by Neil Bauman, Ph.D.
Question: From time to time, I see people writing, “I have 78% hearing loss in my right ear and 95% in the left.” What does this percent mean? I thought sound was measured in decibels (dB), not percent? If this is the case what percent is 115 dB?—R. D.
Answer: Excellent questions. You have good reason to be confused because you cannot equate decibels to percentages no matter what anyone tells you.
Decibels vs. Percent
Sound intensities are indeed measured in decibels (dB). There are two reasons why you can never equate decibels to percentages. First, the decibel scale is open-ended like that of the Richter scale used for measuring earthquake intensities. To calculate a percent you need to know the maximum value possible. In both of these scales there is no limiting maximum value. Therefore, you cannot calculate a percentage. Any attempt to do so is just a bunch of meaningless gibberish!
Second, the decibel scale is logarithmic, while the percent scale is linear. Numbers that appear to be similar have vastly differing meanings. They are as different as trying to compare apples to elephants!
When people (ignorantly) talk about having a 50 percent hearing loss they likely mean that they have a 50 dB loss. Where did the idea come from that we can measure hearing loss in percentages? Here is how Brad Ingrao, an outstanding audiologist, explained it.
To measure sound intensity (the way audiologists measure it) you need to do a mathematical calculation that is so strange that 20 + 20 = 26 dB (SPL).
To make a scale that makes sense to most people (including us knucklehead audiologists), a different equation is used to convert sound intensity using the Sound Pressure Level (SPL) scale to the Hearing Level (HL) scale that goes from 0 dB HL (normal threshold) to 120 dB HL (pain).
If we forget about hearing losses greater than 100 dB (like most people tend to do), we get 0 dB to 100 dB as the usable (dynamic) range of hearing for the average ‘normal’ ear.
Since doctors and audiologists tend to under-estimate their patient’s ability to understand such things (or they don’t understand it themselves), the erroneous concept of dB = % evolved.
There you have it folks. It seems health care professionals think we are too stupid to understand much, so they let us believe error rather than teach us the truth.
We can put a stop to this nonsense right now. Let’s understand how this decibel scale works and why using a percentage value to describe our hearing losses is so very wrong.
First we need to understand that a decibel is not a given intensity (loudness) of sound, but rather, it is a ratio of how many times louder (or softer) a sound is than a given reference sound level.
This means that 0 dB is not the absence of sound, but is an arbitrary zero. We define it as the faintest sound that a young sensitive human ear can hear. Furthermore, because the decibel scale is logarithmic, every 10 dB increase in sound intensity is actually a ten-fold increase. Therefore, a sound intensity of 20 dB is not twice as loud as a sound intensity of 10 dB, but is 10 times as loud, and a sound intensity of 30 dB is 100 times as loud as a sound intensity of 10 dB. Similarly, a sound intensity of 50 dB would be 10,000 times as loud (10 x 10 x 10 x 10) as a sound of 10 dB. This is how the decibel scale works. It is totally unlike the linear percent scale.
Now lets see the fallacy of trying to compare this “funny” decibel scale to the percent scale. To illustrate this, let’s assume (remember this assumption we’re making here is totally wrong) that 0 dB is equal to 0 percent hearing loss and that 100 dB equals a 100 percent loss. This would then mean that 50 percent would equal a 50 dB hearing loss, right? Wrong! Not by a long shot! A 50 percent hearing loss would equal, believe it or not, only a 3 dB loss! Looking at it the other way, a 50 decibel loss is not just half as loud, like it would be in a percentage scale, but would only be one thousandth of one percent as loud!
Here is another example. I have a 70 dB loss. This is not equal to a 70 percent loss by any means. In actual fact it means that the softest sound I can hear needs to be 10,000,000 times louder than the softest sound a person with normal hearing can hear. One out of ten million is definitely not a 70 per cent loss but would be a loss of 99.9999999%! Quite a difference, isn’t it? Now you can see why we must never use percentages when talking about our hearing losses. They just do not equate. They are absolutely meaningless!
Percent Used to Describe Discrimination
Although we cannot use percentages to describe our hearing losses, we correctly use percentages to describe our ability to discriminate sounds. To determine our ability to discriminate between words, our audiologist sets the volume at our most comfortable listening level. She then has us listen to a list of words and we repeat back what we think we heard. The number we get right, converted to a percentage, becomes our discrimination score.
Therefore, if I understood 80 out of 100 words in my right ear, my discrimination is 80% for that ear. I may have an entirely different result for my other ear. Consequently, we can correctly describe our ability to understand what we hear as a percentage. A person could correctly say that his discrimination is 78% in his right ear and 95% in his left ear. But this has nothing to do with the severity of our hearing losses as such.
Percentage and Hearing Disability
If your hearing loss resulted from an accident on the job, there is a formula that is used to calculate the percent disability pension for which you may be eligible. Don’t get mixed up. This is not your hearing loss expressed as a percentage. Rather, this formula calculates how much your degree of hearing loss supposedly impacts your ability to remain employed at full wages.
For example, plunking your hearing loss levels into the formula may yield a result of 75%. This means that with your particular hearing loss, you may be entitled to a 75% disability pension. Again, this is not your average hearing loss expressed as a percentage. If you are interested in how they calculate a percentage disability for any given hearing loss, see my article you can read it at “How Much Are You Worth as a Hard of Hearing Person?“.
Classifying Our Hearing Losses
Hearing health care professionals classify hearing into several categories such as normal, slight, mild, moderate, moderately severe, severe, profound and deaf. Not all of them use all of these categories, nor do they all use the same hearing loss ranges in each one. In the past, most used this simple scale.
Simple Hearing Classification Hearing Threshold
| Normal hearing | down to 20 dB |
| Mild hearing loss | 21 to 40 dB |
| Moderate hearing loss | 41 to 60 dB |
| Severe hearing loss | 61 to 90 dB |
| Profound hearing loss | greater than 90 dB |
Today, research has shown that even hearing losses of only a few decibels can cause significant hearing problems. As a result, many hearing health care professionals have fine-tuned this scale to better reflect this reality. (Note that these ranges are arbitrary and may vary slightly among authorities.)
Today’s Hearing Classification Hearing Threshold
| Normal hearing | -10 to 15 dB |
| Slight hearing loss | 16 to 25 dB |
| Mild hearing loss | 26 to 40 dB |
| Moderate hearing loss | 41 to 55 dB |
| Moderately severe loss | 56 to 70 dB |
| Severe hearing loss | 71 to 90 dB |
| Profound hearing loss | 91 to 120 dB |
| Deaf | greater than 120 dB |
Describing Our Hearing Losses
Unless you have a “flat” curve on your audiogram, how can you accurately describe your hearing loss? Your hearing loss could be different at every frequency so one word could be meaningless.
The best way is to be specific. If I have the typical “ski slope” hearing loss, I could describe it as, “I have a 30 dB loss at 500 Hz, dropping to 100 dB at 4,000 Hz.” A more general way, but still accurate, would be to describe it as, “I have a mild loss in the low frequencies, dropping to profound in the higher frequencies.
The next best way to describe our hearing losses is to average the 4 frequencies that carry most of the speech information to arrive at a single figure. Use the following four frequencies—500 Hz, 1,000 Hz, 2,000 Hz and 3,000 Hz—and average the hearing loss at these frequencies to come up with one figure. However this method falls down if we only have a bit of hearing left in the very low frequencies. Incidentally, it is not right to take the average of our best and worst figures. That could give a very wrong impression of our hearing losses.
If you want a very simple way to describe your hearing loss, the most accurate (and simple) is to say you have either a mild, moderate, severe, or profound hearing loss. Your audiologist can tell you which category your hearing is generally in. (Remember, you could be mild in the low frequencies and profound in the highs—but to oversimplify, you can reasonably accurately reflect your practical hearing loss by using one of these categories.) It is much more meaningful, and far more accurate than trying to use a meaningless percentage. Let’s get back to using these standard audiological terms and stamp out this absurd percent business.
I have loss Rt ear 103DB and Lt ear 35 DB what is the % of hearing loss ?
Hi Yopendra:
You don’t measure hearing loss in percentages. That was the whole point of this article. You simply say you have a profound loss in your right ear and a mild loss in your left ear.
Cordially,
Neil
Dr my son has found profound hearing loss in audiology test he is jst 2 years old plz tell us what shall we do for his father treatment ? Whether he wll become deaf we fear so
Hi Mubeen:
If your son has a profound loss at 2 years old, I’d have him evaluated for a pair of cochlear implants. That would seem to be the most effective treatment at this time.
Cordially,
Neil
Dr. Neil, Your reply to a parent about their 2 year’s hearing loss had me wondering. If along with evaluating the child for Cochlear Implants would you not also recommomend learning ASL to help with communication issues? Would not giving the child language be first on your mind instead of surgery?
Hi Christina:
You have good questions. Here is how I see it. If a child is eligible for a cochlear implant(s), then in a matter of a month or so, they can be hearing. Since young children pick up language very fast, within two years or so, they could have a vocabulary equal to their hearing peers. That is why I recommend a CI over ASL.
In a month’s time with ASL, the child will have a few words/signs learned. But if the parents don’t also know ASL, the child is still basically isolated. ASL is a great supplement to hearing and speechreading. I use all three myself, but I mostly rely on speechreading–I’ve been doing that from birth. I tell people that speechreading was my first “language”.
If you went ahead with the surgury right away, the child will be beginning to have language in a month or so and can then be mainstreamed. That would not be the case in learning ASL. ASL is great if you live in a Deaf community, but if you live in a hearing community, how are you going to communicate with those that live around you? Thus, from a practical point of view, a CI is a better solution than ASL.
Cordially,
Neil
Hello Doc,
I got sudden hearing loos in 2011 and after that my right ear has very low hearing power. During that time my doctor told that i have no opetion for the same. I will appricate and thankful if will help me to know if still i have some hope.
Hi Ajay:
You don’t say, but I assume that you have a sensorineural (inner ear) hearing loss. If so, after 6 years, I’d say the hearing loss is permanent and nothing much can be done to help you other than to wear a hearing aid in that ear.
Cordially,
Neil
Today Audiogram tested by medical and its refers that I have 56.6 dBHz.
Can it be recovered as I cannot hear anything with my left ear sir. But my Right ear is totally ok and it’s working fine.
Hi Tanay:
If you left ear has a hearing loss of 56 dB, then you can hear with that ear. You are not totally deaf in that ear. It may seem like it compared to your other ear, but you still hear a lot of sounds.
You haven’t told me anything about the events surrounding your hearing loss, whether your hearing loss is conductive for sensorineural, etc., so I can’t even hazard a guess whether your hearing will come back or not.
Cordially,
Neil
Hi Doctor, I have hearing loss in my right ear and I went for audiogram and my results show that left ear -10dB and right ear – 11.6 dB….
Is it any problem…i can hear sounds in right ear but little unclear sound and slow sound compares to left….is it leads to permanent deafness…pls mail me doctor
Hi Melvin:
What are these figures you gave–average hearing loss or your greatest loss in one frequency?
Either way, you have good hearing. Normal hearing ranges from -10dB to +25 dB. Your hearing at around +10 dB is right in the middle of the normal range.
Cordially,
Neil
I’m hearing impaired with 97.5 % in both ears. What will db??
Hi Keshav:
Your hearing loss in dB is shown on your audiogram. What does it say?
Cordially,
Neil
Hi doctor
. I have went for audigram and it shows that @4000 Hz 30db in right ear…Is it shows any problem doctor…
I can hear sounds, but Its low and unclear sound….I cant identity which sounds they are…..
Is am going to a deaf in future…pls help me…i feels tensed…pls rply doctor
I was told i had 65% hearing how is that in desibles
Hi Jean:
Who knows what it means as it is a meaningless measurement. You can’t measure hearing loss in percentages. Ask for a copy of your audiogram and tell me the figures on it for each ear and for each frequency and I can tell you what your hearing loss really is.
Cordially,
Neil
My both ears eardiume in hole.And audiology report is moderate hearing losses.my hearing capacity so in chart both ear 40db to 45 db.can I apply physical handicapped certificate .please give me answer.
Hi Indra:
Your hearing loss not bad enough to warrant receiving SSDI. Presumably all you need to do is have the holes repaired by surgery and/or get hearing aids to bring your hearing up to near normal.
Cordially,
Neil
can a hearingloss of 77 db and 57 db resp In right and left ear (mixed hearingloss) can be regarded as physicaly handicapped under amended categories under handicap act?
-Jagdish
can a hearingloss of 77 db and 57 db resp In right and left ear (mixed hearingloss) can be regarded as physicaly handicapped under amended categories under handicap act?
-Jagdish
Hi Jagdish:
Which handicap act are you talking about? And for which country?
That degree of hearing loss is definitely handicapping if you don’t have the appropriate accommodations for your hearing loss. But that doesn’t mean you can’t work productively.
Cordially,
Neil
Can a mixed loss occured due to removal of infectedbones in the ear be cured?
Hi Jagdish:
I don’t think they can fix the conductive part of your middle ear to restore hearing, but a bone conduction hearing aid can bypass the middle ear and let you hear via your inner ear. This will only work as well as your sensorineural hearing permits. If the sensorineural component of your mixed loss is only mild, then bone conduction could work quite well for you. You could investigate getting a BAHA (bone anchored hearing aid).
Cordially,
Neil
Thank you sir for very good information on the basis of very brief record and that too
in the absence of patient. I was talking about indian person with disability act 1995. as per which loss in 60 db or more in better ear in conversation al range of frequency is regarded as impaired . at the same time they also define 40% loss as impaired it looks discrepancies.
also my another question isabout tinitus in the left ear. 6 to 7 types of the sounds comes from it I. of rail engine, flowing water, scisdor cutting hairs , shitties, night insects and one or two more which I could not identified can they stopps by any surgicsl operation?
Hi Jagdish:
Sorry, I don’t know anything about the Indian disability laws so can’t help you there.
Hearing 7 different tinnitus sounds at the same time is not all that common, but it does happen. Around 16% of the people with tinnitus hear 3 or more sounds at a time.
There is only one surgical procedure for tinnitus and that is to cut the auditory nerve leaving you totally and permanently deaf on that side. But there is no guarantee that it will stop your tinnitus. In at least 50% of the cases where they did that, it made no difference to the tinnitus. So that is not something you want to consider.
There are many tinnitus treatments out there. The most effective center around sound therapy and psychological therapy. Doing one of each at the same time works the best for most people.
Cordially,
Neil
Your guidence is really very valuable sir.i am getting pleassure in asking you questions on this topic.do have any trouble sir? i will ask only if you permit.
Hi Jagdish:
Ask your questions. If I have time, I’ll answer them.
Cordially,
Neil
my doctor says i have 40-50% hearing disability should i egligible for disability certificate
sir ,
while taking audiogram, the earphones are either touched close to ear in
testing air conduction and behind ear bones to test
bone conduction.can
whatever response grtting
for any frequencies can be
obtained from a certain
distance, say 5 or 10 feet?
also, in sperch discrimination test,words are said in islated form. can whatever the result obtained may be same if these word
s are tested in a long sentences said in consersational sppech?
Hi Jagdish:
The reason hearing tests are done with earphones tight against the ears is so that the results will be the same for everyone and the same results can be reproduced by any audiologist.
They could have just as easily decided that all hearing testing was to be done at 5 or 10 feet and if everyone used that standard then the results would be reproducible by any tester. However, as the distance increases, the higher frequency sounds won’t be heard because high-frequency sounds do not travel well through air–so you’d only be testing how well you could hear low and mid frequency sounds.
If you wanted to extrapolate the results from headphones out to 5 or 10 feet, you could do so using the inverse squares law that says that the volume of the sound is iversely proportional to the square of the distance.
In speech discrimination again they use standardized word lists and given at the persons most comfortable listening level. This gives reproducible results no matter who does the testing.
The words are all single syllable words so you can’t try to guess the word from the surrounding syllables. Since sentences contain a lot of redundant sounds, if you miss one syllable or word, you can often guess what the missing sound had to be. Thus, this would not be a test of how well you can actually understand any given sound, but a test of your reasoning powers.
The DO use sentences to test how much of language you understand. This is often done in evaluating your hearing for eligibility in getting a cochlear implant, for example. And to show how much better you hear with a CI after you have been implanted. But this is different from a discrimination test.
Cordially,
Neil
Sir,
I have done my last audiometry some month back.these are done on same day at two different audiologists.in first , it shows hearng loss of 77 db (mixed) in left ear and 58 db (mixed)in right ear. in second audiometryon the same day,it shows sensory neural loss in left ear >120 db and conductive in fight ear of 60 db. why so much difference. they couldn’t explaind well for this . so the question.i have operated on both ears 4 times for extensive chlosteotoma (Radical mastoiductomy) hearing aid is not useful in left ear. better extent in right ear but somtimes itis also not so good from right ear also. why this ?
Hi Jagdish:
Those two readings the same day should be much closer together than they are. I suspect that one or both were not doing valid testing. Perhaps they don’t know how–are not properly trained. Perhaps their audiometers are not properly calibrated. Perhaps the headphones were not fitting snug to your ears when they were doing the testing. Etc., etc.
I’d go to the most reputable audiologist or hearing aid dispenser you can find and see what this new testing reveals. And be sure to tell them your ear history so they can take that into account when doing the testing.
Cordially,
Neil
Respected Sir,
My recent audiogram report is as follows:
Right Ear:
1) 0.25kHz=50dB
2)0.5kHz=60dB
3)1kHz=85dB
4)2kHz=115dB
5)4kHz=115dB
6)8kHz=110dB
Left Ear:
1)0.25kHz=40dB
2)0.5kHz=50dB
3)1kHz=80dB
4)2kHz=75dB
5)4kHz=105dB
6)8kHz=110dB
Sir,I am using Widex Hearing Aids,model-Bravissimo BV-18,Channel#3.
Sir,do you recommend a new hearing aid?If yes,then what type of hearing aid?
Thanking you,
Siam
Hi Siam:
I’m not an audiologist and do not fit hearing aids–so I can’t answer your question. You need to ask an audiologist or hearing aid dispenser this question.
Cordially,
Neil
Respected Sir,
There is severe wax accumulation in my both ears for the last years.Doctors cleaned my wax using water but still wax is still remaining.I mean I can feel that too much wax has accumulated and caused blockage.One doctor suggested me to use 10 percent sodi bicarb solution,my wax removed and I was at ease.Unfortunately,wax again appeared maybe due to my tinnitus problem.
Thanking you,
Siam
Hi Siam:
If wax accumulates in your ears, you need to have your ears cleaned out more often. If you wear hearing aids, they can cause wax problems for two reasons. First, the ear molds can irritate the lining of your ear canals so they secrete even more wax. Second, the ear molds push the wax further down the ear canal. Normally, wax moves towards the ear canal entrance and falls out–but ear molds prevent that and thus wax accumulates.
You may have to clean your ears out every week or so.
Finally, tinnitus does not cause ear wax, but ear wax can cause tinnitus by reducing the amount of sound that reaches your ears and thus your brain.
Cordially,
Neil
My mother has told me I have a sixty percent hearing loss. I just want to know how I would label it, as severe, moderate, such. No, I am positive this is not a 60 dB measurement.
Hi Abigail:
You can’t label a percent hearing loss, because there is NO SUCH THING! If your mother didn’t assume that a 60 dB average loss was a 60% loss, then you need to have a proper audiological evaluation done and look at the decibel loss by frequency in order to determine whether your loss is mild, moderate, severe or profound. That’s how you do it.
Cordially,
Neil
I had several firecrackers go off near me on New Year’s Eve, the worst of which was about 10′ from my left ear. I developed continuous tinnitus about a week later, which is more profound in my left ear though noticeable in both.
My audiogram showed a “sub-normal” range in my right ear, dipping to -15 dB at 4kHz and -20 dB at 6-8kHz. The left ear showed sensorineural hearing loss of -18 dB with a notch to -30 dB in the 2kHz range. This range corresponds with the tone of the tinnitus in my left ear.
Given that I have not had some noise exposure in my life (loud music on headphones as a teenager) but nothing excessive or consistent in the 20 years since, would you estimate that this is more likely to be a temporary threshold shift, or a permanent one? If my hearing is going to recover, about how long would that process take? I am a 39 year old male.
I have had tinnitus for one month and apart from a couple brief instances of minor relief, I would say it has not been improving since its initial onset.
Thank you very much for your time.
Hi Jim:
Just a point of clarification. When you read an audiogram, hearing loss is expressed in positive numbers. In other words, if your audiogram line is BELOW the 0 dB line, those numbers are positive numbers. However, if your hearing is so good that the line goes ABOVE the 0 dB line, those are negative numbers. I know it seems backwards, but that is the way it is.
Typically, a temporary threshold shift lasts from a few minutes to a few hours to a few days. Just as typically, I wouldn’t expect hearing to come back after longer than a week. Since that was about 6 weeks ago now, I think you have a permanent hearing loss now.
My rule of thumb for sudden hearing losses, is that the hearing you have after 30 days is what you’ll be left with.
It’s good that your tinnitus has a couple of brief episodes of relief. This indicates to me that if you learn to ignore your tinnitus, you may find those episodes will become longer and occur more often as you habituate to your tinnitus–at which point in will not bother you–just be “there” when you listen for it.
