Audiology

At the Audiology department at Leighton Hospital we offer a range of services including:

• Adult Hearing Assessment

• Adult Hearing Aid Fitting and Care

• Paediatric Hearing Assessment and Treatment

• Bone Anchored Hearing Aid Assessment, Fitting and Care

• Tinnitus Support and Therapy

• Ear Protection

• Custom Earphones

• Custom Swim Moulds

• Hearing Aid Care Tools

For more information on any of the services listed, please click the links above.

The department is open Monday to Friday. 8.30-4.00

Extended hour appointments are available from 8.00 – 5.30.

For Maintenance Clinic opening times, please click here.

Due to the ongoing Covid 19 pandemic there is no longer a 'drop in' hearing aid repair service  at the Audiology Department at Leighton Hospital or at any of our outside clinics.

We have a limited number of drop off and pick up slots at remote locations in the community. We will liase with you to arrange this service. We are also running a postal repair service.

Please contact us by phoning 01270 612197 or emailing audiology@mcht.nhs.uk and we will respond to any queries, hearing aid repair or appointment requests.

Regular maintenance of your hearing aid is important to ensure you get the most from your hearing aid. Daily cleaning with a wet wipe, damp cloth or tissue is important. Dependant on the type of hearing aid you have you will also need to contact us every 4-6 month for replacement parts. Useful videos of various aspects of hearing aid maintenance can be found at c2hearonline.com

If you have an open fit hearing aid (thin tube) you should attend a maintenance clinic every 6 months to have the tubing and dome replaced.

If you have a mould (thick tube and earpiece) you should attend a maintenance clinic every 4-6 months to have the tubing replaced.

For instructions on how to retube your own hearing aid (mould only), please click on the related documents link on the right side of this page.

Additional Accessories

We offer a range of accessories available to purchase in the department,  to help you maintain, and get the most out of your hearing aids.

• Hearing aid care tools

• Oticon Streamer

• Custom earphones

• Custom swim plugs

• Ear Protection

What is Hearing Loss?

Age Related Hearing Loss

Hearing loss comes about in a variety of ways, the most common being age related hearing loss (or presbyacusis). Age related hearing loss is due to wear and tear damage of the hair cells that detect the sounds within the cochlear. This affects our ability to hear particular frequencies at normal levels, and thus there is a loss of hearing at these frequencies.

Noise Induced Hearing Loss

Exposure to noise is another common cause for hearing loss, known as noise induced hearing loss (NIHL). This is caused by being exposed to excessively loud sounds for a long duration of time, most likely affecting those working in industrial scenarios. This type of hearing loss is now being combated by the use of ear defenders, and noise protection ear plugs.

Conductive Hearing Loss

A conductive hearing loss is caused when there is a blockage along the mechanism of hearing (the outer or middle part of the ear). This can be caused by a range of things, from wax and infection, to trauma to the ear drum, or fixation of the ossicles. This can be a temporary or permanent hearing loss, depending on the cause. Often you will be seen by a medical practitioner to determine the cause for this conductive hearing loss.

Genetic Hearing Loss

There is also genetic hearing loss, a hearing impairment passed along in the genes. This can be present from birth, or sometimes may become present later in life. Alternatively, hearing loss may be associated with a particular syndrome, this will be considered alongside a range of other characteristics before a diagnosis is made.

Anatomy of The Ear

The ear is made up of three different parts. The outer ear, the middle ear and the inner ear.

• The outer ear is made up of the part we can see called the pinna and the ear canal which leads down to the ear drum.

• The middle ear is a space filled with air behind the ear drum, where the three smallest bones in the body, the ossciles, are suspended. There is also a tube connecting the middle ear space to the throat called the Eustachian tube.

• Finally, the inner ear, known as the cochlear, transfers the vibrations of the sound waves that pass through the outer and middle parts into an electrical stimulus that is sent along the auditory nerve and is interpreted by the brain as sound.

