When describing hearing loss, we generally look at three categories:

• type of hearing loss,
• degree of hearing loss,
• configuration of hearing loss.

With children, it is especially important to diagnose and treat a hearing loss as early as possible. This limits its potential impact on learning and development. Hearing loss can greatly affect the quality of life for adults as well. Unmanaged hearing loss can have an impact on employment, education, and general well-being.

Type of Hearing Loss

Refer to question "Are there types of hearing loss?"

Degree of Hearing Loss

Degree of hearing loss refers to the severity of the loss. The table below shows one of the more commonly used classification systems. The numbers are representative of the patient's hearing loss range in decibels (dB HL).

Configuration of Hearing Loss

The configuration, or shape, of the hearing loss refers to the degree and pattern of hearing loss across frequencies (tones), as illustrated in a graph called an audiogram. For example, a hearing loss that only affects the high tones would be described as a high-frequency loss. Its configuration would show good hearing in the low tones and poor hearing in the high tones.

On the other hand, if only the low frequencies are affected, the configuration would show poorer hearing for low tones and better hearing for high tones. Some hearing loss configurations are flat, indicating the same amount of hearing loss for low and high tones.

Other descriptors associated with hearing loss are:

• Bilateral versus unilateral. Bilateral means hearing loss in both ears. Unilateral means hearing loss in one ear.
• Symmetrical versus asymmetrical. Symmetrical means the degree and configuration of hearing loss are the same in each ear. Asymmetrical means degree and configuration of hearing loss are different in each ear.
• Progressive versus sudden hearing loss. Progressive means that hearing loss becomes worse over time. Sudden means hearing loss that happens quickly. Such a hearing loss requires immediate medical attention to determine its cause and treatment.
• Fluctuating versus stable hearing loss. Fluctuating means hearing loss that changes over time—sometimes getting better, sometimes getting worse.

 source: American Speach-Language-Hearing-Association

Hearing loss can be categorised by which part of the auditory system is damaged. There are three basic types of hearing loss:

• conductive hearing loss,
• sensorineural hearing loss,
• mixed hearing loss.

Conductive Hearing Loss

Conductive hearing loss occurs when sound is not conducted efficiently through the outer ear canal to the eardrum and the tiny bones (ossicles) of the middle ear. Conductive hearing loss usually involves a reduction in sound level or the ability to hear faint sounds. This type of hearing loss can often be corrected medically or surgically. Some possible causes of conductive hearing loss:

• Fluid in the middle ear from colds
• Ear infection (otitis media)
• Allergies (serous otitis media)
• Poor eustachian tube function
• Perforated eardrum
• Benign tumors
• Impacted earwax (cerumen)
• Infection in the ear canal (external otitis)
• Swimmer's Ear (otitis ecxterna)
• Presence of a foreign body
• Absence or malformation of the outer ear, ear canal, or middle ear

Sensorineural Hearing Loss

Sensorineural hearing loss (SNHL) occurs when there is damage to the inner ear (cochlea), or to the nerve pathways from the inner ear to the brain. Most of the time, SNHL cannot be medically or surgically corrected. This is the most common type of permanent hearing loss. SNHL reduces the ability to hear faint sounds. Even when speech is loud enough to hear, it may still be unclear or sound muffled. Some possible causes of SNHL:

• Illnesses
• Drugs that are toxic to hearing
• Hearing loss that runs in the family (genetic or hereditary)
• Aging
• Head trauma
• Malformation of  the inner ear
• Exposure to loud noise

Mixed Hearing Loss

Sometimes a conductive hearing loss occurs in combination with a sensorineural hearing loss (SNHL). In other words, there may be damage in the outer or middle ear and in the inner ear (cochlea) or auditory nerve. When this occurs, the hearing loss is referred to as a mixed hearing loss.

source: American Speach-Language-Hearing-Association

Yes there are varying degrees of hearing loss. They are presented on the Audiogram below. These range from Mild hearing loss, Moderate hearing loss, Moderately Severe hearing loss, Severe hearing loss, to Profound hearing loss.

