Hearing Loss
Hearing loss and deafness are conditions that affect millions of people around the world and can be caused by various factors, including genetics, noise exposure, infections, and aging. There are several types of hearing loss, ranging from mild hearing loss to complete deafness.
deafness
Deafness is the partial or complete inability to hear. Some people are born without hearing, which is known as congenital deafness.
There are two primary types of hearing loss: conductive and sensorineural, though many individuals experience a mix of both.
Because hearing depends on the mechanical transmission of sound through the ear and the conversion of those vibrations into neural signals, damage at any stage in this pathway can cause hearing loss.
conductive hearing loss
In conductive hearing loss, hearing problems are associated with a failure in the vibration of the eardrum and/or movement of the ossicles. This causes issues with delivering sound energy to the cochlea.
Causes for conductive hearing loss primarily relate to issues in the outer or middle ear, including blockage of the ear canal, a hole in the tympanic membrane, problems with the ossicles, or fluid in the space between the eardrum and cochlea.
This can be treated by surgery, medication, or through devices like hearing aids that amplify incoming sound waves to make the vibration of the eardrum and movement of the ossicles more likely to occur.
When treated early, conductive hearing loss is often reversible.
Another group of people have sensorineural hearing loss, which is the most common form of hearing loss.
sensorineural hearing loss
Sensorineural hearing loss (SNHL) results from damage to the inner ear (cochlea) or the auditory nerve, interfering with how neural signals are transmitted to the brain. This is the most common type of hearing loss and typically progresses with age.
Causes include:
- Prolonged exposure to loud noise, such as concerts or industrial work (noise-induced hearing loss; see Figure 1)
- Aging (presbycusis)
- Head or acoustic trauma
- Infections or diseases (e.g., measles, mumps, meningitis)
- Certain medications or toxins (e.g., solvents, heavy metals)
- Tumors or other structural damage
Sensorineural hearing loss is not reversible but can be managed with hearing aids or cochlear implants. For patients with mild-to-moderate sensorineural hearing loss, conventional hearing aids are helpful, though once the damage to the hair cells is profound, then amplifying the sound through a hearing aid is insufficient, and cochlear implants would be needed for hearing.
Cochlear implants are electronic devices that consist of a microphone, a speech processor, and an electrode array. The device receives incoming sound information and directly stimulates the auditory nerve to transmit information to the brain.
One disease that results in sensorineural hearing loss is Ménière’s disease. Although not well understood, Ménière’s disease results in a degeneration of inner ear structures that can lead to hearing loss, tinnitus (constant ringing or buzzing), vertigo (a sense of spinning), and an increase in pressure within the inner ear (Semaan & Megerian, 2011).
Deaf Culture
Around the world, Deaf communities have developed rich languages, schools, and traditions. This shared identity is known as Deaf culture.
In the United States, many Deaf individuals use American Sign Language (ASL)—a complete, visual language with its own grammar and syntax, independent of English. Globally, there are over 300 different sign languages (World Federation of the Deaf, 2024).
Members of Deaf culture often value:
- Sign language as the primary mode of communication
- Cultural identity and pride within the Deaf community
- Preserving Deaf traditions rather than focusing solely on medical “fixes” like cochlear implants
When a child is diagnosed as deaf, parents (and children, when they are old enough) have difficult decisions to make. Should they consider a cochlear implant? Should the child be enrolled in mainstream schools and taught to verbalize and read lips? Or should the child be sent to a school for deaf children to learn ASL and have increased exposure to Deaf culture? Do you think there might be differences in the way that parents approach these decisions depending on whether or not they are also deaf?