Definition of hearing loss

Common categories of hearing loss classifications are mild hearing loss, moderate hearing loss, moderately
severe hearing loss, severe hearing loss and profound hearing loss.

Definition of hearing loss

Hearing loss can be classified or defined in many ways and categories. This definition / classification is used by
the Global Burden of Disease studies, which is used by the WHO.

Mild hearing loss

What is mild hearing loss? On average, the most quiet sounds that people can hear with their better ear are
between 25 and 34 dB. People who suffer from mild hearing loss will normally have some difficulties keeping up
with conversations, especially in noisy surroundings.

Moderate hearing loss

What is moderate hearing loss? On average, the most quiet sounds heard by people with their better ear are
between 35 and 49 dB. People who suffer from moderate hearing loss have problems hearing in many situations
and will have difficulties keeping up with conversations. People with a moderate hearing loss will benefit from
using hearing aids.

Moderately severe hearing loss

What is moderate hearing loss? On average, the most quiet sounds heard by people with their better ear are
between 35 and 49 dB. People who suffer from moderate hearing loss have problems hearing in many situations
and will have difficulties keeping up with conversations. People with a moderate hearing loss will benefit from
using hearing aids.

Moderately severe hearing loss

What is a moderately severe hearing loss? On average, the most quiet sounds heard by people with their better
ear are between 50 and 64 dB. People who suffer from a moderately severe hearing loss have problems
hearing in most situations when not using hearing aids.

Severe hearing loss

What is severe hearing loss? On average, the most quiet sounds heard by people with their better ear are
between 65 and 79 dB. People who suffer from a severe hearing loss are very hard of hearing and will normally
have to use powerful hearing aids. Often they also rely on lip-reading even when they are using hearing aids.

Profound hearing loss

What is profound hearing loss? On average, the most quiet sounds heard by people with their better ear are 80
dB or more. People who suffer from profound hearing loss have a very weak sense of hearing and need very
strong hearing aids or implants, many also rely on lip-reading and/or sign language.

All these categories are normally defined using a measured audiometric average of 500, 1000, 2000 and 4000
Hz.
 Hearing loss

 Symptoms & causes

 Diagnosis & treatment
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Overview

Hearing loss that occurs gradually as you age (presbycusis) is common. About one-third of people in the United
States between the ages of 65 and 75 have some degree of hearing loss. For those older than 75, that number
is approximately 1 in 2.

Hearing loss is defined as one of three types:

 Conductive (involves outer or middle ear)

 Sensorineural (involves inner ear)

 Mixed (combination of the two)

Aging and chronic exposure to loud noises both contribute to hearing loss. Other factors, such as excessive
earwax, can temporarily reduce how well your ears conduct sounds.

You can't reverse most types of hearing loss. However, you and your doctor or a hearing specialist can take
steps to improve what you hear.
Traveling to the brain

Electrical impulses travel along the auditory nerve and pass through several information-processing centers.
Signals from the right ear travel to the auditory cortex located in the temporal lobe on the left side of the brain.
Signals from the left ear travel to the right auditory cortex.
The auditory cortices sort, process, interpret and file information about the sound. The comparison and analysis
of all the signals that reach the brain enable you to detect certain sounds and suppress other sounds as
background noise.
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Symptoms

Signs and symptoms of hearing loss may include:

 Muffling of speech and other sounds

 Difficulty understanding words, especially against background noise or in a crowd

 Trouble hearing consonants

 Frequently asking others to speak more slowly, clearly and loudly

 Needing to turn up the volume of the television or radio

 Withdrawal from conversations

 Avoidance of some social settings

When to see a doctor

If you have a sudden loss of hearing, particularly in one ear, seek immediate medical attention.

Talk to your doctor if difficulty hearing is interfering with your daily life. Age-related hearing loss occurs gradually,
so you may not notice it at first.

Request an Appointment at Mayo Clinic

Causes

To understand how hearing loss occurs, it can be helpful to first understand how you hear.

How you hear



Middle ear

Your ear consists of three major areas: outer ear, middle ear and inner ear. Sound waves pass through the outer
ear and cause vibrations at the eardrum. The eardrum and three small bones of the middle ear amplify the
vibrations as they travel to the inner ear. There, the vibrations pass through fluid in a snail-shaped structure in the
inner ear (cochlea).

