Health and Wellness

Hearing Loss Assessment, Causes, and Treatment


Sunday, May 01, 2011

The sense of hearing is a complex process of picking up sound and attaching meaning to it. The human ear does this by using all three of its parts – the outer ear, the middle ear and the inner ear. If any part is damaged or missing, hearing loss can occur. The following three paragraphs describe all three parts of the ear and how they work.

The outer ear consists of the ear canal and eardrum, also called the tympanic membrane. Sound travels through the canal and strikes the eardrum causing it to move or vibrate.

The middle ear is the space behind the eardrum that contains three tiny bones that connect the eardrum to the inner ear. Vibrations from the eardrum pass through the three middle ear bones to the inner ear.

The inner ear or cochlea contains our hearing organ. Tiny structures within the cochlea called hair cells change sounds into electric signals. These signals are sent to the brain via the hearing nerve. The brain then interprets these electrical signals as sound and meaning. 

Types and Causes of Hearing Loss

Hearing loss can be in one or both ears and is described by degree and type. It also can occur at specific frequencies. Degree of hearing loss refers to the severity of the loss and is categorized from mild to profound. The two types of hearing loss are:

Conductive hearing loss occurs when the outer ear canal, eardrum, or middle ear bones are blocked or damaged. Conductive hearing loss results in a reduction of sound volume. Some causes of the loss include middle ear infections or wax blockage within the ear canal. Treatment options include medication, surgery and/or hearing aids.

Sensorineural hearing loss occurs when there is damage to the inner ear or to the nerve pathways to the brain. Sensorineural hearing loss affects sound level and speech clarity. Some causes of the loss include heredity/genetics, loud noise exposure, viruses, and aging. Depending of the degree of loss, sensorineural hearing loss is most often treated with hearing aids. It cannot be medically or surgically corrected.

Who is affected by hearing loss?

According to the Center for Hearing and Communication, nearly 38 million people in the United States (approximately one in every 10 Americans) have a hearing problem. Research shows that 30 percent  to 40 percent of people older than 60 have some type of hearing loss and that hearing loss among seniors is the third most common health problem in the country behind arthritis and hypertension. 

Untreated hearing loss can lead to avoidance or withdrawal from social situations, loneliness, reduced earning potential and alertness, increased risk to personal safety, and impaired memory. Some research has shown a connection between hearing loss and dementia.   

Among children in the United States, 15 percent have some degree of hearing loss. Such a condition can cause problems with speech and language development, emotional difficulties and low self-esteem, and learning and behavior problems in school.

What are Hearing Aids?

While there are medical and surgical treatments for some hearing loss, the majority are treated with hearing aids, which are small electronic devices that amplify and alter sound to make up for damaged or non-working parts of the ear.  There are many types and styles of hearing aids but all have similar basic parts: a microphone to pick up sound, an amplifier to make the signal louder, a speaker to direct the amplified sound into the ear, and a battery to power all parts of the aid. Many digital hearing aids also change sounds, like background noise, so that other sounds, like speech, are easier to understand. Modern hearing aids may include many options to ease listening such as:

  • Directional microphones – a multiple microphone system is designed to pick up sounds coming in front of you and reduce some sounds coming from behind or beside you. Their purpose is to improve your ability to hear when around excessive background noise. 

  • Feedback control - software within the hearing aid’s digital chip that reduces hearing aids from squealing in the ear.

  • Bluetooth technology – wireless technology that transmits signals from electronic devices, such as cell phones and television, directly through your hearing aids.

Using hearing aids successfully requires patience, time, effort and realistic expectations. Hearing aids cannot restore a person’s hearing to “normal” nor can they cure a hearing problem. Adjusting to hearing aids is a gradual process requiring you to becoming accustomed to hearing sounds you might not have heard in many years. Once mastered, hearing aids can reconnect you to an active, enjoyable, and rewarding life.  

Hearing Loss Prevention

High noise exposure is one of the most common causes of hearing loss. A single shot from a shotgun, fired at close range, can permanently damage your hearing. Repeated exposure to loud noises (e.g. machinery) for many years can lead to hearing problems. In general, noise is dangerous if:

  • You have to shout over background noise to be heard

  • It is painful to your ears

  • It makes your ears ring

  • You have decreased or muffled hearing for several hours after exposure

Hearing loss prevention begins with hearing protection. Limit exposure time to noisy activities, wear hearing protection such as earmuffs or earplugs, and turn down the volume of televisions, radios and iPods.

Identifying hearing loss

How do you know if you or your loved one truly has a hearing problem? Asking the following questions can help.

  • Do people seem to mumble or speak in a soft voice?

  • Do you feel tired or irritable after a long conversation?

  • Do you sometimes miss key words in a sentence?

  • Do you frequently need to ask people to repeat themselves?

  • Do you have difficulty understanding conversations in a crowded room?

  • Do you often turn the volume up on the TV or radio?

  • Does background noise bother you?

  • Is it sometimes hard to hear telephone conversations?

  • Do you sometimes not hear the doorbell or telephone ring?

  • Are your family or friends complaining about your hearing?

If you answered yes to two or more of these questions, schedule a hearing test with one of our audiologists at the Baton Rouge Clinic by calling our ENT department at (225) 246-4478.

Baton Rouge Clinic ENT physicians can fully assess hearing loss and any underlying, co-existing conditions, and where and when appropriate, recommend further evaluation and/or hearing aids that best fit your lifestyle.

Charlotte Moreau, Au.D., CCC-ACharlotte Moreau, Au.D.
Clinical Audiologist