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Ageing and Hearing Loss

Saturday, March 2, 2019 2:01:14 PM Asia/Calcutta

It is true that hearing loss occurs in most of us as we grow older. Age-related hearing loss or presbycusis is quite a common issue these days that affects older and elderly adults, and sadly in most cases, it is unpreventable. You can only try to stay healthy as long as possible.

In the US, approximately 1 in 3 people in between the age group of 65 and 74 have hearing loss, and about half of those who are of 75 years and above have difficulty hearing. Hearing impairment is ranked third in the list of chronic health conditions which affect people belonging to the age group of 65 and above.

According to the World Health Organization (WHO) estimates, within the year 2025 there will be about 1.2 billion people over 60 years of age worldwide, with more than 500 million individuals who will suffer a significant hearing impairment from presbycusis, also known as an age-related hearing loss.

Presbycusis has a major impact on the quality of life of a person and is related to a significant reduction in his or her communication skills. It also affects the psycho-social aspects of an individual, such as inducing progressive isolation, possibly exacerbating anxiety-depressive status and/or accentuating possible cognitive deficits.


Classifications of Presbycusis

Schuknecht, et al. 1993 categorised presbycusis into four types based on pathology and audiometric findings - sensory, neural, conductive, and metabolic (strial).

  • Sensory presbycusis is defined as epithelial atrophy and loss of sensory hair cells as well as the supporting cells of the organ of Corti, which arise from the base and progress towards the apex. In this type of presbycusis, the slope of the audiogram (a graph which shows the results of the pure-tone hearing test) occurs in the high frequencies, therefore, the speech discrimination is preserved.

  • Neural presbycusis results from nerve cells atrophy in the cochlea and central neural pathway. Atrophy occurs throughout the cochlea with no sheer or dangerous drops in the high-frequency threshold in the audiogram. The speech discrimination decreases severely even before hearing loss is recorded.

  • Conductive or mechanical type arises from thickening and secondary stiffening of the basilar membrane of the cochlea with a gradual sloping high-frequency sensorineural hearing loss. Speech discrimination is preserved in this type of presbycusis.

  • Atrophy of stria vascularis results in metabolic or strial presbycusis which affect the entire cochlea and show a flat curve in the audiogram.


Why Do People Get Hearing Loss as They Age?

There are many factors which contribute to hearing loss as you start ageing. Although it is quite difficult to distinguish age-related hearing loss or presbycusis from other factors that might be responsible for it, yet let us take a look at the possible reasons that might cause hearing loss as you age.

  • Noise-induced hearing loss (NIHL) - It is caused either by long term exposure to sounds which are either too loud or which last for too long. This exposure causes damage to the hair cells present inside the cochlea of the inner ear, which are responsible for converting sound waves into neural signals, thus making them ready to be sent to the brain via the auditory nerve. Once damaged, these hair cells can never grow or regenerate. They are gone forever! Therefore the term ‘permanent hearing loss’!

  • High blood pressure or hypertension - The link between hearing loss and high blood pressure is pretty simple. When your blood pressure is high, your blood vessels are damaged, which is not limited to just one area in your whole circulatory system and thus includes your ears as well and hampering proper blood circulation. In simple words, if the blood circulation in your ears is affected, your ears won’t work well and thus leading to hearing loss problems.

  • Diabetes - High blood glucose levels can damage the small blood vessels in the inner ear, thus affecting your hearing abilities.

  • Ototoxic medications - Medications, like chemotherapy drugs are toxic to the sensory cells of your ears, thus affecting their functioning and causing hearing loss.

  • Genetics - Yes your parents hearing health matters! Some diseases like Otosclerosis, Usher Syndrome, Pendred Syndrome, which cause hearing loss are hereditary.

Apart from these common causes of age-related hearing loss, there can be cases like sudden damage to the internal structure of the outer or the middle ear due to various reasons like a serious injury. However, these conditions are very less as far as presbycusis is concerned.

Studies show that most of the older people who acquire a hearing loss have a combination of both age-related hearing loss and noise-induced hearing loss.


Age-related hearing loss is a gradual process and often occurs in both the ears, affecting them equally. And the sad part is that in most of the cases an individual may not even realise that he or she is suffering from age-related hearing loss and that he or she has lost some of his or her hearing ability. And this realisation is generally late until there are some other damages associated with it. Of course, there are so many hearing loss treatment options, the most common being hearing aids, but you just need to take that action.

But the question arises, ‘How would you know that you have hearing loss?’

