Types of hearing aids

Synonyms

Hearing Aid, Hearing Aid, Hearing Aids, Cochlear Implant, CI, In-Ear Hearing System, IdO, RIC Hearing Aid, Behind-The-Ear, BTE, Hearing Aid, Earbuds, Concha Hearing Aid, Micro CiC, Noise, Tinnitus Noiser, Tinnitus mask, receiver-in-canal, tinnitus control instrument

English: hearing aid

Which hearing systems are available, how are these hearing aids today structured in detail and what makes them different?

First of all, the behind-the-ear devices (BTE) are called. They are placed behind the ear and connected to the earmold by a small tube that runs over the ear to the front.
Depending on the model, behind-the-ear hearing systems can compensate for almost all types of hearing loss, from mild hearing loss to severe hearing loss. Since today's design is smaller and smaller - with the exception of the slightly larger SuperPower systems - and a special-individual adaptation technology is used, the wearing of such a hearing aid is hardly noticeable anymore. Often a BTE system is equipped with a microphone with omnidirectional characteristics, which absorbs the sound evenly from all sides (multidirectional microphone system). This facilitates listening in a noisy environment.
BTE hearing aids can be subdivided into "open" and "closed" systems. However, the latter almost completely fill the outer ear and auditory canal with the earmold. The "closed" system is flexible and individually customizable, which makes them suitable for very different forms of deafness. This conventional BTE system is more powerful, albeit slightly larger than the ones described below. But this also makes it easier to maintain, for example, when changing the battery or when cleaning.
For the earmold an individual ear impression of the wearer is made. This gives it a nearly perfect fit. It forms the bridge between the BTE system and the ear. As the most important component of the hearing aid, the earmold has numerous acoustic functions. His main tasks are the transmission of the amplified sound signals to the eardrum and the pleasant interference-free fit in the ear and thus to ensure the reliable hold of behind the ear part of the hearing system.

Last but not least, feedbacks, these high, whistling noises - often perceived by persons in the environment as extremely disturbing - can be prevented. This is achieved in that the earmold closes the ear canal as tight as possible.
As an advantage of the "open" behind-the-ear hearing aid supply you can see that it usually closes the ear only slightly. Instead of an earmold there is here a thin sound tube ( slim tube ) as a link between the hearing aid and eardrum. As a result, these systems score points with their high sound quality, greater wearing comfort and optimal auditory canal ventilation. All this prevents moisture from accumulating. Unfortunately, this hearing aid can not be used for such a wide range of deafness as the conventional "closed" models.
The just presented "open" hearing aid is similar to the receiver-in-canal ( RIC) hearing system, in which, unlike most other BTE hearing aids, the speaker is no longer behind the ear, but directly sits in the ear canal and is connected by a thin tube to the hearing system. This makes these hearing aids particularly small, light and unobtrusive.
But there are also so-called in-the-ear hearing systems (IdO). These are individually tailored and placed directly and completely in the pinna and ear canal. For this purpose, an ear impression is made for a more precise fit in the ear. Also in this system, there are again different types, which can compensate for depending on Hördefekt slight but only medium hearing.
Various construction options also provide a good selection here: Concha hearing aid filling from the auricle to the smallest hearing aid, which completely disappears into the auditory canal and is called Micro-CiC.
In addition, there are the hearing glasses. This is a pair of glasses that integrates either a hearing aid technology in their temples, or at the temple a hearing aid is mounted. Often the earmold ( earmold ) and the battery compartment are located at the back of the bar. An easy-to-use connector allows easy replacement of the glasses front.
For special diseases, especially of the outer ear, bone conduction hearing systems can be used. In these hearing aids, the sound is not transmitted through the air in the ear canal to the eardrum, but passed over the bone directly into the inner ear. This is necessary, for example, when there is no auditory canal, or secretions are secreted in the auditory canal, which makes it impossible to supply a BTE or ITE hearing aid.
Such a device has a sound transducer that transmits vibrations to the mastoid, a bone behind the ear that belongs to the temporal bone. This causes the inner ear to vibrate, which the deaf person can hear as sound information. Most bone conduction hearing aids are manufactured as hearing glasses. But there is also the possibility to carry a pocket hearing device with a bone conduction. This is then attached to a headband or headband.
Mostly in small children with congenital auditory canal malformations, bone anchored hearing aids are used. Here an ENT doctor surgically implanted a titanium screw in the cranial bone. The hearing aid is then fastened on this screw (BAHA = bone anchored hearing aid) for bone-anchored hearing aids. Due to the direct coupling, these hearing aids transmit larger sound pressures and thus find use even for severe hearing loss.
In addition, there is the cochlear implant, short CI. This is a high-tech, medical device that helps people who suffer from extremely high-grade inner ear hearing loss or deafness improve their hearing. Approximately 700 cochlear implants are currently being performed each year. And the number is rising steadily. Persons affected by extremely severe inner ear hearing loss usually do not make conventional hearing aids successful, as the problem is not the insufficient transmission of sound stimuli to the cochlea receptors, but the process of transforming the sound into the human brain is disturbed useful information. A pure amplification of the sound waves has no success.

