Hearing Loss

An overview of hearing loss, including the psychological effects, types of hearing loss, the progression of hearing loss.

Hearing is essential to the enjoyment of everyday life. While hearing loss is invisible, the effects are not. Helen Keller called deafness “a worse misfortune than being blind – when you lose your vision you lose contact with things, when you lose your hearing you lose contact with people.”

Effects of Hearing Loss

Nearly 36 million Americans have some degree of hearing loss due to genetics, the environment in which they surround themselves or simply as a result of the aging process. With hearing loss, it is often difficult to understand speech. What is not sufficiently appreciated is that the individual’s emotional and mental state may also be affected by the erratic and disrupted communication patterns caused by hearing loss. A person with hearing loss is four times as likely to manifest psychological disturbances than a person with normal hearing. There is also evidence that hearing loss can exacerbate the behavioral picture of patients with Alzheimer’s and other cognitive disorders, affecting memory, alertness and a general ability to cope, beyond the expected limiting factors of the disorder without the presence of hearing loss.


Types of Hearing Loss

There are three types of hearing loss:

1

Sensorineural: the most common type of hearing loss, occurring in the inner ear.

Sensorineural hearing loss is caused by damage to the inner ear and/or auditory nerve due to one or more episodes of prolonged exposure to loud noise, certain medications or simply the process of aging. Once damaged, the inner ear cannot be repaired. Sensorineural hearing decreases the ability to differentiate consonant sounds (thus the fine distinctions in words such as “hat” versus “cat”). Most sensorineural hearing losses can be treated effectively with hearing aids.

2

Conductive: occurring in the in the outer and middle ear.

The most common causes are wax build-up in the ear canal, middle ear infection, a hole in the tympanic membrane or damaged ossicles. In most cases, conductive hearing loss affects the lower frequencies or pitches, making it difficult to hear vowel sounds. Since vowels contain the “power of speech,” an individual with conductive hearing loss perceives speech and other sounds as being much “quieter” than normal. The condition can often be medically treated.

3

Mixed: a combination of conductive and sensorineural hearing loss

Understanding Tinnitus

Tinnitus (pronounced ti-NIGHT-us) is when a noise is heard, but there is no external source for that sound. If your ears have ever rang for hours after spending time in loud noise, such as a music concert, you have experienced tinnitus.

Tinnitus is Not a Disease

Tinnitus is a symptom of an underlying health condition. According to the American Tinnitus Society, tinnitus affects about 1 in 5 Americans. Tinnitus includes more than 50 sounds such as ringing, hissing, roaring and buzzing. Sounds can vary in volume, be heard in one or both ears and can be steady or appear at intervals. The type of sound perceived can be an indicator to the health issue causing the tinnitus (American Tinnitus Society, 2018).

Two of the most common predictors of tinnitus include exposure to noise and hearing loss. It can also be activated by head and neck injury, medication that is toxic to the ear (ototoxic) or an ear infection.

The Impace of Tinnitus

For most people, tinnitus is temporary and is not serious. However, for about 2 million Americans, tinnitus is a chronic condition that negatively impacts a person’s quality of life. If the tinnitus sound a person hears is loud, it can make it difficult for that person to concentrate or hear external sounds. People with tinnitus may also be more sensitive to loud noises; and often, tinnitus seems worse in the early morning or late evening when there are fewer competing external sounds.

Tinnitus can result in stress and physical pain such as headaches along with anxiety, depression or insomnia (Nondahl, Cruickshanks et al, 2007).

Who is at Risk for Tinnitus?

Research shows that tinnitus is more likely to be experienced by:

  • Men more than women
  • Older people, with a peak in the 60-69 age group
  • Caucasians more than other ethnic groups
  • People who work in loud jobs such as construction, mining and manufacturing
  • People with hobbies involving sound such as musicians, hunters and motorsport enthusiasts (American Tinnitus Association, 2018)

Can Tinnitus be Treated?

Yes. There are options available to ease tinnitus symptoms. Though there is no cure, solutions such as hearing aids can provide significant relief.

If you experience tinnitus that lasts more than a few days, call HearUSA to schedule an appointment with a local hearing care provider. At your appointment, your provider will examine your ears and conduct a hearing test for you to help determine the cause of the tinnitus you are experiencing.


The Progression of Hearing Loss

The progression of hearing loss in most cases is subtle from a small amount of hearing loss to greater and greater loss. The implications vary depending on the degree of hearing loss.

Borderline / Normal Hearing:

  • May have problems in difficult listening situations (such as in groups or in noise)
  • May need visual cues (to watch the speaker’s face and especially lips) to understand some conversations and certain speakers
  • May need to sit close to the speaker to understand the conversation
  • If the problem is affecting the person’s ability to function normally in everyday life, they should probably consider a hearing aid if the hearing loss is not treatable medically

Moderate Hearing Loss

  • Difficulty understanding conversations on the telephone
  • Difficulty understanding one-on-one conversations
  • Ask people to speak up to be able to understand what is said
  • The problem is affecting the person’s ability to function normally in everyday life. They should consider a hearing aid if the hearing loss is not medically treatable

Severe Hearing Loss

  • Impossible to function in difficult listening situations (such as in groups or in noise)
  • Impossible to understand conversations on the telephone
  • Difficulty understanding one-on-one conversations
  • Ask people to speak up to be able to understand even part of what is said
  • Needs to sit close to the speaker to understand even part of the conversation
  • Need visual cues (to watch the speaker’s face and especially lips) to understand even part of any conversation and any speaker
  • Difficulty identifying loud environmental sounds (e.g. sirens, phone ringing, car horn honking). This is a significant safety concern
  • The problem affects the person’s ability to function normally in everyday life. They should consider a hearing aid. If the hearing loss is medically treatable, it is most likely a mixed hearing loss and may require amplification post-medical treatment

Profound Hearing Loss

  • Impossible to understand one-on-one conversations
  • Quality of the person’s speech is affected
  • The problem affects the person’s ability to function normally in everyday life. If the hearing loss is medically treatable, it must be a mixed hearing loss and will likely require amplification (hearing aid) post medical treatment to detect speech
  • People with hobbies involving sound such as musicians, hunters and motorsport enthusiasts (American Tinnitus Association, 2018)

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