Hearing Loss

How We Hear:

In order to understand hearing loss, we must first understand how we hear. As one of our five senses, it is a critical component to communicating with the world around us. At birth, the human ear is completely developed and able to perceive sounds from barely audible to very loud, distinguish directionality of sound sources, as well as differentiate between loudness and distance.

The ear is divided into three main parts: outer, middle, and inner ear. The outer ear consists of your pinna (the part of the ear you visually see), the ear canal and the eardrum. When sound waves enter the ear, they are funneled down the ear canal to the eardrum. The eardrum is a flexible membrane that vibrates when sounds waves reach it. On the other side of the eardrum, lie three extremely tiny bones: malleus, incus, and stapes. Once sounds waves vibrate the eardrum, it provides vibration to those small bones which in return amplify the sound. If the transmission of sound is interrupted anywhere in the outer and middle ear systems, it is known as a conductive hearing loss. Conductive hearing losses and are most often treated medically or surgically.

As sound leaves the middle ear, vibration of those three bones elicits a response from the fluid-filled inner ear via the oval window. The inner ear consists of the cochlea (hearing organ) and the auditory nerve.  Once the fluid is in motion, stimulation of small hair cells inside the cochlea are converted into nerve impulses that are communicated to the brain via the auditory nerve. Once these impulses reach the brain, they are interpreted as sound. If the signal is distorted or damaged within the inner ear, it is known as a sensorineural hearing loss. Sensorineural hearing losses are permanent losses that require hearing aids for improved communication.

In some cases, patients may present with hearing losses of both a conductive and sensorineural nature. These losses are usually treated with hearing instruments in combination to medication or surgery. A licensed Audiologist will be able to provide you with your hearing status following a comprehensive hearing evaluation.

Understanding Hearing Loss:

According to the American Academy of Audiology, 36 million Americans suffer from hearing loss, making it the third most common health problem in the United States. If left untreated, hearing loss can affect your ability to understand speech, harm your social and emotional well-being, as well as decrease your quality of life.  

There are several causes of hearing loss:

  • Long-term exposure to noise
  • Illness
  • Medicine
  • Family history of hearing loss
  • Aging
  • Injury
  • Cerumen (ear wax)

Most hearing losses gradually develop over time, so you may not notice subtle changes in the world around you until you are missing those sounds critical for effective communication. Some common indicators of hearing loss are:

  • Increased volume on the TV or radio
  • Difficulty following conversations in crowded or noisy environments
  • Frequently asking others to repeat themselves
  • Feeling as if others mumble or don’t speak clearly
  • Being told you speak too loudly when talking


Tinnitus (ringing in the ears) is a common complaint of people with hearing loss. Tinnitus can be described as any hissing, whistling, roaring, buzzing, or ringing that can be perceived as pulsatile, intermittent, or constant. The sound may be present in one or both ears and can usually be classified as either acute or chronic in nature.

There isn’t a clear-cut reason why people experience tinnitus. Studies suggest fatigue, stress, certain medications, noise exposure, and presence of hearing loss. During your case history, it is important to let the Audiologist know if you are experiencing tinnitus.