Hearing Loss Treatment Options
HEARING AIDS are devices designed to receive normal levels of sound and selectively amplify them.
Traditional hearing aids have changed enormously since they were first designed. Today’s hearing aids, while varying in technology level, are sophisticated real-time digital sound processors, and do not compare to the original analog hearing aids of more than 20 years ago. They are totally different to any “preset” or “internet- sold” amplifier, which are erroneously marketed as ‘hearing aids’. Real hearing aids require an Audiologists’ or Acousticians intervention to program them to create an optimum world of sound for you.
iCAN Audiologists and Acousticians recommend choosing devices based on your specific needs. Everyone is different. We programme products to your unique settings, which is critical to your success. Consulting a professional who understands your hearing loss, your lifestyle requirements and the hearing aids that are available, is the most important step you can take, to ensure that the quantitative and qualitative information about your experience is reflected in your management.
The iCAN Audiologists and Acousticians provide patients with a wide variety of hearing loss treatment options from a number of local and international suppliers so that we are able to give our patients choice among the best possible range of products available.
Options other than hearing aids are available…
A bone anchored hearing aid (BAHA) is a special type of hearing device that helps people with certain kinds of hearing loss, such as conductive or mixed hearing loss, single-sided deafness, or when traditional hearing aids aren’t suitable. The system works by bypassing the outer and middle ear and sending sound vibrations directly through the skull bone to the inner ear (cochlea).
It involves two main parts:
A small titanium implant surgically placed by a qualified ENT, integrated into the bone behind the ear.
A sound processor worn externally, receives sound and converts it into vibrations which are transmitted directly to stimulate your healthier cochlea, thereby avoiding any sound processing via the ear canal or middle ear. In these specific types of hearing loss, less amplification is needed to provide you with clear sound. Implant surgery is typically an outpatient procedure, and the external processor can be attached or removed easily for bathing, swimming or contact sport.
In summary, bone anchored hearing aids are specialised sound-to-vibration devices that deliver sound directly to the inner ear for hearing losses where outer and middle ear conduction pathways are not useable.
A cochlear implant is an electronic device designed to help people with sensorineural hearing losses caused by damaged outer hair (nerve) cells in the inner ear or cochlea, who receive limited benefit from hearing aids. It works by bypassing damaged cells to directly stimulate the auditory nerve leading to the auditory brain.
The implant system has two main parts:
An external microphone with sound processor is worn behind the ear or flatly on the head. It transfers magnetically coded electrical signals to the internal implant. Stimulating electrodes insert into the cochlea to activate signals directly in the auditory nerve, which is designed to naturally convey electrical signals to the brain. Other than receiving a different initiating stimulus, the auditory nerve functions normally to deliver these signals to the brain, interpreted as sounds. This process allows users to perceive sounds and understand speech, although because of a different initiating stimulus, the hearing experience requires time, training and stimulus fine-tuning for good interpretation by the brain.
Surgery to insert the implant may be inpatient or outpatient, followed by a period of activation, programming, and rehabilitation with your audiologist, to optimize sound quality and speech understanding.
An FM (frequency modulated) system is a wireless assistive listening device designed to help people with hearing impairment hear better in noisy or challenging listening environments, such as classrooms or public places. It works by transmitting the speaker’s voice directly via radio waves from a microphone worn by the speaker (for example, a teacher) to a receiver used by the listener. The receiver can be integrated into the listener’s hearing aids, cochlear implants, or be a standalone unit.
The main benefit of FM systems is that they improve the signal-to-noise ratio—meaning the listener hears the speaker’s voice more clearly with reduced background noise, distance, and reverberation effects. This direct transmission helps overcome distant speech signals and competing noise, making speech easier to hear and understand.
FM systems typically consist of:
A microphone and transmitter worn by the speaker.
A receiver integrated in a hearing aid or worn as a stand-alone output.
This technology is especially valuable for children with hearing loss in educational settings but is also used by adults in various environments to improve hearing clarity.
In summary, FM systems boost the clarity of speech by wirelessly delivering the speaker’s voice directly to the listener’s hearing device, effectively reducing noise and distance challenges for individuals with hearing impairment.
Other options for improving hearing in noisy places to help your hearing aid are available, such as Telecoil and upcoming technology, Auracast.
What to expect at your first appointment
At an appointment with an audiologist regarding hearing loss treatment options, you can expect a detailed discussion and personalized plan based on your lifestyle, your expressed goals, and the type and severity of your hearing loss. The key components typically include:
Hearing evaluation: After reviewing your medical history; hearing test results, lifestyle needs for hearing sound, and your personal goals for your hearing life, your audiologist will explore your management plan with you. This will typically include an explanation of the cause and type of hearing loss you have which may be sensorineural (hearing loss in the nerve cells); conductive (hearing loss due to an interrupted pathway of sound before the nerve); or mixed (both sensorineural and conductive components). Your audiologist will also discuss tests that reveal how you understand speech in quiet and speech in noise. The results will have a significant impact on your management plan.
Management recommendations: These vary depending on your diagnosis and needs.
