Audiology

• Comprehensive audiologic evaluation
• Otoacoustic emissions testing (test of outer hair cell function)
• Tinnitus counseling
• Cerumen management (ear wax removal)
• Hearing conservation monitoring
• Custom hearing protection
• Custom musician earplugs
• Hearing aid consultation, fitting, verification, programming, troubleshooting

Hearing loss can affect individuals of all ages and their families. Aging is one of the strongest contributors to hearing loss, but additional factors such as genetics, ear wax build-up, noise exposure, and overall health (history) contribute to the type and severity of your loss. Many times tinnitus (the perception of a sound i.e., ringing, buzzing, whooshing, in the absence of an external stimulus) can co-occur with hearing loss, but this is not always the case.

Our Audiology team can teach patients with hearing loss and their families about communication strategies and leading-edge hearing aid technology to manage difficult listening situations.

Common symptoms of hearing loss include:

• Consistently turning up the volume of the television or radio
• Hearing speech but not fully understanding what was said
• Difficulty hearing in the presence of background noise
• Avoiding or withdrawing from social situations

When to consult a provider:

• If your hearing loss and/or tinnitus is affecting your life, and/or the lives of your loved ones.
• If you experience sudden (complete or partial) loss of hearing. An event such as this warrants immediate medical attention.

The Audiology department at Summit Health works in conjunction with the Ear, Nose, and Throat department. Audiology offers comprehensive diagnostic testing to identify and manage hearing and balance disorders for individuals of all ages.

Audiology also offers options for hearing improvement, such as hearing hearing aids, (have a URL that takes you to the hearing aid page) bone anchored and cochlear implants, as well as assistive listening devices.

Hearing Aids:

Summit health contracts with all major hearing aid manufacturers. This allows you and your audiologist flexibility to choose the most appropriate solution for your hearing needs.

Hearing Aid Styles:

Receiver in the ear (RITE)

Hands down, the “receiver in the ear” (RITE) or “receiver in canal” (RIC), is the most popular style. Most components of the hearing aid are located on top of/behind the ear—microphones, processing chips, battery, Bluetooth antenna. The speaker wire attaches to the piece behind/over the ear, and the speaker sits inside the canal (and is attached to a specific ear piece or custom-fitted ear mold. Separating the speaker from the microphones also decreases the likelihood of feedback. 

Traditional Behind the Ear (BTE)

Behind the Ear (BTE) hearing aids differ from RITE/RIC devices as all components sit on top/behind the ear. This attaches to a thin or thick tube and usually a custom-fitted earpiece. These devices work well for patients with chronic ear drainage, ear infections, and those with profound hearing losses.

Invisible in the canal (IIC) and Completely in the canal (CIC) 

IIC and CIC styles are the smallest and most discreet hearing aids available. “Invisible in the canal” IIC styles are as described—virtually invisible. A wearer places them very deeply in the ears, and they must be removed by tugging on a small pull-out string. “Completely in the canal” CIC are very similar, but don’t sit quite so deeply within the ears. 

These styles are typically fit for people with mild to moderate hearing loss. Because of their small size, they don’t usually come with any manual controls or Bluetooth streaming capability.

In-the-canal (ITC) hearing aids and In-the-ear (ITE)

ITC and ITE hearing aids sit in the lower portion of the outer ear bowl, making them comfortable and easy to use. Because they’re larger than IIC and CIC styles, they can fit a wider range of hearing losses. Their size also allows them to host additional features such as directional microphones, manual controls (ie button) and Bluetooth streaming.

Hearing Aid Technology:

At their core, hearing aids have always been designed with four basic parts: a microphone, a processor, a receiver and a power source. With time, as technology has advanced, other features have become extremely helpful for patients, including the following:

Wireless Technology

Wireless technology allows two hearing aids to operate together as one complete system, instead of acting as two independent devices. The sound input to both hearing aids is shared and decisions about the digital sound processing are based on the combined information. This is known as binaural processing. This technology mimics the brain’s ability to process information coming from both ears and helps reduce manual adjustments.

For example, if one hearing aid is being triggered for directional mode, both hearing aids would likely switch into that mode at the same time. The data transfer rates for wireless hearing aids are measured in nanoseconds, which is much faster than human brain can detect. For the wearer, the adjustments are perceived in real time. Sound processing is therefore synchronized between the two hearing aids, thus improving sound quality for the wearer. 

Wireless hearing aids are also capable of wirelessly communicating with external devices, most often via Bluetooth, telecoils that work with hearing loops, and frequency modulation systems.

Directional microphone systems

Directional microphone systems are designed to boost sounds coming from the front of the wearer and reduce sounds coming from other directions. Different system designs block out more or less of the sounds coming from behind the wearer. These systems improve speech understanding in background noise. Satisfaction is higher for hearing aids with directional microphone systems than for hearing aids without them.

Digital noise reduction

Digital noise reduction systems analyze the signal to determine if it contains unwanted noise. If this unwanted noise is detected, this system reduces the level of noise. This feature makes the background or environmental noise less annoying and increases your listening comfort. Digital noise reduction has been shown to be effective and preferred by hearing aid wearers. 

Impulse noise reduction

Similar in purpose to the digital noise reduction, impulse noise reduction improves listening comfort. This system detects any transient loud noises, such as car keys rattling, typing on a keyboard or dishes rattling, and softens them instantly.

Wind noise reduction

Although fairly specific in its application, wind noise reduction can make a world of difference for those who spend time enjoying outdoor hobbies, like golfers and boaters. Wind noise reduction detects the impact of the wind blowing across the hearing aid microphones and avoids or reduces the amplification of it.  

