Adult audiology hearing aid provision at Leeds Hospital

What is adult audiology hearing aid provision?

Adult audiology hearing aid provision is the service that tests your hearing and, if needed, fits and supports you with a hearing aid. It covers everything from your first hearing assessment through to fitting, follow-up care and repairs.

What conditions does it treat?

This service supports adults with a range of hearing difficulties, including:

• presbycusis, age-related hearing loss that develops gradually and is the most common cause of hearing difficulty
• sensorineural hearing loss, a permanent type caused by problems in the inner ear or hearing nerve
• conductive hearing loss, where sound can't travel properly through the outer or middle ear because of blockages, infection, fluid or structural problems
• mixed hearing loss, which combines both sensorineural and conductive elements
• tinnitus, or persistent noise in the ear or head
• earwax blockage that's affecting your hearing
• single-sided or severe hearing loss that hasn't responded well to conventional hearing aids.

What are the benefits of having adult audiology hearing aid provision?

Getting your hearing properly assessed and, where needed, fitted with a hearing aid can make a real difference to communication, confidence and day-to-day independence.

An assessment also checks for simpler causes, such as earwax blockage or infection, before any hearing aid is considered. Once fitted, you get ongoing free support, including repairs, batteries and retuning, rather than a one-off appointment.

Are there different types of approaches?

Where you're seen depends on your circumstances. If you're 55 or over with typical, gradual hearing loss affecting both ears, you'll usually be cared for by a community hearing provider. Hospital audiology departments focus on adults with more complex hearing or balance problems.

Treatment options can include practical hearing tactics, conventional hearing aids, assistive listening devices, or referral to another service such as ENT (ear, nose and throat). Hearing aids themselves can be fitted with either a custom earmould or a thin tube, depending on what suits you best.

If conventional hearing aids don't give you enough benefit, bone conduction hearing instruments are an alternative, working by sending sound through the bone rather than the outer and middle ear. These can be provided as a long-term, non-surgical option, or fitted surgically as a joint service between audiology and ENT.

What happens before the appointment?

Your GP is usually the first point of contact. After discussing your symptoms, they'll refer you to audiology, or to an ear, nose and throat (ENT) service if that's more appropriate.

You may be sent a questionnaire with your appointment letter; fill this in and bring it along. Try to avoid loud noise for at least 24 hours beforehand, as it can affect your test results. It's worth bringing a partner, relative or friend so they can learn about your hearing loss too.

Your ears need to be clear of wax, since a blockage can mean the test can't go ahead. Olive oil drops can usually soften wax at home, unless you've had a recent ear infection, a perforated eardrum, previous ear surgery or a cleft palate, in which case ask your GP for advice instead.

What happens during the assessment and fitting?

Appointments follow a similar pattern across services, though exact timings vary:

1. The audiologist takes a detailed history of your hearing difficulties, ear health and general health, then looks into your ears with a light (otoscopy) to check for infection or wax.
2. In a sound-proofed room, you wear headphones and press a button or raise your hand each time you hear a tone; this hearing test usually takes 15 to 20 minutes and may be followed by a check of how your eardrum responds to air pressure.
3. Your results are explained, showing which pitches are affected and by how much, and what this means for your daily life.
4. If a hearing aid is likely to help, an impression of your ear is taken to make a mould, and a fitting appointment is arranged; some services can fit a hearing aid at the same visit instead.
5. At fitting, the audiologist programmes the hearing aid to your prescription, checks it's comfortable and sounds right, and shows you how to insert it, change batteries, use the controls and connect it to other devices.

What does aftercare look like?

A follow-up appointment usually takes place 6 to 12 weeks after fitting to check you're getting the most from your hearing aid, with a further fine-tuning appointment if adjustments are needed.

After this, most people move to an open-appointment system, meaning you can get in touch whenever something isn't right, whether that's a fault, discomfort, or a question about using your hearing aid. Repairs are often quick to arrange, sometimes by post, and batteries.

If your hearing changes, or it's been 3 or more years since your last test, you can ask for a reassessment.

What are the risks and complications?

Hearing aid provision is a non-surgical service, so the main practical points to be aware of are:

• your appointment may need to be postponed if your ears are blocked with wax
• wax build-up can block a hearing aid's tubing or cause whistling, so ongoing ear care matters
• tests may show a hearing aid won't help you, in which case alternative support will be discussed instead.