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Hearing Loss
Causes and types of hearing loss
Do you think people mumble a lot? Do others complain about the volume of your radio or television? Do you have difficulty hearing the minister at church or the cashier at the grocery store? Does your family complain that you are not paying attention? Do you feel isolated from society because you miss out on conversations? You may have a hearing loss. You are not alone:
Facts about hearing loss (from the Better Hearing Institute)
- 3 in 10 people over age 60 have hearing loss
- 1 in 6 (14.6%) baby boomers (ages 41-59) have a hearing problem
- 1 in 14 (7.4%) Generation Xers (ages 29-40) already have a hearing loss
- At least 1.4 million children (18 or younger) have hearing problems
- It is estimated that 3 in 1,000 infants are born with serious to profound hearing loss
Myths about hearing loss (from the Better Hearing Institute)
- Minor surgery will fix my hearing loss: Only some types of hearing loss can be treated surgically. Only 5-10% of adult onset hearing loss is medically treatable.
- My one ear is better than the other ear, so I don’t need to worry about hearing loss: Asymmetrical hearing loss may relate to a serious medical condition. You should be evaluated for this condition.
- I’m not “old” yet, so I don’t have hearing loss: Hearing loss affects people of all ages and does not discriminate. Only 35% of individuals with hearing loss are older than 64 years. In the Unites States alone, almost six million people between 18 and 44 years have some degree of hearing loss. More than one million school age children have hearing loss.
- My family doctor would tell me if I had a hearing problem: Only 14% of physicians routinely screen for hearing loss during a physical. Because a doctor’s office is quiet, well lit, and conversation is one-on-one, most individuals with a hearing loss perform fairly well. Your doctor may not even know you have a hearing problem.
- My hearing loss is normal for my age: Many other health issues are “normal” for the situation too, like overweight people having high blood pressure. But the high blood pressure needs to be treated or the person’s health will be at risk. Your hearing and communication ability, which is critical for nearly every activity in which you participate, should receive treatment too.
- There is no help for hearing loss/hearing aids don’t work: While this may have been true in the past, modern advances in hearing aid technology means that nearly 95% of people with a sensorineural hearing loss can receive benefit from hearing aids.
Causes and types of hearing loss
Hearing loss can result from a number of different conditions including Meniere’s disease, otosclerosis , cholesteotoma , or a tumor growth. Hearing loss can also be associated with loud noise exposure, genetic causes, or it may not be a direct result of one individual event. Only your physician, through a complete hearing evaluation will be able to determine the exact cause of your hearing loss. As we live in a noisy society, constant exposure to noise can contribute to a slow progression of hearing loss. Prevention is the best defense against hearing loss. Hearing loss is divided into three main categories: conductive hearing loss, sensorineural hearing loss and mixed hearing loss.
Conductive hearing loss results from some mechanical problem in the external or middle ear. A cerumen (wax) blockage can cause problems as well as a perforation of the eardrum. Additionally, the three bones of the ear (ossicles) may be disconected or stiffened and cannot conduct sound to the cochlea normally. Other problems may be caused by fluid (infected or not infected) in the middle ear. These problems can often be corrected medically or sugically and are typically not permanent.
Sensorineural hearing loss results from a problem in the inner ear (sensory) and/or hearing nerve (neural). The inner ear (cochlea) has thousands of hair cells that transmit sound through the ear. When they are injured, hearing loss can occur. Beyond the level of the cochlea lies the hearing nerve. If this nerve is damaged, transmission of the sound to the brain is affected and a neural hearing loss is present. Sensorineural hearing loss is often permanent and cannot be reversed medically or surgically.
A mixed hearing loss is a combination of a conductive hearing loss and a sensorineural hearing loss. For example, a person has a hearing loss and then develops an ear infection. Medical treatment can resolve the infection, but the sensorinerual loss will remain unchanged.
In order to determine the type, degree and configuration of the hearing loss, a complete audiological evaluation is needed.
Hearing is measured in decibels (dB), not percentage, and testing focuses on the areas of hearing critical to speech understanding. The level of hearing loss ranging from mild to profound, coupled with the configuration of the hearing loss (equal loss across pitches vs. good hearing in the low frequencies and poorer hearing in the high frequencies, etc.), means that two individuals can have the same degree of hearing loss, but different abilities to interpret and understand speech.In many cases, amplification or hearing aids are able to provide the individual with adequate access to sound to help them hear in both quiet and noisy places. When hearing aids are not enough, a cochlear implant may be appropriate.
Audiogram of familiar sounds
Communication guidelines
There are a few simple rules that both the listener (the person with the hearing loss) and the speaker can follow to facilitate communication, whether or not the hearing-impaired individual is wearing a hearing aid.
Hard of Hearing Listeners
- Pick the best spot to communicate by avoiding areas that are poorly lit and very noisy.
- Do not bluff!
- Pay attention to the speaker.
- Provide feedback that you understand or fail to understand.
- Look for visual clues to what is being said.
- Anticipate difficult situations and plan how to minimize problems.
- Tell others how best to talk to you.
- Provide feedback to speakers by saying how well they are doing.
- Arrange for frequent breaks if discussions or meetings are long.
- Ask for written clues of key words if needed.
- The person who begins a conversation must go to the listener.
Speakers
- Get the person’s attention before you speak.
- Speak clearly and at a moderate pace.
- Don’t shout.
- Avoid noisy background situations.
- Rephrase when you are not understood.
- Give clues when changing the subject.
- Use facial expressions and gestures.
- Be patient, positive, and relaxed.
- Don’t put objects in front of your face.
- Do not have objects in your mouth such as gum, cigarettes, or food.
- When in doubt, ask the hard of hearing person for suggestions to improve communications.
- The person who begins a conservation must go to the listener.