How to Find the Right Hearing Aid for You

Just like glasses are for patients with vision loss, a hearing aid helps patients with hearing loss. Hearing loss can be caused by many different factors. An ENT (ear, nose, and throat) specialist, or otolaryngologist, is the best specialist to diagnose causes of hearing loss. Depending on your degree of hearing loss, type of hearing loss, and other medical factors, you may benefit from a hearing aid. A primary care physician can refer you to an ENT specialist, who often works with an audiologist, to evaluate the severity and cause of your hearing loss.

More information on possible causes of hearing loss and impairment can be found by reading about autoimmune inner ear disease, conductive hearing loss, sensorineural hearing loss, pediatric hearing loss, acoustic neuroma, otosclerosis, cochlear implant health, genes and hearing loss, noise-induced hearing loss in children, and treating and managing ear fluid.

An audiogram or hearing test, often performed by an audiologist, assesses the hearing loss. The audiogram is a hearing evaluation of your ability to hear sounds and understand words. The results of these tests will reveal the degree of hearing loss as well as additional information about your ears and overall health. A soundproof booth minimizes competing background noise. After the test, an ENT specialist can help you understand your hearing loss and counsel you on how best to evaluate and manage it.

There are also online hearing tests that can identify hearing loss. While they are not as accurate and do not provide all of the measurements included in a complete hearing test, they are useful to identify problems that would justify getting a complete audiogram administered by a hearing professional.

Degrees of hearing loss vary from patient to patient, but generally fall within the following decibel (dB) level categories:

  • Normal hearing: 0-20 dB
  • Mild hearing loss: 20-40 dB
  • Moderate hearing loss: 40-70 dB
  • Severe hearing loss: 70-90 dB
  • Profound hearing loss: greater than 90 dB

How Do Hearing Aids Work?

Hearing aids are small devices that amplify sound and can help people hear better with hearing loss. Hearing aids differ by design, technology used for amplification (i.e., analog versus digital), and other special features. Generally, the microphone receives sound and converts it into a digital signal; the amplifier increases the strength of the digital signal; and the speaker produces the amplified sound into the ear. Properly fitting hearing aids can be adjusted to preferentially amplify frequencies of loss based on an individual patient’s measured loss.

FDA Final Rule Release

On August 16, 2022, the U.S. Food and Drug Administration (FDA) announced the release of a final rule titled, “Medical Devices: Ear, Nose, and Throat Devices; Establishing Over-the-Counter Hearing Aids,” which establishes regulations for the Over-the-Counter Hearing Aid Act, as enacted in the FDA Reauthorization Act of 2017. The final rule took effect on October 17, 2022. The AAO-HNS released the following statement on the rule.

What Are the Different Types of Hearing Aids?

The best hearing aid for you depends on your age, individual hearing loss and listening needs, the size and shape of your ear and ear canal, and how well you can use your hands. Some hearing aids work better with cellphones, televisions, and other sound systems, and some include Bluetooth options. Styles include:

  • Behind-the-ear (BTE) aids go over the ear and are thinly wired to personally fitted earpieces
  • Receiver-in-the-ear (RITE) aids are placed over the ear but are small and nearly invisible
  • In-the-ear (ITE) hearing aids fit in the ear bowl area and part of the ear canal
  • You may also be able to use smaller in-the-ear, or in-the-canal (ITC) aids
  • The least visible aids are completely-in-the-canal (CIC)
  • A hearing aid that sits on the ear drum, similar to a contact lens

In addition, Personal Sound Amplification Products (PSAPs) and other types of over-the-counter (OTC) hearing devices are less expensive than the average hearing aid. The U.S. Food and Drug Administration states that “PSAPs are not intended to be used as hearing aids to compensate for hearing impairment,” but they may be helpful to some people with mild to moderate hearing loss.

Usually, if you have hearing loss in both ears, using two hearing aids is best. Listening in a noisy environment is difficult with an aid in just one ear because it is harder to distinguish where sounds are coming from. Again, your ENT specialist and/or audiologist can help you decide which device may work best for you and your lifestyle.

How Do I Select a Hearing Aid?

As of October 17, 2022, patients 18 years of age or older will be able to purchase OTC hearing aids without a formal hearing test or fitting if they have mild-to-moderate hearing loss. Hearing aids vary according to style, features, and price so selecting the right one is essential. Prices can range from under $1,000 to more than $4,000 for each device depending on the level of technology (insurance providers may not cover the cost). Product quality and proper care can save you repair costs and enhance your satisfaction. You can consult your ENT specialist or healthcare team for recommendations on hearing aid manufacturers that best meet your hearing requirements.

Pros and Cons of Choosing Prescription vs. OTC Hearing Aids

Choosing between prescription and OTC hearing aids involves weighing the pros and cons of each option based on individual needs, preferences, and circumstances.

Pros of Prescription Hearing Aids

  1. Customization: Tailored to the user’s specific hearing loss and ear anatomy, ensuring optimal performance and comfort.
  2. Advanced Features: Typically include superior sound processing technologies, noise reduction, and connectivity options.
  3. Professional Support: Includes thorough assessments, fittings, and ongoing adjustments from hearing healthcare professionals.
  4. Quality Assurance: Stricter regulatory standards and comprehensive warranties provide reliability and peace of mind.
  5. Warranty: Usually extended.
  6. Satisfaction: High patient satisfaction with quality and support.

Cons of Prescription Hearing Aids

  1. Cost: Generally, more expensive than OTC hearing aids due to the professional availability, counseling, and programing included in the cost. Also, the hearing devices have automated multi-situation modes and advanced technology, which increases costs.
  2. Time-consuming: The process of obtaining and adjusting prescription hearing aids sometimes involves multiple appointments, which can be time-consuming.
  3. Accessibility: Requires a visit to a hearing healthcare provider, which might be inconvenient for some individuals.

Pros of OTC Hearing Aids

  1. Affordability: Usually less expensive than prescription hearing aids, making them accessible to a broader audience.
  2. Convenience: Can be purchased directly from stores or online without the need for professional evaluation.
  3. Quick Solution: Provides immediate relief for those with mild-to-moderate hearing loss.

Cons of OTC Hearing Aids

  1. Limited Customization: One-size-fits-all approach may not address specific hearing needs or fit comfortably.
  2. Basic Technology: Generally, lacks the advanced features and sound processing capabilities of prescription models.
  3. Audiogram Access Difficulty: To optimally program a hearing device an accurate audiogram (or, hearing test), which may be difficult outside a hearing healthcare professional’s office.
  4. Lack of Professional Support: Absence of professional fitting and follow-up care can result in suboptimal performance and user dissatisfaction. Maintenance, cleaning, and technology utilization of hearing aids may be difficult or impossible for some.
  5. Returns: May be difficult or impossible depending on the vendor.

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The information on ENThealth.org is provided solely for educational purposes and does not represent medical advice, nor is it a substitute for seeking professional medical care.