There are many signs which tell you that its time that you take serious action. If you are still confused about whether you are suffering from hearing loss, here’s a simple checklist for you. Ask yourself and try to answer all of them. If you answer with an ‘Yes’ to three or more of these questions, then it’s a good chance that you are having some degree of hearing loss.

  • Do you feel embarrassed while meeting new people?

  • Do you feel that others are mumbling?

  • Do you often ask people to repeat themselves?

  • Do you often find it difficult to understand what others are trying to convey and hence feel frustrated?

  • Do you face problems while listening to the radio or the TV and hence end up raising up the volume which is too loud for others?

  • Do you have a hard time hearing while at the movies or at the theatre?

  • Do you have trouble hearing when you are at a restaurant with your family and friends?

  • Do you face difficulties in understanding speech in a noisy area?

  • Do you have difficulties in differentiating between ‘s’ and ‘th’ sounds?

  • Do you have difficulty understanding what your co-workers, clients or customers are trying to say?

  • Do you often end up arguing with your family members because you are unable to understand them?

  • Do you often avoid attending social gatherings?

  • Do you often avoid making phone calls or even receiving them, thus end up giving excuses via text messages like ‘I was not carrying my phone’ or ‘My phone was silent’, etc.?

  • Do you have a sensation of ringing in the ears or tinnitus?


Now that you know that you might have hearing loss (and that’s why you are reading this blog), head on to know how to fight against it.


How to Fight Against It?

Do not panic! The first and foremost thing that you should do is to get up from your chair at the corner of your room and step outside your house! Visit your nearest hearing clinic or a professional Audiologist and get your hearing tested. An ideal Audiologist is supposed to test your hearing thoroughly, provide you with an audiogram report and explain you the test results in details. Depending on your test results - that is the type and the intensity of your hearing loss, your Audiologist will suggest you the hearing aids (devices that are worn in the ear to enable you to hear better) which would best suit your hearing needs as well as your personal preferences.

A good Audiologist will also do a test and trial with a few hearing aids of various types and determine with which device are you responding the best. Also, he or she would also help you out in the days to come if you face any problems with your device in the future - such as reprogramming and fitting.

Keep in mind that hearing aids are not like eyeglasses, which would give you a clear vision immediately after wearing them. Hearing aids don’t just work that way. It takes time for your brain to adjust to this new hearing world which it was missing for all these days because of your untreated hearing loss.

If, however, you find that your hearing aids are not giving you many benefits even after using them for a long time, then you need to consult your Audiologist immediately. It might be that your hearing loss is so severe such as in case of a severe to profound degree of sensorineural hearing loss, then your Audiologist might recommend you to go for a cochlear implant, an electrical device that is surgically implanted inside your ear and in which you would get a permanent hearing solution, and unlike hearing aids you don’t need to change the device after using it for some years. A cochlear implant only needs to be updated from time to time.

Apart from hearing aids and cochlear implants, there are other devices as well such as assistive listening devices which include telephone and cell phone amplifying devices, smartphone apps to enhance the listening experience and closed-circuit systems like hearing loop systems (example microphones) which are found in places like a theatre, a temple or at some other public event.

Lip reading or speech reading is another option to assist hearing impaired people and to help them understand better what others are trying to convey. Lip reading involves paying close attention to lip movement as well as other body language movements and gestures.


The best way to avoid hearing loss problems is to prevent it. Because prevention is always better than cure!


How Can I Prevent Age-Related Hearing Loss?

Although at present, proper preventive measures of age-related hearing loss have not been found, yet there are certain ways following which can help you prevent hearing loss due to ageing. These are as follows -

  • Protect your ears and avoid being overexposed to loud sounds. In this way, you can prevent noise-induced hearing loss. Use earplugs or other protective wearables whenever you are near a source of some loud sound.

  • Avoid the intake of ototoxic medications until and unless you have no other option.

  • Take care of your high blood pressure and diabetic problems by consulting a good health professional.

  • Get your ears checked from time to time to prevent any serious hearing loss problems in the future.

  • Avoid smoking and drinking.

So stay healthy and hear better for as long as you can!

0 Comments | Posted in Digital Hearing Aids Hearing Aids By Phalguni Bannerjee

Can Hearing Aids Help Tinnitus?

Friday, November 2, 2018 6:44:59 PM Asia/Calcutta

Are you worried about Tinnitus, and tired of living with it for a long time now? Are you wondering whether you will ever get cured of it? The good news is, some Tinnitus problems can be managed with the help of hearing aids. However, it cannot be fully cured with the help of these devices - no matter how technologically advanced digital hearing aids you are using. Also, you must realise that you should consult a certified Audiologist at the earliest - because delaying or avoiding Tinnitus won’t be a solution!


