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A sensorineural hearing loss is characterized by the failure of nervous impulses to reach the brain.
Age-Related Hearing Loss - Presbyacusis Age-related hearing loss is also known as presbyacusis. Noise-Induced Hearing Loss Noise-induced hearing loss is triggered by exposure to loud noises. Congenital Hearing Loss Congenital hearing loss refers to a hearing loss that is present at birth.
Meniere’s Disease Meniere’s disease is an inner ear pathology that affects hearing and balance. Sudden Hearing Loss A sudden hearing loss is the rapid deterioration of hearing acuity that may continue to decline for three consecutive days. Acoustic Neuroma Acoustic neuroma is a noncancerous tumor on the auditory nerve that carries nervous impulses from the cochlea to the brain. A conductive hearing loss is usually a temporary hearing loss the can be treated medically or surgically by an ENT specialist. Hearing aids can be used while waiting for the medical intervention or as an alternative treatment option.
Eardrum PerforationEardrum perforations can be the result of head trauma, middle ear infections or from the failure to heal after a ventilation tube has fallen out. Otosclerosis Otosclerosis is a progressive disorder that results in the fixation of the stapes, the third bone of the ossicles.
Ossicular Discontinuity The ossicles have an important role in the conduction of sound waves from the outer ear to the inner ear.
Cholesteatoma Cholesteatoma is a condition where dead skin is produced in the middle ear to form a cyst behind the eardrum. Impacted Earwax Cerumen or earwax is a natural secretion of glands in the outer ear canal that helps keep the ear safe and clean.
Aural Atresia Aural atresia is a congenital condition where the outer ear has not developed properly at birth.
A hearing loss caused by a combination of both conductive and sensorineural hearing loss. Head trauma is the most common single cause of mixed hearing loss. Head Trauma Injuries to the head can cause damage to the delicate structures of the middle ear or the inner ear. Retirement residence administrators, contact us today to schedule a NO CHARGE hearing awareness activity offered to your senior residents.
Hearing loss can interfere with your ability to communicate and can compro- mise your safety. There are two main types of hearing loss: conductive hearing loss and sen- sorineural hearing loss. Exposure to loud noises—either a one-time exposure or repeated exposure over time—damages both the sensory hair cells of the inner ear and the auditory nerve. Although noise damage to the inner ear is irreversible, there are steps you can take to prevent noise-induced hearing loss.
If you are exposed to loud noise in the workplace, be sure to wear appropriate ear protection.
Another effective form of ear protection (although less effective than ear- muffs) is earplugs made of foam rubber, plastic, or wax. If your workplace is very noisy, it is extremely important that you have your hearing checked regularly. A hearing aid is a small, battery-powered device that ?ts in or over your ear and ampli?es sounds. Although many models of hearing aids are available, most can be placed into one of the following categories. Before choosing a hearing aid, you should have a thorough hearing evaluation (see “Diagnostic Procedures,” page 404) performed by an otolaryngologist or an audiologist. When you receive your hearing aid, you will be tested to determine how well you can hear and understand speech while wearing the device. Tinnitus is the medical term for ringing or other sounds in the ears that occur when there is no external source of these sounds. Tinnitus is caused by hearing loss or by spasms (involuntary muscle contrac- tions) in the muscles of the neck or jaw. There are a number of steps you can take to reduce the severity of your tinni- tus, depending on its cause. Some doctors recommend using a technique called masking to relieve the effects of tinnitus. Meniere’s disease is an abnormality in the inner ear that causes a number of symptoms—dizziness, tinnitus (see page 401), hearing loss that comes and goes, and pressure in the affected ear.
To diagnose Meniere’s disease, a doctor ?rst takes a medical history and per- forms a thorough physical examination. To assess the person’s balance, the doctor may perform a test that includes ?ooding the person’s ears with water.
There is no cure for Meniere’s disease, but certain treatments can help manage the symptoms.
Three types of surgery have been developed to correct the disorder, but their effectiveness has been dif?cult to establish. This permanent hearing loss can be caused by damaged nervous cells of the cochlea or difficulties with the upper auditory pathways. Other than hereditary reasons, this is the most common cause of permanent sensorineural hearing loss.
Individuals exposed to prolonged periods of excessive noise can develop this permanent sensorineural hearing loss.
It is caused by dysfunctions in the outer ear or in the middle ear that prevent the sound waves travelling in the air to soundly reach the inner ear. Otitis Media is an infection in the middle ear causing fluid buildup behind the eardrum, thus limiting the movement of the middle ear’s mechanical chain . This condition is thought to be a hereditary disorder and can be associated with tinnitus and vertigo. The eardrum is attached to the malleus; the malleus is connected to the incus which is connected to the stapes.
