ALL YOU NEED TO KNOW ABOUT HEARING LOSS AND HEARING AIDS Brenda J. Lowe, AuD Arizona Audiology & Hearing Learning Objectives: Discuss common communication deficits for those with hearing loss. List concomitant health conditions that have a correlation with hearing loss. DISCLOSURE OF COMMERCIAL SUPPORT Brenda J. Lowe, AuD does not have a significant financial interest or other relationship with manufacturer(s) of commercial product(s) and /or provider(s) of commercial services discussed in this presentation. 1
Brenda J. Lowe, Au.D. Board Certified Doctor of Audiology 1 Hearing is measured in a sound treated booth finding a person s threshold for specific frequencies across the range of speech. Hearing thresholds from -10 db HL to 20 db HL are considered to be within the range of normal. Any thresholds that fall below 20 db HL are considered to be a loss. 2 3 2
Noise Exposure (occupation and hobbies) Genetics (familial history) Ototoxic Medications (Chemo therapy, IV antibiotics such as Vancomycin & Gentamicin) 4 Patient says they do not hear as well as they used to. Says they have greater difficulty in background noise Spouse says they are missing more than they should Speech is not clear, or says people are mumbling 5 Difficulties hearing on the telephone Avoids going out in large group situations Says they hear men fine, but women are difficult to hear Others complain the TV or Radio is too loud 6 3
Common loss for someone that says things sound muffled, but they hear. Can be due to noise exposure, the aging process, medications, or more often a combination of all the above. 7 Dementia & Hearing Loss Energy Allotment Diabetes (28%) Tinnitus 8 Otoscopy Complete Audiometry (Air, Bone, Speech reception, Word recognition) Impedance (Tympanometry and Acoustic reflex thresholds DPOAEs (Distortion product otoacoustic emissions) 9 4
What are the needs of the patient, what is their lifestyle? What is the shape and degree of their hearing loss? Daily wear hearing aids Extended wear hearing aids Surgical options 10 Lifestyle relates directly to how much background noise the person is exposed to on a regular basis. It determines what level of technology is needed. Active lifestyle Casual lifestyle Quiet lifestyle Very Quiet lifestyle 11 Normal to moderately severe sensorineural hearing loss Open-fit design Would not like the inthe-ear style, it would make them sound like their head was in a barrel 12 5
Moderate sensorineural hearing loss. Common loss due to genetic components, often at birth. Open to variety of styles 13 Surgery: Esteem, Baha & Cochlear Implant Extended Wear Hearing Aid: Lyric Daily Wear Hearing Aids: Variety of Manufacturers Aside from Baha and Cochlear Implants typically these are costs incurred by the patient 14 Esteem is newer to the market. This is considered an elective surgery, no insurance is currently covering the $40,000 device/procedure, for one ear. Extended wear hearing aid: Lyric is the only device. It is an annual fee around $3600 for both ears. Daily wear hearing aids vary greatly in price based on technology. For a decent pair they start at $5000 and go up from there. 15 6
What are some common signs of hearing loss? People are mumbling, I am missing things, I can t hear women as well, TV too loud, etc. When to refer based on concomitant health conditions? Diabetes, chemo therapy or heavy antibiotic treatment, tinnitus, dementia, etc. 16 Bainbridge, K.E., Hoffman, H.J., & Cowie, C.C. (2008). Diabetes and hearing impairment in the United States: audiometric evidence from the national health and nutrition examination survey, 1999-2004. Annals of Internal Medicine, 149(1), 1-10. Lin, F.R., Metter, E.J., O Brien, R.J., Resnick, S.M., Zonderman, A.B., & Ferrucci, L. (2011). Hearing loss and incident dementia. Archives of Neurology, 68(2), 214-220. Martines, F., Bentivegna, D., Martines, E., Sciacca, V., & Martinciglio, G. (2010). Assessing audiological, pathophysiological, and psychological variables in tinnitus patients with and without hearing loss. European Archives of Oto-Rhino-Laryngology, 267(11), 1685-1693. 17 BrendaLoweAuD@gmail.com 18 7