News and Highlights

Hearing and balance disorders associated with COVID-19

The increase in stress derived from the pandemic and factors such as loneliness, anxiety or depression have also aggravated the symptoms of 'tinnitus'

The physiological impacts of Covid-19 seem almost limitless, after the knowledge accumulated during these pandemic months. Complications can range from loss of taste to shortness of breath and, as has already been shown, many of these effects continue for months after the infection or illness has passed.

Now it has been confirmed that Covid-19 can leave other sequelae, as scientific evidence suggests that auditory and vestibular effects should be added to the growing list of symptoms caused by SARS-CoV-2, as revealed today during the last meeting of the American Acoustics Society, held virtually June 8-10.

In this context, Colleen Le Prell, a member of the University of Texas, in Dallas, United States, has detailed the hearing and balance disorders associated with coronavirus infection and how pandemic-related stress and anxiety can aggravate symptoms of tinnitus. Specifically, her presentation, entitled "Hearing disorders secondary to SARS-CoV-2 infection", emphasizes the factors that can influence the relationship between Covid-19 and hearing, since it has been observed that they are multiple.

So far, Covid-19 is known to have inflammatory effects, including on neurological tissue, which can exacerbate other problems. "Inflammation can damage the auditory and vestibular pathways in the central and peripheral nervous system, as well as damage the pathways of smell and taste, and other neural systems," says Le Prell.

In addition to a new injury, there are several studies that suggest that mental anxiety caused by the pandemic, such as stress related to confinement and concerns about the negative impacts of masks on hearing and communication accessibility, may magnify the auditory impacts of the virus. This is especially critical for people who already had tinnitus before the pandemic.

"Increases in tinnitus annoyance were associated with reports of pandemic-related loneliness, trouble sleeping, anxiety, depression, irritability, and financial worries," details Le Prell, who insists that "in other words, participants who experienced a general increase in stress reported that their tinnitus was more bothersome than before the pandemic ”.

 

Medications with effects on hearing

In addition, as the expert argues, some early experimental treatments, such as chloroquine and hydroxychloroquine (which are not recommended by the National Institutes of Health), can also have hearing side effects, particularly in patients with kidney problems. "When the kidneys are not working properly, the drug may not be metabolized or eliminated from the body as quickly, which can increase the physiological concentrations of the drug and the risk of side effects," explains Le Prell.

"Old age is often accompanied by decreased kidney function, and Covid-19 can cause kidney dysfunction, increasing the risk that a patient receiving an experimental therapy for Covid-19 is at risk of toxicity," the expert warns. 

 

Source: audioprotesistas.org

Prevention and custom plugs

Water trapped in the ear canal can cause infection and even damage, but it cannot be removed in any way. What's more, one of the most common methods people use to remove water from the ears can also cause complications. Researchers from Cornell University and Virginia Tech show that head shaking to release trapped water can cause brain damage in young children.

 Anuj Baskota, Seungho Kim, Hosung Kang, and Sunghwan Jung will present their findings at the 72nd Annual Meeting of the Division of Fluid Dynamics of the American Physical Society. The conference is held in Seattle through November 26.

 "Our research is mainly focused on the acceleration required to get the water out of the ear canal," said Baskota. "The critical acceleration that we obtained experimentally in 3D printed glass tubes and ear canals was around the range of 10 times the force of gravity for infant ear sizes, which could cause brain damage."

 For adults, the acceleration was lower due to the larger diameter of the ear canals. They said that the overall volume and position of the water in the canal changes the acceleration needed to remove it.

 "From our experiments and theoretical modeling, we discovered that the surface tension of the fluid is one of the crucial factors that promote water getting stuck in the ear canals," said Baskota. Fortunately, the researchers said there is a solution that does not involve shaking your head.

 "Presumably, putting a few drops of a liquid with a lower surface tension than water, such as alcohol or vinegar, in the ear would reduce the strength of the surface tension allowing the water to flow," Baskota said.