In addition to ear pain and tinnitus, cholesteatoma may also cause the erosion of the ossicles or trigger recurrent middle ear infections and perforated eardrums. In some narrow ear canals or when the cerumen has less of a lubricating quality, the earwax can become impacted and cause a conductive hearing loss.
After a hearing test, hearing care professionals will be able to find out if this is only a conductive hearing loss or a mixed hearing loss.
A head trauma can therefore cause a temporary or permanent hearing loss and can be accompanied by tinnitus.
It develops adapted solutions for individuals, institutions and businesses, to ensure the independence and social well-being of the hard of hearing.
Other ear disorders can cause unpleasant symptoms such as ringing in the ears (tinnitus), dizziness, and loss of balance. Other factors—such as viral or bacterial infections, an inherited disorder, or a benign tumor in the ear—also can produce hearing loss.
Conductive hearing loss occurs when something, such as a buildup of earwax or an abnormality in the eardrum, prevents sound waves from being transmitted to the inner ear.
The longer you are exposed to loud noise and the closer you are to its source, the more damage it can cause. A ticking watch is about 20 decibels, normal conversation is about 60 decibels, and city traf?c noise is about 80 decibels. They may experience problems having a conversation, listening to music, or even hearing a ringing doorbell or telephone.
The most important thing you can do to protect your hearing is to avoid loud noise whenever possible. Using specially designed earmuffs is the most effective way to protect your hearing on the job.
Earplugs are inserted into the outer ear canal and must ?t snugly to provide optimal protection.
If your employer does not have your hearing checked regularly, see your doctor, who will perform hearing tests (see “Diagnostic Pro- cedures,” page 404) to check for hearing loss. He or she will per- form audiometry (see page 404) using an instrument called a screening audio- meter to test your hearing. He or she can perform a simple hearing test to determine whether you have hearing loss and may refer you to an oto- laryngologist or an audiologist for additional testing. Although a hearing aid can be ?tted to only one ear, hearing aids are usually placed in both ears to provide the best overall hearing. Prices typically range from $500 for a standard hearing aid up to $2,500 for hearing aids that are fully computerized and programmable.
You can purchase the hearing aid directly from the doctor or the audiologist or from an independent, licensed hearing aid distributor. You will also learn how to care for your hearing aid, how to insert and remove it, how to change the batteries, and how to use your hearing aid correctly.
This procedure is used to repair a perforated eardrum (a hole in the eardrum) with a tissue graft (a transplantation of healthy tissue from one part of the body to another). The procedure is performed using either local or general anesthesia and may cause mild pain for a few days. This procedure involves implantation of an electronic device to treat severe sensorineural hearing loss (see page 397) that has caused total or near-total deafness.
It is a very common condition, affecting an estimated 35 million people in the United States each year.


The hearing loss, which may not be noticeable, may result from a variety of diseases and conditions, including stiff- ening of the bones in the middle ear, allergies, high blood pressure, diabetes, a tumor, a thyroid condition, or head or neck injury.
Hearing loss typically accompanies tinnitus, but one often becomes apparent before the other. He or she will probably refer you to an otolaryngologist, who will ?rst administer a hearing test. Because the condition is more noticeable in quiet surround- ings, you can try to mask the unwanted sounds in your ears by listening to a competing sound, such as a radio or television, an air conditioner, a ticking clock, or radio static. The symptoms of Meniere’s disease appear suddenly and can occur daily or as seldom as once a year. Meniere’s disease affects about 3 million to 5 million people in the United States, with about 100,000 new cases diagnosed each year.
The doctor is usually able to diagnose the condition on the basis of the person’s symptoms. Another important factor to consider is that all surgery on the ear carries a risk of hearing loss.
In rare cases, labyrinthectomy and vestibular neurectomy may cause permanent balance problems, especially in older people. This test is sometimes used to rule out an acoustic neuroma (a noncancerous tumor in the ear canal).
This hearing test measures the electrical activity of the sensory hair cells in the inner ear in response to sound waves. This condition is not medically or surgically treatable, in most cases hearing aids and assistive listening devices are used to adapt to the hearing difficulties caused by a sensorineural hearing loss.
