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Hearing Aid Consumer Guide

According to the Hearing Health Foundation nearly” 50 million are experiencing hearing loss”. Our goal is to provide resources such as a hearing aid consumer guide to help people make the right decisions before and after they buy hearing aids. We are genuinely here to help answer any questions you may have about hearing loss. Hearing loss, if unaided, results in communication difficulties, social isolation, withdrawal and an overall reduced quality of life. In purchasing hearing aids, you have circumvented these challenges by adopting the only clinical intervention for mild to severe hearing loss.
 
Today, there are a plethora of affordable hearing aids options, each with different features and channels. We are here to help you understand the important essential information of your hearing aids,from knowing how to choose the best one for you to how to clean and maintain so they are performing at their best.
 
As you become accustomed to using your hearing aids, there are various challenges that might surface, especially during the initial orientation period where your brain adjusts and acclimatize to the new sounds and frequencies.
 
We have compiled a categorical list of frequently asked questions in the form of a hearing aid consumer guide to help you navigate everything you need to know before and after your buy affordable high quality hearing aids.

Unaided Hearing Loss

A comprehensive analysis of up-to-date medical literature reveals that unaided hearing loss is associated with many debilitating symptoms in the short-term, as well as chronic diseases in the long-term.
These include, but are not limited to, dementia, major depressive disorder as well as a loss of balance and overall reduction in quality of life.
In this guide, we want to emphasize these problems so that you appreciate the importance of procuring hearing aids as soon as you can in order to mitigate against these health problems.

Increased Risk of Dementia 

Not getting hearing aids can cause several diseases, such as Alzheimer’s Disease or Dementia. One systematic review in 2017 reviewed 17 studies and found that hearing loss is an independent risk factor for the development of dementia in older adults.

Mental Illness And Social Isolation

Unaided hearing loss can lead to isolation, depression, and a less stimulated brain. One national study conducted in 2018 showed that the rates of depression were significantly higher in those with hearing-impairment, compared to those with normal hearing.

A more recent systematic review supported these findings; indicating that hearing loss was associated with a 1.5-fold higher risk of developing depression. Unfortunately, hearing loss has also been shown to be associated with an increased risk of suicidal ideations.

If you or your loved one has hearing loss, it would be in their best interests to ameliorate this worrisome symptom as soon as possible. Hearing loss may superficially appear to be an organic symptom, but in reality, it can adversely impact on one’s mental and psychosocial health as evidenced by these studies.

Vestibular Dysfunction – Balance

Unaided hearing loss also leads to vestibular dysfunction, which is characterized by a loss of balance. This results in a poorer quality of life, as people with hearing loss are precluded from doing outdoor activities or socializing outside of the comfort zone of their home. One study found that hearing aids resulted in improvements in multiple domains of quality of life.
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The researchers found that hearing aids stimulated confidence and attenuated the fear of falling in patients who had developed vestibular dysfunction as a result of long-standing and untreated hearing loss. This improvement is not isolated to adults and the elderly. Indeed, children with one-sided hearing loss often have concomitant vestibular dysfunction, and hearing aids have been shown to improve their sense of balance.

Increased Risk Of Falls

Unaided hearing loss also leads to vestibular dysfunction, which is characterized by a loss of balance. This results in a poorer quality of life, as people with hearing loss are precluded from doing outdoor activities or socializing outside of the comfort zone of their home. One study found that hearing aids resulted in improvements in multiple domains of quality of life.
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The researchers found that hearing aids stimulated confidence and attenuated the fear of falling in patients who had developed vestibular dysfunction as a result of long-standing and untreated hearing loss. This improvement is not isolated to adults and the elderly. Indeed, children with one-sided hearing loss often have concomitant vestibular dysfunction, and hearing aids have been shown to improve their sense of balance.

How Much Do Hearing Aids Cost?

