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Hearing Loss Basics
- Hearing Evaluations
- Hearing Aids
- Hearing Loss in Children
- Assistive Listening


Balance Problems

About Our Team

Cockeysville, MD Office
10153 York Road, Suite 106
(410) 683-0101

Stewartstown, PA Office
200 Bailey Drive, Suite 201
(717) 993-3686

Hearing Loss and Hearing Aids

Did you know that over 40 million Americans suffer from some degree of hearing loss? Remarkably, less than 20% of people with symptoms of hearing loss choose to do something about it. Statistics show that patients wait an average of seven years before pursuing any diagnosis or treatment for the symptoms of hearing loss, and that no other sense is ignored for a longer period of time!

Our auditory system was not designed for the acoustical demands of our current daily exposure to sound; this contributes to the fact that people are being affected by hearing loss earlier in their lives. Hearing loss is as unique as a fingerprint, and no two people have exactly the same hearing impairment. It takes the highest level of expertise by specially trained Audiologists to detect the subtle nuances that differentiate the severity and type of hearing loss.

At AC Hearing, Tinnitus and Balance Associates, LLC, we make it our core philosophy to provide that expertise. We use the most advanced technology available, and employ experienced Audiologists and doctors of Audiology who strive to maintain the highest level of professionalism and integrity. We perform assessments and provide identification, prevention and non-medical treatment of hearing loss, balance disorders and tinnitus. We provide services to area hospitals, residential and skilled care facilities, local otolaryngologists, pediatricians and primary care physicians. A full range of Audiology services is available to patients of all ages.

Our services include:

• Audiologic testing and hearing evaluations

Diagnostic hearing tests should never be done in the home. Accuracy is obtained when tests are performed by an Audiologist in a controlled environment, such as our sound-proof testing booths. AC Hearing, Tinnitus and Balance Associates is licensed and accredited, and participates with many insurance companies, so a patient’s hearing tests may be covered. Advertisements offering “free” hearing tests usually mean that a provider does not have the credentials to bill insurance companies and can actually cost more over time. If a patient’s diagnosis requires the use of a hearing aid, prices are often inflated by claiming to offer “free” screenings to cover the cost of testing and other “free” offers.

AC Hearing, Tinnitus and Balance Associates provides a full range of services, including hearing aid screenings, comprehensive audiologic evaluation, tympanometry, central auditory processing (CAP) testing, air conduction auditory brainstem response (ABR) testing, otoacoustic emissions (OAE) testing, videonystagmography (VNG), computerized platform posturography, computerized evaluation of the visual ocular reflex (using the dynamic visual acuity test for a comprehensive evaluation of the balance system), a balance rehabilitation program, evaluation and related rehabilitation for tinnitus (chronic ringing in the ears), and newborn hearing screenings and diagnostic testing.

• Digital hearing aids at affordable prices

AC Hearing, Tinnitus and Balance Associates offers a wide spectrum of hearing aids, including those incorporating cutting-edge digital technology. As always, we price our hearing aids and assistive listening devices so that everyone can enjoy the benefits of better hearing. We offer affordable pricing, utilizing national programs for low-income patients as well as our own Robert Shafer Hearing Program, which offers significant savings on all hearing aids for all patients.

• Assistive listening and alerting devices

A combination of hearing aids and assistive listening/alerting devices can go a long way toward achieving listening and communication satisfaction in a wider variety of difficult listening situations. Devices we offer include FM Systems, Bluetooth systems, the Pocket Talker (which enhances one-on-one conversations in public), and the telephone typewriter (TTY), which utilizes a regular telephone and a visual terminal. We also have amplified handsets and portable telephone amplifiers. Assistive listening/alerting devices include smoke detectors, special alarm clocks, sound-activated pillow/bed vibrators, and infrared TV systems.

• Evaluations for balance disorders

Forty percent of adults experience symptoms of dizziness that are severe enough to report to their doctors. In the majority of patients, balance disorders can be helped if people receive the proper diagnosis and management. New theories in treatment have created options other than “learning to live with it”. Diagnosing dizziness is a process that usually involves several tests. It starts with a detailed medical history and physical examination. The most common diagnosis is Benign Positional Vertigo, which can be helped with non-invasive repositioning techniques utilized by our vestibular staff. The first test is usually a hearing test to determine if the inner ear has been affected in any way. Videonystagmography, or VNG for short, is the primary test for determining inner-ear vestibular function. The VNG is a series of non-invasive computerized tests to evaluate the transmission of information by the individual components of the balance system. Computerized platform posturography evaluates the gravity-sensing ability and the related spinal reflexes to control balance in an upright position, which contribute to the ability to walk and the related fall potential. The computerized dynamic visual acuity test evaluates the visual-ocular reflex that enables us to maintain visual focus on an object when moving, such as during driving or athletic activities or when reading signs while walking in a mall or grocery store. This test is used by the Navy and Air Force to determine candidacy for scuba divers and pilots. The total test takes approximately two hours.