Cordially,
Neil
Hi. After reading your article, this will seemingly be a stupid question. However, I am 48 yrs old. At age 3 or so, I was diagnosed with moderate to severe hearing loss due to nerve damage received bc of mother contracting German measles while pregnant with me.
My diagnosis at time was 100% loss in right ear and 60-70% loss in left ear. My childhood I wore hearing aids until the constant hum/buzz in my only good ear became a distraction. I am currently unable to afford a dr visit let alone the cost of hearing aids. I understood through your article there is not a conversion from percentages to decibels. But, also, as I’ve aged, my hearing has gotten progressively worse. It is beginning to affect my ability to work. (Most of my life I’ve been employed as a paralegal.
Is there a way for me to get help to see if I would even qualify for disability at this point or in the future of my hearing continues a downward progress?
I thank you, in advance, for any assistance or guidance.
Hi Kelli:
I wouldn’t go the disability route yet. There is one more place you should go before you go in that direction and that is go to your state office of vocational rehabilitation (they may use a different name depending on your state). If you need hearing aids or cochlear implants in order to keep working, or to even get a job, they will provide the hearing aids and/or whatever you need. They will help you in this whole process, so give them a try.
Cordially,
Neil
Dear Dr.I am 44 age old,my left ear has 65% hearing and right ear is 55%
hearing.But i could not continue my teaching professional,is this possible
to recovery my ears.for medical aspects
Hi Mrs. Sheela:
If your hearing loss is a conductive loss, then an ear specialist may be able to recover your lost hearing. However, if you have a sensorineural hearing loss, then that is out of the question. The solution then is to get hearing aids so you can hear better again.
Cordially,
Neil
Dr. Bauman,
How frustrating is it to be asked what percentage hearing loss someone has especially following this particular article?
Sincerely,
A Menieres patient with a sense of humor
Hi Janice:
It could be frustrating if I let it be. But I just assume they didn’t understand, or didn’t really read the article and answer their question if I have the time.
Cordially,
Neil
Also with a sense of humor. You know the old saying- If at first you don’t succeed…..
…… never try sky diving!
My ten year old daughter was recently found to have moderate hearing loss in both ears by the audiologist after failing her hearing test at her well check visit. This came as a shock and as it was explained to me it is due to a problem with her nerves in the inner ear. Her Audio gram showed right ear air conduction test as follows, 45db-125hz
40db – 250hz
40db – 500hz
35db – 750hz
45db – 1k
50db – 1.5k
45db – 2k
40db – 3k
45db – 4k
45db – 6k
45db – 8k and bone conduction
40db – 500hz
45db – 1k
45db – 2k
45db – 4k
Her left ear
Air conduction
50db-125hz
45db-250hz
40db-500hz
45db-750hz
45db-1k
55db-1.5k
55db-2k
55db-3k
55db-4k
50db-6k
60db-8k
Bone conduction
40db-500hz
45db-1k
55db-2k
50db-4k
No wax blockage
No damage to outer, middle ear, both ears and ear drums look good.
What should we expect next. At this time no clear reason for loss. We are also not sure if it has been degenerative as we missed the last two years of well checks.
Sorry so long.
Hi Lindsey:
You daughter’s hearing loss is not likely caused by the “nerves” in her inner ears–that’s a poor way of explaining it. The loss is most likely caused by the nerve ENDINGS called hair cells that have died. The nerves are typically in great shape–just that if the hair cells at the ends of each nerve die, then there is no way to get the sound signal into the nerve to be transmitted to the brain.
She has a flat sensorineural hearing loss with no conductive component. Furthermore the hearing loss is basically the same in both ears (symmetrical). Flat losses are not all that common, especially in sensorineural hearing losses, but it is good in this sense. It makes it easy to hear if sounds are just amplified more. She doesn’t need extra sound amplification in either the low or high frequencies like most hard of hearing people do. So that is a bit of a blessing right there.
You did not say anything about her discrimination scores. This is important to know as well. If she has close to 100% discrimination, then she should do very well with either sound field amplification at school or wear hearing aids.
Do I understand correctly that she had normal hearing about 2 years ago (at her last testing) and it has failed in the past 2 years or so?
It would help to know what caused her hearing loss so you can guard against that cause in the future. Loud noise exposure is highly unlikely, so is a viral cause. I also doubt if ototoxic drugs caused such a loss, although that is one possibility. Has she taken any antibiotics in the past two years or so that might have caused it? It could also be genetic. Is there any hearing losses running in the family on either side?
I’d suggest having her fitted with hearing aids and have hearing tests every 6 months to a year to learn whether her hearing is stable or not.
Cordially,
Neil
Hi NEIL BAUMAN, PH.D I have hearing loss in both ears and tinnitus, i have speech discrimination scores of 88% in right ear and 80% in left ear, and 9.375% hearing disability in both ears and it looks like 40db at 2k 50db at 3k and 60db at 4k, 70 dB at 8K. What kind of hearing loss is this. Thank you.
Hi Jimmy:
What you are describing is the typical moderate, ski-slope, sensorineural hearing loss. This kind of hearing loss typically occurs as you get older.
Cordially,
Neil
I had a cold that led to SSHL in left ear unfortunately couldn’t get an appointment with ENT until yesterday. Put me on Prednisone is it too late? Hearing loss is in 70 to 80 dcb loss. Btw the ear became blocked 30 days ago. Help
I am suffering 71% left ear and 100% right ear profound hearning loss kindly plz suggest me how can i modify my decibel with this report
Hi Kamlesh:
The simple answer is, “You can’t.” All you need is a copy of your audiogram. The correct decibel figures will be on it.
Cordially,
Neil
Thank you, Just so you know I am 50 years old, The Tinnitus is the worst part of it..The noise is a killer is their anything for the Tinnitus?? I worked in high noise environment for 28 years Thanks again
respected sir
please tell me that there is a any solution for recover hearing loss..??
Hi Gurjeet:
It depends on the cause of your hearing loss. For the most common kind of hearing loss, basically you have to wear hearing aids. There is nothing at this time that doctors can do to restore hearing medically–but they are working on it.
Cordially,
Neil
I have 50dBHL hearing on 250 and 500Hz.30 on 1000 to 2000.and 20dBHL on 2000 to 4000 on right ear.
I have 40 on 250 to 500.30 on 500 to 1000.and 20 on 1000 to 2000Hz.I have speech problem.I want to ask you how I can improve my hearing.I am feeling head spin even my hairs are falling.What is the problem.There was no accident happens in my life.
Hi Mujtaba:
You have a mild to moderate reverse slope hearing loss. You say you also have vertigo (things spin). This is consistent with having Meniere’s disease. You should go to an ear specialist and see if he agrees with this assessment.
If you do have Meniere’s disease, there is a simple “cure” that will get rid of the vertigo and stop further hearing loss. You need to go to an upper cervical spine chiropractor and have your top two vertebrae properly aligned. You can learn more about this by reading my article at http://hearinglosshelp.com/blog/atlas-adjustments-alleviate-menieres-disease/ .
Cordially,
Neil
Dr. Bauman,
You answer questions with kindness and caring. I am impressed. I am 75 yrs. old. When I sleep, my left side (facial and ear) are cold and I have to cover that side with blanket or a sheet.
Left ear=84 and right ear= 80. I do not have hearing aids yet.
Hi Sally:
Thanks for the kind words.
If your pure tone averages (PTA) are 84 and 80 dB, then you have a severe hearing loss and need hearing aids if they will help you.
If the left side of your face gets cold when you sleep on your right side, does the opposite also apply, your right side gets cold when you lay on your left side? I’m wondering if your neck is “out” and that is interfering with blood flow to your head. Or perhaps your pillow is the wrong height and doing that.
Cordially,
Neil
My right side does not experience this cold feeling if I sleep on the left. Also, I forgot to mention that I have a dull headache during the night always on the left side. This cold feeling and dull headache has been on going for about 2 years now. I get severe heart burn, so often times a use two pillows. Any thing you suggest will be so appreciated. Thank you.
You are kind and I am grateful.
Sally
Hi Sally:
What happened two years ago before you began getting this cold feeling? I’m thinking that various vertebrae in your neck are out of proper alignment. This could explain the headaches, cold feeling and heartburn.
If I were in your shoes, I go to a special kind of chiropractor called an upper cervical spine chiropractor and have him check you out for proper alignment. That would be my first step. (Conventional chiropractors don’t have the skills to do this well.)
To find an upper cervical specialist go to http://www.upcspine.com/ , then click on “Practitioners” in the menu bar and choose North America and then your state (I’m assuming you are in the USA) and you’ll see a list of the upper cervical spine chiropractors in your state. Each chiropractor has a 10 – 15 line listing. Near the bottom of each listing is a line called “Upper Cervical Approach/Technique Used:” and following that is one of about 10 different techniques. I’m particularly partial to the “Blair Method” so if you can find a Blair chiropractor within reasonable driving distance (a couple hundred miles) that would be my first choice. But the others are also good. Pick someone that has 15 or 20 years experience, not a “newly-minted” upper cervical specialist, as they don’t have the depth of experience your situation may require.
It may also be that your pillow is the wrong height for you. Did you change pillows two years ago?
Cordially,
Neil
Sir,
Wheather the middle ear construction surgery done after mastiodoctomy surgery for overcoming moderate- sever conductive -mixed etc. can be safe? what are succeess rates ?
Hi Sachin:
That is something you need to ask your ear specialist. He’s the only one that knows the condition of your middle ear now after the surgery.
Cordially,
Neil
My Audiologist completed a hearing test and diagnosed I have 240 dab loss in right ear and 250 db loss is left ear.
What does this mean
Hi Chris:
You have something wrong. Those figures are meaningless. Audiometers only measure down to around 100 dB give or take a bit. Are you sure that the figures are not 24 and 25 dB?
Cordially,
Neil
Hi,
I enjoyed your article, it was very informative. I had two hearing tests, a week apart. In the first one, I tested moderate hearing loss in both ears, a week later, I tested at a different facility, severe hearing loss in the left ear, moderate in the right, with the “ski slope.” The doctor noted noise induced hearing loss. Is it declining that fast or are there descrpincies in the tests on a daily bases. My hearing has gotten significantly worse in the last ten years. I hope I can stay where I am and not experience profound hearing loss in the next decade. I’m 47 years young. Thanks- worried.
Hi Simone:
Personally, I’d get a third test to validate either of the other two. You could be losing hearing that fast, but I rather doubt it. There should not be discrepancies of more than abut 5 dB or at the most 10 dB between various testers. Audiometers have to be certified accurate every year at least.
If your hearing loss is from noise, you could expect it to slowly drop even more. So you need to protect your ears from noise in the future.
Cordially,
Neil
sir,
my right ear was discharging since my childhood.few years back i have consult ENT doctor.later they found i have been suffered by bilateral CSOM at right ear.the doctor said that you have do one ear surgery .last year i have undergone my mastoid dectomy surgery..my ear discharge was stopped fully.again i got the little ear discharge and also foul smell were came .kindly guide me for further diagnosis.
Hi Vetri:
You need to go back to your doctor for further treatment.
Cordially,
Neil
Hi My Boots audiologist told me I have 80% hearing loss in the high frequency and normal in the low frequency, so how would that work in db?
Hi Malcolm:
That statement was totally ridiculous, because you can’t measure hearing loss in percentages. You audiologist obviously thinks you are so stupid you couldn’t understand it if he told you the truth, so he invented a fictitious meaningless number to satisfy you.
Now to TRY to answer your question, If your hearing is normal in the low frequencies, that means it is somewhere between 0 and 25 dB.
ASSUMING he is equating 80% with 80 dB (which is not true at all) but lets assume that, then in the high frequencies you have an 80 dB loss. So I imagine you have the standard ski-slope kind of loss.
Cordially,
Neil
Hi Neil, Thanks for that, I think he doesn’t really know what he is talking about and just wants to flog me a hearing aid. yes your right it is the standard ski slope kind of loss, so thanks again for the comments now I know what to do.
Malc
You say that there is no such thing as percentage hearing loss, this is utter rubbish , as yesterday my Audiologist said that i have 45% hearing for a person of my age (48), this is the only way she explained it to me, she did not give it as a decibel equivilent,. She has given me a hearing aid for both ears, what then is your definition as to my level of hearing loss, ie mild, moderate or severe, also what is the equivilent in decibels for my level of hearing at 45%.
Hi Wayne:
The only rubbish going on here is what your audiologist told you. Very simply, your audiologist lied to you–just proving my point that they think you are too stupid to understand the truth if they told you the average decibel loss you have. So she pulled a totally meaningless percentage out of her hat and told you that.
If you want to know what your hearing loss is, look at your audiogram. You have one, don’t you? It is your right to have one so you can ask for a copy. I always do. Then you would know what your hearing loss is in decibels.
There isn’t an equivalent between percentages and decibels. It is absolutely impossible to calculate since the dB scale is open ended just like the Richter scale is for earthquakes. You never hear anyone saying that it was a 45% earthquake when it reads 4.5 on the Richter scale. That would be meaningless. And saying you have a 45% haring loss is just as ridiculous. It is totally meaningless. The Richter scale and the decibel scale are both logarithmic with no upper limits so you cannot calculate a percentage. You NEED an upper limit to equal 100%–and when you don’t have one, you can’t calculate the percentage. Besides percentages really only work with linear scales, not with logarithmic scales.
Having said that, what your (stupid/ignorant/lazy) audiologist might have done is assume that 1 dB equals 1%, so she equates 45 dB with 45%–but this is just not true. If you had a 120 dB loss, then is she going to say you have a 120% loss? There’s no such thing.
If you had a 40 dB loss and she equated it to 40% loss, then if later you had a 50 dB loss she’d equate it to 50%. But the truth is that the difference isn’t just 10%, but 10 TIMES as much or 1000% greater, not just 10% greater. That’s why you just can’t do it.
Cordially,
Neil
Sir i have done audiometry test my ear ,after that i can’t hear my right ear ie. 100% hearing loss but my another ear is absolutely all right…so overall i can hear about 50%, plz inform me that i am in catageory of Physical handicap or not?
Hi Mohan:
Yes, any hearing loss is a physical handicap, but as far as getting disability compensation for it, since you have normal hearing in the other ear, you are not eligible (in the USA) because it does not affect your ability to take care of yourself and do your job.
Cordially,
Neil
Hi, I have severe hearing loss in both ears. I wear behind the ear hearing aids. Hearing loss is hereditary. I also have mastroid (sp) surgery as well as drum repair. In one of your comments you were talking about getting Blair method upper cervical….
I have been suffering migraines
since being a teen at the back of my neck. I’m 35 now. Upper back pain. I also have a backward S curve in my upper spine that I was told I was born with tscoliosis. I frequently have cold numb fingers toes and lips.
I know I’ll always wear aids. Do you think getting adjusted would help with the other stuff going on?
Hi Diana:
If I were in your shoes, I’d certainly try a Blair chiropractor. He isn’t going to hurt you and there is a very good possibility that he will be able to help you to some degree. Since you were born this way, it may not be possible to get your spine the way it should be, but any adjustment in the right direction would be a blessing. For example, you may get rid of the cold fingers and toes, or reduce the number of your migraines, etc.
Just be aware that since this is so longstanding, you may need numerous treatments until the adjustments “hold”. It’s easy for things to slip back into their old ways until muscles, ligaments and tendons adapt to the way they are supposed to be.
You need to ask your Blair chiropractor what he can do for you and what you can reasonably expect–then decide whether you want to proceed with the treatments.
Cordially,
Neil
Sir,
My left ear is closed even without any hole and didn’t have any hearing .. it’s an disability by birth. And my right ear shows 13db in test so I think it’s normal. as one of my ear is not working.. That means 50% disability..
I want to know whether iam disable? And would I get a disability certificate? Please reply
Hi Sriram:
If you have normal hearing in one ear, which you do, you are definitely not eligible for disability–at least here in the USA.
Cordially,
Neil
sir i am not hear left ear total deaffnes and right ear 45 to 80 decibel heared please i get disability certificate
Hi Laxman:
Hearing loss by itself is typically not approved for disability status (SSDI) in the USA. I don’t know what it might be in your country if you are not in the USA.
Rather than seeking disability, it is much better to seek ways to improve your hearing–using hearing aids, assistive listening devices, coping strategies and if necessary cochlear implants. Then you can live a fulfilling life in spite of your hearing loss.
Cordially,
Neil
Hi, My daughter has a cholesteatoma and her last hearing test was 20 in her “Good” ear and 60 in her “bad” ear. Would this cause her problems in her daily life or could this be classed as mild. My Daughter is 10. Thank you for taking time to read this
Hi Stephanie:
I’m assuming the cholesteatoma is only in her bad ear, correct? If so, why is her hearing only 20 dB in her good ear? It should not be that bad at only 10 years of age.
Actually, studies have shown that even a 15 dB loss can significantly affect a child’s work at school. Therefore, don’t let the terms slight or mild hearing loss lull you into a false sense of security. This is a significant loss for a child, not to mention the 60 dB loss in her bad ear.
I assume that she has a conductive (middle ear) loss from the choleateatoma, but she may have an underlying sensorineural (inner ear) hearing loss too.
In any case, if hearing aids will help her, you should consider have her fitted with hearing aids in both ears. That should make a significant difference in how well she hears under good listening conditions. She probably will need other assistive listening devices when in poor listening situations.
Cordially,
Neil
Hello , back in 2008 I was diagnosed with hodgkin’s lymphoma. One of the Chemo’s was Adriamycin, one of many side effects was hearing loss. I can say I am free and clear :). But my hearing has gone down hill , as of 07/20/2016 my hearing is at 81DB and 76DB and steadily getting worse. At only 47yrs old I do have my health but my hearing is NOT.. With this being said were does my hearing stand compaired to normal to deafness >? I have been working since the age of 17 and fear it will effect my job position since it involves talking and listening >? Help…
Hi Richard:
The way they classify hearing loss is:
-10 – 25 dB Normal
26 – 40 dB Mild
41 – 55 dB Moderate
56 – 70 dB Moderately severe
71 – 90 dB Severe
91 – 120 dB Profound
121+ dB Deaf
So your hearing is in the severe category (like mine). Once you reach he prodound category you are essentially deaf although you will still hear some loud close sounds.
As you now know, a severe hearing loss means you don’t hear much normal speech unless it is very close. Thus, you NEED to get and wear properly fitted hearing aids while they will still help you. When your hearing drops further, and especially when your discrimination (or word recognition) drops to around 40%, then it is time to consider getting a cochlear implant.
Neither of these solutions will be perfect, but using them and supplementing them with assistive listening devices in poor listening situations will let you live a fairly normal life as a hard of hearing person.
Cordially,
Neil
Sir,
I have only one ear working.. And the other ear is closed with out any hole or outer features… But you said that iam ineligible for disability but why sir?? combined working of 2 ears is perfect hearing, as I didn’t have an ear how iam not disable??
Also I have a friend whose thumb fingers in both hands are slightly long but he is now eligible for disability..
Why so??
Please reply
Hi Sriram:
In the USA, to be eligible for disability, you have to have a condition such that you cannot look after yourself normally. In your case, you have one good ear so you can talk to people, hear on the phone, etc., etc. Therefore, you are not eligible. Sure having only one ear makes it harder to hear in noise and you cannot tell where sounds are coming from, but it does not prevent you from looking after yourself and leading a reasonably normal life.
Cordially,
Neil
I’m 12 years old and have 30% hearing loss in my right ear due to a ruptured eardrum. I’m starting to notice it worsing yet I don’t want to have hearing aids. I’m in seventh grade! What should I do
Hi Abby:
What I’d do first is go to an ENT doctor and find out why your hearing is getting worse. Maybe you have a middle ear infection because of the hole in your ear drum. If your ear drum has not healed up naturally, it probably would be a good idea to have it repaired surgically.
If you only have a 30 dB loss (there is no such thing as a percent loss no matter who tells you that) you may not really need a hearing aid as long as the hearing in your other ear is normal, unless you realize that you are not hearing things you should be hearing.
One thing that can help you hear better is to sit on the right side of the classroom so your good ear hears into the room. And have your friends sit on your left side so you can hear them better.
Now lets talk about wearing hearing aids. If you have trouble seeing you wear glasses and think nothing of it. So what’s the problem with wearing hearing aids if you can’t hear well? Think of them as “earglasses”. I wear two hearing aids because I am functionally deaf. This means I don’t hear speech if I don’t have them on. Yet when I tell people I have a hearing loss, I’ve had people look at me to see whether I am wearing hearing aids–and not see them even though they are looking for them and I’m bald so I can’t hide them.
What I’m saying is that most people will never notice that you are wearing a hearing aid IF that is what you are worried about. But the WILL notice if you don’t hear them and thus respond inappropriately.
So if wearing a hearing aid (or aids) will help you, go for it. Once you feel comfortable wit them, you’ll be glad you did.
Cordially,
Neil
Hi Dr. Bauman,
My Daughter has CHARGE syndrome and we recently received a sedated ABR to test her hearing. My daughter came back with mild to moderate hearing loss with a DB of 45.
That being said, the audiologist is not recommending hearing aids. Nevertheless, I have requested the aids in order for her speech and language to properly develop.
The Audiologist stated that a DB of 15 is required for speech and language to develop. She also stated that hearing aids will not get my daughters hearing down to the required DB 15.
