Difficulties with Communication Could Signal a Hearing Loss

If an individual has trouble hearing conversations in groups or communicating in noisy environments then we suspect they have a hearing loss.

Difficulties with Communication Could Signal a Hearing Loss

Not all hearing loss is equivalent in how it may be affecting an individual’s communication. We hear with our brains, not our ears. How an individual’s brain processes and interprets the sounds in their environments is unique to every single person. At La Canada Hearing, if an individual has trouble hearing conversations in groups or communicating in noisy environments then we suspect they have a hearing loss.

Types of Hearing Loss

Hearing loss has a lot of different causes and manifestations. It can be sudden or gradual. It can occur in one ear or both ears. It can be temporary or permanent. There can be underlying medical issues or more common age-related changes.  The majority of hearing loss can be classified as Sensorineural or Conductive.

Sensorineural hearing loss is a type of hearing loss in which the root cause lies in the inner ear or sensory organ (cochlea and associated structures) or the vestibulocochlear nerve. Sensorineural hearing loss accounts for about 90% of reported hearing loss and can be easily treated with hearing aids.

Conductive hearing loss occurs when there is a problem transferring sound waves anywhere along the pathway through the outer ear, eardrum, or middle ear . If a conductive hearing loss occurs in conjunction with a sensorineural hearing loss, it is referred to as a mixed hearing loss. However, sometimes you can have hearing loss that is not picked up by conventional hearing tests.

Hidden Hearing Loss

A hidden hearing loss is a type of hearing loss that cannot be measured by the most common hearing test. On suspicion of a hearing loss, the first step is to measure the hearing with an audiogram, but for people with hidden hearing loss, the audiogram looks as it does for someone with normal hearing. Called cochlear synaptopathy, this hidden hearing loss is damage to the synapses, which are the connections between the auditory nerve fibers and sensory cells. This type of damage happens before the loss of sensory cells associated with typical hearing loss. Cochlear synaptopathy may also be related to tinnitus and hyperacusis, the increased sensitivity to sound.

Cause of Hidden Hearing Loss

Many enjoyable sounds that we hear every day are at safe levels that won’t damage our hearing. However, sounds can be harmful when they are too loud—even for a short time, or when they are lasting an extended period of time even if they are not quite as loud. These sounds can damage part of the inner ear and cause permanent hearing loss. This permanent hearing loss can then worsen over the span of a lifetime. With a hidden hearing loss the damage caused by noise is located in nerve cells that connects the cochlea in the inner ear to the brain. The nerve cells lose their connections with the hair cells, so they cannot send information to the brain.  As a result, the brain receives lesser and less efficient information from the ear, and therefore it struggles to interpret the information correctly.

Signs of Hidden hearing Loss

A hidden hearing loss doesn’t normally affect a person’s ability to hear quiet sounds, but it makes it harder to hear sounds specifically when there is competing background noise. A hidden hearing loss cannot be measured with standard hearing tests making it drastically under diagnosed and identified by hearing healthcare professionals. If someone has normal hearing thresholds and difficulties understanding speech in challenging environments then we at La Canada will suspect the presence of hidden hearing loss. We suspect that the nerve fibers that code for louder sounds are damaged. It often affects younger people, who go to loud music concerts or spend time listening to loud music through headphones. People who have a hidden hearing loss when they are younger may suffer from more severe hearing loss as they age.

Treatment of Hearing Loss

What should you do if you suspect you have a hearing loss? If you’ve been struggling to hear, contact us at La Cañada Hearing. We can help to identify any hearing problems and help you get to the bottom of your hearing loss. We provide comprehensive hearing health services, from hearing tests to hearing aid fittings, that will benefit your overall health and well-being.


Written by
Reviewed by
Dr. Kevin H. Ivory
Audiologist & University Instructor
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Dr. Kevin Ivory, Au.D., CCC-A received his Bachelor of Arts (Psychology) Degree from the University of Wisconsin-Madison. He then went on to earn his Doctor of Audiology degree from Rush University Medical Center in Chicago, one of the top 10 audiology residential programs in the country.

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