Communication is a central part of our lives. It is what sets us apart from animals, even though whales and other species can communicate with each other through sounds. Our sense of hearing is essential for interpersonal communication. When we can no longer communicate easily with those around us, our quality of life suffers significantly. Those affected suffer greatly from the consequences of hearing impairment or hearing loss. But how exactly is hearing impairment diagnosed?

Human hearing is a complex process. Sound waves are picked up by the outer ear and directed through the external auditory canal to the eardrum. This causes the eardrum to vibrate. The ossicles pick up these vibrations and transmit them to the cochlea in the inner ear.

There, tiny hair cells convert the sound waves into electrical impulses, which the auditory nerve then immediately transmits to our brain. This is how we perceive sounds, noise, or speech. Hearing loss occurs when there is a disturbance or disorder along this pathway between the ear canal and the brain—and this can have a variety of causes, such as a noisy work environment or ear infections.

To determine whether a person has hearing loss and, if so, to what degree, hearing care professionals and ENT specialists must first determine the hearing threshold. This is the limit at which a person can perceive sounds. Determining this threshold depends on two factors: pitch and volume. Pitch, also known as frequency, is measured in hertz (Hz). In a healthy person, the hearing range is between 0 and 20,000 hertz. The ear is most sensitive to the frequencies of human speech, which range from 500 to 6,000 hertz.

Volume, the second measurable factor or parameter used to determine hearing loss, is measured in decibels (dB). Generally, a person is considered to have poor hearing or hearing loss if they can no longer perceive sounds of 25 dB or lower. These include, for example, the ticking of a wristwatch, falling snow, or the rustling sound of turning the pages of a newspaper.

A person with normal hearing begins to feel uncomfortable at sound levels of 80–85 dB, which is roughly equivalent to the sound of a car engine at close range.

In environments with higher sound pressure levels—as this measured volume is also called—it is absolutely essential to wear hearing protection, as failure to do so can quickly lead to irreparable hearing damage. Studies have shown that even in daycare centers, sound levels can reach up to 117 dB. By comparison, a jet taking off 100 meters away is “only” 100 dB loud.

Why not take our online hearing test right now to see how well your ears are working?

Once a doctor or hearing care professional has determined a person’s hearing threshold, it is compared to that of someone with normal hearing. The difference between normal and impaired hearing, as determined in this way, allows the degree of hearing loss to be assessed.[/vc_column_text]

In addition to determining the degree of hearing loss, hearing care professionals or ENT specialistsalso identify the specific type of hearing loss in order to provide the best possible treatment. It would be an oversimplification to attribute hearing loss solely to a noisy environment. In fact, there are many organic, psychological, and environmental causes—and thus different types of hearing loss. The three main types of hearing loss are:

• Sensorineural hearing loss
• Conductive hearing loss
• Perceptual hearing loss

All three have different causes and symptoms. In the case of sensorineural hearing loss, excessive noise levels typically lead to permanent disruption of sound processing. This is because excessively loud sounds or prolonged exposure to noise irreversibly damage the hair cells in the cochlea of the ear. Although sound signals can still be received, they can no longer be converted.

Far fewer or no auditory frequencies and information reach the brain. People with this condition usually have great difficulty understanding others in noisy environments. In such cases, early intervention with hearing aids or a cochlear implant (CI) is recommended to preserve hearing for life.In conductive hearing loss, on the other hand, sound transmission from the middle ear to the inner ear is disrupted. Those affected still receive the same amount of sound signals but perceive them as significantly muffled—as if they had cotton in their ears. Causes can include bacterial infections of the outer and middle ear, injuries to the eardrum, or even water in the ear canal. The causes of sensorineural hearing loss do not lie in the ear itself but are due to faulty processing of auditory signals in the brain. Although those affected still perceive acoustic signals, the brain is no longer able to process them correctly. This can have many psychological causes, as well as dementia or its precursors, such as age-related forgetfulness.

If this type of hearing loss occurs suddenly, you should call an emergency medical professional, as it may be caused by a stroke, cerebral hemorrhage, sudden severe hearing loss, or other life-threatening conditions.

Hearing loss is not a condition that occurs only in old age. In fact, it is not uncommon for hearing loss to be diagnosed in children and adolescents. So be on the lookout for the symptoms mentioned above in your children, and contact a doctor immediately if necessary. The earlier hearing loss is recognized and diagnosed, the better the chances of preserving your child’s hearing in the long term.

Find out why life with a hearing aid is fun for kids by following little Cindy’s story. And if a little girl can do it, older adults can do it with ease, too.