Frequently Asked Questions about Hearing Loss from our Patients

How do we hear?
Are there different types of hearing loss?
How is the degree of hearing loss measured?
What is loss of loudness vs. loss of clarity?
What are the symptoms of hearing loss?
What should I do if I think I have a hearing loss?
What are my hearing aid options?
What is an audiologist?

How do we hear?

Outer Ear:

Known as the pinna, the outer ear captures sounds from the environment and funnels them into the ear canal.

Middle Ear:

Sound waves travel down the ear canal and hit the eardrum. The eardrum vibrates and transfers the vibrations to the small bones in the middle ear (hammer, anvil and stirrup) which send the vibrations into the inner ear.

Inner Ear:

The vibrations are transferred into one of two parts of the inner ear, the Cochlea. The Cochlea is a snail shaped, fluid filled organ of sound. The vibrations move microscopic, finely tuned sensory cells which send impulses to the brain where sound is interpreted.

The other parts of the inner ear are the Semi Curricular Canals which is responsible for our balance system.

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Are there different types of hearing loss?

Hearing loss is typically divided into two categories: conductive and sensorineural.

  • Conductive - A conductive hearing loss is a problem in the outer and/or middle ear and affects the conduction of sound from the environment to the inner ear/organ of hearing. It can result from something as simple as wax occluding the ear canal to the build up of fluid behind the eardrum. A conductive hearing loss is usually medically or surgically treatable.
  • Sensorineural - A sensorineural hearing loss is a problem in the inner ear. It is permanent and can vary from mild to profound. The causes are numerous and can be the result of, for example, exposure to very loud sounds, the aging process, or genetics. Over 17 million Americans of all ages have this type of hearing loss.

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How is the degree of hearing loss measured?

In order to understand hearing loss, one must understand what “normal” hearing is. Normal hearing means a person can hear sounds at a variety of frequencies (pitches) around 0 – 20 decibels (dB HL). Normal conversational speech typically is at 45 dB HL. Loud speech is around 65dB HL, and sounds like a lawn mower is around 95 dB HL.

When someone has a hearing loss, it means that they have to have sounds louder than 20 dB before they can first detect it. We use the terms mild, moderate, severe and profound to describe the varying degrees of hearing loss.

  • Mild - A person with a mild hearing loss can hear normal speech, however, it will seem “faint.” If the speaker is far away from them or there is background noise, they will have more difficulty understanding what is being said.
  • Moderate - People with a moderate hearing loss will state that everyone mumbles since they won’t be able to hear all of the speech sounds. With increased volume, they will do better; however, the level of concentration required to participate in a conversation, especially in noise, is exhausting, and often leads to people avoiding social situations.
  • Severe – This is the level that most people think of when they think about hearing loss. None of the speech sounds are audible for a person with a severe hearing loss and they may require people to shout to be heard. A hearing aid will make many of the sounds audible, but the listener may need to watch the talker’s lip movements to supplement what they hear.
  • Profound - Speech is mostly inaudible even with a hearing aid for an individual with a profound hearing loss. With a hearing aid, the listener may only hear the low pitch speech sounds, such as vowels and the rhythm of speech. Amplified speech will not be clear and this person may benefit from a cochlear implant.

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What is loss of loudness vs. loss of clarity?

A sensorineural hearing loss is more than just a reduction in sound. It is also a reduction in clarity and speech understanding. The loss of clarity is due to missing or malfunctioning sensory cells in the cochlea. Think of the ear as a piano, and the sensory cells in the ear as the piano keys. If piano keys are missing or out of tune, the music will sound distorted. The sensory cells in the organ of hearing are responsible for converting sounds into a code that the brain can interpret. If sensory cells are missing or are not functioning properly, the code that reaches the brain is incomplete making speech unclear

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What are the symptoms of hearing loss?

If you answer ‘YES’ to more than one of the following questions, you may have a hearing loss and should consult your primary care physician about a referral to a licensed audiologist.

  1. Do voices seem soft or muffled?
  2. Do you have trouble hearing when it is noisy?
  3. Do you have trouble hearing and/or understanding what people say to you?
  4. Do you ask people to repeat what they say?
  5. Do you sometimes mishear or misunderstand what someone says to you?
  6. Do you turn up the volume of the television?
  7. Do you have trouble hearing on the telephone?
  8. Do you have trouble hearing the telephone or doorbell ring?

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What Should I Do If I Think I Have A Hearing Loss?

First of all, you should ask your primary care physician for a referral to a licensed audiologist who can evaluate your hearing acuity. The audiologist will then make the appropriate recommendations for treatment options and communication strategies. In many cases there is technology available that can improve your hearing and quality of life.

We use hearing for communication and safety. Hearing aids can help you to hear what people are saying as well as improve your access to environmental sounds. Everyone’s hearing loss is different and there is no one-size-fits-all device. Consult a licensed audiologist to find out what hearing aid is most appropriate for your hearing loss.

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What Are My Hearing Aid Options?

Hearing aids come in all shapes and sizes and offer different types of technology. A hearing aid is a miniature sound processor that the audiologist will program to make sounds louder specific to your hearing loss. A hearing aid will not restore normal hearing.

The Latest in Hearing Aid Technology

Hearing aids today are much more user friendly and able to improve sound quality than ever before. There is no signal “best hearing aid,” so what might work for one person might not work for another. There are many options out there and the path to choosing the “right hearing aid for you” can be confusing. That’s where Clarke Hearing Center audiologists stand out from the rest.

Your audiologist will discuss the options with you and will make a recommendation based on your particular needs and preference.

Open-Ear Hearing Aids:

These hearing aids leave the ear canal open, allowing for a more natural sound quality by preserving some of the natural resonances of the outer ear. These types of hearing aids are particularly suited for people who have a mild to moderate “high frequency” hearing loss. They may be fit behind the ear or in the folds of the fleshy part of the ear called the pinna. Regardless, they all have a microphone, digital circuitry, amplifier, and battery.

Wireless Technology:

Most high end hearing aids are able to communicate with ear other via wireless technology. If a patient changes the volume in one hearing aid, the other automatically adjusts. If a hearing aid automatically adjusts to sounds coming from the environment, both will adapt to coordinate how they amplify the sounds together.

Also available is the availability for a hearing aid to use Bluetooth technology. Through a “gateway” device, similar in appearance to an iPod, the hearing aids can connect to Bluetooth compatible telephones, computers, TVs and more.

Improved Circuitry

Computer chips can now amplify sounds in several different ways, adapting to how loud a room is and whether speech and or noise are present. The hearing aids will amplify sounds differently when the users are sitting in a room watching television as compared to when in a restaurant when background noise is more of a problem.

Circuits are “smarter” and can recognize speech , putting more emphasis on speech sounds than competing noise. It also can reduce environmental sounds such as wind noise, without compromising the quality of speech sounds.

What patients need to know:

Many people have an outdated perception of what a hearing aid is. Too many people know someone who bought a hearing aid, only to let it sit in their drawer. With the care and attention you will receive from the Clarke Hearing Center staff, you will learn to appreciate the changes in technology and understand how a hearing aid can help you.

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What is an audiologist?

Audiologists are the primary health-care professionals who evaluate, diagnose, treat, and manage hearing loss and balance disorders in adults and children. Audiologists prescribe and fit hearing aids, assist in cochlear implant programs, perform ear or hearing-related surgical monitoring, design and implement hearing conservation programs and newborn hearing screening programs, and provide hearing rehabilitation training.

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We are happy to help answer any additional questions you may have. Call us anytime at V/TTY 413.582.1114.