Our Doctors of Audiology work in conjunction with our ENT doctors to provide comprehensive care for patients of all ages with hearing and/or balance concerns. We provide top-quality hearing healthcare by assessing and understanding your condition to better improve your quality of life. We offer the latest styles in hearing devices from major manufacturers to suit your communicative needs and lifestyle.
Hearing loss has a lot of different causes and manifestations. It can be sudden or gradual. It can occur in one ear or both ears. It can be temporary or permanent. It happens to people of all ages and is associated with the aging process. Before discussing causes and treatments for hearing loss, it is important to understand how hearing works.
How We Hear
There are three sections of the ear: the outer ear, middle ear and inner ear. Each section helps move sound through the process of hearing. When a sound occurs, the outer ear feeds it through the ear canal to the eardrum. The noise causes the eardrum to vibrate. This, in turn, causes three little bones inside the middle ear (malleus, incus, stapes) to move. That movement travels into the inner ear (cochlea), where it makes tiny little hairs move in a fluid. These hairs convert the movement to auditory signals, which are then transmitted to the brain to register the sound.
Signs of hearing loss
Signs of hearing loss can appear gradually or suddenly. The signs of hearing loss below are common to either situation. If you suspect you have a hearing loss and/or experience any of the signs below, you should consult a doctor. You can schedule an appointment with one of our Ear, Nose, and Throat physicians (otolaryngologists) who will conduct a thorough medical examination. In addition, you may also be referred to our Audiology department for a comprehensive audiologic evaluation.
Signs of hearing loss:
- Requiring others to frequently repeat themselves
- Thinking that other people always sound muffled or they’re mumbling
- Difficulty hearing in noisy situations such as restaurants
- TV volume is turned up too high for other people’s preferences
- Frequent misunderstanding in conversation
- Ear noises (e.g. ringing or buzzing, also known as tinnitus)
- Frequent lip-reading or watching people’s faces to help understand what is being said
- Feeling stressed or frustrated from the effort of listening
- Withdrawing from social situations that were once part of your life because of difficulty hearing
- Medically you can be at increased risk of hearing loss if one or more of the following apply:
- Family history of hearing loss
- Taking or have taken medications that can harm the hearing system (ototoxic drugs)
- History of diabetes, heart, circulation or thyroid problems
- History of exposure to very loud sounds over a long period or single exposure to explosive noise
(Source: Better Hearing Institute)
Causes of Hearing Loss
Hearing loss occurs when sound is blocked in any of the three areas of the ear. The most common cause of hearing loss — and one of the most preventable — is exposure to loud noises. Infections, both of the ear or elsewhere in the body, are also a major contributor to hearing loss.
In the Outer Ear: Earwax build-up, infections that cause swelling, a growth in the ear canal, injury or birth defects can restrict hearing in the outer ear.
In the Middle Ear: Fluid build-up is responsible for the most common infections and blockages in the middle ear. Fluid in the middle ear prevents the bones from processing sounds properly. Tumors, both benign and malignant, can also result in hearing loss in the middle ear.
In the Inner Ear: The natural process of aging diminishes hearing from damage to the cochlea (mechanism for converting sound vibrations to brain signals), vestibular labyrinth (which regulates balance), or the acoustic nerve (nerve that sends sound signals to the brain). Additionally, inner ear infections, Meniere’s disease and other nerve-related problems contribute to hearing loss in the inner ear.
Other causes of hearing loss include:
Presbycusis: Age-related hearing loss, such as having difficulty hearing in noisy places, having trouble understanding what people are saying or not registering softer sounds.
Heredity and Genetic Causes: There is a wide variety of diseases and syndromes that are either genetic or hereditary that can cause hearing loss. Some, like rubella (German measles) occur when a pregnant mother has the disease, which causes hearing loss in the baby. Other, rarer types of hereditary and genetic causes include CHARGE Syndrome, Connexin 26 disorder, Goldenhar Syndrome,Treacher Collins Syndrome, Usher Syndrome, Waardenburg Syndrome and otosclerosis (growth of spongy bone tissue in the middle ear).
Most causes of outer ear hearing loss can be remedied. But problems of the middle and inner ear can lead to permanent hearing loss, which is why it is important to seek medical attention quickly if you are experiencing a problem hearing.
Types of Hearing Loss
There are four types of hearing loss:
- Conductive hearing loss: Caused by conditions that block the transmission of sound through the outer ear and eardrum to the middle ear.
- Sensorineural hearing loss: Inner ear damage that occurs as part of the natural process of aging.
- Mixed hearing loss: Mixed hearing loss refers to people who have both conductive and sensorineural hearing loss. Most people experience more than one type of hearing loss.
- Central hearing loss: This occurs when the central nervous system fails to send a readable signal to the brain, which is called a central auditory processing disorder. People with central hearing loss generally can hear all sounds, but can’t separate or process them.
- Hearing loss is measured in four degrees: mild, moderate, severe or profound. The degree of hearing loss drives the selection of the best form of treatment on a case-by-case basis.
