Friday, June 28, 2013

Who makes hearing aids? Is there a difference in quality?

The American Speech-Language-Hearing Association reports that there are currently 22 digital hearing aid manufactures that market over 40 different models of hearing aids. Each premium hearing aid manufacturer employs a unique approach to accommodate various lifestyles. For example:
  • Siemens manufactures rechargeable hearing aids with especially clear sound for moderate to severe hearing loss. Siemens manufactures:
    • The Micon. This is a 48-channel hearing aid that offers many of the hearing aid industry's most advanced programming features.
    • The Aquaris. The Aquaris is the world's first and only truly waterproof hearing aid with an IP68 rating.
    • The miniTek Remote and Streamer. The miniTek wirelessly streams the audio of a cell phone, television, or music player to both hearing aids.
    • Siemens recently released the miniTek Remote App. This app allows the user to adjust the settings of the hearing aids with an Android powered device.
  • Phonak is a Tier 1 manufacturer with excellent speech-in-noise solutions and water-resistant hearing aids.
    • The Bolero Q is Phonak's newest release and features advanced noise suppression features that promote speech clarity in challenging listening environments.
    • Phonak also offers a wireless streamer and microphone. The comPilot and RemoteMic are bluetooth compatible devices that wirelessly transmit audio to both hearing aids.
    • Phonak's Tinnitus Balance App is now available and is designed to help people with tinnitus.
  • Oticon is a premium hearing aid manufacturer that offers quality devices with multiple programming features and wireless accessories.
    • Oticon has a new hearing aid called "Alta" that is currently receiving alot of recognition as an ideal choice for first time hearing aid users. 
    • The ConnectLine and StreamerPro are bluetooth compatible devices that stream the volume of televisions and cell phones wirelessly to both hearing aids.
    • The Alta Diary App from Oticon enables the user to record their listening preferences in difficult acoustic environments and inform the audiologist.
The type of hearing aid best suited for an individual is usually determined by the individual's particular hearing loss, ability to discern speech in noise, and lifestyle. Sorting through what each manufacturer offers and how it applies to your particular hearing loss and lifestyle can be overwhelming.  Be sure to choose the right hearing professional to help you discern the best option for you. For more information, visit our website!

Wednesday, June 26, 2013

What causes tinnitus?

What causes tinnitus?
There are about 200 causes for tinnitus- some benign, some quite troublesome. The problem may be in the outer ear, the skeleton, the middle ear, the inner ear, or along the auditory pathway to the brain. The loudness of the sounds has nothing to do with the cause. An experienced audiologist will help you identify the cause and help you find relief. Causes of tinnitus include:
  • Loud noise exposure
  • Hearing loss
  • Excessive ear wax
  • Ear infection
  • High blood pressure
  • Deficiencies in Vitamin D, Vitamin B12, Zinc
  • Medications such as certain antibiotics (erythromycin, gentacmycin), some cancer treatment medications, unusually high doses of aspirin, and certain diuretics.

Risk Factors for Tinnitus

There are multiple risk factors that can contribute to the onset of tinnitus. These risk factors include:
  • Age related hearing loss
  • Exposure to loud noise
  • Middle ear disease or sinus infections
  • Constricted or poor blood flow 
  • History of migraine headaches

For more information on tinnitus, visit our website.

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Friday, June 21, 2013

Hyperacusis and Abnormal Sound Perception

Children and adults- regardless of hearing levels, may develop troublesome perceptions to sound.
  1. Some may experience intolerance to sounds that others view to be average or only slightly loud. For example, the sound and loudness of the vacuum cleaner may force them to leave the building. Certain acoustic environments, such as a reverberant gymnasium may be painful, causing academic conflicts for completing a physical education course. People with Williams Syndrome often experience hyperacusis. These individuals usually will have normal hearing.
  2. Some people with hearing loss will also experience loudness difficulties that may or may not be hyperacusis. A sensorineural hearing loss usually means that soft sounds are not audible and loud sounds are too loud. There is abnormal growth in loudness. Certain conductive hearing losses, such as those caused by otosclerosis may result in intolerance to loud sounds but no difficulty with soft or medium sounds.
  3. Some individuals find certain sounds at a specific pitch range to be aversive, no matter what the loudness. Public (not scientific) literature describes this as misophonia.
  4. Others fear sounds (phonophobia).
Sound protection and sound desensitization are the general methods used to change this central troublesome perception. Over use of sound plugs will make the condition worse.
Appalachian Audiology offers evaluation, support, education, and treatment for these sound disorders. Treatment follows protocols developed at the University of California (Irvine), the University of Iowa Tinnitus Clinic, and the VA Progressive Tinnitus/Hyperacusis management protocol. Treatment is rarely covered by insurance. Prior authorization is recommended.
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Wednesday, June 19, 2013

