The outer ear (pinna) is the part you can see on the sides of our head and the ear canal. The pinna directs soundwaves into the ear canal.
The middle ear includes the eardrum, three middle ear bones and the middle ear space. The soundwave vibrates the eardrum moving the middle ear bones and increasing the soundwave signal as it enters the inner ear.
The inner ear (cochlea) is shaped like a snail shell divided into three fluid filled ‘tunnels’. The middle ‘tunnel’ has special cells (called hair cells) that send signals to the brain. The brain interprets these signals and we hear them as speech and environmental sounds.
– General health and aural case history; review of your communication needs
– Otoscopy: visual examination of the outer ear and eardrum
– Objective assessment of the function and health of the middle ear
– Assessment of hearing sensitivity across the frequency spectrum through air conduction and bone conduction audiometry
– Assessment of speech understanding in quiet and in noise
– Review of results and discussion of next steps including medical referrals if necessary
Before your appointment take a moment to think about your communication network and where you might experience challenges in hearing:
– Conversations in quiet settings
– Conversations in noisy settings
– Communicating at work or school
– Phone conversations
– Hearing TV or other electronic media
– Conversations in social settings
Everyone’s situations are unique to them. Bring these ideas with you to your appointment, so your clinician is able to make the best selection of technology, style and strategies to help navigate your communication network successfully.
– Play ‘ear doctor’ (e.g with a flashlight): look in teddy’s ear, look in mom or dad’s ear, look in your child’s ear. Gently grasp the top of their ear and pull the ear back slightly to look in ear.
– Play the ‘quiet’ game or statues game. Some tests require your child to sit quietly
– Practice using headphones or earbuds (at a low or comfortable volume setting) listening to music or a program.
– Bring a book or toy your child enjoys.
– Book an appointment at a time where your child will be rested and fed.
Conductive hearing loss occurs due to an issue in the outer or middle ear. Causes include but are not limited to: outer ear infections; significant earwax (cerumen); broken eardrum; disease or injury of the middle ear bones; middle ear infections.
Sensorineural hearing loss occurs due to damage to the hair cells in the cochlea. Causes include but are not limited to noise exposure, ageing, certain medications, genetic issues, and illness.
Mixed hearing loss occurs from issues arising from both the middle and inner ear.
Our audiologists are certified in cerumen management by the College of Speech and Hearing Health Professionals. After careful review of your case history and inspection of your ear canal and wax, the audiologist will determine which procedure will be most suitable for removing the wax – either with handheld curette tools, or through mild suction, or a combination of both.
All hearing aids are made of:
1 or 2 microphones; an amplifier and a speaker (called a receiver); a battery; and a computer chip to tell all the components what to do.
Hearing aids do not just “make things louder”, they have complex systems to assess the sound in the environment, manage noise to help optimise the speech signal, and determine if sounds are speech, noise, or music to help people communicate through their day.
There are a variety of technology levels with specific features to manage communication in variable listening situations. As you go lower in technology, less features are available.
– Premium technology is designed for active listeners who participate in the widest variety of listening situations.
– Advanced technology has features that will help in most communication situations.
– Mid-range technology helps in moderate noise environments and small group settings.
– Basic technology is for individuals who spend all or almost all of their time in quiet settings with one or two conversation partners and little need to connect with other systems like television and cell phones.
Styles or “form factors” (how they look) – see also our Hearing Aids page.
Hearing aids come in a variety of form factors which are generally available in all 4 levels of technology. So the hearing aid will look the same whether it is premium or basic level technology. It is the components inside the aid and how the hearing aid works that determine the level of technology. Some of the smaller hearing aids may have slightly less function (such as noise reduction abilities, or in some cases Bluetooth compatibility) due to their size. It is important to talk to your clinician about what your communication needs are so you can make the best decision for your needs together.
Receiver-in-the-canal (RIC) hearing aids are the most popular and commonly fit hearing aid right now. These are small aids that fit behind-the-ear with a thin wire leading to a dome or custom tip in the ear canal. They are more discrete and lighter in weight compared to standard behind-the-ear hearing aids. They are appropriate for most hearing losses.
Behind-the-ear (BTE) hearing aids: these hearing aids fit around the back of the ear and a standard or slim tube leading to a custom earmold or dome in the ear canal. These aids can fit any degree of hearing loss from mild to profound. They are the most durable and the hearing aid comes with all features available in each specific level of technology.