How it all works

A sound wave is collected by the pinna and guided along the canal to the ear drum. The ear drum then vibrates with the sound pressure of the sound waves which in turns moves the ossciles in a lever action. The ossciles work as a lever mechanism to transfer the sound wave vibrations into the inner ear (cochlear) which is filled with fluid. This fluid then vibrates also, stimulating small hair cells within the cochlear which trigger the firing of neurons. This firing of neurons passes the signal along the nerve to the brain. The sound is then processed by the brain.

How Does Hearing Loss Affect Your Communication?

A hearing loss impacts our ability to distinguish sounds at normal levels. In speech the frequency and intensity varies depending on the speech sound, for instance the word ‘spoon’, the ‘sp’ is a higher frequency sound, compared to the ‘oon’ which is a lower frequency sound. This means that if you have a hearing loss of the higher frequencies you will miss the speech sounds in this area hearing only the ‘oon’ part of the word. This means that the processing of the word becomes more difficult as your brain has to fill in the missing part. Sometimes you will get this right, but others you may get this wrong leading to mishearing of the word, and possibly not understanding what has been said.

When we are hearing in a noisy environment there are other sounds competing with signal you are trying to listen to, masking the speech further. This often leads to greater difficulties in noisy environments as your brain is being asked to fill in a bigger and bigger gap, increasing the chance of you getting the answer wrong.

What to Expect From Your Hearing Aid

Hearing aids work by taking the sound someone with hearing loss is struggling to hear and making it louder, thereby allowing them to hear.

The hearing aid is set to a prescription level based on the hearing test results. The hearing aid will amplify the sounds to an audible level, whilst aiming to reduce background sounds and increase the speech signal. The hearing aids have adaptive technology to try and provide the best signal-to-noise ratio possible. Sometimes the environment that you are in will not allow the hearing aid to pick out one speech sound over another, making it a more difficult listening situation.

A hearing aid will sound a little alien to start, as it will be digital sound that you hear, not natural hearing. Your brain will recognise the change in sound, and alert you to this, paying more attention to everyday sounds that you may not have heard for some time. This will begin to settle over time, as your brain re-learns which sounds are important and which are not. This is the processing aspect of hearing and listening and this takes time to adjust to. A key point to understand is that hearing aids amplify the sounds around you; it is your brain that will decide which of these sounds to listen to.

For more information about hearing aids please click here.

One vs Two Hearing Aids

Based on your hearing test your audiologist will advise you whether one or two hearing aids are necessary. They will consider a number of factors alongside the hearing loss when making this decision. 

Two Aids

When offered two hearing aids some people may think this means that there hearing must be much worse than someone with only one hearing aid. This is not the case, there are benefits to having two hearing aids, so where possible the audiologist will encourage you to try two hearing aids to gain maximum benefit.

Two hearing aids helps to maintain the balance of hearing from left to right to help you in a number of ways, such as localising where a sound has come from, better speech intelligibility in noise, and better sound quality.

One Aid

With one hearing aid, if you have a hearing loss in both ears, you are asking one ear to do the job of two. This puts strain on the ear with the hearing aid, and also deprives the other ear of stimulation.

If you are only offered one hearing aid there may be reasons for this, such as hearing loss in only one ear (unilateral hearing loss), one ear may be unsuitable for a hearing aid in some way. Please speak to you audiologist at this time who will be happy to explain.

Limitations for Hearing Aids and Hearing Loss

Although the technology in hearing aids is greatly improved, they are still only electronic aids to natural hearing. If a patient has very poor natural hearing there is only so much the hearing aid can do. The hearing aids still utilise the patient’s natural outer, middle and inner ear, including the hearing nerve so if there is damage to the hearing nerve the hearing aids are not able to counteract this.

As the hearing aid is an electronic device the sound can sometimes seem not ‘natural’ when it is first fitted. However, if the patient wears the aid regularly this sense can quickly fade. Often the patient will notice a difference in their own voice, this too will fade as the patient adapts to the new sound.

The hearing aid will amplify the sounds around you. Sometimes there will be sounds that you do not wish to hear, you will need to learn how to filter these sounds out. This is something the hearing aid will try to help with, however it will not be able to understand which sounds you do and do not wish to hear.

