requires a hearing aid?

If you think you require a hearing aid, there is only one way to find out. Visit the audiologist to have your condition examined. The audiologist is a trained person who knows the kind of tests to carry out to identify the cause and type of your hearing loss. It is also the job of the audiologist to measure the extent of your hearing loss and determine what treatment is best for you. Those that require a hearing aid includes those who have mild to severe hearing loss.

How can hearing aids improve hearing?

The primary function of the hearing aid is to improve hearing and speech understanding of people with hearing loss. There are different causes of hearing loss. Damage in the hair cells in the inner ear can cause hearing loss. This kind of hearing loss is called sensorineural hearing loss. This kind of hearing loss can occur from aging, diseases, noise and certain kind of medications.
A hearing aid can help patients with mild to severe hearing loss. Sound vibrations entering the ear are magnified. This makes it easier for the surviving hair cells to detect and convert the sound vibrations in neural signals. These signals are then sent to the brain. A severely damaged hair means the greater the degree of the hearing loss. The more severe the hearing loss, the greater the amplifier required by the hearing aid. There are, however, limits to the amount of amplification a hearing aid can provide.
Hearing aids are a very useful device. However, there is a limitation to the kind of hearing loss that the hearing aid can resolve. For the severely damaged inner ear, the hearing aid will be ineffective.

Types of Hearing Aids

In general, hearing aids are divided into two types. Digital and analog hearing aids. The difference between these two lies in how they handle sounds. The Analog hearing aid basically collects sound and makes them louder. It is similar to what happens when you cup your hands behind your ear. Some analog hearing aid may come with a programmable microchip. However, their functions are quite basic.
The digital hearing aid is a bit more of a complex device. It takes sound waves and converts them into digital format. This event is similar to what you see on a computer program. The digital hearing aid processes sound filters it, amplifies and distort it to your personal requirements. In the end, you get a near natural sound been delivered directly into your ear canal. The Digital hearing aid is able to achieve all these through a tiny chip called the Digital Signal Processor (DSP).

Different styles of Hearing Aid

Behind-the-ear (BET)

These kinds of hearing aids are the most common and have been around for quite some time now. They consist of a plastic casing housing all the active components designed to be worn behind the ear. This is then connected to an ear mold that is placed inside the outer ear. Sound waves travel from the hearing aid into the ear through the ear mold. This kind of hearing aid can be used by people of different ages.
Depending on the kind of BTE you will be purchasing, there is a bit of variation in design. Newer BTEs come as small open fit devices that are designed to fit perfectly behind the ear. A tiny tube connecting the receiver and the device is now placed inside the ear. In this case, the canal remains open. This is suitable for people who experience wax build up. This kind of device has a lesser chance of been destroyed by such conditions. Another reason why most people choose this kind of design is the fact that it produced a more clear sound quality.
This kind of hearing aid has a lot more functions than the other forms of hearing aids. It also offers a lot more in terms of control and power.

In the ear (ITE)

This kind of hearing aid is designed to fit completely inside the outer ear. They are used for the treatment of mild to severe hearing loss. This small device fits into a hard plastic casing. Some ITEs are designed with special features which include telecoil. The telecoil allows users to receive sound through the circuitry of the hearing aid rather than the microphone.
This makes hearing very easy over the telephone. With the aid of the telecoil, it is very easy to hear in the public. It also makes it easy to hear in facilities with the special sound system installed. This special sound system is called the induction loop system. This kind of system can be found in churches, auditoriums, schools, and airports.
This kind of device is not suitable for children. Because the casing needs to be replaced as the ear grows.

Canal hearing Aid

The canal hearing aid is designed to fit into the ear canal. This kind of hearing aid is available in different styles. The ITC (in-the-canal) is designed to fit the size of the patient’s ear canal. The CIC (completely-in-canal) hearing aid is almost invisible in the ear canal. These two types are designed for the treatment of mild to the severe hearing problem.
The size of the canal aids can make it difficult for children to use. They are very small and can also cause a lot of discomfort to those who are not used to having things in their ear. They usually have limited sizes of space for batteries and other additional devices like the telecoil. This device is not very suitable for people with severe hearing loss. The reduced size of the canal hearing aid can affect their power and volume.

What are the main components of a hearing aid?

As technology continues to advance, the hearing aid continues to expand. These days, you have a lot of features packed in very small cases. They can be seen as tiny computers wearable on the ear. Understanding this product can be a bit difficult due to its complexity and the level of technology involved in putting it together. Understanding the key parts of the hearing aid will help greatly to improve your hearing problem.
No matter the style and design you wish to go for, all hearing aids come with three major parts.