 

 Having good hearing health will depend above all on whether we protect our hearing correctly

Earplugs, or hearing protectors, are used for different purposes:

• to protect the ear under water
• in noisy environments
• to fall asleep when the environment prevents it (in the case of people who must sleep during the day, for example).

Depending on the use they are going to have, they come in various shapes and materials.

They can be single use or reusable. They can also be distinguished between user-modelable, pre-modelable or custom. These types of hearing protectors do not constitute a problem for the health of the ear as long as they are used properly and in accordance with the manufacturer's recommendations.

 

Types of plugs

Many of the earplugs are made of foam, although the materials can also be silicone, wax, or cotton. Even some, especially those that are often used to combat noise, can be connected with a rope that makes it easy to remove them.

• Soft silicone: They are designed to fit inside the ear canal and are suitable for sleeping, especially for those who have to sleep during the day and want to reduce noise. They are also suitable for places with a lot of noise. Additionally, some are made with soft, hypoallergenic silicone - which does not cause allergies - and is moldable. They are placed on the outside of the ear canal forming an airtight seal.
• Soft foam: They must fit inside the ear. One of the peculiarities of this material is that, once introduced into the external auditory canal, it expands until it fits well. One of the problems is that they can be misplaced, that is, that it protrudes and, therefore, adequate protection is not achieved.
• Wax: They are moldable, hypoallergenic and comfortable. They adapt to the ear and are often used especially for sleeping.

On the other hand, earplugs can be tailored to each individual and are the most recommended for noise, as they filter sound better. As they are pre-molded to measure, they adapt perfectly to the ear canal and are often used especially for professionals who are in noisy environments.

But in addition to the material they are made of, earplugs also respond to specific functions.

Noise plugs

Noise is one of the most common causes of hearing loss. Exposure to noisy environments for a long period of time can lead to serious hearing health problems. Very loud noise, above 140 decibels (dB), even if it is short-lived, can break the eardrum.

In the case of people who work in noisy places, Royal Decree 286/2006 establishes the preventive and control measures that must be applied to protect the health of workers. For example, the use of earplugs or ear muffs is mandatory when daily noise levels are equal to or greater than 85 dB or peak levels equal to or greater than 137 dB.

 Hearing protectors can attenuate noise an average of 30 dB intensity, but it is advisable to use it at least eight hours a work day. Earplugs or helmets can be used; the former work best for low frequency noise and the latter for high frequencies.

On the other hand, children and adolescents, especially, can suffer significant hearing loss if they are exposed to very loud noise or noises that are repeated over time. Thus, listening to loud music is also another of the main causes of hearing loss. In these cases, in addition to lowering the volume of the music, you can also put earplugs in concerts, especially if you are near the stage or the speakers.

 Water plugs

One of the main enemies of the ears, especially for certain types of people with a predisposition to contract external otitis or swimmer's ear, is water. The plugs in these cases are the best preventive measure, whether they bathe in a pool or in the sea. Wax or rubber are the materials with which they are usually made.

It is important, when choosing the best earplug, to bear in mind that water protection requires earplugs that adapt perfectly to the anatomy of the ear canal. Therefore, custom-made plugs will be chosen. After bathing, it is best to remove the plugs and dry your ear well with a towel.

One of the recommendations of the specialists is that those people with a predisposition to get otitis or who have undergone ear surgery use the earplugs, but it is not necessary for healthy people to use them. And if they are used, it must be done with care: one of the problems with these plugs is that they can press the wax of the ear canal and produce plugs that later become infected.

Sleeping plugs

The noise that is generated in some areas, whether due to parties or any other reason, prevents many people from falling asleep. But above all it is complicated for those who must sleep during the day because they work at night. Plugs can be a solution for them.

In such cases, and taking into account that the ear is going to be pressed against the pillow, which can insert the plug inside the pavilion or cause irritation of the external ear, it is advisable to use hypoallergenic silicone plugs, which conform with ease, but also with smoothness and ductility, to the canal without injuring it.