Some people find it more difficult than others to filter sounds. This is not something that can be changed by the hearing aid. There are however a number of listening tactics that you can employ to help in these more challenging listening situations.

A hearing aid is a device that takes everyday sounds and makes them louder so that they can be heard by someone with a hearing loss.

Why do people wear them?

The aim of a hearing aid is to assist in helping someone with a hearing loss, understand speech and the sounds around them to allow them to live a normal life.

How does it work?

Hearing aids have microphones that pick up sounds from the environment, and raise the volume of those sounds, to allow them to be heard by someone with a hearing loss. Each aid is programmed individually to the ear it is fitted to in order to meet a person’s hearing loss. The hearing aids are programmed by specially trained Audiologists.

What hearing aids do we offer?

At Leighton Hospital, we offer Oticon Hearing aids. For more information about Oticon hearing aids please click here.

The Oticon hearing aids we offer are;

• Oticon Synergy on open fit, ‘thin tube’ or ‘corda’

• Oticon Synergy on a mould

• Oticon Dynamo on a mould

In special circumstances we may also offer:

• Phonak Bolero Cros 2 (CROS/Bi-CROS) system

• Phonak Nathos S+ UP

The aid is selected dependant upon a number of factors including the extent of a patients hearing loss, visual ability, dexterity, & anatomy. Your audiologist will advise you which hearing aid is suitable for you.

How to use the hearing aid

• Changing the program - To change the program on your hearing aid you will need to press and hold the rocker switch for about 2 seconds, then release. You will hear two beeps. This means that you have changed to program two. To return to program one, press and hold the rocker switch again and you will hear one beep.

  One beep = program one

  Two beeps = program two

  You may have up to four programs. Dependent upon how many programs you have you may have more settings to change through before returning to the original settings.

  If you are using a Super Power hearing aid you will have a single button, not a rocker switch. It will work in the same way.

• Changing the volume - To change the volume of your hearing aid you will need to press the rocker switch quickly, a short press. You will hear a high pitch ‘pip’ to indicate that you have moved up or down within the volume range. To increase the volume press at the top of the rocker switch (highest part of the rocker switch when behind the ear). To decrease the volume press at the bottom of the rocker switch (lowest part of the rocker switch when behind the ear).

  When you have reached the minimum or the maximum position you will no longer hear the ‘pip’.

  To let you know when you are back to your original setting, known as your preferred level, you will hear two short high pitch ‘pips’.

  On average there are 4 steps to your maximum level and 8 steps to your minimum level. This may vary depending on the settings in the hearing aid. You may also find that your preferred level changes within the volume range, this is because the hearing aid has learning technology, meaning that if  you change the volume in a particular pattern (i.e. turn down two steps every day) the hearing aid will learn that you prefer the sound lower and will automatically start at this reduced level. Therefore the two short high pitch ‘pips’ that indicate your preferred level will have moved position (i.e. you will now have six steps to your maximum level).

• Changing the volume on a super power hearing aid - If you have a Super Power hearing aid you will have a volume wheel, instead of the rocker switch.The wheel will have numbers 1 to 4 marked on it. Number 4 is the maximum position, number 1 is the lowest. Your hearing aid is usually programmed to be set at number 3, your Audiologist may advise you differently depending on your settings.
  
  When moving the wheel up or down you will hear a series of beeps to indicate that you have reached the maximum, or the minimun postion. When you are set to your ideal level (where you have been set by the Audiologist) you will hear two short beeps. It is usual to have a 'mute' function active on the Super Power hearing aids. This means that if you scroll to the lowest setting you will feel a slight 'click' and the hearing aid will mute. To get the sound back you simply need to scroll back up.

• Changing the battery - The battery in a hearing aid lasts approximately 10-14 days. This may vary from person to person and week to week, depending upon the power needed in your hearing aid and the environments that you visit.

