Your Hearing

How Hearing Works

Hearing begins when the outer ear, the visible portion of the ear that is on the outside of the head, channels sound waves down the auditory canal. This tube-like passageway is lined with tiny hairs and small glands that produce ear wax.

The middle ear lies at the end of the auditory canal. It is composed of the eardrum and three small bones, known by the layman as the hammer, the anvil and the stirrup. When sound waves hit the eardrum, it vibrates and, in turn, moves the hammer. The hammer moves the anvil, which moves the stirrup, transmitting the vibrations into the inner ear. The middle ear functions to amplify sound, which is why significant hearing loss can result from any disruption in any of the parts.

The inner ear consists of the cochlea and the nerve of hearing. The cochlea converts sound waves into nerve impulses that travel to the brain via the movement of tiny hair cells. The brain, in turn, allows us to hear…

Do You Have Hearing Loss?

Conductive hearing loss is caused by problems in the outer and/or middle ear. Sensorineural hearing loss can be caused by the aging process, exposure to loud noise, certain medications, infections, head or ear trauma, congenital (birth or prenatal) or hereditary factors, diseases, as well as a number of other causes. In the year 2010, it is estimated 28 million people in the USA have hearing loss.

Answering "yes" to any of the following questions should be reason to have your hearing evaluated by an audiologist.

  • Do you have trouble understanding conversation in a noisy environment?
  • Do you notice that you can "hear", but cannot always "understand" what others are saying?
  • Do you remain quiet in conversations for fear of responding improperly?
  • Do you often ask others to repeat themselves?
  • Do you avoid certain social activities because you cannot hear well?
  • Do you strain to hear soft voices such as those of women and children?
  • Do your friends or family members complain that the television volume is too loud?
  • Do you have a problem hearing on the telephone?

Many people suffer from hearing loss...

In fact, the latest available statistics show that over 10% of the U.S. population reports difficulty hearing. That's more than 31 million people. And as the Baby Boomer generation continues to age, that number promises to increase dramatically.

Are you one of those millions of people who does not hear as well as they once did? If so, you are certainly not alone. Consider these statistics reported by Sergei Kochkin, Ph.D., Executive Director of the Better Hearing Institute :

  • 3 in 10 people over age 60 have hearing loss;
  • 1 in 6 baby boomers (ages 41-59), or 14.6%, have a hearing problem;
  • 1 in 14 Generation Xers (ages 29-40), or 7.4%, already have hearing loss;
  • At least 1.4 million children (18 or younger) have hearing problems;
  • It is estimated that 3 in 1,000 infants are born with serious to profound hearing loss.

In addition, studies have linked untreated hearing loss to emotional, physical, mental, psychological and even economic disadvantages! And, to make matters even worse, there are many "myths" about hearing loss that prevent those with hearing loss from doing anything about it.

Causes of Hearing Loss

One of the most common "myths" about hearing loss is that only "old people" suffer from it! In fact, the reverse is true! The majority (65%) of people with hearing loss are younger than 65 and six million people in the U.S. between 18 and 44 suffer from hearing loss (Better Hearing Institute website).

The truth is that there are several causes of hearing loss with "exposure to noise" ranking high among the reasons. The primary causes of hearing loss are:

  • Exposure to noise
  • Family history of hearing loss
  • Medicine
  • Aging process
  • Disease
  • Head trauma
  • Types of Hearing Loss

Not all hearing loss can be corrected through the use of hearing aids or alternative listening devices. The type of hearing loss determines the specific treatment required.

There are four types of hearing loss:

  • Conductive: This could be caused by something as simple as earwax buildup!
  • Sensorineural: This is caused when tiny hairs in the cochlea are missing or damaged.
  • Mixed: This is a combination of conductive and sensorineural hearing loss.
  • Central: Strokes and central nerve diseases are often the cause of this type of hearing loss, but this type of loss can also occur due to age-related changes in the central auditory system.


Tinnitus is defined as a perception of sound when there is no actual sound in the environment. It is generally perceived in the ears, head, or both. It may sound like crickets, a buzzing, hissing, whooshing, ringing, or other type of sound. Tinnitus is a symptom, not a disease and not necessarily a sign of a serious medical condition. A thorough medical evaluation should be performed prior to any tinnitus treatment in order to rule out a treatable medical condition.

The tinnitus and hyperacusis (decreased tolerance to sound) program of North Shore Audio-Vestibular Lab is an individualized program designed to diagnose, evaluate and treat tinnitus and hyperacusis. The goal is to reduce the disturbing nature of the tinnitus and decreased tolerance to sound through counseling, education, and presentation of various treatment options.

The American Tinnitus Association (ATA) estimates that 50 million Americans have tinnitus and for approximately 12 million of them, the tinnitus is severe and debilitating. Those who have a severe negative reaction to the tinnitus may report problems with concentration, sleep, interpersonal relationships, and general sense of well being.

The evaluation appointment generally takes several hours. It includes a detailed case history, a number of diagnostic procedures and concludes with a review of all test findings and a presentation of treatment options. 

To learn more about hearing loss and for more help along your hearing journey, visit the Resources page.