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The Value of Custom Hearing Aids in a One Size Fits All World

The Value of CUstom Hearing AIds in a one size fits all world

Custom Hearing Aids at WIchita Falls Hearing:

If you’ve been to a hearing care provider recently, whether it be an audiologist, hearing instrument specialist, or anyone else, you might be under the impression that custom made hearing instruments are out of style, or no longer used in today’s world. 

The dominant style of hearing aid these days is a model called the “RIC”- which stands for Receiver In the Canal. There are many reasons why this is the dominant style of hearing aid, but not all of them have much to do with the person wearing them. 

In this article, we’ll discuss the reasons for this, and how for many people, a custom hearing aid is exactly the right solution- especially when utilizing a precision fitting.

Hearing Aid History: The Receiver In The Canal (RIC) Hearing Aid

In order to understand why most practitioners go to a RIC type instrument so often these days, it’s important to understand the history of these devices and who they were meant for. 

   For many years,  many people with hearing loss only in the high frequencies, often brought on by workplace noise exposure, had very few acceptable solutions. Extended exposure to loud sounds typically does damage to the nerves in the inner ear responsible for high pitched sounds. In a lot of cases, a person with a hearing loss like this can have nearly normal hearing in the lower pitch ranges, but higher pitched sounds can be much more difficult to hear. In those days, almost 20% of the people who needed our help fell into this group- and it was very hard to help them. 

Fitting these types of hearing losses used to be very difficult. If we plugged your ear with a hearing aid, your hearing actually became worse in the low frequencies than without the instrument at all. This would create what we refer to as an insertion loss, and an accompanying effect called occlusion. Basically, your ears are plugged, and when you talk, it kind of sounds like you are wearing a bucket over your head. When you chew food, it can be abnormally loud, and a lot of sounds just seem “wrong”. 

If we didn’t plug your ear with a hearing aid or ear mold, then the high pitch sounds that we needed your hearing aid to amplify would leak right out of the ear and the microphone on the hearing aid would pick them up, and try to re-amplify them (they are sound, after all). This would cause feedback, or whistling in the ear. 

It really was a catch 22. In many cases, we couldn’t give you the amplification you needed without giving you side effects that were sometimes worse than the original problem. 

Open Fit Hearing Aids

Then, came the “open fit” hearing aid. These original models were basically small behind the ear devices that would sit discreetly on the ear, and then deliver the amplified high frequency sound directly into the ear canal with no ear mold. The thin tube would deliver the sound to the ear drum, and the body would accept it without the ear being blocked. 

It was a novel solution to an age old problem. With the microphone separated from the ear, the need for an ear mold to avoid feedback (whistling) was reduced. It was a great day for factory workers, gun enthusiasts, and repeated concert goers everywhere. 

Here Comes The RIC

After a few years, the design of these instruments evolved. Instead of the sound moving through a thin tube from behind the ear, the speaker of the hearing aid- technically named the “receiver”, was placed in the ear canal- this allowed for the delivery of more amplification in the ear, and the production of multiple receiver types and strengths- so the same hearing aid could be reconfigured for multiple types of hearing loss. 

A huge benefit of this technological move was the fact that a hearing aid manufacturer could produce one model of hearing aid that would work adequately for 60-70% of patients. This results in a reduced production cost of the instrument. Hearing aid practices could also keep many of these devices on hand. That way, they could be dispensed on the patient immediately after the hearing test, rather than ordering the product and taking weeks for custom production.

So, the manufacturers preferred it, and it improved the business model of the hearing practice. 

But… does that mean that you hear better with one? 

Well, no. Not always.

Remember- the original problem the open fit hearing aid was trying to solve was occlusion- and the rejection of the sound by the user. This was an issue with 20% of people. But, the open fit hearing solution has been applied to 60-70% of people who have purchased hearing aids over the last 5 years. 

However, many people with hearing loss complain about their ability to hear speech in noisy environments.

It’s actually what brings many people in to the office for the first time. 

Here’s the Truth:

Open fit hearing aids don’t tend to perform as well in background noise.

A custom hearing aid will usually do better. 

Also, a custom hearing aid requires considerably more work

and expertise on the part of the provider to fit properly.

There’s a good reason for this. If your ear canal is wide open, background noise comes through into what you hear just as loud as if you were wearing no hearing aid at all. While digital technology has come a long way, no hearing aid can “clean up” background noise if you hear it naturally. 

Closing off the ear canal a bit with a molded instrument gives us the opportunity to focus the sound you are hearing using multiple tiny microphones and advanced sound processing- helping you hear better in noise, and the sound processing in hearing aids has gotten so much better over the years, we can completely solve the occlusion effect for most users– bypassing the problem that the open fit hearing aid was design to help with!

Also, Custom Fit Hearing Aids Are Better Than Ever

Precision fitting is now possible. There was a time when an impression had to be taken of the ear in order to make a custom hearing aid. The material used in this process would often stretch and distort the ear canal, resulting in and inaccurate impression, and a poor fitting hearing aid. It was also a little uncomfortable. Not painful, but not many people enjoyed the process of having an ear impression taken. 

  Now, with new technology, we are able to scan the ear directly using a painless light scanner in less than 2 minutes. We send this scan of your ear to a manufacturer, and a hearing aid is literally produced using 3D printing technology to fit you exactly. 

Then, we are able to program the instrument to best compensate for your hearing loss, measuring the output INSIDE your ear canal, to provide for the most precise output possible. This process is called Real Ear Measurement. Utilizing this technology, we can even tailor the output of the hearing instrument to be tuned to a specific voice in your life- for example, programming a husband’s hearing aid so that he can best hear his wife. 

The result of this combination of precision fitting techniques is a great fitting custom product made just for you, calibrated just for you, and designed to get your hearing the best it can possibly be for the sounds in your life, with the best technology available today.

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