xmlns:og='http://ogp.me/ns# VoiceTalk: Singing & Hearing Aids

March 6, 2013

Singing & Hearing Aids

When I starting wearing Phonak Audeo IX hearing aids four years ago, I was singing at New York City Opera, having weathered the previous season without them, and with loud invasive tinnitus ringing in my head (see my post on surviving tinnitus here). Of course, that was a trip. I was lucky however. After my sudden onset (ok, not so lucky), I only went a year before I started wearing them. I didn't wait too long: I didn't let my ear muscles go to hell. 

If you've been reading this blog, you have some idea now that listening and singing is an active process. The ear and the voice are indivisible. If the ear cannot hear certain frequencies very well, they won't come out of the larynx. This is, of course, the first law of Tomatis. As such, the two muscles of the ear—the tensor tympani and the stapedius—work in such a way as to be rudders in a sea of sound. They have the ability to zoom in on sound as well as ignore it. This is why the constant drip of a faucet can drive you nuts, and you can also sit in a noisy cafe, lost in a good book, oblivious to everything around you. The ear—like the eye—can focus or defocus.

I thought of this matter of the eye and ear focusing when I was at the Y the other day for a swim. Sometimes I wear my contact lenses and sometimes I don't. When I wear glasses, I leave them in my locker when I go to the pool.  I am near-sided, so everything is a blur without correction. Without it, I don't interact with people very much, nor do I give the life guard my usual "thank you" wave when I leave. Why? I'm too busy trying not to stumble, my head being glued to the floor in front of me. And that's how it is with hearing. Hearing loss changes the way you interact with the world.

What does hearing loss do? It deprives the ear muscles of stimulation. Thus deprived, the muscles lose their ability to navigate the aforementioned sea of sound. What do hearing aids do? Stimulate the ear muscles. Do you see where I am going here? Most people don't know they have a listening problem until their ear muscles can't do their job very well, until "straining to hear" becomes the new normal. When that happens? Denial is often the first response.

"No. This can't be happening. If I do nothing, perhaps it will get better. Maybe I just need more sleep." But it doesn't get better. Bargaining enters the picture, be it with God or simply waiting for a bargain (believe me: good hearing aids aren't cheap), which can waste years, even decades. "It's not that bad. My grandmother had hearing loss and she did ok!" Sure. She did great. She stopped talking on the phone, going to church, and became withdrawn.

By the time most people obtain hearing aids (only 1 out of 7 people who need them wear them), their ear muscles can't do their job very well. Getting hearing aids after all that time? It's like having to run 5 miles, do 50 pushups and 20 pullups after not going to the gym for a decade. The ear is out of shape. Everything is too loud: words are jumbled, background noise is a problem, music sounds like noise, the whole thing is damn annoying.

I didn't have any of these problems. However, I would have done things differently. I would have gotten hearing aids right away instead of waiting a year. As it is, my ENT told me that my hearing loss—which is minor—didn't exactly warrant them. It was just above the borderline. He told me that I might consider it if communication became a problem. The day my husband informed me that my speech was sounding a little funny? A little garbled? That did it. I knew what that meant having been to the Listening Centre in Toronto: I knew that the muscles in my ear were starting to "slip." Of course, I also wanted to find a way to treat my tinnitus. While my hearing aids didn't help with that, my speech snapped back into place immediately after I put my hearing aids in. Why? The aids helped me hear through the cascade of ringing I heard in my head, which had a "masking" effect on my listening ability.

Here's the thing: even with hearing loss, the muscles of the ear can still learn to do their job. They need stimulation to do that. Back to my gym analogy. Say you lift weights, but when you do your pull-ups, you only go half-way up. Of course, your "lats" will never get any bigger or more defined. Why? Your muscles aren't fully contracting. This is not unlike how the muscles in the ear work. Without stimulation, they can't contract. What leads them to contract fully? High frequencies. What are the first sounds to go with age? High frequencies. What do my Phonak hearing aids do? Amplify high frequencies up to 8000 Hz, which is where my tinnitus is loudest. Tomatis talked about "flabby'"muscles of the ear. I believe he was onto something.

Now, I don't think you are going to find many audiologists or ENT's who have this perspective. Most think of the ear as a passive participant in the world of sound. Singers and voice teachers, however, know better. Why? The latter, especially, understand what it means to mold a person's listening ability. It's malleable. If you change the way a person listens to sound, you change the way that person perceives themselves. Singing is a psychological matter, not just a mechanical one.

All this to say: you can sing with hearing aids, and you can sing very well. I am. Really. I am. I record myself at least once a week, and I sound very good for a 54 year old man. My voice isn't wobbling, nor it is dark, woofy and old sounding. Not bragging here, but I still sound very much like the guy on my two recordings on my voice studio website. Why? I like to think I know what I am doing technically, and yes—I sing my scales every day. Have I had my vocal issues? Of course. I've had to learn to sing with my aids, which has been a fascinating experience. It took me a while to get used to them. Now they are as much a part of me as my right arm.