In cases where an underlying physical or organic cause requires further investigation for complete diagnosis, or may be open to medical (medication or surgical) treatment, you may be referred to another professional (such as an ENT or neurotologist).
For hearing losses of a permanent nature that cannot be improved or solved with medication or surgery, your management plan will typically involve improving the volume and/or quality of incoming sound signals, aimed at meeting your hearing needs in your lived environments, with the hearing you have. This usually includes offering you specifically suitable, customised and individually programmed hearing aids (either conventional or bone-conducted) designed to restore your access to sounds you can’t hear. You and your audiologist may also add assistive listening devices that are designed for specific tasks, including but not limited to: increasing the speech signals above background noise in noisier places; alerting you for safety; enabling you to interact with electronics (such as cellular phones, televisions, laptops and telephones); and providing additional help in crowd environments (such as theatres, conferences, religious gatherings and lecture halls).
In rare circumstances, a hearing assessment may identify hearing losses that won’t benefit from amplified sound. In these situations, your audiologist may discuss being evaluated for a cochlear implant, which is a surgically implanted device that bypasses damaged parts of the inner ear to directly stimulate the auditory nerve.
Device fitting and customization: If hearing aids or other devices are recommended, your audiologist may take ear impressions prior to fitting and ordering your devices. Fitted devices will be programmed, fine-tuned and optimised by your audiologist for your best outcomes.
Counselling and education: You will receive guidance on device use, maintenance, and realistic expectations for improvement. Counseling can involve family members (with your consent) to support adjustment to living a full quality of life with hearing loss.
Follow-up and ongoing care: Your audiologist will arrange follow-ups to fine-tune devices, monitor progress, and address any concerns.
During the appointment, your audiologist will ensure you understand all available options, answer your questions, and tailor the treatment to your preferences and needs. If medical treatment is needed, they will coordinate referrals accordingly.
In summary, expect a collaborative, personalized approach from an independent audiologist, including discussing a variety of conventional and implantable types of hearing aids or rarely, cochlear implants, assistive devices, medical treatments if applicable, and ongoing support to manage your hearing loss effectively.
Hearing aids and prices
The cost of hearing aids is an area which is often of concern to prospective hearing aid users. The more we know about what the hearing aid is and what the fitting of a hearing aid consists of, the easier it is to understand and direct the decisions that are made.
A hearing aid is part of a therapeutic programme to address hearing health and communication issues and not a device to be purchased in isolation. The cost of a hearing aid varies based on the sophistication of the microchip and the features that this provides. Together with your audiologist or acoustician and following a full investigation, a decision needs to be made on which type of hearing aid technology and style best suits your hearing loss, listening need, lifestyle and budget. A carefully selected device will ensure that you invest wisely in appropriate hearing aid technology which can last you many years.
Hearing aids in South Africa range in price from R 5000.00 to R 60 000.00 per ear and may require additional accessories such as remote microphone technology or TV connectivity. The greater your budget the higher the level of sophistication you will be able to experience.
A large part of the cost of the hearing aids comes from research and development. Hearing aid manufacturers invest millions of dollars and countless man-hours making their devices suit peoples hearing needs more comfortably and effectively with constant software updates and more tech-focused devices. The manufacturers also have to cover the cost of the warranties and services plans, licensing in different countries and meet customs regulations of importing countries – all of which attract large costs in addition to the actual cost of the computer chip. In addition, a reputable manufacturer will have an easily accessible laboratory which is equipped and staffed with trained professionals to provide you with the follow-up services you may need to maintain your hearing aids and train the audiologists or acousticians who will be involved in the hearing aid fitting.
The most important part of the programme is that the hearing aid needs to be selected, fitted and verified by a skilled, qualified practitioner who has the correct equipment to provide this. As a hearing aid user, you may expect a great deal from your hearing instruments – from the minute you put them in, you want to be able to hear as normally as possible by recreating a function of both the ear and the brain. You will need appropriate training and education to enable you to get the most out of the devices that have been prescribed for you, with realistic expectations of their abilities.
The Health Professions Council of South Africa advises against the illegal sales and purchase of internet hearing aids or hearing aids purchased from unregistered practitioners in this country. Unregistered devices and people create risks for the patient due to the lack of clinical knowledge and lack of professional support. While it may seem cheaper, it may cost more in the long run, as medical conditions affecting hearing which may require medical treatment, may be missed or incorrectly diagnosed in favour of fitting a device. Remember the saying: “buy cheap, pay twice”.
Let’s consider the cost of a pair of hearing aids in relation to another item we use every day:
A mid-sized family car costs R 300 000.00 and is paid off over 5 years. On average, we may drive the car for an hour or two a day. This is a cost of R 164.38 per day, or R 82.19 per hour used.
A mid-range pair of hearing instruments may cost R 55 000.00. On average, we would use the hearing aids 14 hours a day. Over a 5-year period, this is a cost of R 30.14 per day or R 2.15 per hours used.
Isn’t it worth investing this amount into improving your quality of life and that of those around you?
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Email: info@ican.org.za
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