Blog series, part 1: "Everything you need to know before your hearing aid fitting"
- tina
- 24 mars
- 5 min läsning
Part 1 - The auditory system and how we hear with our ears but listen with our brains
The auditory system is a complex system consisting of different parts, each with a specific task. A successful hearing aid fitting rests on three pillars: the technical fit of the hearing aid, the expertise of the audiologist, and your understanding of how both the inner ear and the brain process sound.
Why is the audiologist's expertise important?
“Getting a hearing aid” is about much more than just buying a product. It is a process that requires expertise and precision. Through a combination of different tests, we create a comprehensive picture of your hearing loss. The assessment also shows whether we need to refer you to a doctor for medical assessment or treatment. You should always consult a licensed audiologist for your hearing assessment. Online tests may seem convenient, but they are not reliable or accurate enough to form the basis for a reliable diagnostic hearing assessment. In addition, they carry a high risk of missing serious medical conditions – conditions that are caught during a comprehensive assessment by a licensed professional.
Why is your understanding so important?
Understanding how your auditory system works is crucial for several reasons:
Realistic expectations: If you understand that the damaged hair cells in the inner ear cannot be replaced, it will be easier to accept that the sound may initially feel different or unfamiliar.
Brain Adaptation (Acclimatization): If you have been living with an impairment for a long time, your brain has "forgotten" certain sounds. When we reintroduce these sounds through hearing aids, the brain needs time to learn to filter and prioritize them again. Your understanding of this process will give you the patience needed during the first few months.
Empowerment in social situations: When you understand the difference between volume and clarity, you can better communicate your needs to those around you. You can explain that it is not enough for people to speak louder, but that you need a quieter sound environment.
The peripheral auditory system
The auditory system is a very complex system where each part complements the other and has its own specific task. The peripheral auditory system consists of three parts: the outer ear, the middle ear, and the inner ear.
Outer ear: The outer part, the one we can all see, acts as a natural funnel for sounds. It consists of two parts: the pinna and the outermost part of the ear canal.
Middle ear: When sound waves hit the eardrum, it begins to vibrate, and these vibrations set the three auditory ossicles (the hammer, the anvil, and the stirrup) in motion.
Inner ear: The movements in the auditory ossicles then reach the inner ear and the cochlea. Here the critical conversion takes place where mechanical movements are converted into electrical nerve impulses via thousands of tiny hair cells.
The central auditory system – where we actually listen
When the impulses leave the inner ear, they are sent to the central auditory system in the brain. The brain is responsible for listening, interpreting and understanding different sounds. If you have lived with a hearing loss for a long time, the brain has become "used" to listening to certain sounds. To practice the ability to understand different language sounds again, the brain needs access to the sounds and time to practice them. It is a cognitive process that requires both patience and the right stimulation.
You can read more about how this training is done, and how we have built up our hearing aid fitting and follow-up, in our upcoming blog posts.
How we at AUDIOLOGIFORUM investigate your specific hearing profile
To know what type of hearing loss you have, and thus how best to treat it, we - if you assess that your hearing has started to deteriorate - conduct a comprehensive hearing assessment.
The questions we want to answer are, for example:
Is hearing loss unilateral or bilateral?
What degree of impairment do you have? (Mild, moderate, severe?)
What type of impairment do you have? (Sensorineural or conductive?)
How great is your perceived effort?
In what specific situations do you find that your hearing limits you the most?
Different types of hearing loss
We usually divide hearing loss into four main types:
Sensorineural (SNHL): The most common type. It is caused by damage to the inner ear hair cells or the auditory nerve, often caused by age or noise.
Conductive: Sound is stopped on its way through the outer or middle ear (e.g. by wax, fluid or problems with the auditory ossicles).
Mixed: A mixture of both of the above. There is both an obstacle in the way and damage to the inner ear.
Hidden hearing loss: Here the hearing test (audiogram) looks normal, but you still have difficulty understanding speech, especially in environments with a lot of background noise.
In-depth history and clinical examination
It all starts with us listening to your story.
We then perform a thorough examination of the ear (otoscopy) with a high-resolution video camera.
You can watch as we project a live visual image of your ear canal onto a large screen! This is done to ensure that the ear canal is free of wax plugs, and that the eardrum looks healthy.
Diagnostic investigation
We use several different measurement methods to see how sound travels throughout your entire auditory system. The combination of these diagnostic tests provides a comprehensive picture of your hearing loss and shows which treatment is most appropriate for you. The assessment also shows whether we need to refer you to a doctor for medical assessment or treatment.
Some of the tests we perform are:
Tympanometry: We measure the mobility of the eardrum and your acoustic reflexes. This is done to ensure that the middle ear is functioning optimally and that there are no obstructions such as fluid behind the eardrum.
Air and bone conduction: We determine your exact hearing thresholds. A hearing threshold is the faintest sound you can just begin to perceive. We measure both via headphones or plug-in phones (air conduction) and via a small vibrator behind the ear (bone conduction). By comparing these, we see whether any hearing loss is due to a mechanical obstacle in the middle ear or damage to the nerve cells in the inner ear.
Discomfort levels: We measure when sounds becometoo loud for you. We do this to ensure that we have a handle on when sounds become uncomfortable for you. This is important information for us if you choose to start using hearing aids.
Your hearing profile and our recommendations
Once all the tests are completed, we will go over the results together in peace and quiet. We will explain what your specific profile means for your everyday life and your quality of life. You will then make your own decision about any next steps, whether it is with us or someone else.
Do you want to know what your hearing profile looks like?
Do you find it tiring to keep up with conversations? With us, you will receive a thorough review of your entire hearing system in a quiet environment where we have time for your questions.
Tip: If the investigation shows that you have a hearing loss and you choose to proceed with a hearing aid trial with us, the entire cost of the investigation will be credited to the total price.