Hearing Aids and Cochlear Implants

When a sensorineural hearing loss is identified, a hearing aid evaluation is recommended to determine if the patient would benefit from amplification. Today 95% of all nerve hearing losses can be successfully fitted with hearing aids.

When a hearing aid alone is not sufficient or desired, various Assistive Listening Devices (ALDs) are available. An assistive listening device can increase the loudness of a desired sound (radio, TV, someone talking in a restaurant) without increasing the loudness of background noises.

A hearing aid evaluation is performed to determine if the patient is a good candidate to wear/use hearing aids successfully. A hearing aid demonstration is performed (at no charge) so that the patient and other family members can get an idea of the benefit hearing aids can provide.

Hearing aid technology has evolved dramatically over the last 10 years. We specialize in state-of-the-art, most advanced technology while at the same time striving to maintain affordability. Today’s hearing aids reproduce sound with incredible precision and accuracy, even in the most challenging noise environments. We provide very necessary ongoing counseling and follow up services to assure that our patients continue to hear the best they possibly can.

Hearing aids are similar to a miniature public address system. The microphone picks up the sound, the amplifier makes the sound louder, and the receiver (speaker) delivers the sound. Ninety-eight percent of all hearing aids are digital. Digital technology allows advantageous manipulation of sound in many useful ways. Some hearing aids are completely automatic, while others have user-adjustable controls. Your audiologist will work with you to review hearing aid options. The two of you will select the best configuration for your particular needs. All hearing aids are powered by batteries


Hearing aid styles may be broadly classified as “standard” or “custom.” Standard hearing aids include: behind-the-ear (BTE), mini-BTE, and receiver-in-the-canal (RIC) devices. These products are designed to fit most ears and usually require some customization of the earpiece and the connection of the device to the earpiece. Custom hearing aids include: in-the-ear (ITE), in-the-canal (ITC), and completely-in-the-canal (CIC). These products require a custom-molded shell that houses the electronics. Standard and custom hearing aids come in a variety of colors, shapes, and sizes. The choice of hearing aid styles and features is based on several factors, including the exact type and degree of hearing loss, your individual needs (such as communication requirements, lifestyle, and manual dexterity), and your medical and audiological history and related findings.

One or Two Hearing Aids?

If both ears need amplification, your audiologist will recommend two hearing aids. Research has shown two hearing aids provide superior benefits for the majority of people with regard to better word recognition in quiet and noisy backgrounds, better quality of sound, better localization ability, more natural hearing, and so forth. Research has shown that when both ears are candidates for hearing aids and only one ear is fitted, the unaided ear may lose speech recognition ability more rapidly than the fitted ear.


Several features are available to improve the hearing aid experience. The most common are Directional microphones to enhance speech understanding in noise, Noise management to improve listening comfort in noisy situations, Feedback cancellation to alleviate the annoyance of whistling and buzzing, and telephone programs to access sound from phones and other sound sources.


After your hearing aids have been selected, they must be fitted appropriately. Hearing aids must amplify sounds so they can be heard comfortably without causing discomfort, and hearing aids must be secure and physically comfortable in the ear. The hearing aids are adjusted using a computer in the audiologist’s office, and the result can be measured. However, the audiologist’s office does not usually represent the variety of sounds heard in everyday life, and so your new hearing aids will need to be evaluated in the sound environments important to you; a daily journal is useful for this purpose. By working with your audiologist, the hearing aids can be adjusted to perform most functions optimally and automatically in these environments. Megan Hemmer, AuD will likely suggest specific hearing assistive technologies to supplement the hearing aids and to address specific complaints.

Maintenance and Insurance

We will review with you the details of your insurance coverage (if available), financing options, loss, theft and damage insurance, warranty, service protocols, maintenance advice, as well as introductory periods and return policies. As with all electronics, hearing aids require care and maintenance. This includes handling them carefully, not exposing the hearing aids to water and chemicals, and keeping them very clean. Your audiologist will discuss and demonstrate proper daily care as well as maintenance techniques and maintenance products.

The hearing aid user’s manual will review many of these same points. Given the hostile conditions (temperature extremes, high levels of humidity, ear wax,etc.) under which hearing aids operate, daily cleaning and maintenance is recommended. Proper care and maintenance clearly reduces the need for repair.

Expectations and Outcomes

Even with the best technology, it is important to maintain realistic expectations. While hearing aids make sounds easier to hear, they will not restore normal hearing. Hearing aids reintroduce you to a world of sound, and it takes time to adapt to the new sounds.Some people adjust quickly, others take longer. Your audiologist will discuss auditory training programs,communication strategies, and hearing assistive technologies to alleviate difficulties in these situations.

Untreated hearing loss impairs memory and may cause difficulty related to learning new tasks. Untreated hearing loss may result in decreased job performance and has been shown to negatively impact wages and earnings. Hearing loss treated with hearing aids has been shown to decrease fatigue, irritability, risk to personal safety, and withdrawal from social situations. Further, in many research studies, hearing aid use has been shown to increase the wearer’s quality of life.

Types of Hearing Aids

Behind-the-Ear (BTE)
This hearing aid is a small case connected to clear plastic tubing and a custom fit earmold.

In-the-Ear (ITE)

In-the-Canal (ITC)
Smaller than the ITE, this custom instrument fits entirely in the ear canal.

Mini Behind-the-Ear (Mini BTE)
This small BTE style directs sound into the ear canal through thin plastic tubing and a tiny earpiece.

Completely-in-the-Canal (CIC)
This smallest custom instrument fits deep into the ear canal.

Receiver in Canal

Cochlear Implants

Cochlear implant surgery is indicated for patients which severe hearing loss. Patients with severe hearing loss cannot understand speech without hearing aids, but can hear load noises like dogs barking, trains, and airplanes. Cochlear implant surgery is covered with most major insurances, including Medicare and commercial. Surgery is performed as an outpatient procedure, meaning patients are discharged either same day or next morning from the hospital. Surgery is designed to make a two thirds of one millimeter opening (one millimeter is a size of pen tip) in the patient’s cochlea and place an electrode inside (see the picture of the electrode, looks like snail in contact with hearing nerve endings). This electrode will stimulate the hearing nerve with very small electrical stimulations. As the modern electrodes are less traumatic to inner ear structure than the older version, there is a good chance to preserve the remaining hearing.

Cochlear implants are activated in our clinic between 3 to 6 weeks after the surgery by our audiologist Darcy Beals, we also do mapping and upgrades for patients who were implanted in other centers than ours.

For further information please refer to Cochlear website.


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