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Difficulties Experienced by the Hearing Impaired

LOUISVILLE First, here is a quick description of the types of hearing loss to preface the discussion of the resulting difficulties.

Types of Hearing Loss

1. SENORINEURAL hearing loss occurs when there is damage to the cochlea or auditory nerve (VIII). Typically, the hearing loss is permanent and there are no correctible procedures or treatments. This type of hearing loss is most commonly caused by aging and noise exposure, but it can also be caused by genetic abnormalities, inner ear infections, and ototoxic medication. Hearing aids are the most common treatment for sensorineural hearing loss.

2. CONDUCTIVE hearing loss occurs when there is a problem in the outer and/or middle ear that causes the intensity of the sound to be reduced by the time it reaches the inner ear. Cerumen impaction, middle ear effusion, and tympanic membrane perforation are just a few sources of conductive hearing loss. In many cases, the problem can be fixed by a simple procedure or a surgery. However, some conductive hearing losses are not correctible and, in those cases, traditional or bone conduction hearing aids are often used.

3. MIXED hearing loss occurs when there is a combination of sensorineural and conductive hearing loss.

Difficulties as a Result of Hearing Loss

It is well documented that hearing impairment can significantly reduce an individual’s perceived quality of life, as well as that of the spouse. Because hearing loss is so prevalent in the aging population, it is important to be familiar with the major difficulties associated with the impairment.

1. RDUCED AUDIBILITY Simply put, they cannot hear soft sounds. Increasing TV volume and asking people to “speak up” are often the reaction. The easiest way to combat this problem is with hearing aids. For most hearing losses, hearing aids do a fantastic job of making inaudible sounds audible.

2. REDUCED FREQUENCY RESOLUTION This is one of the physiologic ramifications of sensorineural hearing loss. Frequency resolution is the ability of an individual’s ear to detect a signal at one frequency in the presence of another sound at a different frequency. Human speech is a sequence of complex sounds across a broad spectrum. So, when there is a reduction in frequency resolution, even when speech is audible, it can be difficult discriminating one speech sound from another. Hearing aids can help discriminate speech sounds, but cannot fully correct this problem.

3. TROUBLE IN BACKGROUND NOISE The “cocktail party effect” refers to the physiologic phenomenon allowing individuals to focus on a desired auditory signal in the presence of background noise. This ability is drastically reduced with sensorineural hearing loss. Trouble understanding speech in background noise is by far the most common complaint of the hearing impaired individual. Hearing aids can help with this problem but cannot fully correct it.

4. EMOTIONAL EFFECTS Hearing loss can stir up many negative emotions for the patient and his/ her family, such as embarrassment, frustration, anger, paranoia, etc. When an individual experiences these negative emotions long enough, they will begin to withdraw socially, which is alarming. One of the main duties of an audiologist is counseling the patient to reduce these negative emotions and encourage coping skills.

When to Refer to an Audiologist

An audiologist specializes in the assessment and treatment of hearing loss and other ear-related disorders. Any patient who experiences the difficulties discussed above should be closely monitored audiologically. Audiologists also specialize in testing and treating vertigo, which can often be corrected by simple maneuvers performed in office. There have also been many exciting improvements in treatment options for patients experiencing tinnitus.