This severe hearing loss has serious consequences especially for children, as they have no or only insufficient and therefore delayed ability to learn to speak. With them, hearing aids can and should be adjusted as early as the 4th - 6th month. Normally, normal language development goes through a relatively regulated sequence of stages: from the 2nd month the children start to laugh, from the 8th month the first speech is understood, then at the age of one, two and three years one, two, three Three-word and multi-word phrases, until at 4 years speech development is complete. Therefore, especially in deaf-dormant children and adults, extremely high-grade hearing impaired with a demonstrably low hearing gain by a hearing aid and especially in deaf-born children earliest possible diagnosis and appropriate treatment is urgently required.

But what does such a cochlear implant consist of?

It is essentially divided into two parts:
The implant is surgically implanted by an ENT surgeon. Behind the ear or in the breast pocket, on the tether or on the belt, the processor is carried, which consists of a speech processor, a battery part, a cable and a coil.
The functionality is actually quite simple to describe: First, a microphone picks up the sound and converts it into electrical signals. Then the speech processor processes these signals and translates them according to the programming into a special impulse pattern. These are routed via a thin cable to the coil and sent from there through the skin to the implant. The implant, in turn, is in contact with the auditory nerve via an electrode located in the cochlea, which receives the signals and forwards them to the auditory center in the brain. There then the hearing is triggered.
As a rule, hearing-impaired adults benefit from hearing aid care. However, the sense of direction is lacking and in noisy surroundings, comprehension difficulties often arise due to the predominant one-sided care. Children are getting used to the CI easier. So often happens when switching from the hearing aid to the CI, a great developmental thrust.
At least the perception of noises of our everyday life - especially the sounds with signal function (car horns, ...) - with a CI is almost always possible.
Even your own voice can be better controlled, which usually results in a more understandable pronunciation. But even in most other situations an understanding without oral reading is possible with the help of the CI; even on the phone.
Finally, the tinnitus mask - also called noise device, tinnitus noiser or tinnitus control instrument - should be briefly mentioned here, which to a certain extent can also be called a hearing aid. As the name implies, this hearing aid is used to relieve tinnitus symptoms, the annoying continuous tone of unknown cause. The associated therapy is referred to as tinnitus retraining therapy ( tinnitus retraining therapy ).
The look and structure of this device is similar to conventional hearing aids. However, it does not have a microphone, but produces constant duration noise in the frequency range and level, with the intention of masking or at least mitigating the unpleasant tinnitus. This constant noise can be selected as subtle sea noise, the rustling of leaves of a tree, bird chirping and much more in the Tinnitusmasker. This should not be attempted to cover the tinnitus, but to embed him in a pleasant-relaxing background noise.
In case of simultaneous hearing loss ( hypacusis ) or hypersensitivity to noise ( hyperacusis ), it is advisable to use a combination of hearing aid and tinnitus noiser called tinnitus instrument. The tinnitus improves significantly under the increased everyday noises. At rest, it is then almost covered by the generator noise of Noiser. However, it is at
the noise hypersensitivity urgently to an effective limitation of the volume to pay attention!


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