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Guide to hearing. hearing loss and modern solutions .pdf


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Health & Hearing

Hearing Health
Do you have hearing loss?
1-minute self assessment test

Hearing Technology
“Nothing like the old days!”
Virtually invisible and Bluetooth enabled

Hearing Science
Importance of early intervention in the
treatment of hearing loss

How much do hearing aids cost?
A guide to the range of financial assistance that is available

Hear the difference
ReSound Alera® hearing instruments are light, comfortable, practically
invisible and are unsurpassed in providing natural sound quality. They
‘listen’ to the environment and automatically adjust to optimal settings
as you move between different environments, so you don’t have to think
about adjusting your hearing instruments.
ReSound Alera® can connect wirelessly to digital televisions, landline
and mobile phones, computers and personal music players with
exceptional clarity and stability. They do this through the ReSound
Unite™ range of accessories, such as the Unite™ Mini Mic, Unite™
Remote Control, Unite™ TV Streamer and Unite™ Phone Clip. They
send clear, echo-free sound directly into the hearing aid without the
need of an intermediary device.
Hear it for yourself! The Art of Hearing and ReSound have partnered to allow people of Perth
to hear the difference for themselves. You can be fitted with the ReSound Alera® today, so that
you can appreciate the difference these remarkable devices will make to your life.
Call The Art of Hearing today on 08 9390 8811
to make an obligation free appointment.



Contents

> Forward

How the ear works.............................................................. 4
Understand how the ear works and
processes sound

Hearing Loss...........................................................................5

Dear Reader,
Thank you for taking the time to request and read through our magazine, Health
& Hearing.
For many of you, this may be a your first step towards addressing hearing loss or
that of a loved one. In this magazine, we hope to enlighten you about hearing,
hearing conditions and modern solutions.
Although there are many causes for hearing loss, the incidence of the condition
grows steadily as people age. While 30% of adults will be showing signs of
the condition by the age of 50-years, this will rise to 70% of the population by
70-years of age. Hearing loss affects lives, lifestyles, relationships, and often
leads to feelings of isolation.
Studies have shown that when not managed, the condition reduces the
effectiveness of people in the workplace and led to decreased household
income. Even more importantly, people who address their hearing loss earlier
reported feeling younger, more confident, and eager to once again enjoy the
social situations that had become tedious. These findings are consistent with
the experiences of the hundreds of clients who I have helped over the years to
achieve better hearing and a better quality of life.
But as you will read in Health & Hearing, there is some great news for Australians
too. Our government recognises the impact that hearing loss has on both its
citizens’ lives and the national economy. Subsequently, they provide pensioners
and veterans with access to free digital hearing aids. Assistance is available
to all people with hearing loss through tax rebates, health insurance, and
compensation for hearing loss that has developed as a result of exposure to noise
in the workplace.

Tinnitus..................................................................................... 8
This buzzing in my ears is driving me mad!

“I’m too young for hearing aids”.............................. 10
The importance of addressing hearing loss
early – a scientific perspective

Hearing Loss & Dementia.............................................. 11
New study find links between untreated hearing loss and
dementia

Hearing tests....................................................................... 12
This story explains common types of hearing tests and
how to interpret the results

Reading your Audiogram.............................................. 14
Results of the air conduction and bone
conduction hearing tests

Hearing Aids.........................................................................17
“Nothing like the old days”

Cochlear Implants............................................................ 21
How they can help

How much do hearing aids cost?.............................22

Who are The Art of Hearing?
Australians are often shocked to learn that most hearing clinics are actually
owned by hearing aid manufacturers or global retail chains – and thus are really
just well disguised vehicles for pushing their own range of hearing aids. In
contrast, The Art of Hearing is proudly independent. My staff and I will find you
the best treatments from the full range of available solutions, including tinnitus
management, rehabilitation, counseling, and hearing aids from all leading
manufacturers.
We are accredited to provide free hearing aids to pensioners and veterans under
the Australian Government Hearing Services Program*.
We are here to help you at every step of the way and find a solution that works for
you. If you have any questions, or
would like to arrange a hearing test or
trial of the latest digital hearing aids,
please don’t hesitate to call.
Best regards,

