What is the Threshold for Needing a Hearing Aid?

A person is considered to have hearing loss if a loss of 25 dB HL is diagnosed in one ear. This is a combination of sensorineural and conductive loss. The Vibrant Soundbridge, an implantable alternative to an external hearing aid, is approved by the FDA for adults with moderate to severe sensorineural hearing loss. Aetna believes that the Bose hearing aid and other FDA-approved hearing aids sold without a prescription are equally effective alternatives for those who meet the medical necessity criteria for air conduction hearing aids and have a prescription from a doctor or authorized provider.

In order to determine the severity of hearing loss, two measurements are taken into account: how loud something must be before it can be heard and what frequencies are harder to hear (for example, women's voices are higher in pitch compared to men's). The FDA classifies the Vibrant Soundbridge as a surgically implanted device intended to help those with moderate to severe nervous hearing loss. This device includes instructions for self-management of insertion, on-site threshold measurements, selection of a suitable transducer, an instant adjustment tip for measuring a wide range of threshold levels, monitoring environmental noise during threshold measurements, and self-managing procedures to identify characteristics of the audiogram such as asymmetry and conductive hearing loss. It would be beneficial for self-adjusting hearing aids to have a built-in routine that could notify the user if their hearing loss is too mild or severe to benefit from the device, or that would disable the self-adjustment process. When adjusting headphones, whether done by a professional or by the user, it is important to start with an adequate initial response, even if the user can later train the device to apply whatever gain settings they prefer in different environments. Implantable hearing aids (middle ear implants) are an alternative to traditional external hearing aids.

These devices are standalone and self-adjusting, meaning they can be operated in their entirety without help from a professional or special equipment. When measuring dB and Hz together, they indicate the degree of hearing loss in each ear. Examples of semi-implantable electromagnetic hearing aids include the Vibrant Soundbridge system, the Maxum system, the Otomag alpha 1 (M) bone conduction auditory system, and the semi-implantable ossicular stimulator system with middle ear transducer (MET). These devices create an electromagnetic field that vibrates and stimulates the ossicles, sending signals to the cochlea. The possibility of detecting asymmetric, conductive, or mixed hearing loss by measuring thresholds in situ with hearing aids has not yet been explored. In order to find out how poor your hearing is, your doctor may request a formal hearing test, also known as an audiogram.

A Cochrane review by Schilder and colleagues (201) evaluated the effects of bilateral versus unilateral hearing aids in adults with bilateral hearing impairment. Shohet et al. (201) evaluated the effectiveness of the Envoy Esteem fully implantable hearing device in treating profound high-frequency sensorineural hearing loss (PHFSNHL).

Kathie Layssard
Kathie Layssard

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