Case History: your audiologist will find out important information about your lifestyle, overall health as it pertains to your hearing, regular activities and hearing concerns.
Hearing Test: your audiologist will use middle ear testing, acoustic reflex tests, air conduction, bone conduction, speech testing as well as speech in noise testing to learn what type of hearing loss you have and what treatment or referral options you would benefit from.
Cognitive Screening: Your cognition strongly relates to how well you will perform with your hearing aids. This will reveal important information about what devices will suit you best, as well as relay important information to your family doctor about your overall health. The results of the screener will be discussed at your discretion and will be relayed to your family doctor with your consent.
Counselling: Based on the results we see from the hearing test and the cognitive screener, appropriate treatment options and referrals will be made.
Hearing Aid Evaluation: If hearing aids are the best treatment option, hearing aid styles and technology will be reviewed. Depending on what’s important to you, how well you wish to function in challenging noise situations, information from intake and your budget, a technology will be recommended.
Hearing aid trial: Often the best way to understand how a hearing aid works for you in your day-to-day life is by trying it out. This is encouraged at Toronto Hearing Health Clinic so you can feel confident you made the right choice and you are happy with your hearing aids.
Hearing Aid Fitting: Once you are satisfied with your hearing aid selection, your hearing aid will be fitaccording to your comfort and hearing thresholds. Your hearing aid will also be verified to ensure it is optimized for speech understanding.
Hearing Aid Orientation: Once the hearing aid is fit to your individual hearing thresholds, you will be counselled and trained on the specifics of your hearing device, whether it be cell phone function, TV accessories, or individual hearing aid programs, you will know the nitty gritty of how your hearing aid works based on your unique fitting.
Program of Care: Follow up appointments, regular hearing tests and cognitive screens will also be part of your on-going care once a hearing aid is prescribed from Toronto Hearing Health.
Aural Rehab: Additional education and therapy options are available to help your brain better access hearing in noise, help improve auditory memory, and much more!
Sound travels from the external environment down the ear canal to the ear drum.
Sounds from the outer ear vibrate the ear drum, which in turn causes the bones of the middle ear, malleus, incus and stapes, to vibrate. Stapes, also know as ‘anvil’ due to its appearance, vibrates a part of the cochlea known as the oval window, setting cochlear fluids into motion.
Once cochlear fluids are in motion, small structures called hair cells, are responsible for turning the mechanical sound signal from the external environment into an electrical signal which transmits the information from the cochlea to the auditory nerve. There are two kinds of hair cells: outer hair cells, and inner hair cells. These cells are frequency specific, in that they are specialized to ‘hear’ or transmit certain frequencies at extremely soft volumes
Once the signal moves up the auditory nerve, it transmits through the brain stem up to the auditory cortex in the brain, where sound is processed into something meaningful.
Occurs when sound is not transmitted to the inner ear effectively. This type of hearing loss creates an ear plug effect, in that something is blocking sound from getting through the outer and middle ear, like an ear plug.
Sometimes Conductive hearing loss can be resolved with medical intervention.
Some Causes:
Sensorineural hearing loss is progressive and permanent in nature, but progresses slowly, and remains stable for several years. The damage can be cochlear, involving the hair cells, or retrocochlear which is beyond the cochlea. This type of loss can be associated with tinnitus and a reduction of speech clarity, especially in noise. Age related hearing loss, also known as presbycusis, is a type of sensorineural hearing loss.
Some Causes:
Mixed hearing loss is a combination of both conductive hearing loss and sensorineural hearing loss. An example of when this might be apparent is when a patient who has a sensorineural hearing loss develops otosclerosis, meaning their sensorineural hearing loss also has middle ear involvement.
