HEARING & BALANCE


Hearing is one of the five senses. It is a complex process of picking up sound and attaching meaning to it. The ability to hear is critical to understanding the world around us.

The human ear is a fully developed part of our bodies at birth and responds to sounds that are very faint as well as sounds that are very loud. Even before birth, infants respond to sound.

Audiologists

An audiologist has a graduate degree, has completed a clinical internship, has passed a comprehensive national standardized examination and has professional credentials. Most states also have licensure for audiologists. These credentials will help you identify the most qualified person to provide your hearing care services. There are over 10,000 audiologists in the United States who provide hearing care services, including:

  • Comprehensive hearing evaluations for persons of all ages
  • Selections, fitting and dispensing of hearing aids and other assistive listening devices.
  • Patient and family counseling about living with hearing loss
  • Hearing conservation programs to prevent hearing loss
  • Research and development of new evaluation techniques and rehabilitation strategies

Remember! Hearing loss may occur so gradually that one may not be aware that it is happening. The first step in the identification of hearing loss is a comprehensive hearing evaluation by your local audiologist!

How We Hear
Our ears are divided into three sections: the outer ear, middle ear and inner ear. Each section moves and processes sound in its own way. The outer ear feeds sound through the ear canal to the eardrum, causing it to vibrate. These vibrations affect the three little bones inside the middle ear (malleus, incus, stapes), causing them to move. That movement travels into the fluid and tiny hairs of the inner ear (cochlea). These hairs convert movement into auditory signals, which are then transmitted to the brain to register sound.

Do I have hearing loss?
Hearing loss can be caused by many different things and manifest in unique ways.

  • It can be sudden or gradual.
  • It can occur in one ear or both ears.
  • It can be temporary or permanent.

The truth is that hearing loss happens to people of all ages and is associated with the aging process. Before discussing causes and treatments for hearing loss, it is important to understand how hearing works.

Causes of Hearing Loss
Hearing loss occurs when sound is blocked in any of the three areas of the ear. One of the most common causes of hearing loss is exposure to loud noises. However, infections, both of the ear or elsewhere in the body, can also cause hearing loss.

  • Hearing Loss In the Outer Ear: Earwax build-up, infections and swelling, a growth in the ear canal, injury, or birth defects.
  • Hearing Loss In the Middle Ear: Fluid build-up as well as tumors (both benign and malignant).
  • Hearing Loss In the Inner Ear: Aging diminishes hearing due to damage to the cochlea, vestibular labyrinth, or the acoustic nerve. Additionally, hearing loss can be caused by inner ear infections, Meniere’s disease, and other nerve-related problems.

Other causes of hearing loss include:

  • Presbycusis: Age-related hearing loss.
  • Heredity and Genetic Causes: There are a wide variety of diseases and syndromes that are either genetic or hereditary that can cause hearing loss. Some, like rubella (German measles) occur when a pregnant mother has the disease, which causes hearing loss in the baby. Other, rarer types of hereditary and genetic causes include CHARGE Syndrome, Connexin 26 disorder, Goldenhar Syndrome, Treacher Collins Syndrome, Usher Syndrome, Waardenburg Syndrome and otosclerosis (growth of spongy bone tissue in the middle ear).

Most causes of outer ear hearing loss can be remedied, but problems of the middle and inner ear can lead to permanent hearing loss. This is why it is important to seek medical attention quickly if you are experiencing a problem.

Types of Hearing Aids
In addition to comprehensive diagnostic hearing evaluations, Cape Fear Otolaryngology Audiology department provides a full range of hearing aid services. We are proud to offer the most recent advances in hearing aid technology, as well as a wide variety of custom ear mold products. All of our audiologists have a doctorate in audiology and are licensed and certified to dispense hearing aids.

Three Important Questions to Ask Before Purchasing Hearing Aids

Q1: Are you an audiologist or a hearing aid dispenser?
Answer: Both types of professionals can evaluate your hearing and fit hearing aids, but their training varies significantly. Audiologists must have a doctoral or master’s degree, pass national and state exams, and have more than 1000 hours of clinical training before they graduate. Hearing Instruments Specialists generally have from 6 months to 2 years of supervised training or a two-year college degree and in some states must pass a licensing test. All of our providers that specialize in hearing aids are audiologists.

Q2: Do you offer a trial period?
Answer: Yes. We offer a seventy-five day trial period with several post-fitting check-ups during the 75-day period.

Q3: Is your office affiliated with an ear doctor?
Answer: Going to a medical practice allows for a thorough evaluation and having a physician’s evaluation can rule out medical conditions that might be affecting your hearing. At CFO, we have highly qualified Otolaryngologists that work closely with our audiologists to ensure a thorough evaluation.

Size and Style of Hearing Aids
There is technology today for every type of hearing loss and budget, with many sizes, styles, prices and colors available.

  • Behind-The-Ear-Models (BTE)
  • Miniature Behind-The-Ear (Mini-BTE)
  • In-The-Ear Models (lTE)
  • In-The-Canal (lTC)
  • Completely-In-The-Canal (CIC)

Behind-The-Ear (BTE}
Behind-The-Ear hearing aids are the most flexible hearing aids available and cover the greatest range of hearing loss. Your Audiologist will make a custom ear mold of your ear canal which will then be attached to the hearing aid that wraps around the back of your ear.

Miniature Behind-The-Ear (Mini-BTE)
The Mini-BTE is a smaller more concealed version of the BTE. It has grown in its popularity due to its ability to go unnoticed in the ear canal. This device comes in a variety of shapes and colors. This type of device does not need to be custom made.

In-The-Ear (lTE)
The In-The-Ear (ITE) hearing aids are custom-made to fit in the outer part of your ear. There are no visible wires or tubes and they are very light in weight. This device is more suitable for those with dexterity issues.

In-The-Canal (ITC)
The In-The-Canal (ITC) is less visible than the ITE style. This style is small and lightweight.

Completely-ln-The-Canal (CIC)
The Completely-In-The-Canal (CIC) technology fits deep into the ear canal and is the least visible of all the hearing aid technology.

CROS/BICROS
The CROS/BICROS system comes in a BTE style or ITE Style.

Custom Products
All custom molds are fitted by state-licensed audiologists. An exact impression of your ear is taken and sent to the manufacturer with your ordering specifications. Typical turn around time for these custom ear pieces will take 2-3 weeks. Custom earpieces can be designed for use with bud/button style stereo headphones such as today’s iPods and iPhone usage.

  • Custom earpieces are a great choice for those with hard to fit ears and can offer a superior seal for particular anatomies
  • Custom earpieces are made to order and offer virtually unlimited customization options
  • 2-3 week turn around time for your custom earpiece
  • Ear Molds come in a wide range of color options

If you are interested in a custom ear mold and would like to schedule a consultation with an audiologist, please contact our office today!


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Cape Fear Otolaryngology is a state of the art practice specializing in ear, nose, and throat treatments for children, teens, and adults. Our practice was designed with patients in mind and our team of highly skilled physicians and staff look forward to serving you and your family.

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