Your Hearing

1. The outer ear 
Sound waves enter the outer ear and travel through the ear canal to the eardrum, causing it to vibrate. 

2. The middle ear 
This part of the ear is unaffected by hearing loss. The vibrations travel to the eardrum, which is connected to three tiny bones in the middle ear called ossicles. The ossicles naturally amplify the sound before it enters the inner ear.

3. The inner ear 
This part of the ear contains a fluid-filled cochlea lined with thousands of tiny hair cells. With more common hearing losses, hair cells can be damaged or missing along the cochlea. The frequency and severity of hearing loss depends on both the location and number of missing or damaged hair cells.

4. The auditory nerve
Impulses from the remaining intact hair cells travel up the auditory nerve to the brain. Here, the brain may have difficulty interpreting the sound due to the limited acoustic information that can be provided by the functioning hair cells. 

Conductive Hearing Loss
Conductive hearing loss occurs when sound is not conducted efficiently through the ear canal, eardrum, or tiny bones of the middle ear, resulting in a reduction of the loudness of sound that is heard. Conductive losses may result from wax build-up, fluid in the middle ear, middle ear infection, obstructions in the ear canal, perforations (hole) in the eardrum membrane, or disease of any of the three middle ear bones.

Sensorineural Hearing Loss
Sensorineural hearing loss occurs when there is damage to the inner ear (cochlea) or to the nerve pathways from the inner ear (retrocochlear) to the brain. Sensorineural hearing loss cannot be medically or surgically corrected. It is a permanent loss.

Sensorineural hearing loss not only involves a reduction in sound level, or ability to hear faint sounds, but also affects speech understanding, or ability to hear clearly. Sensorineural hearing loss can be caused by diseases, birth injury, drugs that are toxic to the auditory system, and genetic syndromes. Sensorineural hearing loss may also occur as a result of noise exposure, viruses, head trauma, aging, and tumors.

Mixed Hearing Loss
Sometimes a conductive hearing loss occurs in combination with a sensorineural hearing loss. In other words, there may be damage in the outer or middle ear and in the inner ear (cochlea) or auditory nerve. When this occurs, the hearing loss is referred to as a mixed hearing loss.

Central hearing impairment occurs when auditory centres of the brain are affected by injury, disease, tumour, hereditary, or unknown causes. Loudness of sound is not necessarily affected, although understanding of speech, also thought of as the ”clarity” of speech may be affected. In some cases, both loudness and clarity are affected.

Click below for a quick and easy-to-use hearing loss self-assessment. It’s self-administered and will take about 5 to 10 minutes to complete.

Find out now if you have a hearing loss.
Take this quick hearing self-assessment as a first step

These questions are designed to evaluate your hearing ability. Please answer each statement below by ‘Yes’ or ‘No’.

1. Do you have problems understanding people when they talk?
2. Do you often ask people to repeat what they have said?
3. Do you think people are mumbling more often than they used to?
4. Do you have trouble hearing women or children?
5. Do you have difficulty hearing in a noisy place?
6. Do family members complain that you play the radio or TV too loudly?
7. Do you experience ringing in your ears?
8. Do you have difficulty following group conversations?
9. Do you find it difficult to identify from which direction sounds are coming from?
10. Have you been told that you speak too loudly?

If you answered ‘Yes’ to three or more questions, you may have a hearing problem. Step into any Gnosis Hearing outlet. Our Audiologists are here to lend a listening ear.

Behind-the-ear (BTE)

• Can be worn behind the ear with a tube to a custom earmold placed in the outer ear
• For people with mild to profound hearing loss
• Durable; larger size easier to handle and maintain; separate earmold can be easily replaced; easy to use with assistive listening devices
• Can be used by all ages including infants or children

Receiver-in-the-Canal (RIC)

• Ultra-small, lightweight, behind-the-ear (BTE) style that sits snugly behind the ear and connects to the ear with a nearly invisible thin tube
• More natural sound; less occlusion than a traditional BTE

In-the-Ear (ITE) Full Shell

• Fits completely in the outer ear (custom made)
• Small size, can be used with add-on accessories, custom fit
• For people with mild to severe hearing loss, not usually for children

In-the-Canal (ITC) Half Shell

• Fits in ear canal (custom made)
• Small size (barely visible)
• For people with mild to moderate hearing loss

Completely-in-the-Canal (CIC)

• Fits in ear canal (custom made, mostly concealed)
• Smallest size (least visible)
• For people with mild to moderate hearing loss, not usually for children

What you might experience

Your ears feel blocked

• When you first use hearing aids, your ears might feel as though they’re blocked – this is called the occlusion effect.
• Some people describe it as similar to having earplugs in their ears.
• Most hearing aids have a vent that helps address occlusion by allowing natural sound to pass into the ear.
• With open fitting styles you may not experience occlusion at all.