Ravi Gupta
Owner and Audiologist
The Art of Hearing

We all know somebody affected by
hearing loss

Ravi

Owner and Audiologist

A common question

would like to acknowledge
the following sources in the
development of this magazine:

References
Listen Hear! – The economic impact and cost of hearing loss in Australia, Access
Economics 2006
Cochlear Ltd – www.cochlear.com
Office of Hearing Services – http://www.health.gov.au/hear
Spinach Effect – www.spinacheffect.com.au
The Impact of Untreated Hearing Loss on Household Income – Sergei Kochkin, Ph.D.
August 2005
Lin FR, Metter EJ, O’Brien RJ, Resnick SM, Zonderman A, Ferrucci L. Hearing loss and
incident dementia. Arch. Neurol. 2011; In press.
Hearing in South Australia: Disability, Impairment and Quality-of-life, Wilson DH (1997)
Late-onset auditory deprivation: Effects of monaural vs binaural hearing aids. Silman,
Gelfand, Silverman. (1984)
Leading manufacturers
GN Resound – www.gnresound.com.au
Unitron – www.unitron.com.au
Other suppliers
Oticon – www.oticon.com.au
Bernafon – www.bernafon.com.au
Phonak – www.phonak.com.au
Siemens - hearing.siemens.com/au/
Other links
Australian Tinnitus Association - http://www.tinnitus.asn.au/tinnitus.htm

* Condtions apply under the OHS Voucher Scheme

Health & Hearing
© - Spinach Effect Pty Ltd
PO Box 2019, Glenelg SA 5045, Australia
Ph: (08) 8294 7928 www.spinacheffect.com.au

Health & Hearing

page 3

> The Ear

How the ear works
In order to better
understand
hearing loss and
what can be done,
it is first important
to understand how
the ear works and
processes sound.

Outer Ear

Sound first enters our ear at the Pinna, which is the visible part of
the ear on the outside of our head. The Pinna is designed to collect
sound waves and funnel them down the Ear canal towards the
Tympanic membrane (eardrum). Together the Pinna and Ear canal are
referred to as the outer ear.

Outer Ear

Thousands of tiny sensory hair cells within the Cochlea convert
the vibrations into an electro-chemical signal that’s carried by
the auditory nerve to the brain, where sound is processed and
interpreted.

Middle Ear

The middle ear starts with the Tympanic membrane. As sound
waves travelling down the Ear canal reach the Tympanic membrane,
it vibrates like a drum. Behind the eardrum is an air-filled space
containing three tiny bones, the smallest bones found anywhere in
the human body. The vibrations in turn cause these bones to vibrate.
The Middle Ear consists of the eardrum these tiny bones (Malleus,
Incus and Stap-es) and the air pocket in which they reside.

Inner Ear

The cochlea and the semi-circular canals are our organ of both
hearing and our sense of balance. The cochlea, semi-circular canals
and the cochlear nerve (auditory nerve) comprise the parts of the
Inner Ear. Sound passes to the Inner Ear via the vibrations of the
Middle Ear bones, which are connected to the Cochlea at one end.

Electron Microscope image of healthy hair receptors

page 4

Health & Hearing



Hearing

Loss
We all know somebody affected
by hearing loss, as nearly
1 in 5 Australians live with
the condition. Hearing loss
progresses over time and
it is best to recognise the
signs early.

Q

uality of life can be significantly
compromised for people with
hearing loss and their families. The
extent of the hearing loss varies too,
from a mild to a severe hearing loss
where loud safety signals may not be
heard. More commonly it is manifested
as a difficulty with word understanding,
particularly in the presence of
background noise.

