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Hearing Loss

What Causes Hearing Loss?

Hearing loss can occur due to several factors such as the aging process, exposure to loud noise, medication side-effects, infections, head or ear trauma, congenital (birth) or genetic factors, diseases, as well as a number of other causes.

Recent data shows that about 20% of adults in the United States (around 48 million people) report some degree of hearing loss. Hearing loss often occurs gradually throughout a lifetime.

Types of Hearing Loss

Sensorineural Hearing Loss

When the problem is in the inner ear, a sensorineural hearing loss is often a result. This commonly occurs from damage to the small hair cells or nerve fibers in the ear.

Sensorineural hearing loss is the most common type of hearing loss and accounts for more than 90% of hearing loss. Loss may result from disturbance of inner ear circulation, increased inner ear fluid pressure, or disturbances of nerve transmission. There are many excellent options for a patient with sensorineural hearing loss.

Conductive Hearing Loss

When there is a problem in the external or middle ear, a conductive hearing impairment occurs.

Conductive hearing loss happens when sound is not conducted efficiently through the ear canal or to the eardrum, resulting in a reduction of the loudness of the sound as it is heard.

Conductive losses may result from earwax blocking the ear canal, fluid in the middle-ear, middle-ear infection, obstruction of the ear canal, perforation (hole) in the eardrum membrane, or disease of any of the three middle ear bones. All conductive hearing losses should be evaluated by a physician to explore medical or surgical options.

Mixed Hearing Loss

When there are problems in the middle ear and inner ear, mixed hearing impairment is the result (i.e conductive and a sensorineural impairment).

Auditory Neuropathy Spectrum Disorder (ANSD)

The least common hearing impairment is ANSD. This type of loss requires more in-depth diagnostic testing, including a hearing evaluation with pure tones, otoacoustic emissions (OAEs) and auditory brain stem response (ABR) testing.

In this type of hearing loss, the nerve fibers in the ear typically appear to be functioning well, but a breakdown of the information occurs along the pathway to the brain. A person may still have normal testing, but the sound is not encoded properly in the brain.

This type of hearing disorder is diagnosed more often in children, due in part to newborn hearing screenings that use automated ABR equipment and routine speech screenings by pediatricians and school systems. However, ANSD can be present in adults, as well.

How Do I Know if I Have Hearing Loss?

If you think you or a loved one may have hearing loss, you are not alone. Often people notice signs of hearing loss but do not take the steps to get it treated right away. Typically, it takes people an average of seven years to seek treatment. You may have hearing loss if:

Words seem more difficult to understand.

Asking others to repeat what they have said.

Not laughing at jokes due to missing the punchline.

Complaining about other people mumbling.

Asking about details that had already been described.

Listening to the TV much louder than others.

An inability to hear a doorbell or phone ringing.

Watching mouths to read words from lips.

An inability to hear the sounds of birds chirping or wind blowing.

Avoiding noisy environments.

Experiencing a constant ringing in your ears.

What are the Different Degrees of Hearing Loss?

After you undergo a hearing evaluation, the results are plotted on a chart called an audiogram. Loudness is plotted from top to bottom where the top of the graph is very quiet, and the bottom of the graph is very loud. Frequency, or pitch, from low to high, is plotted from left to right. Hearing level (HL) is measured in decibels (dB) and is described in general categories, not by percentages. The general hearing loss categories used by most hearing professionals are as follows:

  • Normal hearing: (0-25 DB)
  • Mild hearing loss (26-40 DB)
  • Moderate hearing loss (41-70 DB)
  • Severe hearing loss (71-90 DB)
  • Profound hearing loss ( >91 DB)

How is Hearing Loss Diagnosed?

If you have any symptoms of hearing loss, you should see a hearing instrument specialist to have a formal hearing evaluation. This hearing test allows the hearing instrument specialist to determine the type, nature, and degree of your hearing loss and provide an indication as to how successful a candidate you will be for hearing aids.

The hearing evaluation will also include a thorough case history and a visual inspection of the ear canal and eardrum. The results of the evaluation can be useful to a physician if the hearing instrument specialist believes your hearing loss may benefit from medical intervention.

Results of the hearing evaluation are plotted on a graph called an audiogram. The audiogram provides a visual view of your hearing test results across various pitches or frequencies, especially the ones necessary for understanding speech.

The audiogram and results from your speech understanding tests are used to create a prescription by which hearing aids are programmed, if necessary.

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