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Hearing Aids for Draining Ears

Hearing aid fittings can be very difficult for individuals with draining ears, and yet, for a child who has chronic hearing loss due to middle ear problems, the use of amplification is critical to ensure normal speech and language development.

Based on the information provided and my knowledge of t-cell immune deficiency, I am assuming that this child has bilateral conductive hearing loss, which is hearing loss due to chronic otitis media without inner ear involvement. I am also assuming the child has been fit with hearing aids that use an earmold to direct the sound from the hearing aid to the ear canal, or an air conduction hearing aid.

When the ears are actively draining, the ear canals should not be blocked with earmolds and the child should not wear his hearing aids. Your child should certainly be followed closely by the ENT (ear, nose and throat doctor) with respect to the 7 sets of tubes and the draining ears.

Considering the situation (above) I can suggest three amplification alternatives.

First, it might be advantageous to use a bone conduction hearing aid. A bone conduction hearing aid delivers sound through a bone conduction vibrator placed on the mastoid bone, which is the hard bone located behind the ear. The bone vibrator is held in place by a headband similar to the one used during a hearing test. With a bone conduction hearing aid, sound is picked up and amplified the same way as in an air conduction hearing aid, but instead of the amplified sound being sent to the ear canal through an earmold, it is directed to the bone vibrator and delivered directly to the inner ear system. When the bone vibrator is stimulated, both inner ears receive the amplified signal, and sound is heard. The main advantage of a bone conduction hearing aid is amplification is received without blocking the ear canals, i.e. no problem with draining ears. The disadvantage of the bone conduction aid is that some of the sound and localization cues provided by binaural input are missed.

Another amplification alternative is to use an assistive listening device (ALD) instead of a hearing aid. With an ALD, the person talking holds a microphone, the sound from the microphone is sent to an amplifier being worn by the listener through either an infrared signal, an FM signal, or a hardwire system, the signal is amplified and then sent to the listener who is wearing some sort of earphone, that is not an earmold. The advantage to this type of system is that there are many different types of earphones available, depending on the system used. Some ALDs use earphones similar to those used in personal stereo systems, similar to earmuffs. Some use ear buds that rest inside the concha, the bowl in the ear that leads to the ear canal. Some systems use an earphone that hangs from the top of the ear over the ear canal so that no part of the ear is blocked. ALDs also offer the advantage of potentially reducing the amount of amplified background noise, since sound is sent directly from the speaker to the listener without interference.

The third option, depending on the exact type and degree of hearing loss, and depending on the child's overall situation is a middle ear implant or bone conduction implant. This is an option that the child's ear doctor can discuss with you.

In summary, it is difficult to provide amplification for children with draining ears, yet it is important to do so. I have recommended three alternatives, and I suggest that you speak with your audiologist and your ear doctor regarding which route is the best for your child. Good Luck to you!

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