Ears Archives - ENT Health https://www.enthealth.org/health_and_wellness_categories/ears/ Wed, 18 Dec 2024 15:19:41 +0000 en-US hourly 1 https://wordpress.org/?v=6.8.3 249128111 OTC Hearing Aids FAQs https://www.enthealth.org/be_ent_smart/otc-hearing-aids-faqs/ Wed, 19 Oct 2022 14:08:38 +0000 https://www.enthealth.org/?post_type=be_ent_smart&p=2432 Over-the-counter (OTC) hearing aids are devices that consumers can buy directly from traditional retailers and pharmacies without the need for a visit to a hearing health professional.

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OTC Hearing Aids FAQs

What Are Over-the-Counter (OTC) Hearing Aids?

Over-the-counter hearing aids are devices that consumers can buy directly from traditional retailers and pharmacies without the need for a visit to a hearing health professional.

Why Are Hearing Aids Now Being Offered Over the Counter?

In 2017, Congress passed bipartisan legislation requiring the U.S. Food and Drug Administration (FDA) to create a category of OTC hearing aids, but it was not fully implemented until now, with OTC hearing aids available in traditional retail and drug stores as soon as October 17, 2022, when the rule took effect.

Who Is a Good Candidate for OTC Hearing Aids versus Prescription Hearing Aids?

OTC hearing aids are for adults 18 years of age or older who think they have mild-to-moderate hearing loss. You may have mild-to-moderate hearing loss if, for example:

  • Sounds or speech seem quiet or muffled to you.
  • You have difficulty hearing in a group setting, with background noise (e.g., restaurant), speaking on the phone, or need to face people when talking to understand them.
  • You ask others to repeat themselves or speak more loudly.
  • People complain that you turn up the TV or radio too high.

Can Children Use OTC Hearing Aids?

Currently, the FDA regulations state that OTC hearing aids are for adults (18 years of age or older). Children should see a hearing health professional for evaluation and obtaining a hearing aid.

What Are the Benefits and Concerns Associated with OTC Hearing Aids?

The primary benefits of OTC hearing aids are the lower cost and ease of purchase of these devices compared to hearing aids obtained from a hearing health professional. Concerns related to OTC hearing aids start with the most basic question: Does the customer have hearing loss and is it the type for which OTC hearing aids are designed? Additional consideration should be given if the individual’s hearing loss comes from a medical problem that can be corrected (eliminating the need for a hearing aid) or addressed to prevent worsening the hearing loss or more serious problems. These conditions would be missed without an evaluation by a hearing health professional. Obtaining the best result and avoiding pain and infection depend on a properly fitting hearing aid. If your OTC hearing aid becomes painful to put in your ear, you should see an ENT (ear, nose, and throat) specialist, or otolaryngologist.

How Much Will OTC Hearing Aids Cost?

The cost of OTC hearing aids will depend on the complexity and features of the device as well as other provisions included in the sale, such as service, returns, and the degree of support the manufacturer provides. Companies that provide telephone-based help and remote programming of the devices charge approximately $1,500 to $3,000 for a pair of OTC hearing aids. Off-the-shelf devices that do not offer those services may cost approximately $200 to $800 for a pair of devices.

Will My Insurance, Medicare, and/or Medicaid Cover OTC Hearing Aids?

Medicare currently does not cover any hearing aids. Medicaid coverage for those over 18 years old will vary by state, and you have to check with your Medicaid program. Some private health insurance plans may cover the cost of hearing aids, so you should check with your particular insurance company or employer regarding coverage for OTC hearing aids.

How Will I Know Which Kind of OTC Hearing Aid to Select? What Is the Return Policy?

The marketplace for OTC hearing aids has just opened (as of October 17, 2022) and identifying the right device for you may be challenging. As more devices become available, it may become easier to select the right device for you. You should also consider these issues:

  • Is it waterproof?
  • Does it block out background sound?
  • Does it have Bluetooth capability?
  • Is it compatible with your smart phone?
  • Does it come with an app to help customize my individual hearing profile?
  • How long does the battery last? Is it rechargeable?
  • Does it have adequate and understandable sizing choices?

Manufacturers of OTC hearing aids are required by the FDA to report their return policy; however, OTC sales do not require a return policy, so you should review that policy before buying an OTC hearing aid. Most reputable prescription hearing aid dispensers offer a one-month trial period, and you should look for something similar for your OTC hearing aids before purchasing them.

What Technological Issues Should I Consider?

Different OTC hearing aids will offer different features, may be programmable, and will likely be offered at different price points, but most OTC hearing aids will probably be compatible with other devices. If compatibility is important to you, be sure to check if your OTC hearing aids will work with your smart phone before purchasing them.

Are There Other Types of Hearing Devices I Should Consider?

For people with the type of hearing loss that would benefit from OTC hearing aids, there are additional options you may consider:

  • A personal amplification device may be helpful and possibly less expensive than OTC hearing aids. These devices are typically a “boxy” receiver attached to headphones and are therefore bulkier than what you would expect from hearing aids. One example is a pocket talker.
  • Personal sound amplification products (PSAPs) amplify sound for the user but are intended for people with normal hearing to amplify sounds in certain situations, such as recreational activities like birdwatching, according to the FDA. PSAPs are regulated as consumer electronics and not medical devices.
  • Traditional prescription hearing aids from an ENT specialist or audiologist are a good choice if you are not getting the boost you would like from OTC hearing aids. OTC devices are not tuned to a hearing test, but prescription hearing aids are tuned to your exact level of hearing.

What Are FDA "Red Flag" Conditions and What Do They Mean?

The list below describes conditions that need medical attention to prevent additional problems and complications. You should see a doctor—preferably an ENT specialist—if you have any of these red flag conditions indicating that there is a medical condition causing your hearing loss, including:

  • Your ear has a birth defect or an usual shape or your ear was injured or deformed in an accident.
  • You have had blood, pus, or fluid coming out of your ear during the past six months.
  • Your ear feels painful or uncomfortable.
  • You have a lot of ear wax, or you think something could be in your ear.
  • You feel dizzy or have a feeling of spinning or swaying (called vertigo).
  • Your hearing changed suddenly in the past six months.
  • Your hearing gets worse then gets better again.
  • You have worse hearing in one ear.
  • You hear ringing or buzzing in only one ear.

Who Should I Talk to If I Have Questions About OTC Hearing Aids?

If you need help deciding if you have hearing loss, if OTC hearing aids are right for you, or if you need prescription strength hearing aids, a hearing specialist—ENT specialist or an audiologist—can help you. Tell them if you are experiencing any red flag conditions listed above. And be sure you know the return policy of the OTC hearing aid you are considering.

Are There Other Resources Available to Learn More About Hearing Loss?

https://www.nia.nih.gov/health/hearing-loss-common-problem-older-adults

otc hearing aids video

Here are some FAQs to help you navigate OTC hearing aids.