  The hearing aid will 'beep' to indicate that the battery is low approximately 1hour - 30 minutes before it runs out. This is only something that can be heard by the person wearing the hearing aid, if you are busy with another task, or are in a noisy environment, you may miss this. If  you miss the beep the hearing aid will play a short jingle just before it switches off.

  To change the battery remove the old one from the battery compartment. Take the sticky tab off the new battery. The battery slots in with the flat shiny side facing towards up (marked with a postive '+' symbol). The drawer should glide shut.

  If you have inserted the battery the wrong way you will feel some resistance when trying to close the drawer. Please do not force the drawer shut as this can damage components inside the hearing aid.

  With the new battery working you should now hear the start up jingle as you put your hearing aid into your ear. This only plays for 7 seconds, so if you take a little longer to put the hearing aid in you may only hear part of this jingle.

  Where to collect replacement batteries

  You can collect replacement batterires from a number of clinics across the mid cheshire area. You will need your brown record book in order to obtain batteries.

  Available Monday - Friday.

• Audiology Department, Leighton Hospital.

• Eagle Bridge Health Centre, Dunwoody Way, Crewe.

• Church View Health Centre, Beam Street, Nantwich.

• Dene Drive Health Centre, Dene Drive, Winsford.

• Ashfields Primary Care Centre, Middlewich Road, Sandbach.

• Victoria Infirmary, Winnington Hill, Northwich.

• Middlewich Clinic, Lewin Street, Middlewich.

• HolmesChapel Health Centre, Holmes Chapel.

• Alsager Health Centre, Sandbach Road South, Alsager

Please note that these functions may not be available on all hearing aids. Speak to your Audiologist to find out more.

What else is available?

• The Loop System

• Streamer

• Tinnitus Assessment

• Bone Anchored Hearing Aids

• Paediatric Assessment

• Noise Protection

• Swim Moulds

• Custom Earphones

• Hearing Aid Maintenance Tools

• Additional Support (PDF document, opens in new window) 

Inserting the earmould is something that a lot of people find difficult to start with. The steps below are designed to help you.

Step 1:

Take hold of your mould by the handle (the part that looks like the handle of a tea cup) using the hand on the same side as the hearing aid.

Left hand for left ear, right hand for right ear.

Try and keep your hand in the position shown as this will help with the insertion of the mould.

Step 2:

Take your hand up to your ear.

You are aiming to align the points – the lower part into the ear canal, and the upper part under the flap of skin at the top.

Step 3:

It is important to ensure that the top part is tucked under as this will keep the mould in place and make sure that all points are sitting correctly.

Take your hand slowly to the ear and you will start to feel the mould against you skin.

Try not to turn your hand or wrist as this will change the alignment.

If these points are not aligned correctly, this can make the ear very sore.

Step 4:

When you feel the tip of the mould in your ear canal you can tilt you hand inwards slightly and this will help the top piece move under the flap of skin.

Step 5:

Begin to guide the mould further into the ear.

The handle piece will start to slip into the back of the ear.

You may need to start to move your thumb out of the way to allow this to happen.

Step 6:

Depending on the shape of your ear you may need to pull you ear lobe down/back to open the bowl of the ear. This will help the mould slip over the outer ridge of your ear and into position.

Step 7:

Once your thumb is out from behind the handle, push on with your fore finger to push to handle into the bowl securely.

You are pushing slightly backwards and inwards.

Your mould is then secure, you can let go of the mould and it will stay in position.

The hearing aid will hang next to your ear.

Step 8:

To put the hearing aid behind the ear you need to take hold of the aid and lift it up and forward.

This will then slide in the crease of the ear next to the head.

Try not to turn or twist the hearing aid as this can cause problems with the tube and the position.

Step 9:

Finally have a feel of the hearing aid to make sure it feels secure.

Once in position the hearing aid should look like the image shown opposite.

Inserting the ear mould correctly will take some practice. Do not be disheartened if it takes you a few attempts.

Remember, if you have the mould to your ear for more than 2 minutes without inserting the mould, STOP; take out the mould, check your alignment, RETRY.