Some things to consider if you suspect you have hearing loss and are a singer.

  1. Get tested! Do it now. Don't wait. Find an audiologist who works with singers. A rare thing perhaps, but they are worth their weight in gold. Start by finding an ENT who works with singers. Ask for a recommendation. 
  2. Get digital hearing aids. Yes. They are very expensive. But they are worth it. Mine are made by Phonak and designed with musicians in mind. They have two microphones. The sound is excellent. Yes. You can find good aids on Ebay, but you will need to find an audiologist who will agree to fit them. You may not, however, be able to return them. 
  3. Get hearing aids that have an "'open port," like the one you see in the photo above. Why? They give you better sound quality. "In-the-ear-canal" hearing aids aren't as good, which leads me to the next point....
  4. Terrified that someone is going to think you are old and that you can't sing well? That someone will see them?  Get over it. Really. I can't say it any other way. I was concerned about this too. But I got over it. Heck. I dealt with being gay and found myself a lot happier. It's that same dynamic. Staying in the closet about hearing loss is self-defeating and ultimately debilitating. The more you let yourself be ruled by this "fear thought," the more you are shooting yourself in the foot. FYI: 9 out out 10 people aren't going to even notice that you have them. Really. I am not making this up. And that 10th person? They are self-aware and won't hold it against you. 
  5. Digital hearing aids will have a "music program" as part of their software. I have this feature turned up. Why? It was cutting off when it reached a certain threshold, one which was too low for singing. You may need to inform your audiologist about this. You may even need to have the music program turned on all the time. Why? You will be hearing high frequencies—a good thing. 
  6. Wear your aids all the time. There is no getting around this. Thinking of them as the car you drive only on weekends is counterproductive. Me? I put them in when I wake up, and take them out when I go to sleep (no...they don't go in the shower or the pool). The only way to get used to wearing them is by wearing them! 
  7. Consider going to a Tomatis practitioner to give your ears a tune up. This will enable you to acclimate to your aids.
  8. Have your aids insured. This typically happens a year after you get them, when the warranty is up. Please don't be cheap and think you don't need it. You do. 
  9. Sing with them! Yes. It's going to be different, perhaps even disconcerting, but it behooves you to get in the swim of things. The more you do it, the better it gets. Listen to music too. Lots of it. Mozart especially, which has been proven to have a beneficial effect. Just make sure you use good earphones, not earbuds, which are not good for your ears. 
  10. Get used to the illusion of sound, that is, the corona of vibration surrounding your head. This is what those with excellent hearing and good vocal technique take as a matter of course. You don't want to smash your voice into the front of your face. Rather, you want to start hearing a clear, vibrant vowel that seems to be at the level of your ears and eyes, upper lip, and projects outwards. 

Having hearing loss isn't the end of the road. You can sing, and sing very well. You can also be a very good voice teacher. The key is to be proactive. 


  1. Thank you for writing this! So inspiring. So many important points were addressed and it's great to know, while most of my peers understand little about hearing loss, there are other people who know these facts! I wish more singers, and people with hearing losses would read this. I am a musical theatre student graduating college this spring and I have a genetic progressive hearing loss. have been wearing hearing aids since I was thirteen. Luckily I have an amazing mother who has been taking me to the audiologist's for hearing tests since birth and always provided me with the top technology in hearing aids. She has two cochlear implants and has been a teacher in deaf education for over thirty years. It's bothersome (and a little insulting) to know other students in my program admit to having hearing losses but don't wear hearing aids because "they don't want to." As a musical theatre singer venturing into the professional world soon (and hoping to end up in NYC in the near future) I thank you again for writing this!

    -Madelyn, 20, Toronto

  2. Thank you so much.... I'm a 35 year old who lost a lot of my hearing as a child but has nonetheless been successful as a singer, and I'm venturing into the world of hearing aids. I'd been told I wouldn't be able to sing while wearing them, but this makes me hopeful.....

    1. Dear Mandi, Thank you for your comment. If you obtain aids that sit in the ear canal, rather than those with an open port, then yes, it is hard to sing with them. The other factor will be the degree of your hearing loss and the amplification necessary. However, if you have been successful as a singer, then good hearing aids should not be a problem. Please let me know how things go, and feel free to get in touch with me at shigovoicestudio@nyc.rr.com. All best regards- Daniel

    2. Sure you can sing with hearing aids I do and they are not expensive ones. I was always shy and self conscious about singing by myself. My new husband is guitar player and singer. When I lost most of my hearing in left ear a year ago was very upset. Got the hearing aids and in Sept my husband started helping me with my voice and timing. Soon I was able to sing live with him and then got daring and wanted to song on my own. Needless to say many months later I am doing great, hard work, lots practicing. Singing live at jams and jamborees, getting lots of compliments and loving it. You can do it too.

