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							                                                     NIDCD Fact Sheet
                                                     Hearing Aids
hearing




                            balance



                                                                        components is made of hard plastic. Some ITE aids                                                                        upgrade opportunities, and the hearing aid company’s          Work with your audiologist until you are comfortable
          How can I find out if I need a hearing                                                                                     Digital aids convert sound waves into numerical                                                                                                                                      How can I care for my hearing aid?
          aid?                                                          may have certain added features installed, such as                                                                       reputation for quality and customer service.                  and satisfied.
                                                                                                                                     codes, similar to the binary code of a computer, before
                                                                        a telecoil, a small magnetic coil that makes it easier                                                                                                                                                                                            Proper maintenance and care will extend the life of
                                                                                                                                     amplifying them. Because the code also includes                                                                           You may experience some of the following problems
                                                                        to hear conversations over the telephone. ITE aids                                                                       What questions should I ask before
          If you think you might have hearing loss and could                                                                         information about a sound’s pitch or loudness, the                                                                                                                                   your hearing aid. Make it a habit to:
                                                                        usually are not worn by young children because the                                                                       buying a hearing aid?                                         as you adjust to wearing your new aid.
          benefit from a hearing aid, visit your physician, who                                                                      aid can be specially programmed to amplify some
          may refer you to an otolaryngologist or audiologist.          casings need to be replaced often as the ear grows.                                                                                                                                    • My hearing aid feels uncomfortable. Some                 • Keep hearing aids away from heat and moisture.
                                                                                                                                     frequencies more than others. Digital circuitry gives       Before you buy a hearing aid, ask your audiologist
          An otolaryngologist is a physician who specializes in                                                                      an audiologist more flexibility in adjusting the aid to                                                                     individuals may find a hearing aid to be slightly
                                                                      • Canal aids fit into the ear canal and are available                                                                      these important questions:                                                                                               • Clean hearing aids as instructed. Earwax and ear
          ear, nose, and throat disorders and will investigate the                                                                   a user’s needs and to certain listening environments.                                                                       uncomfortable at first. Ask your audiologist how
                                                                        in two styles. The in-the-canal (ITC) hearing aid is                                                                                                                                                                                                drainage can damage a hearing aid.
          cause of the hearing loss. An audiologist is a hearing                                                                     These aids also can be programmed to focus on               • What features would be most useful to me?                     long you should wear your hearing aid while you
                                                                        made to fit the size and shape of a person’s ear
          health professional who identifies and measures                                                                            sounds coming from a specific direction. Digital                                                                            are adjusting to it.                                     • Avoid using hairspray or other hair care products
                                                                        canal. A completely-in-canal (CIC) hearing aid is                                                                        • What is the total cost of the hearing aid? Do the
          hearing loss and will perform a hearing test to assess                                                                     circuitry can be used in all types of hearing aids.                                                                                                                                    while wearing hearing aids.
                                                                        nearly hidden in the ear canal. Both types are used                                                                        benefits of newer technologies outweigh the higher          • My voice sounds too loud. The “plugged-up”
          the type and degree of loss.
                                                                        for mild to moderately severe hearing loss.                                                                                costs?                                                        sensation that causes a hearing aid user’s voice to
                                                                                                                                     Which hearing aid will work best for                                                                                                                                                 • Turn off hearing aids when they are not in use.
          Are there different styles of hearing                                                                                      me?                                                                                                                         sound louder inside the head is called the occlusion
                                                                        Because they are small, canal aids may be difficult                                                                      • Is there a trial period to test the hearing aids?
          aids?                                                                                                                                                                                                                                                  effect, and it is very common for new hearing            • Replace dead batteries immediately.
                                                                        for a person to adjust and remove. In addition,                                                                            (Most manufacturers allow a 30- to 60-day trial
                                                                                                                                     The hearing aid that will work best for you depends on                                                                      aid users. Check with your audiologist to see if a
                                                                        canal aids have less space available for batteries                                                                         period during which aids can be returned for a                                                                         • Keep replacement batteries and small aids away
          There are three basic styles of hearing aids. The styles                                                                   the kind and severity of your hearing loss. If you have                                                                     correction is possible. Most individuals get used to
                                                                        and additional devices, such as a telecoil. They                                                                           refund.) What fees are nonrefundable if the aids are                                                                     from children and pets.
          differ by size, their placement on or inside the ear, and                                                                  a hearing loss in both of your ears, two hearing aids                                                                       this effect over time.
                                                                        usually are not recommended for young children                                                                             returned after the trial period?
          the degree to which they amplify sound (see figure on                                                                      are generally recommended because two aids provide                                                                                                                                   Are new types of aids available?
                                                                        or for people with severe to profound hearing loss                                                                                                                                     • I get feedback from my hearing aid. A whistling
          page 1).                                                                                                                   a more natural signal to the brain. Hearing in both ears    • How long is the warranty? Can it be extended?
                                                                        because their reduced size limits their power and                                                                                                                                        sound can be caused by a hearing aid that does not
                                                                                                                                     also will help you understand speech and locate where         Does the warranty cover future maintenance and                                                                         Although they work differently than the hearing
