Understanding Hearing Loss, Causes, Types & Symptoms.
More than 28 million Americans suffer from a significant loss of hearing. Almost half ofunder the age of 65 and 54% of the population over the age of 65 suffer from hearing loss. Hearing loss is the third most common medical condition in our adult population, following only high blood pressure and arthritis. On average, once a person determines that they have a hearing loss, they wait over seven years before seeking assistance. these individuals are The impact of a hearing loss can be far reaching and involve many aspects of one's life. Hearing impaired individuals may have difficulty localizing sounds, understanding speech in busy environments, and participating in everyday normal conversations. This can lead to social isolation, confusion, frustration, tension, anger, stress and depression. Recent studies also indicate that untreated hearing loss negatively affects one's overall health, quality of life and happiness. Causes of Adult Hearing Loss. With the advancement of medical science over the last few decades, one would think that we would be abe to explain the reasons for each individual's hearing loss, unfortunately this is not the case. There are basically two types of hearing loss, Sensorinerual and Conductive. 
Sensorinerual Hearing Loss is the most common type of hearing loss. Previously this type of hearing loss was referred to as Nerve Deafness or Nerve Damage. With this type of hearing loss the hair cells in the inner ear (Cochlea) have become damaged or less effective. Sensorinerual hearing loss is almost never correctable thru medical or surgical means. There are numerous reasons for this condition to occur, but the most common are:
- Aging or Presbycusis, the naturally declining hearing due to the aging process,
- Exposure to loud, sudden or prolonged noise,
- Certain medicines,
- Injury or Infection.
Conductive Hearing Loss occurs when there is a problem in the outer ear or the middle ear, such as ear wax, fluid behind the eardrum, or middle ear infection. Many times this type of hearing loss may be corrected by medical or surgical treatments.
Symptoms of Hearing Loss. If you recognize any of the following symptoms of hearing loss, please contact one of our offices or your personal physician to have your hearing professionally evaluated. If you are not close to a Manan Hearing Care Center please contact us at 1-800-416-2434 for a referral to a competent hearing professional in your area.
Do you have any of the following symptoms? - Have to strain to hear conversations,
- Have to watch other people's faces for speech cues,
- Need to ask people to repeat,
- Misunderstand what people are saying,
- Turn the television or radio up,
- Feel that people are mumbling,
- Hear better on the phone with one ear than the other.
What Manan Hearing Aid Do To Correct Hearing Loss
The fitting of hearing aids begins with audiometry or the
measurement of hearing. Commonly, a pure-tone-hearing test is used to obtain hearing
thresholds at a number of frequencies (e.g., 250, 500, 1000, 1500, 2000, 3000, 4000, 6000, and
8000 Hz). The results are normally plotted and reported in the standard form of
an audiogram. Figure 2 shows an example of an audiogram. Based on the
audiogram, the hearing professional can determine how much speech information is
lost as a result of hearing loss. The audiogram can also be used to suggest how
hearing-aid amplification should be applied at different frequencies to maximize
the recovery of the lost speech information.
Fig 2 |
Fig 2. Audiogram showing the
hearing threshold (red curve) of an impaired ear. The gray area marks where the
energy of conversational speech could spread over intensity and frequency. The
portion of the area above the hearing threshold (i.e., the red curve) is
inaudible to the ear, resulting in a reduced speech-intelligence index (SII) of
0.55. The yellow area marks where the energy of a conversational speech could
spread over intensity and frequency AFTER amplification. The amplification moves
a significant portion of the inaudible speech energy above threshold, improving
the SII to 0.78. |
Call Manan Hearing for a FREE hearing evaluation today. 1-800-416-2434.
More about Hearing Loss:
Conductive losses are caused by problems with the outer or
middle ear (see Fig. 1 for the structures of outer, middle, and inner ear). The
reasons can be buildup of wax or fluid, puncture of eardrum, middle-ear
infection, and diseases that immobilize the bones of the middle ear, which lead
to attenuation in the transmission of the signals. This type of hearing loss
typically reduces sensitivity but not the dynamic range. With sufficient
amplification that gives equal boosts to soft as well as intense sounds, the
patient's perception of the acoustic world can be restored close to normal. For
these patients, hearing aids are an effective remedy. It should be noted that,
in many cases, these conditions can be corrected medically without the use of hearing aids.