Microphone

This is the vital part of the hearing aid that is responsible for collecting sounds. The microphone picks up the sounds from your environment and converts them to electric signals that can be analyzed by the processor. The Microphones are designed with the ability to differentiate between different kinds of noise. It understands the difference between speech and background noise. This helps in the way these sounds are processed for better hearing and understanding.
There are two different kinds of microphones. These are the directional and the omnidirectional microphones. Directional microphones are designed to pick up sound in front of the wearer. This kind of microphone is very useful in noisy areas. It makes it easier to understand conversation even with all the background noise. The omnidirectional microphone picks up sound from different directions around the speaker.
One importance of the omnidirectional microphone is that it gives the wearer a good understanding of where the sound is coming from. With recent upgrades in the hearing aid technology, most hearing aids come equipped with both microphones. This helps to create a seamless and more natural hearing aid experience.

The Amplifier or Processor

The processor is where all the actions are carried out. They can be likened to the computer or the motherboard of the device. The Amplifier or the processor is saddled with the responsibility of converting the electric signals from the microphone into digital signals. This makes it easier for sound manipulation.

It is in the processor that adjustments are made to the sound received to suit the wearer. It also takes into cognizance how much amplification is needed to make up for the wearers hearing loss. The amplifier helps to deal with feedbacks and wind noise. Some amplifiers come with what is known as the tinnitus masking features.
After making all the required adjustments, the processor converts the sound back into an analog signal. What happens in the processor is equivalent to what happens in your computer when typing a program. As technology continues to advance, amplifiers are constantly becoming better and faster.
This helps to improve the quality of the speech and communication. Once the job is done in the amplifier, it is the moved to the final part of the hearing aid which is the receiver.

The Receiver

This is the final part of the hearing aid. All the adjustments made by the processor are sent to the receiver. In the receiver, the enhanced sound is created and converted into audio and sent into the hearer’s ear.
The receiver is usually situated in the wearer’s ear. Depending on the kind of hearing aid you go for, the receiver can be placed directly inside the ear canal.

The modern hearing aid is a very complex and sophisticated piece of hardware. It is designed to carry out a lot of complex activities from gathering of sound to processing in just fractions of seconds. Through constant research and improvement, people suffering from different levels of hearing loss can now enjoy natural listening and conversation.

Other small Components of the Hearing Aid

The ear-hook or tone-hook: this is a tube that is situated over the top of the ear that connects the receiver and the device. This is found in BTE hearing aids.

Battery: this is the main power source of hearing aids. Depending on the functions and type of hearing aid, the power requirements will differ.
Vent: this is designed to allow air flow and reducing the uneasiness associated with having objects in and around the ear.
The volume control: this is used to control sound intensity. This function is not available on all hearing aids.
Wax protector: Most hearing aids come with wax filters which protects them from getting destroyed by ear wax.

The wax protector is very common to ITC hearing aids.

Important things to keep in mind when buying a hearing aid

Before you go ahead to spend your cash on hearing aids, it is important to ask your audiologist the following important questions:

What are the most important features that I will need on a hearing aid?

How much does the hearing aid cost? How do the benefits of the hearing aid match up to the towering prices

Is it important to try a hearing aid before purchasing? How long is a trial period expected to last? What fees can be refunded if the hearing aid is rejected after the trial period?

How long does the warranty cover?

Can the warranty of the product be extended?

Does the warranty cover future repair and maintenance?

Is the audiologist equipped to carry out adjustments and minor maintenance?

What are the services the audiologist offers?

Are there any discounts attached to buying a specific device?

Hearing Aid Technology Levels

There are four levels of technology used in hearing aids and they are basic, standard, advanced and premium. As the technology level increases, the hearing aids become more automatic with more features to help the user communicate in difficult listening situations.

Basic hearing aids are good for someone with a sedate life. It can help you to hear the TV and radio clearly and talk to small groups. This level of technology is good for mildly noisy situations.
Standard hearing aids are aimed at people who have a little more active life. The features are better than the basic features and are designed to help in slightly more challenging sound situations.
The advanced level of technology is ideal for active people. It delivers good sound quality and speech clarity in most situations.

The premium level of technology delivers all of the very latest features of the hearing aid. It is for people who have to hear well in almost every situation. They can handle the most complex sound situations and deliver the best speech clarity and most natural sound.

Comparing Hearing Aid Brands

There are many hearing aid brands currently on the market and it can be difficult to compare all of them. The major brands are Resound, Siemens/Signia, Phonak, Starkey, Widex, Oticon, Unitron, Hansaton and Bernafon.
Some brands of hearing aids help you hear in noisy environments such as the workplace, while some others sync with personal devices such as mobile phones.