How accurate is this?
Any help you can provide is greatly appreciated.
Thank you,
Ray
Hi Ray:
I really need more information in order to properly help you regarding your daughter. I’m assuming that since they did an ABR, she is an infant, correct? Infant hearing testing isn’t as accurate as it is later when they are older.
If she has an average of 45 dB loss, that is significant in a child and amplification is normally indicated. Why did the audiologist not recommend hearing aids? What made her say that?
I don’t think you understood her when she said that 15 dB is required for speech and language to develop. What she probably meant is that if hearing loss is worse than 15 dB, it impairs speech and language development as compared to children who hear better than 15 dB. But you can learn speech and language with a 70 dB loss like I had–and my speech is totally normal.
Furthermore, in school, a child with a hearing loss greater than 15 dB does not do as well in school as those with hearing better than 15 dB according to some studies. A 15 dB loss is called a slight loss, but it is anything but slight in a child’s development.
Hearing aids typically give you back about half your hearing loss. So in my case I now have about an 80 dB loss. Therefore, when I wear my hearing aids, my loss is more like 40 dB. Not normal by any means, but ever so much better than what I have without hearing aids.
Thus, with hearing aids, your daughter could expect to have a 22 dB loss or thereabouts–again not perfect but a lot closer to the 15 dB limit than before. Thus, unless there is some reason to the contrary, amplification (hearing aids and/or assistive devices) would be a great help to her.
Some questions that need to be answered is whether your daughter has a conductive (middle ear) loss, sensorineural (inner ear) loss or a mixed (combined) loss. For example, if she had a pure conductive loss, then a bone conduction hearing aid would be the way to go. If it is all sensorineural hearing loss, then a conventional hearing aid would work.
Some of these questions can’t be answered yet–she needs to get older so she can give some feedback, but early intervention, if it helps, is the way to go. That is why I want to know the audiologist’s reasons for not recommending a hearing aid.
Cordially,
Neil
Hopping you can help me please . My Right ear has a loss of 65 db at 6k .My left is 50 db at 6k , could you please tell me my percentage of hearing loss . Thank you very much
Hi Greg:
You need to reread my article. Then you’d know you can’t express hearing loss in percentages. You can express your degree of disibality from hearing loss in percentages though. But to do that, I need to know you hearing loss at the main test frequencies, not just one frequency.
Cordially,
Neil
Excellent article!
In May of this year I started having problems with my right ear-I am 68 and had never had a ear infection, not even as a child, I finally got into see a very wonderful ENT, in August of this year. He had to go in and do a debridement of the eardrum-the infection has now cleared after multiple courses of antibiotics, oral and drops. I am told that I have a small hole in the eardrum, ear still feels full and hearing is down, He told me I will have a 20 decibel hearing loss, I am wondering how long before my eardrum heals and will this fullness feeling ever go away! Drives me crazy some days. Thank You
Hi Bette:
With a hole in your eardrum, your ear shouldn’t feel full since any excess air/fluid can come out the hole. However, if you middle ear and Eustachian tube are still full of “gunk” then you could get that feeling. You could also have the psychological feeling of fullness because of your hearing loss. Your brain says, “Surely I should be able to hear better if this ear wasn’t blocked, so you get the feeling it is “full” or “blocked” but in this case it is not a physical feeling, but a psychological feeling.
I don’t know how long it will take for your eardrum to heal. That’s a question you should ask your doctor. I suspect in could be 2 or 3 months or more.
Cordially,
Neil
From last 10-15 days i am having a slight problem in hearing on telephones from my right ear.. 2 day back i also had cold the this problem went more …
yesterday i went to audiologist and my results are as
Left ear
250 hz – 25 db
500 hz – 25 db
1000hz – 60db
2000 hz – 75 db
4000 hz – 80db
8000 hz – 95 db
Right ear
is ok
Please advise me as the audiologist told me the problem is critical and treated as medical emergency.
after this i consulted my Dr who have given me medicine
RZL
trinergic -L
Omnacortil – 20
lifestar
Hi Nitesh:
It sounds to me like the cold virus got into your ear. The standard treatment here is to give a steroid such as Prednisone or Prednisolone and if they suspect a virus and it is still soon enough, an anti-viral.
Omnacortil is a brand of Prednisolone, so you have received the standard treatment.
Cordially,
Neil
My child failed his hearing test at school 4 times (the 1000 decibal tone), in his right ear. If I am reading this correctly, this tone would be kinda loud, correct? he sees the ENT on Friday, I am just very concerned and thought maybe you could help.
Hi Monica:
You mean the 1000 Hertz frequency. (There is nothing so loud that could produce 1000 decibels–even a rocket right at the launch pad is only around 200 dB.)
For school testing, I’m sure the tone they hear is not very loud. I don’t know for sure what level they use, but I suspect it will be less than the level of normal speech. So it should not be dangerously loud at all.
Cordially,
Neil
iam a bo of age 22 years ..i have 45 hearing threshold ..docter told me thati have whole in my ear drum .and needs a minor surgery called tympanoplast .how much hearing power will i get after tympanoplast ..does it improve greatly or only 4 ,5 decible ..after tympanoplast ..please suggest me what to do ..problem is seen in my left ear. is it a serious case …?? and what would be your su=ggestion to me..
Hi Sabin:
Having the surgery (tympanoplasty) is a good idea whether you got any hearing back or not because the hole in your ear drum is an avenue for infection to get into your middle ear.
I don’t know how much hearing you would get back with the surgery because you haven’t said whether your hearing loss is conductive (in which case you may get back a lot) or sensorineural (in which case it wouldn’t affect your hearing at all. You’d still have the same degree of hearing loss.) Or you could have a combination of both.
Cordially,
Neil
Why is it so very difficult for audiologists to find the right hearing aid for someone who has profound hearing loss (90-95db)?
Seems some of the ones that do or have worked are no longer being sold. For example, I have 2 Sumo XP hearing aids made by Oticon. The life expectancy is 5-6 years. They recently stopped making them. So, my audiologist swore by Sumo DM being similar. For me, it’s not anywhere near similar as the XP. The audiologist totally narrows my options down to almost nothing. Well, next step would be cochlear implantation. Not even sure if they can fail?
Hi Christine:
Each audiologist has their own favorite hearing aids they carry. They don’t necessarily know about other makes of hearing aids that may help you.
But it may be true that you are almost out of options now if your hearing loss is profound.
The success rate with cochlear implants is very high–depending on what statistics you see upwards of 98%. But anything manmade can fail. In the case of CIs, the failure rate is very low.
Cordially,
Neil
hello sir. i am 32 years old from Ethiopia. i am deaf in one ear while the other ear can detect sound of 50 db. really. I have experienced head trauma earlier in my live at age of 6 years and i become ill which caused me to loss my hearing capabilities. now i have extreme and none stop ear ringing which makes me more problematic and e suspect that i am losing more decibels as time progress with out showing any sign of illness or disease in my ear. so please could pleas tell me ways in the ear loss hearing with out visible signs or pain or illness? how can i keep my hearing power. also tinnitus hurts me so much. thank you.
Hi Dyer:
I’m not surprised you have tinnitus since tinnitus often accompanies hearing loss.
The most common cause of losing more hearing is because of exposing your ears to loud sounds. That will slowly and surely continue to damage your hearing. So can taking any of a number of drugs that cause hearing loss, tinnitus and other ear problems. So you need to protect your ears from loud sounds and from ototoxic drugs.
Even so, you may have damaged the underlying structures in your inner ears, and the result is hearing loss will continue no matter what you do.
Your tinnitus is obviously bothering you. One thing you can do is try to mask your tinnitus with other sounds. These sounds will also help take your mind off your tinnitus. You need to learn to ignore your tinnitus by focusing on the loves of your life.
I’ve had tinnitus for more than 65 years, but I refuse to let it bother me, although it is there all the time. Just treat it as a non-threatening background noise and don’t focus on it just like you ignore a lot of other background sounds.
Cordially,
Neil
Hi mr. Bauman,
I started making housemusic since I was like 17. Around my 21th I got an earinfection on my right ear after which I clearly noticed a loss in higher frequencies. After a small test at the ENT a mild loss was confirmed in the high frequencies around 6-8k (assuming after the 8k a large part was lost too, but can still hear up to like 15k). So ok, after this I was warned and was a sign I had to watch out more with the volume of my headphones. However, after another earinfection on my left ear about 2.5 years ago (which was my ‘good’ ear) I created a small tinnitus and also notable loss of frequencies in the high in a period of about a few days time. 2 weeks later the ENT told me I suffered from a middle earinfection. I was devastated, because making music means quite a lot to me. ATM I study music at university and hope to get a job in the industry. Luckily Im still able to hear good enough that my music/mixing/working doenst suffer because of it, but it has got me really worried because these 2 events happened in a span of a few days and both got my hearing notable worse, although not that worse that its the end of the world. I now do a yearly hearingtest at the ENT.
The ENT told me however that the hearing loss I suffered (mild/modearate. about 30db loss at 6k Left and Right and 40 R/50 L resp. at 8k) was a clear sign of noise induced hearing loss. Which I find strange because the way I experienced it was that my hearing clearly dropped in the high frequencies after both the earinfections. My question is, how are these 2 events related? I am 100% sure that both my ears got noticable worse after these earinfections, but it was just strange to me that my ENT told me it was noise-related.
Also, I have to admit I am just sooo worried that an event like this will happen again. It feels like im at a limit in my hearing that if it gets any worse, it will make my music suffer, and I am in my last year of university studying….right, music. So my last question is: should I be worried? and what can I do to prevent earinfections from f*cking up my ears in the future? Next to that Im doing as much as I can to prevent noise induced hearing loss, like dont make music at too loud levels, take a break often, wearing made earplugs to events etc.
Thanks!
Hi Donny:
I don’t see any problem in your having both hearing loss from noise (the 4 kHz noise notch) and hearing loss from ear infections, especially if the virus got into your inner ears. As hearing loss in the higher frequencies progresses, it tends to hide the noise notch and your audiogram begins to look more like a ski-slope loss.
If you want to prevent ear infections, you need to make sure your immune system is robust. Things that shoot down your immune system are eating too much sugar, excessive stress and not getting enough sleep. It sure wouldn’t hurt to boost your vitamin C and vitamin D3 intake. Most people’s vitamin D3 is much too low and this leads to sickness/infections. It should ideally be in the range of 50 to 70 ng/ml. Most people are down around 20 ng/ml or so and that is much too low for optimal health.
Cordially,
Neil
Dear mr. Bauman,
First of all thanks for your answer! Its really nice to have someone with your knowledge answering my questions as it is of deep concern for me ! 🙂 Also I do think your tip of the Vitamin D is a good one. I will certainly pay more attention to that as I do feel my eating pattern can be better.
Now I have one more question: Do you think I have to worry too much about my future if I want to work in the musicindustry, given my problems? ATM im just 26 yrs old, but I would not know for sure if I would be able to work and let it have an effect on my mixes in that way or another, let alone hope to have a carreer for a few decades ?
Hi Donny:
I can’t really answer that question as I don’t know how you now perceive music pitch, timbre, etc. as compared to a person with normal hearing. There are a number of musical instruments I can’t even hear so I’d never be able to mix them and make them sound good.
Why don’t you contact Richard Einhorn? He is a composer, record producer and sound engineer that lost some of his hearing suddenly in 2010. He can tell you how he does it now and what devices he uses so he can still hear and enjoy music. Tell him I suggested you contact him. He knows me. Go to http://www.richardeinhorn.com and you’ll see his public email address. Let me know how it goes.
Cordially,
Neil
Hi Neil,
Thank you so much! I will contact him. His name does ring a bell, Im sure one of my classmates knows him too!
Now I have one final question. So first of all, I know that clearing your ears too much can make your eardrum go weak if you do it for a long time. I had my hearing tested on this a while ago, and luckily I didnt have any issues with pressure and the Eustachiustube (this was confirmed through tympanometry. My left ear is my ‘bad’ ear for higher frequencies (over 10k). However, when I clear my ears I hear frequencies for some reason I wasnt able to hear before for a while with my left ear, and then after a few minutes it becomes bad again (and I can hear it ‘close’ again). Is this a sign that the haircell nerves that perceive the high freqs are still somewhat intact, but that the problem is some air/pressure-related issue in my left ear? Might be a bit nonsense-question but to me these frequencies matter a bunch to me as it allows me to hear the ‘air’ in the mix much clearer.
And Im sorry if I ask too much, its just that I finaly found someone with the knowledge to answer my questions that only my ENT would be able to answer!
Hi Donny:
Where did you hear that clearing your ears too much can make your eardrum go weak? I’ve never heard that. You clear your ears every time you yawn or swallow and that’s a lot of times a day. Your eardrums are designed to be “cleared” a lot.
In fact, if you didn’t swallow, your audiogram would show you have a conductive hearing loss and your tympanometry would also reflect this.
You have it right. When you swallow and clear your ears, the air pressure is exactly the same both inside and outside your middle ears. At that point, your hearing is the most sensitive so you hear the faint high-frequency sounds better. But as time goes on the air differential between your middle ears and outside changes and your ears become less and less sensitive to sound until you clear your ears again.
This happens for at least two reasons. One, and this is very noticeable when flying, is that there really is quite a change in air pressure as you go up or come down. Two, your middle ear uses up the oxygen in the air in your middle ear creating a bit of a vacuum (an air pressure difference) and thus you have to clear your ears to equalize the air pressure again so you can hear better.
If anything interferes with this mechanism (clogged Eustachian tube for example), you don’t hear as well as you otherwise would.
There is nothing wrong with your hair cells when this happens, it is all mechanical in your middle ears.
Cordially,
Neil
So given your answer would you conclude there is some kind of (probably very small) problem with my Eustachian Tube? Because I do notice a difference before I clear my ears and it sounds more balanced afterwards, even though my tympanometric results where ok according to my ENT.
And it quite suprises me to hear you say that about clearing the ears! I know for a fact that a lot of ENT’s have said this that clearing your ears might damage your hearing if you do it for a very long time (my own ENT also told me this, but that it would have to be a LOT of times). By clearing your ears I do mean it like this: http://www.healcure.org/wp-content/uploads/2015/08/How-to-unpop-clogged-ears-Breathing-exercises.jpg
So in a manner that does involve a lot more pressure than just swallowing or jawning does.
Hi Donny:
You didn’t say you were using the Valsalva maneuver (what you call clearing your ears). I thought you were meaning swallowing or yawning. Two totally different things. You have to be specific or we end up on different pages.
I don’t know why you were always using the Valsalva maneuver. Yawning or swallowing is generally all that is needed. Seems you were getting a bit compulsive about it.
Cordially,
Neil
Hi Neil,
First of all sorry for not telling you earlier, but with you now telling me this, its the first time I ever I hear of the word ‘Valsalva maneuver’ (I honestly didnt know it was called like this, always referred to it as ‘clearing’).
I use this because when I clear my ears the normal way you were talking about, it doesnt feel like it really has an effect. However, when I use the Valsalva maneuver you were referring to, I t feels as I notice a big improvement in my left ear compared to my right (even though its temporary). And you are right about my compulsivity…I use it alot because it just irritates me so much when I hear my music. I dont think its normal the way Im doing it and Id rather stop it, but it just bothers me so much when I am making music or mix music that I miss that part of high frequencies and that Valselva Maneuver does help me in that way (even though mostly temporary).
One addition on my last post:
I found an older thread on a forum which exactly describes my problem and why I use the Valselva Maneuver so much:
http://www.healthboards.com/boards/hearing-disorders/58101-why-valsalva-benefit-temporary.html
Thanks!
Donny
Hi Neil,
I dont know if I was really clear with my last comment, but I wanted to ask you a few more questions concerning this Valsalva Maneuver.
1. Is the statement you made about clearing also apply to the valsalva? (”When you swallow and clear your ears, the air pressure is exactly the same both inside and outside your middle ears.”
So is your hearing actually most representative of how it really is shorty after this maneuver is used?
2. Is it dangerous in any way to use this maneuver multiple times a day ?
3. Does it mean there is some pressureproblem going on in my Eustachian Tube if I use this and I notice a drastic improvement in some frequencies (especially in the tophigh spectrum with the haircells positioned directly in the cochlea)?
Lastly I really want to emphasize Im sorry if I ask you too much or I come over pushy. I just want to say Im really thankful for all the help you already gave and if you feel like dont answering my questions anymore I totally understand.
Thank you!
Donny
both ear 56db to up to 70db moderate severe…can i apply medical certificate
Hi Prince:
I’m not sure what you mean by a medical certificate. Yes, you have a moderately severe hearing loss, but you should still be able to function reasonably well with hearing aid, assistive devices and proper accommodations.
Cordially,
Neil
Dear Sir,
Thank you for a very good article. This percentage loss of hearing mixed with decibels is everywhere…
Think that in the beginning there is a small mistake:
“every 10 dB increase in sound intensity is actually a ten-fold increase. Therefore, a sound intensity of 20 dB is not twice as loud as a sound intensity of 10 dB, but is 10 times as loud, and a sound intensity of 30 dB is 100 times as loud as a sound intensity of 10 dB. Similarly, a sound intensity of 50 dB would be 100,000 times as loud (10 x 10 x 10 x 10 x 10)”.
To my mind, as having 10dB a “starting point”, comparison point – 50dB is 10,000 times (10x10x10x10) as loud, not 100,000 times.
Br,
Hannu H
Hi Hannu:
You are absolutely right. Thanks for pointing this error out. I hate publishing mistakes. (It’s bad enough that I make them.) I must have been thinking of starting at 0 dB, not at 10 dB. I’ve corrected it now, so all is well.
You’ve got a sharp eye. That article has been up for a number of years and you are the first to notice this error.
Cordially,
Neil
Dear Neil,
I have very loud high pitched tinnitus in both ears continuously that affects my hearing and when tested in the UK my audiologist tested both ears at 25. They did not give very much information on the use of hearing aids with in built sound maskers for tinnitus but this is something I would like to pursue. I have tried the other avenues for tinnitus already (distraction, cbt, etc.) I am in the UK so may be able to get them on the NHS or privately. Thank you for any advice. Kind regards Elle M
Hi Elle:
You have it backwards. Tinnitus does not affect your hearing, but hearing loss commonly results in tinnitus.
When you say you were tested at 25, I assume you mean your hearing loss is 25 dB.
Hearing aids with built in tinnitus maskers can be quite effective, but you want certain features in such hearing aids. Here is an excerpt from my book “Take Control of Your Tinnitus–Here’s How” 7th edition.
“When using hearing aids that have tinnitus therapy options built in, such hearing aids should be flexible enough to work:
• In one or both ears
• In just one or in multiple programs
• At different intensities in each ear
• At different intensities in the various programs
• With different noise types in each program and/or in each ear.
In addition, such hearing aids should also have a volume control designed such that the wearer can adjust the volume of the tinnitus therapy signal independently from the volume level of the hearing aid’s microphones.”
In addition to white noise, some hearing aids offer built-in nature sounds as a tinnitus therapy option. Such sounds provide a positive, soothing and stress relieving listening experience. These hearing aids are ideal if you prefer a more natural therapy signal.
There are also hearing aids that have fractal tones built in. For many people fractal tones are much more pleasant that listening to white noise. Fractal tones are pleasant, ever-changing musical tones. Widex has hearing aids with fractal tones built in (what they call Zen tones and Zen therapy). You might want to investigate those hearing aids too.
Cordially,
Neil
Hi doctor,
My husband is 33yrs and he has bilateral mixed hearing loss.
Diagnosis: Right dry central perforation with extensive tympanosclerosis with ossicular necrosis.
Left: left adhesive otitis media with superior retraction with incus necrosis.
He has undergone mastoidectomy with tympanoplasty for both the ears.
post operation Audiogram says,
Right: AC: 50 db ,BC 25db
Left: AC:43db , BC :25 db
1.Can you please let us know whether hearing aids can help him. 2. And hes worried whether this hearing loss will be progressive even tough ears are operated.
3. Hes not able perform well at his office he finds difficulty in managing routine work.
4. Can you please help us what can be done to improve his hearing.
Hi Padma:
From what you have told me, I see no real reason why your husband couldn’t wear hearing aids successfully. He has a moderate hearing loss. He should try out appropriate hearing aids and see how well they work for him.
I don’t know whether his loss will be progressive in the future or not. If the doctors got all the necrosis and assuming no further cells die, maybe his hearing will remain stable. This is a question you have to ask his doctors.
There are two or three avenues he should investigate. First, is to see whether hearing aids will help him. Second is to use assistive devices in those areas where hearing aids are not effective. And third is to learn the many hearing loss coping strategies including speechreading.
Cordially,
Neil
ASSR Test & BERA Test Can Be Performed In awake Condition For adult of aged 23years. If yes Then what is the difference Betn PTA And Assr Or Bera Pls tellme.
Hi Manik:
The article “Auditory Steady-State Response (ASSR): A Beginner’s Guide” can answer your questions better than I can and in much greater detail too.
Note: BERA (Brainsteam Evoked Response Audiometry), BAER (Brainstem Auditory Evoked Response) and ABR (Auditory Brainstem Response) are all synonyms and thus mean the same thing.
