Until you check out whatever we are offering [and because you really need two!] By Sheryl Boatz

It's time for the phrase “a hearing aid" to die! As used in “need a hearing aid", “get a hearing aid" or “buy a hearing aid", this phrase implies people only need one. We have two ears, and usually both of them develop hearing loss. The brain is designed to hear in stereo just like it is designed to use both eyes for depth perception. No one gets a monocle anymore, they get a pair of eyeglasses. Most people in the US also get a pair of hearing aids instead of one (75-80% of Americans, per several studies, with much lower percents in Europe and even lower in Asia).

“Audiologists in the United States have gradually, over the past 30 years, moved from a culture that fits mostly monaural [one ear] . . . to a culture that fits mostly binaural [both ears] . . . . Many of us fit almost all of our bilaterally hearing-impaired patients binaurally, unless there are financial issues or hearing impairment characteristics that contraindicate this type of a fitting. The benefits of binaural fittings have become very obvious to most American audiologists based upon patient experience and proof by the literature time after time." *

Yet the phrase “a hearing aid" persists. I have been avoiding it for at least 20 years at the suggestion of a long forgotten hearing aid marketing person who said: “Don't say 'a hearing aid', say 'hearing aids'." The idea was that we need to train people to think about getting a pair of hearing aids from the very beginning.

This wasn't just about selling more hearing aids. When the research really began to come in proving the benefit of binaural fittings, there was concern that fitting only one ear could be considered malpractice. Someone even developed a waiver form for consumers to sign indicating they had been informed about the value of binaural hearing aids before they could decline to purchase two. As hearing aid users began to replace their old hearing aid with a new pair, I had many of them tell me how they wished they had worn two sooner. Sergei Kochkin, Ph.D. found that cost was one of the least important factors in a consumer's perception of their satisfaction towards hearing aids. **

The brain processes sound best when input from the two ears is equal. Similar to the way we need two eyes for depth perception, we need two ears to tell where sound is coming from. With equal input, the brain can also "squelch" the input from one side and tune into the other side (divide and conquer). It can then switch as desired when trying to follow conversation in a noisy place. You can't do that when all the sound is going into one ear. You also need a little more volume when one ear is doing all the work. If you aid both hearing-impaired ears, you keep them equal (or make them more equal if they are asymmetrical). If you aid one ear but not the other, you usually make them unequal. The unaided ear may also slowly lose its ability to understand speech (due to auditory deprivation). ***

I recently had a patient whose hearing loss was just beginning to be bad enough for me to recommend amplification. She assumed that since her hearing loss was mild, she would only need one hearing aid, but both of her ears had equal loss. She was nearly devastated when I told her two hearing aids were best. It made her feel old and that her hearing loss must be a lot worse than she thought (as if only people with severe loss must need two aids). We're not doing consumers any favors by contributing to this way of thinking. [read full post at ]

* hearinginternational/2012/binaural-fittings-is-it-the-same-everywhere/

** pdfs/Binaural_hearing_aid_complete_review.pdf

*** Abstract on auditory deprivation: pubmed/8219301