The best hearing aid for you is the one that matches your unique lifestyle and the hearing loss symptoms affecting you. Hearing Aids are usually priced between $1,000 and $4,000 in hearing clinics. But similar hearing aids are sold online for $300 to $600.
Let’s get a little background of these brands before comparing their products.

Signia

The Signia brand of hearing aids used to be Siemens. Signia was one of the first to integrate Bluetooth into their devices. The Signia product lines are excellent at reducing background noise. Signia's latest product line is denoted by Nx. They include the rechargeable Pure Charge & Go Nx, Pure 312 Nx and Motion 13 Nx. Signia retail prices start at $1,299.

Unitron

Unitron is owned by the Canadian company Sonova group. The Moxi Now from this company is the world’s smallest Wireless RIC device. Unitron’s hearing aids are the Unitron Moxi All, Moxi Now, Moxi Fit, Moxi Kiss and Moxi Dura. The retail price of Oticon hearing aids start from around $1300

Widex

Widex is from Denmark and has representation in over 100 countries. It claims to have about 10% global market share of the hearing aid market. Widex now includes tinnitus management system on most of its devices. The company targets its devices at active people who want to connect their hearing aid with the iPhone. Their latest devices are the Evoke family. The Evoke 440 has the first ever machine learning feature and contains a Made For iPhone hearing aid.
Other Widex products include the Beyond, Unique, Dream, and Superfamilies. The retail price of Oticon hearing aids starts from $1300.

Oticon

Oticon is known for inventing the very first digital device. Oticon’s latest device is the Oticon Opn (Opn 1, 2 and 3). The Opn hearing aids are currently available in receiver-in-the-ear (RITE) style, a mini RITE with a telecoil and a BTE for severe-to-profound hearing losses. Other models manufactured are the Alta2, Nera2, and Ria2. The retail price of Oticon hearing aids starts from $1600.

Hansaton

Hansaton was founded in 1957 in Germany. It is one of the first to come out with rechargeable hearing aids. Hansaton’s hearing aid includes Hansaton Sound SHD 9 with price starting at around $4,000.

Starkey

Starkey is an American hearing aid manufacturer founded in 1967. They were the first company to introduce In-the-Canal hearing aids. Their latest products are compatible with smartphones and equipped with Acuity Immersion Directionality to improve speech audibility in noisy situations. Starkey’s hearing aids include Starkey Muse iQ family and the Halo iQ products which have wireless capabilities and are specifically branded as Made for iPhone. Starkey hearing aid retail prices start from $1800 to $3500 USD

Phonak

This is one of the world’s most popular hearing aid brands. Phonak is a sister company of Unitron. It was founded in 1947. Phonak was one of the first companies to launch rechargeable hearing aids. Their devices have an Autosense OS which automatically adjusts your hearing aids to suit your listening environment. They are leading producers of hearing aids for children. Phonak’s hearing aids include Phonak Audeo B Direct, Phonak Audeo B Rechargeable, Phonak Audeo B, Phonak Bolero B.
They have just recently released a new hearing aid range called Marvel with new rechargeable hearing aid models. Phonak hearing aid prices start at around $1,400 for their standard range up to $5,000 for their premium technology devices.

Resound

Resound was founded in 1943. The company uses 2.4 GHz technology for better speech understanding. Their latest device is the LiNX 3D and LiNX Quattro Made For iPhone hearing aids. Other hearing aids from Resound include LiNX2, Enya and Enzo 3D. Resound retail prices start at $1,700 USD.

Bernafon

Bernafon offers quality devices at slightly lower prices than the other manufacturers and therefore their devices are perfect for first-time users or those looking for a more budget option. Bernafon’s hearing aid includes Bernafon Zerena. Bernafon retail prices start from $600 to $2,000 depending on the technology level.

Comparisons of some Brand Models

Many hearing aid companies own more than one brand of hearing aid and sell the same hearing aid technology under different names and for different prices. Phonak and Unitron Hearing Aids are owned by the same company. Oticon and Bernafon Hearing Aids are owned by the same company. Many of these brands are similar to one another. Some models from these different brands of hearing aids are compared below.

