The Nature of Hearing Loss and the Fundamentals of Proper Amplification (Part IV)

For decades -- from the 1940's to the early 1990's -- the simple truth is that hearing aids were not capable of providing adequate benefit for most patients with the most common form of hearing loss in adults (sensorineural hearing loss).

For those fifty years or so, hearing instruments were only capable of making every sound louder, no matter what pitch or intensity that sound was.  Remember, as we discussed in earlier parts of this series, most patients with sensorineural hearing loss, which represent the largest bulk of patients with hearing loss by a very large margin, have normal to mildly reduced hearing in the lower pitches, while their hearing in the higher pitches is declining at a much greater rate.  Therefore, they would ideally receive more "help" from a hearing aid in the higher pitches than in the lower pitches, and even better, the hearing aid would treat loudness growth differently in those pitch ranges.

As an aside...
Several years ago, I was having a discussion with a leading executive in the hearing aid industry.  At the time, he was rather discouraged at the rate at which consumers were purchasing devices that he knew were clearly head-and-shoulders above previous generations of technology.  I was surprised at his outlook and I reminded him that you can't undo a reputation created by 50 years of poor performance in just a year or two.

Today, in my office, we are seeing much less reluctance on the part of patients to try amplification.  I'm convinced it is because finally, the majority of patients are reporting greater benefit than was possible just five years ago.

But unfortunately until the recent past, hearing aids were not up to that task and it is that reason that far too many of them spent more time in desk or bureau drawers than ears.

At an absolute bare minimum, if a patient with sensorineural hearing loss is intending to obtain amplification, the hearing aid must be able to process low pitches and high pitches independently.  Otherwise, the patient will experience a great deal of loudness without necessarily noticing improved clarity, which is the point of obtaining the device in the first place!

Fortunately, the majority of hearing aids offered today, even those that might be termed as "less-sophisticated" by today's standards are indeed capable of independent gain in the low and high pitches.  However, all too often, I meet people in my office or socially that did not obtain the proper device.

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The preceding was part of A four part series at Auris Repletus entitled, "The Nature of Hearing Loss and the Fundamentals of Proper Amplification"

- Part I; Part II; Part III; Part IV