Related Conditions

Frequently Asked Questions (FAQs) about Age-related Hearing Loss

How to Find the Right Hearing Aid for You

Hearing Loss with the Use of Protective Face Masks

hearWHO Hearing Screening App

The information on ENThealth.org is provided solely for educational purposes and does not represent medical advice, nor is it a substitute for seeking professional medical care.

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]]> 2432 Understanding Vestibular Migraines https://www.enthealth.org/be_ent_smart/understanding-vestibular-migraines/ Tue, 10 Nov 2020 19:08:57 +0000 https://www.enthealth.org/?post_type=be_ent_smart&p=2098 Vestibular migraine, also referred to as “migraine associated vertigo,” is when a patient also experiences dizziness and imbalance.

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Understanding Vestibular Migraines

Vestibular migraine, also referred to as “migraine associated vertigo,” is when a patient also experiences dizziness and imbalance. Vestibular migraine is one of the most common causes of vertigo, or the sensation of spinning or moving when you are still. Patients may also experience:

  • Light-headedness
  • Vision changes
  • Hearing changes or tinnitus (ringing or buzzing sound in your ear)
  • Headache (many patients report headaches after their dizziness has subsided)
  • Nausea, vomiting, fatigue
  • Motion sickness or sensitivity or complicated visual patterns
  • Visual auras, sensitivity to light, blurring, seeing flashing spots or lights
  • Sensitivity to light or sound
  • Difficulty with concentration or memory issues

Migraines can be described as a recurring type of headache that may occur with auras, which are sensory disturbances such as visual changes, difficulty speaking, and tingling in the arms and legs. A “common” migraine headache does not usually involve auras.

Vestibular migraines may be treated by an ENT (ear, nose, and throat) specialist, or otolaryngologist, and/or a neurologist. Because the symptoms overlap and frequently coincide with inner ear disorders (such as benign paroxysmal positional vertigo and Ménière’s disease), patients often visit several different specialists before establishing a clear diagnosis and starting appropriate treatment. Like common or classic migraines, vestibular migraine often runs in families, and women are more frequently affected than men. Vestibular migraine is also commonly linked with depression and anxiety.

How Do I Know if I Have a Vestibular Migraine?

To make a reasonable diagnosis of vestibular migraine requires a conversation with your doctor to review your medical history. However, a positive diagnosis is likely if you have at least five episodes of moderate to severe symptoms lasting between five minutes and 72 hours, and at least half of your episodes include at least one of the following three features:

  • Headache with at least two of the following four characteristics: (1) unilateral (one-sided) location, (2) pulsating quality, (3) moderate or severe intensity, and/or (4) aggravation by routine physical activity
  • Fear of or sensitivity to light and sound
  • Visual aura

What Are Common Triggers of Migraines?

Common triggers of migraines include:

  • Stress and anxiety
  • Dehydration
  • Poor sleep quality and fatigue
  • Hunger
  • Hormonal changes (such as those experienced during menopause or puberty, menstruation, or hormone therapy)
  • Motion triggers such as unexpected movement (e.g., inside a moving vehicle)
  • Complex or visually “busy” stimuli (ceiling or floor patterns, crowded environments, entertainment screens)

Certain foods can also trigger a vestibular migraine. Your doctor may recommend a diet with low levels of tyramine, an amino acid, monosodium glutamine (MSG), preservatives, caffeine, and alcohol. Your doctor may provide you with a more extensive or modified list of foods to avoid. The goal is not necessarily to abruptly stop these foods if you really enjoy them. Instead, start to moderate and gradually decrease them to help recognize your common triggers. Once your symptoms are controlled, you can slowly add back your desired foods while closely monitoring your symptoms.

Examples of trigger foods include:

  • Aged cheeses
  • Smoked or cured meats
  • Food prepared with soy sauce, vinegar, or yeast extract
  • Pickled and fermented foods (buttermilk, yogurt, sour cream)
  • Onions, olives, pickles
  • Artificial sweeteners
  • Alcohols such as heavier red wines, port wines, sherry wines, scotch, gin, and bourbon
  • Dark chocolate, cocoa, peanut butter
  • High amounts of certain fruits such as figs, red plums, bananas, citrus fruit, raisins, passion fruit
  • Excess caffeine

One method to identify triggers is to keep a daily symptom journal with details such as waking time and bedtime, foods eaten, stress levels, and additional symptoms experienced. Stress relief and improving sleep hygiene may reduce the frequency and severity of attacks.

What Are My Treatment Options?

Medications may be prescribed to prevent episodes if avoiding triggers does not help control symptoms. Preventative mediations can include a beta-blocker (e.g., propranolol), calcium channel blocker (e.g., verapamil), antidepressant (e.g., nortriptyline, venlafaxine), and/or an anticonvulsant (e.g., topiramate). Treatment with an antidepressant or anticonvulsant does not mean you have depression or seizures; they are intended to stabilize the central nervous system and raise the threshold at which attacks are triggered. Medication regimens may be tailored to your existing medical conditions. Once symptoms are controlled, medications may be weaned off and do not necessarily need to be taken forever.

Vestibular rehabilitation is a type of physical therapy that may also be recommended to treat chronic balance dysfunction. Vestibular therapy will train your brain to desensitize itself to common sensory triggers. The course of therapy is often gradually increased in its intensity and can be widely varied to combat multiple types of triggers that include movement, visual perceptions, and posture instability.

Treatment to help stop a vestibular migraine attack once it begins includes rest, observation, hydration, and medications such as anti-nausea, antihistamine, or sedatives if needed. However, the most effective way to treat vestibular migraine is preventing an attack as described above, and it is critical to recognize your triggers. Many cases can be treated with trigger avoidance alone.

What Questions Should I Ask My Doctor?

If you feel like you need to see a doctor to help control your migraine symptoms, you might consider some of these questions during your conversation:

  1. Should I keep a migraine symptom journal and what details should I track?
  2. What are my treatment options and how will they affect my existing medical condition(s)?
  3. Do I need a hearing, balance, or imaging test?
  4. Do I need to see another specialist?

Related Conditions

Frequently Asked Questions (FAQs) about Ménière’s Disease

Sinus Headaches

Vestibular Schwannoma (Acoustic Neuroma)

The information on ENThealth.org is provided solely for educational purposes and does not represent medical advice, nor is it a substitute for seeking professional medical care.

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]]> 2098 What is Skull Base Surgery? https://www.enthealth.org/be_ent_smart/what-is-skull-base-surgery/ Wed, 13 May 2020 17:23:25 +0000 https://www.enthealth.org/?post_type=be_ent_smart&p=2040 Skull base surgery is a specialized type of surgery that focuses on treating conditions at the base of the skull. Otolaryngology skull base surgery is minimally invasive and almost always performed using a team approach.

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What is Skull Base Surgery?