Incidence and Prevalence

According to the CDC estimates, in the US, the prevalence of Tinnitus is about 15% of the total population (that is, about 45 million Americans) - and a majority of them are senior citizens belonging to the age group of 65-85. Apart from ringing in the ears, Tinnitus is also associated with other sounds, such as buzzing, humming, hissing, or even roaring, and in some cases cricket-like - even when there is no presence of external sounds! Tinnitus can occur either in one ear or both the ears, or even in the head - and the ringing sounds can be either constant or intermittent. It has become a common problem nowadays, and about 2 million Americans are suffering from quiet an alarming or chronic stages of Tinnitus. The result being - effect on daily functioning, a decline in the productivity at workplace, difficulties concentrating in academics, misunderstandings in relationships and among family members, sleep disturbances, and worse still - it might affect emotional or psychological conditions.


How Can Hearing Aids Provide Tinnitus Relief?

There are many varieties of advanced and smart digital hearing aids which help manage and reduce tinnitus problems. However, apart from hearing devices, there are many other tinnitus instruments which can be clubbed together with the use of these digital hearing aids to improve outcomes and enhance tinnitus relief. Also, there are various maskers and home masking devices which are used to cover up or conceal the tinnitus sounds.

There is a specialised therapy known as Tinnitus Retraining Therapy (TRT) - which uses cognitive behavioral therapy along with a masking device which makes the person suffering from Tinnitus learn to ignore the background noises of Tinnitus.

All of these methods have the sole aim of comforting or lessening the problem, thus making tinnitus less audible - because tinnitus cannot be cured completely; it can only be treated and in the true sense, be ‘masked’.


Now What is Meant by Masking of Tinnitus?

Just like hearing loss, tinnitus is a problem which cannot be cured, it can only be treated. In other words, if your tinnitus problem is caused due to hearing loss, then hearing aids can help manage and comfort your ringing sounds. It is because when you were living with an untreated hearing loss, your brain was not able to receive all the sounds due to lack of stimulation in the specific sound frequencies in which you are having the loss. For example, you may not be able to hear the sound of birds chirping if you have a high frequency hearing loss.

After you have opted for advanced digital hearing aids, you will again be able to hear those sounds in these frequencies. Studies have shown that after this amplification with the help of hearing machine, people who have hearing loss along with tinnitus, have reported a significant decline in the severity of tinnitus problems as well.

The reason behind this is after the adaptation of digital hearing aids, one is once more able to listen to natural sounds of the surrounding environment, such as the rustling of the leaves, the rainfall, the splash in the pool, the singing of the cuckoo, and so much more - which they were missing for all these days! This ability to hear these natural sounds acts as a ‘masking’ effect for tinnitus - due to which a person who is suffering from both hearing loss and tinnitus will at least be relieved from the annoying ringing sounds which were hampering his/her life activities for so long!

Also, in addition to improving the hearing and communication abilities of the concerned person, hearing aids also amplify the background sounds. This helps reduce the loudness or the prominence of Tinnitus, and help the person concentrate more on the sounds of nature. Simply taking one’s concentration off the disturbing Tinnitus sounds serves as a relief for many people. Besides, on using digital hearing aids, a person is no more required to strain while trying hard to hear something properly. This itself reduces stress, as hearing devices are meant to improve communication, and thus, the concerned person is relieved from Tinnitus problems.

However, you will be surprised to know that there are many advanced digital hearing aids today that are aimed at directly managing Tinnitus problems. So why should you delay in opting one? Just go ahead and stay away from the icy pangs of tinnitus!

Comments | Posted in Digital Hearing Aids By Phalguni Bannerjee

5 Tips to Get the Best Out of Your Digital Hearing Aids

Monday, September 3, 2018 11:39:56 AM Asia/Calcutta

The modern day smart and advanced digital hearing aids are designed to provide you the best hearing experience. People worldwide have given quite positive feedbacks after using digital hearing aids for sometime - and are living quite happily. But there is a trick! To get the best out of your hearing aids, you need to follow certain rules and tips, so as to get connected with the hearing world better!

Digital Hearing Aids

Tips to Hear Better with Digital Hearing Aids

  • Wear them for most of the day! Never go without your hearing aids at any time of the day, even while at home. If you keep them aside, your brain might start forgetting certain natural sounds which it did not hear for a long time. Give your brain enough food for it to stay in good working condition.

  • Start by using your digital hearing aids in a quiet room. One-to-one conversations at home might help, as no background noise would distract you.

  • If you are a new hearing aid user, or are using it after a long time, then follow conversations at TV and radio. If you are watching a movie, then try following the subtitles. It will make you understand speech more easily. Remember! Escaping from difficult situations won’t help! You have to face them to wipe away your fears!

