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Hearing Facts


Hearing & Hearing Loss

How Does Our Hearing Work?

Anatomy Of The Ear

The hearing organ consists of three parts, namely:

  • The outer ear,the part that can be seen on the sides of the head, as well as the earcanal. The earcanal consists of fine hairs and has small glands which produce earwax
  • The middle ear consists of the eardrum and the three bones known as the hammer, anvil and stirrup
  • The inner ear is made up of the cochlea and the auditory nerve

Anatomy of the ear

How Do We Hear

Hearing begins when the outer ear directs or channels sound waves through the ear canal to the eardrum. The sound waves cause the eardrum to vibrate and this movement is then transferred to the hammer from where it it is transferred to the anvil and in turn the stirrup from where it is transferred to the inner ear.

The inner ear converts the sound waves to nerve impulses and these are transferred via the haircells in the cochlea to the nerve and then to the brain. The brain alerts us to long as the message is adequately transferred

How do we hear

Causes Of Hearing Loss

The main causes of hearing loss are:

  • Aging (presbycusis)
  • Excessive noise (mining, construction, shooting, music)
  • Infections
  • Injury
  • Birth defects or genetics
  • Ototoxic reaction to drugs or cancer treatment (antibiotics, chemotherapy, radiation)

Hearing loss can be caused by damage to any one of the parts of the ear.

Typical problems which occur in the outer ear are waxplugs, foreign objects in the canal and infections of the ear canal. These problems can be easily addressed, but it is important to resolve them in order to avoid complications and possible permanent damage

Wax plugs

Wax plugs

Foreign object

Foreign object

Outer ear

  • Causes in the middle ear

The most common problems which occur in the middle ear are infections, fluid behind the eardrum, perforated eardrums and calcification of the middle ear bones (otosclerosis).

  • Causes in the Inner ear

The most common problem is caused by the natural aging process.Other causes include prolonged exposure to loud sounds, exposure to certain medications and skull fractures. Any damage to the minute inner ear hair cells will afeect the transfer of sounds to the hearing nerve. Damage to the inner ear usually cannot be medically treated but can be addressed by the use of a hearing aid

Healthy hair cells

Damaged hair cells

Symptoms Of a Hearing Loss

You might have a hearing loss if you:


  • Require frequent repetition
  • Have difficulty following conversations involving more than 2 people
  • Think that other people are mumbling
  • Have difficulty hearing in noisy situations like conferences, restaurants, malls, or parties
  • Have trouble hearing women or children
  • Have your TV or radio turned up to a high volume
  • Answer or respond inappropriately in conversations
  • Have a ringing in your ears
  • Read lips or have to watch people's faces when they speak


  • Feel stressed from straining to hear what others are saying
  • Feel annoyed at other people because you cannot hear or understand them
  • Feel embarrassed to meet new people or from misunderstanding what others are saying
  • Feel nervous about trying to hear and understand
  • Withdraw from social situations that you once enjoyed because of difficulty hearing


  • Have a family history of hearing loss
  • Take medications that can harm the hearing system (ototoxic drugs)
  • Have diabetes, heart, circulation or thyroid problems
  • Have been exposed to very loud sounds

Degrees Of Hearing Loss

There is a large spectrum of hearing loss between the ability to hear "well" and hear "nothing". Audiologists differentiate between mild, moderate, severe and profound hearing loss. The most common degree of hearing loss which is seen in practice is mild to moderate or moderately-severe.

  • Mild hearing loss
    The individual cannot hear soft sounds. It is difficult to understand speech in a noisy environment
  • Moderate Hearing loss
    Soft and moderate sounds are not heard. The understanding of speech becomes difficult in the presence of background noise
  • Severe hearing loss
    Conversations must be loud. The person will only be able to function in a group situation with concerted effort and concentration
  • Profound hearing loss
    The person will only be able to hear very loud sounds. Communication without a hearing aid will be almost impossible

The Consequences Of Untreated Hearing Loss

Studies have linked untreated hearing loss to:

  • Irritability, negativism and anger
  • Fatigue, tension, stress and depression
  • Avoidance or withdrawal from social situations
  • Social rejection and loneliness
  • Reduced alertness and increased risk in personal safety
  • Impaired memory and ability to learn new tasks
  • Reduced job performance and earning power
  • Diminished psychological and overall health

What Does a Hearing Loss Sound like?

