Frequently Asked
Questions about


Evaluating Your Hearing

Hearing Loss in Adults

Hearing Loss in Children

Testing Hearing in
Babies and Children

Balance Assessment

Hearing Aids

Choosing Hearing Aids

Hearing With Two Ears



analog hearing aids: traditional hearing aids that convert sound into an electric signal, modify and amplify the signal, and reconvert it to sound. Usually the overall volume level is adjusted by the patient with a manual volume control.
audiogram: a graphic representation of auditory sensitivity (hearing threshold levels in decibels [dB]) for pure tone sound plotted as a function of test frequency in cycles per second (hertz, Hz). The audiogram is useful in defining degree of hearing loss.
audiologist: a clinical hearing care specialist who has a minimum of a Master's degree, is board-certified by the American Speech-Language and Hearing Association, and licensed by the State Department of Education. The audiologist determines if a person (infant, child, or adult) has a hearing loss, the type of hearing loss it is, and how the remaining hearing can best be used. If the person is a hearing aid candidate, the audiologist selects and fits the most appropriate aids, teaches their effective use, and monitors progress to verify that maximum benefit has been obtained.
audiology: the health care profession concerned with measurement of auditory system function and nonsurgical, nonmedical management of persons with auditory, vestibular, and communicative impairment.
audiometer: an instrument that presents precisely measured tones of specific frequencies and intensity levels in order to measure hearing (an audiogram)
auditory brainstem response (ABR): electrical activity stimulated by brief sounds such as clicks, generated by the auditory nerve and brainstem, and recorded from the surface of the ear and forehead. This may also be abbreviated as BSER, BAER. ABR is used to assess hearing sensitivity in babies and children, and to evaluate the neural pathway (from ear to brain) in adults.
binaural hearing: hearing with two ears. Two important aspects of binaural hearing are: 1. the brain uses signals from both ears in order to identify where a sound comes from; and 2. hearing with two ears helps in understanding voices, especially in groups of people or moderately noisy rooms. When hearing loss in both ears is treated with binaural (two) hearing aids, lower sound levels are needed for comfortable listening, and it is not necessary to position the better ear towards the speaker. This results in better hearing with less effort.
bone conduction: transmission of sound (mechanical vibrations) from the surface of the skull, such as the bone behind the ear, to the fluids of the cochlea (inner ear). Sounds are then perceived in the usual way. Bone conduction testing is done to help determine if a hearing loss is conductive or sensorineural.
cerumen: a natural secretion of the ear canal, commonly known as
"ear wax."
CIC (completely-in-the-canal): a hearing aid style that is recessed into the ear canal so that it is almost invisible in most ears. This style is most suitable for mild and moderate hearing losses. The newer computer chips make it possible for CICs to be used for a wide range of hearing losses. In addition to cosmetic appeal, CICs are easier to use on the telephone.
compression amplification: a hearing aid that reduces the intensity range of the acoustic signal while increasing overall sound levels (also known as automatic gain control or AGC) to reduce the effect of intolerance to loud sounds.
conductive hearing loss: a hearing loss caused by a problem of the outer or middle ear, resulting in the reduced ability of sound to be conducted to the inner ear. Usually this type of hearing loss is temporary and treatable, and the degree of hearing loss may range from mild to moderate. Common causes of conductive hearing loss include: ear wax (cerumen), foreign objects, swimmer's ear, acute middle ear infection, and fluid in the middle ear. These conditions require prompt medical attention.
decibel (dB): a unit that measures the intensity of sound; a logarithm of the sound pressure (or power) of a sound to a reference sound pressure (or power), rather than a linear scale.
digital: the measurement of a signal in terms of a series of zeroes and ones, not in terms of continuously varying numbers. Digital hearing aids use computers to convert continuous analog signals into discrete data points for processing within the hearing aid, and then reconvert them to analog acoustic signals for use in the listener's ear, allowing sound modifications not possible with non-digital technology.
digital hearing aids: essentially miniature computers that convert sound into electrical energy and then into a mathematical code that represents the intensities and frequencies of the original signal. The digital signal can be processed to meet the wearer's needs, and then reconverted into sound. Digital processing allows a great deal more precision and less distortion than older technologies.
directional microphone: a microphone that is more sensitive to sound coming from one direction than from another; a directional hearing aid uses a directional microphone to enhance reception of signals at the front relative to those from the back.
dynamic range: a listener's range of hearing from the threshold of hearing (softest level heard) to the threshold of loudness discomfort (loudest tolerable level before discomfort). Patients with sensorineural hearing loss often have a reduced dynamic range, and may experience distortions or discomfort at loud sound levels.
earmold: a plastic or silicone piece custom fit to the user's ear, with a short tube that is coupled to the earhook of a behind-the-ear hearing aid. The earmold channels sound from the hearing aid into the ear canal.
electronystagmography (ENG): a test of vestibular (balance) function in which eye movements are recorded during stimulation of the balance system.
eustachian tube: tube running from the nasal cavity to the middle ear. The Eustachian tube helps balance air pressure between the outer ear and the middle ear.
hearing aid: a miniature electronic instrument that makes sounds louder. Sounds are picked up by a microphone, processed and amplified to accommodate the specific nature of the hearing loss, and directed to the wearer's ear. Hearing aids vary in style (completely-in-the-canal, in-the-canal, in-the-ear, behind-the-ear) and in technology (analog, digitally programmable, digital). Current hearing aid technology processes speech and environmental sounds to optimize speech understanding, and keep sound levels audible and comfortable.
hearing level (dBHL): a decibel scale referenced to average normal hearing; the audiogram uses this scale to describe hearing sensitivity.
inner ear: the part of the ear that contains both the organ of hearing (cochlea) and the organ of balance (labyrinth).
Meniere's disease: pathology of the inner ear (cochlea) resulting in a characteristic pattern of symptoms that often include: sensorineural hearing loss that may fluctuate, tinnitus (ringing in the ear), intermittent vertigo or dizziness, and the sensation of ear fullness.
microphone: the component of a hearing aid that transduces, or changes, acoustic (sound) signals into electric signals.

