Types of hearing aids
Hearing aid, hearing system, hearing glasses, cochlear implant, CI, in-the-ear hearing system, ITE, RIC hearing system, behind-the-ear device, BTE, hearing machine, ear tube, concha hearing system, Micro-CiC, intoxication device, tinnitus noiser , Tinnitus masker, receiver-in-canal, tinnitus control instrument
English: hearing aid
Which hearing systems are there, how are today's hearing aids constructed in detail and what differentiates them?
First of all, the Behind-the-ear devices (BTE) to be named. You will get behind that ear and connected to the earmold by a small tube that runs forward over the ear.
Behind-the-ear hearing systems are suitable for almost all types of hearing aid, depending on the design Hearing loss, from mild hearing loss to profound hearing loss. Since today's design is becoming smaller and smaller - the slightly larger ones are an exception SuperPower systems - and a special, individual adaptation technology is used, wearing such a hearing aid is hardly noticeable any more. A BTE system is often equipped with an omnidirectional microphone that picks up the sound evenly from all sides (multi-directional microphone system). This makes listening easier in a noisy environment.
BTE-Hearing aids can be divided into "open" and "closed" systems. The latter fill with the earmold and outer ear Ear canal however almost completely. The "closed" system is flexible and individually adaptable, making it suitable for very different forms of hearing loss. This conventional BTE system is more powerful, albeit slightly larger than the ones described below. But this makes it easier to maintain, for example, when changing the battery or cleaning.
An individual ear impression of the wearer is made for the ear mold. This gives it an almost 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. Its main tasks are to transmit the amplified sound signals to the eardrum and to ensure that it sits comfortably in the ear without interference and thus also ensures that the part of the hearing system that is located behind the ear is held securely.
Last but not least, feedback, these high, whistling noises - which are often perceived as extremely annoying by people in the vicinity - should be prevented. This is achieved in that the ear mold closes the ear canal as tightly as possible.
As an advantage of the “open” behind-the-ear hearing aid fitting, one can certainly see that it usually only closes the ear slightly. Instead of an earmold, there is a thin one here Sound tube (Slim tube) as a link between the hearing aid and eardrum. As a result, these systems can score with high sound quality, greater comfort and optimal ear canal ventilation. All of this prevents moisture from building up. Unfortunately, however, this hearing aid cannot be used for such a broad spectrum of hearing loss as the conventional "closed" models.
This is similar to the “open” hearing aid just presented Receiver-in-the-ear canal hearing aid (RIC hearing system, receiver-in-canal), in which, unlike most other BTE hearing aids, the loudspeaker is no longer behind the ear, but directly in the ear canal and is connected to the hearing system by a thin tube. This makes these hearing systems particularly small, light and inconspicuous.
But there are also so-called In-the-ear hearing systems (I do). These are individually made to measure and placed directly and completely in the auricle and ear canal. ? For this purpose, an ear impression is made for a more precise fit in the ear. There are also different types of this system which, depending on the hearing defect, can compensate for mild to moderate hearing impairments.
Different construction variants also offer a good selection here: from the concha hearing system that fills the auricle to the smallest hearing aid that disappears completely in the ear canal and as a Micro-CiC referred to as.
There are also hearing glasses. This is a glassesthat either have hearing aid technology integrated in their brackets or a hearing aid is mounted on their bracket. The earmold is often located on the back of the temple (Earmold) and the battery compartment. An easy-to-use plug connection enables the front of the glasses to be changed easily.
For special diseases especially des outer ear Bone conduction hearing systems can be used. With these hearing aids, the sound is not transmitted to the eardrum via the air in the ear canal, but directly into the eardrum via the bone Inner ear directed. This is necessary, for example, if there is no ear canal, or secretion is secreted in the ear canal, which means that a BTE- or I do-Making hearing aid impossible.
Such a device has a sound transducer that sends vibrations to the mastoid process (mastoid) transmits, one bone behind the ear that belongs to the temporal bone. This causes the inner ear to vibrate, which the hard of hearing can hear as sound information. Most of the time, bone conduction hearing aids are manufactured as hearing glasses. But there is also the option of wearing a pocket hearing aid with a bone conduction receiver. This is then attached to a headband or headband.