Despite the fact that hearing aids bring immense benefit to patients with hearing loss, only one in seven American adults with hearing loss use them [A2]. A major reason for this is the staggering cost of hearing aids.
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Unsurprisingly, the exorbitant prices of hearing aids affect the socioeconomically disadvantaged groups of patients the worst. The average cost of a pair of hearing aids is about $6,000, a sum that is beyond the reach for many seniors [A3].
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Two major reasons that have been cited for this high cost are the non-competitive hearing aid market, as well as inefficient distribution channels in the United States [A4]. Not including the fact the most hearing practice only provide bundle pricing which means they charge you up front for the time the will spend with you in the future.
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Often bundled up with other services such as cleanings, future hearing tests, fitting, future follow-up appointments, and adjustments. Sometimes this cost will include the cost of batteries for the hearing aid devices, which can average from $8 to $32, as well as a warranty that’ll cover the cost of a new device if it were to get damaged.
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The easiest way to avoid paying for all of these extra services is to purchase a hearing aid device from a hearing professional that does not bundle the price or buy the hearing aids here where there is absolutely no bundling.

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Signia Hearing Aids Prices Unbundled $ 780 – $1,899
The cost of hearing aids can vary considerably even within the same brand (e.g. Siemens Signia). This is because the cost depends on a few factors:
  • Type of hearing aid (ITE, BTE, ITC, CIC or RITE)
  • Number of channels (<16 or >16)
  • Customizability (e.g. personalized to your audiogram, custom-moulded to your ear)
  • Terms of Warranty
  • Additional features (e.g. wind-proofing, reverberation cancelling or noise cancelling)
For example, the Siemens hearing aids prices vary between $ 780 – $1,899. This is because the more affordable models have fewer channels, and less features, whereas the more expensive models feature sound smoothing, binaural directionality and enhanced speech detection algorithms.

Low Quality vs High Quality Hearing Aids

When shopping around for affordable high quality hearing aids choosing the right ones can be challenging, given that most hearing aids can appear similar to one another yet extremely different in price.

How To Tell The Difference From High Quality Hearing Aids & Low Quality

In choosing high quality hearing aids, it is important to consider the following factors:

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Number Of Channels

  • Channels in hearing aids are the ranges of frequencies that are created by digital filters to enhance your hearing experience.
  • The higher the number of channels, the greater the quality of the hearing aids.
  • Channels are responsible for expansion, compression, noise reduction and feedback suppression, amongst other features
  • Quality hearing aids typically start at 16 channels onwards, whereas poor-quality hearing aids have between 0 to 8 channels

Benefits Of Having More Channels

Multi-channel Compression
This allows for the independent adjustment of amplification in several frequency bands. [8]
Directional Microphones
This improves the signal-to-noise ratio by amplifying sound from the front, as opposed to from other directions.
Noise Reduction
Sophisticated algorithms act to suppress unwanted noises.
Environmental Adaption
In addition to noise reduction, algorithms also work to detect and simultaneously suppress wind-noise and even traffic in outdoor environments.
Reverberation Cancellation
Reverberation is a phenomenon that changes the structure of a sound without altering its pitch, and is a common problem faced by users of hearing aids. Some hearing aids with more than 16 channels are able to cancel out this effect.

Customize Hearing Aids With Your Hearing Test

  • Quality hearing aids are fitted with an audiogram (your hearing test) functionality
  • Audiograms are graphs which display your customized hearing level and is a visual representation of your hearing loss
  • Quality hearing aids are able to tweak their performance to fit with your audiogram, in order to produce a tailored hearing aid experience

How To Tell If You’re Dealing With Professional Hearing Aid Providers

1. Licensed Hearing Aid Specialist or Audiologist
  • Quality hearing aid providers, offer licensed hearing aid specialist or audiologist to help you through the entire fitting process (whether online through telecare or in person). This is very important because your hearing is directly corelated with your brain. The specialist is there to answer any questions you may have and teach you what to expect as your brain acclimates to your new hearing aids.
2. RIC versus BTE
  • RIC (receiver in the canal) are newer and preferred in the hearing industry. If the hearing aid provider online or in person don’t offer RIC hearing aids, then they probably don’t offer quality hearing aids.
  • Exceptions of when a BTE is better than RIC, chronic ear infections or profound hearing loss
  • RIC hearing aids have the latest sound processing technology, are more discreet and comfortable than BTE

High Quality Affordable Hearing Aids $780 & Up

Signia Hearing Aids $780 – $999 per hearing aid online

Same exact hearing aids cost $4,500-$6,500 in audiologist office
We always recommend going to an audiologist or hearing specialist to get the whole personalized fitting experience. Unfortunately, purchasing hearing aids from a local hearing cost more, because it’s usually a bundled price that includes their time spent with you. This can start from $4,500 for their lower technology of 12 to 16 channels and upward to $6,500 for 48 channels. These are the same exact hearing aids sold in your local hearing practice  but without the bundled price.
The Signia primax and nx range from 16 channels minimally and can go up to 48 channels. As the premium high quality hearing aids, they are capable of focusing sound directionality, cancel feedback, provide windscreen for optimal sound, reduce noise, equalize and smoothen speech, as well as provide tinnitus therapy.

