Hearing Aids

Hearing Aid Consultation

After obtaining a diagnostic hearing evaluation at our clinic, or by another audiologist within the past six months, our patients are scheduled for a hearing aid consultation, when appropriate, to determine specific hearing devices to meet their audiologic, physical, and social needs. Hearing aids come in a number of styles and sizes, with a variety of features and functions to meet these needs. If there is any indication of the possible need for medical treatment, our patients are referred back to their primary care physician and/or to an otolaryngologist or otologist (physician specializing in medical evaluation and treatment of ear problems) for evaluation and medical clearance for hearing aid use. Family members or significant others are welcome to join the hearing aid consultation appointment.

Hearing Aid Fitting

Hearing aids dispensed at Marin Hearing Center are fit with state-of-the-art equipment to provide the best possible sound for an individual. Counseling on the use and care of the hearing aids is provided, along with written instructions and information. We offer a generous 45-day hearing aid adjustment and trial period. We expect our patients to return to us during this period for consultation and adjustment as needed. If the hearing aids are deemed not beneficial or are otherwise no longer wanted, they may be returned for credit/refund if within this 45-day period. Family members or significant others are welcome to join the hearing aid fitting appointment.

Realistic Expectations

Modern hearing aids work very well when fit and adjusted appropriately; however, they do have limitations. You are advised to keep realistic expectations in mind:

Expect an adjustment period: Adjustment to hearing aids may take effort and time (several days to months), both to learn how to use and care for your hearing aids and to allow your brain to adjust to new sounds. Be patient with yourself! You will likely hear sounds that you have not heard for a long time. You will think of some of these sounds as “good,” (birds, voices of children, TV/radio). Others may be not be as pleasant (e.g., footsteps, refrigerator hum, heating/AC, doorbell/knock, siren, car engine, etc.), but are important for awareness and safety.

Don’t expect to hear normally: Changes due to permanent damage to the inner ear cannot be totally compensated for by hearing aids. Hearing aids do not restore normal hearing. People with identical hearing losses may have very different abilities to understand speech, especially in difficult situations, and results vary from person to person.

Expect to enjoy the sounds of life! Hearing aids are a key factor in staying active, alert, and improving your quality of life. With hearing aids, you will once again enjoy leisure and recreational activities, social events, and conversations with your family, friends, and co-workers. Your hearing aids will also help keep you well and safe by hearing the sounds around you.

The “Best” Hearing Aids

Marin Hearing Center audiologists select hearing aids from major hearing aid manufacturers who have published data regarding their features and effectiveness. Because there is not one “best” hearing aid for all patients, Marin Hearing Center audiologists work with each patient to find the hearing aids that best serve their individual needs. Rest assured that Marin Hearing Center has experience in fitting all types, styles, and models of hearing aids.

Two hearing aids (binaural) or one (monaural)?

If you have hearing loss in both ears and only use a hearing aid for one ear, you will still have significant hearing loss. There is a reason we have two ears, and there are a number of benefits to wearing two hearing aids when there is hearing loss in both ears. These include improved hearing sensitivity, better hearing of speech in noise, improved ability to detect differences in loudness (intensity) and pitch (frequency), and better ability to tell the location of where sound is coming from (sound localization). According to a recent report, most hearing aid users choose hearing aids for both ears and report higher satisfaction than those who choose only one.

Assistive Technology (AT): When hearing aids are not enough

Assistive and alerting devices may be used with or without hearing aids, depending on the device and a patient’s hearing needs. Sometimes hearing aids are not an option or are not enough, such as when the cochlea of the inner ear is too damaged to separate speech from noise or when the fine-tuning mechanisms of the inner ear are lost. Although hearing aids can improve audibility, some AT devices are able to truly improve the signal-to-noise ratio so the information needing to be heard can be understood in the presence of background noise and from a distance at which the hearing aids cannot adequately reach.

Assistive technology is available for use in theaters and houses of worship, on the telephone, in group situations, and for the radio, TV, and computer. These include infrared systems, induction loops, personal amplifiers, Bluetooth systems, FM systems, and other remote microphone systems.

Specialized alerting systems are also available for those with hearing loss, such as smoke alarms, alarm clocks, vibrating bed shakers, and flashing light alerts for the doorbell.

At Marin Hearing Center, we simplify the process of matching your hearing and lifestyle needs to all available technology.

Won’t wearing hearing aids make me stand out?

While you may be concerned about appearance, compensating for a hearing loss by frequently asking people to repeat themselves or inappropriately responding to others (or not responding at all), is more obvious than wearing hearing aids. Today’s hearing aids are small, discreet, and more stylish than ever before. Some are even invisible. Chances are, once you have hearing aids, your quality of life will improve so much that how hearing aids look won’t be an issue for you!

Hearing Aid Styles: Something for everyone!

HA2Modern hearing aids come in a variety of styles and models to fit the needs of the patient. While hearing aids of the past were mostly large and bulky, hearing aids today have become significantly more cosmetically appealing. Patients are now able to choose from more styles than ever before, depending on their hearing loss, personal preferences, and social and dexterity needs. Below is a review of various hearing aid styles.

