There are now several options for the treatment of hearing loss and deafness with different types of hearing aids and cochlear implants. As mentioned in previous sections, infections such as otitis media can often be treated with anti-biotics, but other problems with hearing often require hearing aids or cochlear implants.
Hearing aids, do not replace your hearing, but amplify the sound. New digital hearing aids can be tailored to an individual’s unique hearing loss. Some new digital hearing aids have also been designed to remove distortion, reduce feedback, filter out background noise, and amplify spoken sound. They may also automatically control the volume for you. These are big steps in hearing aid development because in the past the hearing aid would amplify everything, including background noises. Unfortunately, the newer modern hearing aids can be very expensive. Both children and adults can wear hearing aids. Now that babies with hearing difficulties are being diagnosed much earlier, they can be fitted with aids to improve speech and language development in the early years of life.
Following a hearing assessment, if there is significant deafness an individual may require hearing aids. New digital hearing aids are very small and hardly noticeable, fitting right inside the ear. As previously mentioned, hearing aids are not a cure for deafness, but work well for individuals with a mild to moderate hearing loss. Hearing aids will help those with a profound loss, but to a lesser extent. For individuals that have hearing loss in both ears, it is advantageous to wear a hearing aid in each ear to improve your hearing ability and avoid auditory deprivation of the unaided ear.
Hearing aids help many children hear better and in turn respond to their environment. There are also radio aid systems (FM systems) that work well in the classroom, with the teacher wearing a transmitter and the hearing impaired child a receiver. The signal is transmitted by an FM radio transmission to the child’s hearing aid. This has the advantage of cutting out a lot of background noise in the classroom and allows the hearing impaired child to hear the teacher more clearly. FM Systems can also be used in other environments to help the child hear speech.
Bone Anchored Hearing Aids (BAHA)
BAHA hearing aids conduct sound through bone conduction. They are best suited for the people that have conductive hearing loss, unilateral
hearing loss, single sided deafness, or a mixed loss, or those that cannot wear regular hearing aids. This type of aid carries the vibrations of sound through the bone of the skull directly to the cochlea. This hearing aid requires surgery to implant an abutment and a titanium prosthesis in the bone behind the ear to transmit sound waves through the bone to the inner ear, bypassing the external auditory canal and middle ear. A sound processor is attached to the abutment and transmits sound vibrations to the titanium implant. The implant vibrates the skull and inner ear, which stimulate the nerve fibers of the inner ear, allowing hearing.
Individuals with severe to profound hearing loss may not benefit from ordinary hearing aids, but can often improve their hearing with a cochlear implant. Although the implant does not replace normal hearing it gives the listener a good representation of environmental sounds and is especially good for distinguishing speech sounds and spoken language. Normal hearing aids amplify the sound, implants attempt to bypass the damaged parts of the hearing mechanism and take the sounds straight to the auditory nerve. Cochlear implants require a surgical procedure to implant an electrode into the cochlea. This contains an array of 22 electrodes which when excited send impulses to the auditory nerve. A receiver will also be placed under the skin. External components of the cochlear implant include a microphone, speech processor and transmitter which also allows an individual to adjust the sound for quality and amplification.
Following the diagnosis of a hearing impairment, eligible candidates and their parents need to go through an assessment process to make sure they are suitable for an implant. A suitable candidate should:
- have a functioning auditory nerve
- not benefit enough from other kinds of hearing aids
- have potential for good speech, language, and communication skills, and a family willing to work toward speech and language skills with therapy
- live in, or desiring to live in the “hearing world”
- have appropriate services set up for post-cochlear implant aural rehabilitation (through a speech language pathologist/therapist, deaf educator, or auditory verbal therapist).
Cochlear implants are still not a replacement for normal hearing, but they are more effective than normal hearing aids for a severe to profoundly deaf individual. If the child is implanted at an early age and there is good rehabilitation services and a strong commitment from the family, children with cochlear implants often develop very good speech and auditory discrimination skills. Some children with cochlear implants have speech that is as good, if not better than their “hearing” classmates. Although the whole process is very expensive it has changed the lives of many individuals.
There are some cultural and ethical issues around cochlear implants. There are many people within the deaf community that believe it is unfair that a child cannot make the choice between being part of the deaf or the hearing community. The children who are implanted may grow up not knowing whether they are more part of the deaf community or the hearing community. However, if the deaf child is left until he/she is old enough to make the decision for himself, they will miss the critical period where speech develops and the brain learns to interpret sound. The debate continues.
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