Introduction

HEARING IMPAIRMENT (Hard Of Hearing)

Loud & Clear Hearing Aid Centre
As you hear so shall you speak
Deaf need not necessarily remain dumb
To a Hearing Impaired child, silence is not gold.

A) Hearing Impairment Causes/Types

1) Congenital (Since Birth)

Conductive: Conductive hearing loss is the generic term for a decrease in hearing levels as a result of any pathology with in the outer ear or middle ear systems. The specific site of the disorder can be in the ear canal, middle ear cavity, tempering membrane, ossicles or Eustachian tube, or can co-exists in several of these areas. This prevents the efficient conduction of sound to the inner ear. Conductive hearing loss generally produces a mild to moderate level of hearing loss. It can affect hearing in all frequencies relatively equally, or be present just for the lower frequency sounds.

Sensory Neural: impairment originates from disorders involving sensory cells in the cochlea & / or the auditory nerve fibers of the VIII cranial nerve.

2) Acquired

Conductive loss: As described above, any kind of external or middle ear diseases or disorders can cause conductive loss.

Sensory Neural loss: (Usually denoted as Age induced hearing loss or 'Presbycusis')

Presbycusis is the most common type of hearing loss, & is associated with the ageing process. A gradual decline in hearing sensitivity sets in at the age of 18 years, but it is around the age of 45 - 50 that a noticeable change in hearing sensitivity for speech and environmental sound occurs. Sound is perceived but the sound Discrimination is difficult, what exactly is being said is not clear. Talk on one to one basis is perhaps understood but when it comes to one is to many that is in group situation it is difficult to recognize what has been just said as well as to locate the sound i. e. who said it from the group of friends talking.

Age induced hearing loss has an individual progression, which means that some may experience hearing problems quite early in life, while others experience no problems at all.

Loss in hearing sensitivity is most often bilateral, symmetric, progressive & sensorineural in nature. It is generally greatest in the higher frequencies, but present across all frequencies.

B) Incidence

It is estimated that approximately 27 million Americans over the age of 65, as many as 50% may be affected by hearing impairment.

What Is The Right Time To Go In For Testing Your Hearing?
Typically the first sign of hearing problem are often noticed by the family of the hearing impaired person. Usually they have

Difficulty understanding speech in noisy situation
Having turn up the volume
Difficulty when talking over phone

C) Evaluation

Complete evaluation may include PTA - Pure Tone Audiometry, Impedance Audiometry, Speech Audiometry & BSER (BERA)
Just as you have cardiogram for heart , you have an audiogram for hearing. It will help determine hearing thresholds at various frequency levels. It is from PTA that one can diagnose conductive loss from sensorineural loss objectively. In case of conductive loss further evaluation can be carried out by doing Impendence Audiometry BSER acts as an excellent objective diagnostic tool for high risk babies as well as for differential diagnosis in case of adults.
Whether hearing aid is necessary or not is simply understood from PTA. The scientific manner of dispensing Hearing Aid involves PTA as first step as the details of audiometry become part of process of choosing & fitting a hearing aid to alleviate a particular hearing loss.

D) Treatment For Hearing Impairment

Conductive Loss: In most of the cases it can be treated either medically or surgically. In rear cases hearing aid is required.
Sensorineural Loss: Most of such cases whether since birth, or adulthood or due to aging benefit very well with Hearing Aid. In rear cases where the loss is due to impairment in the cochlea (Inner Ear Organ) Cochlear Implant ( Expensive Inner Ear Surgery ) could be suggested.

The hearing aid amplifies sounds in frequencies where the hearing loss is prevalent. They are primarily used to correct sensory neural loss, but can be used to rectify problems in the middle ear that cannot be alleviated through surgery.

E) Different Types Of Hearing Aids

There are four types of hearing aids on the market today.

1) Pocket Model
This model is less preffered in today's time and age. These hearing instruments may be used for all types of hearing loss from mild to most profound.

2) Behind The Ear(BTE)
Instrument is placed behind the ear and the sound is conducted to the ear canal through a plastic tube and an ear mould.
BTE hearing instruments may be used for all types of hearing loss from mild to most profound.

