Question
I have a patient who wears CIC hearing aids. He works in a loud environment and needs to hear when someone is talking to him. He currently wears earmuffs, but can't wear his hearing aids since they feed back. Is there any type of earmuff with a noise cancellation system that might help this patient? Any other suggestions?
Answer
Noise cancellation headsets are not the solution to this problem. More often called ANR (for active noise reduction), these devices can provide benefits in isolated instances with substantial low-frequency noise present, but are only occasionally of value in typical occupational settings and provide no obvious benefits for the hearing aid wearer. For more on the applicability of ANR in occupational noise see https://www.aearo.com/pdf/hearingcons/anr.pdf
Options for such a user are to wear an active sound-transmission earmuff which via use of a mic and internal speaker acts like a generic hearing aid at low sound levels, but gradually shuts down as the ambient noise increases, limiting transmitted sounds to the equivalent of 82-85 dBA. Another option is to turn the gain down on the aids and wear them under earmuffs with as large a cup size as possible to reduce the feedback problems. For the CIC user the E-A-R Ultra9000 earmuff also my be of value due to its external orifice that communicates directly to the concha via an acoustical duct. https://www.e-a-r.com/e-a-r.com/muff_detail.cfm?prod_family=Muff 9000&ind_prod_num=330-3028001 Additionally in select situations one may also consider wearing the aids as hearing protectors (see EARLog 18 at https://www.e-a-r.com/hearingconservation/earlog_main.cfm).
Conducting sound field tests with simulations of the actual ambient noise levels in which the patient typically works is also helpful to validate whatever approach is decided upon.
Elliott H. Berger Senior Scientist, Auditory Research E-A-R / Aearo Company 7911 Zionsville Road Indianapolis, IN 46268-1657 317-692-3031 w 317-692-3116 f
Elliott H. Berger, MS, INCE Bd. Cert.
After receiving his M.S. in Acoustical Engineering from North Carolina State University, Elliott joined the Aearo Company in 1976. As E•A•R/Aearo's Senior Scientist, Auditory Research, he conducts hearing protector research and development. He has written over 60 articles on hearing protection/conservation, and was the principal editor for the 4th and 5th editions of the AIHA Noise & Hearing Conservation Manual. Elliott chairs ANSI working group S12/WG11 on real-world hearing protector performance, and is also involved with numerous other standards committees. In 1993 he was the recipient of the National Hearing Conservation Association's Outstanding Hearing Conservationist Award, and in both 1993 and 1998 received their Outstanding Lecture Award. Elliott is Past President of the National Hearing Conservation Association (NHCA), Past-Chair of the American Industrial Hygiene Association's (AIHA) Committee on Noise and a Fellow of the Association, a Board Member of the of the Council for Accreditation in Occupational Hearing Conservation (CAOHC), a Fellow of the Acoustical Society of America (ASA), and a member of the American Speech-Language-Hearing Association (ASHA).
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