by Neil Bauman, Ph.D.
A man wrote:
I have tinnitus and I would assume some age-related as well as other hearing loss related to my work. I have had three different hearing tests and each result is terrific, but does not explain why in a crowded room (bus or restaurant or something loud) I cannot hear the person right in front of me (always too low) talking to me because speech seems drowned out.
My hearing tests do not account for this. My ENT says it’s due to age, and that men cannot mulit-task as they grow older, but this sounds way to unscientific to me.
There are two issues here–what you are expecting from your ENT, and what is happening to your hearing.
First, let’s deal with your ENT and his knowledge of hearing loss. The truth is, few ENTs seem to know much about hearing loss and its ramifications.
Typically, ENTs are only concerned (and knowledgeable about) the medical aspects of your ears. To them, sensorineural hearing loss, such as you have, is not a medical thing. Thus, they don’t have the knowledge or skills to help you.
The professional trained to help you deal with your hearing loss is called an audiologist. These are the people to see about the problems you raise.
Now let’s move on to your second issue–your problem hearing in noise. You admit to having some “age-related” and “other” hearing loss, yet you claim your hearing test results are “terrific.”
This doesn’t make sense to me. How can your audiogram be “terrific” if you have some known hearing loss? It would mean a lot more if you had said exactly what your audiogram showed–giving the dB loss at each frequency tested.
I suspect your ENT meant that your results are “normal” for a person of your age and background–not that your results show no hearing loss. These are two entirely different things.
The obvious reason why you have difficulty hearing in a crowded room, bus, restaurant or other noisy place is that you have the “normal” high-frequency hearing loss that typically shows up in seniors. I’ll bet that your audiogram actually shows considerable hearing loss at 6,000 Hz and higher.
When this happens, you hear sounds just fine. The problem is that you have trouble understanding what you hear. This is because most of the volume of speech occurs in the low frequencies which you hear very well. At the same time, most of the intelligence of speech lies in the high-frequency consonants which are not very loud to begin with. If you have a high-frequency loss, you don’t hear them well, if at all. This is why you hear people talking, but have trouble understanding them.
In fact, one of the first symptoms of high-frequency hearing loss is that you begin to have more and more trouble hearing (technically trouble understanding) in noisy situations such as you are experiencing.
Also, with hearing loss comes another insidious problem. Your ears/brain can no longer separate the speech you want to hear from the background noise. When your audio filtering system doesn’t work well, all these sounds hit your ears in one loud cacaphony of sound. This makes it very hard to understand speech in noise.
The worse your hearing loss, the worse this effect typically is. For example, I have a severe loss, and in noise, I basically just speechread. The speech sounds I really need just never reach my ears.
Although you say that your “hearing tests do not account for this,” I think carefully looking at your audiogram will show that you really do have a significant high-frequency hearing loss.
When your ENT says it’s due to age, he is really saying that you have the typical high-frequency hearing loss often found in older people. What he fails to realize is the enormous impact this high-frequency hearing loss can have on your ability to communicate in noisy situations.
Putting your hearing problems down to “men cannot mulit-task as they grow older” is a bunch of baloney. Some men multi-task very well, while others cannot do this no matter how young they are.
What really is happening is that you cannot easily multi-task when you have a hearing loss and one of the tasks is listening to speech. For example,I typically have to stop everything I am doing in order to concentrate on the person talking if I am to understand anything they say. That’s just one of the facts of life when you have a sensorineural hearing loss.