3) In The Ear (ITE) / In The Canal(ITC)
Nowadays it is possible to include all electronics of the hearing instrument in the ear mould (ITE) / (ITC)

ITE / ITC are used for mild to sever hearing losses.

4) Completely - In - Canal(CIC)
The smallest and newest type of hearing instrument is fitted all the away into the ear canal. The CIC is the least conspicuous type of hearing instrument.

CICs are mainly used for mild to moderate hearing losses. It could also be fitted for severe hearing loss.

5) Bone Conduction Hearing Aid / Bone Conduction Spectacles
In hearing aid glasses the microphone, amplifier and receiver are built into the bows of the frames. Hearing Aid glasses are operated the same way as BTE hearing aids. A person with a conductive loss might use a type that conducts sounds through the bones, directly to the inner ear.

What Is Digital Hearing Hearing Aid?

Hearing Aid users biggest complain about the hearing is that they need to turn the volume up and down all the day long. That's why 'Digitally Programmable' hearing aids have no volume control. It doesn't need one. Instead, Digitally Programmable automatically adjusts to changes in listening environment - strengthening of softening amplification according to his individual needs.

Unlike most hearing instruments, it automatically separates incoming sounds into low-, medium-, & high -pitched channels. These sounds are amplified differently, because your hearing ability differs according to the pitch, not just loudness, of the sounds you hear. Audiologists uses a computer to preset the Digitally Programmable hearing aid so it automatically adjusts to your unique loud and soft hearing comfort needs. Because Program continually fine-tunes sound volumes, you don't have to. The result is a pleasant, comfortable listening experience - all day long, wherever you are. Programmable comes in both in-the-ear and behind -the-ear models.

How Can You Be Sure Which Is The Right For You?

If you're interested in improving your hearing, you've probably heard a lot about Digital Hearing Instruments. How they amplify sounds more clearly and naturally than conventional hearing aids. Even that they can reduce the distraction of background noise.

Digital hearing technology can do amazing things with the sounds you hear. This technology closely matches the way you hear, as well as your individual listening requirements.

There can't be better designed designed hearing aid than to copy the system that has worked well for thousands of years. Digital hearing aid closely imitates the function of your inner ear.

Nine Channles Of Sound

The inner ear is extraordinarily sensitive to the tiniest differences in sound loudness and pitch. TO recreate this, digital sound processor divides incoming sounds into more narrower channels -each with its own very precise adjustments capabilities. These channels work with circuitry that reacts instantaneously to sudden changes in sound levels and an exclusive technology to prevent over-amplification of soft sounds and noise in quiet surroundings. All together, it provides a more realistic and natural sound quality.

Why Digital Hearing Aid?

Today, more of life's activates depend on accurate understanding and communication, with more interference and distractions. Digital Hearing Instruments with increased sophistication lets us provide you with a significantly more effective hearing solution.

Even better, digital Hearing Instruments unmatched flexibility lets us more precisely fine-tune its performance to complement your lifestyle needs and situations.

What is Digital Feedback Suppression (DFS)?

A hearing Aid with less howl! That is a good description of The DFS. DFS stands for Digital feedback Suppression - a new system that reduces the frequency of hearing instrument howling, or acoustic feedback. No hearing instrument can eliminate feedback. But DFS wearers will not experience it as often as they would with other instruments. Even when the DFS does feed back, the sound is more a peep than a howl - and the unwanted sound is quickly silenced.

The DFS system also allows wearers to use more amplification at high frequencies to use more amplification at high frequencies than was possible before. Conventional hearing instruments cut off high frequencies to avoid feedback.

In fact, DFS wearers usually get significantly more amplification, 5 - 15 dB, in all frequencies without howl. That is what makes the DFS so different.

What Is Cochelear Implant?

Halfway through the eighties The first attempts were made at operating on patients with a completely a functional cochlea but a still functional auditory nerve. The auditory nerve had to be sensitive to stimulation.