          • Behind-the-ear (BTE) hearing aids consist of a hard         volume.                                                                                                                                                                                  fit or work well or is clogged by earwax or fluid. See
                                                                                                                                     the sound is coming from.                                     repairs?                                                                                                               aids described above, implantable hearing aids are
            plastic case worn behind the ear and connected                                                                                                                                                                                                       your audiologist for adjustments.
                                                                      Do all hearing aids work the same way?                                                                                                                                                                                                              designed to help increase the transmission of sound
            to a plastic earmold that fits inside the outer ear.                                                                     You and your audiologist should select a hearing aid        • Can the audiologist make adjustments and provide
                                                                                                                                                                                                                                                               • I hear background noise. A hearing aid does not          vibrations entering the inner ear. A middle ear
            The electronic parts are held in the case behind the                                                                     that best suits your needs and lifestyle. Price is also a     servicing and minor repairs? Will loaner aids be
                                                                      Hearing aids work differently depending on the                                                                                                                                             completely separate the sounds you want to hear          implant (MEI) is a small device attached to one of the
            ear. Sound travels from the hearing aid through                                                                          key consideration because hearing aids range from             provided when repairs are needed?
                                                                      electronics used. The two main types of electronics are                                                                                                                                    from the ones you do not want to hear. Sometimes,        bones of the middle ear. Rather than amplifying the
            the earmold and into the ear. BTE aids are used by                                                                       hundreds to several thousand dollars. Similar to other
                                                                      analog and digital.                                                                                                                                                                        however, the hearing aid may need to be adjusted.        sound traveling to the eardrum, an MEI moves these
            people of all ages for mild to profound hearing loss.                                                                                                                                • What instruction does the audiologist provide?
                                                                                                                                     equipment purchases, style and features affect cost.                                                                                                                                 bones directly. Both techniques have the net result
                                                                                                                                                                                                                                                                 Talk with your audiologist.
                                                                      Analog aids convert sound waves into electrical                However, don’t use price alone to determine the best
            A new kind of BTE aid is an open-fit hearing aid.                                                                                                                                    How can I adjust to my hearing aid?                                                                                      of strengthening sound vibrations entering the inner
                                                                      signals, which are amplified. Analog/adjustable hearing        hearing aid for you. Just because one hearing aid is                                                                      • I hear a buzzing sound when I use my cell
            Small, open-fit aids fit behind the ear completely,                                                                                                                                                                                                                                                           ear so that they can be detected by individuals with
                                                                      aids are custom built to meet the needs of each                more expensive than another does not necessarily            Hearing aids take time and patience to use success-             phone. Some people who wear hearing aids
            with only a narrow tube inserted into the ear canal,                                                                                                                                                                                                                                                          sensorineural hearing loss.
                                                                      user. The aid is programmed by the manufacturer                mean that it will better suit your needs.                   fully. Wearing your aids regularly will help you adjust         or have implanted hearing devices experience
            enabling the canal to remain open. For this reason,
                                                                      according to the specifications recommended by your                                                                        to them.                                                        problems with the radio frequency interference           A bone-anchored hearing aid (BAHA) is a small device
            open-fit hearing aids may be a good choice for                                                                           A hearing aid will not restore your normal hearing.
                                                                      audiologist. Analog/programmable hearing aids have                                                                                                                                         caused by digital cell phones. Both hearing aids         that attaches to the bone behind the ear. The device
            people who experience a buildup of earwax, since                                                                         With practice, however, a hearing aid will increase
                                                                      more than one program or setting. An audiologist                                                                           Become familiar with your hearing aid’s features.               and cell phones are improving, however, so these         transmits sound vibrations directly to the inner ear
            this type of aid is less likely to be damaged by such                                                                    your awareness of sounds and their sources. You
                                                                      can program the aid using a computer, and the                                                                              With your audiologist present, practice putting in and          problems are occurring less often. When you are          through the skull, bypassing the middle ear. BAHAs are
            substances. In addition, some people may prefer                                                                          will want to wear your hearing aid regularly, so
                                                                      user can change the program for different listening                                                                        taking out the aid, cleaning it, identifying right and          being fitted for a new hearing aid, take your cell       generally used by individuals with middle ear problems
            the open-fit hearing aid because their perception of                                                                     select one that is convenient and easy for you to
                                                                      environments—from a small, quiet room to a crowded                                                                         left aids, and replacing the batteries. Ask how to test         phone with you to see if it will work well with the      or deafness in one ear. Because surgery is required
            their voice does not sound “plugged up.”                                                                                 use. Other features to consider include parts or
                                                                      restaurant to large, open areas, such as a theater or                                                                      it in listening environments where you have problems            aid.                                                     to implant either of these devices, many hearing
                                                                      stadium. Analog/programmable circuitry can be used             services covered by the warranty, estimated schedule        with hearing. Learn to adjust the aid’s volume and to                                                                    specialists feel that the benefits may not outweigh the
          • In-the-ear (ITE) hearing aids fit completely inside
                                                                      in all types of hearing aids. Analog aids usually are less     and costs for maintenance and repair, options and           program it for sounds that are too loud or too soft.                                                                     risks.
            the outer ear and are used for mild to severe
            hearing loss. The case holding the electronic             expensive than digital aids.                               2                                                                                                                         3                                                                                                                       4
                                                                                                                                                                                                           NIDCD supports and conducts research and research training on the                                                              NIDCD Fact Sheet




