Hearing Impairments fall mostly into three categories: conductive, sensorineural, or mixed (combination of the
two).
1. Conductive Impairment:
The hearing loss is caused by a blockage of sound prior to reaching the nerve and can involve the outer ear
canal, eardrum or middle ear bones. Many of these conditions may require medical treatment and can possibly
be resolve or improved.
Outer Ear-conductive:
There are a diversity of outer ear pinna, canal or eardrum anomalies that can be observed externally or with
magnification of the ear canal and/or eardrum. Most common conditions usually involve wax or External Otitis.
Wax can be suctioned, washed or picked out by a trained professional. Over the counter ear wax softeners are
available to soften wax so that it may be loosened up or washed out if it is dry and hard. External Otitis is
usually resolved through medications. A white substance may be found in the canal that is often a fungus.
Various obstructions are often found in children ears. Perforation or eardrum ruptures are common with sudden
pressure changes such as diving or water skiing), use of cue tips or as a result of pressure from middle ear fluid.
Middle Ear-conductive:
Impairments involving the middle ear bones or the middle ear system may not appear as obvious to the eye as
they are often located behind the eardrum. Otitis Media or a common ear infection found most often in young
children up to the age of 7- 8 years may be observed with an obvious red appearance of the eardrum or fluid
bubbles behind the eardrum. Middle ear fluid problems are very common in the first year of life and decrease
with the formation of the eustacian tube and age. This condition is not always obvious with otoscopy. A
diagnostic evaluation with a bone oscillator behind the ear shows the nerve as significantly better than air
thresholds obtained while wearing earphones. This separation of air and bone conduction thresholds are
necessary to define the hearing loss as "conductive". A tympanogram is usually very reliable and definitive for
identifying most middle ear fluid problems. Middle ear fluid problems are mostly resolved with medication or
tubes. Occasionally some adults will also encounter middle ear effusion. Eustacian tube dysfunction is a major
cause of middle ear fluid. Fixation of the middle ear bones can sometimes be resolved with medical intervention.
If surgery is not recommended, a hearing aid is an option.
2. Inner ear-Sensorineural Impairment:
Most common sensory hearing impairments involve nerve damage to outer hair cells in the cochlea (a snail shell
shaped organ filled with fluid). The most common cause for this type of hearing impairment is loud noise
exposure or age related genetic hearing impairment. However, there are many other causes for nerve hearing
loss that may involve the cochlea. Some of those may even result in sudden temporary hearing loss. Neural
hearing impairments may involve the 8th nerve, brain stem or neural pathway to the brain. A diagnostic
evaluation is needed to define the type of hearing impairment and sometimes requires very specialized
equipment in order to definitively identify a cause. Most hearing impairments that involve the cochlea outer hair
cells and result in a significant hearing impairment often require the use of hearing aids. This type of hearing
impairment is often permanent and can result in difficulty with speech recognition, especially in background
noise. Hearing aids are mostly used to fit a sensorineural impairment when the hearing loss is significant enough
to cause difficulty with communication. Because of the nature of a sensorineural hearing impairment, individuals
with this type of hearing loss often encounter much difficulty with background noise. Digital hearing aids have
increasing become better at reducing the problem with background noise with noise management programs.
The greater the severity of hearing impairment, the more likely that speech recognition or clarity problems may
occur. Speech recognition or clarity problems are not fixed with a hearing aid. The hearing aid will improve
hearing. However, if a speech recognition problems are identified through a speech recognition test, clarity
problems will remain to some extent, even with the use of a hearing aid. It is unrealistic to expect that a hearing
aid will help a person to hear "normally" again.
two).
1. Conductive Impairment:
The hearing loss is caused by a blockage of sound prior to reaching the nerve and can involve the outer ear
canal, eardrum or middle ear bones. Many of these conditions may require medical treatment and can possibly
be resolve or improved.
Outer Ear-conductive:
There are a diversity of outer ear pinna, canal or eardrum anomalies that can be observed externally or with
magnification of the ear canal and/or eardrum. Most common conditions usually involve wax or External Otitis.
Wax can be suctioned, washed or picked out by a trained professional. Over the counter ear wax softeners are
available to soften wax so that it may be loosened up or washed out if it is dry and hard. External Otitis is
usually resolved through medications. A white substance may be found in the canal that is often a fungus.
Various obstructions are often found in children ears. Perforation or eardrum ruptures are common with sudden
pressure changes such as diving or water skiing), use of cue tips or as a result of pressure from middle ear fluid.
Middle Ear-conductive:
Impairments involving the middle ear bones or the middle ear system may not appear as obvious to the eye as
they are often located behind the eardrum. Otitis Media or a common ear infection found most often in young
children up to the age of 7- 8 years may be observed with an obvious red appearance of the eardrum or fluid
bubbles behind the eardrum. Middle ear fluid problems are very common in the first year of life and decrease
with the formation of the eustacian tube and age. This condition is not always obvious with otoscopy. A
diagnostic evaluation with a bone oscillator behind the ear shows the nerve as significantly better than air
thresholds obtained while wearing earphones. This separation of air and bone conduction thresholds are
necessary to define the hearing loss as "conductive". A tympanogram is usually very reliable and definitive for
identifying most middle ear fluid problems. Middle ear fluid problems are mostly resolved with medication or
tubes. Occasionally some adults will also encounter middle ear effusion. Eustacian tube dysfunction is a major
cause of middle ear fluid. Fixation of the middle ear bones can sometimes be resolved with medical intervention.
