Unhappy mature father and adult son not talking after quarrel

Difficulties with Communication Could Signal a Hearing Loss

Olga Lis, MS, CCC-A

Not every kind of hearing loss has the same effect on a person’s ability to talk. We don’t hear with our ears but with our brains. Every person has a unique way in which their brain processes and makes sense of the sounds around them. We think a person has a hearing loss if they have trouble hearing conversations in groups or talking in noisy places, even if they have passed a hearing test.


Different kinds of hearing loss

Hearing loss can be caused by and show up in many different ways. It can be sudden or gradual. It can happen in either one ear or both. It can be short-term or long-term. There could be a medical problem at the root, or it could just be a regular part of getting older. Most hearing loss can be put into one of two groups: sensorineural or conductive.

Sensorineural hearing loss is a type of hearing loss where the cause is in the inner ear or sensory organ (cochlea and related structures) or the vestibulocochlear nerve. Sensorineural hearing loss makes up about 90% of all cases of hearing loss, and hearing aids are a simple way to treat it.

Conductive hearing loss happens when sound waves can’t travel through the outer ear, eardrum, or middle ear as well as they should. 

When both conductive and sensorineural hearing loss happens simultaneously, it is called a “mixed hearing loss.” 

However, routine hearing tests don’t always pick up on hearing loss, and that’s where we might have a phenomenon known as hidden hearing loss.


Hidden Hearing Loss

If you think you might have hearing loss, the first thing to do is get an audiogram. A hidden hearing loss is a type that the most common hearing test can’t measure. However, if your hearing loss is hidden, the audiogram will look like it does for someone with normal hearing. 

This hidden hearing loss is called cochlear synaptopathy. It is caused by damage to the synapses, the links between the auditory nerve fibers and the sensory cells. This kind of damage happens before hearing loss, caused by the loss of sensory cells. Cochlear synaptopathy may also be linked to tinnitus, hyperacusis, and increased sensitivity to sound.


What causes hidden hearing loss?

Many of the sounds we hear daily are at safe levels that won’t hurt our ears. But sounds can be dangerous if they are too loud, even for a short time, or if they last for a long time, even if they are not as loud. Some inner ears can be hurt by these sounds, leading to permanent hearing loss. This permanent loss of hearing can then get worse over a lifetime. 

When someone has a hidden hearing loss, the damage from noise is in the nerve cells that connect the inner ear’s cochlea to the brain. When nerve cells lose their connections to hair cells, they can’t send information to the brain. So, the brain gets less helpful information from the ear, making it hard for the brain to understand the information correctly.


Signs of hidden hearing loss

Standard hearing tests can’t find a hidden hearing loss, so hearing healthcare professionals don’t find it nearly as often as they should. A person with a hidden hearing loss usually can still hear quiet sounds, but it’s harder to pick out specific sounds when there’s a lot of background noise. 

If a person’s hearing thresholds are normal, but they have trouble understanding speech in noisy places, we will think they have a hidden hearing loss. We think the nerve fibers that tell the brain which sounds are louder are broken. It usually happens to younger people who go to loud concerts or listen to loud music through headphones for long periods. Younger people with a hidden hearing loss may have worse hearing loss as they age.


How to Treat Hearing Loss

What should you do if you think you have trouble hearing? If you have trouble hearing, call us today. We can help you determine what’s wrong with your hearing and find out what’s causing your hearing loss. We offer complete hearing health services, such as hearing tests and hearing aid fittings, that will help your health and well-being.