 

Source: Abc

Hyperacusis, reduce its impact and improve well-being

Better understanding hyperacusis can help reduce its impact and improve the well-being of patients. Clinical and academic audiologist Dr. Dany Pineault shares what we know about this condition and how we can help the patient.

 

WHEN EVERYDAY SOUNDS ARE TOO LOUD

Audiologists are trained to help patients with hearing loss and tinnitus. However, in recent years, hearing physicians have noticed an increase in patients seeking audiological services because sounds are too loud. They are patients with decreased tolerance to sound or hyperacusis (DST).

Although hyperacusis can occur in isolation, most of the time it is associated with tinnitus and hearing loss. Undiagnosed sound tolerance alterations can seriously compromise the results of hearing aid intervention, reducing satisfaction and safety with the services received. Given the far-reaching impact of DST on hearing health and the rehabilitation effort, it is critical that we audiologists better understand hyperacusis in terms of clinical manifestations, assessment guidelines, and management strategies.

 

DEFINITION AND CLASSIFICATION SYSTEMS

 

Generally speaking, hyperacusis is increased awareness and sensitivity to everyday sounds.

While these ordinary ambient sounds are normal in volume for most people, they can be perceived as annoying and trigger abnormal responses such as fear, annoyance, and pain in patients with hyperacusis. Although the nature of these distressing sounds varies from patient to patient, moderately loud noises from the kitchen, bathroom, large gatherings, sporting events, construction sites, and emergency vehicle sirens are common offenders. Did you know that maximum sound levels of up to 107 dB SPL have been measured by simply dropping a spoon into a container? It's no wonder that kitchen noises are such a great source of irritation and distress for DST patients.

 The prevalence of hyperacusis is conservatively estimated at 2% of the general population. However, epidemiological studies conducted on different aspects of DST point to a much higher value. In 2004, Jastreboff & Hazell proposed a classification system based on different forms of sensitivity to sound that are often found among patients with tinnitus and hearing loss. DST was used as a blanket term for hyperacusis (that is, discomfort with moderate and loud sounds), misophonia (that is, dislike / aversion to soft human-made sounds such as chewing), and phonophobia (that is, fear of certain sounds). Ten years later, Tyler and his colleagues added a category for the experience of pain associated with a sound of moderate to moderate intensity. They proposed the following four categories of hyperacusis:

-to volume or intensity (loudness)
-discomfort (misophonia)
-fear (phonophobia)
-painful hyperacusis.

Although misophonia and phonophobia can be disabling, this article focuses on volume hyperacusis concomitant with hearing loss and / or tinnitus. On the other hand, loudness hyperacusis should not be confused with recruitment often seen among patients with damaged cochlea. Recruitment is believed to be an abnormally rapid growth in perceived loudness with increasing sound intensity.

 

CLINICAL MANIFESTATIONS, ETIOLOGY AND NEURAL MECHANISMS

• Most patients report a sudden onset of hyperacusis. Although unilateral cases have been reported, most patients have reduced levels of volume discomfort (LDL) in both ears. The audiometric patterns of hyperacusis-related changes in loudness perception may be the same throughout the frequency range or more pronounced at high frequencies.
• Hyperacusis is triggered by a variety of health problems. Table 1 shows a list of conditions and disorders that are often associated with the development of hyperacusis among adults and children.
• Hyperacusis is often experienced with hearing loss. It is estimated that up to 50% of patients have elevated high frequency thresholds. But the relationship is complex as patients can also show hearing thresholds within the normal range. Therefore, the concept of hidden hearing loss was proposed to explain the development of hyperacusis among these patients.
• Based on their animal studies, Kujawa and Liberman (2009) hypothesized that overexposure to intensely loud sounds could also result in cochlear nerve degeneration without hair cell damage (ie, cochlear synaptopathy) in the ears. humans similar to mice. Hyperacusis is also significantly associated with tinnitus. It is estimated that up to 80% of patients also experience tinnitus. Furthermore, 40% of tinnitus patients also have symptoms of hyperacusis. Although both hearing problems appear to share a similar developmental course, the researchers believe that different neural mechanisms may be responsible for their onset.
• Finally, hyperacusis is related to low levels of well-being. Adults with hyperacusis are more likely than adults without the symptom to report high levels of daily stress, anxiety, and depression. Maladaptive coping strategies, such as avoiding public places and overuse of hearing protection devices, are often reported in an attempt to lessen the distress associated with DST.

