Hearing Aids For Conductive Hearing Loss
November 27, 2020
Hearing aids for conductive hearing loss

Hearing loss is a common issue that can affect sufferers of any age and gender. Over 13% (approximately 30 million) of all people over 12 years of age or older have some form of hearing loss in various forms of severity. Hearing loss can be temporary or permanent depending on the severity and type of damage that has occurred, and treatments vary as a result.

With temporary hearing loss, medical remedies may be the best option. Still, for more severe hearing loss types, the use of hearing aids or other medical procedures may be necessary.

What is Conductive Hearing Loss?

 

What is conductive hearing loss?

 

There are three primary forms of hearing loss and four levels of severity to hearing damage. The three forms of hearing loss are Conductive Hearing Loss, Sensorineural Hearing Loss (SNHL), and Mixed Hearing Loss:

  • Conductive Hearing Loss: Conductive Hearing Loss is a condition when a blockage in the outer or middle ear affects sounds from reaching the inner and impairing hearing. The damage from Conductive Hearing Loss is also known as temporary or transient and is more readily correctible. 
  • Sensorineural Hearing Loss: Sensorineural Hearing Loss, or SNHL, is where hearing is impacted by damage to the inner ear, cochlea and cochlea hairs, or the auditory pathway and nerves. Damage to SNHL sufferers is typically more permanent than with Conductive hearing Loss. 
  • Mixed Hearing Loss: Mixed Hearing Loss occurs when there is damage to the inner ear as with SNHL, and there is also damage to the outer or middle ear. As with SNHL, damage with Mixed Hearing Loss may be more permanent than with Conductive Hearing Loss alone.

People with Conductive Hearing Loss will experience softer sounds to be more difficult to hear and muddled regardless of the pitch. 

Severity Of Hearing Loss

In addition to diagnosing the type of hearing loss, identifying the severity of hearing damage is crucial. There are four levels of hearing loss, mild, moderate, severe, and profound loss. 

Each level of hearing loss is categorized from more treatable forms of hearing loss to permanent loss. It is estimated that roughly 2 percent of the United States’ adult population over 45 years old has some form of more severe hearing loss. 


What Are The Causes of Conductive Hearing Loss?

Conductive Hearing Loss is a common ailment with easily diagnosable causes. Any evaluation with a Personal Care Physician or Ear, Nose, Throat specialist will assess the condition’s damage and potential causation.

Typical Types of Hearing Loss

  • Malformation of the ear or the ear structure
  • Otosclerosis, a genetic defect that affects the bone in the middle ear, impairing sound from transferring to the inner ear
  • Chronic Infection: This can be due to hereditary or environmental causes
  • Tumors in or around the ear and ear canal
  • Head Colds and Allergies that may cause swelling and trap fluid in the ear
  • Ear Wax that is built-up or impacted into the ear canal. Ear wax is the most common form of blockage. 
  • Head Trauma

Common Symptoms of Conductive Hearing Loss

Some of the most common symptoms of Conductive Hearing Loss can range from pain and discomfort in the ear to dizziness and vertigo, muffled sounds, foul-smell emanating from the ear, and pressure in the ear, or any combination of symptoms. Typically symptoms are caused when fluid builds up in the ear canal and cannot drain from the ear, causing a blockage of sound that impairs hearing.


What Types Of Treatments Are Available? 

With Conductive Hearing Loss, multiple treatments are available. Depending on the severity of hearing loss, some simple treatments may be antibiotics or other medical procedures. In a more difficult diagnosis, a hearing aid may be needed. 


How Hearing Aids Work 

 

How hearing aids work

 

A hearing aid is an artificial, electric device worn either behind or inside the ear, working to amplify sound for the sufferer to hear at a normal volume. Hearing aids differ by design, special features, and the type of technology, such as analog or digital, to amplify sound.

Composed of three essential components, a hearing aid works to absorb sound, magnify it, and broadcast it in the ear to make it more powerful a signal for the brain to absorb. 

The three components that make up a hearing aid are a microphone, amplifier, and speaker to amplify the wearer’s sound. A hearing aid process is that the microphone converts sound to electrical signals. The amplifier increases the power of those signals and broadcasts through the speaker and into the ear.

As the hearing absorbs sound, it magnifies the sound and transmits it through the ear canal, making it difficult to hear easily. Hearing loss determined to require a hearing aid is due to some damage to the ear’s small sensory hairs. A hearing aid amplifies those sounds to assist the remaining hairs, enhancing sound vibrates through the auditory canal. This amplified sound makes everyday noise and speech more understandable for the wearer to go about day-to-day activities. 


What Are The Best Hearing Aids For Conductive Hearing Loss?

Depending on the seriousness of the hearing damage, there are a few different options available with regard to hearing aids. A thorough exam by your physician or an Ear, Nose, and Throat specialist is known as an Otolaryngologist or Audiologist. It will identify the damage, cause, and the best type of hearing aid treatment. 

There are several hearing aid options available, including some that also have aesthetic considerations for the wearer.

Types of Hearing Aids

Hearing aids are manufactured to address the specific damage that has occurred and offer various hearing aid types. There are hearing aids designed to fit outside the ear and rest behind the wearer’s ear; some are designed for snuggling into the ear, while others are implanted into the ear canal or cochlea, known as a cochlear implant. 