Cordially,
Neil
Thanks for my first quest answer…..PTA Results Can Differ From ASSR Test results For same person. if yes how it can be
My daughter Aryanna’s hearing test came back right ear5srt 100% 45db speech discrimation dose this mean there some hearing loss not sure how to hear the results
Hi Sherry:
Is that all you were given. To know what her hearing was, I need to see the results as shown on the audiogram–db by frequency.
However, I can take a stab at the limited information you gave. If her SRT is 5 dB, that is excellent. I’d say there was no hearing loss. And her discrimination is 100%–again excellent.
Cordially,
Neil
Hi Neil,
My 17 year old daughter had a hearing test yesterday and was told she is profoundly deaf in one year – I believe it was 110db. Her other year is fine. They have referred her for an MRI scan to find any other concerns. But they have told us that there is nothing they can do? How can this be with such a severe hearing loss? I was told repeatedly that there is nothing they can do. Needless to say, we are extremely concerned and I can’t find any information on why a perfectly health girl can loose her hearing in a matter of months. They suggested that she could “try” a hearing aid, but that wouldn’t give her much hearing.
Regards
Anna
Hi Anna:
Typically, hearing loss like your daughter experienced is the result of the death of the hair cells in the inner ear. Once they are dead, you can’t hear anything. The reason doctors can’t do anything is that they can’t bring dead cells back to life. Dead is dead.
There are a number of things that could have caused this massive hearing loss. Here are four. One is various drugs and medications. Two is a viral attack. Three is a genetic disorder. Four is an autoimmune response.
If they cannot do anything helpful to restore any hearing, then she will have to learn how to live as a person with one ear. She could get a CROS hearing aid that pipes the sounds from your deaf side to the other side so she can hear from both sides of her head.
One trick is to always sit so her deaf ear is to the wall and her good ear faces into the room. So if her left ear is deaf, then she should sit near the left side of a classroom/auditorium/church/etc. so her right ear can better hear what people are saying. (And vice versa if her right ear is deaf.)
Another trick is to have people sit/walk on her good ear side. This will make communicating ever so much easier.
Cordially,
Neil
dear sir,
visual acuity is tested interms of distance.Like that can we test hearing with distance.
For example I heard that clock ticking sound is 20Db.So how far should we stand from a ticking clock for anyone having 20 db hearing?
can we test at home like this?
Hi Jamuna:
Your idea sounds good in theory, but in practice, it doesn’t work very well. For example, when they say a clock ticking–what kind of clock are they talking about–a very quiet wristwatch (when they used to tick), a much louder mantle clock or what? Since clocks all tick at different volumes, you first have to define and calibrate the specific clock.
Furthermore, hearing is tested in total silence so no other sounds interfere and mask the sound you are trying to hear. Thus, unless you were in a soundproof room, whether you hear the ticking clock depends on any ambient noise around you.
In addition, the frequency of the tick matters too. This is because high frequency sounds do not travel through air as well as low frequency sounds. Thus you would not be able to hear a high-frequency ticking sound from as far away as you could hear a low-frequency ticking sound when they were both at exactly the same sound level.
That is why hearing testing is done in a soundproof room and typically with earphones tight against your ears to eliminate other sounds, the effects of distance, and the changes of sounds as they travel through air.
After having said all this, if you have a smart phone, there are a number of Apps that can test your hearing. Some are quite accurate. This would be a quick way to get a good idea of how good or bad your hearing is, but the only accurate way is to use a soundproof booth and a calibrated audiometer.
Cordially,
Neil
Dear sir
very nice of you.
thanks for your immediate response clarifying all my doubts.
thank u sir.
which is the most accurate website for online hearing test sir?
Thank u once again.
wish you a good day
jamuna
Respected sir,
My hearing test report shows my hearing loss Rt-43dB, Lt-45dB
Doctor adv. Me a hearing aid for both
My dought is after using this aid, with medicines can I got normal range,
And if any possibility to recover my hearing sensitivity with surgery.
Pls adv me
Hi Bharat:
I agree with your doctor that getting hearing aids should help you.
Hearing aids don’t make your ears work better. They just help you hear better. So wearing hearing aids isn’t going to improve your natural hearing.
If you have a conductive hearing loss, then surgery can often help you hear better. If your hearing loss is sensorineural, then no surgery can help.
I don’t know anything about your hearing loss so I can only answer in generalities. But the things you can do to prevent more hearing loss are protect your ears from loud sounds and avoid ototoxic drugs as much as possible.
Cordially,
Neil
Respected sir,
How to preventive to cannot loss hearing sensitivity?
I have tinnitus. Multiple time my vertigo would cause to fall and be extremely dizzy. Since I be going Thur this. I been feeling light headed, always sleepy. What should I do?
Hi Donnie:
Why do you have vertigo and tinnitus? Do you have Meniere’s disease? Or are you on any drugs or medications? I need to know more about your situation before I can try to help you.
Cordially,
Neil
My five year olds audiology report is as follows right ear 250-25 500-25 1000-25 2000-25 4000-20. 6000-20. Left ear 250-35 500-45 1000-40 2000-40 4000-45 8000-35 do you think she will need hearing aids
Hi Katrina:
She certainly needs a hearing aid in her left ear and it would be wise to have a hearing aid for her right ear too. You see, 25 dB is the lower limit of “normal” for adults, but in children it is 15 dB. They have done studies that show that even a 15 dB loss (unaided) affects a student’s performance in school. So either she wears hearing aids, or the school needs to provide a sound-field system for her so she doesn’t miss as much.
Cordially,
Neil
My son , age 3 years. audiologist test result is one ear is 100db and other is 90db. so what you advise. hearing aid help? and what kind of hearing aid best. thanks
Hi Muhammad:
You left out some critical information I need. Is the 100 dB and 90 dB your son’s worst hearing and it is better at other frequences, or does he have a flat loss–the same loss across all frequencies.
If it is the latter, then rather than get hearing aids, he needs cochlear implants.
Cordially,
Nel
Sir I have a hearing loss since 4 year .it is growing day to day.i feel very hard to listen from both sides of ears. and using hearing machine (AM111).
when use it feels pain in the year and bone of the year.
left:50db to 70db
right :50db to 90db.
please suggest any solution.
my age is 24years.
Hi Amjad:
What is the cause of your hearing loss? Is your hearing loss sensorineural (inner ear) or conductive (middle ear)?
Are you wearing hearing aids? That is the obvious solution to help you hear better.
Cordially,
Neil
Hi Dr. Bauman,
it would be very kind of you to go through my reports mentioned below.
I am from india. Here for certfication under hearing impairment the loss of hearing should b 6odB in better ear.
Please tell if i am eligible for the certificate.
Also, suggest the possible reason for hearing impariment in my right ear and treatment.
Left ear
60dB-250Hz
55db-500hz
60db-1000hz
55db-2000hz
65db-4000hz
75db-6000hz
80db-8000hz
And,right ear
80db-250hz
90db-500hz
80db-1000hz
80db-2000hz
100db-4000hz
100db-6000hz
Hi Varsha:
You left out one critical piece of information. At what frequencies do they average the results?
Here in the USA, they average your hearing over the frequencies of 500, 1000, 2000 and 3000 Hz.
So assuming they use the same frequencies in India, your hearing in your better (left) ear would be 55, 60, 55 and 60 (I averaged between 2000 and 4000 to get this figure).
The average of 55, 60, 55 and 60 is 57.5 dB, which means your hearing would be just a tiny bit too good to get a certificate (assuming this is the proper criteria),
Before I can tell you what the likely cause of your hearing loss is, you need to tell me a lot more about your hearing loss–how long you’ve had it and anything relating to hearing. It could have been hereditary, from taking ototoxic drugs, from viruses, etc., etc.
Cordially,
Neil
Hi Neil
Please ignore my earlier post as this post explain in broader way.
My daughter aged 10 years has hearing loss in both ears. In right ear – 45 db and left ear -110 db.
I am confused here as one of audiologist suggested that I should go for hearing aid in right ear only as it is 45 db. Hearing aid will not be effective in left year.
Then I told him, that there are several hearing aid which supports 110 db then why should not I go for that. Then he suggested that even if I put in left ear, sound will go via right ear. So as per PTA, we should go first for right ear.
Now, My thinking is I should go for only left ear as it is profound loss,
So please let me know whether should I go for both ears Or should I go for only left ear as it is profound.
Hi Sanjay:
You left out one critical piece of information–what your daughter’s speech discrimination (word recognition) scores are. You see, the amount of hearing loss isn’t the only criterion for getting hearing aids. Lot me explain.
If you have a profound loss and good discrimination, then a hearing aid in the bad ear could be a good idea. However, if her speech discrimination is poor in her bad ear, then all she hears is basically gibberish. Amplifying this gibberish makes it more difficult to understand the good speech sounds coming from her better ear. It overloads her brain and she wouldn’t understand as much as she would if she wasn’t wearing a hearing aid in her bad ear.
So you need her discrimination scores before you can make a good decision.
A 45 dB loss will really affect her in school, so she NEEDS a hearing aid in her better ear to help her hear better (whether she has one in her bad ear or not). Hopefully, her discrimination in her better ear is good (80% or better).
Cordially,
Neil
Thanks Neil. I don’t have her speech discrimination score but she has poor discrimination in her left ear i.e. bad ear. She can’t hear from it as it has profound loss.
As far I understand from you that there is no hearing aid is required in her left ear as she has poor discrimination (0% I guess).
Recently I got complain from her school about her academic as she is not doing well. She understands but not performing well may be due to poor listening .
Children not playing with her and always tease her.
One more thing, I would like to know from you –
Will this hearing loss gradually increase with age?
If yes, then how much ?
will hearing aid stop that loss for further increasing?
Please advise.
Thanks
Hello! I have 30 Db in my left ear with a 100% word recognition. However, my right ear is 80 Db with a word recognition of 8%. My doctor told me that due to this, my right ear is ineligible for an amplifying hearing aid. She said, even if I hear speech in my right ear, it will be highly and unrecognizably distorted. Is this true?Does this mean I have severe hearing loss in my right ear and normal hearing in my left? I think they mentioned it being sudden sensorineural loss. In crowds, with a lot of background noise, I feel like I can’t hear anything. Also if a phone rings or a baby cries, I can sort of hear it, but I cannot possibly find where the sound is coming from. I was wondering if you knew why this was. Thank you!
Hi Sabrina:
I thought your questions would be better answered in a separate article which I’ve just written. You can see this article “Should I Wear a Hearing Aid in My Ear That Has Poor Discrimination?” at http://hearinglosshelp.com/blog/should-i-wear-a-hearing-aid-in-my-ear-that-has-poor-discrimination/
Cordially,
Neil
I’ve had head trauma related hearing loss. I know I need to get tested. The ruptured eardrum comes from physical abuse in 1998. I don’t even try to follow conversations with background noise anymore. It just frustrates me more to try. Bass sounds hurt badly!!! What would be the odds of these ear infections, tinnitus, and gradual hearing loss possibly becoming permanant?
Hi Kathy:
What makes you think you don’t have permanent problems now. If your eardrum ruptured back in 1998–that’s 19 years ago now–and if it hasn’t healed up yet, it sounds permanent to me. Ear infections are much more common if you have a ruptured ear drum as bad stuff can get into your middle ear and cause infections. Why haven’t you had your eardrum repaired? That should give you better hearing and cut down on ear infections. And better hearing may cause your tinnitus to lessen.
From the little you have told me, it seems you should go to an ENT specialist and see what he says.
Cordially,
Neil
I have a slight to moderate hearing loss in both ears, (20-28dB). Should I seek treatment for this , even though it is on the threshold of moderate hearing loss?
Hi Kylie:
20 to 28 dB puts you in the mild hearing loss class. Anything down to 25 dB is considered normal–so you are just over the line from normal. You may find that hearing aids are “too much sound” for your degree of loss.
What you want to do is protect your ears from whatever is causing this loss so it won’t get worse in the future.
Cordially,
Neil
sir,
my left ear is 100% damage and right ear is fine.can i get disability certificate in india?if yes then what is the percentage of disability ? plz ans me
Hi Vaibhav:
I don’t know the rules for India. Here in the USA you would not be eligible because you have normal hearing in one ear.
Cordially,
Neil
My hearing loss happened while I was at work and my HR wants my hearing loss in percentages in order to compensate me. My threshold is 2o in R and 25 in L, my SL is 40db in both R and L and 100% discrimination PBQ in both R and L. What does this mean and how do i figure a percentage in order for HR to know how to compensate?
Hi Ranae:
You haven’t given me enough information to calculate the degree of hearing loss. Attach a copy of your audiogram to an email and send it to me personally. My email address is at the bottom of any page on this website.
Note that for compensation purposes, any loss down to 25 dB is considered normal.
Cordially,
Neil
Hello! This is a cool article– I’ve been wondering about the whole “percent” thing as it didn’t really make sense to me. Both glad and sad that it’s apparently a ridiculous idea, as percentages seem like they’d be easier to explain, but oh well.
Anyway, I do have a couple of questions… First of all, do you know what the usual SRT is for a person with normal hearing? I like having comparisons, and while I can compare my audiogram with other audiograms, I have yet to find a general statistic listing normal hearing SRT.
Second,I’m 19 and I have mixed hearing loss. (though I think the sensorineural component may be more prevalent than the conductive component) According to the hearing tests I’ve taken (from my audiologist) my hearing thresholds are:
Right Ear- 40 dB HL from 250 Hz to 1 kHz, 20 dB HL at 1500 Hz, 10 dB at 2 kHz and 3 kHz, 15 dB at 4 kHz, 10 dB at 6 kHz, and 25 dB at 8 kHz.
Left Ear- 40 dB HL from 250 Hz to 1500 Hz, 20 dB HL at 2 kHz, 10 db HL at 3 kHz, 30 dB HL at 4 kHz, 40 dB HL at 6 kHz, and 50 dB HL at 8 kHz.
The thing is, I don’t really feel like I have that much trouble hearing/understanding people so long as there is little background noise. When I do have difficulty, it is usually with soft speech, loudspeakers (especially in stores), computer video/audio calls, and noisy situations (especially if I’m not attuned to the voice I’m listening to). Also, with the speech banana, supposedly “z” and “v” are at around 30 db somewhere between 250 and 500 Hz, which should be below my hearing. Yet, if I say either of these sounds, I can hear them, and I can hear them when Mom says them too. However, I remember we were next to each other in the car when we checked this so we weren’t really more than two feet apart… And when we tested it at 6 feet apart I couldn’t hear them, so maybe it’s just a distance thing… It is true, however, that I can hear the “s” and “f” sounds in my right ear but not my left. I also have these socks which have little jingle bells on them, which I can hear in my right ear while I walk in them, but not my left. So I know for a fact that the high frequency differences are accurate… Basically, I’m just wondering why it is that I feel like I understand speech better than my audiogram says I should. I’ve had this loss since I was little at least, so maybe I’m just used to it? Maybe my brain just adapted really well? I was officially diagnosed when I was seven, and I’m sure I had HL before then, so I’m used to this level of hearing (as far as I know, I never had any speech delays. I also always did well in school, but then all the schools I’ve ever gone to had small classes, so maybe it was just a better environment). My family tends to talk loudly anyway, so maybe that had something to do with it. Idk. I’ve had it tested three times within the last year, twice at my audiologist’s and once at this random hearing aid booth at the fair, and all three came back with very similar audiogram results, so I know it’s most likely an accurate audiogram… Anyway… Speaking of which, is my loss mild or moderate? Mildly moderate? Moderately mild? Just mild because of the normally-hearing frequencies? Seriously, it’s literally RIGHT on the border….
Final question, just a request for a suggestion, do you think I’d benefit more from hearing aids or from an FM system? My ENT put “HA trial after medically cleared” on both my recent audiograms… I want to try hearing aids, but I’m not completely sure whether or not I need them since I understand most of the time (though I’ll admit I haven’t really spent an extended period of time outside of family settings, and HA’s would have been really nice to have when I was at this one friend’s house where literally the entire family have soft voices), and I’ve heard that they don’t always work for reverse-slope loss, which is mainly what I have.
Sorry this is so long, I tend to write a book when I ask questions… Have a great day!
Sincerely,
E
Hi Elissa:
The SRT for a person with normal hearing approximates the average of their hearing level at 500, 1000 and 2000 Hz using pure tone testing. Thus it can range from a high of -10 dB down to 25 dB (which is the bottom end of normal hearing).
You have a mild reverse cookie-bite loss (you hear better in the mid frequencies than you do in the lows and the highs). It gets its name because the line on your audiogram looks like a person took a bite out of the bottom of a cookie.
You are right. It quiet situations you function quite well, but as the background noise increases, you have more and more trouble understanding speech.
Distance is a factor too. Since you have your worst hearing in the high frequencies, and since high-frequency sounds have little energy they don’t travel far though air. Thus, the further you are from a speaker the fewer (or no) high-frequency sound you hear. Unfortunately, it is these high-frequency sounds that you no longer hear (or hear well) that give speech most of its intelligibility. Thus you can hear people talking, but don’t understand what they are saying.
To compensate for this, you have to get close to the speaker and be in a relatively quiet situation.
One reason you hear speech better than your audiogram says you should is that we talk in sentences. Sentences have both a predictable pattern and lots of redundancy. Thus your brain can figure out a lot of what you miss.
That is why they give you the word recognition (discrimination) test where you only have single-syllable words where you can’t gain meaning from other syllables or any context since there is no context. Thus, you should be able to understand speech better than your word recognition scores indicate.
To calculate your average hearing loss take the results at 500, 1000, 2000 and 3000 Hz and average them. Yours come out at 30 dB in each ear. The classification of hearing averages between 26 and 40 dB is “mild”. So officially, you have a mild hearing loss.
Hearing aids work best in quiet situations where you are close to the speaker. As the distance increases and/or the background noise increases, hearing aids become less and less useful. That is where you want to switch over to an FM system or other assistive device. Of course, if you combine your hearing aids with the assistive device you have an awesome combination–for example using an FM system and coupling it to your hearing aids via t-coils, or built-in FM receivers.
Your right ear is more reverse-slope (or sort of reverse cookie-bite, but you left ear is definitely reverse cookie-bite.
Hearing aids will help you in some situations and not in others. Thus, I say wear them when they help you and take them off when they don’t, and use assistive devices when they help you more han your hearing aids do, and when your hearing aids work better, don’t use the ALDs.
As you can see, there is not one simple answer.It is up to you to find what works best for you in any given situation.
Cordially,
Neil
Dear Sir,
I have 12 dB threshold for my right ear whereas it is 48 dB for the left ear. Doctor says that it is the case of Retracted eardrum in my left ear.
I want to know if the retracted eardrum is curable completely.
Do i have any sort of so called deafness?
Hi Abhijeet:
A 48 dB threshold is another way of saying you have a 48 dB hearing loss which is considered to be a moderate hearing loss. So yes, you have a moderate degree of deafness (or hearing loss) in that ear.
Typically, a retracted ear drum is the result of your Eustachian tube not working properly or your middle ear and/or Eustachian tube is clogged up or blocked.
If you have a cold and mucus gets sucked up your Eustachian tube and blocks air from getting into your middle ear, that could cause the retraction. Typically things will revert to normal when the cold goes away and the gunk in your middle ear and Eustachian tube finally drains out. That could take another two months, so it may not be right away.
If your Eustachian tube is not working properly, it could be that the nerve that controls it (the trigeminal nerve) is pinched. A visit to an upper cervical chiropractor can fix that.
Cordially,
Neil
Thank You very much for your kind reply sir.
Thinking of adopting a 6 year old child who has hearing loss of ABR 70 in one ear and ABR 80 db in the other ear. This child is from China so she can’t be seen until adoption. Do you think hearing aids would greatly help her hearing? Thanks!
Hi Susan:
My hearing is in that range and hearing aids sure help me so I don’t see any reason why they shouldn’t help her too. It won’t be perfect hearing by any means, so she and you will have to also practice good hearing loss coping skills. If hearing aids won’t help her, then consider getting her cochlear implants.
I wish you well on your adoption.
Cordially,
Neil
My son just came from school and they underwent a Hearing test. His right ear is circled at 1000/20dB. What does it mean. Please advice
Hi Ruth:
This just means he has a hearing loss of 20 dB at 1000 Hz. This is considered a mild hearing loss at that frequency. If this is all the hearing loss he has at this point, it’s nothing to worry about.
Cordially,
Neil
Could you please explain this uk audiogram please?
R – BCL 38 HTL 62
L- BCL 33 HTL 58
Also tympanom analyser
Test 1 ytm 226hrtz
0.6 and reflex 1000Hz NR
Test 2 ytm 226hrtz 0.6
Reflex 1000hrtz Yes
My HL has got worse since this testing. It is now mixed bilateral moderate to profound.
MRI scan for mastoid temporal bone was normal, eustachion / nose endoscope was normal.
Could maternal rubella in vitro be the cause of my hl problems and is it likely the cochlea / cranial nerves are damaged?
I have been offered a bone anchored hearing aid would this devise help me better with speech intellligibility? My ENT consultant said to trial it first, but wouldn’t a cochlea implant be a better option if the cochlea/ cranial nerves are damaged?
Thank you.
Hi Laura:
BCL is the abbreviation for bone conduction level–the softest sound you can hear via bone conduction testing for that frequency.
HTL is the abbreviation for hearing threshold level–the softest sound you can hear at that test frequency.