Health & Hearing

page 5

Your Hearing
Self Assessment
Hearing Test

1. I feel discomfort or embarrassment when
meeting new people because of my
hearing
o Never

o Sometimes

o Often

2. I find that following conversations in
a noisy environment, such as a busy
restaurant, can be very difficult
o Never

o Sometimes

o Often

3. People seem to mumble more these days
when they talk, and find myself asking
them to repeat themselves more often
than I used to
o Never

o Sometimes

o Often

4. Others comment that I have the radio or
television turned up too loud for their
liking
o Never

o Sometimes

o Sometimes

o Often

6. Family members have commented that
they think that I may have a hearing
problem – and they become frustrated
when I’ve not fully heard what they have
said
o Never

o Sometimes

o Often

7. Following conversations on the telephone
is particularly difficult, particularly with
children
o Never

o Sometimes

o Often

8. I used to be more active in group
conversations. (E.g. dinner table)
o Never

o Sometimes

o Often

9. I mishear what people have said and
respond inappropriately
o Never

o Sometimes

o Often

10. Sometimes I experience a persistent or
prolonged ‘ringing in my ears’ (known as
tinnitus)
o Never

o Sometimes

In contradiction to many people’s
understanding, hearing loss is rarely
similar to the effect of turning down
the volume on a stereo. It usually
affects different frequencies of sound
by varying amounts. This can lead to
conversations being difficult to follow
– particularly in noisy environments
where competing background noise
“scrambles” speech and conversations.
Not surprisingly, being able to follow
conversations is the single biggest
reason that people seek our help.
If you feel that your hearing is not what
it used to be, or are concerned that a
loved one may be experiencing hearing
loss – take a couple of minutes to do
the short self-assessment test provided
here.

o Often

5. If I did not see the source of a sound,
I find it hard to know what direction it
came from
o Never

Signs of
hearing loss

o Often

Adding up your score
Never
=0
Sometimes = 1
Often
=2

If your total score is more than 5, then your
life is very likely to be affected by hearing
loss and we would recommend a hearing
assessment. If your score is more than 10,
then there is little doubt that your life would
be significantly improved by addressing
your hearing loss and adopting a hearing
solution.

Types of
hearing loss
There are three forms of hearing loss,
Conductive, Sensorineural and Mixed
hearing Loss.

Conductive
Hearing Loss
Conductive hearing loss results from
a problem with the passage of sound
through the outer ear and/or middle ear.
Some common examples include:• Excessive cerumen (earwax) in the ear
canal
• Perforation of the eardrum
• Middle ear infection with fluid
build-up
However, conductive loss accounts for
only 10% of all hearing losses, and they
range from mild to moderate in severity.
The good news is that conductive
hearing loss can often be medically
treated. In many cases hearing can be
completely restored.

Symptoms of
Conductive
Hearing Loss
With conductive hearing loss, the overall
volume of sound is reduced.
Signs of conductive hearing loss may
include:-

page 6

Health & Hearing

• Turning up the volume on the
TV or radio
• Asking people to repeat what
they’ve said
• Hearing in one ear better than
the other
When volume is sufficiently
increased, clarity and
understanding are usually intact
for someone with a conductive
hearing loss. Other symptoms
may also be present, such as ear
pain, drainage from the ears, or a
feeling of pressure or a blockage.

Sensorineural
Hearing Loss
Hearing loss that originates
in the inner ear is referred to
as sensorineural hearing loss
or, in laymens’ terms, “nerve
deafness”.
The vast majority of hearing
losses are sensioneural losses,
and common causes include: • Genetic factors (i.e. hearing
loss can run in families)
• Excessive noise exposure either sudden or prolonged
• Changes in the inner ear due to
ageing
Less common causes include: • Reactions to ear-toxic
medications
• Auditory nerve tumours
• Conditions acquired prior to
birth (congenital)
• Infections such as meningitis
and mumps
• Kidney disease
• Vascular disease
Each cause can lead to damage
to the sensory hair cells or
nerves. Once damaged, the hair
cells can’t repair themselves nor
be medically treated. Therefore,
90% of hearing losses cannot be
cured.
A sensorineural hearing loss
can be of any degree – mild,
moderate, severe or profound.
In more than 95% of cases
involving sensorineural hearing
loss, hearing aids or cochlear
implants are the recommended
course of treatment.



