Hearing Devices and Technology
Healthy Hearing & Balance Care offers a complete range of technology for the prevention and rehabilitation of hearing loss and tinnitus. Our audiologists are qualified and accredited to provide the best hearing solution by selecting, fitting, programming and maintain hearing instruments of all available manufacturers in Australia.
Hearing rehabilitation process
Successful hearing results rely on a number of factors to be considered by the Audiologist before deciding to implement appropriate technology and techniques which may or may not include a hearing aid. This process is an exchange of experiences and knowledge between patient and audiologist.
At Healthy Hearing & Balance Care, we expect that a patient who engages in the hearing rehabilitation process with us is someone who is experiencing difficulties and is serious and ready to take the next step. This person comes to our clinic based on the trust in our expertise and is committed to working with us towards achieving his or her goals.
If you choose to engage in the hearing rehabilitation process at our clinic you will undertake a series of diagnostic hearing and ear function tests to ascertain the origin, characteristics and prognosis of your hearing loss so that your rehabilitation plan can be customized for your profile. The appropriate hearing instrument, when required, will be selected according to your needs and budget.
How to choose a hearing instrument when you really need one?
Healthy Hearing & Balance Care’s audiologists have access to all hearing instruments available worldwide. Independent audiologists have hearing instruments retailing rights and buy directly from the manufacturers’ distributors.
There are many different hearing aids which may be suitable for the rehabilitation of any one individual making the selection process very confusing for the consumer. Our preference is to select the most reliable, efficient and economical model for each of our patient’s needs, regardless of brand. If you, however, have a brand preference we are happy to oblige as long as it is suitable for your audiological profile.
After it has been established that a hearing aid should be part of your hearing rehabilitation process we will help you to select the best available options for your budget and encourage you to browse the internet to become familiar with the technology to help you make an informed decision.
If you decide to purchase your instrument elsewhere we are happy to engage in the rehabilitation process with you ensuring that your pre-selected instrument will provide the best results for your needs.
Off- the- shelf hearing aids
These hearing aids are worn behind the ear (BTE) on the top of the pinna with a tube or wire connecting the instrument into the ear canal before reaching the eardrum. Also known as a receiver in the canal hearing aids (RIC, RIE, RITE), these off the shelf devices are the most prescribed devices at present. They are very popular amongst dispensers due to their flexibility to be instantly fitted when a potential candidate walks through their doors.
They are modular instruments with receiver powers of various degrees, different size tubes or wires and ear tips that can be readily assembled and programmed to an individual’s anatomy and hearing loss on the spot using the manufacturer’s software. The microphone of these hearing aids sits on the top of the ear. They usually do not require any customised parts such as ear moulds. This technology has made the fitting of hearing aids much easier leading to the advent of online sales. Sometimes patients are led to believe that these are the only option.
Custom hearing aids
These hearing aids fit inside the ear canal with no external part sitting behind the ear. They are made based on a physical impression of the individual’s ear which allows a cast of the ear to be built in order to assemble the hearing aid. These instruments are individually made by the manufacturer and are available in different sizes depending on the anatomical characteristics of each individual ear. The choice of size is also based on the individual’s dexterity to handle a smaller device. The smallest size is completely invisible sitting deep inside the ear canal (IIC) while the largest covers the entire outer ear (ITE).
Healthy Hearing & Balance Care Audiologists have long been advocates of completely in the canal hearing aids (CIC). This style is our first choice whenever suitable for an individual’s hearing loss, ear canal’s size and manual dexterity. They provide a more natural perception of sound due to the microphone placed right inside the ear canal, mimicking normal hearing physiology. This style facilitates sound localisation and is straightforward to use on the telephone and with headphones.
Custom hearing aid cannot be purchased online. A consultation with the audiologist is needed to assess the anatomical characteristics and to take an impression of the ear canal.
Disposable hearing aids
Disposable extended wear hearing aids, brand name Lyric by Phonak, is inserted by the audiologist in the clinic under a microscope and remains in the ear 24/7. At the end of its battery life, which lasts for up to 4 months, the hearing aid is removed by the audiologist, totally disposed of and replaced with a completely new unit. It offers an advantage for those with dexterity problems who have difficulties handling the insertion and removal of small hearing aids and battery replacements. The disadvantages are the high ongoing costs, increased risk of ear infection and bleeding, as well as the possibility of the battery running out before your next appointment to obtain a replacement unit.
