Hearing Loss Treatment

Read on to learn about hearing impairment and hearing loss treatment

Treatment for temporary or reversible hearing impairment or loss usually depends on the cause of the hearing loss (deafness). Treatment for permanent hearing loss includes using hearing devices or hearing implants. Although you and your family may view permanent hearing loss as part of aging, proper treatment is important. Hearing loss may contribute to loneliness, depression, and loss of independence. Treatment cannot bring back your hearing, but it can make communication, social interaction, and work and daily activities easier and more enjoyable.

Treatment for reversible hearing loss

This depends on its cause. It is often treated successfully.

Hearing loss caused by: Ototoxic medicines (such as aspirin or ibuprofen) often improves after you stop taking the medicine. An ear infection, such as a middle ear infection, often clears up on its own, but you may need antibiotics. An injury to the ear or head may heal on its own, or you may need surgery. Otosclerosis, acoustic neuroma, or Merniere's disease may require medicine or surgery. An autoimmune problem may be treated with corticosteroid medicines, generally prednisone. Earwax is treated by removing the wax. Do not use a cotton swab or a sharp object to try to remove the wax. This may push the wax even deeper into the ear or may cause injury. 

Permanent hearing loss

In permanent deafness such as age-related and noise-induced hearing loss, hearing devices can often improve how well you hear and communicate. These devices include:

  • Hearing aids. Hearing aids make sounds louder (amplify). They do not restore your hearing, but they may help you function and communicate more easily. Having occasional hearing tests can help you know when your hearing aids needs adjustment.
  • Implanted hearing devices, such as a cochlear implant. Several types of hearing implants are available, each for specific types of hearing problems. Some implants require devices to be worn outside the ear. Newer implants are contained within the ear.
  • Assistive listening devices, alerting devices, and other communication aids.

How hearing impairment is treated will depend on the underlying cause of the condition. For people with sensorineural hearing loss, the condition is permanent. This is because once the sensitive hair cells in the cochlea (the coiled, spiral tube inside the inner ear) are damaged, they cannot be repaired and remain damaged for the rest of a person’s life. However, if your hearing is impaired, various treatment methods can improve your quality of life. Some are discussed below. You may also wish to find services for hearing impairment and deaf support.

Hearing aids

If you have a hearing impairment, you may be able to wear a hearing aid. A hearing aid does not cure a hearing impairment, but it increases the volume of sound entering your ear so that you may be able to hear things more clearly. A hearing aid is an electronic device that consists of: a microphone an amplifier a loudspeaker a battery Modern hearing aids are very small and discreet and can be worn inside your ear. The microphone picks up sound which is made louder by the amplifier.

Hearing aids are fitted with devices that can distinguish between background noise, such as traffic, and foreground noise, such as conversation. Hearing aids are not suitable for everyone. For example, they may not be effective if you have profound hearing impairment. Your GP or audiologist (hearing specialist) will be able to advise you about whether a hearing aid is suitable for you. If a hearing aid is recommended for you, an audiologist will take an impression of your ear so that the hearing aid will fit you perfectly. The hearing aid will be adjusted to suit your level of hearing impairment. You will also be shown how to use and care for it. After your hearing aid has been fitted, you will have a follow-up appointment three months later.

A large range of digital hearing aids are available. Digital signal processing algorithms aim to optimise the benefit to users. Functions available in modern hearing aids include feedback reduction systems enabling the fitting of open moulds (useful for those who get ear infections and those who need high-frequency gain only). Teleloop settings are helpful for theatres, lectures and television. Devices differ in placement. Behind-the-ear (BTE), open fit or mini-BTE (over the ear), in-the ear (ITE), in-the canal (ITC)  and completely in the canal (CITC) are all available.

Bone-conduction hearing aids transmit sound via a bone vibrator held against the mastoid with a band or on the arm of a pair of spectacles. They are useful for the patient who has a conductive or only moderate sensorineural deafness and when a traditional hearing aid with an ear canal insert is unsuitable. Surgical alternatives exist for hearing with electrical devices. A bone-anchored hearing aid system (BAHA) with a titanium implant screwed into the temporal bone, onto which an external abutment is attached protruding through the skin, allows a sound processor (hearing aid) to be clipped onto it with the sound being transmitted through bone to the cochlea. 

NHS hearing aids In the UK

Both analogue and digital hearing aids are commonly used. Most hearing aids that are prescribed through the NHS are now digital. Instead of having moving parts, digital hearing aids contain a very small computer that processes sounds. This enables the hearing aid to be programmed to suit different environments, such as a small quiet room or a large, noisy workshop. Digital hearing aids that are available through the NHS are usually the behind-the-ear (BTE) type. This type of hearing aid is described below along with other types.