Basic Level Affordable Hearing Aids $149 and up

$149 – $749 per hearing aid

For people who are unable to afford high quality hearing aids, we recommend these low cost hearing aids. While these hearing aids may not have 16 channels, they can be personalized to your audiogram.  I would recommend these if you have mostly a low frequency hearing loss not, high frequency hearing loss.

How to Read an Audiogram

The interpretation of an audiogram is straightforward – it is a graph that measures the intensity (loudness) of sound from top to bottom, as well as the frequency (pitch) of sound from left to right [A1]. Low-pitch sounds such as male voices, vowels and bass tones are represented towards the left, whereas high-pitch sounds such as children’s or women’s voices are represented towards the right. Two lines are reflected on the graph for each ear; red (right ear) and blue (left ear). Patients with hearing loss may have varying hearing thresholds depending on the frequency of sounds heard.

Degrees of Hearing Loss

Normal Hearing
0 – 20 dB range
No amplification necessary
Mild Hearing Loss
20 – 40 dB range
Some difficulty in hearing in noisy environments
Hearing aids may be beneficial
Moderate Hearing Loss
40 – 70 dB range
Frequent difficulty in understanding speech in noisy environments
Hearing aids recommended
Severe Hearing Loss
70 – 90 dB range
Requirement for visual assistance during communication
High-power hearing aids are necessary
Profound Hearing Loss
90 – 120 dB
Major challenges in all forms of communication
Requirement for visual assistance during communication
Cochlear implants may be indicated

Hearing Aid Styles

Choosing the right type of hearing aids is determined partly by your audiogram (also known as hearing test), lifestyle, and dexterity level. What type of hearing loss do your have? Normal, mild, moderate, severe, or profound? Generally, the more of a hearing loss such as profound the bigger the hearing aid you will need for your hearing loss. Luckily hearing aids are a lot smaller than they were 5 to 10 years ago.

Behind-the-Ear (BTE) Hearing Aids

BTE hearing aids hook over the ear and pick up incoming sounds before they reach the pinna – a part of the ear that funnels sound further into it.  This leads to a compromise in some sonic cues, resulting in a poorer localization of sound . The main benefit of BTE hearing aids is that it has the most power which is great for severe to profound hearing loss. They hold larger batteries for extended performance life compared to most hearing aids. [5].

Completely-in-the-Canal (CIC) Hearing Aids

CIC hearing aids fit entirely within the ear canal and are moulded to fit each individual. They are barely noticeable and are resistant to wind-noise because of their hidden location. However, they generally do not have as many features or offer as much power as the BTE or ITC hearing aids [7].  This solution works best for mild hearing loss people.

In-the-Canal (ITC) Hearing Aids

ITC hearing aids are similar to CIC hearing aids, in that they are also custom-moulded. However, they only fit partially within the ear canal which means they are very visible.

Receiver-in-the-Canal (RIC) Hearing Aids

RIC hearing aids have a receiver instead of a plastic tube like BTEs. They are typically smaller than BTE hearing aids and sound is usually clearer as the speaker is positioned closer to the ear canal [6].

Lifestyle

Environment Influence the Quality of Sound

The location of the primary talker to whom you are listening to, the presence and absence of background noise, and even the type of background noise can influence the quality of sound processed by your hearing aid [1].

Questions to think about concerning lifestyle. Are you active? Do you meet with people often? Are you at home most of the day? Do you go to restaurants? Do you work? Are you outside? Do you have a smartphone? These are questions that will lead you to the right technology level for you. For example, if you are at home all day then you probably don’t need all the features that of a person that works full time and plays golf.

