Audiology & Hearing Aids

At Atlantic ENT LLC, you will be evaluated by Michael Widick, MD who is a medical doctor and specialist in ear diseases and hearing loss and by Deedra McGugin, AuD who is a doctor of audiology and is a specialist in evaluating hearing loss and fitting and managing hearing devices.

WHY SHOULD I SEE A DOCTOR WHEN I CAN GET A FREE HEARING TEST AT THE HEARING AID PLACE?

Typically hearing tests performed at a Medical Doctor’s office are covered by insurance but do sometimes come with a modest copay or co-insurance. Otolaryngologists, of all medical doctors, have the greatest knowledge of the hearing and balance system and are the only physicians qualified to surgically repair hearing loss. Sometimes hearing loss is caused by serious conditions such as tumors of the auditory or balance nerves (click here) next to the brain. Occasionally these tumors cause paralysis or even strokes in addition to hearing loss and imbalance

Tumor visualized in the perpendicular orientation (axial) image of the MRI scan.

Other problems like perforated eardrums or disease like otosclerosis can be surgically remedied restoring hearing back to its baseline.

A recent trend has occurred where some hearing aid dispensers have aligned themselves with Eye Doctors. Since people with hearing loss often need cataract surgery or have other age related eye problems their business is captured by hearing aid sales people under the auspices of physician supervision. Since I have never received a consultation from an Ophthalmologist for a patient with hearing loss that can’t be explained by age-related loss, I can only assume that the oversight is slight or non-existent. I have patients on practically daily basis in my office whose hearing loss needs further medical evaluation or can remedied in the office. 

For less than the cost a modest meal, you can have the expertise of a team of hearing experts evaluate your hearing. It does not make sense to have your hearing evaluation anywhere else. 

The National Institute of Health provides the following questionaire for guidance for hearing testing. If you are 18 to 64 years old, the following questions will help you determine if you need to have your hearing tested by a health professional. Answer YES or NO. Or simply take the Hearing Loss Quiz on the top right hand side of this page.

  1. Do you sometimes feel embarrassed when you meet new people because you struggle to hear?
     Yes
     No
  2. Do you feel frustrated when talking to members of your family because you have difficulty hearing them?
     Yes
     No
  3. Do you have difficulty hearing or understanding co-workers, clients, or customers?
     Yes
     No
  4. Do you feel restricted or limited by a hearing problem?
     Yes
     No
  5. Do you have difficulty hearing when visiting friends, relatives, or neighbors?
     Yes
     No
  6. Do you have trouble hearing in the movies or in the theater?
     Yes
     No
  7. Does a hearing problem cause you to argue with family members?
     Yes
     No
  8. Do you have trouble hearing the TV or radio at levels that are loud enough for others?
     Yes
     No
  9. Do you feel that any difficulty with your hearing limits your personal life or social life?
     Yes
     No
  10. Do you have trouble hearing family or friends when you are together in a restaurant?
     Yes
     No

If you answered “yes” to three or more of these questions, you may want to see an otolaryngologist (an ear, nose, and throat specialist) or an audiologist for a hearing evaluation. 

Adapted from: Newman, C.W., Weinstein, B.E., Jacobson, G.P., & Hug, G.A. (1990). The Hearing Handicap Inventory for Adults [HHIA]: Psychometric adequacy and audiometric correlates. Ear Hear, 11, 430-433.

WHAT IS AUDIOLOGY?

Audiology is a branch of science that studies hearing, balance, and related disorders.

WHAT IS HEARING IMPAIRMENT?

Hearing impairment is a medical condition requiring evaluation and diagnosis by a physician, preferably an Otolaryngologist – Head & Neck Surgeon.  Good health practice requires that a person with hearing loss have an evaluation by a physician prior to hearing aid provision.

I DON’T HEAR WELL. WHAT SHOULD I DO? WHAT SHOULD I EXPECT?

First, visit a physician who can refer you to an otolaryngologist (an ear, nose, and throat specialist) or make an appointment directly, because many hearing problems can be corrected medically. Here at Atlantic ENT LLC, referrals are rarely needed. If you have ear pain, drainage, excess earwax, hearing loss in only one ear, sudden or rapidly progressive hearing loss, or dizziness, it is especially important that you see an Otolaryngologist, as these may be symptoms indicating a serious medical problem. After your exam, the otolaryngologist will help you obtain a hearing assessment from an audiologist. We can do this in office with Dr. Scheirholtz who practices with Dr. Widick. A screening test from a hearing aid dealer may not be adequate. Our testing will assess your ability to hear pure tone sounds and to understand words as well as other fine mechanisms of the inner ear. The results of these tests will indicate the degree of hearing loss, the type of loss (conductive or sensorineural) and other medical information about your ears and health.