Skull base surgery is a specialized type of surgery that focuses on treating conditions at the base of the skull. This includes areas like the undersurface of the brain and important nerves and vessels that exit out of the brain to support senses such as sight, smell, and hearing. The challenge in skull base surgery is reaching these areas without having to cut through the skull and retract the brain. The goal is to get to and operate on these difficult areas with as little impact on the normal brain as possible.

Otolaryngology skull base surgery is minimally invasive and almost always performed using a team approach. An ENT (ear, nose, and throat) specialist, or otolaryngologist, typically teams with a neurosurgeon to access these areas through the nose, eyelid, forehead, or above and behind the ear.

What Are Common Skull Base Conditions?

Overall, skull base conditions are rare. When a patient does have a skull base condition, it is important to seek out a skull base team that is comfortable and familiar with skull base surgery and the management of these conditions.

Common skull base disorders approached through the nose include pituitary tumors, sinus tumors, and orbital tumors (located near the eye). Many spinal fluid leaks (with fluid that drips out of the nose) can also often be repaired through the nostrils. Common skull base disorders approached from around the ear include acoustic neuroma, petrous apex lesions, aneurysms, and meningiomas.

These conditions often have specific symptoms, such as loss of sight, nosebleeds, facial numbness, asymmetric hearing loss, balance issues, or hormonal disturbances. These symptoms most often come on gradually and are diagnosed by an ENT specialist and/or neurosurgeon using a CT scan and MRI. Specialized tests such as hearing tests, visual field testing, or arterial studies may also be performed.

What Are the Treatment Options?

Not all skull base conditions require surgery. Most skull base tumors are benign, or noninvasive. However, they can put pressure on major nerves and cause serious symptoms when they grow. Minimally invasive surgery to remove these types of tumors focuses on preserving nerve function.

Some skull base tumors are malignant, or harmful, and must be removed. They may require chemotherapy and/or radiation therapy before or after surgery. Many centers have dedicated skull base teams that include oncology specialists to treat tumors. Surgery to remove malignant skull base tumors is also often minimally invasive.

What Questions Should I Ask My Doctor?

  1. What type of skull base condition/tumor do I have?
  2. What symptoms should I expect if this continues to grow?
  3. Are there multiple treatment options, and what are the risks and benefits of each?
  4. Which medical/surgical specialists will be involved in my care?
  5. What is my expected long-term outcome with this condition?

Related Conditions

Conductive Hearing Loss

Sensorineural Hearing Loss (SNHL)

Vestibular Schwannoma (Acoustic Neuroma)

The information on ENThealth.org is provided solely for educational purposes and does not represent medical advice, nor is it a substitute for seeking professional medical care.

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]]> 2040 Telemedicine Best Practices https://www.enthealth.org/be_ent_smart/telemedicine-best-practices/ Tue, 12 May 2020 17:50:23 +0000 https://www.enthealth.org/?post_type=be_ent_smart&p=2038 With the global emergence and spread of the coronavirus disease 2019 (COVID-19), options for practicing telemedicine, or communicating with your healthcare provider virtually, by phone, email, and/or video without physically entering your doctor’s office, have increased dramatically.

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Telemedicine Best Practices

With the global emergence and spread of the coronavirus disease 2019 (COVID-19), options for practicing telemedicine, or communicating with your healthcare provider virtually, by phone, email, and/or video without physically entering your doctor’s office, have increased dramatically.

According to Medscape, “Through an emergency declaration made March 17, 2020, the Centers for Medicare & Medicaid Services (CMS) will pay providers to care for Medicare beneficiaries for office, hospital, and other visits furnished via telehealth anywhere in the country—not just rural areas—and including a patient’s place of residence. These services can also be provided in nursing homes, hospital outpatient departments, and other settings, and across state lines. This goes into effect retroactively to March 6, 2020, and will extend through the COVID-19 public health emergency.”1

What Is 'Telemedicine' and How Does It Differ from 'Telehealth'?

According to Douglas M. Hildrew, MD, Chair of the American Academy of Otolaryngology–Head and Neck Surgery (AAO-HNS) Telemedicine Committee and Assistant Professor of Surgery at the Yale School of Medicine, Division of Otolaryngology–Head & Neck Surgery, “On a very basic level, telemedicine involves using electronic communication strategies to provide clinical services and/or patient care remotely.

“This can be done by way of various mechanisms like voice, video, or even traditional static frame photography. The patient and the physician are not under the same roof and are using some type of electronic communication in order to achieve patient healthcare. The term telehealth, however, is really a larger umbrella term that includes a broader scope of services.”2

What Type of Technology Do I Need for Telemedicine?

There are many types of technologies available for initiating a telemedicine encounter with your healthcare provider and you should first check with them to see what, if any, specific technologies their practice supports. While the AAO-HNS does not endorse any particular electronic communication vendor, Dr. Hildrew suggests that patients investigate options such as Apple FaceTime, Facebook Messenger (not Facebook Live, which is a public-facing platform), Google Hangouts video, Skype, or Zoom for Healthcare to see what is most comfortable for them.

Again, any open, public-facing platforms should not be used for communicating with your healthcare provider.

How Should I Prepare for a Telemedicine Visit?

If you need to schedule a telemedicine visit with your healthcare provider, you need to contact them first to see what availability they have as well as what type of technology they use. It is also very important that you make sure you will be somewhere with either a strong cell phone or Wi-Fi signal throughout the encounter. Some additional, basic tips to follow before your first virtual visit include:

  1. Make sure you have an up-to-date list of all medications that you or your loved one take.
  2. Be ready to share information about any pre-existing medical conditions.
  3. Write down all symptoms that you may be experiencing. How long have you been experiencing them, and with what frequency? Are they new symptoms, or have you had them before?
  4. Take a picture to share with your provider if you have visual signs of a possible medical condition such as swelling, a lump, bruise, wound, or lesion.
  5. Be direct but succinct when speaking with your provider as many practices may be overwhelmed and understaffed while caring for a growing number of unsettled patients.

Please note: If you are experiencing the sudden onslaught of symptoms such as chest pain, weakness in one side of the face or body, a severe, sharp headache, or great difficulty breathing you should call 911 immediately.

You can learn more about COVID-19 and steps you can take to stay safe here.

References

1 https://www.medscape.com/viewarticle/927323?src=soc_tw_200327_mscpedt_news_mdscp_telemed&faf=1
2 https://directory.libsyn.com/episode/index/id/13826069

Related Conditions

Dysgeusia

Hyposmia and Anosmia

Sore Throats

The information on ENThealth.org is provided solely for educational purposes and does not represent medical advice, nor is it a substitute for seeking professional medical care.

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]]> 2038 Noise-induced Hearing Loss in Children https://www.enthealth.org/be_ent_smart/noise-induced-hearing-loss-in-children/ Thu, 05 Sep 2019 18:03:29 +0000 http://www.enthealth.org/?post_type=be_ent_smart&p=1859 About 10 million Americans suffer irreversible noise-induced hearing loss (NIHL).