Feedback management systems

Feedback management systems combat the inevitable feedback (whistling) that occurs in a hearing aid. These feedback loops create an annoying whistling sound that can get in the way of your comfort. Feedback management algorithms can be implemented differently for basic hearing aids or advanced hearing aids. Basic feedback management systems may reduce the overall amplification to remove the whistling. Advanced feedback management systems reduce or eliminate whistling without affecting overall amplification of the hearing aid.

Data logging

Data logging is a feature that stores data about the listening environments in which you wear your hearing aids and your preferences for programs, volume levels and other features. The information can be accessed by the hearing healthcare professional when you return for a follow-up appointment. Your practitioner may use this valuable information to further customize your hearing aid fitting.

Bluetooth compatibility

Bluetooth compatibility is a wireless feature that enables hearing aids to connect to mobile phones, smartwatches, and other devices that use Bluetooth, often through an intermediary device. Bluetooth technology has the ability to improve the signal-to-noise ratio and eliminate feedback from the microphone because the signal bypasses the microphone and directly enters the hearing aid’s processor. A Bluetooth connection is also less likely to experience interference, which can occur with an FM system (see below under basic features). The latest capability is Auracast™ audio broadcast, which allows for multiple users to connect to one broadcast. 

Artificial intelligence

Some premium hearing aids come with artificial intelligence (AI), which allows them to access a deep neural network to process sound. By logging volume control settings and program preferences for certain sound environments, the hearing aids can begin to make these changes automatically when the environment is detected. Essentially, a DNN allows hearing aids to begin to mimic how your brain would hear sound if your hearing wasn’t impaired.  

Smartphone apps

Most of today’s advanced hearing aids come with smartphone apps, allowing the user to make adjustments, contact their hearing care provider, and monitor battery life. Most importantly, some of them work like assistive listening devices, by routing phone calls or other sources of sounds directly to a user’s hearing aids. Some also can convert speech into text, and translate different languages.

Rechargeable batteries

Increasingly, hearing aids have rechargeable batteries, allowing a person to stop swapping out tiny button batteries every few days or weeks. It’s anticipated that these will be widely available with most hearing aid models in the next few years. 

Tinnitus masking features

The most sophisticated hearing aids come with tinnitus masking features. An audiologist or other hearing care provider can program them to emit sounds that mask the tinnitus or ringing in your ears. (But for many people with tinnitus, simply amplifying the sounds you’ve been missing with a hearing aid can help minimize tinnitus, which often develops when a person experiences age-related hearing loss.)

Two-way audio

Several manufacturers are now making hearing aids with two-way streaming audio in the microphone, which makes hands-free calling easier. When a call comes in to your smartphone, you can hear and speak via your hearing aids’ microphone. (You do not need to speak into your smartphone.)

Choosing the Right Hearing Aids:

Our audiologists are not only experts in hearing loss, but hearing aid technology as well. We will work with you to find the right device that allows you to hear better and is within your budget. We will also verify your prescription (with Real Ear Measurements) teach you how to be a confident user, and support you throughout your journey.

When recommending hearing aids, we consider a few factors: your degree of hearing loss, lifestyle, and budget. Hearing loss is diagnosed in degrees; mild, moderate, moderately severe, severe or profound. Your degree of hearing loss will be a major factor in determining how powerful of a hearing aid you will need. We will also look at your lifestyle and how active you are. Individuals with more active lifestyles will require a higher level of technology to keep up with them. The final factor is your budget. There are many affordable hearing aids that can help you hear better that we can show you. No matter what your needs are, we can help you find the right device.

Implants

For some hearing losses, traditional hearing aids are insufficient. If you have maximized your hearing potential with hearing aids, you may be a candidate for a cochlear implant. For other hearing losses (one-sided or mechanical/conductive hearing losses), a bone anchored hearing aid may be most appropriate. After a candidacy evaluation, the surgeon and audiologist will work with you to provide all options.

Diagnostic Audiology:

Hearing

• Comprehensive audiologic evaluation (including otoscopy, tympanometry, pure tone air and bone conduction testing, and speech testing with and without background noise,)
• Otoacoustic emissions testing (test of outer hair cell function)
• Acoustic reflex threshold testing
• Tinnitus counseling
• Hearing conservation monitoring

Balance

• Functional balance testing
• Head impulse testing
• Dix hallpike, supine roll testing (and repositioning maneuvers, if needed)
• VNG testing
• Bithermal caloric irrigation
• Vestibular Evoked Myogenic Potentials (VEMPs)
• Electrocochleography

Other Services

Custom earmolds for hearing aids, noise reduction, swimming, or music

Cerumen management (curette, irrigation, suction)

Dizziness is another common reason patients may be referred to Audiology. Dizziness can be described as imbalance, lightheadedness, vertigo (the perception that you or your environment is moving), foggy-headedness, etc. Your brain, eyes, ears, heart and blood vessels, muscles, bones, and joints all contribute to your sense of balance. If any one of these is not functioning as it should, you can experience dizziness or imbalance. Many medical conditions and medications can cause dizziness or imbalance.

In the Audiology department at Summit Health, we assess your symptoms of dizziness and imbalance by performing a vestibular evaluation. During this evaluation, we seek to understand whether your dizziness or imbalance is originating from the balance organs within your inner ear. The results from this testing will help with the management of your dizziness or imbalance.

Services provided:

• Dix-Hallpike testing and canalith repositioning maneuvers for benign paroxysmal positional vertigo (BPPV)
• Functional balance testing
• Head Impulse Testing (HIT)
• Videonystagmography (VNG)
• Caloric testing