Tinnitus is the perception of a sound in the ears or in the head with no corresponding external stimuli. There are more than 200 potential causes for tinnitus. They can originate from within or outside of the auditory system. Metabolic, pharmacological, dental, somatic and psychological disorders are all possible culprits for tinnitus. Therefore, it is important to note that every patient is different, and that a single treatment will never be able to satisfy the full spectrum of tinnitus patients. Furthermore, patients with other symptoms in addition to tinnitus need to be treated differently.

The use of external sound(s) can provide relief from tinnitus by inducing neurophysiologic functional changes in the different auditory pathways. The aim of sound therapy is to decrease prominence of the tinnitus and facilitate tinnitus habituation while transforming the individual’s reaction to tinnitus through counseling.

There are two types of tinnitus:

  1. Objective – meaning the tinnitus is audible to someone else besides the patient. This type of tinnitus generally originates from middle ear or vascular system.
  2. Subjective – meaning the tinnitus is audible just to the patient. It is often considered as the perceptual consequence of modified neural activity, generated by the central auditory pathway, after peripheral damage. High frequency hearing loss is the highest predictive risk factor for tinnitus.

Subjective tinnitus is a common problem affecting approximately 1 in 5 individuals, although the epidemiologic studies show variable rates. It is considered that 10-15% of the population has chronic and persistent tinnitus; and around 20% of those reporting tinnitus find the condition disruptive enough to seek specialized treatment.

Tinnitus is more common than you may think

There is strong evidence to suggest that acoustic therapy can help mitigate the effects of subjective tinnitus. Acoustic therapy can occur in many forms such as: fitting the patient with appropriate amplification, modifying advanced signal processing features for the purpose of tinnitus treatment, or following a formal tinnitus protocol such as Tinnitus Retraining Therapy (TRT). Signia offers solutions that can be adapted for any therapy protocol to fit the needs of the Hearing Care Professional (HCP) and the patient.

Use of sound therapy for tinnitus

Sound therapy for tinnitus has been defined as any use of sound intended to alter the tinnitus perception and reactions for clinical benefit. Besides hearing instrument use for tinnitus relief, numerous methods of sound therapy have been used since tinnitus masking was introduced in the 1970s Two general types of sound therapy approaches have been investigated for tinnitus management:

  1. Total masking – using an alternative stimulus
    to cover up (mask) the perceived tinnitus.
  2. Partial masking – the addition of an alternative
    stimulus to reduce the focus of the patient’s
    subjective tinnitus on both a conscious
    (psychological level) and unconscious level
    (central auditory perception).

Both employ the use of broadband noise sound generators, hearing instruments, or combination devices.

The clinical application of sound therapies has generally focused on managing reactions to tinnitus and suppressing perception of tinnitus. Sound therapy is thought to provide relief from tinnitus and reduce the emotional consequences of tinnitus. Some individuals experience residual inhibition following total or partial masking (i.e., tinnitus suppression or temporary disappearance of the tinnitus sensation after exposure to an external sound). Additionally, sound therapy may promote habituation to the tinnitus by reducing the contrast between the tinnitus and environmental sound.

Habituation “is the reduction or elimination of Central Nervous System (CNS) activity in response to repetitive stimuli” (Encyclopedia of Neuroscience, 1987). It is a natural process of the CNS and crucial to brain function enabling humans to perform many tasks simultaneously. Habituation is the basis for Dr. Pawel Jastreboff’s Neurophysiologic model of tinnitus (Fig. 1), the predecessor of TRT.

In this model, the starting point is the generation of tinnitus by the cochlea or the 8th cranial nerve. The tinnitus is then detected on a subcortical level and, finally, perceived for interpretation by the auditory cortex. At this point, if the tinnitus results in an emotional reaction from the patient, an involvement from the limbic system can occur. The limbic system controls motivation, mood, and emotion. Therefore, a limbic system reaction to tinnitus can cause insomnia, anxiety, depression, and fear. Further complication arises if the emotional reaction is not quelled as the patient may develop physical symptoms related to the patient’s autonomic nervous system

Whether or not the patient has the ability to habituate to their tinnitus spontaneously is thought to correlate with the impact that tinnitus has on a patient’s daily life. It has been reported that of those reporting the symptom of tinnitus: 80% report no impact on their lives, 15% feel their tinnitus impacts them, and 5% are incapacitated by their tinnitus (Fig. 2).

