Hearing Aids Get Smart And Better Looking

Decades of exposure to loud music, jackhammers, leaf blowers, and other kinds

of racket have taken their toll on the hearing of many adults. Yet many who know they have a problem would rather be caught deaf than wear a hearing aid.

Perhaps they should reconsider. Today's hearing aids are not the unsightly, feedback-generating protuberances that Grandpa used to wear. Advances in technology have made these devices smaller, sleeker, and--thanks to digital programming--better at correcting the most common type of hearing loss, caused by nerve damage.

THIMBLE OR PEA. Hearing aids come in three varieties: behind the ear (BTE), in the ear (ITE), and in the canal (ITC). Those placed in the ear or ear canal are about the size of a thimble and pea respectively--much smaller than devices that house mechanical components in a curved case that hooks behind the ear and connects to an earpiece via a small plastic tube. "Aids today can go so far within the ear that they're virtually impossible to see," says Dr. Mark Ross, professor emeritus at the University of Connecticut and author of several articles on hearing-aid technology.

Aids that fit inside the ear or canal require more attention, however. Their tiny batteries expire as often as every week, and exposure to ear wax causes more frequent repairs. Also, the smallest aids don't have room for the circuitry necessary for customized options. Dr. Robert J. Ruben, chairman of the department of otolaryngology at Montefiore Medical Center in the Bronx, N.Y., notes that with increased hearing-aid size comes greater versatility. People willing to wear a slightly larger device gain "the capability to tune it exactly to their type of hearing loss and hear only what they want to hear."

Until recently, all hearing aids amplified sounds equally, regardless of frequency. Low- frequency sounds, which include background din at a cocktail party and popcorn-crunching at the movies, were always given the same emphasis as high-frequency sounds, such as conversation with friends at the party or between characters on the screen. The result was a lot of noise but few distinguishable sounds. Most hearing loss occurs in the softer, high-frequency range, and this compounds the problem. The wearer of a traditional hearing aid often hears everything but understands little in situations where there is a spectrum of sounds.

The advent of digitally programmed hearing aids about five years ago changed that. These devices use the same technology as computer microchips to customize amplification to hearing loss. Programmable BTE and ITE aids enable audiologists to turn up some frequencies while keeping

others at normal input levels. The high-frequency sound of a confidential whisper can be heard even when there's a babel of background noise.

Several programmable hearing aids also have memories that store frequency-amplification configurations for different situations. By pushing a button on a wireless remote control, the wearer can signal the hearing aid to switch between individualized settings for optimal office, home, telephone, and even concert listening.

NIGHTCLUB DIN. Kathy Buckley, a stand-up comic and spokesperson for the nonprofit Better Hearing Institute (800 EAR-WELL), wears a programmable aid that has special settings for performing and nonperforming situations. Previously, she had a hard time hearing a nightclub audience's response to her act over the competing sounds of clinking glasses and roaring air conditioners. "Now, I hear people's laughter more distinctly, which makes performing more enjoyable," she says.

Good hearing aids don't come cheap. The digitally programmed kind, made by such companies as 3M, ReSound, Phonak, Whidex, Starkey Laboratories, and Oticon, run $3,500 to $4,500 a pair; 90% of those with hearing loss need correction in both ears. To get a high-quality nonprogrammable aid with low distortion, uniform amplification, and manually adjusted volume control, you should expect to pay $1,800 to $2,000 a pair. Health insurance will usually cover some of the cost. And if your vanity pays a price, you'll pick up sounds again that you didn't even know you had been missing.

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