Understanding hearing loss starts with understanding how the ear works. Here you will learn about the parts of the ear and how sound is sent from the outer ear to the inner ear.

There are three parts to the ear, outer ear, middle ear and inner ear. The outer ear consists of the pinna (the part of the ear we can see on the side of the head) and the ear canal. The main job of the outer ear is to collect sound waves and send them down the ear canal to the eardrum. The middle ear includes the eardrum and three small bones. Their job is to amplify the sound waves and send them to the inner ear. The inner ear is located in a snail shaped bone deep inside your head. The hearing nerves called haircells are here. These fine nerve fibers change sound into electrical impulses and sends them to the brain.

How The Ear Works Video

Types of Hearing Loss

There are three types of hearing loss. They are sensorineural, conductive and mixed hearing loss. The most common type is Sensorineural loss. Typically people with sensory loss are successfully treated with hearing aids.

Sensorineural Hearing Loss

More than 90 % of all hearing loss is sensorineural. Sensorineural hearing loss is caused by damage to the fine hearing nerves call haircells. We have hundreds of thousands of haircells located deep in the inner ear. Once damaged, there is no way to repair them. As more and more of the haircells become damaged, hearing loss increases. Sensorineural hearing loss is almost always permanent.

Some causes of sensorineural hearing loss include:

  • Exposure to loud sounds (this is preventable)
  • Diseases such as Meniere’s Disease
  • Genetics (it can run in families)
  • Heart Disease
  • Aging
  • Certain medications including some chemotherapy drugs

Those with sensorineural hearing loss report that it sounds as if people speak softly and/or mumble. Hearing loss reduces the volume for sound and can mumble words making them difficult to understand. Hearing aids are the first step to successfully treating sensorineural hearing loss. Hearing aids can restore normal volume and improve word understanding.

* Protect your haircells! Noise induced sensorinueral hearing loss can be prevented through the use of earplugs or muffs.

Conductive Hearing Loss 

Conductive hearing loss (CHL) results from problems in the outer and middle ear. CHL makes sounds appear softer than they really are. It is similar to turning the volume down on a TV or radio. Those with CHL will often complain that others do not speak up. They need to increase the volume of the TV and radio. When others say it’s too loud, they will deny it is loud because to them, it sounds like a normal volume.

CHL is often the result of a medical condition. There are several diseases that can cause this type of problem. Some common causes include:

  • Ear wax build up
  • Perforated eardrum
  • Fluid behind the eardrum
  • Problems with the bones in the middle ear

Often these types of problems can be resolved. Once resolved, hearing returns to normal. For example, removing ear wax opens the canal allowing sound to move through the ear restoring hearing.  Other causes of CHL are often treated with medication and or surgery. It is uncommon for an outer or middle ear condition to result in permanent hearing loss.

CHL can occur in combination with a sensory hearing loss (SHL). When they occur together, it is called a mixed hearing loss. SHL results from a reduction in the hearing nerves. SHL is usually permanent and is not improved with medication or surgery.

If you have a CHL, have a baseline hearing assessment as part of your evaluation. This will aid in the diagnosis of the underlying cause, allow us to track improvement with treatment, and determine if there is also sensory loss.  

Heart Disease and Hearing Loss

Heart Disease and Hearing Loss are Related

According the American Heart Association, heart disease is the number one killer of women worldwide. In 2005, Harvard University established a staggering relation between heart disease and hearing loss. They found hearing loss occurred 54% more often in people with heart disease then in the general population.

Heart disease damages hearing. Cardiovascular disease reduces the flow of blood through veins, arties and ultimately to the organs of the body. Reduced blood flow damages the heart and other organs including the hearing nerves deep in the inner ear. Researchers at Harvard University believe the hearing nerves are so fragile that the ears are likely the first organs damaged by cardiovascular disease. There are those who believe hearing loss may predict heart disease.

A healthy cardiovascular system has a positive effect on hearing. Eat right and exercise. One study saw a 32% reduction in risk for heart disease when exercising once a week. (Population Healthy Program Faculty, Wisconsin University, 2001-2002)

Have regular hearing checks and use hearing aids when recommended. Those who use hearing aids report greater overall health, more active lifestyle and more active social life. Call 440-205-8848 to schedule a hearing evaluation.

Auditory Processing Disorders

About Auditory Processing Disorders

Auditory processing disorder (APD), is also known as a central auditory processing disorder (CAPD). This little known learning disorder occurs in 5% of children. It is a breakdown in how the brain recognizes and organizes sounds especially speech sounds. Problems become apparent in less than optimal conditions listening situations (noisy places, when the speaker is at a distance, other distractions present, etc.). Problems related to APD become more and more apparent as schoolwork increases in difficulty. Because of this, signs and symptoms become more frequent.

Assessing for APD

Testing for APD includes a basic hearing assessment to ensure hearing is normal. True APD is thought to be present only when hearing is “normal.” This is because pure tones sounds and speech are detected at normal levels in a quiet environment. Hearing sounds and words in quiet is only one aspect processing. Those with true APD do not have a loss of hearing sensitivity, but have a hearing problem in that they have difficulty processing auditory information. That is to say they can hear someone talking but are unable to make out the words or gather the meaning.

Behaviors associated with APD appear similar to other disorders such as ADHA or ADD. APD is often confused with ADHD, and it is possible to have both.

Signs and Symptoms

Symptoms can range from mild to severe and can take many different forms. Here are few of them:

  1. Difficulty hearing the difference in sounds, especially different letters
  2. Difficulty hearing in noisy places
  3. Difficulty hearing rhythms
  4. Difficulty academically
  5. Disorganized
  6. Trouble following multiple step instructions
  7. Does better with written material than auditory
  8. Performs better one-on-one than in groups
  9. Forgetful


An initial appointment is scheduled for basic audiologic assessment.

A second and possibly third appointment will be scheduled for the processing assessment.