Understanding Hearing Loss

There are four types of hearing loss: Conductive, Sensorineural, Mixed and Central. If any part of the hearing system is unable to function, the result is hearing impairment.

Conductive hearing loss

Conductive hearing loss is caused by any condition or disease that impedes the conveyance of sound in its mechanical form through the middle ear cavity to the inner ear. A conductive hearing loss can be the result of a blockage in the external ear canal (e.g. by ear wax) or can be caused by any disorder that unfavorably affects the middle ear’s ability to transmit the mechanical energy to the stapes footplate.

The result of a conductive hearing loss is the reduction of one of the physical attributes of sound called intensity (loudness), so the energy reaching the inner ear is lower or less intense than that in the original stimulus. Therefore, more energy is needed for individuals with a conductive hearing loss to hear sound, but once it’s loud enough and the mechanical impediment is overcome, the ear works in a normal way. Generally, the cause of conductive hearing loss can be identified and treated resulting in a complete or partial improvement in hearing. Following the completion of medical treatment for causes of conductive hearing loss, hearing aids are effective in correcting any remaining hearing loss.

 

Sensorineural Hearing Loss

Sensorineural hearing loss results from inner ear or auditory nerve dysfunction. The sensory component may be from damage to the organ of Corti, an inability of the hair cells to stimulate the nerves of hearing, or a metabolic problem in the fluids of the inner ear. The neural (or retrocochlear) component can be the result of severe damage to the organ of Corti that causes the nerves of hearing to degenerate, or it can be an inability of the hearing nerves themselves to convey electrochemical information through the central auditory pathways.

The cause of sensorineural hearing loss sometimes cannot be determined, it typically does not respond favourably to medical treatment or common solutions, and it is usually described as an irreversible, permanent condition. Like conductive hearing loss, sensorineural hearing loss reduces the intensity of sound and it might introduce an element of distortion into what is heard, resulting in sounds being unclear even when they are loud enough. Once any medically treatable conditions have been ruled out, individuals with a sensorineural hearing loss can be fit with hearing aids to give them access to speech and other important sounds.

 

Mixed Hearing Loss

A mixed hearing loss can be thought of as a sensorineural hearing loss with a conductive component overlaying all or part of the tested audiometric range. So, in addition to some irreversible hearing loss caused by an inner ear or auditory nerve disorder, there is also a dysfunction of the middle ear mechanism that makes the hearing worse than the sensorineural loss alone.

The conductive component may be amenable to medical treatment and reversal of associated hearing problems, but the sensorineural component will most likely be permanent. Digital hearing aids can be beneficial for individuals with a mixed hearing loss, but caution must be exercised by the hearing specialist if the conductive component is due to an active ear infection.

 

Central Hearing Loss

Central hearing loss is caused by a problem with the auditory nerve or sound centres. Sound waves may travel through the ear but this nerve pathway is unable to send electrochemical impulses to the brain. As a result the hearing centres do not receive the signals correctly. Central hearing loss can be a result of a head injury or disease. A common symptom is the ability to detect sound but not being able to understand it. Children suffering from auditory processing disorders fall into this category.

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