Listening to music at loud volumes and motorcycle riding without hearing protection are frequent causes of noise-induced hearing loss. The eardrum and ossicles lack of mobility results in a conductive hearing loss, sound waves are not transformed into amplified vibrations like they should. It can be treated by using hearing aids to overcome the difficulties caused by the hearing loss or by undergoing a stapedectomy. When an individual endures multiple middle ear infections, a cholesteatoma or head trauma, the articulation between these fragile bones can be separated. This condition requires a surgical intervention done by the ENT specialist to remove this middle ear tumor.
Sometimes referred as swimmer’s ear, this condition is often the result of water remaining in the ears after an individual has gone swimming. Impacted earwax must not be removed by cotton swabs (Q-tips) as they remove the natural ear lubricants and can push the earwax deeper in the ear canal. A bone anchored hearing aid can be used in cases where the hearing loss caused by the atresia is only a conductive one to ensure proper development of speech.
If the injury is sustained in the middle ear, the conductive hearing loss may be restored by an ENT specialist. Sound waves enter the outer ear and proceed to the middle ear, where they cause the eardrum to vibrate. One in 10 people in the United States has a hearing loss severe enough to affect his or her ability to hear normal speech. In general, however, noise is loud enough to affect your hearing if you have to shout over it to be heard or if the noise causes pain or ringing in your ears.
Participating in daily activities may become more dif?cult and less enjoyable because the person cannot hear properly and feels left out. They should be replaced promptly if they become soiled or worn, because they will quickly lose their effectiveness.
If hearing loss is detected early, you can take steps to prevent further damage to your ears. This instrument produces a range of sound tones at various frequencies and volumes that are typically heard during speech.
Ampli?- cation of sound in both ears allows the person to hear speech more clearly and helps him or her to distinguish where sounds are coming from, especially in noisy surroundings. A wax impression of your ear will be made so that the laboratory can create a hearing aid that ?ts your ear exactly. You will need to have your hearing aid tested and adjusted regularly to ensure that it is working properly. The person may not need to stay overnight in the hospital but will need to rest at home for about 7 to 10 days after surgery. The implant changes sound waves into electronic impulses that are carried along the auditory nerve to the hearing center in the brain, enabling the person to distinguish different kinds of sounds and often to understand speech. It is esti- mated that 1 to 5 percent of these people have tinnitus so severe that it affects their ability to lead a normal life.
Certain medications—such as anti-in?ammatory drugs, antidepressants, aspirin, or antibiotics—can trigger tinnitus.
Additional tests, such as a computed tomography (CT) scanning or magnetic resonance imaging (MRI), a test for balance, and blood tests, may be performed to determine the cause of your tinnitus.
Some people also ?nd that relaxation exercises (see page 119) help to relax their muscles, improve circulation, and reduce the ringing in their ears.
The dizziness can lead to nausea, vomiting, and sweating and can become so severe that the person has to lie down.
When you move your head, the ?uid moves within the labyrinth, causing nerves in the labyrinth to send signals to the brain about the movement of your body. Hearing tests (see “Diag- nostic Procedures,” next page) and balance tests help to con?rm the diagnosis and rule out other possible causes of the symptoms. Because a brain tumor can produce symptoms similar to those of Meniere’s disease, the person may need to have a scan of the brain to rule out a possible tumor. Eliminating salt (sodium), caffeine, and alcohol relieves the frequency and intensity of episodes in some people.
The most commonly performed surgical treatment for Meniere’s disease is insertion of a shunt (a tiny tube) into the inner ear to drain excess ?uid. The ?rst part meas- ures how well you can hear sounds conducted through the air and indicates the condition of your overall hearing. During the test, a probe that is covered with soundproof material is placed into your outer ear canal, sealing off the entrance to both sound and outside air pressure. During the test, the eardrum is anesthetized and a very ?ne needle is passed through the eardrum until it is very near the sensory hair cells. High pitch sounds are most affected by this form of disability, individuals with presbyacusis will have noted difficulties hearing speech consonants, understanding speech in background noise and hearing high pitch sounds like a birds chirp.
In cases where a noise-induced hearing loss is the result of excessive noise in the work environment, it will be referred as a professional hearing loss. This hereditary disability can be triggered at birth or develop later-on during the individual’s life.
Treatment of this rare pathology requires a collaborative medical team approach that includes the expertise of a neurosurgeon and ENT specialist.
Water finding its way to the middle ear can cause recurrent middle ear infections, thus the perforated eardrum cannot heal.
A stapedectomy is a surgical procedure done by the ENT specialist to replace the stapes by a piston. The Ossicular discontinuity that results will cause a conductive hearing loss often accompanied by tinnitus. One must use natural oil products or carbamide peroxide over the counter softening agents to facilitate earwax removal.