yes

Depends

Unilateral hearing loss (UHL) means that hearing is normal in one ear but there is hearing loss in the other ear. The hearing loss can range from mild to very severe. UHL can occur in both adults and children. Approximately 1 out of every 10,000 children is born with UHL, and nearly 3% of school-age children have UHL. Children with UHL are at higher risk for having academic, speech-language, and social-emotional difficulties than their normal hearing peers. This may be because UHL is often not identified, and the children do not receive intervention. Below are some possible causes of UHL:

• Hearing loss that runs in the family (genetic or hereditary)
• An outer, middle, or inner ear abnormality
• Some syndromes
• Illnesses or infections
• Head injury
• Exposure to loud noise
• Traumatic brain injury (TBI)

 source: American Speach-Language-Hearing-Association

The following animation is a good representation of what it is like for a person with Moderate hearing loss.

If you or someone you know is experiencing these symptoms, please contact our service for assistance.

Yes. There are a number of sources of assistance available to you.

1. Tax relief can be claimed for medical expenses from Revenue at the standard rate of tax (currently 20%). This includes hearing assessments and purchase of hearing aids. Click here for more information and download the MED 1 Form.
2. The Treatment Benefit Scheme is a scheme run by the Department of Social Protection (DSP) that provides dental, optical and aural services to qualified people. The Treatment Benefit Scheme is available to insured workers and retired people who have the required number of PRSI contributions. Currently Hearing aids may be provided by suppliers who have a contract with the Department of Social Protection. earpeace™ is on this medical appliance panel. Our Registration number is 6247. The Department of Social Protection pays half the cost of a hearing aid subject to a fixed maximum grant of €500 for each hearing aid every 4 years. It also pays half the cost of repairs to hearing aids. If you think that you may qualify for this grant either under your own insured employment scheme (MA1) or that of a dependent spouse scheme (MA2) earpeace™ will facilitate your application. Why not contact a member of our team now for an appointment, or complete the online appointment form.
3. Private Health Insurance providers currently allow claims of up to €40 towards hearing assessment.

The outer ear consists of the pinna, or auricle, and the ear canal (external auditory meatus). The pinna – the part of the "ear" that we see on each side of our heads – is made of cartilage and soft tissue so that it keeps a particular shape but is also flexible. The pinna serves as a collector of sound vibrations around us and guides the vibrations into the ear canal. It helps us decide the direction and source of sound.

The middle ear begins with the eardrum at the end of the ear canal. The middle ear contains three tiny bones, called the ossicles. These three bones form a connection from the eardrum to the inner ear. As sound waves hit the eardrum, the eardrum moves back and forth causing the ossicles to move. As a result, the sound wave is changed to a mechanical vibration.

The inner ear contains the sensory organs for hearing and balance. The cochlea is the hearing part of the inner ear. The semicircular canals in the inner ear are part of our balance system. The cochlea is a bony structure shaped like a snail and filled with two fluids (endolymph and perilymph). The Organ of Corti is the sensory receptor inside the cochlea which holds the hair cells, the nerve receptors for hearing.

The mechanical energy from movement of the middle ear bones pushes in a membrane (the oval window) in the cochlea. This force moves the cochlea's fluids that, in turn, stimulate tiny hair cells. Individual hair cells respond to specific sound frequencies (pitches) so that, depending on the pitch of the sound, only certain hair cells are stimulated.

Signals from these hair cells are changed into nerve impulses. The nerve impulses are sent out to the brain by the cochlear portion of the auditory nerve. The auditory nerve carries impulses from the cochlea to a relay station in the mid-brain, the cochlear nucleus. These nerve impulses are then carried on to other brain pathways that end in the auditory cortex (hearing part) of the brain.

Also housed within the inner ear are the semicircular canals, the utricle, and the saccule. These structures help control one’s sense of steadiness or balance. These balance organs share the temporal bone space with the cochlea. These organs also share the same fluid that is in the cochlea.

Hearing is one of the five senses. It is a complex process of picking up sound and attaching meaning to it. The ability to hear is critical to understanding the world around us. Take a look at this video. The human ear is a fully developed part of our bodies at birth and responds to sounds that are very faint as well as sounds that are very loud. Even before birth, infants respond to sound. So, how do we hear?

The ear can be divided into three parts leading up to the brain – the outer ear, middle ear and the inner ear.