The 80% with no impact are thought to be the patients that habituate with no intervention. The 15% with impact correlate to those tinnitus sufferers that have developed an emotional response to their tinnitus and the 5% correlate to individuals experiencing a physical response from the Autonomic Nervous System. Many researchers have theorized that if a tinnitus patient is treated early, with effective counseling and sound therapy, you may be able to mitigate the effects of the tinnitus before a patient reaches the ‘incapacitation’ stage.

Established sound therapy protocols

• Amplification alone – Searchfield, G.D.
Tinnitus Activities Treatment – TAT Tyler, R.S.
Tinnitus Retraining Therapy – TRT Jastreboff, P.J.
Progressive Tinnitus Management – PTM Henry, J.A.
• Cognitive Habituation Tinnitus Treatment – CHaTT

Tinnitus counseling guide

Traditional tinnitus treatment typically addresses the obvious symptom of tinnitus and often includes the use of audiological devices that can deliver sound therapies. While treatment of the tinnitus may reduce or alleviate the stressors associated with it, for example, depression, anxiety, and insomnia, many patients need additional help coping with these ancillary symptoms. Habituation to tinnitus can take between 12-18 months even with appropriate sound therapy; therefore, many patients return to their HCP feeling discouraged, frustrated, and desperate for more immediate relief. Unfortunately, what is often heard is, “There is nothing else that can be done” and “Learn to live with it.” Such messages can quickly diminish hope, leaving the patient feeling misunderstood and afraid that things cannot improve.

The clinician should emphasize to their patient that although there is no “cure” for tinnitus, there are effective, logical techniques that they can do to make tinnitus less noticeable and thereby improve their quality of life. There are a wide variety of tinnitus management counseling options available. These options range from providing basic education and information about tinnitus, to focused activities such as Cognitive Behavior Therapy (CBT), relaxation techniques, and meditation.

Counseling is an essential part of tinnitus treatment. The patient must understand what tinnitus is in order to overcome or avoid the negative associations that inhibit habituation. For some patients, a simple explanation of the causes of tinnitus and the relationship between hearing loss and tinnitus is enough to facilitate a positive outcome. For others, more in-depth systematic counseling may be necessary. This counseling may be provided by the HCP utilizing the various programs’ tools or it may be provided by a mental health professional upon referral.

In TRT, the link between the limbic system and the tinnitus is decreased by using a process called “directive counseling” or “demystification”. This involves a series of intense educational sessions where anatomy, physiology and real examples are discussed in story format to make the tinnitus phenomenon understandable and demystified. For more information go to the TRT website:

In TAT, counseling focuses on the whole person, and considers individual differences and needs. TAT provides structured counseling focused in four areas: thoughts and emotions, hearing and communication, sleep, and concentration in a picture-based approach that facilitates engagement of the patient.

TAT also engages the patient by including homework and activities to demonstrate understanding and facilitate progress. TAT counseling material is free for download and can be easily found at the University of Iowa website:

Cognitive Habituation Tinnitus Therapy (CHaTT©) was developed by Dr. Natan Bauman. CHaTT is a modified TRT program which also includes components of CBT, pictorial representation, and music as a form of distraction and relaxation.

With Progressive Tinnitus Management (PTM), developed for the Veteran’s Administration by James Henry, a hierarchal approach is used to determine whether a patient is a candidate for group counseling and sound therapy or a higher level of individual services including individual counseling by an audiologist and/or a mental health professional. All PTM-related information may be found at the government website:

Many psychologists specialize in CBT which is commonly used in treating a patient’s psychological response to tinnitus. The HCP may consider a multidisciplinary approach to tinnitus treatment in which the HCP fits and adjusts the hearing instruments for effective sound therapy and provides the initial tinnitus counseling. This should include the anatomy of the ear, auditory system involved, and how tinnitus relates to hearing loss. Once sound therapy has begun, a psychologist may provide additional counseling and CBT to further support the emotional well-being of the patient.


There are many forms of sound therapy for the treatment of tinnitus. Providing ear-level devices such as hearing aids, maskers, and combination devices are an accepted and researched part of sound therapy

lifetime hearing denton hearing aid trade in


At Lifetime Hearing-Denton we offer a value for your old/used hearing aids. How do we calculate your value of your hearing aids?