At the operation one or several electrodes ( as many as 22) are inserted into the cochlea. These electrodes are connected with a small induction coil. This coil is implanted in the mastoid. On his body the patient wears a so-called processor, which processes sound from the outside in such a way that optimal use is made of the low dynamics of the auditory nerve. Via another coil and a magnet on the outside of the mastoid this processor is connected with the implant. In this way it is possible to convert sounds into a signal to which the auditory nerve reacts. It is still not understanding of speech , but the 'new' information ( sound & rhythm) is of great value to the previously deaf person in lip-reading and in controlling his own voice.

Which Companies Cochlear Implants Are Available?

Companies like 'Nucleus' , 'Medal', & 'Cochlea' have cochlear implants with electrodes ranging from 9 to 22 costing between 5 lacs to 12 lacs.

Two ears are better than one …..naturally!

"One is less than Half" - Contrary to what you may think, one ear working less effectively than the other can have a significant impact on your daily activities. Hearing with one ear is like trying to see with one eye - it's possible, but not as effective.

"Nature Has A Way With Two" Like two legs, two wings, and two eyes nature has equipped the animal kingdom with a balanced pair of ears for reasons very important to their existence.

"Now that's what is called using your head!" Although our ears are certainly vital our sense of 'hearing' actually occurs in between. Taking the input from both ears, the 'built - in signal processor' known as your brain blends these signals into a single sound "picture" To enjoy true balanced sound perception, BOTH ears must be functioning evenly. Without such equality, our brain presents us with incomplete information. To prevent this, your hearing professional may recommended you wear two hearing aids. Our two ears working together give us the ability to "cut through" or isolate one specific sound over others.

"Localization"Correcting this difference can be important to your safety. Balanced hearing is vital to our ability to locate where a sound is coming from. Our brain instinctively locates a sound source by measuring the tiny differences in duration and intensity between each ear.

"Relaxing, Stress- Less Hearing" With both ears providing even input, less amplification may be required to achieve a comfortable listening level. And you don't need to worry about always getting your 'good ear' turned towards sounds.

Does Your Ear has 'Ringing' Sound? / What is 'Tinnitus'?
Tinnitus is sound perceived only by the patient that does not really exists or in any case does not come from the outside world. All kinds of sounds are described, from wind susurration to whistling kettles and jet airplanes.

What Can Be Done About It?
To be honest there is no one answers to it. Very often, no specific underlying cause for tinnitus an be identified. This implies that there can be no one operation for it. When damage of the hair cells in the inner ear is assumed the cause (i.e. for ex. After some noise trauma) the answer is no. These structures cannot be operated on.

Is Tinnitus Accompanied By Hearing loss?
Very often, yes. Many tinnitus - sufferers have some form of accompanying hearing loss, usually affecting the higher frequencies. To be certain, a high - frequency audiogram may be indicated. There are, however , many cases of tinnitus where hearing sensitivity is absolutely normal.

Will Tinnitus Improve When Patient Wears A Hearing Aid?
If it is accompanied by a hearing loss, then this is often the case. Therefore, we would definitely advise visiting an audiologist. The audiologist can advise you, whether a combination aid ( hearing aid + noiser) might make sense.

F) At 'Loud & Clear' Hearing Aid Centre…

We offer a Complete range of services for Hearing Impairment including :
Complete Audiometric testing for hearing loss
Pre- and post-surgical hearing testing Hearing Aid trails
Custom-made ear moulds ( U V moulds )
Best of Hearing Aids from all leading international manufacturers at competitive rates.
Pocket ( Conventional ) Models
Behind the Ear ( B T E ) : Hearing aids fitted behind the ear
In the canal ( I T C ) Customised for excellent clarity of sound impulses and Hearing.
Completely in the canal (C I C ) : Invisible and tailor made to individual needs.
All the above model of hearing aids can be Simple, Analogue programmable, Digitally programmable or Digital i.e. Completely Computerised
Digital - is superior computerised technology which accuratek

We also cater to the need for group Hearing Aids for the institutional set up.

At 'Nirmitee' we are proud to offer complete computerized training for the Speech and Language Development of the Hearing Impaired Individual ( Hard of Hearing individual). It not only corrects the articulation but also works towards the improvement of the voice quality and the voice projection.