Conductive Hearing Loss: A hearing loss is conductive when there is a problem with the ear canal, the eardrum, and/or the three bones connected to the eardrum. This causes a mechanical (conductive) blockage, preventing the full energy of the sound from reaching your inner ear. Two common reasons for this type of hearing loss are excess wax in the ear canal or fluid behind the eardrum. Medical treatment or surgery may be available for these and other forms of conductive hearing loss.

Sensorineural Hearing Loss: A hearing loss is sensorineural when it results from damage to the inner ear (cochlea) or auditory nerve, often a result of the aging process and/or noise exposure, but also may be secondary to head trauma, systemic illness or infection, or inheritance. Sounds may be unclear or too soft. Sensitivity to loud sounds may occur. Medical or surgical intervention cannot correct most sensorineural hearing losses, but hearing aids may help you reclaim some sounds you are missing as a result of nerve deafness.

WHERE DO I PURCHASE HEARING AIDS?

Federal regulation prohibits any hearing aid sale unless the buyer has first received a physician’s evaluation, so you will need to see your doctor before you purchase a hearing aid. However, the regulation also says that if you are over 18 and aware of the recommendation for a medical exam, you may sign a waiver to forego it.

An otolaryngologist, audiologist, or independent dispenser can dispense aids. Hearing aids should be custom-fit to your ear and hearing needs. Mail-order hearing aids typically cannot be custom-fit.

WHAT ARE COSTS AND STYLES OF HEARING AIDS?

Hearing aids vary in price according to style, features, and local market prices. Price can range from hundreds of dollars to more than $2,500 for a programmable, digital hearing aid. Purchase price should not be the only consideration in buying a hearing aid. Product reliability and customer service can save repair costs and decrease frustration of a malfunctioning hearing aid.

There are several styles:

  • Behind-the-ear (BTE) aids go over the ear and are connected with tubing to custom-fitted earpieces.
  • Open fit receiver-in-the-ear (RITE) aids are a newer design, and while still placed over the ear, they are extremely small and nearly invisible.
  • In-the-ear (ITE) hearing aids fill the entire bowl of the ear and part of the ear canal.
  • Smaller versions of ITEs are called half-shell and in-the-canal (ITC).
  • The least visible aids are completely-in-the-canal (CIC).

The best hearing aid for you depends upon your particular hearing loss and listening needs, the size and shape of your ear and ear canal, and the dexterity of your hands. Many hearing aids have tele-coil “T” switches for telephone use and public sound systems.

Other options, such as FM systems and Bluetooth devices in conjunction with hearing aids, may provide the best benefit for some patients including connection and control by your smart mobile phone.

WILL I NEED A HEARING AID FOR EACH EAR?

Usually, if you have hearing loss in both ears, using two hearing aids is best. Listening in a noisy environment is difficult with amplification in one ear only, and it is more difficult to distinguish where sounds are coming from.

WHAT OTHER QUESTIONS SHOULD I ASK?

Ask about future service and repair. Also inquire about the trial period policy and what fees are refundable if you return the hearing aids during that period. And ask about warranty coverage for your hearing aids and the consumers’ protection program for hearing aid purchasers in your state.

WHAT WILL HAPPEN AT MY HEARING AID FITTING?

The hearing aids will be fitted for your ears. Then, while wearing them, you may also be tested for word understanding in quiet and in noise, and for improvement in hearing tones. Real ear measurements may also be done, which determine how much gain your hearing aids give you.

Next, you will receive instruction about the care of your hearing aids and other helpful strategies.

HOW SHOULD I BEGIN WEARING THE AIDS?

Start using your hearing aids in quiet surroundings, gradually building up to noisier environments. Then eventually work up to wearing your hearing aids all waking hours. Keep a diary to help you remember your experiences and report them accurately to your dispenser for adjustments as needed. Report any concerns on a follow-up appointment. Be patient and allow yourself to get used to the aids and the “new” sounds they allow you to hear.