                                                                                                                                                                                 voice, speech, language
                                                                                                                                                                                                           normal and disordered processes of hearing, balance, smell, taste,
                                                                                                                                                                                                           voice, speech, and language and provides health information, based                                                             Hearing Aids




                                                                                                                         hearing, balance
                                                                                                                                                                                                           upon scientific discovery, to the public.




                                                                                                                                                            smell, taste




                                                                                                                                                                                                                                                                                    hearing




                                                                                                                                                                                                                                                                                                                balance
                                                                                                                                                                                                                                                                                    u.s. DepArtMent of heAlth & huMAn servICes ∙ nAtIonAl InstItutes of heAlth ∙ nAtIonAl InstItute on DeAfness AnD other CoMMunICAtIon DIsorDers




                                                                                                                                                                                                                                                                                                                                                                                                                                   NIH Medical Arts
                                                          In addition, researchers are investigating the use                                For more information, additional addresses and phone
Can I obtain financial assistance for a                                                                                                                                                                                                                                                       What is a hearing aid?                                                           styles of hearing Aids
                                                          of computer-aided technology to design and                                        numbers, or a printed list of organizations, contact:
hearing aid?
                                                          manufacture better hearing aids. Researchers also are
                                                                                                                                            NIDCD Information Clearinghouse                                                                                                                   A hearing aid is a small electronic device that you
                                                          seeking ways to improve sound transmission and to
Hearing aids are generally not covered by health                                                                                            1 Communication Avenue                                                                                                                            wear in or behind your ear. It makes some sounds
                                                          reduce noise interference, feedback, and the occlusion
insurance companies, although some do. For eligible                                                                                         Bethesda, MD 20892-3456                                                                                                                           louder so that a person with hearing loss can listen,
                                                          effect. Additional studies focus on the best ways to                                                                                                                                                                                                                                                                                             receiver in ear canal
children and young adults ages 21 and under,                                                                                                Toll-free Voice: (800) 241-1044                                                                                                                   communicate, and participate more fully in daily
                                                          select and fit hearing aids in children and other groups
Medicaid will pay for the diagnosis and treatment of                                                                                        Toll-free TTY: (800) 241-1055                                                                                                                     activities. A hearing aid can help people hear more in
                                                          whose hearing ability is hard to test.
hearing loss, including hearing aids, under the Early                                                                                       Fax: (301) 770-8977                                                                                                                               both quiet and noisy situations. However, only about
and Periodic Screening, Diagnostic, and Treatment         Another promising research focus is to use lessons                                E-mail: nidcdinfo@nidcd.nih.gov                                                                                                                   one out of five people who would benefit from a
(EPSDT) service. Also, children may be covered by their   learned from animal models to design better                                                                                                                                                                                         hearing aid actually uses one.
state’s early intervention program or State Children’s                                                                                                                                                                                                                                                                                                              Behind-the-ear (Bte)          “Mini” Bte
                                                          microphones for hearing aids. NIDCD-supported
                                                                                                                                                                                                                                                                                              A hearing aid has three basic parts: a microphone,
Health Insurance Program (SCHIP).                         scientists are studying the tiny fly Ormia ochracea
                                                                                                                                                                                                                                                                                              amplifier, and speaker. The hearing aid receives sound
                                                          because its ear structure allows the fly to determine
Medicare does not cover hearing aids for adults;                                                                                                                                                                                                                                              through a microphone, which converts the sound
                                                          the source of a sound easily. Scientists are using
however, diagnostic evaluations are covered if they                                                                                                                                                                                                                                           waves to electrical signals and sends them to an
                                                          the fly’s ear structure as a model for designing
are ordered by a physician for the purpose of assisting                                                                                                                                                                                                                                       amplifier. The amplifier increases the power of the
