Hearing loss

Hearing loss is prevalent, impacting one in every three individuals by the age of 65. However, it's not solely an ailment of the elderly; it's increasingly prevalent among younger individuals exposed to excessive noise.

Hearing loss encompasses varying degrees of impairment in detecting or understanding sound.  For hearing to occur, sound waves pass through the external, middle and inner ear. These waves are then transmitted to the brain for interpretation as sound. Disruptions to this process can result in partial or complete hearing loss.


Indicators of Hearing Loss

Symptoms of hearing loss frequently manifest gradually, often unnoticed by individuals until they are brought to their attention by a family member or friend:

  • Struggling to comprehend words, particularly in noisy environments.

  • Regularly requesting others to repeat themselves.

  • Perceiving speech as muffled.

  • Exhibiting social withdrawal tendencies.

  • Increasing the volume of the television or radio.

Early detection of hearing issues through hearing tests can enhance the likelihood of successful treatment.

Types of Hearing Loss

Hearing loss is divided into two categories: conductive and sensorineural. A third type, known as mixed hearing loss, occurs when patients exhibit characteristics of both conductive and sensorineural categories.

Conductive Hearing Loss

This form of hearing loss arises from issues within the middle ear and is often amenable to medical management. It can be attributed to conditions such as ear infections, excessive earwax buildup, ear trauma, or structural abnormalities. Treatment options, including medications, surgical intervention, and earwax removal, may prove effective depending on the specific circumstances.

Sensorineural Hearing Loss

This form of hearing loss stems from damage to the inner ear and, although seldom curable, is frequently effectively managed with hearing aids or, in certain instances, cochlear implants. It typically arises from nerve impairment due to factors such as aging, exposure to loud noises, viral infections, diseases, and genetic predisposition.

Testing for hearing loss

As the initial step in diagnosing hearing loss, you will undergo a hearing assessment.

This thorough assessment comprises various individual tests aimed at identifying the degree and nature of hearing loss. Our audiologists possess expertise in administering a range of tests to aid in diagnosis and treatment.

Hearing assessments are entirely safe and painless procedures. They are conducted within a soundproof booth, and the outcomes are depicted on a graph illustrating the patient’s hearing response across various frequencies. This graph, known as an audiogram, assists your audiologist in devising the most suitable approach for addressing any hearing impairment.

A standard hearing assessment comprises several distinct tests:

  • Acoustic reflex test: Assesses involuntary muscle contractions in the middle ear to pinpoint the location (the ossicles, cochlea, auditory nerve, etc.) and type of hearing loss 

  • Auditory brainstem response (ABR) testing: Determines the presence of sensorineural hearing loss and is commonly employed for newborn hearing screenings.

  • Otoacoustic emissions (OAEs): Sounds are generated by vibrations of the hair cells in the cochlea of the inner ear. OAE testing utilizes a tiny probe fitted with a microphone and speaker that is used to stimulate the cochlea and measure its response.

  • Pure-tone testing, or pure tone audiometry: Measures your ability to hear sounds of varying pitches and volumes through air conduction.

  • Bone conduction testing: Another type of pure-tone test that measures the inner ear’s response to sound.

  • Speech, or word recognition testing: Used to measure the speech reception threshold (SRT), or the faintest speech you can understand 50 percent of the time.

  • Tympanometry: Evaluates middle ear function to detect fluid, wax buildup, eardrum perforations, or tumors.

Regular hearing assessments are advisable for individuals aged 50 and above, even if they do not perceive any signs of hearing loss. However, such tests are not exclusive to older adults. It's equally important for babies and toddlers to undergo hearing screenings to mitigate potential delays in speech and language development resulting from undetected hearing impairments.


Hearing aids

CU Medicine audiologists are licensed providers of hearing aids and accessories, ensuring our patients have access to comprehensive hearing care.

After your hearing loss has been evaluated and diagnosed, you will collaborate with your audiologist to choose the most suitable hearing devices. The hearing aid style you choose should be based upon your type and degree of hearing loss, lifestyle needs, cosmetic preferences and budget.

In-The-Canal (ITC) style: Designed to be worn discreetly inside the ear canal, these hearing aids are nearly invisible to others. They are ideal for individuals experiencing mild to moderate hearing loss.

Pros: Virtually invisible due to their small size and placement in the ear canal—perfect for those who value discretion.

Cons: Small size translates to shorter battery life and limited features; controls are difficult to adjust; earwax can accumulate and clog speaker.

This style also includes CIC (Completely-In-The-Canal) and IIC (Invisible-In-the-Canal) hearing aids, which are even smaller.

In-The-Ear (ITE) style: This device style is slightly larger than the ITC. In-the-ear hearing aids are suitable for individuals with mild to severe hearing impairment.

Pros: Includes additional features unavailable on smaller ITC hearing aids; easier to handle and adjust controls; larger battery means longer battery life.

Cons: Susceptible to wind noise; earwax frequently clogs the speaker; more visible to others.

This style also includes RITE (Receiver-In-The-Ear) hearing aids and RIC (Receiver-In-the-Canal) hearing aids.

Behind-The-Ear (BTE) style: This is the most popular style of hearing aid due to its easily navigable controls and longer battery life. It is suitable for all degrees of hearing loss and is particularly appealing to both children and older individuals.

Pros. Helps with all types of hearing impairments; a larger battery means a longer battery life; easy to handle and adjust the controls; provides more amplification than smaller types.

Cons: Largest and most visible style; may pick up wind noise.

Open Fit style: A smaller version of the BTE style. Open Fit styles will work for mild to moderate hearing loss.

Pros: Less visible than BTE; no occlusion means more natural sound.

Cons: Prone to low frequency noise leakage; smaller size makes it more difficult to adjust.


Hearing protection

Initiating early measures to safeguard your hearing can significantly reduce the risk of future hearing impairment.

Daily, we encounter various levels of sound, with some surpassing the safe threshold of 85 decibels (dB). Prolonged exposure to noise exceeding this level can lead to permanent and irreversible hearing damage. Noise-induced hearing loss is the most common cause of hearing loss in the U.S. Fortunately, it is easily preventable.

For individuals exposed to high noise levels, wearing hearing protection is crucial. Earplugs are essential in loud environments like rock concerts, sporting events, and when engaging in activities such as motorcycle riding, snowmobiling, lawn mowing, or using power tools. Workers subjected to loud workplace noise must be provided with hearing protection by their employers as mandated by OSHA regulations. Whenever possible, choose quieter products, including quieter power tools and appliances.

When using earphones, remember the “80-90” rule—you can listen at 80 percent of the maximum volume of your music player for 90 minutes per day. Increasing the volume leads to less safe listening time and decreasing the volume results in longer safe listening time.