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Noise-induced Hearing Loss in Children

About 10 million Americans suffer irreversible noise-induced hearing loss (NIHL). What’s more, as many as 17 percent of teens (ages 12 to 19) have features of their hearing that suggest NIHL in one or both ears.1 Noise can be dangerous through a one-time exposure to an intense sound, such as an explosion, or by continuous exposure to loud sounds over long periods of time, such as noise from headphones, headsets, earbuds, and personal listening devices, in addition to loud work environments.

In particular, the “sounds of summer”—concerts, fireworks, motorcycles, sirens, and even firearms—can range anywhere from 95 to 150 decibels (dB). Long or repeated exposure to sounds at or above 85 dB can cause both temporary and permanent hearing loss.

Here’s What You Need to Know about Decibel Levels

NIHL occurs as a result of loud noises that damage the inner ear. Listening to music at volumes louder than 85 dB for long periods of time can cause permanent hearing loss. The National Institute for Occupational Safety and Health (NIOSH) and Centers for Disease Control and Prevention (CDC) permit workers to listen to 85 dB for eight hours in a row. But for every three dB above that, the time that is considered safe is divided in half. That means you’re only recommended to listen at 88 dB for four hours, at 91 dB for two hours, at 94 dB for one hour, at 97 dB for 30 minutes, at 100 dB for 15 minutes, and so on. The average portable music player is played at 100 dB, and cellphones or listening devices in the U.S. can produce a maximum of 115 dB.

What Are the Symptoms of NIHL?

The symptoms of NIHL can be hard to tell in early stages. Hearing loss tends to occur first for high-pitched sounds only. Because of this, the volume of sound heard may be unchanged but the quality of it lessens. Over time, speech may be heard but not completely understood. The presence of background noise can make speech hard to understand. Also, ringing or buzzing (tinnitus) may occur as a result of NIHL.

The hearWHO Hearing Screening App is a free app developed by the World Health Organization for mobile devices which allows people to check their hearing regularly. The app is for people who are at risk of hearing loss or who already have some of the symptoms related to hearing loss.

How Does Noise Exposure Cause Hearing Loss?

Very loud sounds damage the hair cells of the cochlea, the hearing part of the inner ear. These sensitive structures are small sensory cells that convert sound energy into electrical signals that travel to the brain, where the brain converts them into meaningful sounds. Once damaged, hair cells cannot regrow and lose the ability to transmit sound.

When loud sounds are exposed to the ear for a short time, you may experience temporary hearing loss (also known as temporary threshold shift) or ringing in the ears (tinnitus). If the ear is exposed to loud sounds over longer periods of time, the hair cells can be damaged forever, causing permanent sensorineural hearing loss.

Why Are Earplugs Important to Use at Concerts?

Parents should know that various medical studies have found sound levels at music concerts often to be greater than 85 dB, with some reports suggesting that sound intensity may reach 90 to 122 dB. As mentioned earlier, if levels are kept at values greater than 85 dB for long periods of time, this may lead to a dangerous noise exposure. People young and old enjoy going to concerts, but frequent attendees may experience potentially irreversible hearing loss if they are not careful.

One research study examined sound intensity throughout a concert venue, and the effectiveness of earplugs. The findings stated that sound pressure levels appeared equally hazardous in all parts of the concert hall, regardless of the type of music played.2 That’s why earplugs are recommended at every type of music concert, regardless of your distance to the stage.

How Can I Help Protect My Child’s Hearing?

Some helpful tips for protecting your or a loved one’s hearing include:

  • Although wearing earplugs, earmuffs, or other protection to lessen the impact of loud noise may not be fun for young people, parents should encourage their children—particularly those who are musicians—to protect their hearing. Earplugs can reduce sound energy hitting young ears by about 25 dB, and can mean the difference between healthy or lower hearing later in life.
  • Keep all personal music players, smartphones, gaming device headsets, televisions, and stereo equipment on a low volume.
  • If your children are exposed to other noisy environments or workplaces with loud machinery, help them choose quiet activities in their leisure time.

Remember: If you have to shout to hear yourself or someone else, or if ringing, diminished hearing, or a sense of fullness in the ears is experienced after noise exposure, the level of that noise is damaging.

References

1 http://pediatrics.aappublications.org/content/127/1/e39.long

2 “Incidence of spontaneous hearing threshold shifts during modern concert performances,” Opperman, Reifman, Schlauch, Levine; Otol-HNS 2006, 134:4: 667-673.

HEARING LOSS VIDEOS

Here are some tips for preventing hearing loss.

View Video

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Conductive Hearing Loss

Cochlear Implant Health

Frequently Asked Questions (FAQs) about Age-related Hearing Loss

Pediatric Hearing Loss

The information on ENThealth.org is provided solely for educational purposes and does not represent medical advice, nor is it a substitute for seeking professional medical care.

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]]> 1859 Ear Plastic Surgery https://www.enthealth.org/be_ent_smart/ear-plastic-surgery/ Fri, 08 Feb 2019 18:32:52 +0000 http://www.enthealth.org/?post_type=be_ent_smart&p=1695 Ear plastic surgery can help patients born with underdeveloped, protruding, or drooping ear(s) due to weak or poorly formed cartilage.

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Ear Plastic Surgery

Ear plastic surgery can help patients born with underdeveloped, protruding, or drooping ear(s) due to weak or poorly formed cartilage. A partially formed exterior ear is called “microtia,” while a completely undeveloped ear is referred to as “anotia.” Traumatic malformations of the ear also occur due to torn earlobes, automobile or other accidents, animal attacks, and more. Deformity of the ears may cause social anxiety and make children vulnerable to teasing. Regardless of the origin of the ear distortion, many ear conditions can be surgically corrected. These procedures do not alter the patient’s hearing, and may improve appearance and self-confidence.

How Are Ear Abnormalities Corrected?

Interruptions during the formation of the ear can result in different ear shapes, with the most severe being total absence of the ear and possibly the ear canal, or mild folding differences of the ear. The fold of hard, raised cartilage that gives shape to the upper portion of the ear does not form in everyone. This is called “lop-ear deformity,” and it is inherited. The absence of the fold can cause the ear to stick out or flop downward.

Some infants are born without an ear canal. Hearing can be restored with a bone-anchored hearing aid, or it can be surgically opened, and the outer ear reshaped to look like the other ear. Those who are born without an ear or lose an ear due to injury can have an artificial ear surgically attached for cosmetic reasons. These are custom formed to match the patient’s other ear. Alternatively, rib cartilage or a biomedical implant, in addition to the patient’s own soft tissue, can be used to construct a new ear.

To correct prominent ears that lack folds, an ENT (ear, nose, and throat) specialist, or otolaryngologist, places permanent stitches in the upper ear cartilage and ties them in a way that creates a fold to prop up the ear. Scar tissue will form later, holding the fold in place. Corrective surgery, called otoplasty, may be considered on ears that stick out more than 4/5ths of an inch (2 cm) from the back of the head. It can be performed at any age after the ears have reached full size, usually at five- or six-years-old. Having the surgery at a young age has two benefits: (1) the cartilage is more pliable, making it easier to reshape, and (2) the child will experience the psychological benefits of the cosmetic improvement.

