Thursday, July 23, 2009

Better Hearing with Both Ears

I feel the frustrations of my patients who only have one hearing aid and lack hearing in the non-aided ear. The struggles of depending on one ear to do the work of two are sometimes enough that they want to give up.

I grew up hard of hearing and had hearing aids in both ears from a very young age. When I needed to repair one of my hearing aids I would have to go without it for 1-2 weeks while it went to the lab. I can remember the lone ear feeling left out and my own awareness of the auditory world being stunted. Hearing from one ear alone changes the perception of the sounds around you. Think of it as depth perception if you will; having only one ear turns off some of our brain's responses to sounds and how it handles sounds. I felt the absence of my hearing on one side in how I struggled to hear in class, felt isolated on the school bus, felt completely at loss in background noise and had to strain to understand conversation in every environment. I had to make changes by sitting with my aided ear near my friends at the lunch table and moving closer to the teacher in the classroom and turning up the TV. The relief I felt when my hearing aid was returned to me and I had both ears working again is hard to describe. I welcomed the pairing of my ears. Thankfully now that I am working in the profession of audiology and own my practice I have a large supply of spare hearing aids and won't have to experience this again. Unless of course I lose all my hearing and become deafened in one or both ears. So long as I have hearing in both ears I intend to make good use of both ears.

I encourage my patients to aid hearing in both ears when needed. Sometimes, for various reasons, that is not possible and I have a considerable amount of counseling to do to help my patients who can only use one ear. When only one ear is in play difficulties can be expected as the norm, not the exception.


Here is what you need to know.


The benefits of hearing in both ears equally...

1. Ability to localize sounds improves.

2. Ability to understand speech in noisy surroundings improves.

3. Sounds are richer, fuller and more natural.

4. Risk of "auditory deprivation" is reduced.



Your sense of direction...

Why do you suppose you are born with two ears? The brain needs input from both ears to tell us the direction of sounds. Our ears alert us of danger for things such as honking car horns or speeding trucks. Within the brain the neural response from both sides differs by milliseconds but is perceived enough to alert us of direction of sound. This is called localization. Localization keeps us feeling safe and comfortable in everyday situations.


Understanding conversation in noise...

Background noise makes communication difficult for everyone, not just the hard of hearing. But having hearing loss puts you at a particular disadvantage as most hearing loss causes distortion and loss of specificity. This is further impacted by hearing in only one ear as this causes unequal stimulation of the brain for sound. The brain needs both ears' input in order to filter and sort the noises around you. You cannot eliminate noise altogether with hearing aids but having both ears working equally well can help you manage noise better.


A fuller, richer auditory world...

When you hear equally well with both ears, sounds are more comfortable to listen to. You have less strain, sounds have more clarity and depth and give you a sense of spacial awareness. Hearing with both ears can be compared to listening to the radio in stereo. Without stereo the radio can be shallow and flat sounding, hearing with one ear may also sound this way.


Reducing deprivation...

Research has consistently shown over the years that when one ear is ignored (not aided) the brain over time turns it "off." In other words the unaided ear becomes deprived of sound because the brain is making more use of the aided ear. The brain's dependency on the aided ear causes the neural pathways to "re-route" and work in a way that was not intended for the brain to work. The unfortunate side effect is auditory deprivation of the ignored ear. As the ear goes unaided for long periods of time hearing loss is more likely to worsen and clarity for speech, in particular, can be affected. Some patients with auditory deprivation can eventually lose the use of the unaided ear as the brain has ignored it for so long that it becomes unusable or even disruptive.


For these reasons two hearing instruments are recommended when hearing loss occurs in both ears and can be aided in both ears. Each person with hearing loss presents with different circumstances so these recommendations are a generalization and there are exceptions to the rule. If you suspect hearing loss or any other hearing disorder, the best line of defense is to have an evaluation and full diagnostic work up of your hearing sensitivity.

Related Links

1. Better Hearing Institute http://www.betterhearing.org/hearing_solutions/binaural.cfm

2. Rehabilitation Engineering Research Center on Hearing Enhancement - Dr. Ross Article http://www.hearingresearch.org/Dr.Ross/Binaural-Better.htm

This blog posted by Suzanne Yoder, Au.D. Doctor of Audiology and owner of HearWell Center. Please visit our website for more information http://www.hearwellcenter.com/

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