A common question asked by patients is ‘’how much does a hearing aid cost?” or “what is the cheapest hearing aid?” Hearing aid pricing can range drastically depending on the technology or the chip inside. It is a common misconception that hearing aid cost is dictated by the look of the hearing aid, or the style, but this is not the case. A high-end hearing aid and low-end hearing aid can actually look the same, but how they function, especially in noise, will change depending on the chip. Higher-end hearing aids typically have better ear-to-ear communication, more acute or defined noise filtering and noise management technology, more acute directional microphone technology and overall will function better in more difficult listening situations.
Typically, prices range with higher-end hearing aids costing the most, and the cost averages to approximately a cup of coffee a day for mid level hearing aid.
Hearing Aid Technology
Premium
Quiet, one-on-one casual conversations
Small Group conversations (in quiet)
Public transportation (imagine reading a book on the subway)
Group conversations in noise (imagine a family gathering)
Restaurants
Meetings (think boardroom with echoes)
Outdoor activities
Hearing Aid Technology
Mid
Quiet, one-on-one casual conversations
Small Group conversations (in quiet)
Public transportation (imagine reading a book on the subway)
Group conversations in noise (imagine a family gathering)
Restaurants
Meetings (think boardroom with echoes)
Outdoor activities
Hearing Aid Technology
Entry
Quiet, one-on-one casual conversations
Small Group conversations (in quiet)
Public transportation (imagine reading a book on the subway)
Group conversations in noise (imagine a family gathering)
Restaurants
Meetings (think boardroom with echoes)
Outdoor activities
| Hearing Aid Technology | Quiet, one-on-one casual conversations | Small Group conversations (in quiet) | Public transportation (imagine reading a book on the subway) | Group conversations in noise (imagine a family gathering) | Restaurants | Meetings (think boardroom with echoes) | Outdoor activities | Shopping or Public Places |
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Mid |
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Entry |
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It should be noted that how someone functions with hearing aids also depends on their cognitive state. Sometimes a hearing aid might not be the most suitable treatment option for communication. Once assessed, your Toronto audiologist can help make the decision that’s best for you or your family member.
In-the-Ear hearing aids come in a variety of styles. They can range from a larger hearing aid in the ear, which fills the entire ear, called an ITE (in-the-ear), to a small invisible hearing aid style that barely protrudes from the ear canal called an IIC (invisible-in-canal). Instant fit models exist, as well as some styles that require a custom mold to build. This involves placing a soft puddy in the ear, which hardens to obtain a replica of the shape of a person’s individual ear canal.
There are many types of hearing aids on the market, but the behind-the-ear (BTE) hearing aid style is currently the most popular, consistently making up at least 80% of the hearing aid market year after year. BTE’s come in large and discreet styles, ranging from larger BTE’s which have full custom molds and tubes, to small instant fit models, often called RICs (receiver-in-the-canal) or RITEs (receiver-in-the ear). The RITE style is not only discreet, but very comfortable, has more capacity for in-office repairs and often has more Bluetooth features as compared to the in-the-ear styles.
Hearing aids are looking better than ever! Modern hearing aid styles that look nothing like the hearing aids of the past have increased patients’ acceptance of these very important medical devices. Hearing aids also have a lot of technology packed in a small space!
The Active Pro is an ear-bud style that is rechargeable and has Bluetooth capability and advanced features like a motion sensor and narrow beam directionality.
Protecting your hearing is imperative, as preventing a hearing loss is far better than trying to treat one! If you work in a loud environment, an acceptable occupational noise level is 85 dB HL (think heavy city traffic) and is considered safe for a duration of 8 hours. There are two sets of rules to calculate acceptable dosage levels, the 5dB or 3 dB exchange rule. In Canada, 3dB is more commonly used, so if you are in a location that is 88dB for example, you can safely stay in that environment for 4 hours, 91dB would be 2hrs, and so on. A good rule of thumb is that if you’re yelling at someone and trying to communicate, the environment you’re in is likely too loud. Sound level meter apps can also assist in understanding the loudness of your space. The Niosh Sound Level Meter is one example, and is suggested by the Center for Disease Control.
It can even link to your Apple Health app and allow you track important noise exposure information if you feel your noise exposure levels are damaging.
