About Hearing
Understanding hearing loss
Hearing loss is common and often develops gradually. Knowing the signs and the options makes it easier to act early.
How hearing works
Sound passes through the outer, middle and inner ear, and the hearing nerve carries it to the brain. It all happens almost instantly, and a problem at any stage can cause hearing loss.
1
Outer ear
Collects sound and channels it down the ear canal to the eardrum.
2
Middle ear
The eardrum and three tiny bones pass the vibrations on to the inner ear.
3
Inner ear
Inside the cochlea, tiny hair cells turn the vibrations into electrical nerve impulses.
4
Hearing nerve
Carries the impulses from the cochlea to the hearing centres of the brain, where they are recognised as sound.
Types of hearing loss
There are four main types. Most can be helped once the type and degree of hearing loss are known.
Sensorineural
Caused by changes in the inner ear or hearing nerve, often with age or noise exposure. Usually permanent, and often helped by hearing aids or, in some cases, cochlear implants.
Conductive
Sound is blocked on its way through the outer or middle ear, for example by wax, fluid or a problem with the middle ear bones. Some causes can be treated medically.
Mixed
A combination of sensorineural and conductive hearing loss. Depending on the cause, hearing aids, bone conduction or a middle ear implant may help.
Neural
The hearing nerve itself is damaged or missing, so hearing aids and cochlear implants cannot help. An auditory brainstem implant may be an option, through a specialist implant team.
Degrees of hearing loss
Hearing is measured in decibels (dB). The higher your result, the louder a sound must be before you can hear it.
| Degree | Hearing level | What it can mean |
|---|---|---|
| Normal hearing | 0 to 20 dB | Soft sounds such as a dripping tap or birdsong are heard. |
| Mild | 21 to 40 dB | Normal speech is heard, but soft speech, a ticking clock or a dripping tap may be missed. |
| Moderate | 41 to 70 dB | Normal conversation and a ringing phone may be missed. Without treatment, daily life is clearly affected. |
| Severe | 71 to 90 dB | Even loud conversation and traffic may be missed. |
| Profound | 91 dB and above | Very loud sounds such as aeroplanes, trucks or fire alarms may not be heard. |
Ranges as described by MED-EL. Clinics may use slightly different bands.
Your results
How to read an audiogram
An audiogram is a chart of the softest sounds you can hear at each pitch. During the test, the audiologist plays tones one pitch at a time and marks the softest one you hear.
- Pitch (frequency) runs from low on the left to high on the right
- Loudness, in dB, increases from top to bottom
- Marks near the top mean good hearing, and marks lower down mean hearing loss
- The pattern shows the type of hearing loss and helps choose the right solution
If you have an audiogram from a previous test, bring it to your visit and we will go through it with you.
Single-sided deafness
Hearing loss in one ear is more common than many people think, and it affects more than hearing.
Why it matters
- Group conversations are hard to follow
- It is difficult to tell where sounds come from
- Noisy places are tiring and stressful
- You may worry about protecting your good ear
Hearing with both ears lets the brain hear in three dimensions and filter out noise. Causes of hearing loss in one ear include infection, Ménière’s disease, sudden hearing loss and genetics.
The options
- CROS hearing aids send sound from the deaf side to the hearing ear
- Bone conduction solutions, such as BONEBRIDGE and ADHEAR, carry sound to the hearing ear through the bone
- A cochlear implant in the deaf ear can restore hearing with both ears
Which solution for which hearing loss?
A general guide. The right choice always depends on your full assessment.
| Type of hearing loss | Solutions often considered |
|---|---|
| Mild-to-moderate sensorineural | Hearing aids |
| Severe-to-profound sensorineural | Cochlear implant |
| High-frequency loss with useful low-frequency hearing | Electric Acoustic Stimulation (EAS) |
| Mild-to-severe sensorineural, when hearing aids are not suitable | Middle ear implant (VIBRANT SOUNDBRIDGE) |
| Conductive | Medical treatment where possible, hearing aids, BONEBRIDGE, ADHEAR, VIBRANT SOUNDBRIDGE |
| Mixed | Hearing aids, BONEBRIDGE, VIBRANT SOUNDBRIDGE |
| Single-sided deafness | CROS hearing aids, BONEBRIDGE, ADHEAR, cochlear implant |
| Neural | Auditory brainstem implant: please contact us to discuss |
Common signs in adults
- Often asking people to repeat themselves
- Turning the TV or phone up louder than others like
- Struggling to follow conversation in noisy places
- Feeling that people mumble
- Missing the doorbell or phone
- Ringing or buzzing in the ears
Signs in children
- Not reacting to sounds or to their name
- Speech that is slow to develop
- Turning devices up loud
- Difficulty paying attention or following instructions
- Frequent ear infections
If your baby did not pass the newborn hearing screening, book a full hearing test as soon as possible. Early action gives children the best start with speech and language.
Protecting your hearing
- Keep headphone volume moderate and take breaks
- Wear hearing protection around loud noise
- Give your ears time to recover after loud events
- Have your hearing checked regularly, especially if you notice changes
See a doctor promptly if you have
- Sudden hearing loss in one or both ears
- Ear pain with discharge
- Dizziness together with hearing loss or tinnitus
Explore more
Tools and guides to help you understand hearing, for yourself or someone you love.
Signs to watch for, speech milestones by age and what to do if your baby did not pass the newborn screening.
Ten quick questions about everyday listening to see whether a hearing test could help.
Hear how speech and everyday sounds can change with mild, moderate or severe hearing loss.
Learn to read the chart from your hearing test, with an interactive example audiogram.
Hearing loss in one ear: how it affects daily life and the options that can help.
A cochlear implant in one ear and a hearing aid in the other, working as a team.
Noticed any of these signs?
A hearing test is quick, comfortable and gives you clear answers.