Typical depreciation on products can vary. The most common calculation is to take 100% of the MSRP (Manufacturer’s Suggested Retail Price), and divide that amount by the number of useful years of the product.  This leads to the question “How long do hearing aids last?” In order to answer this there are several factors to take into account.

Some people can make a purchase of hearing aids that last for 10 years while others can lose their hearing devices two weeks after purchasing them. This is a very large spread, but after nearly 30 years of dispensing hearing aids, I have found that the average useful life of a hearing aid is still about three to five years.

When I first started dispensing hearing aids, my customers would ask “How long do hearing aids last?” Being new to the industry I asked my mentor this question. My Mentor had been dispensing for 28 years as an owner of a Beltone dealership in upstate New York. His response was “Well, don’t give your opinion on the matter. Do your own research using reliable resources, and then report your findings to your customers.” Later, I would learn that his advice was the best advice I could ever get especially in how to counsel patients correctly.

In 1988 Consumer Reports had made a survey about the longevity of several things and hearing aids were on that list. In that report it listed that hearing aids lasted 3-5 years with two repairs expected during that period. I also discovered that there were two known issues with hearing aids at the time: (1) moisture – hearing aids shorting out due to excessive sweat, or moisture getting inside the hearing aids and corroding the battery contacts, and (2) wax related problems causing the hearing aids to malfunction and stop working.

Manufacturers, well aware of these problems, made great strides in resolving them. They introduced replaceable receivers (speakers) on RIC (Receiver-in-the-Canal) products, and “Nanocoating. These developments virtually eliminated the problems of moisture and ear wax interfering with hearing aids.

Nanocoating is an extremely fine fibre woven material that can be applied to a product. It causes water molecules to cling to itself rather than penetrate a surface.  Part of this technology was derived from a science called “Biomimicry”.

Biomimicry is defined as the design and production of materials, structures, and systems that are modeled on biological entities and processes. These scientific observations in nature (such as examining let’s say an aloe leaf) helps scientists to understand why water is repelled instead of soaking into the leaf. Scientific Engineers then duplicated that design using the same composition, to develop products that mimic nature.  Nanocoating is commonly used today in the production of hearing aids by major manufacturers.

However, despite all the advances in technology, hearing aids still do last longer than back in 1992. The average lifespan of a hearing aids is still 3-5 about 3-5 years. So why is this the case, and what does this have to do with with my trade in value?

The answer is that technological advances have dictated the demand for new hearing aids rather than structural design alone.  Hearing aids that are properly fitted and help people with their hearing problems don’t necessarily need to be replaced. But new technologies are constantly being integrated into hearing aids, for example listening to your phone conversations in both ears hands free while driving your car. Because these new technological advances make hearing aids so much easier to use, and more effective, people see the need to replace older outdated hearing aid models in order to keep up with the changes and benefits of the newer models. Hearing aids can now be manipulated through your Smartphone to quickly and easily make changes to your hearing aid settings in order to adapt to changing hearing environments. This development alone is pretty impressive and exciting!

So do folks trade in their perfectly good programmable hearing aids for new technology? The short answer is YES. In fact, they do this more frequently now than ever before, and as already mentioned, this is primarily due to the rapid advances in technology rather than the size, shape, or a functionality of the hearing aids themselves.

So what then is the value of my old hearing aids? Technically a business can offer you whatever it decides in order to make a sale. The truth is that older hearing aids have very little value due to the rapid changes in technology. However, for a clinic that offers second-hand or refurbished hearing aids free of charge to customers who simply cannot afford new ones, the trade in of older hearing aids becomes significant.

After some research we have found the expected useful life of a hearing instrument is no longer than 7 years. That being said to come to a valuation of the hearing aids, the common formula is to take 100% of the MSRP (Manufacturer Suggested Retail Price) divided by the number of useful years then multiply that by 20%.  Or take the MSRP and multiply that times 20% then dived that out by 7 years. Using the national average of a high quality hearing aid (including warranty at the manufacturer but not including the aftercare provided by the servicing clinic) is about $2,300. (According to AARP in a 2015 survey.