middle ear: an air filled cavity within the mastoid bone extending from the eardrum to the oval window which transmits sound to the inner ear along three tiny connected bones called ossicles.

otitis externa: inflammation which occurs at the opening or outer part of the ear (ear canal.) It can be caused by the growth of bacteria or fungi. Otitis externa is sometimes called swimmer's ear.
otitis media: an inflammation of the middle ear. Otitis media is a non-infectious condition of the middle ear that usually results from a cold, allergic reaction, or a dysfunction of the eustachian tube. Symptoms may include fluid accumulation, mild to moderate hearing loss, earache, and fullness or pressure. Medical assessment and treatment is indicated; treatment usually results in cure. Otitis media occurs most frequently in children. When a hearing loss is present during the time that children are learning language, delays in speech and language development may occur, and so prompt attention is important.
otoacoustic emissions (OAE): sounds measured in the ear canal that are produced in the inner ear in response to soft sounds. OAEs are only produced if both the hearing is normal or close to normal, and middle ear structures are working properly. This is a quick, comfortable test that makes it possible to screen babies' hearing right after birth.
otolaryngologist: a physician who treats diseases of the ears, nose, and throat (also referred to as ENT physician).
otosclerosis : a pathologic condition in which spongy bone grows around the footplate of the stapes (stirrup bone in the middle ear connected to the inner ear fluid) producing conductive hearing loss.
outer ear: the external portion of the ear which collects sound waves and directs them into the middle ear. It consists of the pinna (auricle) and the ear canal, and is separated from the middle ear by the eardrum (tympanic membrane).
presbycusis: sensorineural hearing loss that is associated with aging. Presbycusis is a gradual ongoing loss of hearing linked to changes in the inner ear. People with presbycusis often have difficulty understanding speech, especially in noisy situations, and may be intolerant of loud sounds. Presbycusis usually affects both ears.
programmable hearing aids: hearing aids which can be programmed to alter the signal to compensate for the particular nature of a hearing loss. These hearing aids process the sound like analog hearing aids, but can be programmed in the office using a computer. They usually do not have manual volume controls, and adjust to environmental sound levels automatically.
real ear measurement: a method of measuring how much amplified sound reaches a person's eardrum while the hearing aid is in place in the ear. Real ear measurements help determine if the expected level of amplification is actually arriving at the ear; that is, it verifies that the fitting is correct, and makes it possible to adjust sound to account for individual variation in ear anatomy.
receiver: the component of a hearing aid that transduces, or changes, the amplified electric signal back into an acoustic signal (the loudspeaker).
recruitment: an auditory term referring to abnormally rapid growth of perceived loudness. In some patients with sensorineural hearing loss, as the intensity of the sound increases, the perception of loudness increases even more. For these patients it is especially important to use hearing aids that can "normalize" the relation between soft, moderate, and loud sounds.
sensorineural hearing loss: a loss due to dysfunction within the cochlea (sensory) or along the auditory (neural) pathways to the brain. It may be present from birth, or begin later on. 90% of hearing loss in adults is sensorineural. Sensorineural hearing loss can range from mild to profound. Some sensorineural hearing losses are confined to particular frequency regions such as the higher frequencies. Some sensorineural hearing losses worsen progressively, while some remain relatively stable.
speech audiometry: a battery of tests related to hearing speech, including the threshold for a speech signal (softest level speech can be heard), the ability to understand words clearly at a moderate level, the determination of levels perceived as "most comfortable" and "too loud for comfort."

telecoil: an electromagnetic coil in a hearing aid designed to pick up signals directly from the telephone.

tinnitus: a ringing, swooshing, or other type of noise that seems to originate in the ear or head, and may be constant or variable. Tinnitus is not a disease but a symptom of an underlying condition. One of the most common conditions associated with tinnitus is presbycusis (hearing loss with age). Excessive ear wax, fluid behind the eardrum, and some medications are known causes of tinnitus, which may be treatable in these instances. Tinnitus that accompanies presbycusis is not treatable, although many patients who wear tinnitus report relief while wearing hearing aids.
tympanic membrane: the membrane separating the outer ear from the middle ear (eardrum).
tympanogram: a measure of tympanic membrane (ear drum) mobility as a function of air pressure change within the ear canal. The tympanogram provides information about the functioning of the middle ear system that transmits sound from the outside world into the inner ear.
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