One in eight people in the United States over age 12 has hearing loss in both ears, according to the National Institute on Deafness and other Communication Disorders, and many younger people are now experiencing problems.
At the same time, only one in five who would benefit from a hearing aid actually uses one. And people with hearing loss wait an average of seven years before seeking help, according to the Hearing Loss Association of America.
“Individuals of all ages could benefit from testing, hearing aids, medication, and other treatments,” says Bess Nagler, AuD, CCC-A, clinical manager of audiology at the Center for Hearing and Balance at Mount Sinai. “Often it is a family member who encourages the person with hearing loss to finally come in for an evaluation.”
Bess Nagler, AuD, CCC-A
The number of people who have difficulty hearing is expected to rise dramatically in the coming decades. Age-related hearing loss usually begins around age 60. However, Dr. Nagler notes that many patients seeking evaluations are in their 40s and 50s.
“We are seeing a younger demographic coming into the office for a hearing exam. The emphasis today on sound quality with respect to music and Bluetooth streaming has underscored this trend,” explains Dr. Nagler. “At Mount Sinai Doctors Faculty Practice, we are also seeing an increased awareness about the importance of testing.”
Types of Hearing Loss
Complications with the physical structure of the ear, the nerves, or the connection between the inner ear and the brain are often the genesis of hearing loss. The three categories are:
- Conductive hearing loss occurs when a problem in the outer or middle ear prevents sound from reaching the inner ear. Some causes include ear wax, middle ear fluid from a cold or allergies, acute or chronic ear infection, foreign body, or a perforation in the eardrum. Medication or surgery can often help this type of hearing loss.
- Sensorineural hearing loss occurs due to a problem with the inner ear or the nerve pathway to the brain. Inner ear hair cell damage that occurs as we age is the most common cause. Some other causes include genetic conditions, loud noise exposure, ototoxic medications, tumor on the acoustic nerve, or illnesses. Hearing aids can often help this type of hearing loss.
- Mixed hearing loss is a combination of both conductive and sensorineural hearing loss.
A common pattern of hearing loss is hearing in the normal range in the lower frequencies, but fading out to a more significant hearing loss in the higher frequencies. “In these cases, you can hear people talking but are unable distinguish every sound or word,” says Dr. Nagler. For example, high frequency sounds include consonants such as the s, f, th, and k. These sounds give speech clarity. When you miss these sounds, you need to rely on context or lip-reading (difficult with a mask!) to fill in what is being said, which can be exhausting over time, and difficult when people are wearing a mask. “Individuals often withdraw from the conversation completely, which can be very frustrating for them and their families,” Dr. Nagler says
How Hearing is Evaluated
Having your hearing tested is simple. First, the audiologist will look inside the ears to see if there is wax, fluid, or infection. Then, an objective middle ear function test is performed, measuring energy transmission through the middle ear. Finally, the audiologist will ask you to identify a variety of sounds and pitches in both ears. You will also be asked to repeat a series of words to evaluate what is known as your speech perception. The results are then reviewed and, when needed, referrals are made to an ear, nose, and throat physician.
Ten Signs You Need a Hearing Test
- You ask people to repeat themselves. Conversations feel like a struggle—both in person and on the phone.
- You hear ringing in your ears. Known as tinnitus, these noises are described as a buzzing, roaring, clicking, or hissing in one or both ears. The sensation may come and go or occur all the time. You may also have episodes of dizziness or vertigo.
- The volume is constantly turned up. You need to crank the TV to be able to hear dialogue or music comfortably, or you rely heavily on subtitles. Family and friends tell you the volume is “too loud.”
- It sounds like everyone around you is mumbling. You are always telling people to speak more clearly. This is more noticeable in individuals with high-pitched voices.
- Understanding speech in background noise is more difficult. Filtering out external sounds in a busy environment like a restaurant or a party is challenging.
- You have trouble following multiple voices. While in a meeting or at the dinner table, it is difficult to differentiate who is talking and when. You frequently need to ask the people around you to take turns speaking.
- You leave social situations feeling exhausted. You are straining just to hear. You feel fatigued and need to exert extra effort to hear at public events. Your body feels strained and your neck or back may feel tight from twisting and tensing.
- Everyday sounds are missed. You do not hear the doorbell, alarm clock, or phone ringing. Your loved ones express concerns about safely carrying out everyday tasks.
- You feel isolated or depressed. A strain has developed on your relationships with family and friends. You feel as though they are frustrated with you. It feels easier to avoid social gatherings or situations where there is a lot of noise.
- Family members keep telling you that you need a hearing test. Many people with hearing loss do not realize they are missing out on sounds or conversation. The people who live with you or interact with you every day are your best resource. Listen to their advice.
Advancements in Hearing Aids
More than 28 million adults in the U.S. could benefit from hearing aids. However, less than one in three adults, age 70 or older, wear them. There is still a misconception that hearing aids are bulky, squeaky, and cause sound to be distorted. However, hearing aid technology has improved dramatically over the past two decades and continues to advance every year.
A wide variety of hearing aid styles, ranging from invisible to larger behind-the-ear devices, are available today. Most hearing aids are capable of connecting to Bluetooth, have rechargeable batteries, and can work in tandem with each other to provide the best sound in any given environment. Many have different settings that you can control with a smartphone. For example, if you are in a noisy restaurant, you can choose a program that suppresses background noise.
“Hearing aids can dramatically improve the quality of life for people with hearing loss,” says Dr. Nagler. “It is worthwhile to get a baseline exam, especially if you or your loved ones are noticing any hearing difficulty in your daily life.”
To make an appointment with Dr. Nagler, call 212-241-9410 or email ENTpatientservices@mountsinai.org.