This has been a subject that I have had strong views on. However, overtime I have changed my position slightly. But I have taken some research from several recent journals including https://www.ihsinfo.org/ihsv2/Ceus/pdf/2008_July_Aug_Sept_THP.pdf to help clarify my current stance.
Hearing aid fitting software has a built- in audiometer to obtain hearing levels with the hearing aid in the ear. This procedure is called in situ audiometry. “In situ” is a Latin phrase meaning “in place” . In the case of hearing instruments, it refers to measurements taken with the hearing aid in its natural location: correctly fitted in the ear. The procedure also accounts for the effects of the depth of the instrument in the ear canal, the effectiveness of the seal in the ear canal, the effects of venting, and the specific receiver in that instrument. When we are using the fitting software to set the target and perform the initial adjustments we rely exclusively on the hearing levels (HTLs) obtained during the audiologic evaluation. The fitting formulas used to set the target gain contain the proper algorithms to compute the gain targets based on the desired input levels and hearing instrument style. However, these algorithms are all based on average data. By including data obtained for your specific patient and his or her specific hearing instrument, we are adding a level of customization that patients expect from the sophisticated digital technology used today.
Once the HTLs are corrected for the hearing aid insertion effects, the hearing aid must be calibrated so that its gain response matches the gain targets. Real-ear measurements as a technique for objectively verifying the performance characteristics of a hearing aid are recommended as a best practice in hearing aid fittings (Valente, 2006). However, it is not widely used for reasons such as expense, time limitations, and the need for cumbersome equipment. As a result, about 60% of hearing professionals do not use real-ear measurements (Kirkwood, 2006). Differences in the acoustic characteristics of the ear canals are quite apparent and speak to the need for individual measures to add precision to the fitting rather than relying on average data. The target match will be inaccurate for the individual ear to the extent that the average RECD is different for the ear under test.
It is essential when achieving fitting success that the hearing aid prescription is verified. Without verification you do not know how the hearing aid is performing and therefore whether the patient is benefiting. I would estimate that at least 75% of private hearing centres still DO NOT verify their fittings, in comparison to 95% of NHS departments that DO verify their fittings. What this means is that ‘potentially’ most premium and advanced hearing aids fitted privately, ‘maybe’ under performing in comparison to more basic hearing aids fitted by the NHS. National hearing aid companies do not verify their fittings generally and often fit the aid to the manufacturers settings. When adjustments are made they are often made blindly without knowing the effect they have on output. The research indicates that verification is still needed to ensure (http://www.ncbi.nlm.nih.gov/pubmed/21376007) prescription is met and that in situ measures are not enough on their own, a stand alone verification device provides the best option. I used to feel that in situ measurements, would sufficiently tailor hearing aid gain to accommodate different ear canal properties. I naively used to make that assumption based on the patients first fit satisfaction and acceptance, as patients who were fitted to REM targets were often less satisfied than patients who were fitted using in situ. After reviewing many of my fittings using real ear measurements I have found that some manufacturers match to target better than others, but that there is still room for improvement in 7 out of 10 patients. Using data obtained directly from your patient will ensure the most accurate initial fitting and will help deliver high patient satisfaction. Therefore, I feel that a combination of both will result in a more precise fitting that is more representative of the individual rather than average data. If a centre is doing neither then you should really consider whether you should use them.
If you feel that your hearing aid is not performing properly or that it is not programmed correctly, then contact us on 01494 765144.
Firstly, there is a difference in the level of clinician you will see and this may impact on the depth of your assessment. You are able to be seen via the NHS or privately. To be seen in the NHS you need to be referred to the hospital by your G.P. Depending on where you go will depend on the level of clinician you will see. If you get tested by the hospital you will be assessed by a qualified audiologist, or a trainee audiologist. For most high street hearing centres you will see a hearing aid dispenser or hearing aid audiologist. The difference between a hearing aid audiologist/dispenser and audiologist is the difference between ophthalmologist and a dispensing optician. Your clinician should also be registered with the HCPC. Affliations to groups such as BSHAA, AHHP, BSA, BAA are not essential as membership to these organisations is voluntary.
Most high street hearing centres will offer FREE hearing tests, but remember no business operates for free! Ultimately they will try to sell to you. If you want impartial, no obligation advice then independent hearing centres that levy a small charge for their hearing test would be a better option and eliminates the pressure to buy. Hearing test prices range from £25 to £150, and in some centres the fee will be deducted from the cost of the hearing aids if you purchase them.
You should be asked questions about your current ear health and otological history in order to eliminate any referable conditions and establish likely contributing factors. Also about family history, lifestyle and physical considerations (such as dexterity) should be assessed.
You should have a visual inspection of the ear (otoscopy) which will look for infections, wax, outer and middle ear conditions.
The primary assessment, audiometry (tone testing), should be conducted in a sound proof booth in order to establish hearing thresholds, type and severity of hearing loss. The sounds (tones) will be different frequencies and will be loud and soft. There are two types of tone testing, air conduction (through headphones) and bone conduction (through pad placed at the rear of the ear). This will clarify whether you have problems in the middle, outer, or inner ear. Your responses will be registered via a hand-held button and stored electronically on an audiogram and this should be explained to you in detail.
If you have hearing loss it is often useful and important to have some speech testing done via calibrated speakers, if you are struggling to hear in noise then some form of speech testing is also useful when trying to work out what hearing aid would be most beneficial.
If you have a hearing loss, amplification should be demonstrated to you at the assessment. If you do not experience the hearing aid how do you know it will benefit you? So you should always ask for a demonstration or trial.