Both disposable (Lyric) and conventional deep inside the ear canal (IIC) styles are not fully waterproof but can be used in the shower and while swimming on the surface, providing a swimming cap or an earplug is used to protect the hearing aid. Most of all over the counter hearing aids have a certain degree of water resistance but immersion in water is not recommended.
Disposable hearing aid batteries
All hearing devices are operated by batteries which are easy to replace. The size of the battery depends on the size of the hearing aid. The smaller the aid the shorter its battery life. Battery replacement is usually required every 3 to 10 days, depending on size and power drained by the hearing aid. Sound streaming from mobile phones, tablets, remote microphones, computers and television increases battery drainage reducing its life hence requiring more frequent replacements.
Rechargeable hearing aids
The most important innovation in recent times has been the release of rechargeable hearing aids. They come with a battery charger, much like a mobile phone. The charge lasts for up to 48 hours, depending on the model, and the battery life is span is predicted to be 4 years.
This may be a very convenient feature for those with dexterity problems to handle and replace a small battery. The disadvantage is that rechargeable batteries have a much shorter life compared to disposables and one needs to remember to recharge every day.
The original models have rechargeable batteries which are inserted in the hearing aid by the wearer and are interchangeable with disposables if required. The latest technology, however, has moved away from this design and now the rechargeable batteries are built in the hearing aids, much like a mobile phone.
This may be a disadvantage because if the battery runs out during a conversation, for example, you are off the air for at least ½ hour while the aid sits on the charger.
The other significant inconvenience is that at the end of the inbuilt battery life, the hearing aid will need to be sent back to the manufacturer for replacement.
Hearing rehabilitation service fees
Fees for hearing rehabilitation services in Australia are most commonly bundled into one package where a large sum is charged to cover the hearing aids and all the assessments, fitting, programming and ongoing services for a period varying from 6 months up to 3 years. This approach is misleading because it gives the impression that you are paying for a very expensive hearing aid and all the other services and procedures, fundamental for a hearing aid to work, are offered for free. This common pricing strategy also means that those who acquire a hearing aid and are less dependent of the audiologist for their ongoing hearing health will pay far more than those who need more frequent visits to the clinic to be able to manage their hearing loss.
Since 2011, Healthy Hearing & Balance Care has adopted an unbundled structure of fees. This means that all the services required for a successful hearing rehabilitation program have been itemised and charged according to its provision to each individual patient. This also means that the price of the actual hearing aid is lower as the services and costs are no longer bundled together. Patients are only charged for the procedures they require and pay for each service as they receive it. We try to keep our prices as low as possible while ensuring it is financially viable for our clinic to continue providing much needed audiological services to our community.
Our hearing rehabilitation policy
Hearing aids in Australia are commonly offered on a return for credit basis with a trial period. We follow a 4 weeks hearing aid trial policy although we do not fully agree with this principle. The reason we do not agree is that, as highly qualified and experienced professionals, our audiologists are capable of guiding our patients to make the appropriate decision regarding the most suitable device for their needs. Our initial recommendation is successful more often than not.
Successful results rely on a number of factors that are considered by the audiologist:
- The appropriate technology and features of a hearing instrument
- The professional expertise used to select the appropriate device
- Expert programming of the hearing aid to suit the patient’s condition
- Verification of the results and rehabilitation protocols
Choosing the best options for your situation
You may also choose to buy your hearing aid elsewhere and we will be happy to include the device in your rehabilitation plan. However, we will not be able to honour the warranty, the authenticity and reliability of a product which was not sourced by us.
If you are serious about your hearing and want a successful result we will be happy to provide our itemized list of procedures and fees involved in this process.
You may also wish to browse the internet to become familiar with available hearing aid technology to help you make an informed decision prior to your first consultation with our audiologists.
We provide below a list of reliable websites of reputable hearing aid manufacturers:
Implantable hearing devices
Implantable hearing aids are available for those who cannot benefit from conventional off the shelf or custom made hearing aids.
