What types of tests and treatments do Registered Hearing Instrument Practitioners perform (RHIP)?

Common services and treatments provided by an RHIP include:

Diagnostic hearing tests
Hearing aid fittings and consultations
Hearing aid repairs and maintenance
Hearing loss prevention and protection programs
Earmold and earplug fitting and consultation
Custom musicians earplugs and monitors
Prescribed Amplification
Tinnitus Management
Cochlear implant candidacy evaluations and implant programming

How do I know if I have hearing loss?

If you’re concerned you or a loved one may be experiencing hearing loss, you are not alone. Because hearing loss can come on gradually, it’s often the people around you who notice your hearing problems before you do. Typically, it takes people an average of seven years to seek treatment. If you exhibit the following symptoms, consider visiting an hearing professional:

You hear mumbling when people are speaking to you
You have to ask people to repeat what they said
You laugh at jokes even though you may not have heard the details
You frequently complain that people mumble
You need to ask others about the details of a meeting you just attended
You play the TV or radio louder than your friends, spouse or relatives
You cannot hear the doorbell or the telephone
You find that looking at people when they speak to you makes it easier to understand
You miss environmental sounds, such as birds chirping or leaves blowing
You find yourself avoiding certain restaurants because they are too noisy
You hear a ringing sound in your ears, especially when it is quiet.

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What causes hearing loss?

Hearing loss can be due to several factors such as the aging process, exposure to loud noise, medications, infections, head or ear trauma, congenital (birth) or genetic factors, diseases, as well as a number of other causes. It is estimated that nearly 19 percent of adults in Canada (approximately 4.6 million) report some degree of hearing loss. Hearing loss often occurs gradually throughout a lifetime.

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How is hearing loss diagnosed?

If you exhibit symptoms of hearing loss, you should see an hearing professional to have a formal hearing evaluation. This hearing test, or audiologic evaluation, is diagnostic and allows the provider to determine the type and degree of your hearing loss. There will also be a hearing test that evaluates your sensitivity, acuity and accuracy to speech understanding. Your hearing professional may also test for speech understanding at different volume levels and conditions – like noise – to help the professional recommend the best hearing aids for your particular needs.

The hearing evaluation will also include a thorough case history and a visual inspection of the ear canal and eardrum. Additional tests of middle ear function may also be performed depending on your symptoms. The results of the evaluation can be useful to a physician, if the provider believes your hearing loss may benefit from medical intervention.

Results of the hearing evaluation are plotted on a graph called an audiogram. The audiogram provides a visual view of your hearing test results across various pitches or frequencies, especially the ones necessary for understanding speech. The audiogram and results from your speech understanding tests are used to create a prescription by which hearing aids are programmed, if necessary.

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What are the different types of hearing loss?

There are three main types of hearing loss and each can be caused by different factors and require different hearing aid technology and features to have the best listening experience. The three types of hearing loss include:

Sensorineural hearing loss: When the problem is in the inner ear or a problem with the auditory nerve, a sensorineural hearing loss is the result. This commonly occurs from damage to the small hair cells, or nerve fibers, in the auditory system. Sensorineural hearing loss is the most common type of hearing loss in adults and accounts for more than 90 percent of hearing loss in all hearing aid wearers. The most common causes of this hearing loss are age-related changes and noise exposure. Loss may also result from disturbance of inner ear circulation, increased inner ear fluid pressure or from disturbances of nerve transmission. There are many excellent options for the patient with sensorineural hearing loss.
Conductive hearing loss: When there is a problem in the external or middle ear, a conductive hearing loss occurs. Conductive hearing loss develops when sound is not conducted efficiently through the ear canal, eardrum or tiny bones of the middle ear, resulting in a reduction of the loudness of sound that is heard. Conductive losses may result from earwax blocking the ear canal, fluid in the middle ear, middle ear infection, obstruction of the ear canal, perforation (hole) in the eardrum membrane or disease of any of the three middle ear bones. Individuals with conductive hearing loss can benefit from hearing aids, medical implants, medication or surgical options.
Mixed hearing loss: When there are problems in the middle and inner ear, a mixed hearing impairment is the result. Because mixed hearing loss involves both sensorineural and conductive hearing loss, treatment options from hearing aids to surgery depends on the nature of the impairment and the symptoms experienced.

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What style of hearing aid do I need?

There are many types of hearing aids today and the style or device depends on your lifestyle, budget and hearing loss needs. There are in-the-ear styles as well as behind-the-ear styles. In addition to selecting the right style of device, it’s also important to consider what features would be most beneficial to you. From directional microphones to waterproof options, there are numerous varieties to meet everyone’s personal needs. Today’s hearing aids are even equipped with Bluetooth connectivity to work with wireless technology like a cell phone or television.

Hearing aids are available in many different sizes and styles, thanks to advancements in digital technology and miniaturization of the internal components. Many of today’s hearing aids are considered sleek, compact and innovative – offering solutions to a wide range of hearing aid users. When selecting a style of hearing aid, the following should be considered:

The type/degree of the hearing loss
Power requirements
Manual dexterity and visual abilities
Budget
Cosmetics and aesthetics
Anatomical and medical considerations
Lifestyle requirements

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What are assistive listening devices (ALDs)?

People with all types and degrees of hearing loss can benefit from an assistive listening device (ALD). Since the microphone of a typical hearing aid is worn on or behind your ear, its ability to enhance the talker-to-background-noise ratio can be limited. However, ALDs are designed to increase the loudness of a desired sound, such as a radio, television or a public speaker, without increasing the background noise. This is because the microphone of the assistive listening device is placed close to the talker or device being used, while the microphone of the hearing aid is always close to the listener.

ALDs include alarm clocks, TV listening systems, telephone amplifying devices and auditorium-type assistive listening systems. Many newer devices are small, wireless and compatible with a person’s digital hearing aids. Alarms and other home ALDs may be small devices that are placed discreetly on tables, next to the TV or on the wall.

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What is tinnitus?

Tinnitus is a common disorder affecting over 50 million people in the United States. It is often referred to as “ringing in the ears,” although some people hear hissing, roaring, whistling, buzzing or clicking. Tinnitus is not actually a disease, but a symptom of another underlying condition of the ear, auditory nerve or other influencing factor. Tinnitus can be intermittent or constant, with single or multiple tones. The perceived volume can range from very soft to extremely loud and may be recurrent or constant.

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What causes tinnitus?

The exact cause of tinnitus is not known in every case. However, there are several likely factors that may worsen tinnitus. These include:

Noise-induced hearing loss
Wax build-up in the ear canal
Certain medications
Ear or sinus infections
Age-related hearing loss
Ear diseases and disorders
Jaw misalignment
Cardiovascular disease
Certain types of tumors
Thyroid disorders
Head and neck trauma

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How is tinnitus treated?

Depending on the severity and underlying condition causing the tinnitus, there are several treatments available to improve the perception of unwanted noise. The most common treatments for tinnitus include:

Hearing aids with tinnitus-masking features
Tinnitus retraining therapy
Sound therapy
Avoidance measures
Avoidance of certain medications
Behavioral therapy

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