If surgery is not recommended, a hearing aid is an option.
2. Inner ear-Sensorineural Impairment:
Most common sensory hearing impairments involve nerve damage to outer hair cells in the cochlea (a snail shell
shaped organ filled with fluid). The most common cause for this type of hearing impairment is loud noise
exposure or age related genetic hearing impairment. However, there are many other causes for nerve hearing
loss that may involve the cochlea. Some of those may even result in sudden temporary hearing loss. Neural
hearing impairments may involve the 8th nerve, brain stem or neural pathway to the brain. A diagnostic
evaluation is needed to define the type of hearing impairment and sometimes requires very specialized
equipment in order to definitively identify a cause. Most hearing impairments that involve the cochlea outer hair
cells and result in a significant hearing impairment often require the use of hearing aids. This type of hearing
impairment is often permanent and can result in difficulty with speech recognition, especially in background
noise. Hearing aids are mostly used to fit a sensorineural impairment when the hearing loss is significant enough
to cause difficulty with communication. Because of the nature of a sensorineural hearing impairment, individuals
with this type of hearing loss often encounter much difficulty with background noise. Digital hearing aids have
increasing become better at reducing the problem with background noise with noise management programs.
The greater the severity of hearing impairment, the more likely that speech recognition or clarity problems may
occur. Speech recognition or clarity problems are not fixed with a hearing aid. The hearing aid will improve
hearing. However, if a speech recognition problems are identified through a speech recognition test, clarity
problems will remain to some extent, even with the use of a hearing aid. It is unrealistic to expect that a hearing
aid will help a person to hear "normally" again.
Hearing Impairment
Tinnitus
Tinnitus refers to a noise in the head that most often occurs in the ears. Many people suffer
from tinnitus. Mostly tinnitus is commonly associated with a sensorineural hearing loss.
However, there are other conditions that can cause tinnitus and may not necessarily involve a
hearing loss. It is also possible to have a hearing loss at a frequency that can not be measured
with a standard audiometer.
There are many causes of tinnitus. Some conditions may be temporary while most causes lead
to a a more permanent condition. There are medications, food sources and physical aspects of
heath that may lead to tinnitus. A common cause of tinnitus is loud noise exposure. See,
tinnitus for more information.
from tinnitus. Mostly tinnitus is commonly associated with a sensorineural hearing loss.
However, there are other conditions that can cause tinnitus and may not necessarily involve a
hearing loss. It is also possible to have a hearing loss at a frequency that can not be measured
with a standard audiometer.
There are many causes of tinnitus. Some conditions may be temporary while most causes lead
to a a more permanent condition. There are medications, food sources and physical aspects of
heath that may lead to tinnitus. A common cause of tinnitus is loud noise exposure. See,
tinnitus for more information.
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Low pitch | speech range | (frequency) High pitch
V V
V V
x = Left ear
o = Right ear
> = left ear
< = right ear
o = Right ear
> = left ear
< = right ear
The audiogram to the left is a common permanent
nerve hearing loss that falls within the range of a
hearing aid. The tympanogram above shows
normal eardrum movement.
Cause? This hearing loss is typical of a right
handed shooter with the muzzle blast toward the
left ear, possibly caused by target practise or
hunting. Common symptoms include temporary
drop in hearing and ringing in the ears for a brief
period after shooting.
nerve hearing loss that falls within the range of a
hearing aid. The tympanogram above shows
normal eardrum movement.
Cause? This hearing loss is typical of a right
handed shooter with the muzzle blast toward the
left ear, possibly caused by target practise or
hunting. Common symptoms include temporary
drop in hearing and ringing in the ears for a brief
period after shooting.
S
o
f
t
d
B
L
o
u
d
o
f
t
d
B
L
o
u
d
V V
The audiogram to the left is typical with a common
ear infection involving the middle ear system. The
tympanogram above shows poor eardrum
movement as a result of fluid pressure against the
eardrum.
Cause? = Many children are predisposed to ear
infections early in life because the eustacian tube
does not function as well to circulate air into the
middle ear space and allow for drainage. The
eustacian tube often functions better with age.
Because this condition can be chronic early in life,
speech/language development could be delayed.
ear infection involving the middle ear system. The
tympanogram above shows poor eardrum
movement as a result of fluid pressure against the
eardrum.
Cause? = Many children are predisposed to ear
infections early in life because the eustacian tube
does not function as well to circulate air into the
middle ear space and allow for drainage. The
eustacian tube often functions better with age.
Because this condition can be chronic early in life,
speech/language development could be delayed.
o = Right ear
] = left ear
[ = right ear
] = left ear
[ = right ear