All implantable hearing devices are comprised of an internal component which is surgically implanted by an ear surgeon and an external processor worn over the skull which is fitted, programmed and maintained by an Audiologist. They all operate on batteries.
To date, there is still no commercially available device totally implanted and invisible. Interestingly, conventional hearing aids are still far less visible than any implant.
There are different implantable options to address a variety of hearing and ear disorders.
Implantable technology is only indicated to those who cannot wear a conventional hearing aid to facilitate their hearing habilitation process.
As technology advances, more adults with acquired and congenital (born with) hearing losses are taking advantage of cochlear implant technology, as there is no age restriction. One can be as young as 3 months or as old as 100 to benefit from a hearing implant. All models have an internal part which is surgically implanted and an external part much like a conventional hearing aid. The external part is referred to as “speech processor” or “sound processor”.
Cochlear implants electrically stimulate the hearing nerve direct via electrodes implanted in the cochlea and connected to the external processor via a magnet placed under the skin on the skull behind the ear. It is suitable for those with more severe sensorineural hearing impairments with an intact auditory nerve.
The sound processor which is attached to the internal implant via a magnet is available in 2 different styles: “behind-the-ear” with the main part sitting on the pinna connected via a cable to a coil placed on the skull or one single unit “off the ear” placed on the skull without touching the ear.
Electro-acoustic stimulation (EAS) or Hybrid is a combination of a cochlear implant and a conventional hearing aid in the same device. The indication is for those with reasonably good low-frequency hearing and no hearing in the high frequencies. The cochlear implant portion of the device provides the high frequencies electrically and the low frequencies are acoustically supplied by the hearing aid.
Bone-anchored hearing aids provide hearing via bone conduction stimulating the cochlea through vibration of the skull. They are commonly referred to as BAHA although this acronym is now trademarked by Cochlear Ltd.
There are two different styles using different modes of bone conduction stimulation. One uses an abutment screwed into the mastoid bone behind the ear and the other uses a magnet placed under the skin. The implant is connected to an external sound processor either attached to the abutment as the Cochlear BAHA Connect and the Oticon Medical Ponto or secured by the magnet like the Medel Bonebrige and the Cochlear BAHA Attract.
These implants are suitable for those who have a hearing loss due to external or middle ear disorder such as malformation of the external ear, chronic ear discharge and allergic reactions to plastic which prevent wearing conventional hearing aids.
Another indication is for those with one normal hearing ear and totally deaf on the other ear who do not want to wear a CROS hearing aid and cannot receive a cochlear implant due to a damaged auditory nerve.
Middle ear implants
Middle ear implants also have 2 different applications. It can be implanted on the incus (one of the little bones in the middle ear) or directly on the round window (a membrane that separates the middle ear from the cochlea). The incus approach is indicated for hearing losses that affect the cochlea or the hearing nerve (sensorineural hearing losses) with an intact middle ear. The round window approach is indicated for those with sensorineural or mixed (middle ear and inner ear) hearing losses.
How do we know implantable devices are safe?
It is reassuring to know that hearing implant companies need to follow a very strict protocol before an implantable device can become commercially available in Australia. The organization responsible for approval is the Therapeutic Goods Administration (TGA).
In principle, a hearing implant is indicated only when a conventional hearing aid is not sufficient to provide adequate hearing. The question is how to define adequate hearing? What is appropriate for some may not be satisfactory for others.
How are the hearing outcomes measured?
Manufacturers provide funding for clinical trials and research to compare results and performance. Comparisons are usually based on the users’ ability to recognize speech with the different devices. Such researches can be biased and used for marketing purposes.
Healthy Hearing & Balance Care’s Audiologists have a scientific background which allows them to critically analyze research methods and results to help patients make an informed and unbiased decision.
It is important to remember that as implantable technology progresses, so do conventional hearing aids. In many cases, the same end result may be obtained with either conventional or implantable hearing devices depending on the characteristics of each individual.
How are hearing aids and devices funded in Australia?
Implantable hearing devices are fully covered by private health funds as they are part of the surgical prosthesis schedule of fees.
On the other hand, Private Health Funds only reimburse a minimal amount for conventional hearing aids while they are fully subsidized by the government for children up to 26 and over 65s on an age pension.
Who sets the guidelines for device recommendation?