You have both a middle ear hearing loss (conductive) and an inner ear (sensorineural) hearing loss. When you have both kinds of hearing loss, it is called a mixed hearing loss.
Maternal rubella is definitely a cause of hearing loss. There’s no doubt about that. There is also no doubt that the nerve endings in your cochlea are damaged. Actually, a number of them are dead. Sometimes doctors call this nerve deafness. But that is really a misnomer. The auditory nerve is not dead. It’s the endings of the nerve in the cochlea that die. That’s why you have the sensorineural hearing loss.
Bone-anchored hearing aids is typically best for people with a conductive loss. They are less useful for people with more severe sensorineural losses like you have.
If you are so inclined, you can try out a bone-anchored hearing aid and compare it to the results you get with a conventional hearing aid. Whichever one works better is the way to go. However, remember that your sensorineural hearing is getting worse and therefore a bone-anchored hearing aid will be less and less useful in the future.
Cordially,
Neil
Great article. Very informative and great launching point for me in my “where to start” point in terms of my hearing goes.
I do have a couple quick questions. First let me get my audiogram results out of the way so you get the info. This audiogram was performed July of 2016.
History of TBI due to repeated concussions and head trauma (physical abuse). I am 44. I had PE tubes put in after the audiogram in hopes it would help with the hearing loss. It didn’t. I still have issues following along in conversations; especially when the speaker is on my right. As well, on the phone I have issues and I must have the CC turned on the TV or the volume turned up loud to at least 18 to 20.
Report states:
“Hearing test is consistence with a moderate to moderately severe conductive hearing loss AD with mixed component at 2000 Hz and a mild to moderate mixed hearing loss AS.”
Right
250 – 60 db
500 – 60 db
1K – 70 db
2K – 60db
3K – 60db
4K – 70db
6K – 70db
8 K – 60db
Left
250 – 45db
500 – 45db
1k – 50k
2K – 50K
3K – 50K
4K – 60K
6K – 50K
8K – 60K
Speech Recognition/Discrimination
Left
Test – SRT – 45db
Test – WRS – 100%- 85db
Right
Test – SRT – 55db
Test – 100% – 95db
Stimulus Right
NR for all
Stimulus Left
(Ipsilateral) dB HL 500-NR, 1000 – 95, 2000 -NR
My questions (I will try to make it brief as I have been told I am much like a politician trying to bid for office and lengthy)
1) Given the information (e.g. audiogram, Speech Recognition/discrimination, age, etc), would a hearing aid for at least the worst of the two ears be considerable option for me? Or should I get a second audiogram to update the results to see if there are any changes since the last?
2) Do the test results for the speech recognition vary by age? What do those numbers mean? I was only told “you have hearing loss.” My ENT has since retired so I must find a new doctor. He was hard of hearing himself.
3) Overall, is this too bad? As well, is this something that I would put on my list of medical issues for a SSDI claim along with other issues? (I would not rely on this as a stand along issue as I don’t think would be a standalone issue even though it is a pain in the hind end to not understand what people say and lean in to hear people).
Thank you in advance for you time.
Hi Nikol:
You have a moderate to moderately-severe hearing loss. The good news is that even though you have a significant hearing loss, your discrimination scores are 100%. That means the when speech is loud enough for you to hear, you understand it 100%.
thus you are a good candidate for wearing hearing aids and should have good success wearing them. You actually need two hearing aids, one in each ear for best results.
Your speech discrimination (or word recognition as it is sometimes called) vary mostly with the kind of hearing loss and the degree of hearing loss you have rather than with age. however, as you age you typically lose your higher frequencies. When this happens, you will find your speech discrimination scores typically dropping.
You have what is called a flat loss which is very easy to fit hearing aids to.
You are correct that your degree of hearing loss would not normally be a factor in an SSDI claim. Since you have other health issues, it might not hurt to put it in, but I don’t know that it would make any difference in the outcome.
I think you’ll find that getting to hearing aids will really make a difference in how well you understand people. At the very least, try some out and see how they work for you. I think you’ll be pleased at how well you will hear then.
Cordially,
Neil
respecetd sir
my left ear is in mild hearing loss range and right ear with severe hearing loss.Am i comes in HH category??if yes,what is the % of HH .???
Hi Virendra:
Yes, you have a hearing loss, so you are hard of hearing. Whether you have a mild loss like you have in your one year, or severe loss like you have in your other ear, either way, you are hard of hearing.
You can’t calculate hearing loss in percentage. What you can calculate is the percent disability you have because of a given degree of hearing loss. However, you have not given me enough information to be able to do that.
Cordially,
Neil
Hello doctor,I recently had a hearing test..in the report ,I am having a right ear 23db and left ear 37db…iam of age 23..this loss can be curable or permanent?
Hi Boopathy:
You haven’t given me near enough information for me to answer your question. For example, is your hearing loss due to exposing your ears to loud sounds? Was it caused from taking one of the various drugs that can cause hearing loss? Is your hearing loss hereditary?
Also, those figures of 23 dB and 37 dB, is that the average hearing loss for those ears? It would be much better to tell me your actual hearing loss by frequency as shown on your audiogram.
When did this hearing loss happen?
Cordially,
Neil
For the past one month I am facing hearing loss doctor
Also in the report they mentioned high-frequency mild to severe hearing loss with mixed components
I have had several hearing tests this year. On one of the test results are several scores that I do not understand. Under a column listed as Speech are the following numerical scores.
Right Left
SRT 30 30
PBQ 92% 100%
PS Level 70 70
I understand the audiogram.
Thank you in advance.
Hi John:
SRT stands for Speech Reception Threshold. This is the softest volume of speech where you can just identify half the of words correctly. This is the test where you repeat the spondee words (words with equal stress on each syllable) such as railroad, hotdog, cowboy, ice-cream, etc. Your SRT level is 30 dB.
PB stands for Phonetically Balanced discrimination or word recognition test. This is the test where the volume is set at your most comfortable level (MCL) and you repeat a series of single syllable words that cover all the speech sounds in the English language. Typically, this is a list of 25 words. Your score is expressed as a percentage. In your case, your right ear missed two words (leaving you with a discrimination score of 92% and your left ear got them all right.
The discrimination testing was done at a level of 70 dB in each ear.
Cordially,
Neil
Hello Dr. Bauman.
First, thank you for very clearly explaining why percentages are meangingless and are often misinterpreted by the general public. You much more eloquently articulated what I, as not a doctor, have not been able to when working with clients in my job. I do, however, have a question for you. I have a bilateral profound hearing loss at low and high frequency , with a severe loss in both ears at the mid range. My question is that I use a ComPilot with my hearing aids in order to further amplify sounds to a level that I can work with and to also isolate noise. I’m also totally blind, so it’s important for me to get the most out of my residual hearing. Anyway, my question is, could my using the ComPilot for 12 hours a day further destroy my hearing? Thank you again for the article, and for sharing your medical expertise on this board!
Hi Scott:
Since you run your ComPilot through your hearing aids, theoretically, it should not harm your residual hearing. That’s assuming, of course, that your hearing aids are set to limit loud sounds to below dangerous levels.
However, when you have a profound loss, you need to amplify sounds to dangerous levels just to be able to hear. So I think that these loud levels can, over time, damage your residual hearing. However, what’s the alternative? Not hear? What I do is a combination of both. When I talk to people I need the volume so I can understand them. And that can be too loud for my ears health. So what I do is I don’t wear my hearing aids much. That way, my ears have lots of rest so their accumulated noise exposure each day is kept to a minimum. Remember, it is volume times time that is important. So limit the time you have to hear at “full volume”. When it is quiet around you, of course your hearing aids are not going to be blasting your ears so you are ok then.
In your case, since you are blind, you can’t use your eyes for your ears like I can. Thus, you have to wear your hearing aids to be aware of what is going on around you. That’s just the way it is.
But even if over time you do lose more residual hearing, Plan B is that you could get cochlear implants and hopefully hear again.
Cordially,
Neil
Sir,
My child, age 12 month, baby boy has development delay and found hearing loss in BERA test. BERA test shows profound hearing loss, means child is not able to hear at 90db in both year but Doctor suggest me for ASSR test which shows that child can hear at 70db in left ear and 80db in right ear. Now I am confuse that which hearing aid to use, can hearing aid help to my child. I have not buy the hearing aid yet but want to buy very soon, your advice will help me alot. What is the meaning of BERA and ASSR test, why the difference in these two test?
Hi Sunny:
BERA stands for Brainstem Evoked Response Audiometry. Another common name is ABR (Auditory Brainstem Response). It uses a series of clicks at slow speeds to evoke brainstem responses.
ASSR stands for Auditory Steady-State Response. It uses a series of repeated sounds at high repetition rates.
Both record bioelectric activity from electrodes arranged in similar recording arrays. In both, the output is auditory evoked potentials.
With BERA, results are subjectively interpreted by the person doing the testing. In contrast, ASSR uses sophisticated statistical modeling to come up with the results.
BERA is good for mild-moderate-severe hearing loss. ASSR is good for severe-profound losses.
So, putting this all together, since your child likely has a severe-profound hearing loss, the ASSR results should be more accurate.
Either way, your child has a very significant hearing loss. It is possible that hearing aids will help him, but at the same time, he may have much better results if he gets cochlear implants.
Before I’d rush out and buy hearing aids, I’d have him evaluated for cochlear implants and then make your decision.
Cordially,
Neil
Sir .
May I know what is Hard Of Hearing …?
Any measures for this .?!
Hi Varala:
Hard of hearing is just a term to describe people with some degree of hearing loss.
Hearing loss is divided into several classes, depending on the severity of the loss. These classes range from slight to mild, to moderate, to moderately-severe, to severe to profound and finally deaf.
Here is how they are defined.
-10 to 15 dB Normal Hearing
16 to 25 dB Minimal (slight) Hearing Loss
26 to 40 dB Mild Hearing Loss
41 to 55 dB Moderate Hearing Loss
56 to 70 dB Moderately Severe Hearing Loss
71 to 90 dB Severe Hearing Loss
91 + dB Profound Hearing Loss
Cordially,
Neil
have a nice day sir
i am from pakistan .my daughter reports show profound degree hearing loss up to 100 db .
i contect many docters but thay dont satisfay me .what can i do plz help me and reply me as soon as possible .bundle of thanks
Hi Arslan:
If your daughter has a hearing loss around 100 dB, then hearing aids probably won’t help her much if at all. I’d suggest you consider getting her cochlear implants. With that degree of hearing loss there is probably nothing doctors can do to help her apart from cochlear implants.
Cordially,
Neil
Greets!
Up until just very recently, I often spoke of my hearing loss in a percentage without realizing how erroneous that is. Thanks for this article explaining why!
I was hoping you could help clarify/confirm what type of hearing loss I have and at what level. A brief history: I’ve always had some level of hearing loss and began wearing hearing aids at age 8-9 when it was becoming super noticeable to my parents (I was incredibly shy, so they thought my quietness was due to that, not that I couldn’t hear). The most I know is that my ENT specialist couldn’t determine the cause, although I did have an illness that resulted in nerve damage and temporary partial paralysis in my face which may have had an impact on my hearing (?). I’ve had tinnitus for as long as I can remember, from moderate to quite severe that it becomes debilitating and I have a history of chronic ear infections as a child with a handful of significant infections as an adult. The hearing loss was most severe in the higher frequencies for both ears, but my left ear was overall worse than my right for most of my life. I wore hearing aids in both ears up until my early 20’s. I couldn’t afford hearing aids from ages 23 to 38 so did best I could with lip/speech reading and cupping my ears to help direct/amplify sound. I felt my hearing fluctuated, with my right ear always being my good ear to hear with until another illness a few ears ago wiped out the hearing in that ear completely and I am now profoundly deaf on the right side. Again, ENT specialist and an MRI couldn’t determine what damage was caused. I have had a Bi-CROS system for the past 5 years that is due to be replaced soon. I typically find hearing aids do not help now at age 43 as much as they did when I was younger – amplification doesn’t do much for clarification and most people get frustrated thinking I should be able to understand because I have a hearing device.
Here is my most recent audiogram for my Left Ear (right not tested ‘dead ear’), as best as I can read it as it’s a bit messy:
Bone Conduction
250Hz @ 30dB HL
500Hz @ 40dB HL
1000Hz @ 45dB HL
2000Hz @ 55dB HL
3000Hz @ 80dB HL
4000Hz @ 75dB HL
Air Conduction
250Hz @ 55dB HL
500Hz @ 55dB HL
1000Hz @ 60dB HL
2000Hz @ 65dB HL
3000Hz @ 85dB HL
4000Hz @ 90dB HL
6000Hz @ 100dB HL
8000Hz @ 95dB HL (with arrow pointing down)
My word recognition score was 72% @ 90dB.
My MCL was 85 and my UCL was 100+.
Audiologist Note: 5-10dB decrease overall (from last test I assume)
So, it seems to me that there is a difference of 15dB between bone and air conduction tests at the lower frequencies, but as the frequencies get higher they become closer together as they both slope down to the right. I have no clue what exactly that means. What would you classify my overall hearing at? Obviously, my right ear is profoundly deaf but my left would be moderately-severe to profound at high frequencies? How is the overall classified with such a slope? Also, at what level can the term ‘deaf’ be used in your opinion? Finally, what specific conclusions can be made from the speech audiometry that was performed (I’m not sure why the SRT part was not done at this testing, but I do recall typically becoming frustrated and not doing well in the past).
Thanks in advance for any feedback you might be able to give! Clearly, I’m looking forward to a continual decline to my hearing so any suggestions for coping with this fact and/or the tinnitus is appreciated.
Hi Bonita:
I was the same as you–very shy because of my severe hearing loss. I’m actually quite an outgoing person, but when I am in a situation where I can’t hear, I act shy and basically don’t speak (or else people will think I can hear since my speech is normal).
You have what is called a mixed loss since you have both a conductive (middle ear) component and a sensorineural (inner ear) component to your hearing loss. The separation between your bone conduction (conductive) and air conduction (sensorineural) readings is know as the air-bone gap. As you know it is more or less (depending on the frequency) about 15 dB.
You can classify your hearing loss as a “ski-slope” loss or high-frequency loss ranging from moderate (or moderately-severe since you are right on the 55 dB boundary that separates them) to profound. If you want a single word to describe your hearing, you calculate it by taking your hearing at 500 Hz, 1K, 2K and 4KHz. These figures in your case are 55, 60, 65 & 90. The average of these is 67.5 dB which falls into the range of moderately-severe (56-70 dB).
Thus, you can say you have a moderately-severe hearing loss, or more accurately you could say you have a sloping moderately-severe to profound mixed hearing loss.
“Deaf” is normally defined as hearing below 90 dB. However, if you can’t hear a person speaking to you from 3 or 4 feet away, you could say you are functionally deaf. This is the term I use for my own hearing as I can’t even understand a person from that far away without my hearing aids.
Under ideal conditions, you only understand 72% of what you hear. And since you are seldom in ideal listening conditions (silent room with person speaking at 85 dB–your most comfortable listening level) your speech comprehension will be less than that.
Since speech discrimination testing is done using single-syllable words, and since English is often composed of two or more syllables, you can often figure out the word if you hear one or two of the syllables. Furthermore, English sentences have structure and redundancy built in. Thus, often you can understand speech better than your word recognition score would indicate. But in noisy situations, you won’t even get that much.
As your hearing declines, you’ll need a more powerful hearing aid. When your hearing aid no longer significantly helps you, its time to consider getting cochlear implants.
If your tinnitus is bothering you, you will find a wealth of information on how to take control of it in my book “Take Control of Your Tinnitus”–particularly chapter 16. In your case, as is in mine, I have tinnitus 24/7, but I do not let my tinnitus bother me even though it is there. You can learn to do the same.
Cordially,
Neil
I left ear total deafness profound but 40 DB hearing level in right ear severe please guide me i know hard of hearing disabled person or no
Hi Laxmansing:
If you have 40 dB hearing loss in your right ear, you have a mild to moderate hearing loss. That means you will have some difficulty in understanding speech, particularly in noisy situations. But that does not mean you are disabled, as such. You can still communicate. Getting a hearing aid will make things easier for you.
Cordially,
Neil
Hi doctor,
I having query regarding my 2.5 yrs old son. He is not speaking meaningful words so doctor suggested for BERA test . When we visited doctor said he could make out that my son is listening without doing BERA test so he asked not to do it. Now again I visited child specialist he asked about BERA test. What’s your advice. Please share.thanks.
Hi Vineet:
You can crudely test your child’s hearing yourself. Stand behind him at varying distances and speak to him and see if he turns around or responds to you. If he doesn’t, you know he has a pretty significant hearing loss. That’s how my dad discovered I had a severe hearing loss.
If he responds (appears to be listening) that doesn’t mean he understands what he is hearing–just that he is hearing something. The sounds may have to be louder before he can understand speech.
If you clap your hands or slam a door or bang on pots and pans and there is no response, you know he has a very significant loss.
The BERA test is not harmful or invasive, so I can’t see why your doctor doesn’t think one is necessary. It will give a very good indication of your child’s hearing loss. If I were you, I’d go for it–especially if the above tests show your son isn’t hearing normally.
Cordially,
Neil
sir,
my left ear disability is 64% approved by doctor and right ear is fine.i can get disability certificate in india. in our tax document it mention that (permanent deafness with hearing impairment of 71 decibels and above? ), what is the meaning of this, plz ans me….
Hi Er:
It means that your hearing loss average at 500, 1000, 2000 and 4000 Hz must be greater than 71 dB. You can get these figures off your audiogram.
Cordially,
Neil
hi Doctor.
my PTA report is
Right ear
-125 = 60db
250 =50db
500 =50db
1k =45db
2k =35db
4k =75db
8k =65k
left ear:
-125 =55db
250 =50db
500 =50db
1k =60db
2k =45db
4k =30db
8k =35db
sir it is permanent or recovery is possible please help me.
average loss in db of left ear is 46.5 and right ear average db is 55.. what is the percentage and recovery is possible and what should i do now??
and doctor told me that your hear is internally damage,, the connection between mind and sound signal i.e nerve problem so recovery is not possible and your hearing loss is permanent.. what you say??
Hi Mir:
Your average hearing loss is 46 dB in your right ear and 52 dB in your left ear.
Based on the results of your audiogram, you have a 33% hearing disability. This just means that given the degree of your hearing loss, you would expect to earn 33% less in wages than a person with normal hearing.
You haven’t told me anything about your hearing loss–what caused it, etc. Therefore, I can only guess that you have a sensorineural (inner ear) hearing loss from what you say your doctor said.
Typically, such hearing losses are permanent as your doctor told you. Thus, you need to learn how to live successfully as a hard of hearing person.
If I were you, I’d get hearing aids and use them in hearing situations where they help you. In situations where there is too much noise so they don’t help you, just take them off. That is what I do.
Cordially,
Neil
Hi Doctor,
I just got back from Audiometry tests.Left Ear-68 DBHL Right Ear-68 DB.HL
Although 7 years back my tests results were :
Left Ear:60 Db
Right Ear: 55 DB
I have had this hearing problem since birth
I have some confusion regarding this and hope you clear my head regarding this
1.) During Audiometry Test, i had cold and throat infection. Will this affect the test results. And also i believe its not very accurate considering the huge deviation.
So I m planing to take the test again sometime in future
2.) However If i take again, and assume that results again shows like 7 years back, say my better ear has 55 DBHL. Could i apply for Disability certificate. Here the law states that in order to get certificate, you need to be have 40 % or above hearing impairment.
But to be considered as hearing impaired, you need to have above 60 DBHL. I find this realy confusing
Here is the link stating the law
Could you please take pains to help me out :
http://www.ncpedp.org/sites/all/themes/marinelli/documents/Rights%20of%20Persons%20with%20Disabilities%20(RPWD)%20Act%202016.pdf
Hi Doctor,
Just came back from Audiometry tests:
Left Ear: 68DBHL
Right Ear:68DBHL
However 7 years ago, the test results were as follows:
Left Ear: 60 DBHL
Right Ear: 55 DBHL
I m planning to take the test again since i feel this is not accurate considering there was a huge deviation from 7 years ago. However there are couple of things which i want to clear out with you
1.) When the test was taken, I had mild cold and throat infection. So will this affect the test result ?
2.) According to the law here, in order to avail disability certificate, you need to have 40 % percent impariment in the better ear.
But to be considered as hearing impaired, you need to have 60 DBHL or more. I find this really confusing.(40 % or 60 DBHL) After I retake the test from the qualified authority,assume that the Better ear has 55 DBHL , am i eligible ?
They have even classified percentage with DBHL. Would you please take pains to follow this link: http://www.rehabcouncil.nic.in/writereaddata/hi.pdf
I really hope to get reply from you. Please help me out.
Thanking you for the same 🙂
Hi Sanjay:
Since you have a 68 dB loss in both ears, you qualify as being classified as being hard of hearing for the purposes of your laws. It says this “equates to a 40% hearing impairment” which means you’d qualify for a 40% “pension” or stipend.
BUT it also states that for this to happen you ALSO need to have a speech discrimination score of between 40 and 50 percent in your better ear. You haven’t mentioned what your speech discrimination scores are. You need to find these figures on your audiogram. Sometimes they are called “word recognition”. They are the only figures on your audiogram that are expressed in percentages. The rest are all in decibels (dB).