Hearing Aid Environment Features

Wind-Outdoor

Hearing aids which are exposed to environmental wind and other air flows such as wind that is generated from fans, or even from jogging or riding a bike, can lead to pressure variations in turbulence in the air flow, resulting in wind noise [2]. Some modern hearing aids offer “wind-noise management” settings which can mitigate this effect.
Noisy Environment-Restaurants
Conference rooms, offices and busy food and beverage establishments can lead to reduced speech intelligibility. Hearing aids with binaural processing and in-built noise cancelling algorithms can remove unwanted sounds and enhance speech to produce crisp conversation [4].
Stroll Feature
Do you walk with friends?  Have trouble hearing the passenger in the car? Stroll lets your hearing aids know to point the directional microphones to the side of you instead of in front of you for the situations in life when you are not talking directly in front of someone.
360 degrees
Do you have trouble hearing people talk behind you in the car? How about someone trying to talk behind you while walking? 360 feature lets you tell your directional microphones where you want them to go no matter where the speaker is.
Bluetooth
Do you have trouble hearing on the phone? Hear your conversations on the phone with two ears vs one.  With Bluetooth you can also listen to music and stream online through your hearing aids. This is a great option if you like going to the gym and listen to music or if you travel to get to work, this feature allows you can use the hearing aids like headphones.

Dexterity

Dexterity is important for two reasons.
  • Can you put the hearing aid on correctly? If not, then the hearing aid may cause feedback and intermitting sounds if it’s not on correctly. This will cause a very pleasant experience with the hearing aids.
  • Are you able to change batteries every 3 to 10 days? Hearing aid batteries are small and can be difficult to insert if you have dexterity issues. If this is you then you may want to think of buying rechargeable hearing aids The Cellion and Signia Charge and Go are rechargeable hearing aids that you never have to change batteries.

Talk To A Licensed Hearing Specialist

Talking to a hearing care specialist also known as licensed HIS (Hearing Instrument Specialist) can give you valuable insight on how to make this decision, a licensed hearing specialist will help make a personalized decision based on your budget and lifestyle.
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Tip: Make sure that they have a license number and get their name so you can look them up to confirm you are talking to a real hearing specialist and not a hearing salesperson. To make a free phone/video appointment with our licensed hearing specialist please click here https://hearingbenefitservices.as.me/schedule.php

Causes of Hearing Aid Feedback

Hearing aid feedback management

Hearing aid feedback occurs when sound leaks out of the ear and reaches the hearing aid microphone. The hearing aid then amplifies this sound and delivers it back into the ear. This loop creates the annoying whistling, intermitting or squealing sound known as “feedback”.
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The main causes of hearing aid feedback

Hearing aid is clogged with wax:

Most of the time earwax is the problem. You will generally hear a distorted or intermitting sound. Make sure to clean your hearing aids at least twice a week to receive the best sound and no feedback. Sometimes the hearing aid’s click dome is so full of wax, its best If you replace it all together. Here is a video on how the clean your hearing aids including replacing the RIC (receiver in the ear) hearing aid click dome for Signia, Rexton, Miracle Ear, Hansatan. Here is a link where you can buy click domes

How to clean your RIC hearing aids so they won’t get clogged with wax

Set up an appointment to learn, how you can get RIC hearing aid click domes for free

Failure to insert hearing aids fully or correctly:

Make sure that you have completely inserted the hearing aids into your ear canals. Look in the mirror to check your hearing aids and follow the steps in the video.
  • Place the hearing aid behind your ear
  • Insert the hearing aid in the ear canal

How to insert a RIC hearing in your ear correctly.

.If you find that the hearing aids gradually work themselves out of your ears during the day, you may need larger domes, or retention lock/tails also known as concha locks. If the hearing aid continues to come out even with retention lock and dome adjustment, then you may need a custom silicon ear mold.
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This is especially a good idea If you have lost feeling in your fingers over time, you may find earmolds easier to insert into your ears. Some people have ear canals that move a great deal during chewing and talking jaw movements. Earmolds require an silicone ear impression of your ear, you will need to see your audiologist or hearing specialist to make it and send it to the hearing aid lab for you.
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Poor fitting hearing aids:

Poor fitting hearing aids can lead to a variety of issues. Sometime the standard hearing aid size is not for you. If you have big ears, chances are you do not fit in standard hearing aid length, in which is causing feedback.
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Troubleshooting poor fitting hearing aids:

  • You may have incorrect receiver length if you have big or small ears
  • Gain or loss weight? This can change the size of the ear canal
  • If you are using domes, consider trying a larger size dome or adding a retention lock.

