Unlike whisky, wine, balsamic vinegar and Brad Pitt, your hearing doesn’t improve with age. Just the opposite, in fact. Thanks to a common condition called presbycusis (age-related hearing loss), many people gradually lose their hearing over time. It can be exacerbated by several factors, including noise exposure, viral or bacterial infections, high blood pressure, diabetes and certain medicines.
No wonder roughly 1 in 3 adults between the ages of 65 and 74 have hearing loss and nearly half of people over 75 have trouble hearing, according to the National Institute on Deafness and Other Communication Disorders.
Where to go for help? A number of providers — such as otolaryngologists, audiologists and hearing-instrument specialists — are trained to address ear-related concerns, including hearing loss. But knowing which specialist to visit can be tricky.
Consider starting with your primary care provider, who can check to see if something like an infection, injury or even earwax is the culprit. They may be able to screen for hearing loss by simply reviewing your medical history “and looking for signs and symptoms of hearing loss during the consultation,” says Diane Boyd, a Derwood, Maryland-based audiologist certified by the American Speech-Language-Hearing Association (ASHA).
Depending on what the screening reveals, you may be referred to one of the following types of hearing specialist for further testing or treatment.
An M.D. who specializes in diagnosing and treating diseases of the ears, nose and throat
Commonly known as ENT doctors, otolaryngologists are physicians with a specialization in diseases of the ears, nose and throat. They also perform head and neck surgery, “such as placement of tubes in the eardrum and the removal of middle- and inner-ear growths,” says Allyson Bull, an audiologist in Olney, Maryland. “They can order and assess imaging tests on the ears — a CT scan or MRI — and prescribe medications for treatment of ear disease. They often work with audiologists.” ENT doctors known as otologists and neurotologists receive additional training and specialize in complex ear surgeries or hard-to-treat conditions, like Meniere's disease.
See an otolaryngologist if you:
- Have drainage and/or pain in or around the ear.
- Have hearing loss that comes on suddenly.
- Have dizziness, vertigo or balance problems.
- Have ringing in the ear (a condition known as tinnitus, which can signal hearing loss as well as other health problems, like allergies or high blood pressure).
- Require a cochlear implant (a hearing device for people who have profound hearing loss).
A hearing specialist trained in identifying and evaluating hearing loss and related disorders
Audiologists are not physicians; the Au.D. (short for doctor of audiology) after their name means they’ve completed a four-year doctoral degree and a clinical fellowship. They can evaluate and advise you on the best treatment for hearing loss and related disorders, such as balance disorders and tinnitus. Audiologists are also licensed to dispense hearing aids and provide what’s known as auditory rehabilitation — basically, rehab for the ears — which includes learning to listen again.
“Many people experience hearing decline for several years — often a decade or more — before they seek help, and they get used to not hearing certain sounds that they may not even realize they’re missing,” says audiologist Bria Collins, associate director of audiology professional practices at ASHA. Getting fitted for a hearing aid “isn’t as simple as turning on a switch. If you have a new device, your world will be full of sounds you may not have heard for a while. People often need training and practice to get used to their device and improve their listening.”
See an audiologist if you:
- Have noticed changes in your hearing.
- Want to purchase hearing aids or need help programming your existing ones.
- Have tinnitus.
- Have balance problems.
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Hearing instrument specialist
A hearing professional who conducts basic hearing tests and fits and dispenses hearing aids
The U.S. Food and Drug Administration doesn’t require adults 18 and older to get a medical evaluation before buying certain types of hearing aids. So when does it make sense to skip the ENT, bypass the audiologist and go directly to a hearing instrument specialist (also known as a hearing aid specialist)?
“If you live in a remote location but need hearing aids and a hearing aid specialist is much closer in proximity than an audiologist, or if you already have a hearing aid and a piece has broken off, or you simply need the device cleaned or serviced,” Collins says.
Hearing instrument specialists are licensed to select and fit hearing aids and have extensive training in hearing aid technology. But they aren’t trained to medically evaluate hearing loss; rather, their hearing tests are “for the sole purpose of fitting hearing aids,” Bull explains.
Be sure to check that your hearing instrument specialist follows “best practices,” such as real ear measurements to verify hearing aid settings, and is up to date with continuing education maintenance, Collins advises. Also important: You want to have a choice of hearing aids. “Some professionals work with only one hearing aid company, but hearing aids are not one size fits all. See an audiologist who’s well versed on multiple hearing aid brands so that there can be a backup plan if one particular device doesn’t work for you.”
See a hearing instrument specialist if you:
- Don’t have access to an audiologist.
- Need a hearing test or experience hearing loss in both ears.
- Want to purchase hearing aids or need help programming your existing set.
Kimberly Goad is a New York-based journalist who has covered health for some of the nation’s top consumer publications. Her work has appeared in Women’s Health, Men’s Health and Reader’s Digest.