So if your speech discrimination in your better ear is 50% or greater, then you’d qualify.
Cordially,
Neil
Thanks a lot Doc !
Thats the problem here. We dont do speech discrimination here. Just get done over with Audiometry.
Also, could you please clarify whether having cold/throat infection may affect my Audiometry test result?
Since there is a huge deviation from it from the previous test result
Hi Sanjay:
If you don’t do speech discrimination, why does your law require it for a Disability Certificate? You haven’t had a proper hearing evaluation if they don’t test your speech discrimination.
Yes, a cold could make your results look worse than they really are when you don’t have a cold.
Cordially,
Neil
Hello,
My Son 18 months old has done BERA test and Result says
“Independent Simulation of Right and Left Ears at 105dbnHL with altenative Clicks, Using Ear Buds, No Consistent Potential are noted despite several Clicks.
Threshold studies not possible, Technical Factors were excluded “.
Can you please guide us on below points:
1. Can BERA test Results be wrong , should we try for retest.
2. Is there any other Test required which would help to clear out things that the problem is in Inner Ear or something else.
3. Can mentioned result be due to Swelling / Wax or any other reason.
4. Is Cochlear Implant only solution or is the same can be treated with Medicines or any other solution.
Please guide me.
Request you help for the same
Regards,
Hi Dev:
Yes, any test can be wrong for any number of reasons. If you don’t think the test is consistent with what your son can hear, by all means get him retested at some other facility. If both test results are similar, then that’s a sure sign that they were pretty accurate.
There are lots of other tests, but they require the child to be old enough to respond accurately. That’s the beauty of the BERA test, it doesn’t require any input from the child.
If your son has a profound hearing loss, or is deaf, then, in my opinion, cochlear implants are the only viable alternative at this time.
Cordially,
Neil
Hi, Dr Bauman,
I was unable to hear properly from my left ear & my reports of both the ears from audiologist was like this.
Report comments:
Puretone average [in dbHL]
Rt: 45 dbHL moderate conductive hearing loss.
Lt: 60 dbHL moderately severe conductive hearing loss.
Bilateral ” As type tympnogram with reflexes absent suggestive of middle ear pathology.
Please tell that what should i do , will it get clear by operation of ears or any other help that you can suggest.
Regards
Hi Hitesh:
Since you have a conductive hearing loss, and since conductive hearing losses can often be fixed medically, you should see an ear specialist and see what he thinks. If you have a condition called otosclerosis, often they can use a prosthetic device to replace the stapes bone in your middle ear that let you hear normally again. Sometimes this seems to last forever, but other times the auto sclerosis continues and the device works less and less well after a few years and may have to be replaced again.
Cordially,
Neil
left ear
250 k 40 db
500 k 50 db
1k 50 db
2k 45 db
4k 35db
right ear
250k 30 db
500k 35db
1k 30 db
2k 20 db
4k 20 db
8k 30 db
is it otosclerosis
Hi Tillotma:
There is no way I can tell whether you have otosclerosis based on what you have given me. I’d need to know the results of bone conduction testing as well as the air conduction testing which I assume you sent. And seeing what your tympanogram looks like wouldn’t hurt either.
What makes you think you have otosclerosis?
Cordially,
Neil
Cordially,
Neil
Hi Doctor,
My younger brother almost loss his hearing power as per doctor recommendation 70% in left ear and 80% in right is any medicine helpful for him i.e. please recommend a machine name which is cheaper and better for his hearing power. Thank you
Hi Rajanish:
Typically, no medicine will bring hearing back if the loss is an inner ear (sensorineural) hearing loss.
He needs to go to an audiologist to have his hearing evaluated. The audiologist can suggest a good hearing aid for him.
Cordially,
Neil
Dear Dr.
I have 60 db (Right) and 63 db (Left) ear can i eligible for get Hearing Disability Certificate in India
And also I have One Disability Certificate Issue on year 1992 as given 70 db by the Ali Yavar Jung National Institute, Ministry of Social Justice and Empowerment, Government of India This Certificate eligible for Government Facility and Scheme
Hi Chandrakant:
I don’t keep up with the requirements for other countries. It is always better to go to the government department in your country and ask them directly. They are the ones that know the latest requirements, and you have to go there in apply anyway–so do it now and find out.
Cordially,
Neil
Dear Sir,
My father has one ear 0% hearing as he has to go one ear operation where his ear bone was removed because of a lot of pus. I think the operation was for mastoiditis treatment.
Other ear has 70-80 dBi hearing.
What do you suggest for him ?
Hi Rais:
If he has zero hearing in one ear and a 70 to 80 dB loss in the other, he’s not hearing much. At the very least he should be wearing a hearing aid in his better ear. Even better, he might find a Bi-CROS aid will help him more as it will also pick up the sounds from the deaf side of his head and send it to the hearing side.
Depending on his word recognition score (discrimination), he may be eligible for a cochlear implant instead of a hearing aid.
What did his audiologist recommend?
Cordially,
Neil
Hello sir I am I’m writing this on behalf of my mother she is 46 year old. She had hearing impairment 4 years back and we went to hospital and they side she has problem with her nerve. They put a tube in her ear and passed some liquid. It did not work. Gradually she became complete Def. now she can’t hear anything. and we also tried some hearing AIDS but those wear low quality ones and did not work. That was two year back. So my question is if I could buy her an excellent quality Hearing Aid whether will she be able to hear even if she can’t hear anything at present?
Pardon me if my question was a stupid one. I can afford to buy a good hearing aid now. But will it work for a person who can’t hear anything at present?
Hi Ratheesh:
Most people don’t go totally deaf–although they may think so. They actually have some degree of residual hearing. If your mom has enough residual hearing, then a hearing aid that has enough power may work for her. The only way to know is to have her hearing tested and then see what the results show on the audiogram. If you send me a copy of her audiogram, I should be able to tell you whether she has a good chance of hearing with a hearing aid or not.
I don’t hear much at all without my hearing aids, and with them in quiet situations, I hear quite well. So they can work well in certain situations.
But the degree of hearing loss is only half the equation. The other half is her speech discrimination. If her word recognition (WR) or speech discrimination (SD) scores–they use either term–are low, then hearing aids will just make sounds louder–but what she will hear is just a bunch of gibberish. In that case, getting hearing aids is largely a waste of money.
In that case, basically the only solution is for her to get a cochlear implant. (I’m assuming that her hearing loss is all inner-ear loss (sensorineural) rather that conductive loss.)
Cordially,
Neil
I have 42% hearing loss what it meaning and how hv i convert this percentage into db
Hi Vinu:
As this article points out, you CANNOT have a 42% (or any other percent) hearing loss. Hearing loss is measured in decibels (dB), not percentages. To know your hearing loss in decibels, get a copy of your audiogram. It will show you your hearing loss by frequency in decibels. From that you can calculate your average hearing loss in decibels.
Cordially,
Neil
Hi sir
Before 8 years doctors did Modified radical mastoidectomy with tympanoplasty in my left year, and later in another hospital i had the surgery of Cortical mastoidectomy with type 1 tympanoplasty in right year, after few years and right now also my audiometry report shows that i have mild conductive hearing loss . can it be cured permanently . when i consulted a doctor before few days he said , both ears should be operated again to bring back the hearing ability ..
Sir
my audiometer report is left ear 120db and right ear 45 db . may I regarded a hearing impaired in india?
Hi Milan:
As I understand it, before you are eligible for a Disability Certificate, the hearing loss in your BETTER ear has to be greater than 60 dB–that’s not the worse loss at any frequency, but the average of the loss at the frequencies of 500, 1,000, 2,000 and 4,000 Hz.
Cordially,
Neil
My hearing level in Right ear 35 db and Left ear 120 db, and my hearing loses is birthly , So may I selected as a hearing handicaped certificate ?
Hi Samsujjahan:
As I understand it, before you are eligible for a Disability Certificate, the hearing loss in your BETTER ear has to be greater than 60 dB–that’s not the worse loss at any frequency, but the average of the loss at the frequencies of 500, 1,000, 2,000 and 4,000 Hz. Since your hearing loss is only 35 dB, I don’t think you are eligible, but you should check with officials in your area to be sure.
Cordially,
Neil
Hello Sir,
My right ear having greater than 120 db and my left ear having 113.33 db hearing loss. I would like to know that how much percentage of disability I have??? What should I do at this stage?? I can’t afford the cost of coehar implant….
Lastly…wants to know that if someone do coehar implant ….he would consider as hearing handicapped or normal human???? Please suggest
Dear sir, Medical Board has given me 45% hearing impairement disability but I have 120db hearing loss in my right ear and 113.33db hearing loss in left ear. What’s does it mean….I couldn’t understand between 45% of disability and db hearing loss scale. Is it valid to get pension which is being more than 40%?????
Hi Bittu:
As I understand it, before you are eligible for a Disability Certificate, the hearing loss in your BETTER ear has to be greater than 60 dB–that’s not the worse loss at any frequency, but the average of the loss at the frequencies of 500, 1,000, 2,000 and 4,000 Hz.
So are the 120 dB and 113 dB you’re worst hearing at any frequency, or is it the average of the 4 above frequencies? If it’s the worst frequency, then I can understand why you get a 45% disability, but if its the average for each of your ears, then you should be getting 100% disability–that’s just based on your hearing loss. The other factor they consider is your speech discrimination. If you have a severe hearing loss, but relatively good speech discrimination, then the % disability will be reduced.
Ask them for an explanation and if you don’t understand it, tell me what they said.
Cordially,
Neil
Thanks for your valuable suggestion. Sir , Doctor advised me to go for cochlear implant….I would like to know that is implant patient would also consider as handicapped category or he will be cure with having same category????
Hi Bittu:
I don’t really know. You need to ask the appropriate officials in your area about that. However, my gut feeling is that for those that wear hearing aids, their disability status is tested without wearing their hearing aids, so I’d think the same would apply to those with cochlear implants.
Cordially,
Neil
So which type of hearing aid you recommended in my case??? Your suggestion is important to me
Hi Bittu:
I think you meant to say cochlear implant rather than hearing aids, correct?
Since they are all good, you need to focus on three things. First, which brand has the features you want? Second, who is the best CI surgeon in your area and what CIs does he regularly implant. You want a surgeon that is very familiar with the implant you want to use. Third, what implants is the audiologist that is going to do all the adjusting (mapping) familiar with? You want an audiologist reasonably close to you as you will be going there quite a few times in the first year and then less often later.
Questions two and three are the most important. Then if you still have a choice of two or more brands, decide on the features you would most like to have.
Cordially,
Neil
Sir can u please give formula and examples for for conversion of intensity level to pressure level and also adding of 2same spls and ILs
Hello Sir, My 11 year old daughter has sensorineural hearing loss. She wears hearing aides since 10 months old. She had mild loss in left ear and moderate in right ear. She always had the same hearing until August of 2015 when she was 8 years old. Her hearing test showed her hearing changed from 10 dcb to 20 dcb worst in her right ear. We found out that she had lyme disease. Do you think that her hearing got worst because she got lyme disease? Also, my audiologist said that when there is a sudden decrease in hearing loss you have a two week window to try and get it back with steroids. Is that true? Also, is it normal for hearing to get worst over time with sensorineural hearing loss? Thank you for your expertise and time.
Marie
Hi Marie:
Lyme disease can certainly cause hearing loss. So that is one possibility–but I have no way of telling whether it is the most likely cause in your daughter’s case.
Your audiologist is basically correct. Steroids, if they are going to work (and they do not always work) do best if given as soon as possible after sudden hearing loss occurs within a day or two is ideal. However, steroids still can work effectively in the first two weeks or more, but as the time between the hearing loss and the first steroid taken increases, the less effective steroids become. After 30 days, I personally think steroids are basically useless.
Depending on the cause, sensorineural hearing losses may get worse or may stay the same for decades. For example, my hereditary hearing loss got worse and worse for the first few years of my life (from birth to about 6 or 7 years old), then stayed the same for the next 40 or so years, then progressed as I got older (what they call presbycusis). Other kinds of sensorineural hearing loss continue to progressively get worse as time goes by. Again, I have no way of telling what will happen in your daughter’s case.
Cordially,
Neil
Hello sir, My counsin have hearing problem almost level is reached upto 60Decibals is their any treatment to recover it.Please help me.
Hi Manish:
You haven’t given me any information about your cousin’s hearing loss so I can’t help you. Your cousin needs to see an audiologist and ear doctor to discover the cause of the hearing loss and how bad it is.
Cordially,
Neil
I am a little confused on this Db loss, is higher # good or bad? So I will give you my test results if you don’t mind: L ear 500Hz-25,1000Hz-10. 2000Hz-70(big jump),3000Hz-60, 4000hz-55.
R ear 500-20,1000Hz-25,2000Hz-25,3000HZ-65(again big jump),4000Hz-60. Also have Tinnitus which is driving me nuts. How bad is my hearing??!!
Hi Gary:
Low numbers are good–0 is “perfect”. Negative numbers above zero such as -10 are excellent. Positive numbers show the degree of hearing loss.
You have a moderately-severe hearing loss in the speech range with low-normal hearing in the low frequencies.
What caused your hearing loss? Did your tinnitus accompany your hearing loss, or did it have another cause if you know.
Cordially,
Neil
Hi Sir,
I am an ex Veteran and i had IED’s blowing outside my tank in Iraq.I have Sensorial Hearing Loss of
27db on right ear
and 52db on left ear
I was told by my audiologist that i have 25% bilateral loss of hearing.And he tested me on both “Air”and “Bone”..
For the right ear the readings was same
but on Left ear,the “Air”testing was higher than the “Bone”testing.
Can you please explain the difference between AIR and BONE testing in simple english please.Also i live in the UK.
Is my Audiologist right to give me 25% Bilateral Hearing Loss?
I also have severe Tinitus on my Left ear
Hi Enoch:
First, are the 27 and 52 dB figures your average hearing loss in each ear, or the maximum loss or what? I’ll assume they are the pure tone averages. Since hearng loss is measured in decibels and the decibel scale is logarithmic, you CANNOT express hearing loss in percentages.
There are only two things you can express in percentages as related to hearing loss. You can and do express your word recognition (or discrimination) as a percentage. And for purposes of getting a disability pension, there is a formula that expresses how your degree of hearing loss relates to the degree of disability pension you are eligible for. This too is expressed as a percentage.
Otherwise, you just say you have an average of 27 dB hearing loss in one ear and a 52 dB loss in the other.
Now, on to you other question about air and bone measurements.
Air conduction hearing testing is done via either hearing sounds via a loudspeaker or earphones. In other words the sounds go down your ear canals in the usual manner.
With bone conduction, you wear a transducer (essentially a vibrator) that tightly presses on your mastoid bone behind your ear. The sounds (vibrations) from the transducer “shake” your skull and cause your inner ear to receive these sound signals. This bypasses your middle ear (where the three tiny bones–hammer, anvil and stirrup reside).
This tests how well your middle ear is working as compared to the whole system. Thus, if you have perfect hearing in your inner ear and no hearing in your middle ear, air conduction testing wouldn’t show any hearing (because the sound isn’t being conducted through you middle ear). Then they do the bone conduction testing and the results would show normal hearing (because the vibrations are being transferred through your skull to your inner ear).
So in this extreme case, the air conduction results on your audiogram would be shown along the bottom of the audiogram and the bone conduction results would be near the op of the audiogram.
The distance these two lines are apart on the audiogram is called the air-bone gap. This tells you that you have a problem in your middle ear. In other words you have a conductive loss.
If the two lines are on top of each other, but not at the top of the audiogram) there is no air-bone gap and this indicates that your middle ear is working properly and your hearing loss is all in your inner ear. This is called a sensorineural hearing loss.
You can have both a conductive component and a sensorineural component to your hearing loss. This is called a mixed loss. When you have this situation–which you have–because the air and bone lines are not on top of each other.
I think you have it backwards–the air conduction line is ALWAYS below the bone conduction line if there is an air-bone gap. This is because, as I explained above, if the middle ear is not transmitting sound well, your inner ear doesn’t receive the missing sounds so the air conduction results can never be better than bone conduction, but they can be a worse–which indicates an air-bone gap.
Since tinnitus almost always accompanies significant hearing loss, I would expect that you would have tinnitus–especially in your worse ear.
Cordially,
Neil
Thank you for your reply. Cause(?), old age, time on the flight line years ago, I have no Idea. same,same with the Tinnitus but its getting louder as time goes by. again, Thanks.
My mother in her right ear 80db and left ear 40db. I want to use for her only one hearing aid. pl advise in which ear it is to be fitted.
Hi Jayanta:
You haven’t given me enough information to make a proper decision. Is the 40 and 80 dB figures the worst hearing loss in each ear, or the average hearing loss? What is the shape of the hearing loss on the audiogram–a high-frequency loss, low-frequency loss, flat loss, etc.? What are the word recognition scores (discrimination scores) for each ear?
What is it that your mother wants to hear but can’t? Do people often talk to your mom from her bad ear side or not?
The answers to all these questions can make a difference as to which ear I’d recommend she wear her hearing aid in.
But all things being equal, I’d choose the worse ear. Two exceptions would be if the discrimination in the worse ear is poor (less than 40%), or if she commonly has to be able to hear faint sounds A hearing aid in her worse ear wouldn’t be able to pick them up as well as it would if wearing it in her better ear.
Cordially,
Neil
Dear Sir,
First I would like to appreciate your prompt and valuable response. I am staying away (2000 km) from my mom and not having the technical expertise to respond to your queries; however, I can certainly tell you that in her right ear hearing condition is dismal and left one is comparatively better. Therefore, fitting the hearing aid in that could be a futile exercise and fitting it in the left ear could make her hearing again and would not probably allow the further deterioration of the left ear. That is why I have opted for the left ear which is comparatively in better condition. I do not see much hope of revival of the right ear; remember I am having only one hearing aid . Is my decision okay?
request your valued opinion.
regards,
JAYANTA SARKAR
I have had my comprehensive hearing test .It seems that i suffer from Audio neuropathy.
I had blood transfusion during birth and havent realised that I had hearing problem until recently after I could not perceive speech even at high sounds. Since birth i tried to hide I hearing problem as i was not comfortable telling people until it became serious
Test Results:
BERA tests shows no definable peak even at 5th peak in both my ears
DPOAE absent at all freq in left ear
DPOAE absent at all freq except at 6KHz in right ear
PTA results shows 80dBHL in both the ears
I m shocked as i was given disability certificate .I feel the evaluation was wrong as I lived my whole life normally,(did suffer in classrooms and people did tease me lot but managed it somehow using other skills)
I feel PTA was not done right . Is it ?
In fact I did check since birth and had 60 DBHL but to reach 80 Dbhl is shocking.
Can BERA and DPOAE correlate with PTA result as former is done automatically. Do BERA and DPOAE make sense with 80 percent hearing loss. Can you please interpret BERA and DPOAE result as i could’nt understand a word
Hi Matthew:
From what you said, you’ve obviously had trouble all through your life in hearing well. Because that is all you know, you think of it as being normal. Thus you are shocked when you find out how bad your hearing really is.
I don’t see why your PTA should be off. Why do you think it is not right? The easiest thing to do would go to someone else and have another hearing test and see what the PTA shows there. I’ll bet they’re not going to be too much different.
As for the BERA and DPOAE results, I’m no expert on this it all myself, so I can’t help you there. I don’t understand it either.
Cordially,
Neil
Oh thanks a lot !
BTW can you suggest where there is a treatment for audioneuropathy
Hi Matthew:
Sorry, I can’t recommend any specific place because I don’t keep track of such things. I’d ask your audiologist or your ENT see what they suggest.
Cordially,
Neil
I have had my comprehensive hearing test .It seems that i suffer from Audio neuropathy.
I had blood transfusion during birth and havent realised that I had hearing problem until recently after I could not perceive speech even at high sounds. Since birth i tried to hide I hearing problem as i was not comfortable telling people until it became serious
Test Results:
BERA tests shows no definable peak even at 5th peak in both my ears
DPOAE absent at all freq in left ear
DPOAE absent at all freq except at 6KHz in right ear
PTA results shows 80dBHL in both the ears
I m shocked as i was given disability certificate .I feel the evaluation was wrong as I lived my whole life normally,(did suffer in classrooms and people did tease me lot but managed it somehow using other skills)
I feel PTA was not done right . Is it ?
In fact I did check since birth and had 60 DBHL but to reach 80 Dbhl is shocking.
Can BERA and DPOAE correlate with PTA result as former is done automatically. Do BERA and DPOAE make sense with 80 percent hearing loss. Can you please interpret BERA and DPOAE result as i could’nt understand a word
Hi Matthew:
Sorry to be so long in answering you, but your post got dumped into the spam pile and I just found it.
Hearing loss sort of sneaks up on us so we are not aware of how bad it is becoming. Just yesterday at church, before I put on my hearing aids, I couldn’t hear a sound–yet the organ was playing loudly. Sort of shocked my wife that Icouldn’t hear anything. She’s also hard of hearing, but thought the organ was loud.
If you have an 80 dB loss, you are much the same as me.
Sorry, I can’t help you interpret the BERA and DPOAE results. That’s one area I know almost nothing about.