Evaluation of Hearing Loss
A licensed clinical audiologist will perform a comprehensive audiologic evaluation to determine the status of your hearing. The following tests may be included and are selected according to your individual condition:
- Pure tone audiometry
- Speech audiometry
- Acoustic reflex testing
- Otoacoustic emissions
In addition, if it is determined you have a hearing loss and you are a candidate for amplification, further evaluation may be performed to help determine the most appropriate hearing system for you. This may include:
- Hearing and Communication Questionnaire
- Acceptable Noise Level
- Hearing Loss Treatments
The location, type and degree of hearing loss impact the choice of treatments for any hearing problem. The most common treatment options include:
- Antibiotics, decongestants and pain medication to overcome ear infections
- Myringotomy, a piercing of the eardrum to allow for fluids to drain out of the outer ear
- Insertion of a tube into the Eustachian tube (part of the anatomy that connects the middle ear to the back of the throat) to keep it open and allow for normal fluid drainage. This technique may be recommended for people who get frequent ear infections.
- Amplification, which may include traditional hearing aids and/or other assistive listening devices; select patients may also qualify for a bone anchored hearing aid (BAHA)
- Referral as appropriate to a cochlear implant center for patients determined to be candidates
- Surgery to remove benign or malignant tumors or correct bone- or nerve-related problems
If you experience sudden or prolonged hearing loss with dizziness, fever or pain, please contact our office right away and schedule an appointment with one of our otolaryngologists. We’ll conduct a physical examination as well as a hearing test to determine the type and severity of your hearing loss. We’ll then recommend the best treatment.
Our Doctors of Audiology fit patients with the latest hearing aids from leading hearing aid manufacturers. Taking into account the patient’s lifestyle, hearing needs and budget, hearing aids are selected and programmed on an individual basis right here in the office. All of our hearing aids have a 45-day trial period and a generous warranty, up to three years.
The ear is made up of three sections: the outer ear, middle ear and inner ear. Each of these areas is susceptible to infections, which can be painful. Young children have a greater tendency to get earaches. While most ear pain resolves itself in a matter of days, you should get a physical examination to understand the type of infection, prevent it from spreading and obtain treatment to help alleviate the pain.
Outer Ear Infection (Otitis Externa)
Also known as Swimmer’s Ear, outer ear infections result from an inflammation, often bacterial, in the outer ear. Generally, they happen when water, sand or dirt gets into the ear canal. Moisture in the air or swimming makes the ear more susceptible to this type of ear infection. Symptoms include: severe pain, itching, redness and swelling in the outer ear. There also may be some fluid drainage. Often the pain is worse when chewing or when you pull on the ear. To reduce pain and prevent other long-term effects on the ear, be sure to see a doctor. Complications from untreated otitis externa may include hearing loss, recurring ear infections and bone and cartilage damage. Typically, your doctor will prescribe eardrops that block bacterial growth. In more severe cases, your doctor may also prescribe an antibiotic and pain medication. Most outer ear infections resolve in seven to 10 days.
Middle Ear Infection (Otitis Media)
Middle ear infections can be caused by either bacterial or viral infection. These infections may be triggered by allergies, upper respiratory infections or a blocked Eustachian tube. In chronic cases, a thick, glue-like fluid may be discharged from the middle ear. Treatment is contingent on the cause of the infection and ranges from analgesic eardrops and medications to the surgical insertion of a tube to drain fluid from the middle ear.
Inner Ear Infection (Otitis Interna)
Also known as labyrinthitis, the symptoms of inner ear infections include dizziness, fever, nausea, vomiting, hearing loss and tinnitus. Always seek medical attention if you think you may have an inner ear infection.
If you suspect you or your child may have an ear infection, please contact our office and schedule an appointment with one of our otolaryngologists.
The inner ear serves two purposes: hearing and balance. There are mechanisms in the ear that inform the brain about your position, orientation in space and movement and all times – to keep you in balance. A false sensation of spinning or whirling, known as vertigo, can occur when the signal to the brain is blocked or misfires. In addition to the sensation of dizziness, symptoms may include headache, nausea, sensitivity to bright light, blurred vision, ringing in the ears, ear pain, facial numbness, eye pain, motion sickness, confused thinking, fainting and clumsiness.
Dizziness can also be a symptom of a more serious medical problem, such as high or low blood pressure, heart problems, stroke, tumor, medication side effect or metabolic disorders. Therefore you should always seek medical attention if you experience ongoing or repetitive dizziness.
Common causes of dizziness
An acoustic neuroma is a benign growth on the nerve that connects the inner ear to the brain.
Benign Paroxysmal Positional Vertigo (BPPV):
BPPV occurs when tiny calcium crystals in the ears loosen and begin moving about the wrong part of the ear. It is characterized by sudden, short bursts of dizziness that happen most often as a result of head movement. There is no known cause for BPPV. It usually resolves itself in a matter of days.
Inflammation of the Inner Ear
Dizziness may be one symptom of an inner ear infection.
Meniere’s Disease is characterized by long periods of dizziness, lasting from 30 to 60 minutes or more. It is accompanied by symptoms such as ringing in the ears, hearing loss and a feeling of fullness in the ear. There is no known cause or cure for Meniere’s Disease, although medication and behavior changes can help reduce the severity of the symptoms.
Some migraines (vestibular migraines) can cause a feeling of imbalance and vertigo. This may be accompanied by ringing in the ears or hearing loss. Migraine-related vertigo may occur in conjunction with or separate from the migraine headache.
If you’re experiencing any form of repetitive or chronic dizziness, please contact our office and schedule an appointment with one of our otolaryngologists.