Hearing Loss: Interruptions in the Hearing Journey

Hearing Loss: Interruptions in the Hearing Journey

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As sound flows from its source to our brain it follows a very specific pathway, in which each step along the journey has an important and specific role (review hearing journey here). When there is a problem anywhere along the hearing pathway it can affect an individual’s entire hearing experience and result in a hearing problem or hearing loss. A lot of people think “hearing loss” means someone is Deaf or cannot hear anything at all. This is not always the case. A person’s hearing loss is as unique as the person themselves. Let’s take a look into what that means in more detail.

Types of Hearing Loss

Depending on where the problem occurs along the hearing pathway, the resulting type of hearing problem/loss will be different.

Conductive Hearing Loss
Here, the problem is with the outer and/or middle ear sections of the pathway. The sound is unable to properly reach the cochlea, usually due to a blockage. Several issues can result in blockages:

  • Occluding ear wax in the ear canal
  • Stenosis – extreme narrowing of the ear canal
  • Microtia/atresia – malformed outer ear often causing a complete closure of the ear canal
  • Otitis Media (with/without effusion) – an infection in the middle ear often accompanied by fluid/congestion in the middle ear space
  • Perforated eardrum
  • Otosclerosis – stiffening of the middle ear bones
  • Disarticulation of the ossicles – dysfunction of the ossicular chain

Conductive hearing loss can be temporary (wax blockage or an ear infection) or it can be permanent (atresia or otosclerosis). Regardless of the cause of the conductive hearing loss, there are solutions available to improve your hearing experience.

Sensorineural hearing loss
With sensorineural hearing loss, the issue along the pathway is with the inner ear or beyond. The sensory component of sensorineural hearing loss refers to a problem within the cochlea, specifically with the hair cells.

Damaged or missing hair cells results in specific sounds not being properly transmitted to the brain. Different hair cells in the cochlea are responsible for encoding different frequencies and in most cases, only some of the hair cells are damaged.

For example, an individual may specifically have damage to the hair cells responsible for high frequencies which would result in a high frequency hearing loss while their low frequency hearing levels could remain normal.

In the most extreme cases, most/all the hair cells are damaged resulting in a profound hearing loss.

When we discuss issues “beyond” the cochlea they are usually referring to the neural component of the pathway, the auditory nerve or higher up in the brainstem. These issues are referred to as retrocochlear.

Damage to the auditory nerve could be a result of a prolonged, untreated hearing loss or it could be an independent issue for example an acoustic neuroma.
Some causes of sensorineural hearing loss include:

  • Exposure to loud noise (instantaneous or prolonged)
  • Age
  • Hereditary
  • Ototoxic Drugs
  • Viral infections
  • Nerve damage
  • Syndrome related

Sensorineural hearing loss is the most common type of hearing loss. In some cases, it is congenital but in others it develops over time.

In the rare case of a SUDDEN sensorineural hearing loss, an individual may wake up one morning and feel that they cannot hear at all out of one ear whereas they had no trouble the night before. This is considered an otologic emergency and the individual should go to the Emergency Room immediately.

In most, if not all, cases of sensorineural hearing loss there are a wide variety of treatment options available.

Mixed Hearing Loss
With a mixed hearing loss an individual will have an issue with both the outer/middle ear AND the inner ear. This is when conductive and sensorineural hearing loss occur in the same ear.

The causes of a mixed loss can be considered the same as those listed above and again there are always treatment options available to discuss with your hearing healthcare provider/audiologist. 

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