Why are you concerned about the PTA? It is probably correct. You are functionally deaf whether you choose to believe it or not.
Cordially,
Neil
I am a Veterans Service Officer and I have a Veteran who the VA documented as having with the best rating of 25 at 500hz and the worst of 60 at 4000hz.
The problem is that they said his speech discrimination is 98% in one ear and 96% in the other.
Isn’t the 60 an indication of hearing loss and the % is just his ability to remember words?
Hi Mike:
You are correct in that figures 25 dB and 60 dB are this persons best and worst hearing loss for those frequencies. Hearing loss is always expressed in decibels (dB).
However, you are off in your understanding of discrimination. Discrimination is the person’s ability to UNDERSTAND (not remember) words. Discrimination testing is done using the person’s most comfortable level of speech in a quiet room (in other words, the best listening situation possible). The tester reads from a list of 25 phonetically-balanced single-syllable words. He says, “Say the word” and then the word on the list. The person being tested repeats what he thinks he heard each time. Each correct response adds 4% to the score. Discrimination scores are expressed in percent. A score of 80 – 100% is good while a score of 40% or less is poor. Once your discrimination drops into the poor category, even though you are hearing the words at the correct volume for your hearing loss, you do not understand much of what is being said. It just sounds like so much gibberish or a foreign language.
Thus when assessing a person with hearing loss, you have to evaluate the degree of hearing loss AND their ability to understand what they hear.
Cordially,
Neil
Sir I am Anurag bhujangrao pawar . I am served from bilateral moderately severe conductive hearing loss for left ear and severe conductive hearing loss in right ear … I am indian … Can I get disability certificate ?..
Is there need to be dumb if you want certificate ? Or only deaf also matter.?
Hi Anurag:
No, you don’t have to be mute to get a certificate. Significant hearing loss alone is enough.
Cordially,
Neil
Sir but my district civil hospital told that certificate is not for people like me with hearing problem …. certificate for People those with hearing n mute problem those only get can access for certificate …
Hi Anurag:
I have read the rules for a certificate in India and I think your hospital is not telling you the truth. I’d contact the appropriate government agency and get the answer right from the horse’s mouth so to speak. But it does depend on how bad your hearing loss is.
Cordially,
Neil
Thanks sir , they said I suffered from bilateral moderately severe conductive hearing loss for left ear and severe conductive hearing loss in right ear.
What your opinion after studying indian rules am i applicable for certificate ? Should I convey to other government medical hospital
Hi Anurag:
Often, conductive losses can be fixed by ear specialists. Have you had an ear specialist check your ears out to see whether any medical intervention will help your hearing? That’s what I’d do first, before trying to get a medical certificate.
Cordially,
Neil
Sir
May I considered as a hearing impaired certificate when my audiometry report is —
AC– Frequency Htz
250 500 1000 2000 4000
L- 75 90 110 120 105
R- 55 50 45 40 60
BC-
L- 35 45 60 70 75
R- 25 20 30 40 45 All are in DB.
The audiologist measure LE- 106 DB and RE-45 DB
RE- Moderate hearing loss
LE- Profound S.N. Deafness, If I considered as a hearing impaired then How would be the percentage in India .
Hi SS:
Your act (India) specifies that in order to be eligible for a certificate of disability, your hearing loss in the speech frequencies in your BETTER ear must be an average of 60 dB HL or greater.
To calculate the average hearing loss you take the hearing figures from your audiogram at 500, 1,000, 2,000 and 4,000 Hz, add them up and divide by 4.
When I do that for your better ear the result is 33.75 dB. Since this figure is less than 60 dB, you are not eligible for a Hearing Disability Certificate.
You are also supposed to have a word recognition score of 50% or less in your better ear, but this is not always done.
You are considered hard of hearing, but you are not eligible for the certificate.
Cordially,
Neil
Hi Sir i had loss left ear 90% in childhood but right ear is good.sometimes i had faced cold caused the right ear to the sound very low.sir please solve my problem.Any hearing solution is avaiable 90% and above my left ear.
Hi Sudheer:
A cold can clog up your Eustachian tube and middle ear resulting in temporary hearing loss. When the “gunk” drains out, your hearing returns. It may take a couple of weeks to 3 months for that to happen depending on how thick the gunk is.
If the cold virus attacks your inner ear, then it can cause permanent hearing loss.
You haven’t told me enough to know which situation applies to you.
Cordially,
Neil
I have 93 db loss in right ear, and 18 db in left. Should I consider as hearing impaired or not ??????
I just had a hearing test completed to see if I am fit for duty can you tell me what you think
500-30/25
1000-20/25
2000-10/15
3000-5/5
4000-10/15
6000-25/15
8000-45/40
I am currently awaiting to see an ENT because I am having some pain and issues hearing
Hi Neoloni:
Fit for what duty? Except for some high frequency hearing loss at 8,000 Hz, and your left ear at 500 Hz, your hearing is all in the normal range. So unless you need particularly acute hearing for your job, I’d say you are fit for duty. I dare say that most people with your hearing wouldn’t even be aware they have a hearing loss it is so mild.
Cordially,
Neil
Sir:
VA compensated for bi-lateral hearing loss…..in 2016 my word recognition scores were 52% R, and 60% left, in 2017 they were 60% R, and 58% L……VA had me do another Maryland CNC test in 2018, and my scores were 94%R, and 86% L….I am 71 years old….do you think it’s possible that my hearing could have improved so much?
Thanks,
Ronnie
Hi Ronnie:
You haven’t said anything about your hearing improving–just your word recognition scores. I’d love to know whether you also had an improvement in your hearing.
It seems very unusual for your word recognition scores to improve so much on their own. I’m wondering whether some drugs might account for this. Some drugs can make your word recognition worse, so if you were taking such drugs back then and now are off them, maybe that accounts for the improvement.
Ibuprofen is know to do this as apparent also some of the other NSAIDs.
Cordially,
Neil
Dear Sir,
I am often confused during the pure tone audiometry test. I have bilateral sensorineural hearing loss. In my left ear ,I have mild to moderately severe hearing loss and in my right ear i have moderately severe to severe hearing loss. Is there is any test which can measure my exact hearing thereshold at each frequency. Any hearing test which can automatically detect my hearing threshold without my response.
Hi Lalita:
What are you confused about? You are not sure you are hearing the tone or not? or what? If all your problem is in determining whether you hear the tone or imagine it, ask the tester to change from a single tone to a double tone–so instead of hearing a single “beep”, you hear “beep, beep”. It is much easier to then know whether you are hearing the tone or not.
And if your problem is that your tinnitus sounds like the tone so you think you are hearing it when you’re not, even better than the double tone, is the warble tone. I find I can always distinguish a warble tone from my tinnitus (and from my imagination) so I give the correct response. Not all audiometers have these extra tones, but many of them do. More have the double tone than the warble tone option. So just ask for it.
Cordially,
Neil
Thanks for the reply sir.I was saying that I am confused whether sound is coming or not. ABR test will be helpful for me or not in determining exact hearing threshold?
Hi Lalita:
I really don’t see your problem. If you can’t tell you are hearing a tone, then don’t respond. If you hear it and you know you heard it, you respond. If you think you heard it and didn’t, or vice versa, it will only change the results by 5 dB which is the degree of error they expect. That is why your audiograms can change 5 dB as a result when you take it again. But having warble tones or double tones helps reduce this degree of error even further.
Cordially,
Neil
Sir, Can you please tell how much db if 60% hearing loss
Hi Arjun:
I can’t do that any more that you can tell me how many apples it takes to make an elephant. Apples don’t make elephants. Nor can you convert percentages to dB or vice versa. It’s just not mathematically possible.
How did someone determine you have a 60% hearing loss?
Some professionals lie and tell you that if you have a 60 dB loss, you have a 60% loss because they think you are too stupid to understand the truth–but that is just not right.
Cordially,
Neil
Sir,
I can,t hear right ear and left ear also disturb. My audiometer report is –
RE- 100, 115, 120, 120 &
LE – 40,40,50,55 dbHL frequency in HZ 500,1000,2000,4000 . So , am I eligible for hearing handicaped certificate , if yes, what would be the percentage of hearing? As per rules of India.
Hi Sajeman:
Your act (India) specifies that in order to be eligible for a certificate of disability, your hearing loss in the speech frequencies in your BETTER ear must be an average of 60 dB HL or greater.
To calculate the average hearing loss you take the hearing figures from your audiogram at 500, 1,000, 2,000 and 4,000 Hz, add them up and divide by 4.
When I do that for your better ear the result is 46.25 dB. Since this figure is less than 60 dB, you are not eligible for a Hearing Disability Certificate.
You are also supposed to have a word recognition score of 50% or less in your better ear, but this is not always done.
You have a moderate hearing loss in your better ear, but you are not eligible for the certificate. Your worse ear has a profound loss.
Cordially,
Neil
Thanks sir for your valuable information but I know that the formula of hearing loss is –
(46 db – 25 ) x 1.5 +( 111db – 25) x 1.5 whole are divided by 6
= ( 31 x 5) + (86 x 1.5) /6
= (155 + 129)/6
= 284/6
= 46.3 %
Sir, kindly inform me about the formula, right or worng ?
Hi Sajeman:
Yes, you are essentially correct assuming that the initial figures you used are the average of the 4 frequencies used in this calculation. You have a rounding error as you used 31 for your better ear rather than 31.5. The difference is that the final figure then becomes 47.75% rather than 46.3%.
However, be aware that this formula is not for calculating hearing LOSS, but hearing DISABILITY. In other words this is how much less you are supposedly worth to society because of your hearing loss. Thus, you (on the average) would earn a salary that is 47% less than a person with normal hearing.
Cordially,
Neil
My left side is 20 dB and my right side is 70 dB examined by a swedish audiologist. How many percentage is my hearingloss in my right side?
Hi Tala:
You can’t measure hearing loss in percents.
Cordially,
Neil
Thanks sir for your valuable information but afterall a question is in my mind, when as per rules of India of eligibility of HH is certificate is 60 db better ear or more. Then I think , enyone hearing level is 60 db both ear and asper formula his hearing disability is 52.5 percent it is his minimum level and as per rules , 40 percent or above hearing loss may be treated as hearing handicapped. So, I want to know ,what is the sound level are required for 40 percent disability in both ear?
Hi Sajeman:
Sorry, I can’t understand your question so can’t answer you.
Cordially,
Neil
Sir , i have hearing impaired from left year with 90-120 db , and from right ear 20-30db , and i m from india .. am i eligible for PH category certificate . And what would be my percentage of my hearing impairment .. bcz my doctor said that if u can not hear from 1 ear . It means u r 30% impaired . Plz suggest me
Hi Dipty:
You haven’t given me enough information to calculate your % disability, but I can tell you that you are not eligible as your better ear is in the normal range. The average loss in your left ear is apparently 25 dB and that is considered still normal.
Cordially,
Neil
Hi,
I got tested my dad last week end and these are the results. What is your best recommendation for Hearing Aid for purchasing.
AC PTA 52 dB BC PTA SII 16 %
AC PTA 70 dB BC PTA SII
REF. ANSI S3.6 / IEC 60645-1
PROVISIONAL DIAGNOSIS:
Right ear: Moderate sensorineural hearing loss.
Left ear: Severe sensorineursl hearing loss.
RECOMMENDATIONS: Hearing aid trial and fitting
Hi Tirumala:
We do not sell of fit hearing aids, so we do not recommend specific ones. You need to work with your audiologist or hearing aid dispenser to find the best hearing aid available in your area. We just give general principles for finding the right aid.
Cordially,
Neil
Sir i took treatment from Doctor they checked by machine and declared my left year totally deaf and right ear going 70% so that I want to know am I can get disability certificate if yes then what % will I get in disability
Hi Akash:
You haven’t given me near enough information to calculate your % disability. I need to know your hearing loss in decibels in each ear for each test frequency. Also your word recognition (discrimination) scores for each ear. Unless, I have that, I cannot calculate your % disability.
Cordially,
Neil
Dear Sir,
I met with an accident and have longitudinal temporal lobe fracture in right side my PTA after 3 months gave reading of 56.6dbhl and i hear very less from my right ear is their any chance of getting my hearing back to normal in right ear side please kindly suggest. also my ENT suggested for Ossiculoplasty is it risky.
please kindly give suggestions.
also have tinnitus.also is their any chance that my hearing loss get naturally Ok
Regards
Hi Kumar:
I rather doubt that you’ll get your hearing back after 3 months if you have an inner ear (sensorineural) hearing loss.
If you have a conductive (middle ear) hearing loss, your doctor may be able to do something. You don’t say what kind of hearing loss you have, but obviously some of it must be conductive since your doctor wants to at an ossiculoplasty which is to fix the bones in the middle ear.
If you only have a conductive loss and the doctor can fix your middle ear so it works properly, you may recover all/most of your hearing. I wouldn’t say this operation is all that risky as they just cut your eardrum and work on the bones behind it without having to expose or cut though anything else.
If your tinnitus is due to your hearing loss, if the ossiculoplasty is successful, your tinnitus may fade away.
Cordially,
Neil
Thank you sir for your valuable reply , I have Moderatly severe Conductive hearing loss with mixed component. Thank you again sir its really helpful for me thanks alot.
If you know the maximum frequency that you can hear before the loss of hearing, couldn’t you say the percentage that was lost? If I hear up to 100 dB and then I experience a loss of hearing, now I only hear up to 70 dB. Would I be wrong to tell people I have a 30% loss of hearing?
Hi J:
It sounds good in theory, but it doesn’t work out that way in practice. The decibel scale is still logarithmic and the percent scale is linear. A drop of 30 dB still wouldn’t be a drop of 30% because a 30 dB drop is a reduction of 1000 TIMES, not just 30 linear units. Just a drop of 3 dB means you only hear half as much, not just 3% less. So forget about trying to use percentages in describing hearing losses. It just doesn’t make any sense.
Cordially,
Neil
Hello Dear Doctor
My mother is 69 years old; recently she carried hearing test; the readings are as follows
Right
SRT 55 db
SDS 85%
Left
SRT 45 db
SDS 90%
can you please suggest if my mother will benefit from either of the following?
siemens orion 2 M 16 channel
phonak baseo q15 4 channel
Hi Shailesh:
I do not fit hearing aids so I can’t answer your question. That is a question for an audiologist or hearing aid dispenser.
Cordially,
Neil
thank you! Will you be able to provide/suggest anyone?
Hi Shailesh:
Any qualified audiologist should be able to help you.
Cordially,
Neil
If my chart has written on it:
“90% loss at 9kHz and 11kHz”.
What does this mean?
Hi Eddie:
Who knows what this means because you can’t measure hearing loss in percentages. Furthermore, they almost never test hearing above 8,000 HZ. and 9 and 11 kHz are not standard test frequencies anyway.
If you have a copy of your audiogram, scan it and attach it to an email and send it to me and let me see what they are really saying. My email address is at the bottom of any page on this website.
Cordially,
Neil
Dear Doc Neil,
My name is Ray. I have a two year old son which we found out recently that he has a mild hearing loss. Please allow me to share the results from formal hearing test.
Results:
Absolute latencies for waves I, III, V are within normal for both ears, Interwave latencies for waves I to III, III to V, I to V are with normal limits for both ears. Wave V reproducible down to 40dB for both ears.
Interpretation:
Suggestive of mild hearing loss, BILATERAL.
I would like to know your thoughts and advice Doc Neil.
Regards,
Ray
Hi Ray:
I’d have your son tested again in a few months and if you still get the same results, then it would be a good idea to see what your audiologist feels about getting him hearing aids.
From a practical point of view, do you see any signs that he isn’t hearing well as compared to other children? Does he talk louder, or not notice sounds people with normal hearing hear. Does he hear and understand when you are talking from behind him where he can’t see whether you are talking or not? Those kinds of clues tell you whether he needs hearing aids now or not. But be aware that in school, even a slight hearing loss of 15 dB can affect his grades. So work with your audiologist.
Cordially,
Neil
Here is a contradiction for you.
I pass my hearing test, but certain noises set my ears on fire like the HVAC, people talking loudly in the hallway or our small 8 lb. dog barking at a stranger. It is painful. I can even hear baby mice squeak and very distant sirens, but they don’t bother me. When my ears are in too much pain or I am in a noisy crowded room I can’t follow conversation well. It seems like I hear to much or not well enough.
So what do you call that?
Hi Mrs. Friend:
You may have acoustic shock syndrome typically brought on by exposing your ears to sudden loud sounds. Did this happen to you recently? One of the components is hyperacusis where you hear some sounds–especially higher-frequency sounds as much too loud. You also can have ear pain and other symptoms like you have.
Furthermore, you also likely have a hidden hearing loss, which makes it difficult to understand speech when there is too much background noise. This also happens if you have hearing loss in the high frequencies which they seldom test.
Cordially,
Neil
Dr Neil
I need to send hearing aids to a distant relative of mine who lives in a remote rural area. His audiological test report is:
R+ ear 80 dB
R+ ear 85 dB
I seek help on selecting the online hearing aids.
Will it be alright if I select a hearing aid having specification – ” Ear Digital 8 Channel, 79/139 dB Matrix”?
Thanks and regards
Hi Jetendra:
If your relative lives in a remote area, who is going to “fit” the hearing aids to his specific hearing? You don’t just send someone hearing aids–they have to be specifically programmed to his hearing loss, then tweaked a few times to get it just right.
I commend what you are trying to do, but the way you are doing it isn’t the right way to do it.
Since I don’t fit hearing aids, I can’t tell you whether the hearing aids you are suggesting are the right ones for your relative or not. In any case, you haven’t given enough information to make that decision.
Cordially,
Neil
I have bilateral SNHL in my early 30s. My audiometry test says 2000Hz at 60dB HL and 8000Hz at 80dB HL
SRT/SDT 15th right ear and 40th left ear.
MCL 80th right ear and 75th left ear
Word recognition was 85% in both ears.
Im seeing an audiologist for hearing aids. scheduled soon to see ear nose throat dr and neurologist to check for underlying issues. I have tinnitus and vertigo also.
My question is in your opinion will SNHL progress to total deafness eventually, especially because I noticed it so young at 25yrs old? Do the results of my hearing test seem accurate? Any other information or advice you can give?
Hi Brittany:
I have a lot of questions about your hearing loss. The most common causes of hearing loss in my opinion are
1. Exposing your ears to loud sounds. Have you been doing this–listening to music too loud, going to concerts, discos, etc. where loud music is played and not wearing ear protection? If so, this is a likely cause of your hearing loss.
2. Taking any of the hundreds of drugs that cause hearing loss. Are you taking any drugs/medications and were you taking any in the months before you first noticed your hearing loss?
3. You mention you have tinnitus and vertigo. When did this start–at the same time as your hearing loss? Many drugs can cause hearing loss, tinnitus, and balance problems such as vertigo and dizziness, etc. Another common cause is a viral attack on your ears. Did you have any active virus just before when your vertigo appeared?
4. Does hearing loss run in your family–in other words, is your hearing loss likely to be hereditary?
Now to answer your question. Sensorineural hearing loss typically never progresses to complete deafness. You typically will always have some residual hearing (but it may not be useful if the loss is too profound). If hearing aids no longer significantly help you, you can always get cochlear implants. Many people hear very well while wearing their CIs. So that should be your “Plan B”.
You haven’t said how fast your hearing loss is progressing since you first noticed it. Is it worse now than when you were 25? What was your audiogram like back then?
Once I know all the answers to my questions, I should be better able to answer your question.
Cordially,
Neil
Thanks for getting back to me so soon!
1. I dont think ive been exposed to excessively loud noises in the past and I don’t care for crowded loud places bc im kinda introverted lol.
2. I’ve never been on any long term prescriptions because I never had a primary care doctor until last month. I’ve been to the ER and gotten antibiotics but not recently. Now im on 2 creams from my dermatologist for psoriasis and eczema. I got bloodwork done, vitamin d deficiency (16..30-50 is normal)so im on vitD 50,000UI once a week for 3 months then recheck levels. I tested positive for ANA screen diffuse pattern. Im 32 hearing loss infertile(13yrs no birth control) negative for hiv syphilis hepABC chlamydia gonorrhea(ruled them out from causing my snhl.
3. I can’t pinpoint when the tinnitus started because I ignore it, i get scared it’s delusions/psychosis and it’s embarrassing to admit. The dizziness been happening since I was a kid. Standing up quick, hot showers, being upset, being sick..sometimes I faint.
4. No one in my family had hearing loss..my dad had a massive stroke at 49 then had hearing loss because brain damage.
My doctor is referring me to several specialist . 2 for hearing loss. Rheumatologist(bones-vitD def,autoimmune)
Neurologist(nerve damage, headaches, sleep issues,autoimmune)
Obgyn(infertility)
Allergist(food,environmental,yeast panels)
Good to know I won’t go completely deaf lol I know I’ll still hear distorted words with my hearing aids but, with the cochlear implant are words still distorted with snhl?
I noticed at 25-26 bc my friend whispers when she talks, it’d get super annoying so id just nod and pretend I heard instead of constantly asking what? What?? Lol but our other friend could hear her..then people get annoyed bc I like captions on tv lol..i can hear but can’t understand every word..i thought it was normal.. now my bf of 2yrs has been complaining so I finally decided to get my everything checked out. I’ve never had a hearing test, eye test, labs until a month or two ago. I was shocked when he told me how severe the loss was and I needed aids ugh
I hope I answered all your questions, looking forward to a response!
