Hearing Loss

On a basic level, hearing loss creates difficulty hearing in quiet and background noise. This makes it difficult to connect with others. The resulting loneliness and social isolation can profoundly affect overall health. Untreated hearing loss has been associated with dementia, heart attacks, and trauma.

For people with more severe hearing loss, the first steps to improving outcomes—aiding and restoring hearing, providing oral and/or sign language—are only the beginning. Our clinic is committed to helping patients navigate hearing loss to connect to the important people in their lives.

How We Hear

1. The outer ear collects sound and funnels it down to the eardrum.
   
2. The middle ear begins with the eardrum. The eardrum converts air waves to vibrations. The middle ear bones carries these vibrations to the inner ear.
   
3. The snail shaped inner ear converts these vibrations to a nerve signal that the brain can understand.
   
4. The brain filters noise from speech. It provides meaning to speech and environmental sounds.
   
   

Types of Hearing Loss

• Conductive hearing loss results from blocking sound from getting to the inner ear. Conductive hearing loss results from problems with the outer ear, ear canal, eardrum, or the middle ear. Examples include earwax, growths in the ear canal, perforated eardrums, and middle ear disease like otosclerosis or cholesteatoma. Addressing conductive hearing loss can be as simple as cleaning out the ear or providing a hearing aid. Hearing aids are great solutions for conductive loss as these patients just need sounds to be louder. Sometimes conductive loss requires surgery.
  
• Sensorineural hearing loss affects the inner ear. It is less accurately known as “nerve hearing loss or deafness.” Most often, the site of damage is the hearing portion of the inner ear, the cochlea. The nerve often is intact—indeed, an intact nerve is what allows cochlear implants to work. These patients have difficulty with lower volume but also less clarity. Having trouble hearing in background noise even with louder hearing aids is a frequent concern. Causes of inner ear hearing loss include age, viruses, autoimmune disorders, sudden hearing loss, Meniere’s disease, heredity, trauma, and abnormal inner ear anatomy. Hearing aids and cochlear implants can help patients hear better with a sensorineural loss.
  
• Mixed hearing loss refers to patients who have a combination of conductive and sensorineural hearing loss. It is important to address each component of the hearing loss.
  

Levels of Hearing Loss

Hearing loss is generally graded in levels which in lay terms can be thought of as four different functional levels:

Mild —This is similar to plugging your ears with your fingers. The TV volume is turned excessively up and patients have a bit of difficulty in background noise. This difficulty may require speakers to repeat themselves. Hearing aids are generally used for this category of loss.

Moderate—Background noise is now a real problem.

Severe—Talking on the phone becomes difficult. Cochlear implants are often recommended at this point.

Profound—Talking one-on-one is difficult, it is near impossible to talk to more than one person simultaneously. Telephone use is generally not possible.

Treating Hearing Loss

Improving hearing health is tailored to (1) the type of hearing loss (2) age of onset and (3) goals of the patient.

Thriving with hearing loss requires a comprehensive approach:

1. Harnessing medicine and surgery to holistically address hearing loss.
   
2. Providing hearing aids, cochlear implants, and assistive hearing technology.
   
3. These first steps to improving outcomes—aiding and restoring hearing, providing oral and/or sign language—are only the beginning. We help patients learn to self-advocate for better relationships and employment.