Should you need a hearing aid and purchase one, then you should choose an approved centre that you feel will give you the best service. Do not choose a centre based on price. If you are worried about the price but like the centre, then shop around for ‘like for like’ packages (exact hearing aid recommended not an alternative, warranty period, aftercare period, extras) to ensure the prices you get are accurate and fair. If you are dealing with a professional centre the pricing and hearing aid recommended should be clear and transparent. Hearing aids can then be fitted as quickly as 2 to 10 days from your hearing assessment.
If you would like to book a hearing assessment call Chalfont Hearing on 01494 765144.
Tinnitus affects 1 in 10 people in the UK and can be caused by a host of conditions and can occur in people with normal hearing thresholds and people with hearing loss. Our Subject Patients’ tinnitus was a high frequency sound which was louder some days than others, and was often worse in a quiet environment. After struggling for a long period of time with his tinnitus, he decided to take action. He was referred for treatment, where he was fitted with a device which uses Acoustic Neuromodulation. The treatment is delivered using a small palm size device which delivers low-level sounds to the ear via headphones. The device works by forcing auditory nerve cells sensitive to different frequencies to fire at a different rate and so disrupt the abnormal neuron firing that is associated with tinnitus. This particular type of sound therapy is extremely new in tinnitus treatment and management circles. At the Chalfont Hearing Centre, Bucks, we are also utilising this form of tinnitus management using our preferred device, the Soundcure Serenade. This device also uses amplitude modulated and pitch matched tones. The generated sounds are referred to as S-tones and are customised specifically for your unique tinnitus, which research suggests can reduce your perception of tinnitus. Such devices are not a tinintus cure or a tinnitus miracle but they have had significant results. Serenade is designed for short term relief of tinnitus symptoms and long term relief as part of a tinnitus management program here at Chalfont Hearing Centre near High Wycombe.
Advanced treatments like those provided at the Chalfont Hearing Centre are not available via the NHS, Currently this device costs £1750 and is only available through approved hearing and audiology centres. To book a tinnitus assessment or for more information on our tinnitus sound therapies please contact us on 01494 765144.
When patients begin to tackle their hearing loss, I have found that many feel like they are the only person experiencing what they are going through. Most patients display very similar issues and concerns. However, there is not always positive and constructive advice available. That is why Chalfont Hearing are supporting the local Hard of Hearing Club. This organisation provides the opportunity to meet other people who are similarly affected and discuss new experiences. We promote a holistic and engaging approach to rehabilitation of hearing loss.
This Club has been in existence for over 30 years and is the only one of its kind now remaining in the Bucks, Berks, Herts and Oxon area. It is a friendly and caring club, supporting its members, who have widely differing degrees of hearing loss. During its yearly programme there are at least two evenings devoted to ” Hearing Matters,” while other speakers inform and entertain on a variety of topics. They welcome members from a wide area and try to publicise the benefits the Club has to offer by attending Open Days such as the event held by Chalfont Hearing Centre, whose welcome at the event was much appreciated.
This ” Cindarella of Disabilities” is at last beginning to reach a greater understanding by the general public, and support and advice is becoming more easily available. The Club aims to provide an informal and happy environment for older men and women for whom isolation and lack of communication would become a real problem.
They are always pleased to welcome enquiries and visitors.CONTACT: Kate Weber, 7 Webb Close, Chesham, Bucks, HP5 2JQ ( 01494-773359; Text Messages: 07757 639066)
Where do you go for the best advice on the latest hearing aid technology? and how do you know that you have looked into all of the options available? This is a problem that I have seen patients presented with year after year. Patients are confined to wear NHS hearing aids that are fitted on budget, private patients who visit high street hearing centres who are fitted hearing aids from the manufacturer that owns that chain, or fitted with older technology which is ‘on offer’. Commonly, options and choice of hearing aid technology and assistive devices are limited to what is offered by the Audiologist or dispenser. Fundamentally, for most hearing aid wearers this is the best and easiest format, but I now deal with younger patients who are more ‘tech savvy’ and more inquisitive than what I used to deal with previously. So we have organised the Hearing Aid and Tinnitus Exhibition to help inform those people about all the possible options available to them, without bias but also to give confidence in our service.
Hundreds of people descended upon the village hall in Little Chalfont, Amersham (2/10/13) for the day. The local and wider community were overwhelmed by the quality and substance of information delivered by a host of world leading hearing aid manufacturers and Audiological specialists.
Attendees benefitted from a host of FREE giveaways and hearing healthcare advice. There was an extremely positive and welcoming atmosphere, which was really nice. The day was constantly busy and many thanks are due to Unitron, Widex, Starkey, Soundcure tinnitus, PC Werth, Phonak for making the day a success. Special thanks is also due for the local hard of hearing club who also contributed their efforts. And lastly, the event organisation skills of Eleanor Cox who organised a fluid and successful day for everyone who attended.
For information on our next exhibition call 01494 765144.
Dream – the new hearing aids from Widex – promise to deliver three things: more sound, more words, and to be more personal. But what exactly does this mean? And is it the right match for your needs? Patients are always looking for the best digital hearing aid, for the best performance in background noise, for the best sound quality, for natural hearing and comfort. According to my patients the results and the performance is exceptional. The Widex Dream 440 seems to stand head and shoulders above other premium aids in comparison tests. Almost all of my patients are premium level patients and therefore demand the best diagnostic service, precision fitting and quality hearing aids. So far no one has been disappointed. In objective testing conducted in our practice, patients performance on speech tests and speech in noise tests were drastically improved when fitted with the Widex Dream 44o hearing aids. We are offering free trials and demonstrations on the Widex Dream 440. We are confident that this hearing aid will out perform your existing aids and our expert fitting process will surpass our competitors, that until the end of November we are offering free hearing tests (usually £45) and free hearing aid trials to anyone interested in the Widex Dream 440.
To book a hearing test and free Widex Dream 440 hearing aid trial call 01494 765144 or email firstname.lastname@example.org today!