Behind-the-ear (BTE) Styles


  • Traditional behind-the-ear hearing aids (BTE). This type of instrument utilizes two parts: the hearing aid and the earmold. The hearing aid is worn behind the ear and connects to a custom-made earmold with plastic tubing that fits in the user’s ear. The earmold is created from an impression of the outer ear and ear canal. The impression is taken in the professional’s office and is then sent to a manufacturer for production. New earmolds must be periodically made to maintain a proper fit as the outer ear changes or grows (especially in children). BTE hearing aids are suitable for almost all types and degrees of hearing loss and for persons of all ages. They are the most appropriate style for infants and young children and also for individuals with more severe hearing losses.
  • BTE Receiver in the canal aids (RIC/RITE). In his type of BTE, the processor is located behind the ear and is available in a number of sizes depending on the features desired and the severity of the hearing loss. The receiver (“loud speaker”) is attached to the earwire and is placed deep in the ear canal. Depending on the hearing loss needs, these hearing aids can be fit with non-custom earpieces (“ear tips” or “domes”) or with custom ear pieces for more power or retention in the ear.
  • BTE Slim-Tube: This type of BTE can be fit to patients with varying degrees of hearing loss. While they do not provide the extended frequency bandwidth common in RICs, they may be quite appropriate for patients with mild to moderate hearing loss. The receiver remains within the BTE portion of the hearing aid, and the slim tube provides a channel for the sound to travel from the processor to the ear. As with RICs, these hearing aids can be fit with non-custom earpieces (“ear tips” or “domes”) or with custom ear pieces for more power or retention in the ear.

In-the-ear Hearing Aid (ITE) Styles

The ITE style instrument is built into a custom-made shell obtained from an impression of the outer ear and ear canal. The ITE is appropriate for mild to severe hearing losses.

  • Full-shell ITE (FS). These ITE styles completely fill the concha bowl of the outer ear. This style may be required for patients with dexterity or power issues.
  • Half shell ITE (HS). These ITE styles are similar to the full-shell ITE, but have a reduced amount of material in the ear. This style may be preferable to a full-shell ITE for cosmetic concerns, as long as dexterity and power issues are appropriate. Sometimes this is actually easier for a patient to insert and remove than a FS ITE.
  • In-the-canal hearing aid (ITC). This type of device is a smaller version of the ITE FS and HS. The device only partially extrudes into the outer ear. This style of hearing aid is typically appropriate for mild to moderately-severe hearing losses. Patient variables may be factors in this choice, such as dexterity in terms of insertion and removal, as well as battery placement. However, this style may actually be easier to use for some patents than other styles.
  • Completely-in-the-canal hearing aid (CIC).Like the ITC, the entire CIC is built into a custom-made shell obtained from an impression of the ear canal. The CIC, however, fits a bit farther into the ear canal and typically extends deeper toward the eardrum than the ITC. Although generally not quite “invisible,” this hearing aid style is often very inconspicuous. These instruments are usually appropriate for mild to moderate hearing losses, as well as for sloping high-frequency hearing losses.
  • HA12Invisible in-the-canal hearing aid (IIC). IIC hearing aids are a relatively new addition to custom-fit hearing aids. With increasing public demand for invisible hearing aids, a number of companies are now offering IICs.It is important to note that actual physical fit (and “invisibility”) of these devices is dependent upon the individual patient’s ear canal size and measurements. For some patients, these devices are truly invisible; for others, the ear canal size and orientation may not be accommodated, and an IIC and may more closely resemble a CIC or ITC.

Bone-conduction Hearing Devices

Traditional bone-conduction hearing aids are generally being supplanted by surgical and non-surgical bone-anchored systems from Cochlear Americas and Oticon Medical, though still may be in use for certain conductive hearing losses or as a precursor to surgery.

Traditional bone-conduction device

Traditional bone-conduction device

Cochlear Baha

Cochlear Baha

Oticon Medical

Oticon Medical

Please contact the sites below for more information on the bone-anchored systems of Cochlear Americas and Oticon Medical.

HA13Another recent development in non-surgical bone-conduction devices is the SoundBite™ from Sonitus Medical (www.sonitusmedical.com or www.soundbitehearing.com ), which includes a behind-the-ear processor and an in-the-mouth device that transmits sound to the processor via the teeth. SoundBite is cleared by the FDA for the treatment of single-sided deafness and conductive hearing loss..

At Marin Hearing Center, we stay on the cutting edge of technology and research. Should any of these bone-conduction devices be potentially appropriately for you, Marin Hearing Center can refer you to facilities in the area who work with them.

Cochlear Implants

HA7The cochlear implant may be appropriate for an individual with severe-to-profound hearing loss who is unable to benefit from conventional hearing aids due to the severity of hearing loss, including the inability to understand speech.The implant consists of an external portion that sits behind the ear and a second portion that is surgically placed under the skin. A microphone on the external portion picks up sound from the environment; a speech processor then selects and arranges the sounds, and a transmitter and receiver convert the sounds to electrical impulses. Electrodes then collect the impulses and send them to the auditory nerve. As with other devices, a cochlear implant does not restore normal hearing, but it can help a deaf person understand speech.

If we find that your hearing loss might be such that you could potentially benefit from a cochlear implant, Marin Hearing Center will refer you to a recommended medical center for evaluation and medical/surgical intervention.

Body-worn Hearing Aids

HA14Popular in the 1950s, this style of hearing aid utilizes a body- or pocket-worn rectangular case connected by cords to earmolds. Because of acoustic advantages and technological advancements in ear-level hearing aids, body hearing aids are virtually no longer used.

Eyeglass Hearing Aids

HA10Also popular in the 1950s, this style places hearing aids within the frames of eyeglasses. As with the BTE style, clear plastic tubing connects the hearing aids to earmolds. Because technology has not improved for this style due to inherent limitations of trying to couple eyeglasses and hearing aids, this style is no longer recommended and its features are very limited.