Hearing Loss



Sound waves are picked up by the tympanic membrane and the vibrations in the ossicles are sent by the eighth cranial nerve to the brain. IN this way, we register the concept of sound.

Ear cartilage continues to grow during our life, which is why older people have larger ears than younger people.


Hearing Loss

The gradual hearing loss that occurs as you age (presbycusis) is a common condition. An estimated one-third of Americans older than age 60 and one-half of those older than age 85 have some degree of hearing loss.
Over time, the wear and tear on your ears from noise contributes to hearing loss by damaging the cochlea, a part of your inner ear.

Men are affected more than women with symptoms occurring after age 50.


Causes of Hearing Loss

Some hearing loss is inherited, other loss comes from tumours, illness, trauma, repeated exposure to loud noise and aging. Even certain medications can impact hearing.

Menieres, an inner ear disease also causes deafness along with a sense of pressure in the ear and dizziness.

Acoustic neuromas, tumours cause buzzing in the ear called tinnitus.

Even simple causes like earwax blockage, can prevent your ears from conducting sounds as well as they should.


Diagnosing Hearing Loss

Onset of age-related hearing loss is very gradual. At first, sounds become muffled and differentiation between different sounds is reduced. It is first noticed in noisy surroundings – and is often first noticed whilst speaking on the phone.

Sudden hearing loss can occur with viral infections of the inner ear.


Hearing Tests

Hearing tests can be carried out by a number of different professionals:

  • an ear, nose and throat [ENT] specialist, also called an otolaryngologist
  • audiological physician [doctor specialising in hearing problems]
  • audiologist [a specialist in the testing of hearing and fitting of hearing aids]


Audiometer - The examination will use tuning forks and a special electronic device with headphones called an audiometer. This device produces sounds of different volumes and pitch (frequencies). During testing, you are asked to indicate, usually by pushing a button, when you hear a sound in the headphones. The level at which a person cannot hear a sound of a certain frequency, is known as their threshold.

Otoacoustic emissions test - This is used if a sensorineural cause is suspected. The test measures the responses the cochlea makes to sounds produced by a probe placed in the outer ear.

Auditory brainstem responses - This test measures the activity of the cochlea, auditory nerve and brain when a sound is heard.

MRI Scan - If the cause of the hearing loss seems to be due to a brain abnormality, a magnetic resonance imaging (MRI) scan of the head may be recommended.


Measuring Hearing Loss

Hearing loss is measured in decibels hearing level (dBHL). A person who can hear sounds across a range of frequencies at 0 to 20 dB is considered to have normal hearing. The thresholds for the different types of hearing loss are as follows:

Mild - 25 to 39 dBHL

Moderate - 40 to 68 dBHL

Severe - 70 to 94 dBHL

Profoundly deaf people cannot hear sounds quieter than 95 dB

For an online tutorial on hearing loss and treatments - http://www.nlm.nih.gov/medlineplus/tutorials/hearingloss/htm/index.htm


Treating Hearing Loss – Non Age Related

The treatment of hearing loss depends on the cause:

  • A bacterial infection of the middle ear can be treated with antibiotics
  • Blockages of the outer and middle ears can be cleared
  • Damaged eardrums can be repaired surgically
  • Ossicles affected by otosclerosis can be replaced with artificial bones.\
  • Acoustic neuroma can be removed surgically


Treating hearing loss –Age Related

There is no cure for the hearing loss, but options are available to enhance residual hearing.

Hearing aids - tiny discrete instruments worn in or behind the ear. Hearing aids can be worn on one or both ears. Many different types of hearing aid are available and the audiologist will advise as to which type best suits your needs. To find the hearing aid that works best for you, you may have to try more than one.

Personal listening systems - help you hear what you want to hear while eliminating or lowering other noises around you. Some, called auditory training systems and loop systems, make it easier for you to hear someone in a crowded room or group setting. Others, such as FM systems and personal amplifiers, are better for one-on-one conversations.

TV listening systems -help you listen to the television or the radio without being bothered by other noises around you. These systems can be used with or without hearing aids and do not require you to use a very high volume.

Direct audio input hearing aids - are hearing aids that can be plugged into TVs, stereos, microphones, auditory trainers, and personal FM systems to help you hear better.

Telephone amplifying devices - some telephones are made to work with certain hearing aids. If your hearing aid has a "T" switch, you can ask your telephone company about getting a phone with an amplifying coil (T-coil). If your hearing aid is in the "T" position, this coil is activated when you pick up the phone. It allows you to listen at a comfortable volume and helps lessen background noise. You can also buy a special type of telephone receiver and other devices to make sounds louder on the phone.

Mobile phone amplifying devices - to help people who use a T-coil hear better on mobile phones, an amplifying device called a loopset is available. The wire loop goes around your neck and connects to the mobile phone. The loop transmits speech from the phone to the hearing aid in your ear. It also helps get rid of background noise to make it easier to talk in a noisy environment.

Auditorium-type assistive listening systems - many auditoriums, movie theaters, churches, synagogues, and other public places are equipped with special sound systems for people with hearing loss. These systems send sounds directly to your ears to help you hear better. Some can be used with a hearing aid and others without.