An ENT specialist begins the surgery with an incision behind the ear where the ear joins the head. In addition, ears may also be reshaped, reduced in size, or made more symmetrical. The reshaped ear is then secured in position while healing occurs. Typically, otoplasty surgery takes about two hours. The soft dressings over the ears will be used for a few weeks as protection, and the patient usually experiences only mild discomfort. Headbands are sometimes recommended beyond that for a month following surgery.

Can a Torn Earlobe be Corrected?

A torn earlobe can be easily repaired surgically, usually in the ENT specialist’s office. In severe cases, the surgeon may cut a small triangular notch at the bottom of the lobe. A matching flap is then created from tissue on the other side of the tear, and the two wedges are fitted together and stitched. Earlobes usually heal quickly with minimal scarring. In most cases, repaired earlobes can be pierced four to six weeks after surgery to support light-weight earrings.

Does Insurance Pay for Ear Surgery?

Insurance usually does not cover surgery solely for cosmetic reasons. However, insurance may cover, in whole or in part, surgery to correct a congenital or traumatic defect. Before cosmetic ear surgery, discuss the procedure with your insurance carrier to determine what coverage, if any, you can expect.

Related Conditions

Cleft Lip and Cleft Palate

Nasal Fractures

Facial Plastic Surgery

The information on ENThealth.org is provided solely for educational purposes and does not represent medical advice, nor is it a substitute for seeking professional medical care.

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]]> 1695 Genes and Hearing Loss https://www.enthealth.org/be_ent_smart/genes-and-hearing-loss/ Fri, 08 Feb 2019 16:16:14 +0000 http://www.enthealth.org/?post_type=be_ent_smart&p=1691 Genes play an important role in congenital hearing loss, causing about 60 percent of deafness in infants, affecting as many as three of every 1,000 babies.

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Genes and Hearing Loss

Genes play an important role in congenital hearing loss, causing about 60 percent of deafness in infants. One of the most common congenital (present at birth) abnormalities is hearing loss or deafness, affecting as many as three of every 1,000 babies. Exact data is not available, but it is likely that genes also play an important role in hearing loss in the elderly.

Genes are part of your DNA and give you the traits that make you different from everyone else, your eye color and hair, for examples. Genetics is the study of genes and disorders caused by “abnormal” genes. Genes can become mutated, or changed, and this can cause disorders in our bodies. In addition to gene mutation, other causes of hearing loss at any stage of a person’s life include medical problems, environmental exposure, trauma, and medications.

Hearing loss because of gene mutation is often categorized as “syndromic” versus “non-syndromic.” In both cases, the genes can have different ways of being passed down from parents, the most common being “autosomal dominant” (meaning that if you get the abnormal gene from only one parent, you can develop the condition), or “autosomal recessive” (meaning that two copies of the abnormal gene must be present).

Syndromic means that in addition to the hearing loss, there are other disorders in the body. When hearing loss is passed down from parents, 15 to 30 percent are syndromic. Over 400 syndromes are known to include hearing loss. They can be caused by chromosomes that are not normal (having extra or missing chromosomes, or parts of chromosomes), parent passing them to child, or due to many factors working together, including genetic and environmental.

Syndromes can appear in many different ways, and some problems may be mild to severe. An example of when syndromes express themselves in different ways is Waardenburg syndrome. Within the same family, some members may have dystopia canthorum (an unusually wide bridge of the nose due to the inner angles of the eyes moved more sideways than they should be), white forelock (a white patch of hair in front of the head), heterochromia iridis (two different-colored irises or two colors in the same iris), and hearing loss, while others may only have dystopia canthorum.

Non-syndromic hearing loss happens in about 70 percent of genetic hearing loss. This means that the abnormal gene causing the hearing loss does not cause any other associated disorders. Eighty percent of non-syndromic hearing loss cases are due to autosomal recessive genes, and nearly 20 percent are caused by autosomal dominant genes. Less than two percent of cases are caused by X-linked and mitochondrial genetic malfunctions. Mitochondrial genetic disorders happen due to damaged mitochondria—the structures in each cell of the body that are responsible for making energy. X-linked gene problems occur because of disorders in the mother’s X chromosome.

How Do Genes Work?

Genes are highly complex and form a roadmap of sorts for the synthesis of proteins, which are the building blocks for everything in the body: hair, eyes, ears, heart, lungs, etc. Every child inherits half of their genes from one parent and half from the other parent. If the inherited genes are abnormal or defective, a health disorder such as hearing loss or deafness can occur. Hearing disorders are commonly inherited in one of four ways:

  1. Autosomal Dominant Inheritance—For autosomal dominant disorders, only one “bad” copy of the gene is needed to affect the child. A “heterozygous” parent has two types of the same gene (in this case, one mutated and the other normal), each with a 50 percent chance of affecting the child. An affected homozygous parent (who has two same affected genes) will pass an abnormal copy to all their children, and they will all be affected. Autosomal dominant traits usually affect males and females equally.
  2. Autosomal Recessive Inheritance—For autosomal recessive disorders, the child must inherit a bad copy of the gene from both parents. If there is one good copy of the gene, the child will not be affected. It’s possible for two unaffected heterozygous parents (each parent with one bad copy) to have an affected child (a 25 percent chance), which means that this disorder can skip generations.
  3. X-linked Inheritance—These disorders are from genes that are on the sex chromosomes. Males have an X chromosome and a Y chromosome, while females have two copies of the X chromosome only. Each female inherits an X chromosome from her mother and her father. On the other hand, each male inherits an X chromosome from his mother and a Y chromosome from his father. Genes that are only on the X chromosome are more likely to affect males because they don’t have a competing gene on another chromosome.
  4. Mitochondrial Inheritance—Mitochondria also have their own DNA. Only the mitochondria in the egg from the mother can be passed from one generation to the next. This leads to a pattern where only affected mothers (not affected fathers) can pass on a disorder from one generation to the next. Being sensitive to hearing loss from aminoglycoside antibiotics, which are used to treat serious infections, can be inherited through mitochondrial DNA. This is the most common cause of deafness in China.

Advances in molecular biology and genetics over the past 10 years have helped scientists and doctors understand how the inner ear develops, works, and how it can be abnormal. Researchers have identified several genes responsible for deafness or hearing loss, including the “GJB2” gene mutation. As one of the most common genetic causes of hearing loss, GJB2-related hearing loss is an autosomal recessive genetic disorder because the mutations only cause deafness in individuals who inherit two copies of the mutated gene, one from each parent. A person with one mutated copy and one normal copy is a carrier but is not deaf. Screening tests for the GJB2 gene are available for at-risk people to help them determine their risk of having a child with hearing problems. Additionally, panels to screen for genetic hearing loss have been developed if you or your healthcare provider suspect that there may be a genetic cause for the hearing loss.

