Hearing loss can impair performance in school or work, and the enjoyment of relationships and social activities. A comprehensive diagnostic audiogram and a complete ear, nose and throat evaluation are the first steps to take to diagnose and treat a hearing problem. Sometimes correcting hearing loss can be as simple as removing cerumen from the ear canal, but treatment may include medical treatments, surgery, hearing aids, or even implantable devices (BAHA). Please click here to see our hearing solutions and hearing protection options.
Three Types of Hearing Loss
Conductive Hearing Loss
Conductive hearing loss is really a mechanical phenomenon and occurs when sound is not conducted efficiently through the ear canal, the eardrum, or the middle ear bones. This can be caused by a perforated eardrum, middle ear infection or fluid, impacted earwax, or occasionally a tumor or growth in the ear. Many times, conductive loss can be corrected. If you have a hearing loss and a history of cerumen impaction, please advise us of this history when making your appointment so that we can schedule an evaluation and possible cerumen removal by one of our otolaryngologists prior to the hearing test.
Sensorineural Hearing Loss
Sensorineural hearing loss is the most common type of hearing loss. From ages 64-75, one in every three persons will have hearing loss. Over the age of 75, half of the population has hearing loss. The most common causes of sensorineural hearing loss are age related changes, noise exposure, inner ear blood circulation, inner ear fluid disturbances and problems with the auditory nerve.
Sensorineural hearing loss is a neurologic problem, and may be due to damage to the inner ear (cochlea), or auditory nerve. Unfortunately, in addition to the reduction in hearing, there is also often a reduction in speech understanding, especially when there is noise in the background. There can be many causes, and it can occur at any age. There are exceptions, but generally the loss cannot be medically or surgically corrected. If the loss cannot be corrected, hearing aids are typically the main treatment option.
Sudden Sensorineural Hearing Loss
Sudden sensorineural hearing loss is a special type of sensorineural hearing loss that results in the rapid loss of hearing, usually in only one ear, that happens all at once or over a period of up to 3 days. This condition is considered an ENT emergency and an immediate evaluation and intervention are needed to attempt to prevent the current loss from becoming a permanent loss. Time sensitive administration of high-dose oral and intratympanic steroids are critical in the rescue attempt to recover the hearing loss. More info on SSNHL treatment.
Mixed Hearing Loss
When hearing loss has both conductive and sensorineural components, it is referred to as a mixed hearing loss. Treatment recommendations are made according to the type and degree of each component of the hearing loss.
A hearing assessment in our office may include any of the following components to determine the degree and type of hearing loss:
- Patient History: to identify possible contributing factors to hearing loss.
- Otoscopy: visual inspection of the ear canal and eardrum to assess for infection, excessive earwax, drainage, or a hole/tube in the eardrum that may affect the hearing test.
- Tympanometry: air pressure is introduced into the ear canal to assess eardrum movement. This identifies if fluid may be present in the middle ear, if a pressure-equalization tube (PE tube) is working properly, or the possible presence of a eardrum perforation.
- Acoustic Reflex testing: louder sounds are presented to check for a reflex that typically occurs.
- Pure Tone Testing: using insert earphones and with an oscillator behind the ear, different pitches are presented to assess for hearing loss
- Visual Reinforcement Audiometry and/or Condition Play Audiometry: the pediatric patient is conditioned to turn towards the sound or conditioned to “drop a toy” into a bucket or “play” when the sound is presented to his/her ears.
- Speech Testing: helps determine the ability to discriminate speech, as these results may impact the benefits of amplification (hearing aids).
- Tinnitus Assessment: consists of tinnitus pitch matching, tinnitus loudness, minimal masking level and residual masking level evaluations.