In cases where it is a permanent sensorineural hearing loss, hearing aids can be used to adapt to the hearing difficulties.
The vibrations move through three tiny bones—the malleus (hammer), incus (anvil), and stapes (stirrup)—in the middle ear and proceed into the inner ear, where they are changed into nerve impulses. Sensorineural hearing loss refers to hearing problems that occur because of damage to the inner ear or the auditory nerve. Sounds between 90 and 100 decibels, such as a rock concert or a jet engine, may damage your hearing.
Temporary hearing loss that lasts for a few hours after exposure to loud noise is a sign of damage to your hearing. If other peo- ple can hear music coming from your headphones, the sound is probably loud enough to cause permanent damage to your hearing. Usually they are worn by people who work around noisy equipment or under extremely noisy conditions, such as construc- tion workers or airport baggage handlers.
You should also consider factors such as comfort, appearance, durability, reliability, and the service agreement.
No matter where you purchase your hearing aid, however, it is essential to have it custom-?tted to your ear for best results.
The procedure is often performed using local anesthesia and causes a minimal amount of pain.
However, most cases of tinnitus result from damage to the sensory hair cells and the microscopic endings of the auditory nerve, which are in the inner ear. If your tinnitus is caused by high blood pressure or poor circulation, you should have your blood pressure checked regularly and work with your doctor to control it. Your doctor may recommend a tinnitus masker, which is worn like a hearing aid and gives off a more pleasant sound that masks the tinnitus. Meniere’s disease usually affects only one ear and is a somewhat common cause of hearing loss. The most common hearing test used to diagnose Meniere’s disease is audiometry, in which a person’s ability to hear sounds of varying frequencies and volumes is evaluated.
Stopping the use of tobacco (see page 107) and reducing stress (see page 118) also may lessen the severity of symptoms.


In another type of surgery, called vestibular neurectomy, the nerve responsible for balance is cut so it can no longer send distorted messages to the brain. The test is usually administered in a sound- proof room using a machine called an audiometer. The probe then transmits a continuous sound as air is pumped into the ear canal through the probe at various pressure lev- els (from low to high), and a microphone in the probe measures re?ected sound waves. Sound tones of varying frequency (low to high) and loudness are then transmitted into the ear through headphones, while the needle detects the electrical activity of the sensory hair cells. In Quebec, individuals with a professional hearing loss can benefit from CSST support programs. Premature labour and lack of oxygen at birth are non-genetic factors that can cause a congenital hearing loss. It is thought that this disease is caused by excessive liquid in the inner ear and treatment plans often include the modification of dietary habits.
A sudden hearing loss must be treated as an emergency and a physician must be consulted quickly.
In cases where the infection persists or occurs frequently, an ENT specialist can perform a small procedure called a myringotomy. To avoid water in the ears, audiologists recommend the use of specialized hearing protection products when swimming or during bathing and showering.
The conductive hearing loss can be treated with hearing aids to amplify the incoming sound and balance out the shortcomings caused by the discontinuity.
The outer ear canal becomes red and the individual might experience ear pain and high sensitivity at the infected ear.
These nerve impulses are transmitted by way of the vestibulocochlear nerve to the brain, where they are perceived as sound.
The changes occur very gradually and usually go unnoticed until a family member or friend mentions the person’s hearing problems.
Such damage can occur as a result of the aging process or because of exposure to loud noise.
Sounds that are between 120 and 140 decibels are usually painful and even a brief exposure can cause permanent hearing loss. You can purchase earplugs in a variety of styles, shapes, and sizes at your local pharmacy.
You may also contact your local health department or the local of?ce of the Occupational Safety and Health Administration (OSHA) to report the problem. The results of this test will determine whether your hearing loss is serious enough for your doctor to refer you to an audiologist, a health professional trained in evaluating hearing loss and ?tting hearing aids (see below), or an otolaryngologist, a physician who specializes in treating disorders of the ear, nose, and throat. The smallest and least visible devices are completely-in-the-canal hearing aids, which ?t more deeply inside the ear canal. It is important to note that hearing aids purchased through mail order usually cannot be custom-?tted. You should begin by wearing the device ?rst in quiet surroundings and gradually work up to noisier situations. The person may need to stay overnight in the hospital and will need to rest at home for about a week after surgery.
The internal component (a special signal processor and elec- trodes) is surgically implanted into the ear while the person is under general anesthesia.
The symptoms may be constant or come and go, the pitch can vary from high to low, and the sound can pulsate in time with the heartbeat. If the tin- nitus is caused by an infection, your doctor will probably prescribe antibiotics.
