Hearing

Hearing refers to the awareness of sounds and placing meaning to those sounds. It involves a series of steps in which several parts of your ear and nervous system work together so you can understand sounds. The part where you understand is called auditory perception.

Hearing helps you stay aware of your surroundings and connect with the world around you. This is why it’s important to protect your hearing as best as you can.

What are the parts of my auditory system?

Your auditory (hearing) system consists of many different parts, including your:

• Outer ear: Your outer ear is made up of the visible external part (pinna) and your ear canal.
• Middle ear: Your middle ear consists of your eardrum and three tiny bones called ossicles.
• Inner ear: Your inner ear contains a spiral cavity — the cochlea — that’s lined with sensory cells (often called hair cells).
• Auditory nervous system: This system includes your auditory nerve, which connects the sensory cells in your cochlea to your brain, and the parts of your brain that perceive sound.

How does hearing work?

Your hearing process involves all the parts of the auditory system mentioned. Here’s how they work together:

1. Sound waves from the environment travel through your ear canal and strike your eardrum, causing it to vibrate.
2. The vibrations travel from your eardrum to the ossicles.
3. Your ossicles carry the sound vibrations to your cochlea, within your inner ear.
4. The sensory cells (hair cells) inside your cochlea encode the sound and send signals to your auditory nerve.
5. Your brain receives the signals from your auditory nerve and translates them into sound perception. In other words, your brain is where your sense of hearing comes to life.

Think of the hearing process as a journey, where vibrations in the air eventually become signals your brain can understand and attach meaning to. A sharp sense of hearing requires all parts to work properly.

What conditions can impact my hearing?

Diseases, injuries and even medicines can affect your hearing. Any of the following can harm your auditory system:

• Aging: Hearing weakens as you grow older. Lots of factors can contribute to age-related hearing loss.
• Trauma: Pushing cotton swabs or other objects into your ear can lead to a torn eardrum. Head injuries can damage the structures of your middle and inner ear or the parts of your brain that deal with hearing.
• Diseases: Cardiovascular disease and diabetes can increase your risk of hearing issues by decreasing the blood supply to your auditory system. Infections can also cause damage.
• Tumors: Growths in any part of your auditory system can interfere with your hearing.
• Medication: Some medicines can cause inner ear damage as a side effect. This is called ototoxicity.
• Sound exposure: Noise-induced hearing loss happens when exposure to loud sounds damages the sensory hair cells inside your inner ear. It can happen suddenly or over time. Once they’re damaged, these cells don’t grow back. This is a big reason why hearing fades as we age.
• Earwax buildup: Earwax in your ear canal is normal and healthy. But an earwax blockage can cause hearing loss, ringing in your ears and other symptoms.

Signs that something isn’t working right

See a hearing care specialist if you notice any changes in your hearing or your ability to understand others. Hearing loss can occur over time, so it’s a good idea to have your hearing tested on a regular basis. This is especially true if you have a family history of hearing loss.

Visit a hearing care provider right away if you have sudden hearing loss in one or both ears. In cases of sudden sensorineural (inner ear) hearing loss, getting care within the first 72 hours is the best way to reduce your risk of permanent hearing loss.

How can I keep my hearing healthy?

There are many easy things you can do to protect your ears and your hearing, such as:

• Wear hearing protection, like earplugs or earmuffs, during loud activities.
• Keep the volume at a safe level when listening to music or the TV.
• Avoid sticking objects in your ear, like cotton swabs, to clean out earwax.
• Work with your healthcare provider to manage diseases that can impact your hearing.
• Get your hearing tested regularly, especially after age 60. Most hearing care professionals recommend an annual hearing test.