Hearing Loss

Hearing Science

An audiological exam tests your ability to hear sounds and understand words. Sounds vary according to the intensity (volume or loudness) and the tone/frequency (the speed of sound wave vibrations).

Hearing occurs when sound waves move to the nerves of the inner ear and then the brain. Sound waves can travel to the inner ear by air conduction (through the ear canal, eardrum, and bones of the middle ear) or bone conduction (through the bones around and behind the ear).


INTENSITY of sound is measured in decibels (dB):

  • A whisper is about 20 dB
  • Loud music (some concerts) is around 80 to 120 dB
  • A jet engine is about 140 to 180 dB

Usually, sounds greater than 85 dB can cause hearing loss in a few hours. Louder sounds can cause immediate pain, and hearing loss can develop in a very short time.

TONE/FREQUENCY of sound is measured in cycles per second (cps) or Hertz:

  • Low bass tones range around 50 to 60 Hz
  • Shrill, high-pitched tones range around 10,000 Hz or higher

The normal range of human hearing is from 20 Hz to 20,000 Hz, and some animals can hear up to 50,000 Hz.

Nearly 30 million Americans have impaired hearing – that’s one in ten of the general population and one in three persons over the age of 60. Medical devices such as hearing aids and rehabilitation can substantially reduce hearing loss in the vast majority of patients.

Audiologists classify hearing loss as either “conductive“, “sensorineural“, or “mixed.”

A hearing loss is conductive when there is a problem with the ear canal, the eardrum and/or the middle ear including the three bones connected to the eardrum. Common reasons for this type of hearing loss are a plug of excess wax in the ear canal or fluid behind the eardrum. Medical treatment or surgery may be available for these and more complex forms of conductive hearing loss.

A hearing loss is sensorineural when it results from damage to the inner ear (cochlea) or auditory nerve, often as a result of the aging process and/or noise exposure. Sounds may be unclear and/or too soft. Sensitivity to loud sounds may occur. Medical or surgical intervention cannot correct most sensorineural hearing losses. However, hearing aids may help you reclaim some sounds that you are missing as a result of nerve deafness.

A mixed hearing loss is a combination of both conductive and sensorineural type hearing problems.

How do you know if you have a hearing loss?

Many people have a hard time believing or accepting that they have a hearing loss. Some people feel that hearing loss is associated with age and are hesitant to wear hearing aids. Due to machine noise, loud music, or other by-products of our noisy environment, a growing number of people are experiencing hearing loss at younger ages.

Hearing loss occurs gradually, and it is not always easy to determine if you’re experiencing it. Often, people discover their hearing loss from the reactions of others – usually family members.


The following questions may help you decide whether you should have your hearing checked:

1. Do you turn up the TV or radio is louder than other family members prefer?
2. Do you have difficulty understanding speech in a background of noise, for instance in restaurants?
3. Do you have more difficulty understanding children and women than men?
4. Do you experience difficulty hearing in meetings or any group situation?
5. Do you have problems hearing at public speaking events or church?
6. Do you have ringing in your ears?

A Simple Hearing Assessment

Most hearing losses occur gradually over the years, therefore, it is often difficult to recognize. Try this simple self-assessment of your hearing status. If you answer yes to one or more of the following statements, you should consider scheduling an appointment with an audiologist because you may have a problem with your hearing.

  • I use “huh” or “what” more than before.
  • I ask people to repeat themselves.
  • I need the radio or TV louder than other family members.
  • I avoid participating in groups because I don’t hear well.
  • I avoid speaking to strangers because I don’t hear well.
  • I watch TV less often because I can’t hear well.
  • I have difficulty understanding some people on the phone.
  • I try to avoid small talk at family gatherings.
  • I have trouble understanding people in noisy restaurants.
  • I find it necessary to watch people with whom I am speaking.
  • I am bothered by loud sounds.
  • I have arguments with family members because of my hearing.
  • I can hear but can’t understand what people are saying.
  • I have trouble with unexpected speech or rapid speech.
  • I complain that people do not talk clearly anymore.
  • I miss the punch line of jokes or key words in sentences.
  • I have trouble understanding the speaker in church or meetings.
  • I cannot easily locate the direction that sound is coming from.
  • I have ringing or other sounds in my ears.

If you suspect you have a hearing loss, please contact our office. We will schedule a comprehensive audiogram to determine the type and degree of hearing loss and advise you on your next step (whether you need to see a physician or can proceed to discuss your hearing options).