Related Conditions

Conductive Hearing Loss

Sensorineural Hearing Loss

Pediatric Hearing Loss

Frequently Asked Questions (FAQs) about Age-related Hearing Loss

The information on ENThealth.org is provided solely for educational purposes and does not represent medical advice, nor is it a substitute for seeking professional medical care.

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]]> 1691 Ear Tubes https://www.enthealth.org/be_ent_smart/ear-tubes/ Wed, 26 Sep 2018 15:16:33 +0000 http://www.enthealth.org/?post_type=be_ent_smart&p=1166 Ear tubes are tiny cylinders placed through the ear drum (called tympanic membrane) to allow air into the middle ear. Each year, more than half a million ear tube surgeries are performed on children.

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Ear Tubes

Most children have experienced at least one painful ear infection by the age of five. Many ear infections resolve on their own, especially if they are viral, and some bacterial infections require treatment with antibiotics. Sometimes recurrent ear infections and/or persistent fluid in the middle ear may become a chronic problem leading to other issues such as hearing loss, poor school performance, or behavior and speech problems. In these cases, insertion of ear tubes by an ENT (ear, nose, and throat) specialist, or otolaryngologist, may be considered.

Ear tubes are tiny cylinders placed through the ear drum (called tympanic membrane) to allow air into the middle ear. They may also be called tympanostomy tubes, myringotomy tubes, ventilation tubes, or PE (pressure equalization) tubes.

These tubes can be made of various materials and come in two basic types: short-term and long-term. Short-term tubes are smaller and typically stay in place for six months to two years before falling out on their own. Long-term tubes are larger and have flanges that secure them in place for a longer period of time. Long-term tubes may fall out on their own, but removal by an otolaryngologist may be necessary.

Who Needs Ear Tubes and Why?

Ear tubes may be recommended when someone experiences repeated middle ear infection (acute otitis media) or has hearing loss caused by persistent middle ear fluid (otitis media with effusion). These conditions most commonly occur in children, but can also be present in teens and adults, and can lead to speech and balance problems, hearing loss, poor school performance, and changes in the structure of the ear drum.

Other less common conditions that may warrant the placement of ear tubes are malformation of the ear drum or eustachian tube, Down syndrome, cleft palate, and barotrauma (injury to the middle ear caused by a reduction of air pressure, usually seen with altitude changes as in flying and scuba diving).

Each year, more than half a million ear tube surgeries are performed on children, making it the most common childhood surgery performed with anesthesia. The average age for ear tube insertion is one- to three-years-old. Inserting ear tubes may:

  • Reduce the risk of future ear infection
  • Restore hearing loss caused by middle ear fluid
  • Improve speech problems and balance problems
  • Improve behavior and sleep problems caused by repetitive ear infections
  • Help children do their best in school

What Are the Treatment Options?

Observation and medical management are typically the first steps of treatment. Your ENT specialist will help you decide when, and if, ear tubes are the best option for you and your child.

Ear tubes are inserted during an outpatient surgical procedure called a myringotomy with tympanostomy tube insertion. A myringotomy refers to a small incision made in the ear drum or tympanic membrane, which is most often done under a surgical microscope with a small scalpel. If an ear tube is not inserted, the hole would heal and close within a few days. To prevent this, an ear tube is placed in the hole to keep it open and allow air to reach the middle ear space (ventilation).

During Surgery

Most young children as well as some older children and adults require a short general anesthetic. Tubes can also be safely placed in the office setting without general anesthesia using a local anesthetic in select younger children1 and most older children and adults. A small incision is made in the ear drum and the fluid behind the ear drum in the middle ear space is suctioned out. The ear tube is then placed in the opening. Ear drops may be administered after the ear tube is placed and may be prescribed for a few days. The procedure usually lasts less than 15 minutes and patients recover very quickly with little or no pain.

Sometimes the ENT specialist will recommend removal of the adenoid tissue (lymph tissue located in the upper portion of the throat just behind the nose) when ear tubes are placed for persistent middle-ear fluid. This is often considered in children over the age of four, or when a repeat tube insertion is necessary.

Adenoidectomy can also help address issues of chronic nasal obstruction, significant snoring, or incessant runny nose that happens even when the child doesn’t have a cold. Current research indicates that removing adenoid tissue at the same time as placement of ear tubes for persistent middle-ear fluid can reduce the risk of recurrent ear infections and the need for repeat surgery in children four years and older.

After Surgery

After surgery, the patient is monitored in the recovery room (if general anesthesia was used) and will usually go home within an hour or two. Patients usually experience little or no postoperative pain, but grogginess, irritability, and/or nausea from the anesthesia can occur temporarily. When done in the office, recovery is immediate.

Hearing loss caused by the presence of middle ear fluid is immediately resolved by surgery. Children with speech, language, learning, or balance problems may take several weeks or months to improve.

Your ENT specialist will provide specific postoperative instructions, including when to seek attention and when to set follow-up appointments. They may also prescribe an antibiotic ear drops for a few days. An audiogram should be performed after surgery, if hearing loss is present before the tubes are placed. This test will make sure that hearing has improved with the surgery.

Although the tube does have a small opening (about 1/20th of an inch) that could allow water to enter the middle ear, research studies show no benefit in keeping the ears dry, and current guidelines do not recommend routine water precautions. Therefore, you do not need to restrict swimming or bathing in clean, treated water while tubes are in place, and you do not need to use earplugs, head bands, or other water-tight devices unless specifically recommended by your doctor.

Consultation with an ENT specialist may be warranted if you or your child has experienced repeated or severe ear infections, ear infections that are not resolved with antibiotics, hearing loss due to fluid in the middle ear, barotrauma or excessive ear pressure injury, or have an anatomic abnormality that inhibits drainage of the middle ear.

Are There Any Dangers or Potential Complications?

Myringotomy with insertion of ear tubes is an extremely common and safe procedure with minimal complications. When complications do occur, they may include:

  • Perforation—This can rarely happen when a tube comes out or a long-term tube is removed and the hole in the ear drum does not close. The hole can be patched through a surgical procedure called a tympanoplasty or myringoplasty.
  • Scarring—Any irritation of the ear drum (recurrent ear infections), including repeated insertion of ear tubes, can cause scarring called tympanosclerosis or myringosclerosis. In most cases, this causes no problem with hearing and does not need any treatment.
  • Infection—Ear infections can still occur with a tube in place and cause ear discharge or drainage. However, these infections are usually infrequent, do not cause prolonged hearing loss (because the infection drains out), and may go away on their own or be treated effectively with antibiotic ear drops. Oral antibiotics are rarely needed.
  • Ear tubes come out too early or stay in too long—If an ear tube expels from the ear drum too soon (which is unpredictable), fluid may return and repeat surgery may be needed. Ear tubes that remain too long may result in perforation or may require removal by an otolaryngologist.

