Circulatory Shock, types and stages, compensatory mechanisms
Hearing Audiology | Clermont FL
1. Since 2001, Dr. Turri has been helping people hear their world with clarity. Utilizing advanced skills, techniques and superior technology to deliver the hearing help patients need. Dr. Turri has been providing outstanding hearing healthcare to the people in their community
7. Conductive Hearing Loss Occurs in Ear Canal and Middle Ear Only 5% of Hearing Loss Cases Caused by trauma or disease
8. Sensorineural Hearing Loss Occurs in Cochlea or Inner Ear Often called Nerve Loss or Nerve Damage 95% of hearing loss Cases are Nerve Loss Causes: aging, noise exposure, disease
31. Even people with normal hearing have difficulty hearing in noisy environments People with hearing loss need speech to stand out more against the background noise
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33. Digital hearing aids with directional microphone technology manage the background noise, helping you to focus in on the sounds in front of and next to you
34. Digital hearing aids with directional microphone technology provide excellent background noise management
Go to customer web site or use digital camera to insert pictures and art.
This slide is optional. Typically I have the Audiologist or dispenser speak BRIEFLY to introduce themselves, their staff and talk a bit about their practice. You can also have them talk about the ear and how we hear. This information is contained in the next few slides.
Here’s how we hear: As I am speaking to you, sound is collected by the external ear and travels through the ear canal. If the ear canal is not obstructed by too much wax, the sound strikes the ear drum and causes it to vibrate. The ear drum is the gateway to the MIDDLE EAR. Attached to the ear drum are the three smallest bones in the body. The vibrating ear drum causes the bones to mechanically conduct sound if everything is functioning properly. The mechanical movement of the ear drum and bones moves sound to the inner ear (snail shape). At this point, sound is converted to an electrical impulse as the movement causes fluid to wash over tiny hair cells (or nerve endings) in the inner ear. This sends a neurological impulse to the brain. This is how we hear if everything is functioning properly
Now let’s SEE how this process works with a tour of the ear. (you can give an overview on previous screen and add more detail on this tour).
Unfortunately, the process of hearing can break down along the path. Your hearing health care professional can not only determine IF you have a hearing loss but also the type of hearing loss. A conductive hearing loss is related to the ear canal or middle ear. Excessive wax or middle ear disorders result in a loss of sound conduction. It is possible that this type of hearing loss can be treated medically.
However, most hearing losses are related to the INNER EAR. This type of loss is known as SENSORINEURAL HEARING LOSS (often referred to as NERVE LOSS). This represents the majority of hearing losses as a result of noise exposure, aging or disease. The course of action with this type of loss is amplification
Now to the questions: Why can I hear but not understand? Does anyone have this problem?
To understand how this can happen, let’s talk about how we measure hearing. Hearing is measured in FREQUENCY (pitch) and LOUDNESS. Like the piano keys, sound occurs as different pitches. (PLAY SOUND DEMO)
Of course, the sounds we hear occur at different LOUDNESS levels (PLAY SOUND DEMO).
A hearing test is merely a measurement of sounds at different loudness levels at each frequency or pitch. Think of frequency across the top like the piano keys. The low pitch (bass) sounds are on the left side. The middle pitch sounds are in the center and the high pitch (treble) sounds are on the right. Your hearing test is intended to measure the softest sounds you can hear at each pitch. The other component is to determine what you perceive as TOO LOUD at each pitch. This person has a normal range of hearing between threshold (just audible) and too loud.
Here’s a very common example of someone who has a MILD HIGH FREQUENCY hearing loss. This person has a normal range of hearing in the low pitch region. He can hear soft sounds and as sounds become louder he perceives them in a typical manner. However, in the high pitch region, he cannot hear soft sounds. As sounds reach the conversational level, he perceives them as soft. The difference between just audible and too loud has been reduced. As you can see, the vowels are generally more low in pitch and more powerful. The consonants are more high in pitch and softer. The problem is that while the vowels carry the power of speech, the softer high pitch sounds carry the meaning of speech. (Did she say sin, fin or thin…..did he say STOP or TOP?). Someone with this type of loss would perceive sufficient loudness but a reduced level of understanding.
Hearing instrument technology has evolved considerably over the years. However, up until the mid 1980s, most still amplified soft and loud sounds the same. This approach makes no sense since most people with a hearing loss do not have difficulty with loud sounds. They only need help with softer sounds.
Hearing instrument technology has evolved considerably over the years. However, up until the mid 1980s, most still amplified soft and loud sounds the same. This approach makes no sense since most people with a hearing loss do not have difficulty with loud sounds. They only need help with softer sounds.
Hearing instrument technology has evolved considerably over the years. However, up until the mid 1980s, most still amplified soft and loud sounds the same. This approach makes no sense since most people with a hearing loss do not have difficulty with loud sounds. They only need help with softer sounds.
(At this point, if the dispenser has been talking, they would introduce you as the GNR representative. You also may want to have a testimonial from a happy user). You would say hello and welcome followed by: Having done many of these presentations, quite often I hear the same questions. Therefore, this presentation has been developed to address the most commonly asked questions regarding hearing loss and technology. These include:
The challenge is: what kind do you have? Most hearing devices look similar. Although the are available in a variety of sizes, styles and brands, all devices have a microphone to pick up sound an amplifier to process the sound and a speaker or receiver to deliver the sound The amplifier is INSIDE the device. This is the key component that determines the level of technology available to the hearing health care professional to better solve common challenges associated with hearing loss.