    3. Thank you for your comment, Marie Gauvin. Great to hear that you are having success singing with your aids.

  3. Dear Daniel, thankyou for sharing your story and for advice. Yesterday I was referred to an audiologist after contracting a viral infection in the inner ear which has caused high frequency hearing loss. I am an opera singer and singing teacher and I have never felt so vulnerable in my life. You have just given me a real sense of hope. I haven't yet contacted the audiologist, the whole idea has been terrifying, but now I just want to get on with it, thank you. Kathryn Zerk

  4. Dear Kathryn—Thank you for your message. First off: my heart goes out to you! And I am sorry to hear about your infection and subsequent hearing loss. I've been wearing hearing aids now for about 5 years, and they feel like part of me. I teach with them, of course, and sing with them—all very life-changing, but in a good way. Do contact your audiologist, and let me know how things go via email, ok? Wishing you all good things- Daniel

  5. In tip two, you mention that you should get digital hearing aids despite their extra costs. How much more would you be paying compared to the quality you'd get from digital hearing aids? We're trying to find the best option for our mom.

  6. Thanks for your comment, Felicity. My post is geared towards singers. Top-of-the-line digital hearing aids cost in the neighborhood of 6 K. What does one get for that? These have 10 to 12 bands of sound which are molded to the listener's ear, while those at half that cost have only 5 or 6 bands of sound. As a musician, I wanted the highest quality I could obtain. However, if speaking is the only concern, this is a different matter.

  7. I am voice teacher who just began teaching a man in his 60s who is noticing some problems while singing in the church choir. He wears hearing aids (probably the inner kind) and finds that his singing, which was always good, is off-key now. He is a tenor who seems to be consistently sharp on the higher notes. Singing with another person seems like it helps, but he is hoping to sing solos like he used to. I have only had one lesson with him so this is all I've noticed so far. I was wondering if there are vocal exercises I can do with him that would help his situation. I'm thinking there probably isn't, as it is a hearing loss issue. But he's so sad about it and worried that he's messing up the rest of the choir. Any suggestions? He says that singing with just me in the room is easy, but singing when there are lots of people around is difficult as he finds it hard to distinguish between sounds. So it sounds like it's best when all the tenors sing as a section, but bad when all four choral parts sing together because it sounds like cacophony to him.

    1. Mary—Thank you for your comment. Several things stand out in your words that need further clarification. Find out what kind of hearing aids your student has. Are they really good ones? If not, why not? The answer to this is usually a financial matter. However, aids which aren't top-of-the-line digital ones are not good enough for singers. That's the first step. Once properly fitted, the process of singing with the aids can begin. If you have been reading my blog, you will know that I emphasize the singer's own audition which is apprehended via bone and air conduction. In simple terms, this means "feeling/hearing" that all the vowels have a vibratory core that is felt inside the skull as well as outside it. Closed vowels like [e] and [i] aid the singer in hearing the vibratory formation within the skull, that is, bone conduction, which must be extended to all other vowels. As well, the singer needs to re-learn to hear the voice is "stereo," that is, surrounding the head. This awareness can, of course, be somewhat obscured while singing with others. The trick, of course, is to maintain an awareness of bone conduction while singing with others. To understand this further would entail a demonstration, but I hope my words lead you in the right direction. Please feel free to be in touch via email. Daniel

  8. Thank you so much for your posts, particularly the historically oriented ones. I really enjoy reading them.

    I just wanted to point out that the muscles of the middle ear (stapedius and tensor tympani) actually only dampen the sound being transmitted to the cochlea. The stapedius muscle contracts when suddenly exposed to a loud sound in order to protect the cochlea from over stimulation. About 90% of hearing loss is sensorineural, meaning that it is caused by either cochlear or neural deficits. Thus strengthening the muscles of the middle ear will not improve hearing. The cochlea is arranged in a tonotopic fashion, that is to say that the haircells in each region of the cochlea respond to different frequencies (the base responds to high frequencies and apex to low frequencies). In the case of noise induced hearing loss (NIHL), it is the haircells in the cochlea that are no longer able to respond to certain frequencies (particularly in the 3-4kHz region). Once the haircells are gone (due to noise exposure, drug ototoxicity, or various other reasons), they are gone for good. Thus hearing aids, unlike glasses or contacts, are not corrective; they simply amplify the sound so that it can be picked up by the remaining haircells. A good analogy for this is listening to the radio in the car. If the signal is weak, turning the volume up may help with intelligibility but not clarity (since the static will also be increased). However, the good news is that haircell regeneration research is underway and looks like it may be a viable solution in the future.