We cannot hear how other people hear. In turn, a person with a hearing loss can also not describe to us what it sounds like not to hear certain sounds. They will often say they can hear we are speaking, but cannot make out what we are saying. Hearing loss usually results in certain speech sounds being unclear. Consonants, especially /p/, /k/, /f/, /t/ and /s/, are no longer heard.

Effect of hearing

Click here to experience what a hearing loss sounds like

Protect Your Hearing

What Are The Effects Of Noise?

Too much noise can cause lasting damage to your hearing. Next to age, it is the most common cause of permanent hearing loss and can therefore usually not be corrected surgically or medically.

Frequent exposure to loud or moderately loud noise over a long period of time can damage the fine hair cells of the inner ear. Cells and nerves in the inner ear are destroyed by continuous or repeated exposure to loud sounds. If enough cells are destroyed, hearing is permanently damaged.

Both the amount of noise and the length of time you are exposed to the noise determine its potential to damage your hearing. Noise levels are measured in decibels (dB). The higher the decibel level, the louder the noise. Sounds louder than 80 decibels, are considered to be potentially hazardous

What Are The Symptoms Of Noise-Induced Hearing Loss?

Although noise-induced hearing loss is one of the most common occupational illnesses, it is often ignored because there are no visible effects. A noise-induced hearing loss usually develops over a long period of time, and is very rarely associated with any pain. The symptoms are usually feelings of pressure or fullness in the ears, speech sounds muffled, and a ringing sound in the ears, usually noticed when in a quiet place. These symptoms can last for up to several days after the exposure to noise ends.

People often assume that if the symptoms go away, their hearing has recovered back to normal. This is not true. Even if no more symptoms occur, some of the cells in the inner ear may have been destroyed or damaged by the exposure to noise. You will develop a permanent hearing loss if the noise exposure is repeated and more cells are destroyed.

The first signs of a permanent noise-induced hearing loss are:

  • not hearing high-pitched sounds or
  • not understanding speech when in a crowd or an area with a lot of background noise, such as a restaurant.

If the exposure to noise is continued, hearing will decline further. This results in a progressive loss of communication, socialization, and responsiveness to the environment.

How Can You Decide Which Noises Are Too Loud?

The following signs should be a warning that the noise around you is too loud:

  • If you have to shout to be heard above the noise.
  • If you can't understand someone who is speaking to you from less than 1m away.
  • Speech around you sounds muffled or dull after leaving a noise area
  • You have pain or ringing In your ears (tinnitus) after exposure to noise.

How Can I Prevent Noise-Induced Hearing Loss?

The key word in dealing with noise is protection

Non Occupational Noise

Non-occupational noises are also regularly encountered during recreational activities and are a source of premature hearing reduction. Peak noise levels, in dB, are provided in the following table.

Noise Level in dB
Firecracker 180
Gunshot 167
Car Stereo 154
Jet 135
Children's toys 150
Sporting events 127
Rock concert 120
Garden Blower 120
Gyms 120
Games Arcade 110
Night Clubs 97
Movies 94
Lawnmower 94
Bulldozer 88

When You Are Exposed To Noise, The Keyword Is "Protection"

One third of permanent hearing loss could be prevented with proper hearing protection. At Michaelides and Vermaas we supply a variety of hearing protectors:

Hunting Ear Protection

Hunters Plugs

Hunting requires one to have the ability to hear very soft sounds, while still protecting the ear from the peak noise levels of a shot gun blast. Fortunately, hunters have many options for protection. Not only can they choose from custom or over-the-counter ear plugs or ear muffs, they can also choose protection devices that provide amplification while reducing the sounds of gunfire down to a safe level.

Ear Protection for Musicians

Music Ear

Professional musicians work in a high decibel environment in which hearing loss, tinnitus, hyper-sensitivity to sound and sound distortion can result. Traditional earplugs will not work for the professional musician, as they reduce sound by muffling low-to-mid-range frequencies. Special musicians ear moulds are available that can protect the musician's ears from loud sounds without distortingwhat they hear. Many products are available that will even enhance the music experience. Benjamin Franklin got it right when he said "an ounce of prevention is worth a pound of cure." Just as you would take preventative measures to protect yourself from heart disease or diabetes, it pays to protect yourself from hearing loss.

