It has recently come to my notice that many people ask me for recommendations about the best hearing aids to use, in Kenya, or if they should consider a cochlear implant. As a person who has been using a cochlear implant for the last 17 years, I can see why I might be seen as a credible source of information. Just as well, I’ll be honest: I don’t know much about what’s in the local- forget international- market and I’m still learning new things about the assistive devices for the hard of hearing and deaf around the world. However, I can break down the differences between hearing aids and implants as well as offer some tips on determining which choice might be the most suitable one for you, or your child.
First, The Types of Hearing Loss
A person with hearing loss of any magnitude is categorized as one with any of the following 4 conditions:
- Conductive Hearing Loss: This is caused by interference in the movement of sound waves as it passes through the outer and middle ear on its way to the inner ear. The condition is either permanent or temporary and can often be medically or surgically corrected/improved. For instance, hearing aid devices can be used to amplify weak sounds.
- Sensorineural Hearing Loss: This is caused by interference in the movement of sound waves as it passes through the inner ear and/or the cochlear (the auditory, or hearing, nerve). The condition is permanent and usually cannot be medically or surgically corrected/improved. In this case, hearing aids and/or implants may be used as remedies depending on the diagnosis.
- Mixed Hearing Loss: This is caused by a combination of Conductive and Sensorineural hearing loss elements. The condition is either permanent or temporary and may be medically or surgically corrected/improved. Hearing aids and/or implants can be used as remedies depending on the diagnosis.
- Central Auditory Processing Disorder: This is a condition where there are typically no problems with the outer, middle, or inner parts of the ear but auditory signals are not processed properly by the brain. The person can “hear” sound, but cannot understand what is being heard. The information is not made sense of in the brain in a typical or efficient manner. Thus resulting in poor hearing. Hearing therefore is not a problem here but matters cognition. Hence why therapy is a popular remedy component.
Second, The Condition for Aids or Implantations
According to the Wyoming Early Hearing Detection and Intervention (EHDI) Program in Wyoming, America, normal hearing ranges from -10 to 15 decibels (dB). Consequently, the further away from the normal range one is unable to recognize sound, the more profound and severe the hearing loss is. As to deciding if hearing aids are better versus implantations, it depends on the diagnosis by an audiologist since the aids people use vary depending on how severe their hearing is for that particular person, which hearing aid works best for them based on their current pick-up of sounds; their profession and habits, etc. The Program also listed the following break-down of hearing ability for those with hearing loss:
16 to 25 dB: Minimal Hearing Loss
This is compared to the ability to hear when index fingers are placed in ears.
26 to 40 dB: Mild Hearing Loss
At this point children often experience difficulty learning early reading skills such as letter/sound associations.
41 to 55 dB: Moderate Hearing Loss
Even with hearing aids, if there is background noise, a person may miss much of what is being said. Children certainly will.
56 to 70 dB: Moderately Severe Hearing Loss
Without amplification, a 55 dB hearing loss can cause a child to miss up to 100% of speech information.
71 to 90 dB: Severe Hearing Loss
A child with hearing loss greater than 70 dB may be a candidate for cochlear implants while a child with loss greater than 90 dB will not be able to perceive most speech sounds with traditional hearing aids.
91+ dB: Profound Hearing Loss
This is me. At this point, there is no “sound awareness” to speak of.
Third, Differentiating Hearing Aids and Cochlear Implants
While both hearing aids work to enable the user to hear the world and better communicate with others in private and social gatherings, there are distinct differences. For instance, hearing aids are worn inside and/or around the ear while cochlear implants are outside the ear. Take note that actions or decisions are best taken only after a thorough evaluation by an audiologist. The following list is merely a compilation of general information to distinguish cochlear implants from hearing aids.
|Advised with Mild to Moderate Hearing Loss||Advised with Severe to Profound Hearing Loss|
|Removable||Part of it is implanted via outpatient surgery; can affect MRI scans|
|Magnifies sound and reduces unwanted sound||Electrical impulses via nerves are translated by the brain as sound|
|Totally, or nearly, restores hearing||Stimulates hearing; No restoration of hearing|
|Need an audiologist for fitting and learn maintenance||Need surgery and audiologist for speech/hearing therapy, fitting, and learn maintenance|
|$1,000-4,000 each; Some insurance plans cover costs; wider range of prices||Up to $100,000+ each; Most plans seem cover majority, or all, costs (figure inclusive of therapy and initial consultations). Plus, damage repairs are expensive|
|Worn during most sports; Some care needed. Some are waterproof or waterproof covers can be used||Requires care, especially from water-contact and contact sports. Some versions are waterproof, otherwise the outer part has to be removed|
|Advised until no type/version works for hearing loss||Advised when Hearing Aids confirmed to have weak amplification. Surgery is a serious matter to consider, especially for the medically weak|
Technological Development: The Past, The Hybrid; The Future?
So there is something out there for every deaf and hearing challenged person? Definitely.
Is there anything else? Definitely.
The market has progressed from using ear trumpets to a time when stores are selling accessories to make your aid unique, there are cochlear implant exterior versions which don’t hook on the ear, different color option for the hardware, Bluetooth and Wireless Volume-Pitch Control options, hybrids- devices with technologies found in cochlear implants and hearing aids- and other forms of implanted auditory assistive devices besides the cochlear implant, like the Bone Anchored Hearing Aid (BAHA), which will be covered in future articles by yours truly.
The most exciting part? Developments are continuously being worked on to make the internal and external equipment lighter, smaller, more durable, trendy, and connectable to items in the modern world, like our phones. There’s always something to look forward to.
So, my Pitch?
Know yourself first. If you feel you, or your child, may have hearing loss, get it assessed as soon as possible. In this way, you will know which aid is most suitable to provide maximum auditory capability as of that moment. It also helps to have newborns assessed and will provide parents ample time to learn about hearing loss while preparing for the potential financial costs and lifestyle changes needed to provide for the needs of a hearing challenged child.
There is no wrong or right choice. It’s about maximizing the benefits with the lowest cost to enable a person to hear what they love most in the days to come.
By: Ann Yebei