Millions of people with hearing loss use hearing aids. These tiny devices are the best treatment for most.
This article presents user-innovated eHealth solutions in the field of hearing rehabilitation based on a participatory design process with older people. Participants envisioned visions for future eHealth-assisted client journeys that are personalized, preventive, and predictive.
What is a hearing test?
A hearing test, also known as an audiogram, helps a healthcare provider see how much and what kind of hearing loss you have. It is typically conducted in a sound-treated room, where you sit wearing earphones or headphones while the audiologist tests your hearing. You are asked to identify a series of sounds played at different pitches and volumes, and how well you hear them is charted on an audiogram graph. These charts help the audiologist pinpoint your hearing loss’s type, degree, and configuration. There are several types of hearing testing, including pure-tone tests and speech testing. Other tests, such as otoacoustic emission testing and a head MRI, can help determine the cause of your hearing loss.
A screening test is a quick pass/fail test that measures your ability to hear different tones, usually in one ear at a time. It only takes a few minutes to complete and is often done with a smartphone app, but it is not as comprehensive as a full hearing evaluation.
When you get a full hearing test, the audiologist will also measure how well you understand speech, which requires more complex sound processing. For this test, the audiologist will talk to you through earphones and ask you to repeat simple words at various volume levels. They will then listen to your responses and compare the softest words you were able to hear to the normal results for your age and gender.
Some hearing tests are designed to determine the cause of your hearing loss, such as otoacoustic emissions (OAE) or a brainstem auditory evoked potential (BAEP). With OAE testing, a small earphone is placed in your ear, and clicks and beeps are played. The movement of your eardrum is recorded and displayed as a graphic on the computer screen, which can indicate whether there is a blockage in the outer or middle ears, fluid buildup, a hole in the eardrum or a tumor. This is frequently done in newborns. BAEP tests help the audiologist check the pathways between the inner and outer ears and are sometimes used with children who can’t complete pure-tone tests.
How does a hearing test work?
Hearing loss happens slowly, and it may take a while before family members notice you’re having difficulty. The good news is that a hearing test is an easy exam to add to your yearly physicals and a vital one at that.
A hearing test uses headphones and a device that emits a series of tones at different volume levels and pitches, known as an audiometer. The sounds are played through the headphones, and you will be asked to respond with a button press or raise of your hand when you hear them. The audiologist will then plot your results on an audiogram – a visual representation of your hearing.
A variety of other tests, such as an otoacoustic emissions test, tympanometry, and speech reception threshold, also determine the type of hearing loss and its severity. These tests will help determine what is causing your hearing loss, which could be as simple as age-related decline or as complicated as a neurological disorder like tinnitus.
In addition to detecting hearing loss, regular hearing tests can help early detect other health conditions. For example, untreated hearing loss can lead to anxiety and depression. Having the proper assessment and treatment can reduce these symptoms and alleviate stress related to socializing and participating in community events, such as Folsom Street.
It’s also important to get a hearing test if you are experiencing other symptoms of hearing loss, such as tinnitus or trouble understanding speech in noisy environments. This will allow your audiologist to diagnose the problem and recommend an appropriate treatment.
Keeping up with regular hearing tests is essential because it gives you a baseline to compare your results against. Having an established history of your hearing will make it easier to spot any changes that might occur. This allows you to catch the problem sooner so that it can be treated before your hearing gets any worse. This can help prevent the negative effects of untreated hearing loss, which include isolation from your family and friends, difficulty navigating public places like restaurants or Folsom Street, and reduced quality of life.
What is a hearing aid?
The goal of hearing aids is to make speech sounds as clear and understandable as possible. They do this by taking the load off your brain to improve speech intelligibility and reduce background noise. The basic elements of a hearing aid are a microphone that picks up sound, amplifier circuitry that makes the sounds louder, and a miniature loudspeaker (receiver) that delivers the amplified sounds into your ears. Some models have directional microphones that can adjust to give priority to sounds in front of you in noisy environments. The type of hearing aid you choose will depend on your loss’s severity and listening needs.
There are two main types of hearing aids – analog and digital. Digital models use a computer chip programmed by your hearing professional that analyzes sound a million times per second to separate speech from background noise. It can also offer programs tailored to your hearing loss, giving you more control over your listening experience.
In-the-ear (ITE) models are available that range from half-shell designs that fit into the lower bowl of your outer ear to full-shell styles that sit inside your ear canal. If desired, these larger styles can host additional features like directional microphones and manual controls, such as a volume wheel. They are also the preferred style for people with dexterity problems, who find it easier to handle larger-sized aids.
Completely-in-the-canal (CIC) models are built into a custom shell that fits within the ear canal, making it the least visible model. They are suitable for mild to moderate hearing loss and can sometimes accommodate extra features, such as a telecoil (magnetic coil), which makes it easier to hear conversations on the telephone and allows you to use special public facilities that have installed induction loop systems for hearing.
Your audiologist will show you how to wear and care for your new hearing aids, check their status, and change the batteries. It may take time to get used to wearing them, but the benefits will be well worth it. In addition, your audiologist can recommend assistive devices that can help you at home or at work, such as a bed-shaker alarm, a flashing doorbell, or a device to amplify the television.
What is tinnitus?
Tinnitus (TIN-ih-tus) is a noise in your ears or head with no external source. It can sound like ringing in the ears, but it also can be whistling, chirping, hissing, roaring, or even shrieking. The sound may be constant, or it may come and go. Some people find their tinnitus less bothersome after treating the underlying cause. For example, if your tinnitus is caused by ear infections or hearing loss, treatment of those conditions can eliminate the unwanted noise.
Other tinnitus causes include medications that can affect the inner ear or brain functions linked to hearing and head or neck injuries. Often, the louder the noise and the more pitches are heard in the tinnitus, the more likely an injury or condition is to be present.
A 2019 study found that tinnitus is a result of spontaneous electrical firings in the brain’s auditory system that don’t correspond to real sounds. The brain mistakenly codes the signals as a sound, expecting them to continue to occur. This is similar to how phantom limb pain works in amputees.
Some tinnitus is caused by pressure on the ears, such as in the case of an ear or sinus infection or the buildup of earwax. In some cases, tinnitus is associated with high blood pressure or narrowing of the arteries, and treating these conditions should help ease the symptoms.
Other external sources, such as the hum of a fan or radio cause other tinnitus. For these types of tinnitus, masking techniques can provide relief by covering unwanted sounds with other sounds that are easier for your brain to process. For the best results, these treatments should be done in combination with hearing aids to amplify other sounds and reduce the impact of your tinnitus on your quality of life. Tinnitus can seriously affect a person’s mental, physical, and emotional health. It can lead to depression or social withdrawal, and it can have an impact on your relationships. Constant noise in the ears usually doesn’t indicate a medical problem, but it can be very annoying and distracting.