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- From: fulk@cs.rochester.edu (Mark Fulk)
- Newsgroups: sci.skeptic,sci.med
- Subject: Re: Hearing aids (ATTN: Ruth Ginzberg: suggestion for FAQ)
- Message-ID: <1992Dec21.164105.18079@cs.rochester.edu>
- Date: 21 Dec 92 16:41:05 GMT
- References: <GERRY.92Dec16125546@onion.cmu.edu>
- Organization: University of Rochester
- Lines: 78
-
- This issue has come up a few times in the last couple of years, so perhaps
- it is time for an FAQ entry. The following information is courtesy of my
- wife, a speech pathologist, who had to train with audiologists and sometimes
- has to administer hearing tests in her line of work:
-
- NEVER buy a hearing aid from a dealer. They are only interested in selling
- you something expensive, and they are not qualified to prescribe an aid.
-
- If you have a hearing problem, you should discuss it with your doctor
- and possibly an ENT doctor (otolaryngologist), in order to rule out
- any treatable causes. Most likely there will not be anything they
- can do; they should refer you to an audiologist. Many ENTs have an
- audiologist working in their office.
-
- You want to see an audiologist with certification from the American Speech,
- Language, and Hearing Association (ASHA), in the US and Canada; I do
- not know the names of other national certification bodies.
-
- The audiologist will spend around half an hour testing your hearing in a
- sound-proof booth. She will also take molds of your ears for the aid.
- At the time of your visit, you should make an appointment for a followup
- a few weeks after you get your aid.
-
- The followup visit is part of the original audiologist's fee, so don't skip
- it in order to save a few bucks; you won't save anything and you will miss
- a chance for a potentially important adjustment.
-
- Why should you bother?
-
- 1) Modern aids are quite complicated; they can selectively filter, boost,
- and shift frequencies. They are at least as complicated as glasses;
- an ill-fitted aid can be worse then no aid at all.
-
- 2) Human ears all suffer from a curious defect: the threshold for permanent
- damage is well below the threshold for pain (90 dB versus 110 dB). In a
- person with a hearing problem, a level of sound that damages the ears may
- not even seem very loud. A badly-adjusted aid can produce damaging sound
- levels, and a badly made ear mold can allow audio feedback, which can easily
- reach damaging, even extremely painful, levels.
-
- 3) If a pair of glasses fits very badly, the patient quickly notices and
- returns to the optometrist. Unfortunately, a badly fitted hearing aid
- can do a great deal of harm long before the patient notices.
-
- 4) In New York, and some other states, audiologists are allowed to sell the
- hearing aid they prescribe. The selling price is equal to the audiologist's
- purchase price, so no profit is made on the transaction (actually, given
- the carrying costs, the audiologist loses money). If your state allows
- this, you should definitely get your aid from the audiologist; going
- to a dealer costs more and the dealer may try to pass off an aid that
- pays a higher profit margin, saying that it's obviously better, being
- more expensive. Repeated experiences of dealers misfilling prescriptions
- is the reason for the New York law. If you have to go to a dealer to
- get your prescription filled, insist that it be filled exactly as written,
- and make an appointment with the audiologist for an adjustment ASAP.
-
- ----------
-
- And a note on "nerve deafness:"
-
- So-called "nerve deafness" is usually the result of damage, not to nerves,
- but to the hair cells of the cochlea. These cells run in a line in the
- inside of the cochlear spiral; the _basilar membrane_ extends from the
- other side of the tube to lie against them. Vibrations in the cochlea
- push the membrane, which pushes the hairs (cilia), which cause the hair
- cells to develop potentials that are passed on to the auditory neurons.
- Very loud sounds cause the basilar membrane to shear off the hairs;
- unfortunately, the hair cells never grow new hairs. Some infections
- (measles, sometimes) can also destroy the hair cells.
-
- The usual cause of hearing loss in the hearing population is noise-induced
- damage to the hair cells. Sensitivity to the higher frequencies is most
- hurt; people with this loss often have trouble distinguishing among
- fricatives (s, f, soft th) and unvoiced stops (p, t, k).
-
- --
- Mark A. Fulk University of Rochester
- Computer Science Department fulk@cs.rochester.edu
-