 

Table 1: Lists of Conditions and Disorders Often Associated with the Development of Hyperacusis.
Although the exact physiological mechanisms underlying the development of hyperacusis have not yet been confirmed, researchers point to excessive central gain (hyperactivity) in the auditory pathways.

A functional magnetic resonance study performed among subjects with and without DST has found elevated sound-evoked activity in the inferior colliculus, medial geniculate body, and primary auditory cortex among subjects with hyperacusis when exposed to noise emitted at different intensities.

 

 

COMPREHENSIVE GUIDELINES FOR THE ASSESSMENT OF HYPERACUSE

A complete medical history is needed to access critical information on the events surrounding the onset of hyperacusis (e.g., After noise exposure, head injury, stapedectomy), detailed inventory of nuisance sounds (e.g. Eg, Kitchen sounds, emergency vehicles, breathing / food sounds), specific reactions experienced with the DST (eg, discomfort, pain, annoyance, fear), associated hearing problems (eg. , difficulty hearing, difficulty understanding speech in noise, tinnitus), behavior changes (eg, avoiding noisy situations, excessive use of earplugs) and their impact on quality of life (eg. , irritability, inability to relax, withdrawing from social interactions, relationship problems, interference with work).


When hyperacusis is suspected among patients with hearing loss and tinnitus, it is important that audiologists take precautions with some routine tests (eg, Acoustic Reflex) to avoid discomfort and pain. Aazh and Moore found that 21% of patients in a clinic specialized in tinnitus and hyperacusis experienced a stimulus level that exceeded their LDL (loudness discomfort level).

Table 2: Hyperacusis severity classification system based on volume discomfort level (suggested by Goldstein and Shulman).

 

Figure 1. Visual analog scale (VAS) for loudness hyperacusis.

 

Although there is no collective agreement on the best diagnostic procedure for the evaluation of hyperacusis, the measurement of LDL at 0.5, 1, 2, 4 and 8 kHz is still the most widely used method. Patients are asked to rate the volume of the sounds heard through the audiometer headphones. Starting from a level that the audiogram predicts to be comfortable, the tones are presented in 5 dB increments until the patient indicates that the sound has reached an uncomfortable volume level (before any discomfort or pain).

Furthermore, there is no consensus on the diagnostic criteria for the severity of hyperacusis. However, Goldstein and Shulman suggested a classification system based on LDL obtained at two different frequencies (Table 2). They found a positive correlation between hyperacusis and LDL. But the lack of standardized testing protocols and the risk of causing distress and pain have led to the development of new clinical tools. Various self-report measures (eg, Visual Analogue Scale (VAS) and Modified Khalfa Hyperacusis Questionnaire) are also recommended for assessing the severity and distress associated with hyperacusis. VAS is the most widely used method to assess pain intensity and frequency (i.e., acute or chronic) due to the large amount of empirical evidence supporting its validity and reliability (Figure 1).

Finally, since patients with hyperacusis and tinnitus are more prone to anxiety and depression, it is essential to detect emotional disorders to avoid unsuccessful treatment with hearing aids. Screening for mental health conditions is facilitated by the administration of validated self-report measures of emotional disorders. Many clinicians use the Perceived Stress Scale (PSS), the Hospital Anxiety and Depression Scale, and the Patient Health Questionnaire (PHQ-9) for their ease of administration.


If a patient scores high on these questionnaires, referral to a mental health professional for evaluation and treatment may take precedence over audiological intervention.