Your doctor may pre- scribe diuretics to help your body eliminate excess ?uid, thereby decreasing the severity and frequency of episodes.
Because this nerve lies close to the nerves that are responsible for hearing and facial muscle control, this type of surgery carries a risk of loss of hearing or facial movement. Through headphones, you listen to a series of sound tones that range from high to low, one tone at a time. Noise-induced hearing loss can otherwise be triggered by sudden extremely loud sounds such as a gunshot.
Similarly, complications during pregnancy such as maternal viral infections, toxin consumption and maternal diabetes cause the disability. The physician will investigate the reasons of the hearing loss and prescribe a cure when possible. A myringotomy is an incision in the eardrum to insert a ventilation tube through the eardrum to allow for the draining of the fluid in the middle ear. In most cases, a Perforated Eardrum will heal by itself while in some cases it requires medical intervention. Otherwise, surgery can be performed by an ENT specialist to reconstruct the Ossicular chain. This infection can trigger draining of pus from the ear canal, which may also be the cause a conductive hearing loss. Among older people, a third of those between ages 65 and 74 and half of those over age 85 have hearing loss.
Examples of things that can produce sounds over 120 decibels include motorcy- cles, snowmobiles, jackhammers, ?recrackers, woodworking tools, and ?rearms.
The person may become a source of annoyance or frustration and be ridiculed or ignored by family and friends.
In-the-canal hearing aids and completely-in-the-canal hearing aids are the most cosmetically appealing because they provide powerful assistance to hearing without being visible. Although a hearing aid cannot cure your hearing loss, it can allow you to hear sounds and voices more clearly so that you can communicate better and more easily participate in your usual activities.
If there is an obstruction, such as a buildup of earwax or dirt, your doctor will remove it. Before trying any of these techniques, however, talk to your doctor about which methods are best for you. This test is used to detect ?uid in the middle ear, a perforated eardrum, and disorders of the three tiny sound-conducting bones (the malleus or hammer, the incus or anvil, and the stapes or stirrup) of the middle ear.
Individuals of all ages can be affected by this form of hearing loss, often accompanied by tinnitus.
Systematic neonatal hearing screening programs are being developed nation-wide to identify hearing loss at a young age. Sudden hearing loss can be treated with steroids or antibiotics in certain cases caused by infections. The tube placed will allow for normal hearing acuity and should remain in place for 3 to 12 months. An ENT specialist can perform a surgical procedure called a tympanoplasty to repair an eardrum perforation. Many hearing aids also come with telephone pickup switches that provide special assistance while you are on the phone or listening to a public sound system. The ear will heal in about 4 to 6 weeks, after which the physician will ?t the person with the external components (a microphone, a transmitting coil, a speech processor, and connecting wires). These annoy- ing sounds can be a major source of distraction and irritation, affecting per- formance at work and other daily activities.
During a third type of surgery called a labyrinthectomy, the surgeon removes the membrane inside the labyrinth to eliminate the dizziness caused by Meniere’s disease.
Similar to age-related hearing loss, the disability has greater impact on high pitch sounds. Early detection of congenital hearing loss will result in a prompt intervention treatment which increases the chances of normal speech and social development. For ototoxic drugs, it is recommended to immediately stop the use of the problematic medication.
Middle ear infections are more frequent at a young age and can disturb proper speech development. The person will then work with an audiologist to adjust the settings on the implant for the best hearing level and to learn how to use the device properly. Some people bene?t by joining a support group where they can share experiences and information with other people who have tinnitus. The sound level decreases gradually until you are no longer able to hear the tone; this point is your hearing thresh- old for that frequency. Unlike many other forms, noise-induced hearing loss can be prevented with proper hearing protection and by eliminating noise at the source. A visit to the audiologist and to an ENT specialist is equally important for proper treatment of a sudden hearing loss. Bone conduction hearing aids can be used to overcome the limits caused by a middle ear infection.
The second part of the test measures how well you can hear sounds conducted through your head and indicates whether your hearing loss is conductive or sensorineural (see page 397). When using these hearing aids, sound waves find their way directly to the cochlea via the temporal bone. The procedure is the same as for the ?rst part of the test, but this time you wear special vibrating head- phones. Consequently, the conductive hearing loss will have no effect on the person’s ability to hear sounds.
Next you are tested for words to establish the lowest threshold at which you can hear two-syllable words (called your speech-reception thresh- old) and to determine the percentage of one-syllable words you can repeat back correctly (called speech discrimination).Your hearing thresholds for all parts of the test are recorded on a graph called an audiogram.



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