Amplifying Hearing Loss Frequencies — Won't This Create a Vicious CIrcle?

[bellafjelle]

Let's say that a patient by the name Bob has a hearing loss at a certain frequency, in this case let's make that 8000 Hz.

Bob generally has all frequencies intact within the normal range 0 to -20 dB besides from the one at 8000 Hz which is at -35 dB.

Bob is about to try Acoustic Reset Neuromodulatin for his tinnitus tone which is around the 6500 Hz area and to increase the effectiveness of the therapy he wishes to make a 15 dB gain on the 8000 Hz area so he can actually hear the ACRN frequencies around the tinnitus.

Bob is afraid of doing damage to his hearing by making that gain. He is not quite sure how to understand hearing thresholds.

If a person with a significant hearing loss tries to listen for the difficult tones and then needs to amplify these tones, a normal hearing person would find that way too loud. Knowing that the amplification is loud for a normal hearing won't that just create even more hearing loss for the patient even though the amplification will sound normal for him?

Is hearing loss a vicious circle of amplifying > losing more hearing > more amplifying > even more hearing loss and so on?

Is it safe for a patient with hearing loss to increase the bad frequencies when listening to music?

 

[GregCA]

Is hearing loss a vicious circle of amplifying > losing more hearing > more amplifying > even more hearing loss and so on?

With at 35 dB threshold, you need a 35 dB sound to hear it. Listening to a 35 dB sound for a few hours is not believed to do damage to your ears.

When the thresholds get higher (severe/profound) then amplification becomes quite loud, and you are stuck in the conundrum that you brought up. In general, people would rather hear something now and risk damage their hearing vs not hearing anything now and keeping their current "poor hearing" intact. Only the first option allows you to hear anything at all; the second keeps you "in the dark" forever.

Hearing aids work that way, but they'll cap the output to safe levels. After a certain degree of hearing loss, they can't help you, and you need to think about other options such as a cochlear implant.

 

[Tinker Bell]

With at 35 dB threshold, you need a 35 dB sound to hear it. Listening to a 35 dB sound for a few hours is not believed to do damage to your ears.

When the thresholds get higher (severe/profound) then amplification becomes quite loud, and you are stuck in the conundrum that you brought up. In general, people would rather hear something now and risk damage their hearing vs not hearing anything now and keeping their current "poor hearing" intact. Only the first option allows you to hear anything at all; the second keeps you "in the dark" forever.

Hearing aids work that way, but they'll cap the output to safe levels. After a certain degree of hearing loss, they can't help you, and you need to think about other options such as a cochlear implant.

I have been curious regarding this. My hearing loss is a 70dB drop at 6k. Would a hearing aid really blast sounds at that level? An ear specialist who sees patients with tinnitus recommended a hearing aid, I don't think he would do that if it could further damage my hearing. Especially since he also cautioned me to use earplugs when sounds are uncomfortably loud to me.

Meanwhile I have a family member who possibly has 50dB loss across all frequencies in both ears. They're undergoing further testing, but would hearing aids really put all sounds at that volume?

 

[bellafjelle]

Ok. Let me add a thing to that.

If person A can hear his favorite music at 60 dB without problems and person B needs to amplify the 8000 hz to 85 dB to be able to percieve all frequencies equal to person A, is that potentially dangerous?

 

[linearb]

I assumed this would be about hearing aids, because there's an obvious corollary to the question of "can hearing aids over time cause additional hearing damage?"

Intuitively I would assume the answer to be yes, and there appear to be a very limited number of studies to support that.
http://hearinghealthmatters.org/waynesworld/2013/hearing-aids-hearing-loss-part-ii/

https://www.sharecare.com/health/hearing-damage/can-hearing-aid-cause-hearing-loss

These tend to say "yes, if the volume is set too high" without really qualifying what that means. If someone has a 70db threshold (profound loss), I can't imagine any way of setting the hearing aids which would both provide useful amplification, and not also cause damage.