Behind-the-ear (BTE) hearing aids

Behind-the-ear (BTE) hearing aids usually have an earmould which sits inside your ear. The rest of the hearing aid is connected to the earmould and lies behind your outer ear. Some types of BTE hearing aids have two microphones that enable you to listen to sounds in the general vicinity or to focus on sounds that are coming from a specific direction. This can be particularly useful in noisy environments.

In-the-ear (ITE) hearing aids

In-the-ear (ITE) hearing aids are like an earmould. They fill the area just outside your ear canal and fill the opening of your ear canal. The working parts of the hearing aid are either located in a small compartment that is attached to the earmould or inside the earmould itself.

In-the-canal (ITC) hearing aids

In-the-canal (ITC) hearing aids fill the outer part of the ear canal and are just visible.

Completely in-the-canal (CIC) hearing aids

Completely in-the-canal (CIC) hearing aids are even smaller and less visible than ITE hearing aids. However, they may not be recommended if you have severe hearing loss.

Body-worn (BW) hearing aids

Body-worn (BW) hearing aids have a small box containing the microphone. The box can be clipped to your clothes or you can put it inside a pocket. A lead connects the box to an earphone which delivers sound to your ear.

Bone conduction hearing aids

Bone conduction hearing aids are recommended for people with conductive hearing loss or for those who can't wear a more conventional type of hearing aid. Bone conduction hearing aids vibrate in response to the sounds going into the microphone. The part of the hearing aid that vibrates is held against the bone behind the ear (mastoid) by a headband. The vibrations pass through the mastoid bone to the cochlea and are converted into sound in the usual way. They can be very effective but can be painful to wear for long periods.

Bone Anchored Hearing Aids (BAHA)

A bone anchored hearing aid requires an operation. A pedestal is screwed into the bone behind the ear and sticks through the skin to allow a hearing aid to be clipped on and off the pedestal. It is worn during the day and removed at night. Unlike a bone conduction hearing aid it is not uncomfortable to wear and it is used for patients with conductive hearing loss, or in some patients who have no hearing in one of their ears.

Middle Ear Implants

These are surgically implanted devices which attach to the hearing bones and make them vibrate. They are suitable for people who can't use a hearing aid but have hearing loss at a level where a bone anchored hearing aid would not help.

CROS/BiCROS

CROS hearing aids are recommended for people who only have hearing in one ear. They work by picking up sounds from the side that does not have hearing and transmitting them to the ear that is able to hear. BiCROS hearing aids work in a similar way to CROS hearing aids and may be useful for people who do not have any hearing in one ear and have limited hearing in the other ear. This type of hearing aid also makes sounds louder. Disposable hearing aids

Disposable hearing aids are sometimes recommended for people who have mild to moderate hearing loss. The battery inside a disposable hearing aid usually lasts for about 10 weeks, after which time the hearing aid is thrown away and replaced. Disposable hearing aids cost around £26 a month and are usually only available privately.

Cochlear implants

Cochlear implants are small hearing devices that are fitted behind your ear during surgery. They have an external sound processor and internal parts including a receiver coil, an electronics package and a long wire with electrodes on it (an electrode array). The electrode array is fed into the cochlea and stimulates the hearing nerve. The processor takes in sound, analyses it and then converts it to signals which are transmitted along the electrode array into the cochlea. This means that cochlear implants are only suitable for people whose hearing nerves are functioning normally.

A cochlear implant is sometimes recommended for adults or children who have profound sensorineural hearing loss in both ears which is not helped by hearing aids. Both ears are usually implanted for children whereas adults are often only able to have one cochlear implant. Before a cochlear implant is recommended, you will be assessed to find out whether it will help improve your hearing. During the assessment, any disabilities or communication problems that you have will be taken into consideration, which may mean that the usual hearing tests are not suitable. If a cochlear implant is recommended, it will be inserted into your ear (or both ears) during an operation and will be switched on a few weeks later. There are currently around 10,000 people in the UK with cochlear implants and the number is increasing each year.

British Sign Language (BSL)

Sometimes, hearing impairment can affect your speech as well as your ability to understand other people. Many people with a hearing impairment learn to communicate in other ways instead of, or as well as, using spoken English. For people who experience hearing loss after they have learnt to talk, lip-reading can be a very useful skill. Lip-reading is where you watch a person’s mouth movements while they are speaking in order to understand what they are saying.

For people who are born with a hearing impairment, lip-reading is much more difficult. Those who are born with a hearing impairment often learn sign language, such as British Sign Language (BSL), which is a form of communication that uses hand movements and facial expressions to convey meaning. BSL is completely different from spoken English and has its own grammar and syntax (word order). Other types of sign language include Signed English and Paget Gorman Signed Speech.

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