Sensorineural hearing losses can be caused by
problems with the cochlea or the auditory nerve, as a result of exposure to
noise and toxins, diseases, or simply aging. Hearing losses with cochlear origin
exhibit a number of distinct characteristics. First, they typically occur at
high frequencies, with low-frequency hearing affected to a less degree, or even
being normal. Second, in the frequency region of significant loss (such as at
high frequencies), the loss of sensitivity is mostly for soft sounds; loudness
perception of intense sounds remains largely normal. As a result, the range of
sounds that are perceptible, the dynamic range, is reduced. Finally, in a noisy
environment, patients with such losses have difficulty understanding speech,
even when the speech signal is clearly audible. This effect on speech perception
is probably the most damaging, and it is also a defect that is most difficult to
correct, with hearing aids, or any other means.
To understand the
symptoms of sensorineural hearing loss, it would be helpful to look at the
functions of the key sensory cells of the auditory system, and, in particular,
what happens to these sensory cells in a damaged cochlea. After the acoustic
signal is converted into mechanic vibration by the middle ear, the middle-ear
bone structure drives the energy into cochlea via the oval window, to create a
localized vibration on the basilar membrane (BM). Along the length of the BM in
the cochlea sit three rows of outer hair cells and one row of inner hair cells.
In responding to an incoming tone, the basilar membrane will vibrate, with the
location of the peak vibration depending on the frequency. In this mapping from
signal frequency to BM place, the higher the signal frequency, the closer the
peak of vibration will be to the entrance to the cochlea, or the oval window. At
the peak location, the outer hair cells, through their motility, will amplify
the vibration by pumping additional energy into the BM system. The inner hair
cells, which are the auditory sensory receptors, are driven by the amplified
vibration, and transmit the information to auditory nerves connected to them.
The Outer hair cells serve two main functions. First, they provide
amplification to weak sound but not to intense ones. This function is
effectively an automatic gain control (AGC) system, compressing a wide dynamic
range of input into something that can be managed by the auditory nerve system.
Second, they sharpen the contour of the BM frequency response to tones, thus
enhancing the frequency selectivity of the auditory system.
Along the
basilar membrane, sensory cells at high-frequency locations near the cochlear
entrance are more vulnerable to damage than those at deeper, lower-frequency io
locations. This explains why hearing loss usually begins at high frequencies. At
a given BM location, the outer hair cells are more vulnerable than inner hair
cells to insults to the cochlea. As a result, even at its early stage,
sensorineural hearing loss can be identified with symptoms of losing the
outer-hair-cell functions, i.e., a loss of sensitivity to soft sounds, a
reduction of dynamic range, and a reduction of frequency selectivity.
When the damage at a region on the BM is so severe that both outer and
inner hair cells are destroyed, some researchers call this a “dead” region.
Acoustic information normally transmitted via this region must now be
transmitted via sensory cells at neighboring regions. Along with the reduction
of dynamic range, this loss in the effective number of frequency channels
hampers the capacity of the auditory system to transmit information of signals
in the auditory world, particularly the speech signals.
Speech signals
are particularly affected by the decreased capacity of information transmission
with sensorineural hearing loss because speech signals spread over a wide range
in both intensity and frequency. Of the two major elements of speech sounds, the
vowels are less affected, because they are relatively long and intense, and have
energy concentrated at low frequencies. Consonants, on the other hand, are more
affected in their perception, because they are short and soft, and typically
have energy spread over a wide frequency range. This is unfortunate, because
consonant recognition is key to speech understanding.
Speech perception
is made even more difficult because of impairment to the frequency resolution,
and perhaps also to the temporal resolution. With compromised resolutions,
speech segments that can be processed separately in normal ears will now
interfere with other segments in time and frequency, making important speech
features indistinct or even masked.
The complex mechanisms of
sensorineural hearing loss present a challenge for hearing industry. In many
ways, a hearing aid does not have the same degree of magic effect that a pair of
eyeglasses can produce, because the deficits of cochlear damage usually cannot
be fully corrected. With that in mind, there is still much that can be done to
improve the listening comfort, the sound quality, and, most of all, speech
intelligibility. For so many who suffer the consequences of hearing losses, even
a partial recovery of their auditory ability can go a long way in enlightening
their life. For this, any effort for making a good hearing aid is a worthy
effort. For more information on hearing , hearing loss, hearing aids or other assistive listening devices, contact: Manan Hearing Care at 1-800-416-2434 or email info@mananhearing.com
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