What Questions Should I Ask My Doctor?

  1. What would be the expected short- and long-term improvement from ear tube placement for my child’s hearing? Speech? Infections? Balance?
  2. What kinds of risks are associated with ear tube placement?
  3. Are there any other procedures that might need to be done at the same time as ear tube placement?
  4. How would ear infections be treated once ear tubes are in place?

1 AAO-HNS/F Position Statement, “In-Office Placement of Tubes in Pediatric Patients While Awake” https://www.entnet.org/resource/in-office-placement-of-tubes-in-pediatric-patients-while-awake/.

EAR TUBES VIDEO

Drs. Nikhilia P. Raol and Daniel C. Chelius provide an overview of ear tubes.

Related Conditions

Pediatric Hearing Loss

Swimmer's Ear

Earaches

The information on ENThealth.org is provided solely for educational purposes and does not represent medical advice, nor is it a substitute for seeking professional medical care.

The post Ear Tubes appeared first on ENT Health.

]]> 1166 Cochlear Implant Health https://www.enthealth.org/be_ent_smart/cochlear-implant-health/ Tue, 25 Sep 2018 18:34:04 +0000 http://www.enthealth.org/?post_type=be_ent_smart&p=1153 A cochlear implant is a device that can be used to improve hearing, and is typically used for people who do not benefit from a hearing aid or other assistive listening devices. Learn more.

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Cochlear Implant Health

A cochlear implant is a device that can be used to improve hearing in people with a specific form of hearing loss known as sensorineural hearing loss (when sound cannot be properly transmitted from the inner ear to the hearing portion of the brain). Cochlear implants are typically used for people who do not benefit from a hearing aid or other assistive listening devices because of the severity of their hearing loss.

Unlike hearing aids, which increase the volume of sound and deliver it to the ear, cochlear implants bypass the area of the inner ear that is not functioning correctly (called the cochlea), and directly stimulate the nervous structures of the inner ear. Additionally, unlike conventional hearing aids, cochlear implants require a surgical procedure. The cochlear implant device has two components: an internal device that is implanted surgically, and an external device that is worn like a hearing aid. This external device picks up sound from the environment and delivers it to the internal device.

What is the Appropriate Age Range for Cochlear Implants?

Cochlear implants can be used on infants, children, and adults with severe to profound sensorineural hearing loss. The minimal age of FDA approval for cochlear implants is 12 months, however, devices have been safely implanted in infants as young as six months. Patients with better hearing at lower tones have been found to benefit from implants as well. There is no maximum age limit; recently, even people in their 90s have successfully received cochlear implants.

How Do I Know If I’m Eligible for a Cochlear Implant?

To see if you or a family member are eligible for a cochlear implant, you should have a hearing test to evaluate your current hearing level. Next, a cochlear implant surgeon will look at your ear’s anatomy and review your hearing test to see if you may be a candidate for implantation. This may include a CT scan or MRI scan of your inner ear to ensure that the device can be safely implanted. You will also meet with an implant audiologist to have a cochlear implant hearing evaluation, which may include a more in-depth evaluation of your ability to hear noise and understand speech. In infants and young children, this testing is typically not performed. Cochlear implants are continually improving and can help many types of hearing loss.

What Does the Surgical Procedure Include?

Cochlear implantation involves placing an electrode within the cochlea to bypass the area of the inner ear that is not functioning correctly, and directly stimulating the nerve. An incision is made behind the ear and a processor attached to the electrode is implanted behind the ear. The procedure is usually a same-day surgery, and you will need to see your surgeon within a few days to two weeks following surgery to make sure you are healing properly.

The device will be tested during surgery to ensure that it is working correctly, and that your ear is responding to the device. However, you will not be able to hear immediately following the procedure to let your wound heal before “activating” the device. This will be done by the implant audiologist approximately two to four weeks following the surgery depending on your age and healing. Once the device is activated, your implant audiologist will work with you to optimize the device’s programming and your hearing response.

Why Are Vaccinations Important for Cochlear Implant Users?

Bacterial meningitis is a serious, life-threatening infection of the brain and the fluid that surrounds the brain. Individuals who have a cochlear implant are at increased risk for bacterial meningitis. Although this risk is small, it is important for children and adults with cochlear implants to be vaccinated against the type of bacteria that seems to cause the majority of meningitis cases, Steptococcus pneumoniae (Pneumococcus). Additional vaccines are available against other potential causes of meningitis, including Haemophilus influenzae type b (Hib) and Meningococcus. These vaccines are widely available and strengthen the body’s defenses against infection.

What Follow-up Care is Necessary?

Children and adults with cochlear implants who develop a middle ear infection (known as otitis media) or a fever of uncertain cause should seek medical treatment and monitoring until the infection resolves. Infections in a child or an adult with a cochlear implant should be taken seriously. Untreated middle ear and other infections may spread to produce meningitis. Cochlear implant users and their families should also be aware that vaccinations do not eliminate the risk of meningitis.

In addition, if an ear with a cochlear implant develops a discharge from the ear canal, causes pain, swelling, or redness around the processor behind the ear, or produces unusual ear symptoms or a watery nasal discharge, it is important to have that ear examined by the surgeon who performed the surgery, or another suitable experienced cochlear implant surgeon.

An annual checkup with an audiologist is recommended to map and reprogram the device as needed to ensure optimal hearing.

What Questions Should I Ask My Doctor?

  1. How do I decide on which ear may need an implant, or both?
  2. What do I do if I experience ear drainage?
  3. What do I do if I experience abnormal sound or changes in sound quality?
  4. What do I do if there is redness around the magnet site?
  5. What alternatives are there for managing my hearing loss?

COCHLEAR IMPLANT VIDEOS

Dr. William R. Blythe provides an overview of cochlear implants.

View Video

Related Conditions

Ear Tubes

Frequently Asked Questions (FAQs) about Age-related Hearing Loss

Pediatric Hearing Loss

Swimmer's Ear

The information on ENThealth.org is provided solely for educational purposes and does not represent medical advice, nor is it a substitute for seeking professional medical care.

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]]> 1153 How to Find the Right Hearing Aid for You https://www.enthealth.org/be_ent_smart/how-to-find-the-right-hearing-aid-for-you/ Tue, 25 Sep 2018 17:35:34 +0000 http://www.enthealth.org/?post_type=be_ent_smart&p=1146 Depending on your degree of hearing loss, type of hearing loss, and other medical factors, you may benefit from a hearing aid. Learn more about selecting the right option for you.

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How to Find the Right Hearing Aid for You

Just like glasses are for patients with vision loss, a hearing aid helps patients with hearing loss. Hearing loss can be caused by many different factors. An ENT (ear, nose, and throat) specialist, or otolaryngologist, is the best specialist to diagnose causes of hearing loss. Depending on your degree of hearing loss, type of hearing loss, and other medical factors, you may benefit from a hearing aid. A primary care physician can refer you to an ENT specialist, who often works with an audiologist, to evaluate the severity and cause of your hearing loss.