 

[Tinker Bell]

I assumed this would be about hearing aids, because there's an obvious corollary to the question of "can hearing aids over time cause additional hearing damage?"

Intuitively I would assume the answer to be yes, and there appear to be a very limited number of studies to support that.
http://hearinghealthmatters.org/waynesworld/2013/hearing-aids-hearing-loss-part-ii/

https://www.sharecare.com/health/hearing-damage/can-hearing-aid-cause-hearing-loss

These tend to say "yes, if the volume is set too high" without really qualifying what that means. If someone has a 70db threshold (profound loss), I can't imagine any way of setting the hearing aids which would both provide useful amplification, and not also cause damage.

I have wondered about this. Is it better for the ear to hear the sound, or does hearing aid amplification make hearing loss worse?

The first link had dates from the 1950s and 60s. Hearing aid technology has improved significantly since then. I read a book recently about a child with hearing aids in the 1970s, she could freely adjust the volume and sometimes the microphone she wore caused sounds to suddenly blast.

I also think this would be confusing regarding whether correlation actually equals causation when it comes to increased hearing loss. For example, I wear eye glasses and my eyesight has continued to decrease over the years. That is not due to my glasses, it's just age and genetics. If I were to stop wearing my glasses and instead blindly stumble around my home, would my eyesight decline more rapidly due to the added strain of trying to see?

Is it the same for hearing loss? Is it better to get hearing aids when first needed or wait?

 

[GregCA]

I have been curious regarding this. My hearing loss is a 70dB drop at 6k. Would a hearing aid really blast sounds at that level?

Kind of. 70 dB is not considered harmful I think (if I recall OSHA guidelines)... but we do know that "mileage may vary" when it comes to cochleas. There are standardized tables that define how much amplification you are supposed to get in a certain band based on your loss, and it's not exactly 1-1 mapping (look up NAL tables for more info). Those tables have evolved in time too, and some manufacturers of hearing aids won't disclose their "special recipe".

Hopefully it is safe, but I think it's hard to know for sure.
I have a hearing aid and I wear it, so I've decided to take the risk.

Meanwhile I have a family member who possibly has 50dB loss across all frequencies in both ears. They're undergoing further testing, but would hearing aids really put all sounds at that volume?

I assume they do because if they didn't, wouldn't that person not hear anything?

The first link had dates from the 1950s and 60s. Hearing aid technology has improved significantly since then. I read a book recently about a child with hearing aids in the 1970s, she could freely adjust the volume and sometimes the microphone she wore caused sounds to suddenly blast.

Even today, some "cheap" HAs will indeed work in this fashion, but "serious" HAs limit their output to avoid over-amplification.

 

[Tinker Bell]

I assume they do because if they didn't, wouldn't that person not hear anything?

She has never worn a hearing aid. Just discovered it, she had no idea she had hearing loss. Neither did anyone else. I misspoke, too, I rechecked the audiogram and the loss fluctuates between 30 to 50dB. She says she cannot hear whispers, but can hear regular conversation.

Thank you for addressing my other questions!

 

[Bobby B]

Studies have shown that stimulating those damaged hair cell can be beneficial

HA is one option but this will amplify sound at the frequncy if sound at these frequncies is present to begin with and how often can you controls that

My loss is severe at 12khz and above so I sleep with white noise and cricket noises that are set at these frequncies using a good sound source , a powerful high quality horn tweeter and a good amp - 8 hours of this per day (night ) is helping already getting better hearing and less intrusive T over the day

I set it at approx 55db which is the minimum where I start to hear it

 

[Another Howard]

Never yet got a straight audiology answer to whether an aid might worsen hearing. This forum is rather more helpful!
Let's just add this: I dug out an older, prescribed, hearing aid to try. It seemed fine but my children were first to say can't you hear the whistle?
No I could not, but a mic into my computer showed a non-stop 6kHz feedback tone - too high for me to hear. However... for the first time ever... I now have a pulsating tinnitus in my weak right ear. Takes effort to ignore.