What every otolaryngologist should know about hearing aids.

The otolaryngologist does not have to fit hearing aids, but he does have to know with a broad encompassing view what is being done by the hearing aid dispenser and the audiologist in regards to hearing aid fitting and selection. The acquisition of a hearing aid is part of the general care for the hard of hearing. In this particular case, the otolaryngologist should always be the "Captain of the Ship." With him, as paramedical advisors and assistors, are the audiologist and the hearing aid dispenser. The ultimate responsibility of the members of this team to see that the patient is properly fitted and cared for is with the otolaryngologist. When problems exist with improper diagnosis or care, the medical-legal responsibility falls on the shoulders of the otolaryngologist. Having an audiologist work with the otolaryngologist is most desirable for the measurement and recommendations for the hearing aid. The new FDA regulations require an otolaryngologic examination prior to fitting hearing aids, except for personal and religious reasons. Children under 18 years of age require both a medical and audiologic examination. To simplify conversation with other members of this team, one should have some basic concepts clarified: 1) The nature of a hearing aid. 2) The concepts and nomenclature used in and for probably 90% of all descriptions regarding hearing aids. 3) Types of aids. 4) Coupling methods which involve ear molds, tubes, vents, and inserts. 5) Types of fittings, whether cross, bi-cross, monaural, etc. 6) Distortion. 7) Measurements. 8) Problems in fitting of hearing aids. It is reasonable to assume that adequate background in these simple basic concepts regarding hearing aids will permit the otolaryngologist to supervise and understand the nature of some of the complaints made by patients. It is totally desirable that a patient be seen by an otolaryngologist prior to being fit with a hearing aid. This can be accomplished by education of the public by the otolaryngologist.