How The Auditory System Works

The auditory system is one of the human body’s most complex and delicate sensory systems. When functioning normally, the auditory system processes and transforms acoustical energy through the intricate structures of the outer, middle and inner ear and then on to the auditory center of the brain, where it can be identified as sound. The entire process occurs within a split-second timeframe. The process of hearing begins with the outer ear, which collects sound (acoustic) energy and directs it through the ear canal to the eardrum. The incoming waves of sound energy cause the eardrum to vibrate, setting into motion the malleus, incus and stapes (also known as the hammer, anvil and stirrup) bones that make up the ossicular chain of the middle ear chamber, which is connected to the Eustachian tube. The middle ear’s anatomical structure and conductive motion combine to amplify the sound by appx. 2.3 decibels (dB) and transform it effectively into a fluid (hydraulic) vibration inside our inner ear. When the stirrup - the third bone in the middle ear - vibrates against the oval window membrane that leads to the inner ear, fluids within the spiral-shaped cochlea of the inner ear chamber are set into motion. This hydraulic energy causes the oscillation of thousands of tiny sensory hair cells that reside on the cochlea’s basilar membrane. The motion of the cells triggers chemical-electrical signals that are transmitted through the cochlea’s nerve fibers to the brain along the auditory nerve pathway. The brain can then translate the impulses of energy into recognizable sound patterns.

Symptoms of Hearing Loss

  • Failure to respond to sound (i.e. speech, T.V., radio)

  • Complaining of earache or a discharge from the ear

  • Confuses or misunderstands other people, especially in groups

  • Watching the speakers face

  • Problems with language development and/or pronunciation of sounds

  • Withdrawing from social activities

  • High level of frustration

  • Ringing in the ears

Causes of Hearing Loss

  • Excessive ear wax

  • Middle ear infection

  • Acoustic trauma

  • Congenital hearing loss

  • Genetically determined hearing loss

  • Age induced hearing loss (most common)

  • Noise induced hearing loss

  • Ototoxic medications

Effects of Untreated Hearing Loss:

  • More rapid decline in speech recognition

  • Isolation and social withdrawal

  • Anxiety

  • Depression

  • Anger and frustration

  • Embarrassment

Degree of hearing Loss:

Learn more here.

Hearing Loss in Children:

Hearing loss in children negatively impacts speech and language development. Therefore, early identification and rehabilitation are necessary to prevent these delays.

normal copy.png

The audiogram is a graphic representation of how we hear. It provides information on the degree and type of hearing loss. Hearing loss is not difficult to document. But understanding the audiogram is not always easy.


The audiogram is a graph laid out like a piano keyboard with low to high frequencies graphed from left to right on the horizontal axis.


The vertical axis charts loudness of sound in decibels—starting with soft sounds at the top and loud sounds on the bottom.  

It is common for individuals to permanently lose their hearing in only a portion of the pitch range. That is, many people first lose their ability to hear high-frequency sounds like ‘s,’ ‘sh,’ and ‘ch' or the voices of children or women with higher-pitched voices. In many cases, speech is "heard" but misunderstood. When a portion of the speech spectrum is missing, it sounds like mumbling.

Types of Hearing Loss

Many people associate hearing loss with aging, and although it is by far the most common cause, there are many other causes of hearing impairment. Hearing loss may be congenital and be caused by factors such as illness during pregnancy and complications during birth. For these types of hearing loss, hearing aids may often be a help. Other types of hearing loss are hereditary and genetically determined. These types may progress gradually and require more powerful hearing aids.

Conductive Hearing Loss

Conductive Hearing Loss

If the loss can be localized to the outer or middle ear, the hearing loss is conductive. The specific hearing loss can originate at the pinna (visible ear), ear canal, eardrum, middle ear bones or any combination of these. Contact Us to schedule an appointment today.


Mixed Hearing Loss

Mixed hearing loss is a combination of conductive and sensorineural hearing loss, which means there is damage in both the outer or middle ear and in the inner ear. This type of hearing loss ranges in severity from mild to profound.

Sensorineural Hearing Loss

Sensorineural Hearing Loss

When the loss is caused by a problem involving the inner ear (cochlea/auditory nerve), it is considered a sensorineural hearing loss. This type of loss occurs when the hair cells, neural fibers or their connections to the cochlea are damaged or do not function optimally.

central hearing loss

Central Hearing Loss

Central hearing loss refers to a problem with the eighth cranial nerve, auditory brainstem, or cerebral cortex of the central nervous system, and affects the person's ability to filter out competing auditory signals.