Excessive hearing aid gain (volume):

Did you increase the volume on the app by accident? Reduce hearing aid volume manually on your hearing aids or on your app. If it interferes with your ability to hear you may need a higher receiver level. For example M medium to P power or P to HP high power.
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Ear wax in the ears:

Impacted ear wax forms a wall in the ears that causes sound to bounce back out of the ears. Have a doctor check your ears for wax is the ultimate best solution. Its normal, your ears naturally make wax to protect your ears and keep them healthy.
Ear wax normally migrates out of your ear over time as skin grows outward from your eardrums. Wearing hearing aids can block this migration. Hearing aids in your ears may also stimulate the glands in the skin that produce ear wax. Do not use cotton swabs to clean your ears because these will tend to push wax further down your ear canal. Instead, have your ears professionally cleaned by a doctor. If you’re unable to have a doctor clean your ear, most audiologist recommend Dubrox as a safe way to remove wax at home. Be sure not to use drops too frequently because they can dry out your ears.

How to Clean Hearing Aids

How to Clean RIC Hearing Aids (Receiver in the Ear)

Tip: Never use alcohol on hearing aids, especially on the plastic casing. Alcohol breaks down plastic over time. There are special hearing aid wipes and hearing aid spray sanitizer that do not contain alcohol.
What you will need:
-Hearing aid brush or toothbrush
-Toothpick (optional)
-Tissue or cloth
-Hearing aid

Follow these steps to clean your RIC hearing aids:

  1. Use the black brush that came with your hearing aids alternately a toothbrush to brush the hearing aid exterior case. Pay special attention to the microphones which are on the top side of the hearing aid.
  2. Use a tissue or cloth to wipe wax off the dome and receiver area.
  3. Use the wax loop of your black brush to gently remove any wax that you see from center hole of the dome. Be careful not to poke into the wax trap underneath.
  4. Deeper clean – For a deeper clean you can use a dental toothpick to retract wax from the click dome and receiver.
  5. If the dome is very soiled, remove the click dome and clean it with the brush or replace it altogether.
  6. If you have taken the click dome on and off more than twice, put on a new dome and throw away the old dome. Over time, dome plastic stretches and does not adhere to the receiver as well.
  7. Before you put the hearing aid in your ear, make sure that the click dome is secure on the receiver. We do not want the click dome to get stuck in your ear.
  8. If you have a custom mold instead of a dome, use the wax loop end of the black brush to remove wax from the hole where the sound comes out.
  9. If you have disposable hearing aid batteries, make it a habit to inspect the battery compartment when you change your batteries. Gently brush out any debris that you see in the compartment.

Remove/Replace Click Domes – Signia/Siemens/Miracle Ear/Rexton

  • The new dome package has a removal tool indicated by an arrow. Wedge this slot tool in between the dome and the receiver.
  • Twist the click dome
  • Select a new dome. Make sure that it is the same style and size as your old dome.
  • Press the dome on to the receiver. You will hear a “click” when the dome is fully seated.
  • Tug on the dome to make sure that it is firmly in place.

Other domes

  1. Grasp the dome with your fingers and pull it off the receiver.
  2. Select a new dome. Make sure that it is the same style and size as your old dome.
  3. Press the dome on to the receiver firmly.
  4. Lift the dome’s edge slightly and look at the center stem part that slips on the receiver. Make sure the stem has fully covered the attachment area of the receiver. This is usually a narrow part of the receiver.

How to Clean Hearing Aids (Instant Fit CIC Style)

Never use alcohol on hearing aids, especially on the plastic casing. Alcohol breaks down plastic over time. There are special hearing aid wipes that do not contain alcohol.
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1. Pull the click sleeve off the hearing aid and wipe with a tissue or cloth.
2. Wipe the aid shell.
3. Make sure no debris is in the center hole of the click sleeve. This is where sound exits.
4. Put the click sleeve back on the hearing aid. Make sure you hear a “click”.
5. Brush the hearing aid microphone.
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Make it a habit to inspect the battery compartment when you change your batteries. Gently brush out any debris that you see in the compartment.

