When hearing loss occurs
You’re having a meeting in a quiet room with just a few people,
and you can hear just about everything people say. Later, you’re
on a noisy train coming home and a neighbor sits down beside you. He
tells you a joke — you know it’s a joke because he’s
laughing. You laugh, too, even though you haven’t heard enough
to understand the joke.
This experience is typical of people whose hearing has begun to decline,
especially those whose hearing loss is age-related, noise-related, or
a combination of both. Hearing loss usually comes on so gradually, over
so many years, that it can be hard to realize that you don’t hear as well as you used to. The difference
at first may not be that great, because people have a marvelous capacity to compensate
for what they can’t hear. For example, you may fill in gaps by
picking up on the facial expressions and gestures of your conversational
partner.
But with age, the first sounds to go tend to be high-frequency
sounds. What this means in practical terms is that you can
hear the vowels just fine, but consonants like “f” and “th” give you trouble. You may not be able
to tell whether someone said “fish” or “this,” “thing” or “sing.” And
you may have the most difficulty hearing over the phone or when there’s
a lot of background noise. In a quiet room, you may do just
fine.
As years pass, high-frequency sounds become harder to hear,
even when the room is quiet. That’s when the doorbell and the telephone may ring and ring
before you realize it. Lower-frequency sounds may also become problematic. You
may find yourself increasingly asking others to repeat themselves, or shrinking
back from conversation to avoid embarrassment.
Kinds of hearing loss
There are two basic types of hearing loss, sensorineural and conductive.
Many people have a combination, especially as they age. These
people are said to have mixed hearing loss. Hearing loss that is strictly
due to aging is called presbycusis, a form of sensorineural hearing loss.
Although hearing loss that’s related to noise damage and age comes on gradually,
other kinds of hearing loss occur suddenly. Knowing which type of hearing loss
you have is the first step in determining which treatment is right for you; treatment
options may include being fitted with a hearing aid or, in some cases, surgery.
Sensorineural hearing loss. More than 80% of people
who are hard of hearing have sensorineural hearing loss. It’s the
result of the destruction of the sensory cells, or hair cells, in the
ear or the nerves that help transmit sound messages to the brain. Sensory
cells can be damaged or killed off by loud noises, toxic drugs, head
injuries, and above all, aging. When sensorineural hearing loss is caused
by aging or by an ongoing exposure to loud noise, it comes on gradually,
over a period of many years. But it can start suddenly when the cause
is a head injury, a toxic drug, or an extremely loud noise, such as an
explosion. Sensorineural hearing loss is usually permanent.
Conductive hearing loss. This type of hearing loss
is caused by something that blocks or hinders sound waves from passing
through the outer or middle ear. The source of the obstruction can be
any number of things, including earwax, an accumulation of fluid, inflammation
from an ear infection, a cyst or other abnormal growth, or a foreign
body that became lodged accidentally in the ear. Unlike sensorineural
hearing loss, conductive hearing loss is often treatable with medicine
or surgery. For example, you can remove excess earwax with a cleaning
kit used at home, or you can ask your doctor to remove it.
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What is Hearing Loss?
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