  • Try using them in noisier environments. Go out at a busy crowd, a local supermarket or a restaurant. It will help improve your speech perception even in noise, and will also help your digital hearing aids store your preferred programs so that these can be referred to whenever needed.

  • Use the phone well. Place the phone close to the hearing aid’s microphone. It will enhance your speech perception, and will also reduce whistling and other feedback sounds from the device.

So what are you doing to get the most out of your valuable digital hearing aids?

Comments | Posted in Digital Hearing Aids By Phalguni Bannerjee

The Concept of Directionality Used in Digital Hearing Aids

Monday, August 6, 2018 5:30:55 PM Asia/Calcutta

The progress and development of hearing aids is an amazing procedure worth studying! Right from its beginning of its evolution starting with horns, down to the modern day digital hearing aids, hearing devices have been continuously been incorporated with innovations and technological advancements. While the past few decades saw the use of analog hearing aids, the past few years have being seeing a wonderful evolution of the technologically advanced digital hearing aids that have proved themselves to be absolutely indispensable in the present generation.


What is Directionality?

First let us understand what are directional systems. We, as the listeners, are surrounded by various kinds of sounds throughout the day - even during sleep! It is just that while we are asleep, our brain simply ignores any incoming sounds, and hence let’s us have a ‘sound’ sleep! We get to hear sounds coming from every direction, and our brain is clever enough to understand and identify which sound is coming from which direction! Thus, we can understand whether a speeding car is approaching from the left backside or the right while we are on the roads!

But among these hundreds and thousands of sounds that we get to hear every single day, some are soothing to us, some are important to us, while some are absolutely unwanted to us. Our brain again does the job of filtering each of these sounds - it helps us stay focussed on the important and soothing sounds that we actually want to hear, by preventing all the unwanted and disturbing sounds (termed as noises) from diverting us.

This same mechanism is adapted by the digital hearing aids of our generation. The term ‘directionality’, therefore, refers to a hearing aid’s sensitivity to the different kinds of sounds coming from various directions. This feature of directionality is now incorporated in the digital hearing aids of today, which help us to stay focussed on some particular sounds which are important for us - by leaving out the unwanted noises; such as the ones coming from front of us like speech sounds, while the background noises are diminished or are cancelled out altogether.


What are the types of Directionality?

  • Omni-directionality

Omni-directionality refers to the phenomenon in which the hearing aid amplifies each and every sound coming from all the directions. If we imagine ourselves standing at the centre of a circle, the sounds which are coming from the centre as well as from the further distance on or near the circumference, are all amplified equally.

Omni- Directional Systems in Hearing Aids

  • Fixed Directionality

This feature is found today in most of the digital hearing aids, which enables them to amplify those sounds which are coming from your front, such as the speech sounds coming from the speaker you are conversing with and who is sitting in front of you. Suppose you are sitting at a dinner table and you want to listen to a particular person speaking with you, and hence do not want to listen to what the other persons sitting at the sides or at the back of you are saying. The Fixed Directionality feature present in digital hearing aids is capable of distinguishing between speech and noise, and hence reduces or cancels out the background sounds, and amplifies and makes you stay focussed only on the important sounds in front.

Fixed Directional Systems in Hearing Aids

  • Adaptive Directionality

But what if the source of the sound keeps changing? It means that the direction of sound is also changing, thus constantly shifting your point of attention. What if you want to listen to people speaking from various directions around you - such as from the front, back and the sides? In such a case, the Adaptive Directionality feature found in almost all the advanced and updated digital hearing aids, comes at your rescue! This system has a remarkable speed of analyzing the loudest sounds which enables you listen to all the important sounds coming from all the directions around you. The feature is also advanced enough to take into account different sound frequency ranges and analyzes and adjusts the amplification in each of them. Accordingly it enables us to hear only specific ones, which we want to hear - by cancelling out the unwanted ones.

Adaptive Directional Systems in Hearing Aids

  • Hybrid Adaptive Directionality

This feature performs exactly like a healthy, open ear canal. It is much more advanced due to its capability to help the person wearing digital hearing aids actually listen clearly to important sounds even in challenging situations - such as the wind, or at environments which have a echo - such as at a wide hilly region. The Hybrid Adaptive Directionality feature combines two patterns - the Adaptive and the Omni Directionality ones. It maintains the important sounds by “fixing” or adjusting the amplification on the low frequency ranges and constantly adapts to the higher ones so as to help reduce the unwanted noises.


In a nutshell, it is always advised by certified Audiologists to go for the advanced and the more updated digital hearing aids, as they would not only make you hear better, but would also enable you to enjoy what you hear!