Why can I hear low
pitched sounds
better than high
frequency sounds?

Symptoms of
Sensorineural
Hearing Loss
While the overall volume of sound
may be reduced, the clarity of sounds
or voices is also affected. People
with sensorineural hearing loss will
often hear people speaking, but can’t
always understand all the words, even
when the volume is adequate. Music
may also sound distorted, leading to
decreased enjoyment.
The symptoms of sensorineural hearing
loss may include: • Turning up the volume on the TV or
radio
• Asking people to repeat what they
have said
• Perception of people mumbling or
not speaking clearly
• Lack of clarity when listening to
speech
• Difficulty hearing in noise.

Mixed Hearing Loss
The transmission of sound can be
blocked in multiple places along the
auditory path. When a hearing loss
occurs from conditions in the inner ear
as well as the outer and/or middle ear,
this is known as mixed hearing loss. An
example of a mixed hearing loss may
be someone with inner ear damage due
to exposure to noise in their workplace
over many years, who also currently
has an infection that has led to a fluid
build up in the middle ear.

Noise induced
hearing loss
Given the impact of noise, it is not
surprising that males are considerably
more likely to have hearing loss than
women – including being twice as likely
to have a moderate to severe hearing
loss.
These days, people are more aware of
the damage that noise can do to their
hearing. This is illustrated through
mandatory provision of ear protection
on work sites and within factories.
Nevertheless, every day millions of
Australians are exposing themselves
to noise levels that will surely lead to
long-term damage to their hearing,
including the use of personal stereo
systems.
The chart below illustrates the time it
takes to cause permanent damage to
your hearing when you’re exposed to
different levels and sources of sound.

Nerves have different sensitivities
to deformation of the sensory hair
cells within the cochlea. A sound that
has high frequencies of vibration
will excite receptor cells near the
opening of the cochlea, while a sound
mostly containing low frequencies
will stimulate cells at the end of the
cochlea.
Over time the high frequency hair cell
receptors receive more movement
by the incoming pressure waves of
the fluid inside the cochlea. For this
reason, high frequency receptors are
more prone to long term damage than
the low frequency hair cell receptors,
which are more protected further up
the cochlea.

“What is the
best protection
against noise
damage?”

Causes of
hearing loss

Noise attenuating
ear plugs

While the ageing process is a major
contributor to hearing loss, it is
certainly not a condition reserved
for the later stages of life. Studies
have shown that exposure to noise
is thought to be a contributing
factor in around 37% of cases of the
condition. Interestingly, around 50% of
Australians with hearing loss are still of
traditional working age (i.e. under 65
years).

Ear protection is extremely important for
people who are exposed regularly to noise.
The best form of protection are custom fitted,
noise attenuating ear plugs.
These can purchased and fitted at
a The Art of Hearing clinic

Other contributing factors of hearing
loss include:• Infection or injury (17.1% of cases)
• Born with hearing loss (4.4% of
cases)
• Other causes (16.8% of cases)

Health & Hearing

page 7

> Tinnitus

This buzzing
in my ears is driving me mad!

At some stage our lives, all of us are likely to
experience ringing in our ears when there is no
apparent source of a sound.
It may be evident coming home from a rock
concert, or for a short period as a result
of a sudden extreme noise, such as a gun
discharging nearby.
Unfortunately for many people, this buzzing or ringing sound can
be persistent, intermittent, and prolonged – and this is a condition
known as tinnitus. It can cause frustration and great distress.
While it does occur in every stage of life and affects
both men and women, the condition is most
common amongst men. According to an
American study, almost 12 percent of
men who are 65 to 74 years of age are
affected by tinnitus.
Tinnitus is not a disease
in itself but rather
a reflection of
something else
that is going on
in the hearing
system or
brain.