How to Pay for Hearing Aids

According to The Better Hearing Institute, two out of three adults with hearing loss do not purchase hearing aids because of financial constraints. Most audiology practices now accept multiple forms of payment. Below are some ideas for how you can acquire the resources to purchase hearing instruments:

Health Insurance
More and more health insurance companies are beginning to pay a portion of hearing aid costs. Check with your insurance company to confirm the potential coverage amount. Sometimes the type of hearing instrument a plan will cover may not be suited for an individual's degree of hearing loss. Be sure to confer with your audiologist and insurance provider before confirming the amount of coverage your plan will provide.
Monthly Payments through CareCredit
CareCredit also offers interest-free financing plans. Qualified applicants can obtain a line of credit to purchase the hearing instruments and pay them off in monthly installments. CareCredit offers monthly payment options, no up-front costs, and no pre-payment penalties. Interested individuals can apply online and receive instant approval. The entire application process takes about 10 minutes.

For more information on CareCredit or to apply for a line of credit, click here.

The Better Hearing Institute also offers a free publication that features multiple programs that assist individuals with purchasing hearing aids. To access this resource, click here.

Appalachian Audiology offers multiple payment options for hearing aid purchases. For more information, visit our website!

Monday, June 17, 2013

An Update on "made for iPhone" Hearing Aids

It’s been nearly one year since Apple confirmed reports that it was working with top-tier hearing aid manufacturers to create “made for iPhone” hearing aids. In theory, “made for iPhone” hearing aids would provide two valuable features:
  • Seamless connectivity between premium hearing aids and smartphones
  • iPhone accessibility to hearing aid settings (use your iPhone to access and adjust the settings of the hearing aids)
While “made for iPhone” hearing aids have yet to be released, GN ReSound has announced its intention to release hearing instruments by the end of 2013 that bear this distinction.
patent applied for by Apple also implies that the global innovator is seeking to create a social network for hearing aid users. The goal would be to facilitate connection among hearing aid users through a social media platform where their unique instrument settings could be openly shared.
Currently, iPhone 5 and 4 models comply with the FCC’s hearing aid compatibility standards. However, to maximize the clarity of your particular model of iPhone, you will need to activate the “Hearing Aid Mode.” To do this on an iPhone 4 or 5 with the iOS 5 or later, go to Settings > General > Accessibility and make the appropriate adjustment to turn the Hearing Aid Mode to “on.” For more information on iPhones and hearing aid compatibility, visit Apple’s hearing aid compatibility page.
Many hearing aid manufacturers have released smartphone and tablet APPs for their devices. Click here for APPs from Siemens, Phonak, Oticon, and GN ReSound.

Image provided courtesy of Salvatore Vuono of

Friday, June 14, 2013

How Long Should Hearing Aid Batteries Last? Conclusion

As we've discussed in our previous blog entries, The Hearing Review highlights five factors
that impact how long a hearing aid battery will last:

  1. Severity of hearing loss
  2. Daily use of the hearing aid
  3. Battery size
  4. Number of features in the hearing aid
  5. Environment
So, how long should hearing aid batteries last? Does the brand of hearing aid battery matter?

Battery Life
On average, a hearing aid battery should last about 7 days. Sometimes the life cycle can be as short as 5 days or as long as 10 days. The Hearing Review breaks down the typical lifespan of each battery size the following way: 

    • Size 10: 3-10 days
    • Size 312: 3-12 days
    • Size 13: 6-14 days
    • Size 675: 9-20 days
If your hearing aid batteries are lasting less than 5 days, it could be an indication that the hearing instrument needs repair. Consult with your audiologist to see if you should send your hearing instruments in for repair.

Brand of Hearing Aid Battery
The voltage of the hearing aid battery is more important than the brand. Most store brand hearing aid batteries provide 1.4 volts of power. However, Appalachian Audiology only sells hearing aid batteries that offer 1.45 volts of power. The higher the voltage, the more power the battery will supply to the hearing instrument. This will directly impact how well the hearing instruments perform. We strongly encourage hearing aid users to purchase batteries with 1.45 volts.

For more information on battery life, read The Hearing Review's handout entitled: "Important Battery Facts for Today's Hearing Instruments."