Bone-anchored hearing aids are mostly used in young children with congenital ear canal malformations. A titanium screw is surgically implanted in the skull bone by an ENT doctor. The hearing aid is then attached to this screw (BAHA = bone anchored Hearing aid, engl. for bone-anchored hearing aid). Due to the direct coupling, these hearing aids transmit greater sound pressures and are therefore used even with severe hearing impairments.
In addition, there is that Cochlea Implant, CI for short. This is a high-tech medical device that people who have extremely profound inner ear hearing loss or deafness suffer, for better or at all for Listen helps. About 700 cochlear implantations are currently carried out every year. And the number is steadily increasing. People affected by extremely severe inner ear hearing loss usually do not achieve the desired success with conventional hearing aids, since the problem is not in the inadequate transmission of the sound stimuli to the receptors in the cochlea (Cochlea), but it is the process of converting sound into for human brain usable information is disturbed. A pure amplification of the sound waves is therefore unsuccessful.
This severe hearing impairment has particularly serious effects on children, as they have no or only an inadequate and therefore delayed opportunity to learn to speak. With them, hearing aids can and should be fitted in the 4th - 6th month. Normally, normal language development goes through a relatively regulated sequence of stages: from the 2nd month the children begin to babble, from the 8th month onwards.The first language comprehension takes place every month, followed by one, two, three-word and multi-word sentences at the age of one, two and three years, until language development is fully completed at the age of 4. Therefore, especially in children who are deaf after language acquisition and adults with extremely severe hearing loss with a demonstrably insufficient hearing gain from a hearing aid, and especially in children born deaf, diagnosis and appropriate treatment as early as possible is urgently indicated.
But what is such a cochlear implant made of?
It is essentially divided into two:
The implant is surgically implanted by an ENT surgeon. The processor, which consists of a speech processor, a battery pack, a cable and a coil, is worn behind the ear or in the breast pocket, on the tether or on the belt.
The way it works can actually be described quite simply: First, a microphone picks up the sound and converts it into electrical signals. The speech processor then processes these signals and translates them into a special impulse pattern according to the programming. These are conducted to the coil via a thin cable and from there through the skin sent to the implant. However, the implant in turn stands over an in the cochlea (Cochlea) located electrode in contact with the auditory nerve, which receives the signals and forwards them to the auditory center in the brain. The hearing perception is then triggered there.
As a rule, there is a gain in hearing aid provision for adults with severe hearing impairment. However, there is a lack of directional hearing and in noisy surroundings, difficulties in understanding often arise due to the predominantly one-sided supply. It is easier for children to get used to the CI. When switching from hearing aids to CI, there is often a major development boost.
At least the perception of noises in our daily life - especially the noises with a signal function (car horns, ...) - is almost always possible with a CI.
Your own voice can also be better controlled, which usually results in a more understandable pronunciation. However, in most other situations, too, communication without reading from the mouth is possible with the help of the CI; even on the phone.
Finally, the tinnitus mask - also known as the intoxication device, tinnitus noiser or tinnitus control instrument - should be briefly discussed here, which to a certain extent can also be referred to as a hearing aid. As the name suggests, this hearing aid is used for the relief of Tinnitus symptoms, the annoying continuous tone of unknown cause. The associated therapy is called tinnitus retraining therapy (tinnitus retraining therapy).
In terms of appearance and structure, this device is similar to conventional hearing aids. However, it does not have a microphone, but generates constant constant noise in terms of frequency range and level, with the intention of preventing the unpleasant Tinnitus to cover up or at least to soften it. With the tinnitus masker, this continuous noise can also be selected as the subtle sound of the sea, the rustling of leaves on a tree, the chirping of birds and much more. The aim is not to try to cover up the tinnitus, but to embed it in a pleasant, relaxing background noise.
If hearing loss occurs simultaneously with the tinnitus (Hypacusis) or oversensitivity to noises (Hyperacusis) it is advisable to use a combination of hearing aid and tinnitus noiser known as a tinnitus instrument. The tinnitus improves significantly under the increased everyday noises. At rest it is almost covered by the generator noise of the noiser. However, is at
the noise-hypersensitivity urgently to pay attention to an effective limitation of the volume!
more information on this topic
- Hearing aids
More interesting information on the topic ear:
- Anatomy ear
- Inner ear
- outer ear
- Middle ear
- Hearing loss in children
An overview of all topics already published in the field of ENT can be found at ENT A-Z