
Of
our five senses, hearing is most commonly affected as we age. Hearing
loss that is significant enough to interfere with social function affects
25% of persons age 65 to 74 and 50% of those age 75 and older. Not being
able to hear or understand conversations limits a person’s use
of the telephone, affects the ability to participate in social activities,
and leads to a sense of isolation.
Geriatric
hearing loss may be caused by a variety of problems, some of which are
amenable to treatment. Presbycusis may be the most common cause of diminished
hearing in the older population, but it should not be diagnosed until
other potential causes of hearing loss have been ruled out.
The severity
of a patient’s hearing loss is determined by audiometry. Although
physicians can use a small screening audiometer or audioscope to determine
which patients should be referred for an audiometry evaluation, it is
probably best to refer a patient based on complaints about hearing,
either from the patient or family members.
Hearing
loss can be divided into four types, based on the components of the
auditory system that are involved:
-
Conductive
hearing loss; caused by imperfect function of the ear canal, tympanic
membrane, or ossicles, which are located in the outer and middle ear.
-
Sensorineural
hearing loss; caused by injury to the cochlea or auditory nerve, which
are located in the inner ear.
-
Mixed
loss; mixture of conductive and sensorineural losses.
- Central
loss; usually by a stroke and affects the central nervous system.

Analog or
digital hearing aids are the treatment of choice for older patients with
sensorineural hearing loss. They can be adjusted so that the amount of
amplification varies depending on the frequency of the sound. Hearing
aids can be precisely tailored to the individual’s pattern of hearing
loss.
Digital and
programmable hearing aids are particularly useful for individuals with
steep, high-frequency hearing loss who have difficulty with conversational
speech in the presence of a high level of background noise. Hearing aids
can be placed completely in the canal (CIC), in the ear (ITE), or behind
the ear (BTE).
- The CIC
Hearing Aid fits deeply into the ear canal and is nearly invisible.
- The ITE
Hearing Aid fills in and outside the ear.
- The BTE
Hearing Aid consists of a casing that rests behind the ear
and an ear mold through which sound is delivered.The microchips are
essentially the same for all of these devices. Individuals with severe
hearing loss who require a great deal of amplification and power are
candidates for BTE hearing aids, which have the largest power sources.

An audiologist
or hearing instrument specialist should be consulted for hearing aid evaluation
and fitting. An individual who has bilateral hearing loss should be fitted
with bilateral hearing aids. Bilateral aids (2 aids) allow improved discrimination,
better sound localization, and greater perception of speech in noise.
Typical cost
for a hearing aid ranges from $1,000 to $3,000 for each device. If a single
hearing aid is the only feasible option, it should be fitted for the ear
that has the least amount of hearing loss. This allows the patient to
have close-to-normal restoration of hearing in at least one ear.
Hearing aids
cannot return the user’s hearing ability to normal, but properly
fitted hearing aids can improve the patient’s ability to understand
conversational speech in the presence of background noise. To avoid disappointment,
patients must understand these limitations prior to purchasing a hearing
aid and recognize that hearing aids should be judged not on their subjective
appeal but on their ability to restore functional hearing. Individuals
who lead quiet, sedentary lives with minimal workplace or social interaction
are much less likely to find hearing aids useful than individuals who
continue to work or have active social lives.

Many forms of hearing loss are treatable, and treatment can lead to significant
improvements in productivity and quality of life. Although age-related
hearing loss (presbycusis) is common in older patients, the diagnosis
should not be made until other possible causes have been ruled out. Once
the type of hearing loss has been diagnosed, hearing aids can be used
to improve hearing and social functioning. Hearinsg aid selection should
be based upon the patient’s level of hearing loss, comfort with
wearing the device, and ability to operate it. Call us at 1-800-880-4327
or click here to get in touch with us.
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