Hearing Loss

One in eight people in the United States over the age of 12 has hearing loss. The number increases with age, with about two percent of adults 45-54 and nearly nine percent of adults 55-64 living with hearing loss. No matter your age or the type of hearing loss you have, you can find support for hearing loss at any of the Audiology & Hearing Aid Solutions offices in Northern New Jersey. 

How the ear works

The auditory system is an incredibly complex structure that brings together your ears and your brain to convert vibrations in the air around you into the sense we call hearing, so you perceive sound.  

  • The process begins when the air vibrates and creates sound waves that travel through the environment. The outer ear gathers these waves and sends them down the ear canal to the eardrum.
  • The vibrating sound waves make the eardrum vibrate. When the eardrum vibrates, it moves three tiny bones in the middle ear.
  • The movement of these bones moves the fluid in the inner ear (cochlea).
  • Moving inner ear fluid bends the hair cells. As the hair cells bend, they convert movement into electrical impulses.
  • The auditory nerve transmits these electrical impulses to the brain where they are processed and interpreted as sound.

The outer ear

The outer part of the ear is the pinna or auricle. The grooves and ridges in the pinna work with the ear canal to naturally boost the volume for vibrations in the 2000-3000 Hz frequency range. Many consonant sounds fall in this range. 

The ear canal is the second component of the outer ear. It is also known as the external auditory meatus. Only a few layers of hair and skin line the ear canal. It is rich in blood vessels. The earwax (cerumen) produced in the canal protects the skin from bacteria and moisture. The amount of earwax produced varies by the individual and is only a problem if it completely blocks the ear canal. 

The middle ear

At the bottom of the ear canal lies the tympanic membrane or eardrum. This thin membrane divides the middle and outer ear. It may be thin, but it is strong.  Behind the eardrum lay three tiny bones that connect to form a chain. These ossicles amplify the strength of vibrations of the eardrum and then send the vibrations to the inner ear. 

Bone encases the middle ear; it does not associate with outside air except through the Eustachian tube. This tube provides the air pressure equalizing system for the ear. The tube stays closed unless it is involuntarily opened by swallowing, yawning or chewing. You can intentionally open the tube to relieve the feeling of pressure in the ears as when flying in an airplane or ascending a mountain. 

The inner ear

The inner ear is found deep within the temporal bone, the skull portion found on both sides of the head above and to the sides of the outer ear. The inner ear contains the semicircular canals and the cochlea.

The semicircular canals play an important part of maintaining balance and are not involved in hearing.  The inner ear contains the cochlea, a fluid-filled structure that resembles a snail. The cochlea converts the vibrations from the tympanic membrane and the ossicles into electrical impulses. The fluid in the cochlea moves with the vibrations and bends the hair cells. This bending action sends electrical signals via the auditory nerve to the brain. 

Types of hearing loss

There are 3 main types of hearing loss–conductive, sensorineural, and mixed.  Hearing loss is also classified by degrees, such as mild, moderate, moderately-severe, severe or profound. A complete diagnostic audiological exam determines both the type of hearing loss you have, as well as the degree.  

Conductive hearing loss

When sound is not properly conducted to the inner ear and cochlea, the result is conductive hearing loss. The ear canal, eardrum (tympanic membrane) or the middle ear (ossicles and Eustachian tube) may be the source of the problem. The inner ear and auditory nerve are not affected by this type of hearing loss. 

Causes of conductive hearing loss include:

  • Outer or middle ear infections
  • Complete earwax blockage
  • Deterioration of the middle ear bones (ossicles)
  • Otosclerosis, the fixation of the ossicles
  • Perforated tympanic membrane or a hole in the eardrum
  • Absence of the outer ear or middle ear structures

This type of hearing loss may be permanent or temporary. Medical management can correct some conductive hearing loss, while hearing aids may be a solution for permanent conductive hearing loss. 

Sensorineural hearing loss

Sensorineural hearing loss occurs when there is a problem in the cochlea or auditory nerve. Most sensorineural hearing is the result of abnormal or damaged hair cells in the cochlea. This prevents sound from being transmitted to the brain.  

Causes of sensorineural hearing loss include:

  • Congenital: The hair cells are abnormal at birth, making this a congenital condition.
  • Damage to hair cells: Hair cell damage due to genetics, infection, drugs, trauma or over-exposure to noise.
  • Presbycusis: Age-related hearing loss

Sensorineural hearing loss is usually permanent and can be stable or worsen over time. Hearing aids are the most common treatment.

Mixed hearing loss

Mixed hearing loss occurs when a person has both sensorineural and conductive hearing loss. There is a problem in the inner ear as well as the outer or middle ear. 

The conductive hearing loss may be temporary or permanent, and the sensorineural hearing loss is permanent. Mixed hearing loss may be treated with medical management and hearing aids. 

Degrees of hearing loss

Hearing loss can range from mild to profound. Audiology & Hearing Aid Solutions uses pure tone audiometry to measure the degree of your hearing loss. This test is painless. You’ll simply sit in a sound-proof booth, while we adjust the volume of sound that is just barely audible in each ear. These results are placed on an audiogram and reviewed with you by our team of professionals..

  • Those with mild hearing loss may have trouble hearing people speak in soft tones. Background noise and distance are also challenging.
  • With moderate hearing loss, holding conversations is difficult, even at close range and without background noise.
  • Those with moderately-severe hearing loss find participating in group discussions difficult.
  • Severe hearing loss prevents normal conversation in any environment.
  • Those with profound hearing loss may not be able to understand speech, even with amplification.