    Thank you again for all your posts. I'm a huge fan of your work.

    1. Thank you for your comment, Joe Uthup. I encourage your to read Tomatis' "The Ear and the Voice." You will find there that Tomatis makes a distinction between listening and hearing. The model that you outline is one of hearing rather than listening—a passive rather than an active mechanism.

  9. According to Tomatis, the muscles of the ear do a lot more than dampen sound entering the ear. In fact, they act as rudders of sound, and have a "zoom" mechanism that allows one to focus and defocus on sound like the eye does regarding visual information. This enables one to sit in a cafe reading a book and not "hear" anything around one for a good half-hour, while others, who's ears are not functioning properly, feel positively assaulted in the same environment. Obviously, something more than "hearing" is at work. Tomatis calls this "listening,' that is, the ability of the ear to focus on sound—and I might add, regardless of loss of hearing.

    I have a friend who went a long time without hearing aids. He can't wear them at work because he finds the sounds around him disturbing. I, on the other hand, find the same environment to not be a problem at all. The difference? I am a musician and am trained to attend to the world of sound, while my friend interacts in a passive manner.

    My point here is this, and one that I made in my post: regardless of the loss of hearing, the muscles of the ear are able to focus on sound just like the eye can on visual information. Does this mean that hearing aids are corrective? No. But again, your post reflects a passive rather than an active perspective.

    1. Thank you for your reply. I completely agree with you that there is a distinction between listening and hearing. The phenomenon you describe in which an individual is able to focus in and out on specific sounds is known as the "Cocktail Party Effect" which is essentially a form of auditory stream segregation. However, this is actually a neurological phenomenon, not a muscular phenomenon. I do agree that active training should positively affect the way in which an individual attends to the world of sound. However, it is the brain that is trained in this process and not the muscles of the middle ear. I could be wrong but this is what I have learned in my studies as a musician minoring in speech and hearing. Thank you again for your kind reply. Best wishes!


    2. Joe—I doubt very much that the training you received came from a "Tomatis" perspective, who, btw, had a very different view of how sound reaches the ear. I encourage you to read the middle section of "The Ear and the Voice."

  10. I think this what is happening to me. I am a classically trained singer. I am told time and time again that I have a beautiful voice. Unfortunately I haven't had ANY success because of my pitch problems. It's quite embarrassing. It's like having awful body odor. It stinks. I have been scolded and told I need to be a better student and practice more, I have heard many times that perhaps I am a mezzo instead of a soprano since I'm singing flat, I have spent years with teachers who believed I had to much tension in my body which caused my pitch problems and I have also heard many many times that I am singing unsupported. This has been my problem since I began singing in high school,on through college and beyond. When I turned 30, I decided if I did not place in a competition I was trying for, I would give up singing.
    When I did not place, I stopped singing and studying. I dropped my then voice teacher who used to scold me for my pitch problems. I got married and had a baby. But I missed singing. On a whim, at 33, I took a few lessons with a teacher a friend was studying with. This teacher suspected I had a weak ear and she asked me to put cotton in one ear while I sang. After she asked me which ear did I think was my stronger ear. I picked the wrong one based off of how I felt. (I couldn't honestly hear a difference) she told me I was wrong in my choice. And I decided to stop studying with her because I didn't want to go through another teacher student discipline journey.
    After having my 2nd child I missed singing again. I joined an amateur chorus. There were auditions for solos in the mozart requiem. I really wanted it so I practiced hard and recorded myself. On all of the recordings, I sang flat! Trying different things to sing in tune, I covered my left ear. When I listend back to the recording it was PERFECTLY IN TUNE!! So, I bought earplugs and did the audition. I impressed the auditioned and have been getting more offers. I'm sure to always plug my left ear where ever and when ever I sing.
    I'm so happy I found your blog. I think my problem is hearing certain frequencies in my left ear. Now, I will start on a new journey with my singing.

    1. Thank you for your comment, Mich Spence. First off: I am very sorry to hear that your teachers were rough with you. No one deserves to be treated in that way. Ever. Second: It's really great that you have found that your right ear can lead you. I believe you may be able to use both your ears with continued training. To do this, you might practice by holding your RIGHT HAND closed in a fist (like holding a brush handle) up to the right side of your mouth. Hold it very close, no more than 2-3 inches away, located on the right side of your mouth, which will direct your singing and speaking tone to your right ear. This will help you get used to leading with the right ear. I was given this exercise after I was at the Listening Centre in Toronto in 1999, and did it as advised for a whole year. If possible, you might also consider a course of Tomatis listening training which awakens the right ear to lead. I wish you all the best, and look forward to hearing news of your progress. Email me! Daniel


I welcome your comments.