Hearing Aid Basics for Patients with an Acoustic Neuroma

There are many things to keep in mind when looking into getting hearing devices. The duration and the severity of the hearing loss in the affected ear (the ear which has/had the acoustic neuroma), and in the non-affected ear, will influence your experience with amplification. The most important thing to keep in mind is that it always takes time to get used to amplified sound. It is quite common for certain environmental sounds (for example: water running in a sink, dishes clattering, papers rustling) and certain speech sounds (for example /S/ and /SH/) to sound louder and unnatural. You may find that amplified sound is too sharp or too tinny, that your own voice may sound loud or echo, and that familiar sounds in the environment may sound very different than before. It can take several weeks to several months of regularly using hearing aids for these sounds to become more normal.

This brings us to another important point; be patient with yourself and go at your own pace. Ideally, you would wear the hearing device most waking hours of the day, apart from when you are showering or going for a swim. However, every person is different - if you feel comfortable wearing the hearing device for 16 hours a day, that’s great! If you prefer to take it more slowly, you can gradually work your way up to a full day of wear. Try to wear the devices for at least six hours a day. You can always wear them in quieter environments to get familiar with the sound quality before wearing them in a more challenging environment, like a restaurant.

Even the best hearing aids are never going to sound as good as normal hearing. For most people with age-related hearing loss, their ears are like radios with the volume turned down - a hearing aid is like turning up the volume, the sound will be loud and have good clarity. For most patients with acoustic neuromas, their ears are like a radio with the volume turned down and the dial tuned slightly off-station. Just like a radio, there is some ‘fuzz’ or distortion. When a hearing aid brings the volume up, it is definitely easier to hear, but the quality of the sound isn’t perfect. Amplified sound coming from a hearing device cannot fix the damage in the ear and the nerve.

The ability to localize sounds (or determine where sounds are coming from), the ability to hear speech when there is background noise, and even the clarity of the sound can be impacted when there has been an acoustic neuroma or hearing loss from other causes. While hearing devices can make it easier to hear some sounds that were not heard before and easier to hear in more difficult environments, it is no replacement for a healthy auditory system. It is important to have realistic expectations when getting used to a new device.

Now let us look at the three different types of amplification available. Among the following types of amplification, there are different manufacturers, models and costs. All of these factors should be discussed with your audiologist when it comes time to make your decision.

  1. Hearing aids 
    This is the type of amplification most people are familiar with. There are hearing aids that fit into your ear canal (invisible in the canal, completely in the canal, in the canal and in the ear styles) and others that sit behind your ear with a piece fitting in your ear canal (behind the ear or receiver in the canal styles). Depending on the degree of hearing loss and the clarity of speech in the affected ear (among other things) as well as the degree of hearing loss in the non-affected ear, either one or two hearing aids may be recommended.

  2. Masking devices
    Approximately 60%-70% of people with tinnitus (perception of ringing, buzzing or other noises in the ear) will notice some improvement in their tinnitus when wearing a hearing aid. However, if a hearing aid alone is not enough to manage the tinnitus, a masking device can help. Some hearing aids have a masking feature which essentially will produce a soft sound (white noise, water noise, chimes etc.) to help distract your brain from the tinnitus. Not all hearing aids have this masking feature available. If your tinnitus is bothersome, this is something to discuss with your audiologist when choosing which type of device will be best suited for you.

  3. CROS and Bi-CROS 
    These devices are used when the affected ear isn’t a good candidate for a hearing aid. The amount of hearing loss or remaining clarity may be so poor that a hearing aid on that ear wouldn’t help you understand speech. A microphone on the poorer ear picks up the sound and sends it over to a hearing aid on your better ear. A CROS is used when the better ear has normal hearing. A biCROS is used when the better ear has some hearing loss and needs some additional amplification. CROS and biCROS systems sometimes take a bit of time to learn to localize sounds, as the brain has to retrain itself hearing all of the sounds coming from the better ear.




Most hearing aids have options for rechargeable batteries, streaming calls and music from your smartphone, and acting as a wireless headset for your television. These are all things to discuss with your hearing care professional.

Some people who are not successful with hearing aids or CROS/biCROS systems are candidates for other devices - such as a bone-anchored hearing aid (BAHA) or a cochlear implant (CI).

This is not something that you will be doing alone. Make sure to find a hearing care professional that you feel comfortable working with. There are usually a few visits needed to get things sounding right. It is also important to educate your family, friends and co-workers. Even if you have done everything up to this point perfectly, you will still have difficulty understanding speech if the people around you do not communicate correctly.

In all environments, but especially in challenging ones (for example restaurants, parties and family gatherings) make sure everyone is using the correct communication strategies. Ensure that the person talking to you gets your attention before they begin speaking, that they are looking at you and that you are looking at them. Someone with no formal training can still get some benefit from lip reading. Ask people to speak slowly, clearly and loudly (without shouting as that can make it harder to understand what is being said).

If you need to have someone repeat themselves, you can ask them to rephrase rather than repeat. You are doing your part by wearing a hearing aid - they need to do their part by having good communication habits and understanding that hearing aids don’t give you normal hearing. Lastly, be patient with your family, friends and co-workers, as they may need some time to learn better communication habits.



Christine Kennedy grew up on Vancouver Island, where she obtained her Bachelor of Science in Neuropsychology at Vancouver Island University. She moved to Ottawa to pursue her Master's in Health Science in Audiology at the University of Ottawa.

Emily Dawber graduated from Queen's University with a BAH in Psychology and completed her Master’s of Clinical Science in Audiology at the University of Western Ontario.

Christine and Emily have both been with Costco since 2015, currently practising in the Ottawa area.