 

HYPERACUSE MANAGEMENT STRATEGIES



There is currently no cure for hyperacusis. However, many audiological management strategies have been found to be effective in reducing its impact and improving quality of life. In fact, amplification, sound therapy, and counseling have been shown to promote a reduction in center gain and, consequently, expansion of dynamic range.

Traditionally, fitting hearing aids to loud hyperacusis patients with associated hearing loss was contraindicated due to lack of assessment guidelines and hearing aid limitations. However, recent technological advances make it possible to safely improve a patient's hearing sensitivity and sound tolerance levels. Patients with mild and moderate intensity hyperacusis may benefit from the use of hearing aids equipped with a transient noise reduction feature that can attenuate loud household impact noises, such as the clattering of plates and doors slamming.

In addition, hearing aids with dynamic noise cancellation capabilities (eg Phonak Audéo Paradise) can help reduce annoying city noises, improve sound comfort level, and preserve speech audibility. Patients with a more severe degree of hyperacusis can also benefit from hearing aids equipped with therapeutic sound-generating capabilities. Continuous low-level white or pink noise can distract and sometimes relieve patients of annoying ambient sounds. Formby and her colleagues measured an average 10 to 12 dB improvement in LDL after treatment with combined devices.

________________________________________

But technological intervention alone is not enough. Audiologists must spend time educating patients about the hidden consequences of overuse of hearing protection devices and avoiding noisy social settings. Maladaptive coping strategies have been shown to worsen hyperacusis and distress with symptoms.

Professionals are reminded to always be kind, empathetic, patient and understanding, as it takes time to make positive changes and regain a sense of control with altered sound tolerance.

Finally, it may be necessary to seek help from mental health professionals who specialize in cognitive behavioral therapy for patients with poor general well-being.

 

Source: Blog centro auditivo Cuenca

Writer by Dr. Dany Pineault.

 

 

Strategies to detect and address cognitive impairment

Without the intention of supplanting other specialists, the audiologist must explore whether the person with hearing loss suffers from mild cognitive impairment, using some simple tests

 

Without the intention of supplanting other specialists, the audiologist should explore whether the person with hearing loss suffers from some mild cognitive impairment, using some simple tests. The success of your work will largely depend on these disorders and should be detected. The ANA has brought together several experts to share their experiences and advice in a complex field.

 

 By way of introduction to the workshop "Hearing health and cognitive health", the audiologist Joan Ros, third vice president of the ANA, has highlighted the interest of this workshop in identifying which people may suffer cognitive deterioration when they arrive at the office, given that of a factor that then strongly influences the results of the hearing aid fitting, as a disturbing element.

 

Olga Ferrer, ENT and specialist in Geriatrics, has stressed that the degree of cognitive impairment can be confusing, before analyzing in detail, because it also depends on the cultural level of the person. The mild one can be accompanied by a certain dependence or difficulty for tasks outside the basic ones, or memory losses, and not all these mild cases will go into dementia, only 10% -20%.

 

He has also regretted that "edaism" is promoted, everything related to age is bad, since childhood, what has to do with aging is negatively associated (loss of freedom, quality of life ...) In short This age should not be approached in the spirit of "emulating youth." It is true that a loss of all abilities may occur, because the person has not had sound stimuli. Mild cognitive impairment can lead to severe, but can it be reversed? This specialist has indicated that some therapies are being tried in residences.

 

"To grow old is to look younger, to be a bad copy of your youth, with which old age will always be negative, due to a materialistic conception, lack of important principles, such as knowing how to see things coming, anticipating", has opined Ferrer.

 

Presbycusis could be better addressed by the protagonists, not by their caregivers, because the former are in a kind of social exile with a lack of freedom. "This will not happen when aging has a value in itself," he concluded.

 

Various useful tests

 

Dr. Jesús Valero, professor at the Ramon Llull University of Barcelona and an expert in presbycusis, explained the fundamental reason for the importance of exploring the cognitive state of a presbycusis: because the act of hearing is cerebral and if there is any type of impairment in its activity, it influences hearing.

