Disorders of Hearing

At the Texas Ear Center, we are committed to providing our patients the latest techniques in hearing restoration. We offer a wide variety of services for hearing loss, including medical treatments, surgery, hearing aids, and implantable devices.

How Hearing Works

The main function of the ear is to convert sound signals, which are pressure waves, into electrical signals that can be transmitted by the hearing (cochlear) nerve to the brain. The external ear, including the ear canal, collects the sound energy and directs it to the ear drum (tympanic membrane). At this point, the air pressure waves of sound then become mechanical (vibrational) energy. The signal then goes through the three middle ear bones (malleus, incus, and stapes) and enters the inner ear (cochlea) as fluid energy waves. The cochlea contains hair cells that turn the fluid vibrational signals into electrochemical signals that communicate with the hearing (auditory) nerve.

[Fig. 1]: Normal hearing mechanism.

Causes of Hearing Loss

Hearing loss can be caused by many different problems. A conduction problem occurs if the sound pathway in the ear canal, eardrum, or middle ear is disrupted (conductive hearing loss). These conditions are usually correctable with office procedures or surgery. Hearing aids can also be used in these cases. A sensorineural hearing loss occurs when the inner ear or hearing nerve is damaged or becomes dysfunctional. Common causes of this type of hearing loss include age-related hearing loss (presbycusis), noise-induced hearing loss, hearing loss due to trauma or inherited disorders, and many others. In general, these types of hearing loss cannot be corrected surgically. In many cases, hearing aids are a good option.

Hearing Loss Disorders

Symptoms Associated with Hearing Loss

Many patients with hearing loss experience an abnormal sensation called tinnitus. This condition is typically described as any type of noise that only the patient hears. The quality of the sound is variable and includes buzzing, tones, crickets, whistling, etc. Tinnitus is often the first symptom a patient with hearing loss notices and can occur with even mild hearing loss. Most patients find that the tinnitus is loudest and most noticeable when they are not distracted by activities and the environment is very quiet like at bedtime.

What is the Evaluation Process?

Patients with hearing loss first undergo a full ear, nose and throat evaluation. If needed, they may also have a hearing test completed in order to produce an audiogram. Patients may also need to have a MRI or a CT scan. Based on the medical evaluation, the treatment options for the hearing loss will be presented to you.

Conductive Hearing Loss

Most cases of conductive hearing loss can be corrected surgically. In cases where the hearing cannot be restored surgically, or in patients who desire non-surgical treatment, hearing aids are the main treatment option. There are some conditions such as cholesteatoma, where the main treatment goal is to alleviate the medical condition and hearing restoration is a secondary goal.

Sensorineural Hearing Loss

Most cases of sensorineural hearing loss cannot be corrected surgically. Hearing aids are typically the main treatment option. These devices now employ modern programmable electronics that make them function much better than older aids that are not programmable. Hearing aids typically allow patients to hear better and reduce the sensation of tinnitus. Patients whose hearing is so severe that hearing aids are not useful may be candidates for the cochlear implant.

Specialized Treatment for Hearing Loss

Implantable Hearing Devices

There are some cases of hearing loss in which surgical repair or hearing aids may be ineffective.

The BAHA and Osia allow patients with a conductive hearing loss (problem with area 2 in Fig. 1) to hear. It can also help patients with a severe to profound sensorineural hearing loss (problem with area 1 in Fig. 1) on one side if the hearing on the other side is still functional.

The Cochlear Implant allows patients hearing loss on both sides that is so severe that reconstructive surgery or hearing aids are not effective.

The implantable hearing device such as the Maxum Middle Ear Implant is helpful for patient with hearing loss that is too severe for hearing aids but not quite severe enough for the cochlear implant.

Implantable Hearing Devices

Click on any of the links below to learn more about Implantable Hearing Devices & how it is treated.