Your own voice sounds different

• When you first wear hearing aids, your voice will seem louder.
• As you wear them more regularly you will get used to the sound.

You hear whistling from the hearing aids

• High-pitched whistling is known as feedback.
• It can happen when you turn on your hearing aids while inserting them into your ears, when slipping clothing over your head, hugging someone or putting your hand close to your ear.
• Hearing aids have feedback management technologies that greatly reduce the possibility of whistling.

Strategies that can help you communicate more effectively

• Tell others that you have a hearing loss and let them know how they can help (e.g. make sure you have my attention before speaking to me, speak slower, look directly at me).
• Keep background noise to a minimum – turn down the radio and television when you’re talking, and avoid fans or running water during conversations.
• Move closer to the person speaking and position yourself so you can always see them.
• In large groups, position yourself in the center. At large gatherings, such as church services or lectures, sit at the front of the room. Use an assistive listening device, if available.

How family and friends can help

Reduce background noise

• Reduce background noise by turning down the television or radio, turning off the dishwasher, fan and other noisy devices.
• Move closer to the listener.
• Try to have only one person speaking at a time in large groups, when possible.

Make it easy to read your lips

• Do not cover your mouth or chew gum or food when speaking.
• Reduce the distance between you and the listener. Look directly at the person when speaking.
• Ensure conversation areas are well lit so the listener can watch facial expressions.
• Avoid conversations in the car where it is difficult to hear between the front and back seats or to read lips.
• Get the listener’s attention before you begin speaking.

Speak naturally

• Speak at a normal conversational level, avoiding loud, exaggerated speech.
• Do not speak too quickly.
• Pronounce your words clearly and allow the listener time to fully comprehend the conversation.
• Rephrase a sentence rather than simply repeating it, as some phrases are easier to lip read than others.

Batteries

• Store batteries in a dry, safe location away from children and pets.
• Replace dead batteries immediately.
• Always recycle or discard batteries carefully.

Care

• Do not get hearing aids wet. Remove hearing aids when swimming, showering, perspiring, etc.
• Apply hair care products before putting on your hearing aids.
• Take your hearing aids to your hearing healthcare professional for regular servicing and performance checks.
• Avoid dropping or banging your hearing aids on hard surfaces.

Storing

• Store hearing aids in a cool, dry place.
  
• Open the battery doors when they’re not in use.
  
• Protect your hearing aids from excessive heat (hair dryer, vehicle glove compartment or dashboard).

Cleaning

• Clean your hearing aids every day. Use a soft cloth, tissue or special hearing aid brush to wipe the outside. Never use alcohol or cleansers. They harm the internal components and circuitry.
• Use a dehumidifier kit regularly to prevent moisture from entering the hearing aids and damaging the components. You may be able to purchase one from your hearing healthcare professional.
• Use a wax loop or brush to remove ear wax and other debris. Never use a straight pin or other sharp object to clean wax from your hearing aids.
• Replace behind-the-ear earmolds when they become dry, cracked, stiff or discolored.

Does hearing aid help in solving hearing loss?

Yes, hearing aids are primarily useful in improving the hearing and speech comprehension of people who have hearing loss. Recent research showed that 93% of hearing impaired could benefit from hearing aids with guidance from audiologist. A hearing aid magnifies sound vibrations entering the ear. Surviving hair cells detect the larger vibrations and convert them into neural signals that are passed along to the brain. The greater the damage to a person’s hair cells, the more severe the hearing loss, and the greater the hearing aid amplification needed to make up the difference. A qualified audiologist would be able to determine to what extent hearing aid amplification could help an individual. No hearing aid can solve every hearing problem or restore to normal hearing, but they are designed to provide amplification so that you can hear and understand better.

When should I get a hearing aid?

