As a well-known and highly respected hearing aid center, we are often asked the question “Do I really need two hearing aids?” This is a common question because investing in hearing aids can be a costly endeavor. Some individuals would reason that purchasing one hearing aid is the wise decision because it would be half the cost. What those people don’t realize is that there are a lot of advantages to purchasing two hearing aids instead of just one. The purpose of this blog is to answer this all too common question: “Does double the cost really equal double the benefits?”
One of the obvious benefits to wearing two hearing aids is the overall loudness they provide to both ears. This increase in loudness is referred to as binaural summation. Having two hearing aids can provide up to 10 decibels of additional gain to the overall perceived enhancement of sound quality. In addition to providing this overall loudness, having two hearing instruments can provide addition benefits that most people don’t realize and some of them are discussed here:
Our brain is designed to use the sound information coming in through both ears to fully understand our surroundings. By using the speech and the noise coming in through both ears and comparing them against each other, our brain can decipher what information is pertinent to understanding speech information and focus on that sound source, while at the same time ignoring the background noise or distant conversations that are competing for our attention. When we only use one instrument we are not taking advantage of our brains’ natural abilities to focus on speech in difficult listening situations.
Localization is our ability to identify the direction a sound is coming from, or the ability to identify the location of a sound source. When we are trying to understand someone talking to us, it is important to be able to identify where they are in the room. If we are unable to locate them, our brain has a difficult time focusing on what they are saying to us. For example if you are in a restaurant with 4-5 other people around a table and your friend from the left side of you begins to talk to you, you may not notice that they are speaking to you, or if you do, you may not be able to focus on what they are saying until you can fully identify who is talking to you and where the voice is coming from and then turn to face them.
With only one hearing aid an individual may have things louder on one side but it does not always bring back the clarity and understanding of speech that they were expecting. In an article titled “Bilateral or unilateral amplification: Is there a difference? A brief tutorial” one of the aspects they addressed was speech intelligibility in both fitted scenarios. The article states that past research has shown that there is a 5 percent increase in speech perception when using bilateral amplification versus unilateral. They reviewed research that obtained subjective measures when looking at things they could not measure, like in terms of sound quality. They found there was no comparison between the two scenarios, proving that bilateral amplification provided brightness, clarity, fullness, loudness, nearness, fullness, spaciousness where unilateral amplification could not.
Tinnitus is the official term for what most people call “ringing in the ears” and this ringing in our ears can often be an effect from the trauma we encountered that caused our hearing loss. The loud noise exposure either brief or long term not only wears out the fine inner ear hair cells which causes hearing loss, but can also cause a ringing sensation in our ears due to a lack of stimulation to the nerves that used to carry the sound information up to the brain.
In the same study mentioned above “Bilateral or unilateral amplification: Is there a difference? A brief tutorial”, they also looked at subjective measures of the suppression of tinnitus. They found that bilateral amplification had reduced or eliminated tinnitus. They did not find the same results when a patient was using just one hearing aid. They did find however, that in the case of using a unilateral fitting it could subdue and relieve the tinnitus on that same side as is being amplified but could not suppress it all together if it was present in both ears.
A less known fact about hearing loss is, that when an individual has hearing loss and goes a few years without amplification to that ear it can begin to deteriorate, this is known as auditory deprivation. Auditory deprivation studies have shown that if an ear was left unaided it did not change in terms of threshold pure tones or speech recognition thresholds, but did lose the ability to discriminate speech later on. One recent study reported that approximately 25% of the unilateral fittings demonstrated deprivation effect on the unaided side. The research also concluded that older patients are at greater risk for higher levels of deprivation.
If you are an individual who is over the age of 80 that also has cognitive (mental capability) delays and signs of dementia. In the study titled “Unilateral versus Bilateral Amplification Adults with Impaired Hearing” some individuals meeting these criteria were shown to perform better in background noise when they used one hearing aid. They found that a hearing aid on both ears was “over-stimulating” in a noisy setting. They attributed it to the fact that somewhere in the central nervous pathway the two speech signals would actually cancel each other out
It is obvious to most, that if you have hearing loss on one side but not the other that you would only need one hearing aid, and for the most part this is true. However, there are some circumstances where an individual feels off balance with only one hearing aid and will sometimes purchase two hearing aids to gain a sense of equality between both ears.
When an individual has hearing loss on both sides that requires a hearing aid for both ears it will double the cost of the purchase. Some individuals cannot afford two hearing aids whether they need two or not. In these situations it is important to understand that the investment of one hearing aid will benefit the user substantially when compared to no amplification. The hearing aid wearer will not be able to take advantage of the benefits that come from wearing two hearing aids, but no damage or residual effects will occur from using only one hearing aid.
Over the years, we have had many patients struggle with the epic battle of cost vs. benefit. The only way to make the decision for those who are still on the fence about it is to put both hearing aids on to see what the effects are for them. This can be done in a trial period to see if the benefits truly outweigh the cost. In an individual’s place of residence, work, or social functions, they will be able to decide for themselves if the benefits outweigh the cost for them. In my experience and according to all of the research, if an individual has hearing loss on both sides, the benefits of using two hearing aids will typically outweigh the cost and most find this out for themselves when they try it. It is recommended that everyone discuss their specific situation with a licensed hearing professional as every individual and their circumstances differ.
Should you or a loved one have questions about hearing loss or your need for amplification, the licensed clinicians in the Shea Hearing Aid Center are here to help. Please give us a call at (901) 415-6667 and we’ll be glad to assist you.
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