How do we hear?
The outer ear collects and directs sound into the ear canal. The sound causes the eardrum to vibrate and these vibrations are sent to the middle ear. The middle ear is an air-filled space that contains three tiny bones. These bones provide a lever action and direct the sound into the inner ear. The inner ear is a fluid-filled space that contains thousands of tiny specialized cells called hair cells. These hair cells send electrical impulses that travel along the hearing nerve. The brain then "reads" the impulses, and the individual perceives sound.
What is hearing loss?
Hearing loss is any alteration of hearing capacity. Hearing loss can be mild, moderate, severe, profound, or total. In addition, hearing loss can be classified as conductive, sensorineural, mixed, or central. Conductive and sensorineural hearing loss are the two most common types of hearing loss.
What is a conductive hearing loss?
A conductive hearing loss may result from blockage of the outer ear canal, a perforation (hole) in the eardrum, a middle ear infection, or a disease of any of the three middle ear bones. This type of impairment is often correctable through medical and/or surgical intervention. A person with a conductive hearing loss may notice a full or plugged sensation in the ears. With this type of impairment, a person hears quite well if the sound is loud.
What is a sensorineural hearing loss?
A sensorineural hearing loss may result from disturbance of inner ear circulation or fluid pressure or from disturbances of nerve transmission. The most common cause of sensorineural impairment is an age-related change in the inner ear or in the nerve endings. This hearing loss is often referred to as "nerve damage." This type of impairment is not medically or surgically correctable, but rarely leads to deafness. Sensorineural impairment can almost always be helped with use of hearing aids.
A person with a sensorineural hearing loss may be able to hear people talking, but have difficulty understanding what is being said. Increasing the loudness of speech may not always provide a clear and easily understood message. Hearing is usually better in quiet places and when the speakers are face-to-face.
Who gets a hearing loss?
Anyone of any age can have a hearing loss although it is more common in older adults. One in ten Americans has a hearing loss.
What are the most common signs of a hearing loss?
People with a hearing loss often:
- Complain that people are mumbling
- Have difficulty hearing when background noise is present
- Ask people to repeat themselves
- Have difficulty hearing in group situations
- Have difficulty hearing when not facing the talker
- Say that the TV/radio/telephone is not clear
- Disagree over TV volume level
- Are impatient, frustrated, withdrawn
Who should I see if I have a hearing loss?
The first step is to have your hearing evaluated. An audiologist, a professional who specializes in evaluating and treating hearing loss, will use sophisticated tests to determine the type and degree of your hearing loss and its impact on your ability to communicate.
Obtaining medical clearance from your physician is in your best interest. The physician determines that your hearing cannot be improved by medical or surgical treatment. Before you can be fitted for hearing aids, you must obtain a written statement from your physician. (In some institutions, a medical waiver is accepted for individuals over the age of 18 years.)
If I'm interested in hearing aids, what are the actual steps I need to take?
- Audiologic evaluation, which will assess:
- Pure tone thresholds
- Word recognition ability in a quiet setting
- Assessment of middle ear function
- Assessment of hearing handicap
- Medical clearance:
- Physician verifies hearing loss is not medically/surgically treatable
- Rules out contraindications for using amplification
- Hearing aid evaluation
- Options in style and technology
- Assessment of communication needs
- Ear impressions
- Hearing aid ordered
- Hearing aid fitting
- Verify good physical fit
- Verify expected benefit
- Orientation and counseling
- Follow-up
- Address any questions or problems
- Make any necessary adjustments
- Counseling
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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 8/22/2008...#6432
