Hearing is a highly complex task that can take vibrations in the air and turn them into an idea. Great speeches, alarm sounds, dog barks or beautiful music begin as mere vibrations reaching the ears.
Hearing begins with detection (“a sound is present”). Next comes discrimination (“that is a word”), followed by recognition (“I know those words”) and, finally, comprehension (“I understand that idea”). Each step in the process involves a different part of you. Your ears only detect vibrations and send electrical impulses toward the brain. Various brain structures perform the rest of the task.
There are patients who complain of difficulty hearing, yet traditional audiometric testing comes back normal. Many of these patients complain of poor hearing in noisy places or difficulty decoding speech. They may struggle in their occupations or relationships. Such “hidden” loss of hearing must be approached with a larger tool box and knowledge of the pathway listed above. There may be a breakdown in one of the four stages of hearing listed above.
Hearing scientists have discovered there can be damage to the hearing system that cannot be detected by traditional testing methods. Patients with a history of chronic ear infections, exposure to loud noise or toxins, such as certain medications, can incur damage to the nerve fibers that originate in the ear. This can interfere with the brain receiving a clean signal from the ears. Some of the brain regions responsible for memory can be affected. There are even regions of the brain responsible for adapting to noisy rooms.
Hidden hearing loss can be improved with modern technology. Listening strategies and technology, such as directional microphones and remote microphones, can help minimize the intrusion of background noise and emphasize the desired sounds. Only a thorough diagnostic evaluation can determine the best direction to take. We want to keep you on a clear path to good hearing and ear health.