You’ll be in safe hands if you are seeing an Audiologist for hearing aid prescription and fitting. Audiologists are professionals that specialize in evaluation and treatment of hearing loss. Audiologists are qualified personnel who perform diagnostic hearing evaluation and they hold a university degree in Audiology. He or she must be able to provide a thorough diagnostic evaluation, hearing aid fitting and usage training, as well as counseling in hearing communication strategies. Let’s not confuse Audiologist with ENT specialist. ENT specialists are doctors who specialize in any treatment of ear, nose and throat areas. Usually Audiologists and ENT specialists work hand-in hand to give the most desirable hearing solution for the patients.

Who shall I consult for hearing aid prescription and fitting?

“I beg your pardon, could you speak louder?”

If you’ve been asking this question, then the answer is probably “now”. The soonest you learn to adapt to hearing aid, the better is the outcome. Of course, you don’t like the prospect of wearing hearing aids, nobody does. But think of the experiences you’ve had or didn’t have, and the impact hearing difficulties have been having on your life. Remember too, while you may be the one with the hearing loss, all of your associates have a hearing problem- and that’s you. Consider communication as a two-way street: if your half is impaired or uncertain, it will also affect everyone else you talk to. So, talk to a qualified audiologist immediately.

How much do hearing aids cost?

There are a few costs involved in purchasing a hearing aid – the cost of hearing aid itself and also other costs. Hearing aid price is dependent on its technology sophistication. Generally, digital hearing aid with basic functions cost a few hundred to over a thousand; while advanced digital hearing aids could cost a few thousands, however you stand to benefit from clearer speech and less disturbance from noise particularly in a noisy environment. The periphery costs include accessories like batteries, desiccant, ear moulds that need replacement from time to time and cost of repair beyond warranty period. Besides that, your audiologist may charge you for some audiological services. Nevertheless, as compared to the inconvenience of hearing difficulty, the cost is often justifiable.

People say that hearing aids are noisy, is that true?

Most of the hearing impaired persons find the hearing aids “noisy” because they are unable to tolerate the environmental noises that they had merely forgotten, secondary to a hearing loss left untreated for long period of time. Besides, hearing aid technology also determines the sound quality of one’s hearing aids. Analog circuit by itself generates circuit noises, which may create irritation to the users and affect the listening experience. On the other hand, digital circuitry allows the hearing aids to be precisely programmed to match a client’s individual hearing loss, improve clarity of sounds, offers faster processing of sound and enhances listening in noise. I would suggest you to get a digital hearing aid at your budget, and start to relearn sounds. Even those with normal hearing also cannot stop interference on background noises. But the ability to concentrate on important sounds, i.e. speech, could be relearned with practice.

Which hearing aid will work best for me?

The one that is best for you will depends on many factors such as the amount of hearing loss you have, the particular situation where you want the hearing aids to help, your vision and dexterity, how you want the hearing aids to look, the hearing technology and your budget too. The best way to determine the best hearing aid for you is to have your hearing tested by a qualified audiologist who should explain the pros and cons of each type of hearing aid to you. It is quite common to spend an hour just to figure out which hearing aid works best for you.

Tell me, where is the best place to buy a hearing aid?

As hearing aid dispensing is currently unregulated in Malaysia, consumer should be mindful in getting the right product and service. Some useful tips for you:

• The best advice is to look for centre with qualified audiologist (with university degree) whenever possible, don’t hesitate to verify the qualification.
• A professional centre will provide you a comprehensive hearing test, consultation and evaluation of potential hearing aid benefit, prior to purchase.
• Ideally, the centre should be able to offer selection of more than one brand of hearing aid without bias.
• Make sure you are entitled to regular follow-up visits.
• Ask if you could return the hearing aid for refund if it is not satisfactory.

Lastly, we wish you success in hearing rehabilitation process and enjoy effective communication with your loved one.

What is an ENT (ear, nose & throat doctor) specialist?

Otolaryngologists (also called ear-nose-and-throat, or ENT doctors) are physicians who have advanced training in disorders of the ear, nose, throat and head and neck. They treat ear, nose and throat diseases requiring medical or surgical means.

What are the levels of hearing aid technology?

There are essentially three levels of hearing aid technology.
ANALOG technology is the technology that has been around for many decades. Analogue technology is basic technology and offers limited adjustment capability.
DIGITALLY PROGRAMMABLE technology is the ”mid range technology. Digitally programmable units are actually analogue units digitally controlled by the computer/handheld programmer in the office.
DIGITAL technology is the most sophisticated hearing aid technology. A digital hearing aid means it is 100% digital. Simply put, it is a complete computer by itself. Digital technology gives the audiologist maximum control over sound quality and sound processing characteristics. The audiologist can easily manipulate the parameters according to what you need to hear and want to hear. As technology advances, many sophisticated features like feedback canceller, noise reduction and directional microphone are incorporated in the digital hearing aid. The digital hearing aid is now better in fulfilling the hearing needs of the hard-of-hearing.