Stigma of hearing loss

A University of California study found that hearing loss stigma and the choice to seek treatment is directly related to three factors:

  • Alteration of self-perception
  • Ageism
  • Vanity

Impacts of untreated hearing loss

Too often, people know they are experiencing hearing loss, but they put off getting help. On average, a person waits seven years before seeking treatment. Don’t let frustration with hearing loss keep you from seeing the audiologist and don’t accept hearing loss as a sign of aging. Untreated hearing loss can have a negative impact on your social, psychological, cognitive and physical health. It also has serious impacts on the quality of your life.  Untreated hearing loss can cause:

  • Irritability, negativism and anger
  • Fatigue, tension, stress and depression
  • Avoidance or withdrawal from social situations
  • Social rejection and loneliness
  • Reduced alertness and increased risk to personal safety 

Untreated hearing loss and cognitive decline

Untreated hearing loss impacts your cognitive health. When your ability to hear declines, your brain receives less auditory input to process. Just like working your muscles keeps them fit, working your brain keeps it fit too. So, loss of input to process can lead to memory loss or even dementia. As the portion of your brain responsible for processing sound weakens, your brain weakens overall. 

Unfortunately, some people see hearing aids and perceive the wearer as old, less intelligent, mentally ill or only hearing what they want to hear.

Wearing hearing aids was found to negatively alter the self-perception of study participants. They perceived themselves differently and worried about how they would appear to others while wearing the hearing aids. Typically, men see hearing aids as a sign of weakness and women see them as a sign of aging.

Today’s hearing aids are small and some are completely invisible, so there is no need to let the vanity factor stand between you and hearing better. 

Comorbidities

Many health connections can be connected to hearing loss. These comorbidities are conditions that have links to hearing loss, meaning if you have hearing loss, you may be at a higher risk for other medical issues, and vice versa.  Common examples are:

Cognitive decline

With untreated hearing loss, the brain gets overworked by constantly straining to understand speech and sound. An overworked brain doesn’t work efficiently.  Also, brain cells can shrink from lack of stimulation, including the parts of the brain that receive and process sound.

Dementia

For those 60 years and older, the severity of the untreated hearing loss is closely related to the risk of dementia, perhaps due to shared brain pathways.  However, don’t assume you’re suffering from dementia if you’re having trouble with memory or problem-solving.  Hearing loss has some of the same symptoms as cognitive impairment, so it’s vital to have regular hearing checks.

Diabetes

Hearing loss occurs almost twice as often in adults who have diabetes than in those who don’t. Over time, high blood sugar levels can damage small blood vessels and nerves in the inner ear.

Heart disease

Studies have shown that good circulation plays a role in maintaining good hearing health. Conversely, inadequate blood flow and trauma to the blood vessels of the inner ear can contribute to hearing loss.

Kidney disease

An estimated 54% of American adults with chronic kidney disease have hearing loss, possibly caused by toxins related to kidney failure.

Risk of falls

Hearing loss can cause diminished spatial awareness and reduced attention capacity – which can increase the risk of falls. Sounds also help us balance.  It is possible that treating hearing loss can serve as a type of ‘balance aid’ like a cane.  

Vision loss

Decreased sensory awareness from vision and hearing loss makes daily living activities more difficult and may put personal safety at risk.

Aging

Age-related hearing loss affects more men than women and while permanent, is treatable with hearing devices.

Understanding tinnitus

Ringing, buzzing, whooshing or hissing in your ears – no matter how you describe the sound, the condition is called tinnitus.  For most people, tinnitus is a temporary annoyance. But for others, it is a debilitating condition that makes sleeping difficult and life unbearable.

Tinnitus symptoms

The most common tinnitus sounds are:

  • Ringing
  • Buzzing
  • Whooshing
  • Hissing 
  • Clicking

The sound may be heard constantly or intermittently. It can even keep some people from sleeping. 

Tinnitus causes

Tinnitus is a symptom of another condition. Tinnitus can be caused by:

  • Exposure to loud noise
  • Medication
  • Hearing loss
  • Ear infection
  • Trauma to the ear
  • Earwax buildup
  • Meniere’s disease
  • Vascular disorders

Some tinnitus can be resolved easily if the cause is temporary, such as an infection or a buildup of earwax. Other tinnitus requires a long-term management plan.

Tinnitus treatments

There are several different treatment methods available depending on your situation. Audiology & Hearing Aid Solutions can assess the severity of your symptoms, how they impact your quality of life, review possible causes, and recommend one of the following treatments:

  • Hearing aids: Hearing aids are a powerful ally in treating tinnitus. Hearing aids equipped with tinnitus-masking features help cover the tinnitus and provide relief from the unwanted noise.
  • Tinnitus retraining therapy (TRT): TRT helps individuals find tinnitus by retraining your mind to block out and hear certain tones, which in turn, helps to ease the symptoms caused by tinnitus.
  • White noise machines: If your tinnitus isn’t as severe or only bothers you at night, a white noise machine may provide relief. White noise machines produce a steady sound to mask the tinnitus noises.
  • Medical intervention: If earwax build-up, medication, or infection cause your tinnitus, the proper course of action may include removing the earwax, switching medications, or taking antibiotics. Behavioral therapy can also help treat the varying emotions you may experience with tinnitus, from anxiety to anger.