Lip reading or speech reading -special trainers can help you learn how to lip read or speech read.

Cochlear Implant - When a hearing aid does not give sufficient amplification, as with profound deafness, a cochlear implant is an option. The device transmits sound directly into the auditory nerve via electrodes surgically implanted into the cochlea.


Cochlear Implants

Cochlear implants have three parts: a headpiece, a speech processor, and a receiver. The headpiece includes a microphone and a transmitter. It is worn just behind the ear where it picks up sound and sends it to the speech processor, a beeper-sized device that can fit in your pocket or on a belt. The speech processor converts the sound into a special signal that is sent to the receiver. The receiver, a small round disc about the size of a quarter that a surgeon places under the skin behind one ear, sends a sound signal to the brain.

The Cochlear Implant Association International (CIAI) provides information and support to implantees.


Hearing Loss Issues

Loss of hearing can raise a number of concerns around insurance cover, job status etc

Hearing loss can impact your family. You may be surprised to learn that some of your marital issues are a direct result of your hearing loss. In my own family, we experienced discomfort at the uncomfortable volume my father used when watching television; whilst he insisted that his hearing was fine. This caused a social breakdown as family members no longer gathered in the main reception room, to avoid this noise barrage.

Oral communications can become strained. Difficult communications are tiring and eventually people may avoid or limit their communications with the hard of hearing.

Social Stigma - In an article “Dim view of aging linked to hearing loss” March 2006 :

Older adults who harbor negative stereotypes about aging may have a more rapid decline in their hearing, a new study suggests. Researchers at Yale University found that among older men and women, between 70 and 96 years old, those who held to the stereotypes of older adults as "frail" and "senile" showed a greater decline in hearing over the next three years. The link was independent of a number of factors in hearing loss, including age, physical health and depression. The effect was seen even in study participants who had "perfect scores" on hearing tests at the study's start, lead study author Becca R. Levy told Reuters Health

For the lastest news in hearing loss treatments and products.


For Further Information


Freephone 0808 808 0123
Textphone 0808 808 9000
Email: [email protected]


Alexander Graham Bell Association for the Deaf and Hard of Hearing (AG Bell)
3417 Volta Place, NW
Washington, DC 20007-2778
Voice: (202) 337-5220
Toll-free Voice: (866) 337-5220
TTY: (202) 337-5221
Fax: (202) 337-8314
E-mail: [email protected]
Internet: www.agbell.org

American Academy of Audiology (AAA)
11730 Plaza America Drive, Suite 300
Reston, VA 20190
Voice: (703) 790-8466
Toll-free Voice: (800) 222-2336
TTY: (703) 790-8466
Fax: (703) 790-8631
E-mail: [email protected]
Internet: www.audiology.org

American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS)
One Prince Street
Alexandria, VA 22314-3357
Voice: (703) 836-4444
TTY: (703) 519-1585
Fax: (703) 683-5100
E-mail: [email protected]
Internet: www.entnet.org

American Speech-Language-Hearing Association (ASHA)
10801 Rockville Pike
Rockville, MD 20852
Voice: (301) 897-5700
Toll-free Voice: (800) 638-8255
TTY: (301) 897-0157
Fax: (301) 571-0457
E-mail: [email protected]
Internet: www.asha.org

American Tinnitus Association (ATA)
P.O. Box 5
Portland, OR 97207-0005
Voice: (503) 248-9985
Toll-free Voice: (800) 634-8978
Fax: (503) 248-0024
E-mail: [email protected]
Internet: www.ata.org

Hearing Loss Association of America
7910 Woodmont Avenue, Suite 1200
Bethesda, MD 20814
Voice: (301) 657-2248
TTY: (301) 657-2249
Fax: (301) 913-9413
E-mail: [email protected]
Internet: www.hearingloss.org

League for the Hard of Hearing (LHH)
50 Broadway
New York, NY 10004
Voice: (917) 305-7700
TTY: (917) 305-7999
Fax: (917) 305-7888
Internet: www.lhh.org

WISE EARS!® A Public Education Campaign to Prevent Noise-Induced Hearing Loss
Office of Health Communication and Public Liaison, NIDCD,
31 Center Drive, MSC 2320
Bethesda, MD 20892-2320
Voice: (301) 496-7243
Toll-free Voice: (800) 241-1044
Toll-Free TTY: (800) 241-1055
Fax: (301) 402-0018
E-mail: [email protected]


Australian Government Department of Health and Ageing

Better Hearing
Phone: (03) 9510-1577 for a telephone consultation
5 High St Prahran with a Hearing Loss Management Advisor
Emailing us at: [email protected]

New Zealand:

The Oticon Foundation
Tel.: +64 4 473 3330
142 Lambton Quay
P O Box 9128
Wellington, New Zealand
[email protected]

New Zealand Audiology Society
PO Box 9724, Newmarket
Auckland, New Zealand
Phone: +64 9 625 1664
Free Phone NZ: 0800 625 166
Email: [email protected]

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