What causes hearing loss?

Hearing loss that can be experienced as a result of a number of possible contributing situations.  When you visit your local California hearing aid store, your audiologist will be happy to talk with you about your daily lifestyle, health, work life, and hear any specific concerns that you may have, before drawing conclusions for your personalized care.

What IS hearing loss?

Hearing loss is described by varying degrees, not percentages. Hearing loss may be mild, moderate, moderately-severe, severe or profound and vary across pitches. It is determined by a simple hearing test as the amount of volume loss you experience compared to an average of many other adult listeners with normal auditory systems. The volume, or intensity, of sounds you hear is measured in decibels (dB), 0 dB being the softest whisper and 120 dB being a jet engine. The softest sounds one can hear are called thresholds. Normal hearing thresholds for adults are considered 0 to 25 dB.

Are all hearing impairments the same?

There are a variety of types of hearing loss, all of which will have specific diagnosis that will help personalize your care.

Conductive Hearing Loss

Conductive hearing loss occurs when there is a problem with the way sound is conducted to the inner ear or cochlea. The problem may lie in the outer ear (pinna or ear canal), eardrum (tympanic membrane), or the middle ear (ossicles and Eustachian tube). The inner ear remains unaffected in this type of hearing loss.

Some causes of conductive hearing loss can include outer or middle ear infections, complete earwax blockage, deterioration of the middle ear bones (ossicles), fixation of the ossicles (otosclerosis), a hole in the tympanic membrane, or absence of the outer ear or middle ear structures.

Conductive hearing losses may be temporary or permanent, depending on the source of the problem. Medical management can correct some cases of conductive hearing loss, while amplification may be a recommended treatment option in more long-standing or permanent cases.

Individuals with conductive hearing loss may report that sounds are muffled or quiet. Generally, when sounds are made louder, these individuals can hear well again.

Sensorineural Hearing Loss

Sensorineural (sen-sory-nuhral) hearing loss occurs when there is a problem with the sensory receptors of the hearing system, specifically in the cochlea of the inner ear. The majority of sensorineural hearing loss occurs as a result of an abnormality or damage to the hair cells in the cochlea. This abnormality prevents sound from being transmitted to the brain normally, resulting in a hearing loss.

The hair cells may have been abnormal since birth (congenital), damaged as a result of genetics, infection, drugs, trauma or over-exposure to noise (late-onset or acquired), or damaged as a result of the aging process, a kind of hearing loss known as presbycusis (pres-be-cue-sis).

Sensorineural hearing losses are generally permanent and may stay stable or worsen over time. Routine hearing tests are needed to monitor the hearing loss. Amplification, including hearing aids or cochlear implants in the most severe cases, is a common treatment recommendation.

Individuals with sensorineural hearing loss may report muffled speech, ringing in the ears (tinnitus), difficulty hearing in background noise or that others do not speak clearly.

Mixed Hearing Loss

Mixed hearing loss occurs when a person has an existing sensorineural hearing loss in combination with a conductive hearing loss. It is, very literally, a mix of sensorineural and conductive hearing losses. This means there is a problem in the inner ear as well as in the outer or middle ear. The conductive hearing loss may be temporary or permanent, depending on the source of the problem.

Mixed hearing loss can sometimes be treated with medical management, and hearing aids are a common treatment recommendation.

Neural Hearing Loss

Neural hearing loss occurs when the auditory nerve that carries impulses from the cochlea to the brain is missing or abnormal. It is difficult to determine the exact location of neural hearing loss. Some causes of neural hearing loss include genetics, acoustic tumors, in-utero exposure to certain infections, severe jaundice in infancy and low birth weight associated with premature birth.

Amplification may be recommended in some cases of neural hearing loss depending on the severity of the damage to the hearing nerve.

Individuals with neural hearing loss often have difficulty understanding speech, even when it is loud enough, as well as in background noise.

How do I know if I need to have my hearing checked?

You should have your hearing checked if you:

• Have to strain to hear normal conversations or watch faces to follow what people say

• Frequently ask people to repeat themselves

• Have difficulty understanding women, young children or people with high pitched voices

• Hearing ringing or other noises in your ear

• Turn up the TV or radio excessively to hear them clearly

• Have trouble identifying where sounds are coming from