Hearing Loss Q&A
Audiologists are healthcare professionals who evaluate, diagnose, treat, and manage hearing loss and hearing conditions like tinnitus and balance disorders. An audiologist holds a minimum of a Master’s degree in Audiology. Professionals seeking education in Audiology who do not currently hold a Master’s degree must now pursue a Doctoral degree in Audiology (Au.D). Audiologists must be licensed in the state where they practice, and are regulated by the Division of Consumer Affairs.
An audiologist may be awarded the Certificate of Clinical Competence in Audiology by the American Speech-Language-Hearing Association (ASHA), otherwise known as the CCC-A. With additional training and expertise, the audiologist may receive the honor of Fellow, which is bestowed by the American Academy of Audiology (AAA).
Common services and treatments provided by a Hearing Care Provider at Swift Audiology include:
If you think you or a loved one may have hearing loss, you are not alone. Oftentimes it takes people on average of seven years to seek advice on their signs of hearing loss. If you experience any of the following, you may have hearing loss and should have a hearing test and evaluation:
- You can hear people speaking but you strain to understand the words and what they mean.
- You frequently ask people to repeat what they just said.
- You catch yourself not laughing at jokes or stories when others are because you missed too much of the story or punch line.
- You frequently say that others mumble.
- You need to ask others about the details of a meeting you just attended.
- You play the TV or radio louder than your friends and family. They are always asking you to turn it down.
- You may not hear the doorbell or the telephone
- You find that you’re looking at people and trying to read lips when they speak.
- You realize you are missing environmental sounds such as birds or leaves blowing.
- You find yourself avoiding certain restaurants or environments because they are too noisy and you cannot understand the people with you.
- You hear a consistent sound in your ears, especially when it is quiet, that may be a hum, chirping or ringing.
If you have any of the symptoms described above of hearing loss, you should see an Hearing Care Provider or a Pennsylvania certified Hearing Instrument Specialist to have a formal hearing test and evaluation. This hearing test, or audiologic evaluation, is diagnostic in nature and allows the hearing professionial to determine the type, nature and degree of your hearing loss. Your sensitivity, acuity and accuracy to speech understanding will be assessed as well. Your audiologist may also test for speech understanding at different volume levels and in different conditions, such as noise, to provide an indication as to how successful of a candidate you will be for hearing aids.
The hearing evaluation will also include a thorough case history and a visual inspection of the ear canal and eardrum. Additional tests of middle ear function may also be performed. The results of the evaluation can be useful to a physician, if the Hearing Care Provider believes your hearing loss may benefit from medical intervention.
Results of the hearing evaluation are plotted on a graph called an audiogram. The audiogram provides a visual view of your hearing test results across various pitches or frequencies, especially the ones necessary for understanding speech.
The audiogram and results from your speech understanding tests are used to create a prescription by which hearing aids are programmed, if necessary.
After you undergo a hearing test and evaluation, the results are plotted on a chart called an audiogram. Loudness is plotted from top to bottom. The top of the graph is very quiet and the bottom of the graph is very loud. Frequency, or pitch, from low to high, is plotted from left to right. Hearing level (HL) is measured in decibels (dB) and is described in general categories, not by percentages. The general hearing loss categories used by most hearing professionals are as follows:
- Normal hearing (0 to 25 dB HL)
- Mild hearing loss (26 to 40 dB HL)
- Moderate hearing loss (41 to 70 dB HL)
- Severe hearing loss (71 to 90 dB HL)
- Profound hearing loss (greater than 91 dB HL)
There are four types of hearing loss:
- Sensorineural hearing loss: When the problem is in the inner ear, a sensorineural hearing loss is the result. This commonly occurs from damage to the small hair cells, or nerve fibers, in the organ of hearing. Sensorineural hearing loss is the most common type of hearing loss and accounts for more than 90 percent of hearing loss in all hearing aid wearers. The most common causes of this hearing loss are age-related changes and noise exposure. Loss may also result from disturbance of inner ear circulation, increased inner ear fluid pressure, or from disturbances of nerve transmission. There are many excellent options for the patient with sensorineural hearing loss.
- Conductive hearing loss: When there is a problem in the external or middle ear, a conductive hearing impairment occurs. Conductive hearing loss occurs when sound is not conducted efficiently through the ear canal, eardrum, or tiny bones of the middle ear, resulting in a reduction of the loudness of sound that is heard. Conductive losses may result from earwax blocking the ear canal, fluid in the middle ear, middle ear infection, obstruction of the ear canal, perforation (hole) in the eardrum membrane, or disease of any of the three middle ear bones. All conductive hearing losses should be evaluated by a physician to explore medical and surgical options.
- Mixed hearing loss: When there are problems in the middle and inner ear, a mixed hearing impairment is the result (i.e. conductive and a sensorineural impairment).
- Auditory neuropathy spectrum disorder (ANSD): The least common hearing impairment is ANSD. This type of loss requires more in-depth diagnostic testing, including a hearing evaluation with pure tones, otoacoustic emissions (OAEs) and auditory brainstem response (ABR) testing. In this type of hearing loss, the nerve fibers in the organ of hearing typically appear to be functioning well, but a breakdown of the information occurs along the pathway to the brain. A person may still have normal hearing to sounds, but the sound is not encoded properly at the brain. This type of hearing disorder is diagnosed more often in children, due in part to newborn hearing screenings that use automated ABR equipment and routine speech screenings by pediatricians and school systems, but can be present in adults as well.
