II. Precautions
- Strongly consider consulting Audiology before any Hearing Aid purchase
- Formal Hearing Tests are often covered by insurance
- Many Hearing Aid resellers (including prescribed Hearing Aids, e.g. costco) offer free Hearing evaluation
- Performed prior to purchase of Hearing Aid
- Most Hearing Aid companies offer a trial period during which product returns are allowed
- Shop for devices that offer at least 30 day trial period and clearly stated return policy
- Also look for products with an adequate warranty and good customer support policy
- Online and mobile phone Hearing Tests are also available
- Evaluate Hearing Loss in clinic
- Consider Hearing Loss red flags (e.g. associated Vertigo, chronic Ear Drainage, Sudden Sensorineural Hearing Loss)
- Consider reversible Hearing Loss causes (e.g. impacted cerumen, Medication Causes of Hearing Loss)
III. Indications
- Mild to Moderate Hearing Loss
- Patients who turn up the television volume higher than others, or frequently ask others to repeat themselves
IV. Contraindications
- Complex Hearing needs
- Limited technological knowledge
- Severe Hearing Loss
- Patients unable to hear loud sounds (power tools) or to hear conversations in a quiet room
V. Background
- Various Hearing Aid products have been available OTC
- FDA Reauthorization Act (2017) allows for direct-to-consumer sales of Hearing Aids
- Indicated for mild Hearing Loss
- Best outcomes with a complete audiology evaluation and rehabilitation
- Contrast with Hearing amplifiers used by hunters and bird watchers (e.g. iHEAR TReO)
- As of 2022, many new OTC Hearing Aids (e.g. Lexie, Jabra Enhance)
- Crystal Ear was available as a mail order product from TechnoBrands (Comtrad) in the 1990s
- Linear conventional analog Hearing Aid (most simple Hearing Aid type_
- Weak amplification in speech range (200-6000 Hz)
- One-size-fits-all device (came with 2 sleeves to help fit to ear canal)
- Court settlement regarding false advertising
- Was not recommended by Medical Letter
- (1998) Med Lett Drugs Ther 40(1028): 62 [PubMed]
VI. Types
- Personal sound amplification device (e.g. Pocket Talker)
- Low cost, handheld device with headset (e.g. $20) available at retail stores
- Provides only amplification without noise cancelling or other features
- Preset Over-the-Counter Hearing Aids
- Easy set-up, easy use devices with limited features
- Available in retail stores at moderate cost (e.g. $200)
- Self-Fitting Over-the-Counter Hearing Aids
- Customizable OTC Hearing Aids (via smartphone app), and more difficult to setup
- Available in retail stores and relatively expensive for OTC devices (e.g. $700)
- However, prescription, standard Hearing Aids may cost up to $6000
VII. Advantages
- Inexpensive ($200-$1000 in contrast to $1000-$6000)
VIII. Disadvantages: Direct-To_Consumer Hearing Aids
- May be difficult to handle and place in ear canal
- May not prevent acoustic feedback (occurs when air escapes ear canal)
- Inadequate in noisy environments
- Helps only a minority of persons with Hearing Loss
- Those with mild, flat Hearing Loss
- Requires proper selection and setting
- Contrast with prescribed Hearing Aids which are typically managed by an audiologist
- Multiple size ear tips
- Volume settings
- Noise reduction settings
-
Hearing Aid batteries may not be rechargeable
- Disposable, replaceable batteries last 3 to 20 days (depending on usage, battery size, noise cancellation)
- Hearing Aid batteries are hazardous waste and requires special disposal
IX. Resources
- Hearing Aids (NIDCD)
- Best OTC Hearing Aids (NCOA)
- OTC Hearing Aids FAQ (Johns Hopkins)
X. References
- (2022) Presc Lett 29(12): 70
- Michels (2019) Am Fam Physician 100(2): 98-108 [PubMed]
- Unwin (2024) Am Fam Physician 109(3): 279-83 [PubMed]