So, $2,300 x 20% = $460 if your device is 3 years old then multiply $460 x 3 =$1,380, then subtract that amount (depreciation cost) from the MSRP leaving the value at $920. But remember this will probably include at least one repair (in that time frame), so deduct the average cost for a hearing aid repair ($140 -$225). This leaves you with the value after 3 years of about $695 – $780. This is why you may see advertisements that offer $1400 -$1,500 for a set of old hearing aids. These clinics are giving trying to cater for the best trade-in scenario for all hearing aids because it’s just too much effort to do the calculations!

fda over the counter hearing aids


Here is the Real Story Behind Over the Counter (OTC) Hearing Aids

OTC (Over The Counter) hearing devices are back in the spotlight. Hearing healthcare professionals, manufacturers, and lawmakers are taking a hard look at what this means for the economy, and where these products currently stand in the marketplace.

Hearing devices known as PSAP’s (Personal Sound Amplified Products) have been around for many years and are nothing new. Currently they can legally be bought online or through mail order. Sadly, while there will always be people looking for the next “something for nothing” gadget that promises to fix their hearing problem, they inevitably end up losing their hard-earned cash while becoming disilussioned about amplification products and hearing professionals in general.

The most common mantras we hear from those who need hearing aids goes something like this:

It seems to me that hearing aids are so expensive! With all the new technology available to us today, why can’t we make something less costly for people who aren’t made of money? Besides, there is only about $48 worth of circuits and plastic in those things anyway – and I should know because I worked for company ABCXYZ for 6 months …“

“The cost of hearing aids is so high. It’s important for U.S. lawmakers to bring down these costs through new legislation, so that competition will drive prices down, thereby making hearing aids more affordable for everyone.”

The FDA and some lawmakers appear to make a valid point about making hearing help available to as many Americans as possible. They claim that the high cost of hearing devices make them inaccessible to those who need them most. However, many healthcare professionals, including myself, disagree.

These well meaning individuals are either ignorant of the facts, or present a biased argument because of political or monetary gain. Their biases prevent them from correctly evaluating the situation and coming up with the right solution to the problem.


Hearing aids are already priced at an affordable rate. Ironically it is the same rate that PSAP’s or OTC devices will be priced at when they hit the market (About $368-$650 each).  But why do more people not know about this?Simply because it’s not showcased at the Audiologist or Hearing Aid dispenser’s office, and for good reason!

The professionals know better than anyone else that these devices don’t work well enough. No matter which way you see it, an OTC device simply does not work as well as other (more expensive) hearing aids in a noisy environment. An OTC or PSAP will never ever be able to compete with a hearing system that processes complex speech in noise simultaneously while improving the SNR (Signal-to-Noise Ratio).


Let’s consider why using two hearing aids is far superior to using one. The human eye provides us with clues as to why this is true. With two eyes we can perceive depth because we have another perspective. But when using only one eye everything appears to be flat or subjects in view may look larger. This can be very deceiving because it impairs our ability to judge depth or distance correctly. There is no doubt that a person can see much better with two eyes rather than one.

The concept is the same with hearing aids. When wearing one hearing aid, (even with a directional microphone), it becomes difficult to locate the source of sound or speech. This principle applies to all hearing aid devices.

Firstly, with only a single point of reference your brain cannot compare signals effectively. For example, a sound created on your left side (while wearing a hearing aid in your right ear), will be perceived to originate from your right side. Without a second point of reference, you will automatically look toward the direction of the louder sound source. In other words, you will look in the wrong direction. The implication of this problem is that you could walk across a street, hear the sound of a car horn, then look in the wrong direction. The outcome could be fatal.

Secondly, wearing only one hearing device does not improve the signal-to-noise ratio for a person with binaural hearing loss, especially noise induced hearing loss. This is because background noise is predominantly low pitched. Therefore a person with this type of hearing loss (who has better hearing ability for low frequencies compared to their inability to hear high frequency portions of speech), will struggle to hear the speech cues. High frequency portions of speech are vital in isolating speech when we listen in a noisy environment.


Amplification alone does not solve the problem of being able to isolate speech above other sounds around us (i.e. it does not improve the signal-to-noise ratio). Many people who chant the mantra of “low cost hearing aids” purchase one hearing aid instead of two. Those suffering with mild to moderate hearing loss sometimes conduct a self-diagnosis, and opt to amplify sound in the ear they strugle with the most.

