How do I know if I have hearing loss?

Hearing loss occurs to most people as they age. Hearing loss can be due to the aging process, exposure to loud noise, certain medications, infections, head or ear trauma, congenital (birth or prenatal) or hereditary factors, diseases, as well as a number of other causes. A survey done in 2008 showed that there were 35 million people in the USA with hearing loss. Hearing loss is the single most common birth ‘defect’ in America. Hearing loss in adults, particularly in seniors, is common.

You may have hearing loss if:

  • You hear people speaking but you have to strain to understand their words.
  • You frequently ask people to repeat what they said.
  • You don’t laugh at jokes because you miss too much of the story or the punch line.
  • You frequently complain that people mumble.
  • You need to ask others about the details of a meeting you just attended.
  • You play the TV or radio louder than your friends, spouse and relatives.
  • You cannot hear the doorbell or the telephone.
  • You find that looking at people when they speak to you makes it easier to understand.

If you have any of these symptoms, you should see a hearing care professional to get an ‘audiometric evaluation.’ An audiometric evaluation (AE) is the term used to describe a diagnostic hearing test, performed by a licensed hearing care professional. An AE is not just pressing the button when you hear a ‘beep.’ Rather, an audiometric evaluation allows the hearing care professional to determine the type and degree of your hearing loss, and it tells the professional how well or how poorly you understand speech. After all, speech is the single most important sound, and the ability to understand speech is extremely important. The AE also includes a thorough case history (interview) as well as visual inspection of the ear canals and eardrum. The results of the AE are useful to the physician should the hearing aid consultant conclude that your hearing problem may be treated with medical or surgical alternatives.

What Are The Different Degrees/Types Of Hearing Loss?

Results of the audiometric evaluation are plotted on a chart called an audiogram. Loudness is plotted from top to bottom. Frequency (pitch), from low to high, is plotted from left to right. Hearing loss (HL) is measured in decibels (dB) (intensity) and is described in general categories. Hearing loss is not measured in percentages. The general hearing loss categories used by most hearing professionals are as follows:

  • Normal hearing (0 to 25 dB HL)
  • Mild hearing loss (26 to 40 dB HL)
  • Moderate hearing loss (41 to 70 dB HL)
  • Severe hearing loss (71 to 90 dB HL)
  • Profound hearing loss (greater than 91 dB HL)

Types of Hearing Loss

The external and the middle ear conduct and transform sound; the inner ear receives it. When there is a problem in the external or middle ear, a conductive hearing impairment occurs. When the problem is in the inner ear, a sensorineural or hair cell loss is the result. Difficulty in both the middle and inner ear results in a mixed hearing impairment (i.e. conductive and a sensorineural impairment). Central hearing loss has more to do with the brain than the ear, and will be discussed only briefly.

Conductive hearing loss occurs when sound is not conducted efficiently through the ear canal, eardrum, or tiny bones of the middle ear, resulting in a reduction of the loudness of sound that is heard. Conductive losses may result from earwax blocking the ear canal, fluid in the middle ear, middle ear infection, obstructions in the ear canal, perforations (hole) in the eardrum membrane, or disease of any of the three middle ear bones.

A person with a conductive hearing loss may notice that their ears may seem to be full or plugged. This person may speak softly because they hear their own voice quite loudly. Crunchy foods, such as celery or carrots, sound very loud and this person may have to stop chewing to hear what is being said. All conductive hearing losses should be evaluated by a physician to explore medical and surgical options. Conductive hearing loss represents approximately 10% of all hearing losses.

Sensorineural hearing loss is the most common type of hearing loss. More than 90 percent of all hearing aid wearers have sensorineural hearing loss. The most common causes of sensorineural hearing loss are age related changes to hearing and noise exposure. A sensorineural hearing loss may also result from disturbance of inner ear circulation, increased inner fluid pressure or from disturbances of nerve transmission. Sensorineural hearing loss is also called ‘cochlear loss,’ an ‘inner ear loss’ and is also commonly called ‘nerve loss.’ Years ago, many professionals said there was nothing that could be done for sensorineural hearing loss – that is totally incorrect today. There are many excellent options for the patient with sensorineural hearing loss.

A person with a sensorineural hearing loss may report that they can hear people talking, but they can’t understand what they are saying. An increase in the loudness of speech may only add to their confusion. This person will usually hear better in quiet places and may have difficulty understanding what is said over the telephone.

Central hearing impairment occurs when auditory centers of the brain are affected by injury, disease, tumor, hereditary, or unknown causes. Loudness of sound is not necessarily affected, although understanding of speech, also thought of as the ‘clarity’ of speech may be affected. Certainly both loudness and clarity may be affected too.

Sensorineural Hearing Loss

Sensorineural Hearing Loss

Conductive Hearing Loss

Conductive Hearing Loss

Mixed Hearing Loss

Mixed Hearing Loss

What Are The Negative Effects Of Hearing Loss?

Many people delay in seeking help for their hearing loss because they think it is insignificant and others won’t notice. They think they can deal with it by simply turning up the TV volume or asking friends to repeat themselves. The fact is, research has linked untreated hearing loss to significant issues such as:

  • Irritability, negativism and anger
  • Fatigue, tension, stress and depression
  • Avoidance or withdrawal from social situations
  • Social rejection and loneliness
  • Reduced alertness and increased risk to personal safety
  • Impaired memory and ability to learn new tasks
  • Reduced job performance and earning power
  • Diminished psychological and overall health