More information on possible causes of hearing loss and impairment can be found by reading about autoimmune inner ear disease, conductive hearing loss, sensorineural hearing loss, pediatric hearing loss, acoustic neuroma, otosclerosis, cochlear implant health, genes and hearing loss, noise-induced hearing loss in children, and treating and managing ear fluid.

An audiogram or hearing test, often performed by an audiologist, assesses the hearing loss. The audiogram is a hearing evaluation of your ability to hear sounds and understand words. The results of these tests will reveal the degree of hearing loss as well as additional information about your ears and overall health. A soundproof booth minimizes competing background noise. After the test, an ENT specialist can help you understand your hearing loss and counsel you on how best to evaluate and manage it.

There are also online hearing tests that can identify hearing loss. While they are not as accurate and do not provide all of the measurements included in a complete hearing test, they are useful to identify problems that would justify getting a complete audiogram administered by a hearing professional.

Degrees of hearing loss vary from patient to patient, but generally fall within the following decibel (dB) level categories:

  • Normal hearing: 0-20 dB
  • Mild hearing loss: 20-40 dB
  • Moderate hearing loss: 40-70 dB
  • Severe hearing loss: 70-90 dB
  • Profound hearing loss: greater than 90 dB

How Do Hearing Aids Work?

Hearing aids are small devices that amplify sound and can help people hear better with hearing loss. Hearing aids differ by design, technology used for amplification (i.e., analog versus digital), and other special features. Generally, the microphone receives sound and converts it into a digital signal; the amplifier increases the strength of the digital signal; and the speaker produces the amplified sound into the ear. Properly fitting hearing aids can be adjusted to preferentially amplify frequencies of loss based on an individual patient’s measured loss.

FDA Final Rule Release

On August 16, 2022, the U.S. Food and Drug Administration (FDA) announced the release of a final rule titled, “Medical Devices: Ear, Nose, and Throat Devices; Establishing Over-the-Counter Hearing Aids,” which establishes regulations for the Over-the-Counter Hearing Aid Act, as enacted in the FDA Reauthorization Act of 2017. The final rule took effect on October 17, 2022. The AAO-HNS released the following statement on the rule.

What Are the Different Types of Hearing Aids?

The best hearing aid for you depends on your age, individual hearing loss and listening needs, the size and shape of your ear and ear canal, and how well you can use your hands. Some hearing aids work better with cellphones, televisions, and other sound systems, and some include Bluetooth options. Styles include:

  • Behind-the-ear (BTE) aids go over the ear and are thinly wired to personally fitted earpieces
  • Receiver-in-the-ear (RITE) aids are placed over the ear but are small and nearly invisible
  • In-the-ear (ITE) hearing aids fit in the ear bowl area and part of the ear canal
  • You may also be able to use smaller in-the-ear, or in-the-canal (ITC) aids
  • The least visible aids are completely-in-the-canal (CIC)
  • A hearing aid that sits on the ear drum, similar to a contact lens

In addition, Personal Sound Amplification Products (PSAPs) and other types of over-the-counter (OTC) hearing devices are less expensive than the average hearing aid. The U.S. Food and Drug Administration states that “PSAPs are not intended to be used as hearing aids to compensate for hearing impairment,” but they may be helpful to some people with mild to moderate hearing loss.

Usually, if you have hearing loss in both ears, using two hearing aids is best. Listening in a noisy environment is difficult with an aid in just one ear because it is harder to distinguish where sounds are coming from. Again, your ENT specialist and/or audiologist can help you decide which device may work best for you and your lifestyle.

How Do I Select a Hearing Aid?

As of October 17, 2022, patients 18 years of age or older will be able to purchase OTC hearing aids without a formal hearing test or fitting if they have mild-to-moderate hearing loss. Hearing aids vary according to style, features, and price so selecting the right one is essential. Prices can range from under $1,000 to more than $4,000 for each device depending on the level of technology (insurance providers may not cover the cost). Product quality and proper care can save you repair costs and enhance your satisfaction. You can consult your ENT specialist or healthcare team for recommendations on hearing aid manufacturers that best meet your hearing requirements.

Pros and Cons of Choosing Prescription vs. OTC Hearing Aids

Choosing between prescription and OTC hearing aids involves weighing the pros and cons of each option based on individual needs, preferences, and circumstances.

Pros of Prescription Hearing Aids

  1. Customization: Tailored to the user’s specific hearing loss and ear anatomy, ensuring optimal performance and comfort.
  2. Advanced Features: Typically include superior sound processing technologies, noise reduction, and connectivity options.
  3. Professional Support: Includes thorough assessments, fittings, and ongoing adjustments from hearing healthcare professionals.
  4. Quality Assurance: Stricter regulatory standards and comprehensive warranties provide reliability and peace of mind.
  5. Warranty: Usually extended.
  6. Satisfaction: High patient satisfaction with quality and support.

Cons of Prescription Hearing Aids

  1. Cost: Generally, more expensive than OTC hearing aids due to the professional availability, counseling, and programing included in the cost. Also, the hearing devices have automated multi-situation modes and advanced technology, which increases costs.
  2. Time-consuming: The process of obtaining and adjusting prescription hearing aids sometimes involves multiple appointments, which can be time-consuming.
  3. Accessibility: Requires a visit to a hearing healthcare provider, which might be inconvenient for some individuals.

Pros of OTC Hearing Aids

  1. Affordability: Usually less expensive than prescription hearing aids, making them accessible to a broader audience.
  2. Convenience: Can be purchased directly from stores or online without the need for professional evaluation.
  3. Quick Solution: Provides immediate relief for those with mild-to-moderate hearing loss.

Cons of OTC Hearing Aids

  1. Limited Customization: One-size-fits-all approach may not address specific hearing needs or fit comfortably.
  2. Basic Technology: Generally, lacks the advanced features and sound processing capabilities of prescription models.
  3. Audiogram Access Difficulty: To optimally program a hearing device an accurate audiogram (or, hearing test), which may be difficult outside a hearing healthcare professional’s office.
  4. Lack of Professional Support: Absence of professional fitting and follow-up care can result in suboptimal performance and user dissatisfaction. Maintenance, cleaning, and technology utilization of hearing aids may be difficult or impossible for some.
  5. Returns: May be difficult or impossible depending on the vendor.

Related Conditions

Frequently Asked Questions (FAQs) about Age-related Hearing Loss

Hearing Loss with the Use of Protective Face Masks

hearWHO Hearing Screening App

OTC Hearing Aids FAQs

The information on ENThealth.org is provided solely for educational purposes and does not represent medical advice, nor is it a substitute for seeking professional medical care.

The post How to Find the Right Hearing Aid for You appeared first on ENT Health.

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