Comments | Posted in Digital Hearing Aids By Phalguni Bannerjee

5 Tips to Hear Better in a Noisy Environment

Saturday, June 30, 2018 7:10:30 PM Asia/Calcutta

It is often advised by Audiologists to avoid communicating in a noisy environment, especially if you are suffering from hearing loss and is a new user of digital hearing aids. This trick really works in adjusting to the new world of hearing. But what if you have no choice but to attend or go through some noisy situation? Or if you are the one who have been indoors for quite a while now, and are planning to face this world with your new digital hearing aids on? In either of the case, the very foremost thing that you need to do is to stay calm and not to panic. We are here to help you out!


What are the Tips to Help Me Communicate Easily in a Chaotic Environment?

Although the modern day digital hearing aids are designed to make you feel comfortable even in some cacophonous situation, yet you need to know some tricks and tips about how to tackle these unwanted situations, especially if you are a new hearing aid user. If, however, you are feeling comfortable in using analog hearing aids and are reluctant to switch over to digital hearing aids, our advice is either to opt for the later (after consulting an experienced Audiologist) which are much more advanced, thus having the capability to handle noisy situations, or else it is a must for you to follow these important tips for communicating in such situations. So let’s go through 5 most important ones which you MUST follow!

1. Use two hearing aids rather than one. There are a number of advantages of using two hearing aids which include -

     a) The better ability to hear sounds from all directions coming from either side.

     b) Increased loudness and clarity, as the amplified sounds are equally distributed to both the ears.

     c) You will be able to understand and locate from which direction the sound source is originating.

     d) Using binaural devices, especially digital hearing aids, will increase your ability to hear speech sounds better and will enhance speech understanding even in noisy backgrounds.

     e) Using binaural digital hearing aids will prevent accidents from happening. If you are on the streets with only one hearing aid put on, you might have a wrong notion of the direction of a vehicle approaching from behind. For example, you are on a major crossing and a car is speeding from behind from the right side (suppose). In such a case you might assume that it is coming from the left side, because you are wearing your device in the left ear (suppose). It is a dangerous situation as your brain will prompt you to move to the right side from which the car is actually proceeding. It might lead to serious accidents.

Although you might do better with one hearing aid in normal situations, but in noisy situations you will realize that your devices are performing better.

2. Use digital hearing aids as they have digital signal processing (DSP). This technology allows the device to differentiate between speech and noise. In other words, the digital hearing aids - due to their DSP technology - enable you to listen to speech sounds clearly as the device reduces or cancels out background noise. Also, you must use the directional microphone setting of your digital devices so that you can switch the device from an omnidirectional setting to a directional setting. In case you do not know the difference between the two - if your digital hearing aids is in the omnidirectional mode, then you will hear sounds coming from all directions - namely front, back, right and left, top and bottom. But if you switch over to the directional setting, your hearing aid will pick up only the primary sounds which are coming from the front of the hearing aid user. So if you sit face-to-face with the speaker, you will clearly be able to listen to his/her speech - and not only listen, but also understand what the person is saying. In this case, you are able to focus only on a particular and an important sound source - which is speech. To attain the best result, make sure that the directional microphone is properly positioned.

3. Use the FM technology of your digital hearing aids. FM technology is the best solution for you if you have difficulty hearing in noise. It comprises two components -

     a) An FM transmitter which will pick up the speaker’s speech sounds and send it to the FM receiver.

     b) An FM receiver which will receive the speech sounds picked up by the transmitter and deliver them directly to the person’s ears (such as via loudspeakers).

FM technology is an advanced feature in the modern day digital hearing aids, as it helps the user clearly listen to the speech sounds which are which are closer to him/her. This technology amplifies the speech and makes it louder than the other background noises as much as 20 dB higher.

4. Take part in regular auditory training sessions. Recent researches have proved auditory training programs for adults with hearing impairment to be quite effective in improving their speech understanding capability in noise, while using advanced digital hearing aids.

5. Be at a comfortable position while conversing and face the speaker properly. Choose a place which is not dark, but well-lit. Make sure that the speaker’s face is visible clearly enough. This will enable you to read the person’s lips while trying to listen and understand his/her speech.


To conclude, the above tips will be quite effective in enabling you to listen much clearly even in noisy areas, especially if you are a new hearing aid user, and will also enhance your speech understanding capability. If you are still facing problems in understanding speech even while using good quality digital hearing aids, you must immediately consult an expert and certified Audiologist without delay.

Comments | Posted in Digital Hearing Aids By Phalguni Bannerjee
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