Hearing Loss

Hearing loss is extremely common. It is a natural part of the aging process, though the severity and rate of decline will vary due to a number of factors. Hearing loss may also be congenital, or the result of various injuries to the ear.

  • Approximately 15% of American adults (37.5 million) aged 18 and over report some trouble hearing.
  • About 2 percent of adults aged 45 to 54 have disabling hearing loss. The rate increases to 8.5 percent for adults aged 55 to 64. Nearly 25 percent of those aged 65 to 74 and 50 percent of those who are 75 and older have disabling hearing loss.
  • About 28.8 million U.S. adults could benefit from using hearing aids.
  • Among adults aged 70 and older with hearing loss who could benefit from hearing aids, fewer than one in three (30 percent) has ever used them. Even fewer adults aged 20 to 69 (approximately 16 percent) who could benefit from wearing hearing aids have ever used them.

Statistics from NIDCD website (https://www.nidcd.nih.gov/health/statistics/quick-statistics-hearing)

Anatomy and Mechanism of Hearing

The ear is divided into three sections. The outer ear consists of the auricle (what you think of as the ear on the side of your head) and the ear canal (where a provider looks into the ear with an otoscope) The shape of the auricle helps collect sound from the environment and funnel it into the ear canal.

The sound waves then hit the eardrum (tympanic membrane) at the interface between the outer and middle ear. The middle ear is an air-filled space that contains three bones (malleus, incus, and stapes) that are attached to the ear drum. These bones serve as a lever system to amplify the vibrations from the eardrum as they pass into the inner ear.

The inner ear consists of the vestibular system (balance organs) and the cochlea (hearing organ). The cochlea is a series of fluid filled chambers. The soundwaves will travel through the cochlea and ultimately interact with small hair cells within the cochlea. This will cause the hair cell to bend, which then sends a nerve signal to the brain. The hair cells are arranged in a way such that they respond to different frequencies or tones. In this way, the inner ear can signal to the brain the various complex sounds that you are hearing.

Types of Hearing Loss

Conductive loss consists of anything that prevents the sound waves from reaching the inner ear. This can include wax or infection in the ear canal, a hole or scarring in the eardrum, fluid in the middle ear, or a problem with the middle ear hearing bones.

Sensorineural hearing loss is caused by a problem with the hair and/or nerve cells in the inner ear. These cells are naturally lost with the aging process. Loud noise exposure will contribute to hearing loss. Other causes of sensorineural hearing loss include certain medications, medical conditions including diabetes or autoimmune disorders, and genetic factors.

Diagnosis and Treatment

The diagnosis of hearing loss typically involves an audiogram (hearing test) and clinic visit to review the history and examine the ears. Sometimes further testing such as imaging with an MRI or CT scan may be indicated to evaluate the cause of hearing loss. Once a diagnosis is made, the treatment options can include observation, surgical procedures, or the use of listening devices or hearing aids.

The team at San Diego Ear, Nose, and Throat includes board certified physicians, physician assistants, and audiologists that are dedicated to providing comprehensive and compassionate care. We are here to assist along the way from the evaluation and diagnosis to the discussion of potential surgical treatments or the use of hearing aids. Our audiology team is a fully licensed hearing aid center pleased to assist with the selection of appropriate hearing aids link (link to hearing aid page), inquire into insurance benefits, and continue with hearing aid adjustments and maintenance.

Tips for hearing loss

  • First recognize that hearing loss is an issue. It can sometimes be difficult to accept that there is a problem.
  • Make family, friends, and colleagues aware of the issue so they can speak more clearly. You can ask them to make face to face contact to help with facial expression and lip reading.
  • Try to avoid noisy environments when having one-on-one conversations. Background noise can greatly interfere with your ability to hear the desired conversation.
  • In a group, position yourself so that you can see everyone (sit at the head of the table). If you have one bad ear, you can position yourself at a corner so the good ear is best exposed to the group.
  • There are a variety of assistive listening devices available. You can use amplifying devices for the phone. FM systems with headphones can assist with TV watching.

Resources

Some people suffering from hearing loss experience social anxiety, lowered self-confidence, isolation, or depression.  The Hearing Loss Association of California offers support groups in the San Diego area as well as a newsletter.  You can find out more at http://hearinglosssandiego.org/.