Image provided courtesy of David Castillo Dominici

Wednesday, June 12, 2013

How Long Should Hearing Aid Batteries Last? Pt. 2

In our last blog, we talked about three of the five factors that impact the lifespan of a hearing aid battery. They were:
  • Severity of hearing loss
  • How many hours per day the individual wears the hearing instruments
  • The size of the battery
Two other factors that determine how long a hearing aid battery will last are:
  • Unique features of different models of hearing instruments
  • Environment
Unique Features
Premium hearing instruments are available in three different levels of technology. Each technology level features an increasing number of microphones and channels, wireless connectivity to cell phones and televisions with the use of a remote, FM compatibility, and programming features with different strategies for promoting speech intelligibility in challenging environments. The number of microphones, use of wireless accessories, and sophistication of programming features determine "how hard the hearing aid has to work" to account for an individual's hearing loss and lifestyle. This directly impacts how much battery life the hearing instrument consumes to maximize its performance.

The Hearing Review highlights how different environments impact the lifespan of hearing aid batteries:
  • Low Humidity
    • Less humid environments (such as indoor environments during the winter time or homes that use wood burning fireplaces) can cause batteries to dry out more quickly and therefore shorten their life cycle.
  • High Humidity
    • More humid environments (working outdoors in the heat) can cause the battery to take on more moisture. This can also reduce its lifespan.
  • Temperature
    • Battery life shortens due to the lower output of voltage in colder environments.
  • Altitude
    • Higher altitudes reduce battery life due to a decrease in the amount of oxygen that is available. 
With this in mind, how do you pick the right hearing aid battery? Does the quality of hearing aid batteries vary among different brands? How long should you expect your hearing aid batteries to last? Next blog...

To read The Hearing Review's article on hearing aid battery life (the source of information for this post), click here.

Image provided courtesy of digitalart of

Monday, June 10, 2013

How Long Should Hearing Aid Batteries Last?

How long should hearing aid batteries last? What determines a battery's lifespan? Is there a difference in the type and brand of battery? Are hearing aids with rechargeable batteries worth the additional expense of the charger? We'll answer these questions in this week's series of blog posts. This information comes from a handout distributed online by The Hearing Review.

There are five factors that impact how long a hearing aid battery should last. 

  1. Severity of hearing loss
    • The degree of hearing loss will determine the level of amplification an audiologist programs into the hearing aid. The level of amplification will increase the amount of power needed to ensure the hearing aid functions properly. This directly impacts how much battery life is consumed to power the hearing instrument.
    2. How many hours per day the individual uses the hearing instrument
    • The length of time the hearing aid is worn each day directly impacts the amount of battery life that is consumed.
    3. The size of the battery
    • Larger batteries have a longer life than smaller batteries. Smaller batteries have less "ingredients" to power the device. Therefore, smaller batteries typically have a shorter lifespan than larger batteries.
In general, a battery should last around 7-10 days. Battery life that is 3 days or less is often an indication that something is wrong with the hearing instrument and indicates that it needs to be sent to the manufacturer for repair. More in our next blog post...

To view the handout from The Hearing Review (the source of this information), click here.

Image provided courtesy of digitalart of

Friday, June 7, 2013

5 Considerations Before You Buy Hearing Aids, Conclusion

In our last two blog posts, we talked about how an individual's lifestyle, physical limitations, and ability to hear in noise are major considerations in choosing the right hearing instruments. Two other considerations must be made before purchasing hearing aids:

  • Type and Degree of Hearing Loss
  • Budget

Hearing Loss
Choosing a hearing instrument that will properly address your particular type and degree of hearing loss is a primary consideration for an audiologist.
  • For example, if an individual has a high frequency hearing loss with a normal low frequency response, a hearing aid that permits low frequencies to enter the ear normally while allowing only high frequencies to be amplified would be ideal. This is called selective amplification. However, if the individual with this type of hearing loss chooses a hearing aid that totally plugs the ear canal, the effect is often an artificial sound.
  • If an individual has a moderate to severe hearing loss in the low frequencies, almost any model of hearing aid can be adapted to the hearing loss.
  • As an individual's hearing changes, the hearing aid will need further adjustments. It is important to select a model of hearing aid your audiologist can adjust should your hearing change. If you select a model that is barely within the fitting range for that model and your hearing drops, you will have to buy a new hearing aid. We don't want that! It's imperative to pick a model of hearing aid with "head room"!
All manufacturers of hearing aids make three levels of technology: Level 1, Level 2, and Level 3. Hearing aids are placed in a level based on the sophistication of the microphones and the number of channels. A Level 1 hearing aid has 4-8 channels and the microphones are usually fixed-directional. A Level 2 hearing aid has 8-12 channels and the microphones offer adaptive directionality. A Level 3 hearing aid has up to 48 channels with multi-channel adaptive directionality in the microphones. In general, the noisier your world, the better you will do with a higher level hearing aid.  