 

Although audiologists are not prepared for a neurological analysis, they are in a position to do a brief examination to find out to what extent the person may suffer from mild cognitive impairment. In case you observe that you may have a more serious problem, you should always refer to neurologists, psychiatrists or clinical psychologists. As instruments, short cognitive tests can be used in the auditory centers, which are carried out in less than 20 minutes, some five minutes, which interrogate about daily tasks and evaluate memory.

 

Valero has specifically referred to the minimental test (MMSE), whose results are influenced by the age of the person and their years of schooling, which are factors to take into account to determine the requirement when measuring the evaluation of the results of the proof. Also, to the Pfeiffer questionnaire, which explores memory, fundamentally, with 10 very basic questions. And he has also mentioned others such as digit memory and the Montreal Cognitive Assessment.

 

As "limits" of the brief cognitive tests, this specialist has indicated that it is necessary to be very patient because older people and those with hearing loss are evaluated. Also, be cautious with factors such as the years of schooling and training of the person and be aware that no diagnosis is going to be made.

 

The difficulty of the "cocktail party"

 

For Rafael Rubio, audiologist from Zaragoza and member of the ANA board of directors, the difficulty of the "cocktail party" -the effect of confusion for the person with hearing loss when several interlocutors speak to him and there is background noise- represents the biggest problem when there is also cognitive deterioration.

 

In fact, "dynamic listening" is more complicated than "static" (with a single face-to-face interlocutor), and it is about seeing what influence this possible decline in cognitive abilities has on attention when there are cross conversations. In addition, for the affected person, this leads to chronic and persistent, severe fatigue, two to four times more effort than the normal-hearing population. Rubio has compared it to understanding another language, when you still don't have a high level.

 

And there is also emotional fatigue, the autosuggestion of believing that one is going to feel bad, further aggravated if there is tinnitus. Both hearing aids and cochlear implants reduce persistent fatigue and also the possibility of temporary fatigue, which is due to a temporary or temporary cause.

 

"We can do very little with cognitive impairment, but tremendously interesting":

 

 -Detection (MOCCA test, Pfeiffer, immediate memory test, available on the Internet).

-Management of expectations. Do not promise goals without being cautious, hearing aids are a support, not a panacea.

-Tracing. Check if your cognitive loss remains stable or consider consulting a professional, in view of the tests carried out over time.

 

Obvious red flags

 -Less work capacity,

-disorientation in time and place,

-language problems, the person cannot find words,

-poverty of judgment,

-abstract thinking problems,

-frequent and unexpected mood swings,

-mistrays things or leaves them in inappropriate places,

-suspicions, fears, self-referential ideas (everything revolves around him), feels non-existent physical limitations,

-Loss of initiative,

-difficulty performing family tasks

-In cortical dementia, for example, due to Alzheimer's, they may laugh as well as cry, but retain normal language until very advanced stages. They make an incoherent speech with correct words. They have very impaired memory and lack of introspection.

-In subcortical dementias, they suffer from motor impairment, posture, language articulation problems (the pandemic has highlighted this)

 

No technological tool, for now

 Efren Poveda, specialist in Innovation, has asked if, just as there is a tool from each manufacturer for tinnitus, there is a technical means for cognitive impairment. Valero has opined in this regard that there should be the possibility that the person with this mild cognitive loss receives a series of attentions to stop it and not go further. With children there is such coverage. From his experience, Ferrer has explained that in these mild cases there are a series of products, neurotransmitters that make the brain work better, cognition does not recover, but behavior improves (sometimes they even show aggressiveness). The handicap is that "the public health system is careful, because they are very expensive and it takes them to the minimum." He has also related his complicated experience with the pandemic, because it was necessary to isolate the elderly without space, restrict visits from relatives ... a "chaotic situation", when there is a "crucial importance of the social relationship" for these people.

 

 

 

 

 

Source: Audio on Cover

 

How many types of hearing aids exist?

Only 36% of people with hearing loss use hearing aids.