They are often reluctant to purchase a second hearing aid because it then moves them into a price point of more advanced hearing aids. But even if they do decide to purchase a second hearing aid, they fall into the trap of using two hearing aids that are designed to work INDEPENDANTLY OF EACH OTHER rather than being SYNCHRONISED. Because each individual unit has no way of interacting with the other unit, this can agravate the persons hearing problems even more. Every hearing professional knows that If the signal-to-noise ratio is not improved, audability in a noisy environment is not improved.

It is important to note that there is currently no technology that exists in over-the-counter hearing devices that enables them to isolate and redirect speech. Unlike advanced hearing aids.They are designed to work as independent devices and can therefore not interact with a second hearing device.


If we already have low cost products available at the dispensing offices of hearing instrument specialists and Audiologists, then why is there a push to introduce an over-the-counter device?

Many of my colleagues will say that “these are patients that will never come into your office in the first place. While this may be true in some cases, I contend that it is no reason for us to sit by idly and let them be taken advantage of by someone that wants to make millions in product sales, or who wants to make a name for themselves in the political arena!

Our ethics teach us to not engage in this kind of behavior. As a Board Certificant Holder I must adhere to what is in our Ethical Code of Conduct under the section:

Responsibilities To The Patient/Client

The Certificant, as a practitioner in the hearing health care profession, shall hold paramount the welfare of the patient/client. The Certificant shall respect the inherent dignity and rights of all individuals. The Certificant shall adhere to the core values of the profession and shall act in the best interest of the patient/client over the interest of the Certificant. The Certificant shall not engage in conflicts of interest that interfere with professional judgment.

I guess that the folks that are pushing this issue are not being held to a level of any standard, or ethics that compels them to do the right thing. It is my opinion that the driver of this bill to endorse OTC devices is surrounded by money or political gain, and not in the best interest of the consumer/patient/client.

Those of us professionals who see patients daily, and help them through their struggles to maintain their level of communication with their family, loved ones and the general public, know that being able to hear and understand is most important to them. Through counseling and low cost devices we find creative solutions to help them maintain their dignity and ability to communicate effectively.

Helen Keller, once said that losing one’s hearing is worse than one’s sight, because losing one’s sight cuts you off from “things” but losing your ability to hear cuts you off from “people”.

The proponents of OTC hearing aids, seek only to sell a product of sub-standard quality to an eager community desperate to engage with the people around them. It just does not seem right to me to take advantage of a person in a desperate situation in order to make a profit, or simply to gain a political advantage.

This movement also seeks to drive a wedge between the professional and the patient. Ironically it is the professional who provides the keys to better hearing and successful hearing aid fitting. The hearing professional focuses on developing and maintaining good relationships with their clients. They get to know their customer in order to deliver meaningul and effective hearing solutions that count. A hearing aid professional simply cannot be put in the same category of a vendor peddling low-cost, innefective hearing aids!


If you find yourself in the predicament described in this article, call Vincent, Amanda, or Michelle for a no-obligation friendly discussion to see if we can find a great solution to your hearing challenges.

Because we also offer FREE HEARING TESTS with no obligation to do business with us, you can only gain by coming to see us before you make your next expensive mistake!

The levels of professional advice, service and attention to detail that we provide for our valued customers at Lifetime Hearing Denton, is priceless and certainly cannot be compared to over-the-counter hearing devices, no matter how cheap they are. Those who know us can testify to the levels of service, attention to detail, and sound professional advice they get once they come through our doors!. Our customers become our friends, and have no hesitation in refering us to their family, friends, and colleagues.

We are so confident of the great customer experience enjoyed by many, that we will put you in contact with one or more of our customers so that you can get first hand testimonials from them.

So what have you got to lose?

Call AMANDA, MICHELLE, or VINNY now on (940) 2432766, or visit us at Lifetime Hearing Denton, 301 Dallas Dr #126, Denton, TX, 76205

listening to music with hearing aids


Listening to Music With Hearing Aids

Listening to music with hearing aids can be frustrating. Folks with normal hearing enjoy musical celebrations this time of year, but for us with hearing loss, it presents difficulty.  Be it a concert at U.N.T.or an unexpected caroler come a wassailing, it can be unnerving.  I have worn hearing aids for several years now and find that listening to music tends to lose its luster on any “automatic adjusting” program.  But why is this the case? Hearing aids get confused on the automatic program while listening to music. Hearing aids have trouble distinguishing between musical notes played from a violin or piccolo, versus actual feedback created by the physical product itself. The short answer is that hearing aids create artifacts when attempting to correct the “perceived” feedback while in automatic program mode.

