In reality we should not say how is your hearing but should actually say how is your ability to communicate with those around you. Typically hearing loss is referred to as mild, moderate, severe and profound. The problem with these vague terms is it does not describe the true impact of hearing loss. The most common type of hearing loss is the sloping high frequency hearing loss that starts out in the mild range and ends in the moderate to severe range in the high frequencies (pitches).

This loss will first be noticed by friends and family as a difficulty to communicate in situations with background noise, especially female or children’s voices. The difficulties will be increased if the person is not facing you directly, such as a waitress that is standing above you or someone walking away from you while talking. TV and radio will generally be louder than needed by others in the room, especially those with normal or near normal hearing. Most people will begin to notice hearing loss and wait seven years before seeking help. Sudden changes in hearing are perceived as a pressure or feeling of fullness rather than hearing loss. This is because the auditory pathways have a sensory deprivation that gives the sense of a vacuum and interpreted as pressure. This is many times mis-diagnosed as a middle ear infection and treated with medication. Seek an audiology evaluation immediately if this occurs for the proper course of treatment.

In men hearing loss tends to begin in the mid-thirties and women in their forties. The maturing ear tends to lose the high frequencies first causing the difficulties described before. Noise exposure, medication harmful to hearing (ototoxic), medical conditions of the ear and genetics can all play a role in the progression of hearing loss.

The Evaluation

The audiology evaluation is conducted to assess the functional status of the auditory system to determine the appropriate treatment strategy for any identified hearing loss.

The evaluation must include any and all necessary procedures needed to determine a thorough history of hearing loss potential and related concerns, auditory sensitivity referred to as hearing threshold, speech recognition capability at normal or hearing impaired levels, determine the type of hearing loss, determine the best referral pathway and if there is a need for amplification intervention.

The audiology evaluation, when performed by a licensed and registered audiologist, is not performed for the purpose of fitting hearing aids.

The typical audiology evaluation should be completed in a sound treated room (sound booth) to reduced or eliminate ambient background noise that can contaminate the accuracy of the test results. This contamination can lead to misinterpretation of the test results and an improper referral.

Testing may include air conduction, bone conduction, speech reception thresholds, speech recognition, tympanometry and distortion product otoacoustic emissions (DPOAE).