Hearing loss is one of the most common conditions affecting adults. Approximately 17 percent, or 36 million, of American adults say that they have some degree of hearing loss ranging from a mild loss in which a person misses certain high-pitched sounds, such as the voices of women and children, to a total loss of hearing. Hearing loss can be a sudden or gradual decrease in how well you can hear and can be hereditary, a result of disease, trauma, certain medications, or long-term exposure to loud noises. Depending on the cause, it can be mild or severe, temporary or permanent. You can’t reverse hearing loss; however, through a better understanding of the ear, hearing loss, and the signs of hearing loss combined with the expertise and guidance of our audiologists and ENT specialists, you can take steps to improve what you hear.

How the Ear Works

There are three parts to the ear: the outer, middle, and inner ear. Each part plays its own unique role in hearing.

The outer ear includes the pinna, ear canal, and eardrum. Sound is channeled in to the middle ear via these structures. The design of the pinna, or outermost visible part of the ear, is to gather sound waves and direct them down the canal towards the eardrum.

The middle ear is comprised of the three smallest bones of the human body. When sound reaches the eardrum (tympanic membrane or TM), the eardrum vibrates which in turn causes movement of the tiny bones in the middle ear, also known as ossicles. The sound is then mechanically transmitted through to the inner ear.

The inner ear converts the sound to an electrical impulse. The movement of the ossicles causes movement of inner ear fluid, stimulating hair-like cells called cilia in the cochlea. This 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 type of hearing loss present is determined by which part of the ear is not functioning properly. This can only be determined by a comprehensive hearing evaluation, including tympanometry and air and bone conduction testing.

Types and Causes of Hearing Loss

There are three types of hearing loss: sensorineural, conductive, and mixed. The type of hearing loss is determined by where the deficit lies in the hearing system. The only way to determine the type of hearing loss that exists is by getting a comprehensive hearing examination including air and bone conduction audiometry.

Sensorineural hearing loss results from damage to the inner ear (cochlea) and/or the auditory nerve. This is a common type of hearing loss as we get older but can occur at any age and in children. There are many causes of sensorineural hearing loss including age, genetic predisposition, medicines, abnormal development, noise exposure, tumors, and infections. Sensorineural hearing loss is typically treated with hearing aids, but occasionally antibiotics, steroids, or even surgery is necessary.

Conductive hearing loss is a blockage of the sound from being conducted along the auditory pathway. The hearing loss is typically generated in the outer or middle ear, meaning the cochlea and the hearing nerve underneath are working properly but do not receive adequate signal/sound transmissions. Causes of conductive hearing loss include wax, middle ear fluid, disease, and abnormal middle ear bones. This is usually a problem with the middle ear or outer ear and is treated by hearing aids, surgery, wax removal, or medicines.

Mixed hearing loss is a combination of sensorineural and conductive type hearing losses. This hearing loss can be treated a number of different ways. CornerStone’s healthcare providers will discuss all your treatment options with you.

Signs That You May Have Hearing Loss

Hearing loss often comes on very gradually. This makes it difficult to notice the problem in the early stages. People with hearing loss often learn to adapt to their environment and attempt to conceal their condition. If you or someone you know are showing signs of hearing loss, as outlined below, it is vital to seek a consultation with a certified audiologist for the appropriate intervention and management.

Signs that you may have hearing loss

  • Ringing or roaring in the ears
  • Increasing the volume of the radio or TV to the point that others complain
  • Difficulty hearing in background noise
  • The need to frequently ask others to repeat themselves
  • Hearing conversation but not understanding it
  • Feeling that people are mumbling when they are talking
  • Avoiding social settings and withdrawing from conversations
  • Avoiding talking on the telephone because the volume is inadequate

Other reasons to have your hearing tested include

  • Pain in the ear
  • Sudden onset hearing loss
  • Unexplained dizziness
  • Pressure or fullness in your ears
  • Chronic ear infections
  • Delayed speech and language in children
  • Family history of hearing loss