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Hearing Solutions of Arizona™

About Hearing Loss: Causes, Diagnosis, and Treatment

Hearing impairment can affect everyone, and it can occur at any point during a person’s life. Hearing loss affects different people to varying degrees and for different reasons, and can be triggered by any number of environmental and biological factors. Genetic factors, prolonged exposure to loud noises, disease or illness, physical trauma to the ear, and aging are all causes of hearing loss.

Although many forms of hearing loss cannot be reversed, people who suffer from impaired hearing need not resign themselves to a world of fainter, less distinct sounds. By acquiring a thorough understanding of the different types of hearing loss, their causes, and the solutions available for treating them, patients can often successfully restore their ability to listen, converse, and perceive the world around them.

• How the Ear Works
• Types of Hearing Loss
• Conductive Hearing Loss
• Sensorineural Hearing Loss
• Mixed Hearing Loss
• Degree of Hearing Loss
• Diagnosing Hearing Loss
• Treatment Options

How the Ear Works

The ear is a complex, specialized organ responsible for hearing. The ear also plays an important role in balance. It is comprised of three sections: the outer ear, which includes the auricle and ear canal; the middle ear, which includes the eardrum and the three smallest bones in the human body (malleus, incus, and stapes); and the inner ear, which includes the cochlea and nerve pathways to the brain. The auricle, which is composed of the visible cartilage and skin on the outside of your ear, acts like a satellite dish, collecting sound waves that then travel through the ear canal and cause vibrations in the eardrum. The vibrations are then transmitted and amplified by the middle ear bones, or ossicles. This mechanical energy is then transmitted to the inner ear, where they are relayed to a snail-shaped organ called the cochlea. Inside the cochlea, thousands of tiny hairs help translate these vibrations into electrical signals. From here, a nerve known as the eighth nerve carries these signals to the brain, where they are interpreted as sound.

Types of Hearing Loss

Hearing loss is generally categorized by location—that is, what part of the ear is damaged—as well as by severity and age of onset. There are three primary types of hearing loss: conductive, sensorineural, and one that is a combination of both, referred to as mixed hearing loss.

Conductive Hearing Loss

Conductive hearing loss results from sound waves being conducted through the outer and/or middle ear inefficiently. In other words, sound waves are blocked or muffled before they can reach the inner ear, which is still functioning properly.

Conductive hearing loss can be caused by a number of factors, including:

• Otitis Media, also known as a middle ear infection, wherein the middle ear becomes inflamed as a result of a respiratory virus or infection;
• Otosclerosis, which results from abnormal growth of bone of the middle ear;
• Temporary Impaction or Blockage, which can include a build-up of earwax or the presence of a foreign body;
• Other Causes, such as bone fractures, perforation of the eardrum, tumors, or the absence or disfigurement of the outer ear, ear canal, or middle ear.

Sensorineural Hearing Loss

Sensorineural hearing loss results from damage to the inner ear (cochlea) or the nerve pathways that transmit sound vibrations to the brain. Sensorineural hearing loss cannot be reversed and is not treatable through surgery or medication, but it can be significantly improved through the use of a hearing aid or assistive listening device.

There are several factors that can lead to sensorineural hearing loss, including:

• Presbycusis, which is the term for the gradual hearing loss that occurs as a person ages. This type of hearing loss is caused by the natural toll of the aging process on the cochlea (inner ear), and it may grow more severe as a person ages. Presbycusis first affects the ability to hear high frequencies, which can inhibit a person’s ability to distinguish between similar sounding words.
• Noise-Induced Hearing Loss, which results from exposure to loud noises over a long period of time. This is one of the most common types of hearing loss, and, unfortunately, it is also the most preventable. For example, a person who works around noisy construction equipment or very loud music without protective hearing devices will almost certainly develop some degree of hearing loss over time. The results are gradual, painless, and frequently undetectable until hearing loss has occurred.
• Ototoxic Medication, which can cause a toxic reaction in the inner ear and lead to hearing loss.
• Head Injuries, Diseases, and Genetic Disorders, which can all contribute to sensorineural hearing loss. Genetic disorders in particular cause many problems; in fact, hearing loss is the most prevalent type of birth defect in the United States.

Mixed Hearing Loss

Mixed hearing loss refers to a combination of conductive and sensorineural hearing loss, which can involve damage in the outer, middle, and inner ear simultaneously.

Degree of Hearing Loss

Hearing loss is measured in degrees that attempt to correlate the expected degree of hearing difficulty that may be encountered. Typically, hearing loss cases are divided into five categories, ranging from normal to profound, based on the patient’s ability to perceive sound at different decibels (dB). The decibel levels listed below represent the softest sound that a patient with the indicated level of hearing loss is able to perceive.

• Normal range or no impairment – 0 dB to 20 dB (near total silence to a faint whisper)
• Mild loss – 20 dB to 40 dB (whisper to a low voice)
• Moderate loss – 45 dB to 60 dB (rainfall, normal conversation)
• Severe loss – 65 dB to 85 dB (up to about the level of a vacuum cleaner)
• Profound loss – 90 dB or more (anything louder than a lawnmower, car horn, etc)

Diagnosing Hearing Loss

To determine your level of hearing loss, Dr. Debra Venkatesh will administer various hearing tests. Dr. Venkatesh will perform an audiometric test, in which you will wear earphones that play tones at different frequencies and volumes into one ear and then the other. You will signal to Dr. Venkatesh when you hear a tone by raising your hand. This procedure will help her to identify the softest level of sound that you are able to perceive and to ascertain how well you can understand various sounds, thus allowing her to determine your degree of hearing loss.

Dr. Venkatesh will also conduct a physical examination of the ears in order to asses the overall condition of your ear canal and eardrum. This will allow her, in part, to determine whether your hearing loss is conductive or sensorineural in nature.

Treatment Options

Treatment for hearing loss will depend on the type and degree of loss.

• Conductive hearing loss – If your hearing loss results from a blockage in the ear canal (such as earwax or fluid buildup), your doctor can usually remove or drain the blockage without surgery. If the ear is infected, as with otitis media, it can usually be treated with antibiotics. If you suffer from otosclerosis, your hearing may be improved through surgery.
• Sensorineural hearing loss – If your hearing loss is caused by damage to the inner ear, a hearing aid or assistive listening device can help by amplifying sounds and making it easier for you to hear. If you have very severe hearing loss, you may benefit from a cochlear implant, which compensates for the damaged parts of your inner ear and allows you to regain some degree of hearing.

After your hearing has been thoroughly evaluated, Dr. Venkatesh will discuss the risks and benefits of each treatment option and help you make the decision that is right for you.

Contact Hearing Solutions of Arizona

If you are concerned about hearing loss, please contact our office to arrange an appointment with Dr. Venkatesh. We look forward to helping you hear more clearly!