Understanding Severe Hearing Loss
Hearing loss can range from mild to profound, with severe hearing loss defined as a loss of 70-90 decibels. This level of hearing loss significantly impairs communication and often requires the use of powerful hearing aids or cochlear implants. According to the National Institute on Deafness and Other Communication Disorders (NIDCD), approximately 1 in 1,000 children are born with profound hearing loss, defined as a loss greater than 90 decibels. This translates to over 38,000 babies born each year in the US with severe to profound hearing loss. Understanding the implications of severe hearing loss and the available treatment options is critical.
Causes of Severe Hearing Loss
There are many potential causes of severe hearing loss, including:
- Genetic factors - Approximately 50% of hearing loss cases have a genetic origin
- Complications at birth - Such as low birth weight, lack of oxygen, and neonatal jaundice
- Infections - Like meningitis, cytomegalovirus, and rubella
- Chronic ear infections
- Exposure to loud noises
- Aging
- Head trauma
- Certain medications and chemotherapy drugs
Effects of Severe Hearing Loss
Without treatment, severe hearing loss can have significant effects on a person's life, including:
- Delayed speech and language development in children
- Social isolation and loneliness
- Difficulty learning and reduced academic performance
- Increased risk of accidents due to lack of auditory cues
- Higher unemployment rates
- Cognitive decline in older adults
Fortunately, with early identification and proper hearing aids or implants, many of these effects can be prevented or minimized.
Hearing Aid Options for Severe Loss
While no device can restore normal hearing, hearing aids and implants provide significant benefit to those with severe hearing loss. Powerful hearing aids can amplify sounds up to 80-90 decibels for severe losses, while cochlear implants can stimulate the auditory nerve directly. Let's explore the leading hearing aid options for severe hearing loss.
Behind-the-Ear (BTE) Hearing Aids
Behind-the-ear hearing aids are the most powerful and versatile style available. They fit behind the ear and are connected to a custom earpiece via tubing. BTE aids are excellent for severe hearing loss for the following reasons:
- More amplification - The larger size accommodates bigger batteries and components.
- Adjustable fit - The tubing and earpieces come in various sizes for a customized fit.
- Advanced features - They can accommodate telecoils, Bluetooth connectivity, and directional microphones.
- Easier adjustments - The controls and settings are easier to access on the exterior.
BTE hearing aids range greatly in price based on included features. Basic models start around $1400-$1600 per pair, while advanced digital versions go up to $2500-$5000. They are suitable for adults and children with profound hearing loss.
In-the-Ear (ITE) Hearing Aids
In-the-ear hearing aids fit completely inside the ear. They are custom-made to perfectly fit the unique shape of the wearer's ear canal. ITE aids can provide extra power and amplification in a discreet package by:
- Increased vent size - Allows optimal air flow to amplify sounds.
- Tighter seal - Prevents feedback and minimizes echo.
- Closer to eardrum - Delivers amplified soundwaves directly to the eardrum.
However, ITE hearing aids are not recommended for children still growing and those with severe ear malformations. They range in price from $2000-$3000 per pair.
In-the-Canal (ITC) Hearing Aids
In-the-canal hearing aids sit partially inside the ear canal. They are larger than completely-in-canal aids but smaller than full ITE styles. ITC aids have some benefits for severe loss:
- Discreet appearance - Only small portion sticks out visibly.
- Good amplification - Bigger size than CIC allows more power.
- Comfortable fit - Custom-molded to the unique ear canal shape.
However, ITC aids are not as versatile and amplified as the larger BTE and full ITE styles. They cost approximately $1700-$2500 per pair.
Cochlear Implants
Cochlear implants are small electronic devices surgically implanted under the skin behind the ear. They convert sounds into electrical signals that stimulate the auditory nerve directly, bypassing damaged portions of the ear. Cochlear implants are an option for severe to profound hearing loss when conventional hearing aids no longer provide benefit.
The components include:
- External microphone and speech processor - Worn behind the ear to detect and process sound.
- Transmitter and receiver - Receives signals from processor and converts to electrical stimuli.
- Electrode array - Surgically implanted into the cochlea of the inner ear to stimulate the auditory nerve.
Though the surgery and therapy required is extensive, cochlear implants can restore useful hearing to those with even total deafness. However, at $50,000-$100,000, the cost is significantly higher than hearing aids.
Factors in Choosing Hearing Aids for Severe Loss
Choosing the right hearing aid for severe loss is crucial. Some factors to keep in mind include:
Degree of Hearing Loss
Consider your exact level of hearing loss, from severe to profound, to determine how much amplification you need. Talk to your audiologist about your latest hearing tests.
Type and Severity of Ear Damage
Certain types of inner ear hair cell damage reduce the effectiveness of amplification from hearing aids. In these cases, cochlear implants may provide better results.
Age and Lifestyle Needs
Younger individuals often benefit more from cochlear implantation due to the importance of auditory stimulation in language development. Factors like cosmetic appeal and dexterity also come into play.
Unilateral vs. Bilateral Loss
For single-sided deafness, CROS hearing aids or bone-anchored implants may be an option to consider in addition to standard unilateral aids.
Cognitive Function
Since cochlear implants require extensive speech therapy, those with cognitive decline may not be good candidates. Traditional hearing aids may be easier to adjust to.
Cost
Hearing aids range from $1400-$3000 per device, while cochlear implants cost $50,000-$100,000. Insurance coverage and personal finances play a major role.
Types of Technology in Hearing Aids for Severe Loss
Hearing aids for severe loss incorporate a variety of technologies to provide maximum benefit. Some key features include:
Digital Sound Processing
Digital sound processing provides more precise amplification than analog models based on your unique hearing profile. Adjustments can be made via smartphone apps.
Feedback Reduction
Advanced feedback cancellation technology prevents annoying whistling and echoing, especially helpful for severe loss requiring high amplification.
Noise Reduction
Directional microphones and adaptive noise reduction filters help suppress distracting background sounds to amplify speech signals.
Wireless Connectivity
Bluetooth allows seamless audio streaming and hands-free phone calls. Compatibility with iOS and Android makes hearing aids easier to control remotely.
Rechargeable Batteries
Some higher end models have integrated lithium-ion batteries that recharge overnight for maximum convenience.
Direct Smartphone Connectivity
Made for iPhone hearing aids connect directly to Apple devices for streaming and adjustments via accessible controls.
Care and Maintenance of Hearing Aids for Severe Loss
Properly caring for powerful hearing aids requires some minor maintenance:
Keep Them Dry
Moisture can damage hearing aid components. Use a dehumidifier or drying kit.
Clean Regularly
Follow manufacturer guidelines on cleaning. Avoid getting debris in microphone ports.
Store Safely
Keep hearing aids in a protective case when not in use. Turn off and remove batteries when storing for prolonged periods.
Replace Wax Guards
Wax guards prevent earwax buildup. Check and replace them about once a month.
Monitor Battery Life
Carry extra batteries when on-the-go. Rechargeable models require careful overnight charging.
Keep Them Updated
Download software and firmware updates periodically to keep hearing aids working at peak performance.
Overcoming Challenges of Severe Hearing Loss
Though severe hearing loss poses many challenges, the prognosis can be good with proper treatment and support. In addition to hearing aids and cochlear implants, be sure to:
- Learn lip reading skills
- Benefit from speech therapy
- Join a support community
- Consider learning sign language
- Educate friends and family
- Advocate for accommodations
- Treat associated ear diseases
- Remain patient and proactive
Severe hearing loss may feel overwhelming and isolating at times. But by understanding the available treatment options and taking advantage of support services, you or your loved one can continue thriving and communicating in daily life.
Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.
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