Custom In-the-ear (ITE) hearing aids: these aids fit the entire ‘bowl’ of your ear into your ear canal. These can be easier to manipulate for individuals with dexterity issues.
Custom In-the-canal (ITC) hearing aids: these are smaller aids that fit in the lower part of the bowl of your ear and into your ear canal. Aesthetically they are smaller; however, there are some limits to their noise reduction abilities due to the size of the aid and microphone placement.
Custom Completely-in-the-canal (CIC) hearing aids: these fit just behind the cartilage at the front of your ear (called the tragus) and into the ear canal. Due to the size of these aids there are limitations (compared to other form factors) for noise reduction as well they may have limited or no connectivity (such as Bluetooth).
Custom invisible in-the-canal (IIC) hearing aids: these aids fit deeper into the ear canal and are the least visible. The small size puts some limitations on the features (for instance they cannot be Bluetooth compatible)
Hearing aids are not ready ‘out of the box’ and it will take time for your ears and more specifically your brain to adapt to using hearing aids. For hearing aids to work optimally, a complete diagnostic hearing assessment is first required. Once the aids are selected, the aids will be optimally fit to your hearing loss using Real Ear Measures (REMs). Through REMs, we are able to objectively fit your hearing loss to a “prescription” which ensures the aids are set specifically to your needs and the sound dynamics of your ear canal.
In most cases, hearing loss occurs in both ears. We require two ears to help us communicate in noisy environments as well as for localising where sound is coming from. Having balanced hearing reduces listening effort and fatigue. Optimise your hearing health by wearing two hearing aids if recommended.
Bluetooth™ is a short range wireless technology that allows electronic devices to exchange data. For instance it allows a cellphone call to be sent into Bluetooth™ compatible hearing aids so that the end-user can hear the cellphone call directly through both of their hearing aids. It is always advantageous to hear a call through both ears instead of just one. Some hearing aids act as the wireless ‘hands-free’ microphone and in other cases there is a small clip (about the size of a key fob) worn on your shirt or hung around your neck that is used as the ‘hands-free’ microphone.
Most hearing aids are equipped with a small button, wheel or lever that allows you to adjust the volume on your hearing aids. For those that do not wish to touch their hearing aids, you can get a small hand-held volume control (about the size of a key fob). Alternatively, most current-technology hearing aids can be adjusted via an app on your cellphone.
The hearing aid trial period is two months. During this time, you will return for check-up appointments with your clinician every two to three weeks. In some cases, appointments can be virtual. During the initial fitting, your hearing aids will be fitted using real ear measures (REMs). You will be counselled on care and use of the hearing aids. In the follow-up appointments, your clinician will review care and use of the hearing aids, communication strategies, address sound quality and acclimatization issues, and fit issues if any. The goal of this trial period is to insure you are receiving optimal benefit from your hearing aids.
Yes, there are many other assistive listening and alerting devices that can be of assistance. These include remote microphones that can help you hear better in background noise or in large group settings such as meetings, as well as alerting devices that vibrate or flash to help you better hear your doorbell or fire alarm.
No, not necessarily. It will depend on your degree of hearing loss, your listening needs, and your motivation to wear hearing aids. As hearing aids cannot be one-size-fits-all, it’s important to determine what strategies are needed to best manage your hearing needs. For some, it is taking a course on communication strategies. For others, it’s trialing hearing aids or assistive listening devices. Book an appointment today and speak to one of our clinicians to find out what is best for you.
Hearing aids range in cost between $4000 to $6500 for a pair. Hearing aids are not covered by MSP, but you may be eligible for funding assistance from a third party such as employee benefits programs, Veteran Affairs Canada (VAC), WorksafeBC, First Nations Health, WorkBC, Ministry of Social Development and Poverty Reduction, etc. Speak to your clinician if you are looking for funding for children under 19 years of age.
Yes, just as there are fees for health services such as physiotherapy and dentistry, we also charge fees for our audiology services. In BC, audiology services are not covered through the Medical Services Plan (MSP) unless it is an assessment through a hospital or public health unit, which require a medical referral. (Wait times for public health services will vary, from a few months to more than a year). Please contact our office directly to find out more about fees for various services. Some people may also be eligible for third party funding.
In BC, hearing assessments for children (age 0 – 18 yrs) are free through Public Health. Some families elect to obtain a hearing assessment privately through clinics such as Network Hearing and pay a fee for the assessment. For hearing aids, the first pair of hearing aids for children are covered by the BC Early Hearing Program, up to the age of 3 years.