The Phonak Audéo B versus the Widex Evoke 440

The Phonak Audeo B is a Receiver-in-Canal hearing aid. The Audeo B has different variants (B312, B-R, B-13, and B-Direct). There are three sizes of behind the ear model and three in the ear models of the Evoke 440 available. They are the Passion (RIC), the Fusion (BTE), and the Fashion (over the ear). The others three are a standardly sized in-the-ear, a completely-in-the-canal and the smallest which is the CIC-M
The Audeo B 312 has a push button (program control, volume control, and mute control), water-resistant coating, an ingress protection rating of IP68, and uses size 312 hearing aid batteries. The Widex Fusion 2 has these same features but it has a telecoil push button (Program control and Volume Control), unlike the Phonak B312.
In the Evoke 440 series, only the Fusion 2 allows direct stereo streaming from iPhone. This feature is found in the Audeo B-R and Audeo B-Direct. Audéo B uses a unique operating system called AutoSense OS.
It senses the surroundings and adjusts hearing aids accordingly. The Widex Evoke 440 series has a SoundSense Adapt feature which learns from the wearer's preferences and helps guide them to a better, more personalized sound.
The price of the Phonak Audeo B ranges from $1,200 to $1, 800 while that of the Widex Evoke 440 series starts from $2,0009(USD)

The Resound LiNX3D versus the Starkey Halo iQ

Both the ReSound LiNX 3D and the Starkey Halo iQ are Receiver in the Ear hearing aids. They both have telecoils, dedicated volume control, push button (program control and volume control) and water resistant coating. Additionally, they both use size 13 hearing aid batteries. They are both Android compatible Made For iPhone. They are both suited to mild, moderate, severe, and profound hearing loss. The retail price of LiNX 3D starts from $1,900 USD while that of the Halo iQ starts from $1,800 USD.

Oticon Opn 1 miniRITE versus the Signia Pure Nx 7Nx

Both have push buttons but the Signia Pure Nx has dedicated volume control. They both don’t have telecoils. Both have Ingress protection rating of IP68 and use 312 rechargeable batteries. Additionally, both are compatible with Android and Made For iPhone. The Oticon Opn is only good for only mild, moderate, and severe hearing loss whereas the Signia Pure Nx is good for all three conditions including profound hearing loss. The price of the Oticon Opn 1 miniRITE is around $1,999.00 while that of the Signia Pure Nx is around $1,799.

Adjusting to the hearing aid as a new user

As a new user, the hearing aid requires a lot of time and patience to get used to. The best way you can adjust to the hearing aid faster is by wearing them constantly. It is very important to work closely with an audiologist to help you get familiar with the functions of your hearing aid. He guides you through the difficult stage of getting used to your device.

There are activities you should practice with your audiologist as a new user of the hearing aid.

Practice wearing your new device and taking them off.

Practice cleaning your device for the first time.

Identify right and left hearing aids where applicable.

Practice removing and replacing batteries.

Learn how to adjust the volume of the hearing aid to what is best for you.

Practice how to adjust your hearing aids in noisy environments to improve hearing.

It is very important to continue to practice until you are fully comfortable with your hearing aid.
Some of the experiences of people trying out the hearing aid for the first time include the following:
They feel uncomfortable with the hearing aid in most cases, the hearing aid feels a bit uncomfortable at first. It is important to get advice from your audiologist as regards how long you need to have your hearing aid on per day while adjusting to it.
Their voice may seem to sound too loud or echo: this results from what is commonly known as the “plugged-up” feeling that makes device user’s voice sound louder in his head. This condition is known as the occlusion effect. This experience is very common in new users of the hearing aid device. You may want to visit your audiologist to check if there are any remedies for this condition. However, the feeling tends to fizzle out over a period of time.
The problem associated with receiving feedbacks from hearing aids: the whistling sound heard by some new users of the hearing aid can be caused by the following:

A faulty hearing aid

Hearing aids that are not properly fixed.

The device may have been clogged with ear wax or other fluids from the ear.

The problem associated with background noises: the hearing aid only has a limited control to background noises. It does not completely separate the background noise from what you want to hear. Sometimes, all you need is some slight adjustments made to the hearing aid. Endeavor to visit your audiologist to help you adjust to what is most suitable for you.
Buzzing sound in your ear when using the cell phone: the buzzing sound is as a result of radio frequency interference. This is common in most people who have an implanted hearing device or use a hearing aid. However, as the cell phone industry as well as the hearing aid industry continue to grow, this kind of problem is actively becoming less and less common. It is important to carry your phone along when receiving the hearing aid for the first time to ensure the two work perfectly well.

How to take care of your hearing aid to make them last longer

Ensure to keep hearing aids away from heat and moisture.

Endeavor to make out time and clean your hearing aid as required. When cleaning, ensure you adhere to the instruction to avoid damaging the device.