How To Remove & Replace Click Sleeves Instant Fit CIC Style

How To Put On Hearing Aids

RIC Hearing Aid Style

  • Visually inspect your hearing aids. Make sure you have cleaned off any wax. Check that the parts of the hearing aids fit together well. Domes should be tight against the receivers
  • Remember that the right hearing aid usually has a red marker (Red is Right) somewhere on the body. The left hearing aid has a blue marker (Blue is Left).

How To Put on A Hearing Aid (RIC style)

  • Place the body of the hearing aid on the ear first, and then place the receiver wire inside of the ear. A few patients prefer to place the receiver in the ear first, especially if they have custom-made molds attached. Use a lighted three-fold makeup mirror to help you see what you are doing.
  • Place the body of the hearing aid over the top of your ear.
  • You may need to use your other hand to pull back on your ear to straighten your ear canal. If you have a retention tail or concha lock, tuck it inside the bowl part of your ear.
  • Make sure the hearing aid dome is snug inside your ear so you do not hear feedback.

CIC Instant Fit Hearing Aids

How To Put On A Hearing Aid (CIC style)

  1. First, visually inspect the hearing aid and make sure the click sleeve is firmly attached. Close the battery door of the hearing aid.
  2. Red hearing aid goes into the right ear (Red is Right) and the blue hearing aid goes into the left ear (Blue is Left)..
  3. Hold the hearing aid in your fingers. Remember that the click sleeve goes into your ear.
  4. Oriented so that the microphone is towards the top and the pull string is on the bottom. There is also a bend in the hearing aid. The outer smooth curve of the bend should be towards the front of your ear.
  5. Push the hearing aid into your ear.
  6. Gently wiggle it back and forth until it is fully seated in the ear.
  7. Check your ear in a mirror.

Conclusion

Given that at least 30% of adults in the United States of America have hearing loss, it comes as no surprise that millions of Americans face the challenges that come with hearing loss. From orientation, to cleaning, maintenance, and troubleshooting, we hope that you have gleaned some useful insights from our hearing aid consumer guide.

Still have a burning question that was unanswered? Schedule an appointment here here! 

References

1. Surr, R.K., et al., Influence of environmental factors on hearing aid microphone preference. J Am Acad Audiol, 2002. 13(6): p. 308-22.

2. Zakis, J.A., Wind noise at microphones within and across hearing aids at wind speeds below and above microphone saturation. J Acoust Soc Am, 2011. 129(6): p. 3897-907.

3. Madsen, S.M.K. and B.C.J. Moore, Music and hearing aids. Trends in hearing, 2014. 18: p. 2331216514558271.

4. Husstedt, H., A. Mertins, and M. Frenz, Evaluation of Noise Reduction Algorithms in Hearing Aids for Multiple Signals From Equal or Different Directions. Trends in hearing, 2018. 22: p. 2331216518803198-2331216518803198.

5. Xu, J. and W. Han, Improvement of Adult BTE Hearing Aid Wearers’ Front/Back Localization Performance Using Digital Pinna-Cue Preserving Technologies: An Evidence-Based Review. Korean journal of audiology, 2014. 18(3): p. 97-104.

6. Winkler, A., M. Latzel, and I. Holube, Open Versus Closed Hearing-Aid Fittings: A Literature Review of Both Fitting Approaches. Trends in hearing, 2016. 20: p. 2331216516631741.

7. Akeroyd, M.A. and W.M. Whitmer, Spatial hearing and hearing aids. ENT & audiology news, 2011. 20(5): p. 76-79.

8. Cox, R.M., J.A. Johnson, and J. Xu, Impact of advanced hearing aid technology on speech understanding for older listeners with mild to moderate, adult-onset, sensorineural hearing loss. Gerontology, 2014. 60(6): p. 557-568.

A 1. Walker, J.J., et al., Audiometry screening and interpretation. Am Fam Physician, 2013. 87(1): p. 41-7.

A 2. Chien, W. and F.R. Lin, Prevalence of hearing aid use among older adults in the United States. Arch Intern Med, 2012. 172(3): p. 292-3.

A 3. Fischer, M.E., et al., Determinants of hearing aid acquisition in older adults. Am J Public Health, 2011. 101(8): p. 1449-55.

A 4. Blustein, J. and B.E. Weinstein, Opening the Market for Lower Cost Hearing Aids: Regulatory Change Can Improve the Health of Older Americans. Am J Public Health, 2016. 106(6): p. 1032-5.

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