Attached to nerve cells in the cochlea are thousands of tiny hairs that help translate sound vibrations into
electrical signals that are transmitted to your brain. Your brain turns these signals into sound.

How hearing loss can occur

Causes of hearing loss include:

 Damage to the inner ear. Aging and exposure to loud noise may cause wear and tear on the hairs or
nerve cells in the cochlea that send sound signals to the brain. When these hairs or nerve cells are
damaged or missing, electrical signals aren't transmitted as efficiently, and hearing loss occurs.

Higher pitched tones may become muffled to you. It may become difficult for you to pick out words
against background noise.

 Gradual buildup of earwax. Earwax can block the ear canal and prevent conduction of sound waves.
Earwax removal can help restore your hearing.
  Ear infection and abnormal bone growths or tumors. In the outer or middle ear, any of these can cause
hearing loss.

 Ruptured eardrum (tympanic membrane perforation). Loud blasts of noise, sudden changes in pressure,
poking your eardrum with an object and infection can cause your eardrum to rupture and affect your
hearing.

Risk factors

Factors that may damage or lead to loss of the hairs and nerve cells in your inner ear include:

 Aging. Degeneration of inner ear structures occurs over time.

 Loud noise. Exposure to loud sounds can damage the cells of your inner ear. Damage can occur with
long-term exposure to loud noises, or from a short blast of noise, such as from a gunshot.

 Heredity. Your genetic makeup may make you more susceptible to ear damage from sound or
deterioration from aging.

 Occupational noises. Jobs where loud noise is a regular part of the working environment, such as farming,
construction or factory work, can lead to damage inside your ear.

 Recreational noises. Exposure to explosive noises, such as from firearms and jet engines, can cause
immediate, permanent hearing loss. Other recreational activities with dangerously high noise levels
include snowmobiling, motorcycling, carpentry or listening to loud music.

 Some medications. Drugs such as the antibiotic gentamicin, sildenafil (Viagra) and certain chemotherapy
drugs, can damage the inner ear. Temporary effects on your hearing — ringing in the ear (tinnitus) or
hearing loss — can occur if you take very high doses of aspirin, other pain relievers, antimalarial drugs or
loop diuretics.

 Some illnesses. Diseases or illnesses that result in high fever, such as meningitis, may damage the cochlea.

Comparing loudness of common sounds

The chart below lists common sounds and their decibel levels. The Environmental Protection Agency's (EPA)
safe noise level is 70 decibels. The louder the noise, the less time it takes to cause permanent hearing damage.

Sound levels of common noises

Decibels Noise source

Safe range
Sound levels of common noises

Decibels Noise source

30 Whisper

40 Refrigerator

60 Normal conversation

75 Dishwasher

Risk range

85 Heavy city traffic, school cafeteria

95 Motorcycle

100 Snowmobile

110 Chain saw, jackhammer, rock concert, symphony

115 Sandblasting

120 Ambulance siren, thunder

140-165 Firecracker, firearms

Maximum sound-exposure durations

Below are the maximum noise levels on the job to which you may be exposed without hearing protection, and
for how long.

Maximum job-noise exposure allowed by law

Sound level, decibels Duration, daily

BASED ON OCCUPATIONAL SAFETY & HEALTH ADMINISTRATION, 2008

90 8 hours

92 6 hours

95 4 hours

97 3 hours

100 2 hours

102 1.5 hours

105 1 hour

110 30 minutes

115 15 minutes or less

Complications

Hearing loss can have a significant effect on your quality of life. Older adults with hearing loss may report
feelings of depression. Because hearing loss can make conversation difficult, some people experience feelings
of isolation. Hearing loss is also associated with cognitive impairment and decline.
The mechanism of interaction between hearing loss, cognitive impairment, depression and isolation is being
actively studied. Initial research suggests that treating hearing loss can have a positive effect on cognitive
performance, especially memory.

Prevention

The following steps can help you prevent noise-induced hearing loss and avoid worsening of age-related
hearing loss:

 Protect your ears. Limiting the duration and intensity of your exposure to noise is the best protection. In the
workplace, plastic earplugs or glycerin-filled earmuffs can help protect your ears from damaging noise.

 Have your hearing tested. Consider regular hearing tests if you work in a noisy environment. If you've lost
some hearing, you can take steps to prevent further loss.