                                                          miniature directional microphones for hearing aids.
the physician in developing a treatment plan. Since                                                                                                                                                                                                                                           signals and then sends them to the ear through a
                                                          These microphones amplify the sound coming from
Medicare has declared the BAHA a prosthetic device                                                                                                                                                                                                                                            speaker.
                                                          a particular direction (usually the direction a person
and not a hearing aid, Medicare will cover the BAHA if
                                                          is facing), but not the sounds that arrive from other                                                                                                                                                                               How can hearing aids help?
other coverage policies are met.
                                                          directions. Directional microphones hold great promise
Some nonprofit organizations provide financial            for making it easier for people to hear a single                                                                                                                                                                                    Hearing aids are primarily useful in improving the                          In-the-ear (Ite)             In-the-canal (ItC)
assistance for hearing aids, while others may help        conversation, even when surrounded by other noises                                                                                                                                                                                  hearing and speech comprehension of people who
provide used or refurbished aids. Contact the National    and voices.                                                                                                                                                                                                                         have hearing loss that results from damage to the
Institute on Deafness and Other Communication                                                                                                                                                                     NIDCD Fact Sheet: Hearing Aids                                              small sensory cells in the inner ear, called hair cells.
                                                          Where can I find more information?                                                                                                                      Publication No. 99-4340
Disorders’ (NIDCD’s) Information Clearinghouse with                                                                                                                                                                                                                                           This type of hearing loss is called sensorineural hearing
                                                                                                                                                                                                                  Updated April 2007
questions about organizations that offer financial                                                                                                                                                                                                                                            loss. The damage can occur as a result of disease,
                                                          NIDCD maintains a directory of organizations that can                                                                                                   For more information, contact:
assistance for hearing aids.                                                                                                                                                                                                                                                                  aging, or injury from noise or certain medicines.
                                                          answer questions and provide printed or electronic                                                                                                      NIDCD Information Clearinghouse
                                                          information on hearing aids. Please see the list of                                                                                                     1 Communication Avenue                                                      A hearing aid magnifies sound vibrations entering the
What research is being done on hearing                                                                                                                                                                            Bethesda, MD 20892-3456
aids?                                                     organizations at www.nidcd.nih.gov/directory.                                                                                                           Toll-free Voice: (800) 241-1044                                             ear. Surviving hair cells detect the larger vibrations and
                                                                                                                                                                                                                  Toll-free TTY:   (800) 241-1055                                             convert them into neural signals that are passed along
                                                          Use the following keywords to help you search for                                                                                                       Fax:             (301) 770-8977                                                                                                                                        Completely-in-canal
Researchers are looking at ways to apply new signal                                                                                                                                                                                                                                           to the brain. The greater the damage to a person’s hair                                          (CIC)
                                                          organizations that are relevant to hearing aids:                                                                                                        E-mail:          nidcdinfo@nidcd.nih.gov
processing strategies to the design of hearing aids.                                                                                                                                                              Internet:        www.nidcd.nih.gov                                          cells, the more severe the hearing loss, and the greater
Signal processing is the method used to modify normal      • Hearing aids                                                                                                                                                                                                                     the hearing aid amplification needed to make up the              addition, if the inner ear is too damaged, even large
                                                                                                                                                                                                                  The NIDCD Information Clearinghouse is a
sound waves into amplified sound that is the best                                                                                                                                                                 service of the National Institute on Deafness                               difference. However, there are practical limits to the           vibrations will not be converted into neural signals. In
possible match to the remaining hearing for a hearing      • Assistive listening device                                                                                                                           and Other Communication Disorders, National                                 amount of amplification a hearing aid can provide. In            this situation, a hearing aid would be ineffective.
aid user. NIDCD-funded researchers also are studying                                                                                                                                                              Institutes of Health, U.S. Department of Health
                                                           • Assistive technology                                                                                                                                 and Human Services.                                                                                                                                                                                          1
how hearing aids can enhance speech signals to
improve understanding.


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