According to the National Institute on Deafness and Other Communication Disorders, approximately 15 percent of American adults report some trouble hearing, representing 37.5 million people.
Age-related hearing loss (presbycusis) is the most common, with some degree of hearing loss affecting one-third of people between the ages of 65 and 74, and half of people over the age of 75.
“In addition to aging, progressive hearing loss can stem from other factors such as exposure to loud noise, genetic components, and toxic medications like chemotherapy,” said Lauren Carmen, AuD, an audiologist with Swift Audiology, which has four offices in western Pennsylvania.
Hearing loss falls into one of three categories: sensorineural (damage to the nerves in the inner ear); conductive (when sounds cannot get into the outer and middle ear); and mixed, which is a combination of the two.
Robert Petruso, AuD, owner of R. W. Petruso Hearing and Audiology Center, with multiple locations in Pennsylvania, West Virginia and Ohio, said that patients who are fitted for hearing aids primarily are those with sensorineural hearing losses. “The end goal would be, of course, to assist in communication in their everyday lives,” he said. “With that comes better health, living, connectivity to the people and things around them.
“The ability to communicate is a huge factor for everybody, and how effectively they communicate depends on how well they can hear,” he added.
Petruso noted that conductive hearing loss is typically treatable but will often result in a referral to an ENT, while age-related hearing loss can often be helped with hearing aids.
Based on the results on an audiogram, which measures the sounds that one can hear at different pitches and intensity, an audiologist will prescribe a hearing aid based on a formula that is tailored to the individual.
“Every hearing aid is catered for that person’s hearing loss, depending on what their hearing test looks like. For most hearing losses that we see, most people have better low pitch hearing and not very good high pitch hearing,” said Dr. Petruso. “We look at pitch across the scale, from low to high pitch, and the volume is how loud each of those ranges is. We look at each one of those points and we build a customized prescription for that patient.”
Hearing aids are sophisticated devices that amplify sounds for those with hearing loss, and fortunately, the technology has come a long way over the years. The type of hearing aid needed is dependent on the type of hearing loss along with an individuals’ needs and lifestyle; the higher the level of technology, the more the device can be fine-tuned.
“I’ve been an audiologist for five years, and in that time, hearing aids have gotten way better at mimicking our auditory system,” said Dr. Carmen, adding that the main goal of a hearing aid is to help people hear and understand speech.
“Hearing aids are not just amplifiers. They are specific to a person’s hearing loss and have features built in which allow the patient to hear optimally in different listening situations,” she continued. “These devices survey the room around the patient and process this information over 500 times every second to figure out what is speech and what is noise and adjust accordingly.”
There are many great hearing aid brands, all of which process sounds in their own unique way. Different brands and styles of hearing aids offer different features, from behind-the-ear technology versus in-the-ear models, or even in-the-ear models that are practically invisible. Certain brands have motion sensors to help better identify speech when a person is in motion. Others have developed special algorithms to help distinguish soft-spoken individuals and those wearing masks.
One thing that is up-and-coming is the use of artificial intelligence (AI). For example, Dr. Carmen referred to deep neural networks, which can help with speech enhancement.
“Hearing aid developers programmed 12 million real environmental sound clips into a hearing aid’s software and trained the device to look at characteristics of each of these sounds through specific algorithms,” she explained. “This processing helps the hearing aid distinguish which sounds are important in a patient’s life and which sounds are not, to better amplify what the user wants to hear and to diminish ambient noise.”
The bottom line is that AI can help people to better understand speech in background noise, which can remain a problem, even with the use of traditional hearing aids for those with sensorineural hearing loss.
Some hearing aids offer Bluetooth compatibility with smartphones. “If you can imagine, there are a lot of people with hearing aids who have not been able to have a hands-free device,” said Dr. Petruso. “But in the past few years, that connectivity has gotten better and better with certain cell phones and other electronics. That gives the patient that connectivity that most other people have and gives them hands-free options for calling.”
He added that it also gives them binaural (using both ears) hearing when on the telephone, which is another big advantage.
According to Dr. Carmen, hearing aids that are Bluetooth compatible have apps that give the patient the ability to make adjustments, such as with pitch and volume levels. There are also specific programs for TV, music, or restaurant settings, which can be adjusted via an app.
Dr. Petruso added that hearing evaluations should be part of an annual physical. “There are things that can cause hearing loss that can be more health-related, like tumors or other illnesses that sometimes the hearing or audiogram test picks up on,” he said. “Then the patient would get referred out to the next channel to figure out what is going on.”
Although technology is getting better all the time, Dr. Carmen said that hearing aids will not restore your hearing to 100 percent, but they have come a long way as they can be fine-tuned to an individual’s hearing loss.