For most people, hearing problems develop gradually, usually over a period of years. Due to its slow rate of deterioration, it can be difficult to recognise the signs of hearing loss when they first appear. It’s often the family and friends closest to you that begin to become frustrated about your hearing; after all, you can’t miss what you can’t hear.
Before you can understand hearing loss, we need to understand a little about how we hear. The ear is divided into 3 sections – the outer ear, the middle ear and the inner ear. The outer ear consists of the ear canal and eardrum. Sounds travelling down the ear canal need to make it up to the eardrum, causing it to vibrate and send these sounds through to the middle ear. The middle ear contains a chain of 3 small bones that connect the ear drum through to the opening to the inner ear. When the eardrum vibrates, the 3 bones continue to send the series of vibrations through to the inner ear, which is filled with fluid. The inner ear contains the permanent hearing organ, called the cochlea. The vibrations from the middle ear causes the inner ear fluid to move, which causes the hair cells lining the inside of the cochlea to move. This movement sends an electrical impulse up the hearing nerve to the brain for the sounds to be processed. Therefore, hearing is about how the 3 sections of the ear work together to transmit sounds, but is also about how the brain works to process those sounds. Hearing loss can occur when there is a break down in how these sounds are transmitted. Permanent, or sensorineural, hearing loss occurs when there is damage to the hair cells in the cochlea of the inner ear.
So, how can you tell if you have a hearing loss?
- Do you have tinnitus? Tinnitus refers to any intermittent or continuous noises (hissing or buzzing for examples) or ringing in the ear/s or head experienced by a person in the absence of external noise. Tinnitus is usually a symptom of problems in the hearing system (outer, middle or inner ears). Tinnitus as a symptom of sensorineural hearing loss means that there is some damage to the hair cells of the inner ear, and can often be experienced before a hearing loss is detected.
- Do you have difficulties hearing and following conversations in noisy environments? Hearing speech in the presence of background noise tends to be the most commonly reported difficulty for people with hearing loss, and is often the main complaint from people with slight or mild hearing problems. High frequency hearing loss (loss of high-pitched sounds in hearing) is quite common and it is the high pitched sounds of speech that give us cues to hear speech clearly. Once background noise is added to the mixture, hearing someone clearly can be made exponentially more difficult if you have even a slight hearing loss.
- Do you have difficulties hearing softly spoken people, whispers or sounds/speech from a distance? As with the above point, the clarity of speech comes from hearing the high pitched sounds, so if you have a hearing loss, it is common to miss out on these important cues, so people can sound like they’re mumbling.
- Do you have difficulties hearing women’s or children’s voices? As discussed, the high pitched sounds are often the first to deteriorate as we age, so hearing and understanding what women with higher-pitched voices or children can be difficult.
- Do you find yourself asking people to repeat themselves? If you can’t hear someone clearly, you will find yourself saying ‘what?’ or ‘huh?’ and generally asking for someone to repeat themselves. Even people with hearing in the normal range will sometimes require someone to repeat themselves, but if you have hearing problems, you will find yourself asking for repeats more often. Our family and friends will quite often be the first to notice this as well, and might become annoyed at having to constantly repeat themselves.
- Do you often find you’ve misunderstood a conversation and/or responded inappropriately? Our brains quite often try to work harder to help us understand what we might not have heard by filling in the blanks. However, it doesn’t always get this right. Missing the clarity of words might mean that words like ‘feet’, ‘heat’, ‘seat’ and ‘heat,’ for examples, might sound the same to you. If you’ve misunderstood what someone has said because you haven’t heard them clearly, you might think the conversation is about something else entirely and respond inappropriately.
- Do you find yourself straining to hear conversations and feel more tired after doing so? When hearing loss starts to occur, your brain tries to help you compensate by utilising other cues such as visual cues or contextual cues to help you follow a conversation. This often means that you’re consciously or sub-consciously working harder to follow and understand conversations, which can be exhausting after a while.
- Do you have difficulties following a conversation if two or more people are talking at the same time? Once again, your brain is working harder to try to follow a conversation, but if there are competing sounds such as background noise or multiple conversations, it can be very difficult to ignore some of those sounds.
- Do you get complaints that the television is turned up too loud? This is often a common complaint from family members of people with hearing difficulties. You might even find that increasing the television volume makes the sound louder, but not necessarily any clearer and easier to understand.
- Do you have difficulties hearing someone over the telephone? Different people speak differently over the phone, so it can sometimes be more difficult to understand someone over the telephone, but if you’re finding that this is becoming increasingly worse for you, you may have a hearing problem. When we use the telephone, we’re relying on our hearing, as there are no visual cues to help us out.
Please note that the above material is for general information only – it is recommended that if you answered yes to 2 or more of the above points, then you may wish to consult a hearing specialist to have your hearing checked to confirm if you have a hearing problem and for advice regarding your options.