Around 11% of the Spanish population has some type of hearing loss. Of the total, only 36% use hearing aids, according to data from the National Association of Hearing Care Professionals, devices that allow them to improve, since they can recover part of the lost hearing. However, many people with hearing loss are still reluctant to use hearing aids, although, thanks to advances in this field, we are increasingly finding almost invisible and more technologically advanced models.

29% of Spaniards have more hearing and understanding problems due to the use of the mask

 

Hearing aids vary greatly in price, size, characteristics and the way they are inserted into the ear, but we can distinguish between those that are placed inside the ear (in-ear or ITE), those that are placed outside, behind the ear (behind the ear or BTE ) and headphone-in-channel (RIC). Within these models, we find different types:

 

Completely in duct or CIC

This in-the-ear hearing aid is the smallest on the market and also the most discreet, as it is completely inserted into the canal and is made to measure. It is recommended for people with mild to moderate hearing loss as, due to its size, it often does not include additional features, such as a volume control or a directional microphone. It is not recommended for people with a tendency to have a lot of earwax because it is susceptible to wax clogging the speaker, or for those with very small ear canal.

In duct or ITC

Also in-the-ear, ITC hearing aids are custom molded and partially fit into the ear canal. They are not as discreet as CICs, but they have more features, such as microphones on the outside with the possibility of directionality, essential for improving hearing in noisy environments. It is recommended for people with moderate / severe hearing loss and, like CIC, it is not recommended for people with narrow channels or a tendency to accumulate wax.

 

Half shell / shell or HS

This ITE hearing aid is also made to measure, but it is less discreet than the previous ones, since part of it is located in the shell of the auditory pinna or ear. It is recommended for both mildly and severely deaf people and includes features that do not fit smaller style hearing aids, such as volume control or directional microphones for listening in noisy environments. Being larger, the battery also lasts longer. Like the rest of in-the-ear, it is not recommended for people with narrow channels or a tendency to accumulate wax.

A pioneering system adapts hearing aids remotely to avoid isolation

 

Receiver in the ear or RITE / Receiver in the canal or RIC

This model is partially invisible, since part of the hearing aid is located inside and part outside, and both parts are connected by means of a thin. They are recommended for slight to moderate losses and when the microphone is placed outside, perfect directionality and manual control is achieved. When the receiver is located outside, the sound that is achieved is more natural.

 

Behind the ear or BTE

These hearing aids are the most traditional, those that hook on the upper part of the ear and rest behind it. A tube connects the hearing aid to a custom earpiece (ear mold) that fits into the ear canal, and both parts are visible. This type of hearing aid is recommended for any level of hearing loss and for people of all ages. They offer greater power and have more functionalities, such as directionality, volume control, connectivity with Smartphone etc.

Open fit

An open-fit hearing aid is a variation of the retro-auricular hearing aid with a thin tube and an open dome in the ear, whereby the receiver at the end of the thin tube is located inside the ear. By keeping the ear canal very open, sounds are more natural and, although it is visible, its smaller size makes it less visible than BTEs. It is recommended for mild to moderate high frequency hearing loss. It is not recommended for patients with wax problems.

 

Within these models, we find many variations in terms of price, aesthetics, functionalities, etc.

 

How to get used to them and keep them

Hearing aids, whatever the model, require maintenance, which basically consists of periodic checks and daily cleaning. In addition, we must get used to them little by little, because, although they improve hearing considerably, this will not be like when we did not have any hearing problems, so it may take time to get used to it. In this sense, we give you the following tips:

Wearing the hearing aid to all daily activities

The more we wear them, the sooner we get used to them.

Adjust it gradually each day and learn to control sound and noise

A fundamental advice is to respect the adaptation phase. Little by little adapting the level of your hearing aid is essential to get to it, since each activity and each day will require adjustments until you find the point where you are most comfortable.

Clean it daily

It is a fundamental part of the maintenance of your hearing aid, because in addition to lasting longer, it will allow us to hear better. Depending on the type of hearing aid, the cleaning will be different. Nor can we forget to change the batteries and check them regularly.

 

 

 

Source: 20minutes