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Common questions
About hearing loss
What is hearing loss?
The sounds that we hear everyday cover a range of pitches from the sound of a low-pitch foghorn to the sound of a high-pitch squeal. We also hear sounds at different loudness – from soft sounds like the rustling of leaves, to the loud sounds like jet engine noise during its take-off. A person with a hearing loss can still hear, but not the full range of sounds. Depending on the extent of the hearing loss and the pitch range of the hearing loss, a person with a hearing loss may only miss some soft, high-pitched sounds; while others with a more severe degree may not be able to hear conversation. In effect, part of their hearing range is lost.

 
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Hearing loss is one of the world's most common but mostly often ignored health problems. It is an invisible handicap which can have far reaching medical, social and psychological effects. Hearing loss can be as a result of any one (or more) of the following factors:

  • Aging process
  • Noise exposure
  • Ototoxicity (certain medications)
  • Infections
  • Head or ear trauma
  • Congenital
  • Hereditary factors
  • Diseases

Others symptoms associated with hearing loss are: earache, dizziness or tinnitus (buzzing or ringing in the ears).

It is important to distinguish between the terms 'hearing loss' and 'deafness'. The term deafness refers to total loss of hearing whereas 'hearing loss' refers to partial loss of hearing. The medical and social problems of the hard of hearing or vastly different from that of the deaf and therefore should not be grouped together.

What Are Some of the Effects of a Hearing Loss?
The most direct effect of a hearing loss is the inability to hear soft sounds. Depending on the degree of the hearing loss, some people may have a hard time hearing conversational sounds or even loud sounds. Some people may hear speech sounds, but they may not understand their meaning. This is especially noticeable in noisy places. Still, many people with a hearing loss also notice a constant ringing or rushing sound in their ears (tinnitus).

What is the incidence of hearing loss?

  • Approximately 10% of the world population suffers from hearing loss.
  • At least 25% of people over the age of 61 years suffer from hearing loss.
  • Up to 90% of these people can be helped.
  • In the year 2001, there were approximately 28 million people in the USA with hearing loss
  • Hearing loss is the single most common birth 'defect' in America
  • The average time delay from when someone realises they have a hearing problem to the point they attempt to do something about it is 7 years.

How do I know if I have a hearing loss?
You may have a hearing loss if:

  • You hear people speaking but you have difficulty understanding what they are saying
  • You are frequently having to ask for repetitions
  • You feel left out in conversations
  • You are always complaining that others are mumbling
  • You need to ask others about the details of what transpired at a meeting or presentation you attended
  • You don't laugh at jokes because you missed part of what was said
  • Spouses, friends or relatives frequently have to ask you to turn the TV or radio down
  • You do not hear the doorbell or telephone
  • You have difficulty determining which direction sounds are coming from
  • You have a history of exposure to loud noise (construction sites, loud music, shooting etc.)
  • You understand more of what is being said if you are looking at the person speaking to you.
  • Soft sounds seemed to have disappeared altogether in speech.

What does hearing loss mean for me?
If you have a hearing loss you may feel isolated and lonely. You may hesitate to become involved in conversations for fear of misunderstanding and responding inappropriately. You may start to become withdrawn from social gatherings and make excuses to stay at home. You may find that you are sometimes treated as if you are less intelligent than those with normal hearing. This is because your hearing difficulty may put you in situations where you might misinterpret a question and respond inappropriately. Or perhaps you might not hear a question at all and your lack of response may be interpreted as stupidity.

What can be done about my hearing loss?
If you have experienced any of the above-mentioned symptoms, you will need to see an audiologist or an acoustician (hearing aid specialist) for an audiological evaluation. The audiological evaluation conducted by the audiologist will allow for the determination of the type and degree of your hearing loss. It will also be able to determine how well or how poorly you understand speech. The evaluation will include a thorough case history as well as a visual inspection of the ear canal and the ear drum. Each component of the evaluation is vital in order for the audiologist to determine the nature of the hearing loss and whether or not medical or surgical intervention is necessary.

An audiologist is a person who has a degree in audiology. Audiologists work in a variety of settings including hospitals, schools, clinics, rehabilitation centres, universities, speech and hearing centres, private practices, hearing aid manufacturers, as well as ENT centres. Although a large number of hearing problems do not require medical or surgical intervention, audiologists are clinically and academically trained to determine those that do need medical referral and will refer to the appropriate physician where necessary.

The acoustician or hearing aid specialist has been trained in the assessment of patients who are specifically seeking rehabilitation for their hearing loss. The acoustician is licensed to perform basic hearing tests and can sell and service hearing aids and related products.

What are the different degrees of hearing loss?
Results from a hearing test are plotted on a graph called an audiogram. Intensity is plotted on the y-axis (from top to bottom) and is measured in decibels (dBs). Frequency is plotted on the x-axis (from left to right) and is measured in Hertz (Hz). Hearing loss is described in categories and is not measured in percentages.

  1. Normal hearing (0-25 dB HL)
  2. Mild hearing loss (26-40dB HL
  3. Moderate hearing loss (41-70dB HL)
  4. Severe hearing loss (71-90dB HL)
  5. Profound hearing loss (91+)

Are there different types of hearing loss?
There are primarily two types of hearing loss. One is called a conductive hearing loss. This type of hearing loss has its origin within the ear-canal and/or the middle ear where the three tiny bones (hammer, anvil, stirrup) reside. Examples of such a hearing loss may include accumulation of ear wax within the ear-canal, perforation of the ear drum, and diseases of the middle ear like otosclerosis. Often, a conductive loss can be medically corrected and should be evaluated by an audiologist and an ENT to explore medical and surgical options

The other type of hearing loss is called a sensorineural hearing loss. This is the most common type of hearing loss. It has its origin within the inner ear where the sensory hearing cells and the hearing nerve are located.The most common cause of a sensorineural loss is presbycusis (hearing loss due to age related changes) and noise exposure. A person with a sensorineural loss may find that they have difficulty understanding speech. This person will generally hear better in a quiet environment but will have difficulty hearing in a noisy environment or over the telephone.

Other causes likes constant exposure to loud sounds, certain medications, hereditary etc can result in this type of hearing loss. Many people also called this a nerve loss.

A less common form of hearing loss is called Central loss. This kind of loss occurs when the auditory centres of the brain are affected by injury, disease, tumours or hereditary factors. Loudness of sound is not necessarily affected although understanding of speech may be affected.

How do I cope with my hearing loss?
In order to become a successful communicator, one needs to learn assertive ways of dealing with communication failure. Friends and family members can become great contributors in alleviating some of the difficulties associated with communication. The following guidelines should be given to friends and family to help them communicate with a hearing impaired person:

  • Make Sure you have the person's attention before you begin speaking
  • Look directly at the person whilst you are speaking
  • Make sure you maintain eye contact
  • Make sure you face is clearly visible and in good light
  • Avoid distracting movements such as chewing or smoking so that the person can read your lips as much as possible.
  • Speak in a normal tone of voice and don’t exaggerate your lip movements
  • Use gestures, facial expressions and body language to make understanding easier
  • Rephrase your sentences if necessary
  • Eliminate background noise where possible

 
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