 Avoid recreational risks. Activities such as riding a snowmobile, hunting, using power tools or listening to
rock concerts can damage your hearing over time. Wearing hearing protectors or taking breaks from the
noise can protect your ears. Turning down the music volume is helpful too.
 Developmental Milestones Of Your Baby: Hearing
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Becoming a mom is the greatest pleasure of life. As soon as you get to know that a little life is taking
shape inside you, you start reading up on all pregnancy milestones and after the baby is born you wish
to track and know about all milestones like walking and talking.
As a mother, you can’t wait to play songs for your baby and see them move to the beats in their own
cute way. So, you must be wondering, when does your baby start hearing? Well, you would be
surprised to know that the baby starts hearing right in your womb. The foetus develops the ability to
hear in about 18 weeks of the pregnancy. Isn’t it beautiful?
Baby’s hearing in the womb
The ears and the earlobes of the baby are formed around the eighth week of pregnancy. After three
months, the baby starts hearing the sounds. In the third trimester, the ears of the baby are fully formed
and functional when he can hear all the sounds in your vicinity like your own heartbeat, your voice,
TV, music, etc. This is why most of the women play classical or spiritual music when they are
pregnant. In fact as per the ancient practice of ‘Garbh Sanskar’ it is recommended that women should
chant mantras and listen to good religious music since the baby can hear it.
Also Read: 7 Best (& Proven) Home Remedies to Treat Low Iron in Kids
Baby’s hearing development after birth
After the baby is born, the hearing ability of the baby develops speedily. You can expect the hearing of
the baby to be fully developed between 4 to 7 weeks.
As per the National Institute on Deafness and Other Communication Disorders, you must be aware of
what to expect as your baby gets old. Such awareness will let you know when to consult a doctor. Here
is the month-wise hearing development milestone, which you can observe:
 Newborn to 2 months: As a newborn, the baby’s hearing is already developed, however, the baby will
mostly respond to high pitched sounds and often to the sound of your voice. The baby may get startled
at loud or unexpected sounds.
 3 months to 6 months: At this age, the part of the baby’s brain which regulates hearing, smell and
language is further developed. Now the baby will react to the sounds. You can try singing a lullaby or
talk to them to see if they look directly at you or if they giggle and smile. The baby may also try and
respond to what you say.
 6 months to 12 months: This is the time when the baby is able to hear even the subtle voices and will
react too. You can even expect them to mimic the sounds they hear frequently.
 12 months and above – Since the baby is now nearing his birthday, your baby will be able to recognize
and react to almost all kinds of sounds. They can even differentiate between your voice and your
partner’s. The babies may respond better to their favourite song or cartoon characters.
Chart
 When to worry?
All the doctors do sound screenings for the newborn babies. If the baby hasn’t responded well in his
auditory screening, you can observe the reaction of the baby to sounds at regular intervals at your
home. If the baby is continuously lagging behind the hearing development milestones, you may consult
a doctor.
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Develop your baby’s hearing
You can actually help your baby develop his hearing ability. Here are some tips for you:
 Talk to your baby. Even when the baby is small and he may not understand what you say and mean,
still you and your partner should keep talking to him.
 Play good music. Don’t put a very loud music, just play a subtle and relaxing number. If it’s is an
instrumental piece, even better. It is known to develop the acoustic senses in the babies.
 Sing and read to your baby. There is nothing more comforting and soothing for the babies than
listening to the voice of their parents. Sing a lullaby or a mild song to him and a story at bedtime to
make him calm and easy.
 Play some musical instrument like piano or sitar. Even a toy version for the baby is fine.
 Clap your hands. Baby respond well to the clapping sound. If you can dance along, it will be much
more fascinating for him.
 Buy him musical toys. This is also one of the ways to develop his hearing senses.
At the same time, it is also important to know that the following may disrupt the hearing ability of your
baby:
 Loud Noises
 Premature Delivery
 High bilirubin
 Any Infections in pregnancy like Rubella
 Head injury or trauma
 Meningitis
 Any Infections in the ear
 Genetic Disorders
 Damage due to earbuds
 Loud Fireworks
 Continuous high fever
Every baby has its own pace of learning and developing. You shouldn’t be too concerned if your baby
is strictly not adhering to the milestones, but you must be alert to observe any abnormality so that you
can seek the right medical advice on time.