• The outer ear consists of the ear canal and eardrum. Sound travels down the ear canal, striking the eardrum and causing it to move or vibrate.
• The middle ear is a space behind the eardrum that contains three small bones called ossicles. This chain of tiny bones is connected to the eardrum at one end and to an opening to the inner ear at the other end. Vibrations from the eardrum cause the ossicles to vibrate which, in turn, creates movement of the fluid in the inner ear.
• Movement of the fluid in the inner ear, or cochlea, causes changes in tiny structures called hair cells. This movement of the hair cells sends electric signals from the inner ear up the auditory nerve (also known as the hearing nerve) to the brain.

The brain then interprets these electrical signals as sound.

source: American Speach Language Hearing Association

The ear is a self cleaning organ and does not require any active cleaning. Cotton buds should not be used for cleaning the ear.

Do not insert or put anything into the ear. Do not use any oil, sticks, pins etc. because these can lead to infection in the ear.

Anyone regularly exposed to hazardous noise should have an annual hearing test. Also, anyone who notices a change in their hearing, or who develops tinnitus, should have their ears checked immediately.

The degree of hearing hazard is related to both the level of the noise as well as to the duration of the exposure. It is better to protect against loud noise as soon as one gets exposed to it. Get your ears protected before you enter the loud noise area.

There are two rules: First, if you have to raise your voice to talk to someone who is an arm's length away, then the noise is likely to be hazardous. Second, if your ears are ringing or sounds seem dull or flat after leaving a noisy place, then you probably were exposed to hazardous noise. See the Noise Thermometer for further information.

Length of the average ear canal is 24mm. The length of a typical ear plug ranges from 12 - 18 mm. Also the path from the opening of the ear canal to the eardrum is not straight. The irregularity of the canal protects the ear drum from injury.

The risk of hearing loss increases as sound is played louder and louder for long durations. It has been shown that listening through ear/head phones at 95% of maximum sound volume for 5 minutes continuously will damage the hearing capacity. Breaks should be taken while listening through ear/headphones.

Using ear plugs will not cause an infection. Have clean hands when using ear plugs that need to be rolled or formed with your fingers.

Certain medicines are harmful for ears. They damage the cells situated in the inner ear and lead to nerve hearing loss. Some medicines known to have adverse effects on the ears are gentamycin, streptomycin, frusemide, chloroquine, and a spirin. These medicines must be used only on the advice of a qualified doctor.

Source: World Health Organisation

The common causes are fungal infection, allergy, chronic dermatitis of the canal and eczematous otitis externa. After examination suitable ear drops are prescribed.

Source: World Health Organisation

The pain in the ear can be caused by problems such as impacted wax in the ear, acute infection in the ear canal, acute infection of the ear drum or because of fluid in the middle ear. It is commonly seen in children. The child should be taken for an ear check-up if the child complains of pain in the ear or hearing loss; you detect discharge from the ear, improper speech development and if the child does not understand properly what you say. Consult your doctor, paediatrician or an ENT specialist urgently.

Many small children need to have tubes placed in their ears because of recurring ear infections. These tubes equalise the pressure between the external and the middle ear and help in the draining out of fluid from the middle ear. Most tubes are automatically extruded after a period of time (6 months to 2 years). If the child still has recurring ear infections, they may have another set of tubes inserted in their eardrums.

Ears can be blocked due to a number of reasons. The external ear canal can be blocked with earwax or a small foreign object. Ear wax is normal in the ear canal but sometimes it accumulates and completely blocks the canal. Foreign objects should never be put into the ear canal. These types of blocks can cause hearing difficulty and discomfort, and must be removed. Another type of blockage in the ear can occur in the middle ear, which is most often caused by an ear infection and fluid. In both cases it is important to see a doctor who will diagnose the problem and prescribe the correct treatment.

Ringing in your ears, also called Tinnitus, can be distressing. Most often a person with tinnitus also has a hearing loss, but not always. There are a number of causes of tinnitus including: hearing loss, allergies, medications, physical damage to the ear and other medical problems. A person can have ringing during an ear infection. It disappears after the infection. If the ringing doesn't go away within a month, go back to your doctor.