Hearing can be one of life’s greatest pleasures. Whether it’s
an evening at the symphony with your spouse, a dinner party with your
oldest friends, or a tea party with your granddaughter, you stand to
miss out on a lot if your hearing is impaired. Indeed, accurate hearing
is essential to full participation in every aspect of life: social,
occupational, familial…even personal. If you think you may have
a hearing loss, you are in good company. The sad fact is about 1 in
every 10 Americans struggle with their hearing, according to the National
Institute on Deafness and Other Communication Disorders (NIDCD). That’s
34 million persons in the U.S. suffering from hearing loss right now.
As sobering as that sounds, there is good news. The technology available
to help people overcome hearing loss is more advanced than ever, and
our procedures for identifying areas of loss and fitting instruments
to compensate for the loss are more accurate than ever before.
There two main types of hearing loss: Conductive and Sensorineural.
They both have to do with a failure to transfer sound along the path
from the outer ear to the brain’s hearing centers.
In the case of Conductive hearing loss, the transmission of sound
through the outer and/or middle ear is limited because of disease
or disorder. The most common treatments are medical and surgical for
this type of loss, but in some cases hearing aids can be effective
Failure to fully or accurately transmit sound through the inner ear
(cochlea) or along the neural pathways is called Sensorineural hearing
loss. Usually the cause of this failure is damage to the interior
workings of the cochlea. Sound vibrations are transmitted through
the middle ear and into the cochlea, where they pass over and stimulate
minute hair cells. When damaged, these hair cells cannot accurately
convert sound vibrations into the neuro-electrical impulses that travel
through the auditory nerve to the brain. The result is a reduction
in perception and interpretation of the hearing impulses. This decrease
in hearing sensitivity is typically treated by carefully targeting
sound amplification with hearing instruments to compensate for damaged
Causes of sensorineural hearing loss can be congenital (present at
birth) or acquired (after birth). Congenital causes might include:
infections, prematurity, hereditary factors, or birth trauma. Acquired
causes include: overexposure to noise, ear infections, head injury,
disease (like meningitis or encephalitis), or a negative side effect
of some drugs.
of hearing loss is determined by a comprehensive hearing evaluation.
A comprehensive hearing evaluation will determine the softest levels
you can hear sounds of different pitches. These levels are called your
thresholds, and are measured in an intensity scale called “decibels
hearing level” or dB HL. Normal hearing is defined as thresholds
for all sounds within the 0 dB HL to 25 dB HL range. Degrees of hearing
loss are defined as follows:
Hearing Loss: Thresholds in the 26 dB–40 dB range.
People with a mild hearing loss have difficulty hearing and understanding
soft sounds and soft speech. Hearing aids are recommended when mild
hearing loss cannot be medically treated. A wide range of styles, including
some that are nearly invisible when worn, is available. New, open ear
hearing aid models offer benefits for people with mild and moderate
high frequency hearing loss.
Hearing Loss: Thresholds in the 41 dB–70 dB range.
With a moderate loss, conversations can be difficult to follow, especially
in noisy environments. People with moderate hearing loss often perceive
that other people are mumbling, because their hearing loss prevents
them from hearing speech clearly. Even in quiet environments, people
with moderate hearing loss find it hard to have a conversation in a
group of people, or if the person speaking has their back turned or
has a soft voice. They may often rely on visual cues or lipreading to
help fill in what they don’t hear, without even realizing it.
Hearing aids are recommended for moderate hearing loss that cannot be
medically treated. A wide range of styles is available.
Hearing Loss: Thresholds in the 71 dB–90 dB range.
People with severe hearing loss cannot hear soft or moderate sounds,
birds singing, or conversational speech. They require the person speaking
to them to use a very loud voice in order to hear speech at all. In
addition, when volume is increased, words or sounds may sound unclear
Hearing Loss: Thresholds greater than 90 dB. Profound
hearing loss is sometimes referred to as “deafness”. People
with profound hearing loss can typically only hear very loud environmental
almost all cases of severe and profound hearing loss, hearing aids or
cochlear implants are recommended.
While the causes,
types, and degrees of hearing loss vary, the symptoms of hearing loss
are essentially the same. People with hearing loss typically find
that the answer is “yes” to the following questions below.
• Do I hear but have a difficult time understanding?
• I hear sounds, but have trouble distinguishing words.
• I frequently have to ask people to repeat themselves.
• I have difficulty understanding conversations in restaurants
• My hearing keeps me from enjoying good times with friends
• I’m embarrassed by my hearing difficulties.
• I have to turn up the volume when watching the TV.
• I have particular trouble hearing the voices of women and
• I have trouble hearing at movies, concerts, church and in
If you answered
"yes" a few of these questions, you could have a hearing
loss. We invite you to schedule a free hearing
evaluation with us to determine the extent of your loss and identify
a treatment program. While not all hearing loss can be remedied, there
is a good chance our highly trained specialists can help you with
of Untreated Hearing Loss
Chances are, if you’re reading about hearing loss, you’ve
already been dealing with it for some time. Studies show, in fact,
that people with progressive hearing loss wait an average of 5-15
years before seeking treatment (1). During those years, some undesirable
Medically, the biggest problem with allowing hearing loss to go untreated
may be a condition known as Auditory Deprivation (2). When the neurons
that carry "hearing" signals to the brain experience prolonged
lack of stimulation because of damage to the hair cells, they degenerate
(similar to how an unused muscle, or your ability to play an unpracticed
musical instrument would degenerate). This leaves dead regions where
certain sound frequencies can no longer be interpreted. Even if these
areas are stimulated again through noise amplification, the brain
may no longer be able to interpret the noise. The result is a chronic
decrease in speech understanding. In other words, "use it or
lose it" applies to hearing too.
From a lifestyle point of view, hearing loss can create many negative
effects, both on the individual with loss, and his or her family,
friends, or work associates. Individuals with hearing loss are more
likely to experience:
irritation, or frustration at communication difficulties
• Feelings of inadequacy in everyday interactions
• Fear of being ridiculed, pitied, or appearing less intelligent
• Feelings of being prematurely old, handicapped, or abnormal
• Tendency to avoid social gatherings, outdoor activities,
even personal interactions
• Embarrassment at having to ask for repetitions or at not
• Physical fatigue from straining to hear
• Personal safety risks
The effects of
hearing loss on the friends, family, and associates of an individual
with loss might include:
• Relationship problems from misunderstandings. Someone with
hearing loss may answer a question inappropriately or not at all,
or may incorrectly hear requests, comments, or instruction leading
to undesired action or inaction
• Significant others may be required to interpret for the individual
with hearing loss causing stressful logistical and conversational
• Feelings of rejection or misunderstanding because of communication
• Feelings of guilt arising from not including an individual
with hearing loss in conversation or activities
• Feelings of resentment at not being able to enjoy certain
activities because of reclusive behavior of an individual with hearing
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