Behind The Ear Hearing Aids

Behind the ear hearing aids

 

Constructed hard plastic rests behind the ear and molds to the outer ear; behind the ear, hearing aids are the most traditional hearing devices. The one problem with a traditional behind the ear device is that the earmold can create an uncomfortable feeling of the ear being plugged up. These hearing devices are used for hearing loss that is mild to moderate and is the most prevalent remedy for less severe hearing loss. 

An additional option behind the ear style hearing aids is called a “mini” or open-air hearing aid. The base sits behind the ear but rather than an earmold to the outer ear as with standard hearing aids, the “mini” or open-air hearing aid has a small, narrow tube that inserts into the ear making for the ear canal to remain open. The “mini” hearing aid is great for the aesthetic design and wearer’s comfort instead of a traditional behind the ear device. 


In The Ear Hearing Aids

 

In the ear hearing aids

For more severe hearing loss, such as moderate to severe, an internal hearing aid is ideal. Made of hard plastic, an in-the-ear hearing device fits entirely in the ear. Some in-the-ear devices have what is known as a telecoil, a small magnetic coil that assists the user with receiving sound without the use of a microphone. 

This design assists with the user hearing sound, such as conversations over a telephone. People with Typical hearing loss, especially ones that use any assisted hearing device, know that a telephone call is difficult to hear due to the different frequencies that a call creates than in-person conversation. 

An additional benefit of telecoils is that public locations provide special sound systems known as “induction loops.” An induction loop is often found in public areas such as schools, libraries, and more as they enhance people’s listening ability with in-ear aids. Young children do not wear this type of hearing aid as the plastic body needs to be replaced regularly as the child’s ear grows in size. 

In The Ear Canal

There are two types of in the ear hearing aids, or ITC devices. Both are designed to be implanted into the canal and are sized according to the wearer’s ear canal, and are designed for mild to moderate hearing loss. A basic device is known as n in the canal, or ITC, hearing aid and is shaped to the wearer’s ear canal’s specificity.

The other type of in-the-ear canal hearing aid is known as a CIC for completely-in-canal type hearing devices. This is a device that is placed into the ear canal and is almost naked to the eye. Due to their size, in-the-ear type devices are great for aesthetics but are difficult to remove, lack the opportunity for add-ons like a telecoil, and are tough to maintain or upkeep.


General Design of Hearing Aids

Hearing aids are engineered in one of two formats. The first is an analog hearing device, while the second is a digital hearing aid. The primary difference in the two types is that with analog, the sound is received as it was transmitted; that is, the volume and modulation is as natural as it was made. 

With a digital hearing aid, the first difference is that sound is converted from electric waves like an analog device; instead, the sound is transformed into a numerical scale before amplified. Another difference with a digital device is that sound is modulated by the device, so loud noise can become softer, and softer sounds can become louder as needed. 


Analog Hearing Aids

 

Analog hearing aids

The first is an analog hearing aid and works to convert sound into electric waves on a continuous spectrum. That means that any sound is not modulated but is received as a continuous sound wave and making it louder. This can be difficult or uncomfortable, depending on whether the sound is too soft or too loud, and amplification can’t be increased.

The patients’ audiologist programs analog hearing aids to accommodate various volume levels the wearer may experience, such as noise in a crowded restaurant versus in a quiet library. The volume is adjustable to the specific listening environment of the user by simply pressing a button. Typically analog devices are cheaper and easier to adapt to the particular needs of an individual wearer.


Digital Hearing Aids

Digital hearing aids work much like that of a computer. The device is programmed to translate sound into a binary code and process the modulation or amplification needed for the sound wave as it gets passed along the ear canal. These devices can be programmable to meet specific criteria and frequency for the wearer on a case by case basis making digital devices much more flexible than the analog versions. 


Additional Features of Hearing Aids

Options for each hearing aid vary, but in general, the ability to program the type of sound amplification needed is from 

Telecoil: A telecoil setting allows for settings that work to eliminate environmental sounds like the ambient noise of a crowded room to isolate the specific sound that is focused on. This feature works well for telephone calls, movie theatres, and anywhere that distracting noise needs to be minimized. 

Direct Audio: This feature allows an external microphone to transmit sound directly from a device such as a TV, audio jack, or computer.

Directional Microphone: This feature focuses its microphone toward a specific target direction to amplify only those sounds as it is directed. This programming allows the wearer to have more control over unnecessary or ambient noise and focus on the sound, such as speech, in the direction most desired. 

Feedback Suppression: Anyone who has taken their cell phone too close to another’s while on a call understands the sound of feedback. The echoing ring of the two phones' microphones working against each other creates that noise. For the hearing aid wearer, this feedback can be a painful experience, so having the feature to minimize the feedback effect is a welcome one. 

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Drew Sutton M.D.

Drew Sutton, MD is a board-certified otolaryngologist. He has extensive experience and training in sinus and respiratory diseases, ear and skull base surgery, and pulmonary disorders. He has served as a Clinical Instructor at Grady Hospital Emory University for more than 12 years.

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