Hearing loss... how much does it affect communication?

Sensorineural hearing loss was the diagnosis used most commonly for a hearing loss that did not involve the outer or middle ear.  This diagnosis was used to include a sensori, neural or central cause of hearing loss.  With our advanced evaluation capabilities, we can better differentiate between these types of hearing loss to allow accurate referral and rehabilitation options based on the location of the underlying cause.

How does the ear work? The ear has three parts:
• The outer ear consists of the pinna and the ear canal. The pinna collects sound, and the ear canal funnels it toward the ear drum.

• The middle ear consists of the tympanic membrane (ear drum), ossicles (ear bones), middle ear space, muscles, tendons and ligaments. The ear drum changes the sound energy into mechanical-vibration energy that travels across the ossicles. This movement increases the mechanical-vibration energy by a 2:1 ratio. The first bone is the malleus (hammer), the second is the incus (anvil), and the last is the stapes (stirrup). The stapes vibrates in and out of a “window” that leads to the fluid in the inner ear.

• The inner ear consists of three main parts: the vestibule, the semi-circular canals used for maintaining balance, and the cochlea. The movement of the stapes sets up waves in the inner ear fluid. Hair cells sense the waves and cause electrical impulses to be sent up the VIIIth nerve (or hearing and balance nerve) to the brain for interpretation.

Hearing Loss

Hearing Loss can be caused by many factors. Age-related hearing loss is very common; but hearing loss can also be the result of noise exposure, medications or illness. Different types of hearing loss are categorized as follows:

• Sensori hearing loss occurs when crucial parts of the inner ear lose sensitivity to certain sounds. Most often this is a result of a decrease or cessation of function of the hair cells. In most cases, sensori hearing loss cannot be corrected through medical intervention. However, it can be helped through the use of hearing aids and aural rehabilitation, which can improve communication ability. A common cause of sensori hearing loss is presbycusis, or the deterioration of hearing with aging.  This is a very common type of hearing loss in the elderly population or those with a genetic history.  This can also be seen in conjunction with noise induced hearing loss, in which an individual may have an extended exposure to loud sounds in their past.  The effects of noise induced hearing loss may not present for several years, but are more likely for patients who have a prolonged exposure to noise.  Current research has found that the use of hearing protection for all noise related activities can help curb the effects of noise exposure.

• Conductive hearing loss occurs when there is a problem in the outer ear or middle ear (the parts of the ear responsible for sending sound to the inner ear). Outer ear problems include impacted earwax (cerumen) or an infection that causes blockage in the external ear canal. Middle-ear problems include fluid caused by an ear infection or damage to the tympanic membrane or ossicles. Treatment of conductive hearing loss often requires medical intervention.

• Mixed hearing loss occurs when there is a problem in both the conductive and sensorineural mechanisms.

• Neural hearing loss is less common, but is caused by the inability of the VIIIth nerve to transmit information from a normal or near normal cochlea to the brainstem and auditory cortex. Treatments have included cochlear implants and, more recently, brainstem implants.

Disorders of the Auditory System

Ototoxic medications

Infections or certain cancers may be treated with intravenous or oral antibiotics and chemotherapy, which may result in changes in subjective or objective hearing.  These medications are considered ototoxic.  Intense doses of ototoxic medications generally result in a bilateral decrease that is more severe in the high frequencies. 

Patients undergoing intense doses of ototoxic medications should have their hearing evaluated prior to beginning medication in order to obtain a baseline.  After that time, hearing should be re-evaluated in 3 to 6 month intervals to monitor for decreased hearing sensitivity, or sooner at physician request, or noted subjective change in hearing.  Testing should be performed utilizing high frequency pure tones through a minimum of 12,000 Hz. but up to 16,000 Hz. and high frequency otoacoustic emissions through 12000 Hz.            

Our Audiology staff perform these tests utilizing advanced equipment to monitor for any fluctuations of hearing sensitivity, especially in the high frequencies.  We provide an in-depth report for the referring physician following testing, as well as to the patient as warranted.

An AC Associates Audiologist will determine each patient’s type and degree of hearing loss by conducting a hearing evaluation. Based on the findings, possible additional testing and a solution or treatment plan will be recommended.

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