There are many styles, types and brands of hearing aids today, and the style or device is dependent upon your individual need and lifestyle. We assess this during our hearing evaluation and work together to select the right device with you.
There are in-the-ear styles as well as behind-the-ear styles. Also, hearing aid technology has advanced, with many new and improved options from which to choose. Hearing aids are available in many different sizes and styles, thanks to advancements in digital technology and miniaturization of the internal components. Many of today’s hearing aids are considered sleek, compact, and innovative – offering solutions to a wide range of hearing aid users. When selecting a style of hearing aid, the following should be considered:
- The type/degree of the hearing loss
- Power requirements
- Manual dexterity and visual abilities
- Cosmetics and aesthetics
- Skin sensitivities
- Anatomical and medical considerations
People with all types and degrees of hearing loss can benefit from an assistive listening device (ALD). Since the microphone of a typical hearing aid is worn on or behind your ear, its ability to enhance the talker-to-background-noise ratio is limited. However, ALDs are designed to increase the loudness of a desired voice, such as a radio, television, or a public speaker, without increasing the background noise. This is because the microphone of the assistive listening device is placed close to the talker or device of interest, while the microphone of the hearing aid is always close to the listener.
ALDs include alarm clocks, TV listening systems, telephone amplifying devices, and auditorium-type assistive listening systems. Many newer devices are small, wireless, and compatible with a person’s digital hearing aids. Alarms and other home ALDs may be small devices that are placed discreetly on tables, next to the TV, or on the wall.
Tinnitus is a common disorder affecting over 50 million people in the United States. It is often referred to as “ringing in the ears,” although some people hear hissing, roaring, whistling, chirping, or clicking. Tinnitus, often called head noise, is not a disease, but a symptom of another underlying condition of the ear, auditory nerve, or elsewhere. Tinnitus can be intermittent or constant, with single or multiple tones. Its perceived volume can range from very soft to extremely loud.
Swift Audiology is staffed at each office to perform Tinnitus evaluations and offer professional recommendations and treatment plans; which may include the use of hearing devices to mask the sounds being heard.
The exact cause of tinnitus is not known in every case. However, there are several likely factors which may cause tinnitus or make existing head noise worse. These include:
- Noise-induced hearing loss
- Wax build-up in the ear canal
- Certain medications
- Ear or sinus infections
- Age-related hearing loss
- Ear diseases and disorders
- Jaw misalignment
- Cardiovascular disease
- Certain types of tumors
- Thyroid disorders
- Head and neck trauma
Generally, most patients will not need any medical treatment for tinnitus. There are several treatments and measures to help with the management of tinnitus including:
- Listening to a fan or radio
- Tinnitus-masking devices
- Biofeedback training
- Avoidance measures
- Avoidance of certain medications
- Hearing aids, if the listener also has a hearing loss
If these measures do not work, there are several medications that have been utilized to suppress tinnitus. Some patients benefit with these drugs and others do not. Each patient has an individual response to medication, and what works for one patient may not work for another.
There are vast differences in the professional roles in diagnosing and treatment of hearing loss. It is still common today for someone to get screened, tested, or
fitted with a hearing aid by someone and still not know what qualifications that person had. How do you know who you can trust? An important distinction to understand when treating your hearing loss is the difference between an Audiologist and a hearing aid dispenser. An Audiologist is a Doctor of Audiology who is trained in the science of hearing; while a dispenser, or a hearing instrument specialist received certifications and license through the state of application. At Swift Audiology all of our Hearing Instrument Specialist are Board Certified through Pennsylvania.
Audiologist: An Audiologist is trained to diagnose, treat and monitor disorders of the hearing and balance system. They are trained in anatomy and physiology, amplification devices, cochlear implants, electrophysiology, acoustics, psychophysics and auditory rehabilitation. Doctors of Audiology complete, at a minimum, an undergraduate and doctoral level degree in audiology, as well as a supervised externship prior to state licensure and national certification. This usually requires 8 years of post-secondary education (4 years of college and 4 years of graduate school). The graduate school years focus on the medical, diagnostic and rehabilitative aspects of hearing loss, hearing aids and the vestibular system. Upon completion of training, Audiologists must also pass a national standardized examination in order to be eligible for state licensure. Continuing education requirements must be met in order for an Audiologist to maintain state licensure.
Hearing Instrument Specialist (Dispenser): A hearing instrument specialist is licensed to perform audiometric testing for the purpose of evaluating hearing loss and fitting hearing aids to meet these losses. To obtain a license, Hearing Instrument Specialist at Swift Audiology are required to have a minimum of 6-months direct supervision by an existing licensed individual (audiologist or existing HIS), and then pass an extensive exam through the National Board for Certification in Hearing Instrument Sciences. An individual must pass this exam to be allowed to test, diagnose hearing loss and fit with hearing aids. Continuing education requirements must be met in order for a HIS to maintain state licensure.
Hearing Instrument Specialists at Swift Audiology are Board Certified, which means they continue to meet high standards of practicum and care for patients.
At Swift Audiology, our audiologists and hearing instrument specialists work together closely to ensure the highest level of care for all of the patients we serve.