The key component is the amplifier!
The level of technology in the amplifier is critical. This tiny little chip makes all the difference.
Unlike conventional devices that allow the hearing health care professional little or no control for customization for your unique hearing loss, the GN ReSound devices are computer programmable in the local office. This will allow for better first fit customization as well as better fine tuning over time.
But, does being fully digital necessarily means better solutions to common challenges associated with hearing loss? What can GN ReSound digital technology offer beyond being digitally programmable?
In addition to size, the level of amplifier technology is important. Again, generally conventional technology will amplify soft and loud sounds the same. A manual volume control is required to adjust volume. Also, sound quality is also inferior since generally the dispenser is not able to sufficiently adjust low and high pitch sounds independently based on your unique hearing loss. On the other hand, good quality computer programmable devices generally can automatically adjust volume many, many times per second to make sure loud sounds are never too loud and soft sounds are audible. Also, sound is generally more natural because of the ability to more independently set bass (low pitch) and treble (high pitch) based on your unique hearing loss.
The number one problem associated with hearing loss is difficulty hearing in noise.
Expectations are critical. Remember, even people that do not have a hearing loss do not hear as well in noisy situations as they do in quiet. Of course, a hearing loss compounds this problem.
To understand the challenge in addressing this problem of not hearing in noise, we must ask, WHAT IS NOISE? (Pick someone in the audience and ask them this question). Everyone wants to hear better in noise but, what is noise. For example, if I am in front of you speaking and five people are behind you having a conversation, how do you expect the hearing aids to know that I am more interesting to you than the people behind you? What is noise? Although I do not have a hearing loss, I have difficulty in this situation. Typically I turn and look at the person that is speaking. I focus on their speech. Also, we all read lips more than we know (turn around as you say this).
Generally hearing aids amplify sound with one microphone that picks up all sound from all around. Some devices have two microphones. In noisy situations, hearing impaired people will notice a dramatic improvement in understanding with two microphones. The front microphone will make the DECISION to emphasize the sound in front (where you are looking) and the back microphone will pick up and reduce the sounds from your sides and behind. This shift in the balance of sound will greatly aid understanding. This technology is not available in all sizes of hearing instruments.
Of course, people are not always kind enough to be noisy behind you. Sometimes the noise and the sound you want to hear come from the same direction. To aid this problem, the GN ReSound digital devices also have a fast acting noise reduction system. Generally noise tends to be steady (listen to this projector fan)… Generally noise tends to fluctuate (use hand motion). Our digital devices have the ability to automatically make very fast DECISIONS about what is noise-like and what is speech-like. Most digital devices employ some type of strategy like this. However, listen to the GN ReSound difference….
What is that whistling sound? Do any of you have hearing aids that whistle or know anyone that has this problem? Why do hearing aids whistle? Let’s use the example of this P.A. system I am using. Who knows what will happen if I move too close to the speaker with my microphone? (WAIT). Of course, we will have whistling or distortion. Why? Because my voice is being picked up by the microphone, amplified by the amplifier and delivered through the speaker. If I am too close, the microphone picks up my amplified voice and amplifies it over and over until the point of distortion. How do we solve this? (wait). If I turn down the volume, what happens? (you can’t hear in the audience). If I move away what happens? (problem solved). Remember, all hearing aids have a microphone, an amplifier and a speaker. The degree of your hearing loss will dictate how much we need to turn up sound for you to hear. If you loss is mild or moderate, you can probably wear any style of hearing device without feedback. However, if you have more of a loss, we will have to deliver more power. Of course, the challenge is to give power without feedback. In smaller devices, if we turn up the power, we will fight feedback. If we move the microphone and speaker apart (different style of device) we can deliver more power without feedback. The other issue related to this is the sound of your voice. Generally we try to provide a vent in the devices to make you feel less plugged up. However, this can also provide a path for amplified sound to leak back to the microphone and cause feedback if the power needed is higher and the microphone and speaker are close together (smaller styles). THIS IS THE CHALLENGE !!!!!!
The GN ReSound digital device provide a truly revolutionary approach to minimizing the problems associated with feedback. We take advantage of the power of digital to attempt to cancel the feedback without turning down volume. Listen to the difference:
The last thing we will talk about regarding the power of digital technology has to do with the phone. I won’t bore you with the details but generally listening on the phone while wearing hearing aids has been a major challenge. Generally the level of amplification for having a face to face conversation vs. on the phone is very different. Also, not all phones are the same. Some are traditional home phones, some are cordless, some are cell phones. The bottom line is that the GN ReSound digital devices offer your hearing health care professional better tools to better address the challenges associated with listening on the phone with hearing aids.
O.K. I have a hearing loss. But, who am I hurting. Can’t I get by without hearing aids? After all, who am I hurting? A study by a government agency, the National Council on Aging, looked at the impact of untreated hearing loss. They found:
An increased degree of…. The big one is less social activity. People tend to withdraw from things they would like to do because they just cannot enjoy themselves if they cannot hear.
The good news is that the same study found benefits of amplification...
We have talked quite a bit about technology (probably too much!). Remember, superior technology is important but….
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