Hi Brittany:
Short term drugs can affect your hearing too. So if you notice a relationship between taking say a course of antibiotics and a drop in your hearing, pay attention to it. That drug could be damaging your hearing each time you take it. Think back–is there any such drug in your history starting from when you were 24 and to the present.
Your Vitamin D is way down. Doctors think 30 to 50 is normal, but if you look at what the health experts say, you should be up between 60 and 80. I’d target 70. I hope you are taking vitamin D3 and not D2 or some other D. I doubt that 50,000 IU a week is enough. I take 10,000 per day–so that’s 70,000 per week. I need to get my blood levels checked and see how I am doing. In the winter you need more because you don’t get a much sun exposure so your skin doesn’t make as much vitamin D.
Re question 3, it sounds like your blood pressure is too low. When I was much younger–from a kid to up to your age now, I had exactly the same problems. It’s called orthostatic dizziness. I’d go to stand up from getting out of bed and I’d faint unless I let myself flop back onto the bed. Even just standing still for a long time would cause me to faint. This went on for years. Once my blood pressure rose to around 140 (systolic) I’ve never had that problem again. And doctors say that blood pressure level is to high–but I know my body better and this is what I need.
I know hundreds of people with cochlear implants and most of them say that speech sounds normal to them now. At first it sounds very Mickey-mousey but soon your brain learns what is happening and then it lets it sound normal. The problem most people have with their CIs is that music doesn’t sound normal.
Most people with a hearing loss sneaking up on them nod and pretend. It’s called bluffing. Not a good thing to do. Better to be honest and tell people you can’t hear them, or else you risk them getting mad at you as you have found out.
Having the captions on the TV is a problem because they cover part of the action. But I’m like you, I NEED the captions in order to understand what people are saying. In fact, 95% of the time, my TVs sound is off and I just speechread and read the captions. But any time I want to hear, I have a room loop for my TVs and hear quite well (but never perfectly) using my hearing aids with their t-coils turned on, or using a loop receiver.
Let me know what all your specialists find out.
Cordially,
Neil
Yes you’re right I do have low blood pressure, last two were: 94/60 and 92/60 with anxiety and nervousness from being at the doctor.
So I have an update with news from my allergy doctor. He did environmental skin prick test then internal allergy injections. The panel had 56 extracts. Im allergic to 48 of them. I have to take benadryl, nasal sprays throat sprays, like everyone else with allergies but didn’t know it was so extreme. The treatment is epi-pens(insurance allows 2x month but only use if I go in shock)and immunotherapy injections 1x week to make me immue to them. I have food allergy testing tomorrow. I didn’t explain my health history so I’ll do that. But first a list of specialist im going to see.
Audiologist.
Otolaryngist.
Rheumatologist.
Neurologist.
Allergist/Immunologist.
Obgyn.
Dermatologist.
My symptoms are as follows:
Fatigue, psoriasis, dermatitis, skin rashes, small lesions(come and go, not widespread)stomach cramps, nausea, vomiting(rarer) diarrhea or constipation, bone muscle joint pain/numbness, sensitive to smells lights sounds touch, allergies nose throat inflammation, itching, hives, extreme coughing and sneezing, asthma, low blood pressure, dizziness, fainting spells, headaches, acid reflux and heartburn, malabsorption/vit d deficiency, reproduction issues, hearing loss, tinnitus(hearing mumbling, familiar voices in next room, when no ones there, puppies whinning, high pitched shrieking that increases volume until it hurts my ears) reoccurring infections; respiratory, sinus, gastrointestinal, yeast and urinary tract infections and skin and tooth abscesses, reoccurring cold and flu(more between ages 8-15) sleep issues and sleep hallucinations. Also, depression, anxiety, ocd tendencies, obsessive thoughts, mood changes, pain attacks, disscociative state where I zone out and blank stare.
Many symptoms started at age 8. Symptoms come and go and change between mild and more sereve.
It’s systematic(affecting the entire body)could be
1. Disease
2. Infection
3. Trigger (allergy)
I’ve done research obsessively and suspect it’s autoimmune diseases or mast cell activation syndrome or systematic mastocytosis(multiple types with veried degrees of symptoms)
I learned these diseases cause immflamation throughout the body, with that being said…
With the ACE test(adverse childhood experiences) my score was 10/10. Toxic stress causes cortisol(fight or flight hormone) to be continuously released throughoutthe body causing immflamation-inflammation causes disease.
It’s hard to talk to people that have an interest or knowledge of health issues so id like your opinion on the topics discussed. Also, your opinion on benefits and risks of immunotherapy injections for my treatment of allergies considering my health issues and do you think those drug will diminish my hearing further? Im interested in psychotherapy but apprehensive about a diagnosis because it’s an opinion and not necessarily evidence. I have mixed feelings thinking symptoms are serious in panicked and obsessed to thinking in being ridiculous, nothing’s wronh-avoid it! I seen a PhD behind your name, are you a medical or mental health doctor?
Hi Brittany:
I’m afraid I can’t help you with all your medical problems. I’m not a medical doctor. But I am interested in good health and how to stay that way.
My expertise is in “ears” and I have studied in this field for the past 25 years. However,my Ph.D. is in a field totally unrelated to medicine, audiology, pharmacy, etc.–would you believe ancient astronomy?
Cordially,
Neil
Hi, I was told recently that I am only hearing at 25 % what does that mean
Hi Jackie:
It means absolutely nothing. Find out what your loss is in decibels and I’ll tell you what it means. Or get a copy of your audiogram and email it to me and I’ll explain it to you.
Cordially,
Neil
RE SRT 45 DBS DS 96 %
LE SRT 45 DBS DS 92 %
Hello Dr., my wife just had a hearing test, and those are her results. I’m a bit confused, and I’m trying to make sense with the results of these numbers. I did read your article, but I’m still confused. Any help you can give me into reading/making sense of these results would be much appreciated. Thank you in advance with your help in this matter.
Hi Sam:
SRT (speech reception thresholds) are measured in decibels (dB). You wife has SRTs of 45 dB. That is correct to use dB.
The DS stands for Discrimination or often WR “Word Recognition”. This is the one thing in audiology where you always use percentages. Reread the second heading in this article “Percent Used to Describe Discrimination”.
Basically everything on an audiogram is measured in decibles EXCEPT Discrimination scores which are always in percent.
Cordially,
Neil
My 9 year old son recently had his check-up after a cold and had hearing challenges. Our pediatrian saw fluid in the ear. We went back recently and had his hearing tested again. There was no longer fluid in his ear. His right ear passed @25db. His left ear 500@30db; 1K@25 db; 2k@25db and 4K@45db. Would allergies and/or blowing his nose in a pressurized cabin (on a plane) a cause?!
Last year, he passed easily. He has not had any antibiotics this past year or any accidents. Curious what could have caused such a drastic change.
Hi Angela:
Actually, he didn’t “see” fluid in the ear. Eardrums are not transparent like a fishtank so that you can actually see fluid. They are translucent like frosted glass. So what you see is basically shadows which you interpret as you see fit. And because all you see is shadows, you can be wrong in your interpretation.
I don’t understand this “right ear passed at 25 dB. For children, the pass is 15 dB. For adults it is 25 dB. Studies have shown that children even with a 15 dB hearing loss do not do as well in school as those with better hearing. The 15 dB for children and 25 dB loss for adults is considered “normal”. I wouldn’t call it “normal” but “common”. Normal would be 0 dB.–no loss at all.
What did his audiogram show at 8K? Was it better or worse? If it was better, then I’d say your son has noise induced hearing loss with the typical 4K “noise notch”. If it was worse than 45 dB, then he has a typical sloping high frequency hearing loss.
The first thing I’d want to know was whether his hearing loss is conductive (probably from a cold or allergies and thus “gunk” in his middle ear/Eustachian tube reducing hearing) or sensorineural (from noise, drugs, etc.)
Did they do a tympanogram? And what did it show–both before and recently? This gives good clues whether the middle ear is performing normally or not.
When on a plane, if he had congestion in his Eustachian tubes or the back of his throat, as the plane descends, if he yawns, swallows, etc. the pressure in the cabin is greater than that it his middle ear, thus when his Eustachian tubes momentarily open, the any “gunk” is sucked into his middle ear and voila–instant muffledness (hearing loss). When the “gunk” drains out, his hearing should return to normal. Depending on how thick this “gunk” is, it could take a few days up to 3 months or so.
Cordially,
Neil
Hi! He got his hearing test today. His audiogram for his left ear is below.
At 8K was 0 db.
At 250, 500, 1K, he was 5 db.
At 2K, it dropped to 20 db.
At 3K it dropped to 55 db.
At 4K, it went up slightly to 40 db
At 6K, it was back at 0 db
His right ear tested between 0-5 db from 250 to 8K
His tympanometry results are:
Right ear: Type A, Peak pressure -15; Physical vol 0.81; compliance .39
Left ear: Type A; peak pressure -14; physical vol 0.75; compliance 0.34
His speech audiometry was left 20 dBHL for SRT and right 10 dBHL for SRT with 100% WRS in both ears.
They are recommending yearly testing to track it.
Would love any thoughts on what may have caused such a drastic change and/or any remedies that are possible. Luckily it is not affecting language comprehension or academic performance.
Thanks!
Hi Angela:
I’m assuming that he has no conductive loss–that this was all sensorineural hearing loss?
How long has this hearing loss existed. You told me the results of his previous audiogram. Did the audiogram before that show anything out of the ordinary?
My first reaction to this hearing loss is that it is a noise notch and that his left ear was exposed to loud noise sometime between when his audiogram showed normal and his previous audiogram, although his previous audiogram may have been affected by congestion from the cold he had. Can you think of any loud noise incidents in the past that were particularly close to his left ear?
Another possibility is it is a hereditary hearing loss, but it only affected one ear. And if it was hereditary, you should find similar “cookie bite” hearing losses in other family members–you, your husband, previous generations, etc. Since you have not mentioned that, I still wonder about noise.
Another possibility could be taking one of the many ototoxic drugs that damage ears–although typically drugs take out high-frequency hearing first so he shouldn’t have 0 dB at 8K.
Cordially,
Neil
It is unknown how long the hearing loss existsed other than the previous one was normal!
Other than his 5 year old sister screaming in his eye, I don’t recall any other loud noise this past year.
My father has hearing loss and I feel like I might too so I have scheduled a hearing test for myself to see if it is hereditary since his body is similar to mine (he had eczema from 2-8 which miraculously disappeared overnight?!). He hasn’t taken any antibiotics this past year. I only time he was seriously sick was last year. Literally the day after he got a flu shot he had the highest temperature he has ever gotten. He didn’t take any meds for this. After 48 hours he recovered.
I will check in after I get my hearing test next week to share my results! THANKS for sharing all your insights!
Hi Angela:
The flu shot could have done it. I hear from numbers of people that have sudden hearing loss following having the flu shot. This hearing loss may occur within a day or two or be delayed 3 weeks or more.
Is that any way you can correlate his hearing loss with his having the flu shot?
Cordially,
Neil
HI, Dr. Bauman
My 11 year old daughter recently had an audio exam conducted with an Audiometer GSI-61. Deafness runs in the family on my maternal side. I was told that my daughter is 100% deaf in her left ear and a hearing aid would not help. I was wondering if she may become totally deaf in the long run.
The results were:
Threshold (SRT): R 5dB and L 95dB
SL for discrimination: R 40dB, and L 5dB
Speech dis: R 100% and L-0 %
Masking level: right – and left 80dB
Hi Tiffany:
She is essentially deaf in her left ear, but she still can hear some loud sounds. However, since her speech discrimination is 0%, that means that she can’t understand anything she hears with that ear. That is why a hearing aid won’t help her.
Since her right ear is normal, I don’t see any reason why that ear should go deaf in the future. She will probably go through life as a 1-eared person.
Cordially,
Neil
Hi Doc
I have a 25-30 Db loss at 4k i also have tinnitus 24/7. It’s only in left ear. Its loud enough that it bothers me a good part of the day. Ive stopped playing in bands. I would like to play in bands again(rock n roll)but am afraid to make the tinnitus worse as i might go crazy. Do you think with hearing protection it would be ok?
Thanks Walter
Hi Walter:
That hearing loss at 4K is called a “noise notch” and is caused by exposing your ears to loud music for too long a time. Tinnitus typically accompanies hearing loss, and also noise damage, so you come by it honestly.
If you want to play in bands, just keep the racket down. So either you all play softly so the combined volume stays below 80 dB at all times, or you need to wear ear protectors.
Wearing ear protectors of the right strength will let you hear your music, but not at a level that will damage them or make your tinnitus worse. If you get musician’s ear protectors, you’ll preserve the fidelity of the music so it sounds right to you. If you wear regular ones, they will block more of the low frequency sounds so your music will sound thin and not full. Musician’s ear protectors cost a lot more, but they could be worth it to you.
Cordially,
Neil
Hi Neil
Thank you so much for your reply. It gives me hope to play again . Also one part i left out is that i also have a sensitivity to some sounds even at relatively low volume . Just wondering if this info would change any of your suggestions
Thanks again Walter
Hi Walter:
That sound sensitivity is called loudness hyperacusis and is one of the results of exposing your ears to too-loud sounds.
You just want to be careful to not wear ear protectors when you don’t need them as that can make the hyperacusis worse–but not wearing them when you need to will also make it worse–so walk the fine line between the two and all should be well.
Cordially,
Neil
Hello Dr ,
My doctor mentioned 80% loss and suggested hearing aid. But my other ear is perfectly fine. When I visited another hearing specialist he suggested hearing aid is not recommended for more than 50 percent loss also because another ear is perfectly fine.
Do I need a hearing aid or I don’t?
Hi Saze:
You’ve left out one critical piece of information and that is what your discrimination score is on your bad ear. It is sometimes called word recognition score. If it is poor, for example, less than 40%, then you may find that wearing a hearing aid chess overloads your brain with gibberish. This makes it harder for your brain to understand what your good ear is hearing. So it’s not how bad the hearing is in your bad year, but how bad your discrimination is that largely factors into whether you should wear a hearing aid or not.
If you don’t wear a hearing aid, you will also not have the ability to tell where sounds are coming from. Thus, even wearing a hearing aid that does not let you understand everything, but if it lets you hear the sounds, then you will have directionality and not wonder where sound is coming from.
my suggestion is to try wearing a hearing aid and see whether it helps you are not. Try it out for two weeks or so and if you notice that it is helping you with directionality and even understanding people on your hearing aid side, then go for it. On the other hand, if you find that wearing it makes it more difficult for you to understand speech, then don’t wear it and return it to where you got it for a refund. You typically have 30 days to return a hearing aid for a refund, but asked before you buy it.
Also, don’t forget that hearing aids don’t work well under all conditions. Typically the further you are from the speaker and the louder the background noise, the less useful a hearing aid is. So try out the hearing aid where it is not too noisy and where the speaker is not more than say six date 10 feet away from you. That will give you a good evaluation of whether the hearing aid will help you are not.
If you find the hearing aid does not help you but you need help hearing from your deaf side then you should consider a special kind of hearing aid called a CROS aid. This hearing aid is in two parts. You wear what looks like a hearing aid on each year, but the one on your bad side is basically a microphone and a transmitter that transmits the sound from your bad side to your good ear. The hearing aid on your good side receives the signal amplifies that and feeds it into your ear canal so you can hear from your bad side. It does not block your ear canal so you hear normally from your good ear.
Some people love their CROS aids, and others don’t. You will have to try one out to see whether this is a solution for you or not if you choose not to wear a traditional hearing aid in your bad year.
Cordially,
Neil
Good morning Dr. Bauman, Oct.28,2019
We have a very unusual situation. In Jan. 2019 some new neighbors who are flipping a house next door moved in with very loud barking dogs. We tried an ultra sound electronic Bark-free device attached to our house in hopes it would work as advertised. Instead another neighbor found the ultra sound(which only emits when it senses barking) annoying. So I loaned the annoyed neighbor the device (which she has never returned) and no longer use such a device. We have been visited by the county sheriff and have two complaints filed about us disturbing the peace. The annoyed neighbor insists there is a noise coming from our house which only she can hear and that she is losing her hearing. She came to our house a few days ago wearing earplugs with these complaints. No one else can hear her noises. It seems symptomatic of Tinnitus. What do you think?? I have tried to contact our county health dept for her.
Russ & Jeanette
Hi Russ & Jeanette:
Your situation is not all that uncommon, believe it or not. Your neighbor is hearing phantom sounds that also have phantom directionality–so she KNOWS the sounds come from your house–but of course it is all in her head. The proof is that no one else can hear it. Furthermore, one of the characteristics of people with this condition is that they are losing hearing, and typically are older people.
Some people hear their neighbors playing loud music and complain to the police, etc., but again it is all in their heads, and is not real.
This condition is called Musical Ear Syndrome and is a close cousin of tinnitus.
I wrote a comprehensive article on it. You can read it at https://hearinglosshelp.com/blog/musical-ear-syndrome-the-phantom-voices-ethereal-music-other-spooky-sounds-many-hard-of-hearing-people-secretly-experience/
If she calls the cops on you again, have this article on hand to give them. If they want more information, have them contact me.
Note that she is NOT crazy–this is not a mental illness, rather her brain is fooling her into thinking that you guys are inconsiderate neighbors making various loud sounds at inappropriate times. It’s really just her auditory system not working quite right.
If she is willing to read it, give her a copy of the article to read too. If she has “all her marbles” she will realize and understand what is going on in her head. If she doesn’t have all her marbles, you are in a tough position because she will not admit it is all in her head–and will continue to call the cops on you for making all that “phantom” racket. That is why they need to know about this condition too.
Cordially,
Neil
I have loss RT 75dbhl and LT 72dbhl. I got promotion but my senior want to know what is the percentage my hearing loss then he transfer all my documents to authorities. Please help me to know.
Hi: Ankit:
You CANNOT measure hearing loss in percentages because hearing loss is measured in decibels which is a logarithmic scale with no endpoint so it CANNOT be converted to percentages.
Besides, hearing loss varies by frequency. You can calculate the average loss, but it is still in decibels, not percentages.
There are only two things you can calculate in percentages in relation to hearing loss. First, your ability to understand speech–called discrimination or word recognition. That is always shown as a percentage. Second, you can, for compensation purposes, use a formula to calculate how much your hearing loss supposedly impacts your ability to make money. This is expressed as a percentage. But it is flawed as it neglects to consider some important factors.
If this is what you really are wanting, then read my article on this subject. It will teach you how to come up with this percentage. The link is at https://hearinglosshelp.com/blog/how-much-are-you-worth-as-a-hard-of-hearing-person/ .
Cordially,
Neil
Hello – Thanks for the informative article! I had a sudden SNHL in my right ear 3 years ago, with high pitched tinnitus (continuous to this day) and some numbness (also continuous). My audiogram is a ski slope pattern, from +30db at 250 to +60db at 4000 and +70db at 8000. I developed partial facial paralysis about 18 months ago, also on the right side, continuing to this date. My doctors haven’t been able to figure out why this is happening. I had a brain MRI with IAC, which did not show an acoustic neuroma. I was told I have irritation or some damage to CNs 7 and 8 and Bell’s Palsy. My hearing is getting slowly worse and is starting to worsen in my left ear now.
Do you have any thoughts on what is happening? Could an acoustic neuroma have been missed on the MRI?
Thanks so much for your ideas!
Hi Melissa:
I doubt you have an acoustic neuroma from what you say. What I really think you have is that your upper cervical vertebrae are out of proper alignment thus pinching your 8th cranial nerve (the one that controls your hearing and balance), and likely some other nerves such as your trigeminal nerve (5th CN) and facial nerve (7th CN).
That could account for the numbness and tinnitus and hearing loss that occurred suddenly 3 years ago and if the cervical alignment deteriorated 18 months ago, that could account for your Bell’s palsy/facial paralysis.
So I think your doctors are right that your 7th and 8th cranial nerves are irritated. The problem is that they are not thinking that this irritation is due to your neck being out of proper alignment because they can’t see any obvious misalignment. However, this misalignment can be subtle, not a gross misalignment that they would notice.
Were you ever in an automobile accident in the past? Often this results in your C1 and C2 vertebrae being knocked out of proper alignment–and symptoms such as yours only show up 25 years later.
If I were in your shoes, I know what I’d definitely do. I’d hurry to an upper cervical spine chiropractor and have them check me out for proper alignment. One or two treatments may be all it takes, but it could take a number of treatments over several months if the treatments don’t “hold” their correct positions. In my case, it only took two treatments. My C1/C2 were out by just 3 degrees one way and 3 degrees another way and that was enough to cause me problems. After two treatments I was out less than 1 degree combined and since then I’ve never had the problem again–and that was 6 or 7 years ago now.
To find one of these special upper cervical chiropractors (NOT conventional chiropractors), go to http://www.upcspine.com/ and click on the “Practitioners” button along the top, then find one close to you. Sometimes that can be a few hundred miles depending on where you live.
That’s the first thing I’d do. You want to know whether the problem is with your vertebrae out of proper alignment because that is the easiest problem to fix. Once that is done, then you can see what symptoms are still remaining, if any.
Cordially,
Neil