Binaural hearing: Do I need two hearing aids?

Listening with both ears is as normal as seeing with both eyes. Basically, if you have two ears with hearing loss that could benefit from hearing aids, you need two hearing aids. We are born with two ears for a reason. We have two ears because we need two ears! If we try to amplify sound in only one ear, you cannot expect to do very well. Even the best hearing aid will sound ”flat” or ”dull” when worn in only one ear.

There are many advantages associated with binaural (two ear) listening and importantly, there are problems associated with wearing only one hearing aid — if you are indeed a candidate for binaural amplification.

• Better overall sound quality.
• Clearer speech especially in challenging situations like public gatherings and noisy environment.
• Localization (the ability to locate the sources and directions of sounds). It is more important to know where the warning signals (e.g. traffic noise, sirens) are coming from in order to react.
• More balanced hearing.
• Ability to hear from either side of the head, not just the “good” side.

People cannot hear well using only one ear. There are studies in the research literature that show that children with one normal ear and one ”deaf” ear are ten times more likely to repeat a grade as compared to children with two normally hearing ears. Additionally, we know that if you have two ears with hearing impairment, and you wear only one hearing aid, the unaided ear is likely to lose word recognition ability more quickly than the ear wearing the hearing aid.

Will wearing hearing aids make my hearing worse?

No, the hearing aid cannot damage your hearing. When you wear the aid regularly, your hearing will feel ‘dull’ without it as you have become used to amplification. “Use it or lose it” is a principle of hearing mechanism. The longer a person with a hearing loss goes without hearing help, the poorer the listening habits and speech understanding become. Relearning to use hearing then takes much more time and is more difficult.

The hearing aids pick up more noise than speech?

Hearing aids amplify every sound within range of their microphones, including background noise. It is confusing at first, as you have not heard loud background sounds for a long time. Actually you have merely forgotten what background noises sounded like and how you learned to ignore some of them. You’ll probably be able to train your mind to block out the noise and concentrate on speech and the meaningful sounds you want to hear. You might try to turn the hearing aid volume down. This might cut down some of the background noise levels. Fortunately, people usually speak louder in a noisy environment.

You must relearn how to listen and to sort out sounds that are important. Remember, even those who have normal hearing cannot stop interference on background noise. However, the ability to concentrate on sounds that are important can be relearned with practice.

Owing to the advancement of technologies, certain hearing aids come with special features to enhance speech and reduce background noise. They are directional microphone and noise reduction circuit. Please talk to your audiologist about this.

How long will my hearing aids last?

Many factors determine the life expectancy of hearing aids. This includes the care taken by you, periodic cleaning by your dispenser, your work environment, your body chemistry (salts and acids in your perspiration) and the part of country you live in (shorter in high humidity areas).

Mechanically, a good hearing aid can last, with proper care, for many years. However changing needs on your part and continued improvements in electronics typically shorten the period to about 3-5 years. Even when they last longer, and many do, improvements in the performance of hearing aids and your desire to have something better, may be the deciding factor.

When hearing aids begin to be costly in the way of repairs, this provides a good indication that new ones may be needed.

Can I use the telephone while I’m wearing my hearing aids?

Since our country does not have built-in telecoil in the regular house phone yet, use of the telephone can present a problem. The only way is to lift the telephone receiver near (but not too near, lest it causes feedback!) the microphone of the hearing aid. You may also consider a telephone pad if you are wearing a custom made hearing aid. It serves to reduce feedback and you can put the receiver on your ear as usual.

Alternatively, you can purchase a special telephone with telecoil built-in. In that way, you may use the telecoil in your hearing aids to converse without the interruption of background noise. Please talk to your audiologist on hearing aids and telephones with telecoil.

Or you may like to consider using an amplified telephone that elevates the volume for ease of listening. Similarly, your audiologist will be able to provide you with suitable device that suits your listening needs.

