Hearing Loss
What Causes Hearing Loss | When to Treat Hearing Loss | Understanding Hearing Loss | Degree and Types of Hearing Loss Realistic Expectations for Hearing Aids| What is an Audiologist?
Take This Simple Test:
Do you have difficulty understanding what is being said unless you are directly facing the speaker?
Do you find yourself complaining that people are mumbling or slurring their words?
Are you continually asking people to repeat words or phrases, though they feel they're speaking loud enough?
Do you prefer the radio or television louder than others do?
Do you have difficulty understanding conversations within a group of people?
Do you avoid gatherings where listening may be difficult?
Do you have trouble hearing at the movies, your house of worship or in a concert hall where sounds may be at a distance?
Do you have ringing in your ears or other buzzing or humming noises?
If you answered yes to even two of these questions, you may have hearing loss and should see an audiologist.

What Causes Hearing Loss?
• Most hearing loss that is caused by nerve damage can be treated by an audiologist with hearing aids, assistive listening devices, and hearing rehabilitation.
• Almost all types of hearing loss are treatable by an audiologist.

When to Treat Hearing Loss
Hearing Loss should be evaluated and treated when a person notices difficulty hearing or their family and friends notice difficulty hearing. Statistics show it takes the average person seven years to realize they have a hearing loss and seven more years to do something about it. Often times family and significant others notice difficulty long before the actual hearing impaired individual. Hearing loss is not something that typically happens overnight, it is a slow process, so often times the hearing impaired individual is not aware of what they are missing. If a hearing loss happens suddenly, your physician should be contacted immediately. Sudden hearing loss may be the sign of something more serious requiring medical attention and if addressed promptly may not be permanent.

Understanding Hearing Loss

For most people hearing loss occurs gradually, so you may not notice the signs right away. Some of the most common signs of hearing loss include:
• People sound as though they are mumbling.
• You can hear people talking but cannot understand them.
• Hearing conversation in background noise, like restaurants, is very difficult.
• Family and friends notice your hearing loss and make mention of it.
• You have to turn the TV volume louder than what others find comfortable.

Numerous recent studies have shown that untreated hearing loss affects our emotional and social well-being, our relationships with friends and family, and overall quality of life. For individuals still in the workplace, hearing loss can have a negative impact on income potential as well.

Degree and 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, from low to high, is plotted from left to right. Hearing loss (HL) is measured in decibels (dB) 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)

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 an audiologist and a physician to explore medical and surgical options.

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 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. Today, there are many excellent options for patients 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.

Realistic Expectations for Hearing Aids

Hearing aids work very well when fit and adjusted appropriately. They amplify sound! You might find that you like one hearing aid better than the other. The left and right hearing aids will probably not fit exactly the same and they probably won’t sound exactly the same. Nonetheless, hearing aids should be comfortable with respect to the physical fit and sound quality. Hearing aids do not restore normal hearing and are not as good as normal hearing. You will be aware of the hearing aids in your ears. Until you get used to it, your voice will sound “funny” when you wear hearing aids. When you wear hearing aids for the first time, you will probably notice your voice sounds funny! You will hear your voice amplified through the hearing aid. You may describe this sensation as feeling “plugged up” or hearing your voice echoing. This is normal and will usually go away in a few days after you have given yourself a chance to get accustomed to your new hearing aids and learned to adjust the volume control. There are adjustments that the audiologist can do to relieve these symptoms, should these persist beyond the first few days of wearing your new aids. Hearing aids should not to be worn in extremely noisy environments, although some hearing aids have features that make noisy environments more tolerable. Hearing aids, however, cannot eliminate background noise.

People adjust to hearing aids at different rates. Some people need a day or two to learn about and adjust to their hearing aids, most need a few weeks and some may need a few months. There is no perfect way to learn about hearing aids. I usually recommend you wear the hearing aids for a few hours the first day, and add about an hour a day for each day that follows. Do not try to set an endurance record. Over a period of time you will lengthen the amount of time that you wear the hearing aid. Eventually, you will wear the hearing aids most of your waking hours. It is recommended that you interact with those people you are most familiar with during your first few days. Start off listening with your hearing aids in a favorable listening environment and work towards more difficult listening situations. Let your friends and family know that you are using your new hearing aids.

Helpful Steps to Learning to Use a Hearing Aid
1. Use the aid at first in your own home environment.
2. Wear the aid only as long as you are comfortable with it.
3. Accustom yourself to the use of the aid by listening to just one other person - husband or wife, neighbor or friend.
4. Do not strain to catch every word.
5. Do not be discouraged by the interference of background noises.
6. Practice locating the source of the sound by listening only.
7. Increase your tolerance for loud sounds.
8. Practice learning to discriminate different speech sounds.
9. Listen to something read aloud.
10. Gradually extend the number of persons with whom you talk, still within your own home environment.
11. Gradually increase the number of situations in which you use your hearing aid.
12. Take part in an organized course of aural rehabilitation; see your audiologist to learn about these courses.

Physical Fit
One concern with all new hearing aids is the physical fit. Hearing aids need to be comfortable, not too tight and not too loose, they should fit just right. Do not wear the hearing aids if they cause any discomfort or irritations. Call your audiologist to schedule an appointment time to remedy the problem as soon as possible. Do not wear them if they are uncomfortable.

What Is an Audiologist?
Audiology is a highly recognized profession and has been ranked by U.S. News and World Report as one of the Best Careers in 2006, 2007, and 2008
• Au-di-ol-o-gists: Audiologists are the primary health-care professionals who evaluate, diagnose, treat, and manage hearing loss and balance disorders in adults and children.
• 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
• provide hearing rehabilitation training such as, auditory training, speech reading, and listening skills improvement

Most audiologists have at least a master’s degree in audiology. Many audiologists today are earning the doctor of audiology (Au.D) degree while others can obtain doctoral degrees such as PhD, ScD, etc., from accredited universities with special training in the prevention, identification, assessment, and treatment of hearing disorders.
• Audiologists must be licensed in most states.
• Audiologists treat all ages and types of hearing loss: adults, teens, children, and infants.
• Audiologists work in a variety of settings, such as, Hospitals, clinics, private practices, ENT offices, universities, K-12 schools, government, military, and VA hospitals.

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