Avoid use of hairspray and other hair care products when using the product to avoid damage.

Ensure to put off the hearing aid when it is not in use. This will help prolong the battery life as well as maintain the maximum lifespan of the hearing aid.

Ensure to replace dead batteries as soon as possible to avoid damaging the device.

Do not keep your device where children and pet can easily get to them.

What other kinds of aids are available?

Apart from the hearing aids described above, there are other kinds of hearing aids available. These hearing aids are designed to work differently. They help to amplify the sound vibrations that enter the inner ear. One of these devices is known as the middle ear implant (MEI). This is a small device implanted on one of the bones of the middle ear. The MEI does not amplify the sound coming into the middle ear directly.
Rather, it moves the bones directly. This technique also provides the net result of improving sound vibrations that go into the inner ear. It is also a very useful way to help individuals with a sensorineural hearing loss to detect the sound entering the ear.

The second type of uncommon hearing device is the bone-anchored hearing aid (BAHA). This is a very small device that is attached to the bone behind the ear. This kind of hearing aid is designed to transmit sound vibrations through the skull to the inner ear. This device makes it possible to bypass the middle ear during sound transmission. This device is suitable for people with deafness on one ear or middle ear problem.

Many hearing specialists tend to shy away from these hearing aids because they require a surgery to implant. The often feel it is too risky when compared to its intended benefits.

What further researches are been made that are geared toward improving hearing aids?

Researchers are working tirelessly to figure out ways of applying new signal processing strategies to their recent designs of hearing aids. When we talk of signal processing, we refer to the method that is used to transform normal sound waves into amplified sound. This amplified sound is tailored according to the individual user’s preference.

The NIDCD has thrown in a lot of funds into researches on how a hearing aid can help improve speech signal thereby improve understanding. Current researches are focused on finding out how computer-aided design can help in the production of more effective and better hearing aids.

Some of the key points of the hearing aid include better ways to improve the transmission of sound and how to reduce noise interference. This research also applies to feedbacks and occlusion effect reduction.
There are also separate researches that are focused on how to best select a hearing aid and how to best fit it. This research focuses more on children and other groups that testing their hearing ability is difficult to ascertain.

Another branch of research focuses on the use of lessons learned from animal models to determine the best way to design microphones for hearing aids. Scientists under the support of NIDCD are currently studying the tiny fly ormiaochracea due to this flies ear structure that allows it to determine the source of a sound easily and faster. This fly’s ear structure is currently been adopted in the design of directional microphones for hearing aids.

These microphones are designed to intensify sounds coming from a particular direction (This is basically designed to amplify sounds coming from the direction the person is facing).

With advancements in directional microphones, it will become easier for people with hearing loss to focus on one conversation even when surrounded by a lot of background noise. There is a lot of promising features this microphone can deliver in the near future.

OTC Hearing Aid

The price of hearing aids has continued to rise over the past making it difficult for people to access the device. So far only one out of five people who require a hearing aid actually use it. This is due to the high cost. However, there are also countries like the UK where the price of the hearing aid is heavily subsidized.

With the signing of the OTC hearing act of 2017, the law is designed to make it easier for customers to gain access to the hearing aid without necessarily going through the process of visiting an audiologist.

The OTC bill requires the FDA to provide the specifications and requirements for hearing aids that will be sold under the OTC act. There are specific standards to be met to ensure the quality of the product. There are, however, some challenges with building one size for all.
The requirements when it comes to hearing loss can differ from person to person. The idea of creating a standard specification for everybody may not go well with some people.

Conclusion

Hearing loss is not a condition to be treated with kid gloves. It is very serious and should be tackled as soon as it is noticed. Loss of hearing can be a major source of embarrassment and depression in people suffering from the condition. The best remedy for treating hearing loss remains the hearing aid.

The signing of the OTC bill into law has made it easier to access hearing aids over the counter. It has reduced the huge costs spent on the audiologist for examination and prescription. There are also a lot of awareness programs geared towards enlightening people of the dangers of leaving a hearing loss problem untreated for quite a long time.

There are different types of hearing aid in the market today, depending on your taste and requirements, the audiologist will recommend a tailored design for you. Hearing aids are not very easy to adjust to. It takes a lot of patience and practice to become used to the device. It is the duty of the audiologist to help you through this process and make requires adjustments you need.

Over the past years, we have seen a lot of improvements in the hearing aid. As technology continues to advance, we are bound to see more improvements. Researchers are working round the clock to ensure a better hearing aid for people with hearing losses. With more improvements, communication becomes more seamless and people with hearing loss can learn to communicate better with the rest of society.