Switch to Music Program Mode

The best way to listen to music is by using hearing aids with an integrated music program. This enables you to enjoy the full dynamic ranges of the music. Have your hearing aid dispenser install a “Music” program for your hearing aid. When you listen to music you can then simply change the program on your hearing aids to music mode, and the result will be great sound quality without any feedback.

Recently my wife and I attended an exuberant packed-house holiday musical performance at the Margot and Bill Winspear Performance Hall at U.N.T.  I was enjoying the concert, but it wasn’t until I adjusted my hearing aids to the “Music” program via my iPhone that I could really enjoy the full and complex musical sounds of the music.

Its Time to Listen to the Music Again

One of the greatest novelists of all time, Leo Tolstoy once said that “music is the shorthand of emotion” and for most of us, being able to listen to music is indeed one of life’s great joys — and something we often take for granted.

If you’ve suffered some degree of hearing loss, you’ll know that listening to music is no longer what it used to be. How we hear music is subjective and individual, making it difficult to reproduce authentically and naturally through a hearing aid. The good news is that hearing your favorite music the way you remember it is within reach.

Get Your Hearing Aid Music Program From Lifetime Hearing Denton

Come and see us at Lifetime Hearing Denton so that we can advise you on the best solution for your needs. Don’t miss out on the joy of music this Christmas!




Hearing loss and dementia in ageing adults

There appears to be a link between hearing loss, dementia, and cognitive decline in ageing adults.

So which came first, the chicken or the egg? Or better stated after reviewing the 2016  White paper ACTA Otorhinolarngol Ital 2016 ; 36 : 155-166, which came first hearing loss or cognitive decline?

The summary states:

Age related hearing loss (ARHL) has multi-factorial pathogenesis and it is an inevitable hearing impairment associated with reduction of communicative skills related to ageing. Increasing evidence has linked ARHL to more rapid progression of cognitive decline and incidental dementia.

It also states:

Long term hearing depravation of auditory inputs can impact cognitive performance by decreasing the quality of communication leading to social isolation and depression and facilitate dementia. On the contrary, the limited cognitive skills may reduce the cognitive resources available for auditory perception, increasing the effects of HL. In addition, hearing loss and cognitive decline may reflect a ‘common cause’ on the auditory pathway to the brain.

Hearing loss increases a person’s tendency towards dementia

This report is endorsing the fact that hearing loss increases a persons’ tendency towards dementia, something that new studies have been demonstrating that impaired hearing can contribute to cognitive load and therefore affect attentional and cognitive resources that are important for maintaining posture and balance.  However, it also states to the contrary that cognitive decline outside of hearing loss can contribute to the onset of other contributing factors such as hearing loss. Either way, going on without hearing help for auditory depravation simply put, is destined for a cascade of progressive risks to mortality.

Hearing loss contributes to isolation and social withdrawal

In general, we know that hearing loss contributes to isolation and social withdrawal, but new evidence indicates there is so much more. The decline in older adults with untreated moderate to profound hearing loss may develop a cascade of conditions including communication difficulties, social isolation, depression, an association with falls, and declines in physical functioning, decreased quality of life and even cognitive decline, that can be counteracted by a hearing aid. There is this “cascading hypothesis” among professionals where the relationship of HL and cognitive decline, the natural consequence is that the use of hearing aids or a cochlear implant should be associated with better cognitive performance.

Hearing loss and cognitive decline interferes with good health

Hearing loss and cognitive decline as a consequence interferes with good health and reports have found that HL is associated with a 20% increase in mortality compared with normal hearing in community dwelling older adults aged 70-79. Staying active is critical in maintaining ones well being and sense of worth.

Robust evidence suggests that HL in the elderly is independently associated with the development of cognitive decline and dementia. Several hypotheses on the pathogenic relationship between HL and cognitive decline have been argued and summarized in conceptual thinking where the hearing impairment impacts cognitive load, alters brain structure and function, leads to social isolation and depression related with common genetic and environmental factors.

HL and its general effects on cognition are highly prevalent in older patients and the effects there of may be preventable and treatable with rehabilitative devices like hearing aids or cochlear implants, which remains to be widely underutilized.  HL is something that goes undetected in many cases, therefore, it is the recommendation of the medical community and this specialist to have your hearing tested early.