Severe Hearing Loss: When Hearing Aids Alone Are Not Enough - Attune
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Severe Hearing Loss: When Hearing Aids Alone Are Not Enough

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Hearing aids are small powerhouses of highly advanced technology that allows people with moderate to severe hearing loss to hear again. However, not everyone benefits from hearing aids. In this case, cochlear implants may be a better option. Hearing aids and cochlear implants however, both come with their own set of benefits and limitations. Today, we will answer the question of whether having both, hearing aids and cochlear implants, can help those with very little to no hearing.

One in five Australians or approximately five million people have difficulties with their hearing. Over half the population aged between 60 and 70 have a hearing loss issue. Most of them would benefit from having hearing aids, cochlear implants, or both – hearing aid in one ear with a cochlear implant for the other ear. So the short answer is yes!

On a global scale, the need for treating those who can’t hear is just as urgent. The World Health Organisation (WHO) reports that over 5 per cent of the world’s population have disabling hearing loss or can’t hear at all. It is estimated that by 2050 over 900 million people (1 in 10) will have disabling hearing loss.

In this article, we will define the meaning of severe hearing loss and its impacts and discuss the pros and cons of both hearing aids and cochlear implants.

Having a full diagnostic hearing test done is the first step on the way to better hearing health. Your Attune audiologist will also be able to advise you about the advantages of hearing aids and cochlear implants as stand-alone products and as well as in combination with each other.

What is Severe Hearing Loss?

Someone suffering from severe hearing loss may understand some speech and use visual information e.g. body language and facial expressions to fill the gaps. Someone with severe hearing loss may wear hearing aids or have a cochlear implant to help them hear better. Only a hearing test can determine your level and degree of hearing loss. The results of a hearing test also provide recommendations on suitable hearing solutions.

Many people with hearing loss experience a drop in self-esteem and confidence because of their impaired ability to communicate with other people. Having hearing loss can also limit one’s ability to learn to speak a new language.

Other impacts of having a severe hearing loss may include:

  • Difficulty talking 1:1 with someone even in a quiet environment
  • Needing to ask people for repeats regularly as you can’t hear them clearly
  • Unable to follow group (> 2 people) conversations
  • Struggling or unable to hear in situations with background noise
  • Feeling tired from the greater effort of listening because you can’t hear
  • Becoming depressed as relationships suffer from the poor communication
  • Social isolation because you can’t hear well enough to join in conversations
  • Avoiding or not using the phone
  • Not able to enjoy TV programs as before because you can’t hear the speech clearly

Most hearing loss is a result of ageing or genetics, but one-third of people acquire their hearing loss through preventable means. Experts believe that 37 per cent of the hearing loss experienced by individuals was caused by preventable and repeated exposure to loud noise that is known as noise-induced hearing loss.

talking with a doctor

What are Hearing Aids?

Hearing aids are small devices worn in or behind the ear. Hearing aids are removable and used to amplify sound for people with residual hearing. They are equipped with sophisticated digital technology that allows the user to customise their hearing experience.

There are different reasons for choosing a hearing aid over a cochlear implant. Either way, you would first need to see an audiologist who can further explain the specifications and features of each hearing device. You may also consult other health professionals, such as your GP or an ENT (Ear, Nose & Throat) specialist. They can refer you for a diagnostic hearing test, hearing aid discussion, and a cochlear implant assessment if indicated.

Hearing Aid Advantages: 

  • Hearing aids come in a wide range of prices
  • Cost much less than getting a cochlear implant
  • Hearing aids of today allow people to hear the sounds of the world around them with immediate speech recognition at work and play
  • The digital nature of hearing aids allows for a highly customisable experience
  • Natural sound quality and auto-adjusts for different listening environments

Did you know?

You may be eligible for subsidised hearing services and hearing aids through the government system (Hearing Services Program HSP). If you are in a health fund then you may be able to get some rebate towards the cost of hearing aids. Please check with your relevant health fund or ask your audiologist about different funding options.

What are Cochlear Implants?

how your cochlear implant works

A cochlear implant is a very small device that is surgically and discretely implanted behind a person’s ear. The implant helps you hear better by communicating with an external sound processor. The processor is worn on the head just behind the top of the ear and held in place magnetically. Cochlear implants involve a surgical procedure carried out by an ENT Implant specialist.

Unlike hearing aids, cochlear implants do not amplify sound. Instead, they channel sound to bypass the damaged parts of the cochlea and directly stimulate the auditory nerve. The implant generates electrical signals that it sends to the auditory nerve, which then passes it onto the auditory part of the brain where they are recognised as sounds. 

A cochlear implant does not sound like natural speech when it is first turned on. Your audiologist can help you give these sounds meaning and will provide auditory rehabilitation training over the weeks and months following your implant surgery.

Getting a cochlear implant is not suitable for everyone and involves invasive surgery and great commitment post-surgery. It requires months of auditory training assisted by your audiologist to achieve the best outcome.  

Factors that lead to cochlear implant assessment      

Your audiologist will assist you before and during a cochlear implant assessment. If the following sounds familiar, a cochlear implant might be right for you: 

  • Severe hearing loss and can’t hear well in both ears
  • Single-sided deafness
  • Restricted social activities 
  • Job in jeopardy
  • Stopped using phone/s due to poor speech understanding
  • Emotional isolation 
  • One-on-one discussions become difficult/tiring because you can’t hear properly
  • Hearing aids fail to restore communication
  • Reliance on lip reading
  • Unable to participate in group discussions because you can’t hear over the cross-talk

Cochlear Implant Advantages: 

  • It is an excellent option when attempts to enhance hearing with powerful hearing aids no longer work
  • They make communication and social interaction with family, friends and colleagues easier and more enjoyable
  • Cochlear implants are best for those with severe to profound hearing loss
  • Cochlear implants provide the possibility of experiencing sound when before it was impossible 
  • It can completely change a recipient’s life from isolation to social inclusion 
  • There are a few different avenues for funding a Cochlear implant.

best suited for cochlear implants

Hearing Aids and Cochlear Implants in Combination

Cochlear implants help people with severe to profound hearing loss, who do not receive enough benefit when using hearing aids. For some people, using a hearing aid with a severe to profound hearing loss can be like listening to a loud, badly tuned radio. However, there are also those who can’t hear and still benefit from well-fitted hearing aids. 

Then there are people who have a severe loss and wear a hearing aid in one ear and have a cochlear implant in the other ear. This combination of two different hearing solutions has become very common. This is because we know that it is important to keep stimulating the hearing nerve to the brain as long as possible. The brain is able to adapt to hearing sounds in two different ways (acoustic via the hearing aid, electrical via the cochlear implant) and put all the information together to give meaning to words and sentences to enable conversation. 

Hearing from two ears is the natural way to hear and gives us the ability to understand where a sound is coming from. It also helps us hear better in complex noise environments. Those who are assessed as eligible to wear a hearing aid and a cochlear implant will find it the best way forward. 

Wrapping it up

Thanks to the advancements of modern technology, people who have lost their natural hearing, can lead a long, fruitful life and enjoy being engaged in a hearing world. If you feel that either hearing aids, a cochlear implant, or a combination of both may help you or a loved one, please see your audiologist as soon as possible.

If you have any questions about hearing aids or cochlear implants for severe hearing loss, feel free to give us a call or get in touch with your local Attune Hearing clinic to schedule an appointment. 

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