Your ear is comprised of three parts: the outer ear, the middle ear, and the inner ear. Each part of the ear has a different function. The primary function of the outer ear is to carry sounds to the middle ear. When sound travels down the ear canal to the eardrum and strikes it, it causes it to vibrate. Behind the eardrum is the middle ear space. This space contains three small bones called the ossicles. This chain of tiny bones is connected to the eardrum at one end and to an opening to the inner ear at the other end. Vibrations from the eardrum cause the ossicles to vibrate which, in turn, creates movement of the fluid in the inner ear. This movement of the fluid in the inner ear converts the sound into nerve impulses which are transmitted to the brain so that you may perceive the sound.
There are three types of hearing loss:
- CONDUCTIVE HEARING LOSS: Occurs when sound cannot be conducted efficiently through the outer and middle ear. As a result, a reduction in sound level or the ability to hear faint sounds is common. Conductive hearing loss can be the result of a wax buildup, hole in the eardrum, an ear infection, stiffening of the middle ear bones, or a tumor. Often times, conductive hearing loss can be reversed with medical treatment.
- SENSORINEURAL HEARING LOSS: The loss of sound sensitivity produced by damage to the inner ear or the nerve pathways from the ear to the brain. Sensorineural hearing loss, commonly referred to as “nerve deafness”, typically occurs as a result of the aging process. However, it can also be the result of continuous loud noise exposure, certain toxic medications, or an inherited condition. Generally, this type of hearing loss is permanent.
- MIXED HEARING LOSS: A combination of sensorineural and conductive hearing loss.
How do I know if I have a hearing loss?
Hearing loss occurs when sound sensitivity is reduced by a dysfunction in the auditory system. It typically occurs gradually over time and often is first noticed by family and friends. Some telltale signs of hearing loss include having trouble understanding others, ringing in the ears, increased TV or stereo volume, or having trouble hearing soft or high-pitched sounds. Any of these signs maybe an indication of hearing loss. If there are any concerns, a baseline audiogram (hearing test) is recommended. These test results will tell us if there is a hearing loss at this time. Some hearing losses requires medical intervention; other hearing losses warrant the use of hearing instruments.
The following questions may help you determine if you should be evaluated for possible hearing loss:
- Are you sometimes unsure of what others around you have said?
- Do you wish that people around you would speak louder or more distinctly?
- Are you often asking family members and friends to repeat themselves?
- Do you have trouble hearing over the telephone?
- Do you have trouble following conversations in the presence of background noise?
- Do you experience ringing in your ears?
- Do you find yourself withdrawing from social situations because you are unable to follow along in conversations?
If you answered “YES” to any of the above questions, you should consider scheduling an appointment for an audiogram (hearing evaluation). At that time, your audiologist and otolaryngologist (ear, nose, and Throat physician) will decide on the appropriate course of action for your particular condition, whether it is medical treatment and/or consideration of hearing instruments.
Infants and Young Children
A child’s development of speech and language is largely dependent on the child’s ability to hear various sounds and words and learning to reproduce them on their own. The first three years of life are the most crucial for appropriate speech and language development. If a child is unable to hear during the early years of life when language is developing, it is possible that the child will suffer from developmental difficulties later on. Therefore, early detection and intervention for hearing loss is crucial in decreasing the likelihood of speech and hearing delays.
Of course, infants and young children cannot answer the above questions so they must rely on the parents/care giver to detect possible hearing loss. If you have concerns about your child’s hearing, ask yourself the following questions:
- Were there any complications during your child’s pregnancy, labor, or delivery?
- Has your child been exposed to any of the following (particularly while in utero): bacterial meningitis, syphilis, herpes, or Cytomegalovirus (CMV)?
- Was your child born prematurely and/or weighed less than 3.3 lbs. at birth?
- Did your child spend time in the Neonatal Intensive Care Unit (NICU)?
- Has your child been given intravenous antibiotics for any reason?
- Does your child have a history of chronic or multiple ear infections?
- Do you have concerns about your child’s speech and language development?
- Is there a family history of childhood sensorineural hearing loss?
If you answered “YES” to any of the following questions, your child should be seen by an ENT physician and receive a hearing evaluation.
Noise Exposure and Hearing Loss
Most people do not realize that their daily activities, whether occupational or recreational, can be potentially hazardous to their hearing. Exposure to loud noise can damage the hearing mechanisms in our ears. The damage may be temporary or permanent depending on the intensity and duration of the noise exposure. With short-term exposure to noise (i.e. an occasional rock concert) hearing will most likely recover within a day. However, if an individual repeatedly exposes themselves to loud levels of noise, there is a high likelihood that over time some permanent hearing loss will develop.
People who work around loud equipment or machinery, military personnel, and those individuals who are employed in the construction or airline industry are particularly susceptible to what is referred to as a “noise-induced hearing loss” (NIHL). NIHL can be caused by a one-time exposure to an intense “impulse” sound, such as an explosion, or by continuous exposure to loud sounds over an extended period of time.
Numerous recreational activities can also be potentially damaging to hearing. Such activities include: listening to loud music though a stereo or iPod, motorcycles, firearms (i.e. target shooting or hunting), power tools, and lawn care equipment. The use of hearing protection should be used when participating in any of the above activities.
Regardless of whether your noise exposure is on the job, at home, or through recreational activities the use of hearing protection is warranted. If you work in a noisy environment, hearing protection devices may already be available through your employer. If not, the use of custom hearing protection is ideal for a variety of noisy environments. Custom products range from solid earplugs for heavy equipment use to earplugs for musicians that protect your ears from potentially damaging sounds while preserving a natural sound quality. If interested, please schedule an appointment with an audiologist to discuss all custom made hearing protection product options.