Realistic Expectations

Hearing aids work very well when fit and adjusted appropriately. They amplify sound! You might find that you like one hearing aid better than the other. The left and right hearing aids will probably not fit exactly the same and they probably won’t sound exactly the same. Nonetheless, hearing aids should be comfortable with respect to the physical fit and sound quality. Hearing aids do not restore normal hearing and are not as good as normal hearing. You will be aware of the hearing aids in your ears. Until you get used to it, your voice will sound ”funny” when you wear hearing aids. Hearing aids should not to be worn in extremely noisy environments. Some hearing aids have features that make noisy environments more tolerable; however, hearing aids cannot eliminate background noise.

“Hearing Aid” Alone is Not Enough!

To communicate effectively, you need to fully utilize your ears AND eyes. You will not communicate well using your hearing aids alone. To facilitate optimal communication, you will need to pick up cues from the speaker’s gestures, body language and facial expressions! Besides that, remember to reduce the distance between the speaker and the listener, reduce or eliminate background noises from the listening environment and use good lighting. If someone is speaking to you from another room, while the radio is on, with children playing at your side, it will be very difficult to adequately communicate, despite fantastic hearing aids.

How do I know if I have a hearing loss?

Signs of hearing loss include:

• Having to ask others to repeat themselves often.
• Difficulty following conversations with background noise or in group situations.
• Finding children’s and women’s voices difficult to hear.
• Having the TV or radio turned up louder than normal.

Our hearing loss self assessment can guide you through an initial assessment and help determine if you should contact us for further assistance.

Can I try out hearing aids before I commit to buying them?

We offer a great try-before-you-buy program. It allows you to take home and try out hearing aids at different levels of performance in the actual situations you need them. You decide what works best for you – before committing to buying a thing. During this time, our audiologist can adjust the hearing aids to provide optimal comfort and sound so you can experience what it is like to wear hearing aids every day.

Will my hearing aids restore my hearing to normal, like my eyeglasses do for vision loss?

Hearing aids don’t result in completely normal hearing. Even though they make sounds louder, the louder sounds are still sent to damaged hair cells in the cochlea. Fitting a hearing aid to a sensorineural hearing loss with damaged hair cells is like fitting eye glasses on someone with damage to the retina. Fitting a conductive hearing loss, where hair cells are intact, is more like fitting glasses. While damaged hair cells cannot be replaced, hearing aids greatly improve your ability to hear and can dramatically enhance your quality of life.

Is it difficult to adjust to wearing hearing aids?

Wearing hearing aids for the first time requires that you re-learn how to hear: you can expect a short adjustment period. This experience will be different for everyone. Talk to your audiologist about any concerns that you have. Be patient and stick with it – you’ll be enjoying the benefits soon.

Will hearing aids make my tinnitus worse?

No. Many people with tinnitus experience relief from wearing hearing aids. If you do experience any change in your tinnitus, please contact us immediately.

Will my ears feel sore after wearing my hearing aids all day?

When you begin wearing hearing aids, you can expect to experience some tenderness as you adjust to them sitting behind or in your ears. If this soreness persists after a couple of weeks, talk to your audiologist, who will determine if your hearing aids require further adjustments.

How long will my batteries last?

Battery life depends on the length of time you wear your hearing aids, the size of your hearing aids, the type of circuit you have, and the size of battery you use. Ask your audiologist about the estimated life of your particular batteries and refer to your hearing aid guide for additional information.

Why do my hearing aids whistle in my ears?

Referred to as feedback, whistling can be a result of your hearing aids being inserted incorrectly or your volume being too high. If adjustments to the fitting and volume do not correct the feedback, talk to your audiologist, who will determine if your hearing aids require further adjustments.

Will my hearing aids restore my hearing to normal, like my eyeglasses do for vision loss?

Hearing aids don’t result in completely normal hearing. Even though they make sounds louder, the louder sounds are still sent to damaged hair cells in the cochlea. Fitting a hearing aid to a sensorineural hearing loss with damaged hair cells is like fitting eye glasses on someone with damage to the retina. Fitting a conductive hearing loss, where hair cells are intact, is more like fitting glasses. While damaged hair cells cannot be replaced, hearing aids greatly improve your ability to hear and can dramatically enhance your quality of life.

Can hearing aids help me hear in background noise?

Digital hearing aids that offer directional microphones combined with noise reduction offer sophisticated ways of processing sound to reduce as much background noise as possible. However, noise cannot be completely eliminated by any hearing aids, and keeping some level of background noise also results in a more natural listening experience.

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