Usually, the manufacturers of the device themselves set the criteria of an individual’s suitability for their products. They usually have charts and tables showing the audiogram (hearing test results) of people who would benefit from their hearing devices. Surely no one knows a product better than those who make them. Their candidacy recommendations are usually correct.
There are however several overlaps in the candidacy amongst many of the devices available. It means that a person with a given hearing profile may benefit from several different technology options either conventional or implantable.
How to choose the correct hearing aid device?
- Who do you trust?
- It is inevitable that each one will preach what they know best.
- The manufacturers may tell you that their own products are the best…
- The surgeons may tell you that implantable devices are the best…
- Audiologists who fit hearing aids only may tell that hearing aids are the best…
- Audiologists who do implants only may tell that implants are the best…
- Consumers who are happy with their own devices will also tell that theirs is the best…
Implantable and conventional hearing aid technologies are advancing very rapidly. Unfortunately for the implant companies, their devices require much longer clinical trials and more strict approval protocols before their release. For this reason, conventional hearing aid technology available is always ahead of implantable.
This is not to say that conventional hearing aids are any better than implantable technology. There is an important place for implantable devices but candidates must be aware that selection criteria overlap. Ideally, before considering surgery, an implant candidate should exhaust all the possibilities of a conventional device.
Another critical point when selecting an implantable device is that the external parts are not interchangeable amongst the different manufacturer. Once you chose one implant you are bound to that company for life.
Manufacturers are constantly perfecting their external processors which are made back compatible with the previous generations of their internal surgically implanted parts. This ensures that users are able to update their processors as new technology becomes available.
Who are the candidates for a hearing implant device?
Those with a profound sensorineural hearing loss who have very little or non-recordable hearing measured through a diagnostic audiometer are straightforward candidates for a cochlear implant, providing they have an intact auditory nerve.
Those with chronic ear discharge, malformed external ears and/or chronic skin allergies, which prevent the use of a hearing aid plastic mould in the ear canal, are definitely appropriate candidates for a bone-anchored device providing they have sufficient residual bone conduction hearing thresholds.
What about everybody else in between?
As a rule of thumb, all the others will qualify for more than one technology and may equally benefit from many of them. It is a matter of choosing which is more appropriate for the individual’s overall needs.
What about choosing the correct model?
Some people believe that a device which provides benefit to a friend will automatically be suitable for them. This is usually not the case. To compare the results one needs to consider causes, degree, progression and duration of hearing loss by detailed audiological assessment including lifestyle and communication needs. Even when these factors are identical we may still not obtain the same outcome with the same device due to other individual differences.
Who should make the choice?
Before proceeding with an implant, choose a qualified Audiologist that you trust. Have a comprehensive audiological assessment. Explore the latest advances in conventional hearing aid technology. Try the best available for your needs and undergo some auditory training if appropriate. Take advantage of wireless technology such as remote microphones to increase the signal to noise ratio that will improve hearing in noisy environments.
If after exploring all options, an implant is deemed to be the best choice for you, do not hesitate. Current surgical techniques and implantable technologies are safer than ever.
The following websites will help you to further understand the implantable hearing technology available in Australia:
Assistive listening devices can make hearing easier
Healthy Hearing & Balance Care also offers a range of complementary devices to help to improve hearing capacity in more challenging situations such as in the presence of background noise, in large auditoriums and on the telephone.
These assistive listening devices are used in conjunction with either conventional or implantable hearing instruments and can be wired or wirelessly connected using blue-tooth, infra-red and 2.4GHz technology.
Many hearing aid models offer the option to wirelessly connect to smartphones, tablets and personal music players.
Telecoil to connect to public and personal loop systems are also available in most conventional and implantable hearing aids.
Custom-made hearing and ear protection
Hearing loss and tinnitus prevention are a core part of our services. Exposure to loud noises is one of the main causes of hearing loss and tinnitus in our society.
Our Audiologists are highly skilled at taking precise ear impressions and selecting the appropriate custom-made products such as:
- Noise earplugs
- Musician earplugs
- In-ear monitors
- Earpieces for mobile phones and MP3 players
- Swimmers plugs
More information and appointments
Please contact: firstname.lastname@example.org or
Phone: 02 93873599