Causes of Tinnitus
Most commonly, tinnitus is related
to hearing loss. Current theories
suggest that because the cochlea is
no longer sending the normal signals
to the brain, the brain becomes
confused and essentially develops
its own noise to make up for the lack
of normal sound signals. This then is
interpreted as a sound, tinnitus.
This tinnitus can be made worse by
anything that makes our hearing
worse, such as ear infection or excess
wax in the ear.

page 8

Other causes of Tinnitus include
trauma to the ear resulting from:
• Loud noise exposure
• Adverse reaction to medications
drugs such as aspirin, antibiotics
and quinine
• A symptom of Meniere’s disease,
which can also cause dizziness,
nausea, and fluctuating hearing
loss
• A rare cause is a certain type of
brain tumor known as an acoustic
neuroma. The tumors grow on the
nerve that supplies hearing and can
cause tinnitus. This type of tinnitus
is usually only noticed in one ear

Health & Hearing

• Pregnancy, anaemia and an
overactive thyroid can cause
certain types of tinnitus
• Benign intracranial hypertension an increase in the pressure of the
fluid surrounding the brain
• Jaw joint misalignment or muscles
of the ear or throat ‘twitching’ can
cause a ‘clicking’ type of tinnitus
• Stress and fatigue can sometimes
worsen the symptoms of tinnitus,
as can caffeine, smoking and
alcohol



Treatments
for Tinnitus
Most cases of tinnitus should be
evaluated by an Ear, Nose, and Throat
physician to be sure that the tinnitus is
not caused by another treatable problem.
While research has yet to discover a
cure, there are a number of treatments
to help sufferers manage the condition.
Generally the process begins with trying
to identify the cause.
If hearing loss is present, a hearing aid
is likely to reduce the problem. Some
wearers report that hearing aids have
completely alleviated their condition.
Another option to help people manage
is the use of a Therapeutic Noise
Generator, a device which looks like
a hearing aid and is recommended
for people with no hearing
loss. It produces a blend of
external sounds which
stimulate fibres of the
hearing nerve,
helping deviate
attention away
from the
tinnitus.

Cognitive Behaviour Therapy (CBT),
offered by clinical psychologists, can
also be effective in alleviating distress
and adapting to tinnitus. CBT is
threefold: changing the way a person
perceives tinnitus; teaching ways to
focus attention away from tinnitus;
and achieving control over stress.
For the vast majority of people there
is no specific surgical procedure that
provides a treatment for tinnitus.
However, following successful
surgical treatment for some ear
problems, tinnitus may sometimes
disappear (e.g. otosclerosis, middle
ear effusion). Accurate diagnosis and
treatment of Meniere’s disease
may also result significantly reduced
tinnitus.
There is some school of thought that
herbal remedies and Vitamin B12,
taken under medical supervision, may
be helpful for some people. It really
depends on the cause of the tinnitus
and we recommend that you consult a
specialist to discuss these options.
Where tinnitus is related to a jaw
alignment problem, it is treatable.
If you suspect this is a possible cause,
it is worthwhile consulting your
dentist.

Unfortunately, tinnitus is
not a simple problem with
a simple solution.

Everybody’s
tinnitus noise
is specific to
them, and
as a result
treatments
need to be
tailored to the
individual.
If you would like to
discuss your problem or
arrange an assessment,
we recommend that you
call us to arrange an
appointment with one of
our experts.

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With our 360o iSolate nanotech protection, offered on all modern ReSound
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To find out more, call The Art of Hearing today on 08 9390 8811 or
visit www.gnresound.com.au

Health & Hearing

page 9


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