Before you purchase hearing aids, be sure to clarify what is included in the purchase price. At Appalachian Audiology, hearing aid prices include the hearing devices, accessories, and ear molds (should ear molds need to be made). The price also includes service and adjustments for the life of the hearing aid. We also include 10 packs of batteries (roughly one year's supply of batteries), a Dry Spot dehumidifier to store the hearing devices within, and a generous repair and service warranty. 

In general, the most sophisticated, technologically advanced hearing instrument in the world should not cost more than $2800-$3000 per instrument. 
If someone is charging more, be careful! 

For specific hearing instrument pricing, please click here.

Wednesday, June 5, 2013

5 Considerations Before You Buy Hearing Aids, Pt. 2

As we discussed in our last blog post, hearing aids continue to advance at a rapid pace. With all of the features available in modern hearing instruments, how do you know which devices to buy? We recommend 5 considerations before purchasing hearing aids. The first consideration is how well you hear speech in the presence of background noise. Two other important factors to account for are your lifestyle and the presence of any physical limitations. Do you like to be outdoors? Do you golf, hike, ski, or play sports regularly? Are you confined to a wheelchair? Do you require an oxygen tank?


An individual's lifestyle and physical limitations must be considered before selecting the appropriate hearing aids.

  • Some hearing aids can be firmly attached with acoustically tuned head bands (great for skiing), with sports clips (for kayaking, water-skiing, hiking back-country), and with clips to eyeglasses or collars (used for individuals with dimentia).
  • Some hearing aids pick up sounds from behind or to the side.
    • If the user is confined to a wheelchair, rear facing microphones are terrific to hear the caregiver.
    • If the user is a realtor who drives clients who ride "shotgun" and/or in the back seat, two manufacturers provide adaptive microphones who identify the primary talker and "zoom" to that person.
  • Some hearing aids are far better suited to individuals who spend lots of time on the phone or on the computer.
  • Reduced manual dexterity may result in the inability to deal with changing batteries or even inserting the hearing aid.
  • Individuals who use oxygen with a cannula find it difficult to fit behind the ear hearing aids and the oxygen tube simultaneously. They are better fit with custom, in the ear or in the canal hearing aids.
  • "Technically challenged" and those resistant to any manual controls on a hearing aid should inquire about the vast number of automatic features to eliminate the need for manual controls.
  • Those with ear malformations will be glad to find a large array of features to keep the hearing aids in place.
For more information on how to choose the right hearing instruments, click here.

Monday, June 3, 2013

5 Considerations Before You Buy Hearing Aids

Hearing aid technology continues to advance at a pace second only to the technology that fuels modern space exploration. Within the last three decades, hearing aid circuits have gone from making 3 judgments per second to 300 million judgments per second! This faster processing speed enables the audiologist to simultaneously raise the volume for speech and lower the volume for noise, amplify the telephone, and selectively reduce sound from the sides and behind you. With all the different styles and features of modern hearing aids, how do you select the device that will best accommodate your particular degree of hearing loss? What should you know before your purchase hearing aids?

We believe there are 5 major considerations an individual must make before buying hearing instruments. The first consideration is how well you understand speech in noisy environments.

  • The severity of the hearing loss is not a predictor of how much difficulty you may have while trying to hear in a noisy restaurant, in an outboard motorboat, etc.
  • Individuals with normal hearing typically can hear even if the background noise is as loud or slightly louder than the target speech. 
  • For people who have a sensorineural hearing loss, the optimal ratio between the loudness of the speech and the loudness of the background noise changes. It is far more difficult to hear in noise with a sensorineural hearing loss.
  • A normal ratio is 0-4 dB (speech is as loud or 4 dB louder than the noise). You can hear even at Cracker Barrell!
  • An abnormal ratio is greater than 4 dB. Unfortunately, the ratio for individuals with sensorineural hearing loss can be greater than 15 dB (meaning, if the speech is 15 dB louder than the noise, you can hear with clarity).
  • Some people with a sensorineural hearing loss require a ratio of 10 dB , others may need only 6 dB, etc. This should be part of the hearing evalatuion and reviewed prior to selecting hearing aid circuits, since all hearing aid circuits vary in the speech to noise ratio improvement.
The takeaway message is: many hearing aids work okay in quiet rooms but do not effectively improve hearing in noisy rooms. Multi-microphone technology, increased number of channels, very fast processing speed all contribute to improved speech understanding in noise.
No matter how skilled the audiologist is in programming the hearing aid, the circuit should be matched to the needs of the user or improved hearing in noise cannot occur.
For more information on what you should consider before purchasing hearing aids, click here.