how we hear. Better understanding of hearing loss The diagram above illustrates the steps involved.

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1 How we hear Better understanding of hearing loss begins by understanding how we hear. The diagram above illustrates the steps involved. 1. Sound waves are collected by the outer ear and channeled along the ear canal to the eardrum., 2. When sound waves reach the eardrum, the impact creates vibrations that are transferred through a series of three tiny bones. 3. The third of these bones is connected to a delicate, snail-shaped structure called the cochlea. The cochlea is filled with fluid and lined with thousands of microscopic hairs. The vibrations are transmitted to the fluid in the cochlea, where the hair cells are bent by the wave-like action of fluid inside the cochlea. The bending of these hairs sets off nerve impulses that are then passed through the auditory nerve. 4. The auditory nerve carries the signal to the hearing center of the brain which combines the input from the left and right ears and interprets it into what we perceive as "sounds."

2 Symptoms of hearing loss Recognizing a hearing loss in yourself, or someone you know, is the first step toward improving the situation. Symptoms include: Difficulty hearing high-pitched sounds, such as birds singing, or difficulty understanding higher pitched voices such as women's and children's. Difficulty hearing or understanding at public gatherings: concert halls, theaters, houses of worship - where sound sources are far from the listener Difficulty understanding conversations within a group of people, or when background noise is present. Some people with certain types of hearing loss report that speech is loud enough, but not clear. The voices they hear are "mumbled." Because hearing loss can develop over several ye~rs, most people are not aware of the extent of their loss until family or friends bring it to their attention. Even then they might deny that they have difficulty hearing. People with mild hearing loss often use the following tactics to cope with the situation: Turning up the volume on the TV to a level that disturbs others -. Consistently asking people to repeat themselves, or to speak louder Avoiding social situations such as restaurants or parties, where noise can make it difficult to hear conversation Turning the head to one side while listening Although these habits can help individuals with hearing loss in some situations, the hearing loss is most likely depriving them of a wide range of life's sounds. Eventually, as the hearing loss progresses, the above techniques won't provide adequate hearing assistance. Causes of hearing impairment Most often a hearing loss develops gradually and painlessly. Hearing loss can be caused by: The natural aging process Exposure to loud or constant noise Inherited medical conditions Illness Traumatic injury Ototoxic medications Tumors

3 Your hearing loss is as unique as your fingerprint Because all the factors listed on the previous page combine in different degrees for different people, no two people have exactly the same hearing impairment. Types of hearing loss There are three general types of hearing loss: 1. Conductive hearing loss occurs when the eardrum, bones and membranes don't properly transmit vibrations to the cochlea. Causes include traumatic head injury or birth defects. 1 \. Testing for hearing loss If you suspect a hearing loss, the first step is to make an appointment with a Hearing Care Professional for proper testing and evaluation. Testing is painless, comfortable and safe. It includes checking your ability to recognize everyday words at different volume levels and to hear different tones. The data from this test will be used to determine the type and severity of your hearing loss, and whether you might benefit from hearing aids. 2. Sensorineural hearing loss is characterized by deterioration of the cochlea. Causes include the aging process and excessive exposure to loud noise. 3. Mixed hearing loss involves a combination of both conductive and sensori'neural hearing loss. Hearing loss is universal- it crosses all ages and genders. Fourteen percent of Americans between the ages of 41 and 59 suffer from hearing loss, while six million Americans between 18 and 44 years of age also suffer from some type of loss.2

4 Hearing instruments might be the answer Thanks to today's technological it is likely that nearly 95 percent of individuals with hearing loss can be helped with hearing instruments.2 How do hearing instruments work? Inside each hearing instrument, waves enter the microphone. microphone advances, The sound then converts sound from acoustic energy to electric energy. Using intelligent formulae, the digital signal processor processes electric signals. The hearing instrument's receiver than converts the electric energy back to acoustic energy so amplified sounds are able to enter the ear or earmold. Years of clinical and field trial research have shown the following amplification instruments) benefits of binaural (wearing two hearing over wearing just one: A more normal, "balanced" sound Better overall sound quality Better understanding in groups and in noisy situations A more relaxed listening experience The ability to set volume controls lower, enabling the wearer to hear sound at a softer, more comfortable level Why two ears are better than one Approximately 90% percent of individuals with hearing loss have loss in both ears.2 Studies show that, even when a hearing loss is more severe in one ear, most people with hearing loss benefit from using both ears to listen and hear.

5 One of the most important amplification roles binaural can play is to improve the wearer's ability to identify the source of a particular sound. The brain uses signals from both ears to determine the direction a sound is coming from. Without the ability to hear properly with both ears, situations such as finding the person who's calling your name, determining whether someone's knocking at the front or back door, or crossing the street can be difficult or even dangerous. ITC (In-the-Canal) Still small and discreet, these models are easy to handle and offer the user additional control functions. ITE (In-the-Ear) This size features the widest selection of usercontrolled functions and comfort features. Many styles to meet your sense of style Hearing instruments are available in many styles designed to meet most hearing needs: BTE (Behind-the-Ear) These fit snugly behind your ear and are attached to a custom earpiece molded to the shape of your outer ear. Micro-CICM (Completely-inthe-Canal), The smallest of all hearing instruments, these are designed to hide more completely in the ear canal and are virtually invisible when worn. Micro-ClC Open Fit BTE Open Fit BTEsare specifically designed to eliminate the occlusion effect and provide the wearer with a discreet hearing solution. Some models have the speaker (receiver) in the ear canal and offer other unique features.

6 The wireless revolution for today's digital hearing instruments Until recently, hearing instruments functioned as independent devices. Individuals using two instruments had to operate each separately. Now some models contain wireless communication capability, which enables them to share information. The result is two hearing instruments functioning as one synchronized system and automatically and synchronously adapt the settings in both instruments for the listening environment. A remote control small enough for your pocket can be used to change volume and preferences. Multiple listening programs Automatic or manual volume control AutoPhone'" Bi-directional remote control If you have a hearing loss that might be helped with hearing instruments, your Hearing Care Professional can select the right model. Of course, no instrument can solve all hearing problems, and not everyone benefits equally. Hearing instruments from Siemens contain the most sophisticated digital circuitry with more functions and features packed into a hearing instrument than ever before. Features may include: e2e wireless'" Advanced digital sound processing Speech'and noise management technology SoundSmoothing'" DataLearning'" ewindscreen'" 1 High speed feedback cancellation Automatic and adaptive directional microphone systems References 1Kochkin. S. MarkeTrak VII Setter Hearing Institute.