Almost anyone who is experiencing difficulty with communication due to hearing loss is a candidate for hearing instruments. There are some hearing losses that can be medically treated without a need for amplication (hearing aids). However, that is typically the exception and not the rule. The good news is there are usually warning signs that there is a possible hearing loss.

Do you feel that people mumble and do not speak clearly?

Do you understand some people better than others?

Do you frequently ask people to speak up or repeat themselves?

Do you have difficulty understanding on the phone?

Do you find it difficult to follow a conversation in a crowded room or with background noise?

Do you turn the volume of the television or radio up louder than is comfortable for others?

Do you find it difficult to hear in public places, such as an auditorium or church?

Do family and friends comment on your inability to hear?

Do you ever concentrate to listen so hard that you become fatigued?

Do you have ringing in your ears?

If you answered yes to any of the above questions, you may have a hearing loss and should have your hearing evaluated by a hearing professional. It is recommended that everyone have his or her hearing tested annually.

Yes, with a hearing loss, it is difficult to understand speech. What is not sufficiently appreciated is that a patient's emotional and mental state may also be affected by the disrupted communication patterns caused by hearing loss. A patient with hearing loss is four times as likely to manifest psychological disturbances than a person with normal hearing. There is also evidence that hearing loss can exacerbate the behavioral picture of patients with Alzheimer's and other cognitive disorders.

Ringing (tinnitus is the technical term) in the absence of stimulating sound from outside the ear can be caused by many things, from fatigue to certain doses of medications such as aspirin. It is believed that the ringing is due to spontaneous activity in the cochlea. The most common cause of tinnitus is hearing loss, and in particular sensorineural hearing loss. This is probably because patients with sensorineural hearing loss have some damage in the cochlea that is causing the hearing loss. It is these damaged sections that are presumed to be producing the spontaneous activity that leads a patient to hear sounds in their ear.

Sound is vibration that travels through a medium, typically the air. When these vibrations reach the outer ear, this is the beginning of hearing. The ear has four main parts that sound must travel through for you to hear: the outer ear, the middle ear, the inner ear, and beyond the inner ear that includes the VIIIth nerve and the brain.

There are three types of hearing loss:

Conductive

Sensorineural

Sensorineural

If you have a hearing loss that is caused by a medically treatment problem, the problem could obviously get worse over time without treatment. If the hearing loss is due to a condition such as a lesion or tumor in the auditory system, this could be potentially life threatening.

Whether the condition is medically treatable such as most conductive losses, or due to damage such as noise exposure or age, the result in the brain is the same, it does not get stimulated. This is called auditory deprivation. The brain is not getting stimulated by sound or is getting distorted versions of the sound due to the damage in the auditory system.

There have been many studies done on auditory deprivation to determine the long term effects on the brain. These studies suggest that if the brain is not stimulated, the potential to "forget" how to hear is great and is closely related to the length of time that brain goes without stimulation. The longer the patient goes without treatment (including amplification if that is warranted) the more likely it is the brain will forget how to hear and understand speech even after treatment is implemented. These findings suggest that it is important to seek appropriate treatment in a timely manner for hearing loss if the brain maintain its ability to understand speech.