Industry Emphasis Hearing Aids Since the first hearing aids were manufactured in the early 1800 s the industry has emphasized making instruments: Less cumbersome Cosmetically appealing Better? 1 2 Basic Design and Function Hearing aids make sound louder Often have special components or circuitry to: Alter frequency response to Fit individual s loss Adjust to sound environment Emphasize sound coming from a preferred direction Compress the range of sound in the environment to fit residual dynamic range of hearing 3 4 Body aid Eyeglass aid BTE - behind-the-ear (postauricular) ITE - in-the-ear ITC - in-the-canal CIC - completely-in the-canal Type Market Share (2009) Ave. Cost BTE 64.1% $1,789 ITE ITC $1,375 $1,348 CIC? Other? Overall $1,601 5 6 1
Digital Block Diagram Hearing Aid Components Basic Microphone Amplifier (Digital Signal Processor) Receiver Battery Additional Volume control Telecoil (t-coil) Multiple memories Direct audio input (DAI) FM receiver 7 8 Components 9 10 BTEs (Postauricular) 11 Less prone to feedback Applications: High-power High-frequency Flexibility Most suitable for progressive or fluctuating losses Superior T-coil performance Superior connectivity (FM, DAI, Bluetooth, etc.) Cosmetics and comfort 12 2
Acoustical factors Greater "psychological" comfort Less interference with eyeglasses Increased chance of acoustic feedback Reduced connectivity Recasing is much more expensive than simple earmold replacement. Small ears many not accommodate size especially if options (e.g., T-coils) are needed. 13 14 ITE General purpose Some flexibility Directional mic T-coil (variable quality) DAI (awkward) FM Acoustical? Cosmetics Canal Aids Prone to feedback Ear canal size must accommodate electronics Good manual dexterity is required Restricted connectivity 15 16 CICs Batteries Cosmetics only! Prone to feedback Ear canal size must accommodate electronics Little flexibility No connectivity Type Color Code Uses 675 Blue 13 Orange 312 Brown Cochlear Implants Some Power BTEs BTEs minibtes ITCs minibtes 10 Yellow ITCs CICs 17 18 3
Step 1 - Comprehensive audiologic assessment Step 2 - Treatment planning Step 3 - Hearing aid selection Style, features, options Selection of gain/frequency response by prescription Ear impression Step 4 - Verification Quality control Physical fit Performance (probe mic = primary method ) Audibility Comfort Tolerance 19 20 Step 5 - Orientation Use and care Expectations for performance Step 6 - Validation To determine impact of intervention Audiological Assessment Case History Candidate - Not a candidate Candidate Category Otoscopic Inspection Medical referral Type of aid Hearing Evaluation Candidate - Not a candidate >>>>>medical referral 21 Candidacy & Rehab Assessment Need for amplification Potential benefit 22 Treatment Planning Hearing aid - no aid. No additional AR - More AR Hearing Aid Selection Nonelectroacoustic Characteristics Monaural Binaural Ear Type of instrument Medical Clearance Halt AR - Proceed with AR Type of ear mold (basics) 23 Electroacoustic Characteristics Gain frequency response - electrical & acoustical Maximum output and compression 24 4
Daily Hearing Aid Check Verification Quality Control Physical Fit Performance No aid - Keep old aid - Get new aid See attached Hearing Aid Orientation Hearing Aid Use and Care Expectations for Performance Validation No additional AR - More AR 25 26 Hearing Aid Troubleshooting See attached 27 5