Hearing loss – the ability to hear clearly has a huge influence on our lives, which is why it’s so important to recognize the early signs. In the US, over 36 million adults are affected by hearing loss, ranging in severity from mild loss of hearing that limits the ability to hear certain high-pitched sounds to complete loss of hearing.
Understanding Your Hearing
There are three parts to the ear: the outer ear, the middle ear and the inner ear. Each part plays its own unique role in hearing.
The outer ear includes the pinna, ear canal and eardrum. Sound is channeled into the middle ear via these structures. The pinna, or outermost visible part of the ear, gathers sound waves and directs them down the ear canal toward the eardrum. The eardrum (tympanic membrane) separates the external ear and the middle ear.
The middle ear is comprised of the three smallest bones of the human body, the ossicles. When sound reaches the eardrum, the tympanic membrane vibrates. This vibration causes vibration of the ossicles, which are structured like a lever to amplify sound. The sound is then mechanically transmitted into the inner ear (cochlea).
The inner ear converts the sound to an electrical nerve impulse. The movement of the ossicles causes pressure waves in the inner ear fluid that stimulate hair-like cells called cilia in the cochlea. The electrical impulse then travels along the auditory nerve (8th nerve) to the brain.
A problem at any point along this transmission can result in hearing loss. The actual type of hearing loss is determined by discovering which part of the ear is not functioning properly.
If you notice a change in your hearing, ability to understand people in noisy situations or ringing in the ears, or if you notice these things in someone you know, it is important to have or recommend a hearing evaluation by a certified audiologist, or seek the care of an ENT physician – request an appointment today.
Indications Of Hearing Loss
Typically, hearing loss occurs very gradually, first in the high pitches, over a period of years, making it difficult for the patient to notice at first by the patient. Difficulty understanding people in noisy situations is often the first obvious sign of hearing loss. Many people refer to this condition as “an understanding problem” rather than a hearing problem because the patient can still hear some low and middle frequencies just fine. Ringing in the ears, especially when things are quiet, is another common noticeable sign of hearing loss.
If you or someone you know experience any of the symptoms listed below, it is important to consult a doctor of audiology to assess the situation and determine the best next steps. Early treatment is critical for optimal results. Indications of hearing loss may include:
- Ringing or roaring in the ears, especially in a quiet situation
- Difficulty hearing or understanding others in the presence of background noise
- Hearing a person speak, but not fully understanding all of the words
- The need to frequently ask others to repeat themselves
- The feeling that others are mumbling when they are talking
- Avoidance of social settings and withdrawal from conversations
- The need to increase the volume of the radio or TV to a level that causes others to complain
- Difficulty talking on the telephone because the volume is not loud enough
Hearing should also be tested and assessed in most instances if you or another experiences any of the following:
- Pain in the ear lasting for more than a day
- Sudden onset of hearing loss or a plugged ear
- Unexplained dizziness
- A sensation of pressure or fullness in your ears
- Chronic ear infections
- Delayed speech and language in children
- Family history of hearing loss
- Recent trauma to the ear
- Recent drainage from the ear
Types Of Hearing Loss
The ear is made up of three sections: the outer ear, the middle ear and the inner ear. Loss of hearing can be the result of a problem in any one of these three parts of the ear. Most often the type of hearing loss is directly related to the part of the ear where the problem originated.
Sensorineural hearing loss – Also referred to as “nerve deafness,” this type of hearing loss is a result of damage to or deterioration of the inner ear and/or auditory nerve. Common causes include age, genetic predisposition, medications, abnormal development, noise exposure, tumors and infections. Sensorineural hearing loss most often occurs in older patients, but it can appear at any age, even in children and newborns. Although hearing aids are typically used to treat sensorineural hearing loss, steroids, antibiotics and/or surgery may also be needed for some patients.
Conductive hearing loss – This hearing loss occurs in the outer ear or middle ear. It usually results from a blockage in the ear’s auditory pathway. This blockage prevents sound waves from reaching the eardrum, causing it not to properly vibrate. Or it prevents vibrations from being conducted through the ossicles (middle ear bones) to the inner ear. This blockage is usually caused by earwax, foreign bodies, fluid, a perforation of the eardrum, fused or stuck bones in the middle ear, or growths or scar tissue in the middle ear. Typically, conductive hearing loss can be treated using hearing aids, ear wax removal, medications and/or surgery to correct the mechanical problem.
Otitis media – A frequent cause of conductive hearing loss, especially in children, is otitis media. With this condition, ear swelling and obstruction of the eustachian tube causes inflammation of the middle ear (otitis media), which prevents the eardrum from vibrating properly – learn more about ear infections and treatment options.
Mixed hearing loss – This type of hearing loss is a combination of both sensorineural and conductive hearing loss. Mixed hearing loss can usually be treated in a wide variety of ways. Our team of audiologists and otolaryngologists at CornerStone Ear, Nose & Throat work closely with each patient to determine the best course of treatment in cases of mixed hearing loss. Often a strategy must be developed to lay out the safest and most beneficial approach, especially when the hearing loss is not symmetrical (the same on both sides).
Testing For Hearing Loss
Since the various parts of the ear all play vital roles in the hearing process, determining the cause of hearing loss usually requires a comprehensive hearing evaluation that may include tympanometry as well as air and bone conduction pure tone audiometry (hearing testing).
Tympanometry – This test examines the tympanic membrane that divides the outer ear and middle ear. Measuring the movements of the tympanic membrane as it responds to pressure allows our audiologist to create a graph called a tympanogram. This process helps to determine if there is fluid or infection in the ear, a tear or hole in the eardrum, or a problem with the eustachian tube, which connects the throat and nose to the middle ear.
Air and bone conduction pure tone audiometry – During an air conduction hearing test, also referred to as pure tone testing, the patient listens to a series of single-frequency tones so the audiologist can determine the softest sound that the ear can detect. If the results of this test indicate hearing loss, a bone conduction test is usually performed as well. During the bone conduction test, a small vibrator is placed behind the ear and sound is transmitted through the bones of the skull directly to the cochlea of the ear being tested. There is no pain associated with this test. Results of these two tests help to determine where the problem originates in the ear, as well as the severity of the hearing loss and the type of hearing loss.