Recreational Shooters

Hunters Plugs

As many as 50 percent of all recreational shooters may suffer some degree of hearing loss. It is generally thought that loud noises in excess of 90 decibels are harmful to hearing over prolonged exposure. Most gunfire exceeds 130 decibels and requires reliable, quality hearing protection. Using ear protection can prevent needless and permanent damage to hearing


Moto Ear

The biggest source of noise comes from wind. There are two types of hearing protection for bikers. The Moto Com that allows communication while you ride and the Moto Ear that provides hearing protection while you ride

Industrial Hearing Protection

Noise Ban

Loud, constant sounds all day long at work can cause long term hearing problems. Loud, sudden noises (gunfire, industrial noises, woodworking, motorcycles, loud music, motorized lawn equipment, noisy hobbies and other noises louder than 90 db) are more damaging to hearing than earplugs can significantly reduce loud noises and prevent hearing damage and loss. Hearing protectors not properly fitted to the wearer's ears do not effectively prevent damaging noises from penetrating the ear canal.

Protect The Hearing That You Have Now!

Have your hearing checked.

Persons at risk for hearing loss should have their hearing tested every year. You are at risk if you are regularly exposed to loud noise at work or recreation 

There are three types of hearing loss:

Conductive hearing loss

Conductive hearing loss is caused by any condition that blocks or impedes the conveyance of sound through the outer or middle ear. The result is a reduction in the loudness of the sound that reaches the cochlea. Generally, the cause of this hearing loss can be medically treated

Sensorineural hearing Loss

Sensorineural hearing loss results from inner ear or auditory nerve dysfunction. Often the cause cannot be determined. It is typically irreversible and permanent. It, too, reduces the intensity of the sound, but it might also result in a lack of clarity even when sounds, particularly speech, are loud enough. The treatment for sensorineural hearing loss is amplification through hearing aids

Mixed hearing loss

A mixed hearing loss is a combination of a conductive and a sensorineural hearing loss. Hearing aids can be beneficial for people with a mixed hearing loss after the conductive component has been treated

Do YOU have a hearing loss?
Hearing In Children

Normal development of children's communication is as follows:

Age Communication Behaviour
5 months Turn to the source of sounds
6 months Recognise voices and engage in vocal play
9 months Demonstrate understanding of simple words
10 months Babbles by stringing sounds together
12 months A few recognisable words are spoken
18 months Understands simple phrases, points to body parts on request, vocabulary of 20-50 spoken words and short phrases
24 months Spoken vocabulary 200 -300 words. Speaks simple sentences, speech mostly understood by adults. Listens to read stories
3-5 years Uses spoken language effectively, reflects emotions, give information and ask questions. Understands language well. All speech sounds clear and understandable by 5 years

Signs Of Hearing Problems In Children

The single most important sign of hearing loss in children is the failure to develop language. If children have severe or profound hearing loss, it is obvious because they do not respond to sound. Sometimes it is difficult to detect mild forms of hearing loss, including a hearing loss only in one ear. Even a mild hearing loss can have a negative impact on communication development and school performance.

Common warning signs include:

  1. Family member or teacher concerned about:
    • Hearing ability
    • Language delay
    • Attention or behaviour difficulties
    • Academic performance
  2. Inappropriate or lack of response to soft or moderate level sounds or speech3 Frequent use of "what" or "huh"
  3. Intently watching faces of speakers
  4. Difficulty understanding speech in presence of background noise
  5. Sitting close to TV or turning volume up high
  6. Not responding over telephone or continuously switching ears when trying to talk on phone
  7. Not startled by loud sounds
  8. Unable to locate source of a sound

Hearing Can Be Evaluated At Any Age

Hearing tests can be done in children of any age using objective and subjective audiologic test technologies. If there are any concerns, a hearing test should not be delayed.

All newborn babies should be screened for hearing loss before 1 month of age. If a hearing loss is present, it should be confirmed by 3 months and intervention should be in place by 6 months (JCIH, 2000)

Risk Conditions For Childhood Hearing Loss (JCIH, 2000)


  • Admission of 48 hours or more to hospital
  • Findings associated with syndrome known to cause hearing loss
  • Family history of hereditary childhood hearing loss
  • Craniofacial abnormalities, including abnormalities of outer ear and/or ear canal
  • In-utero infections like cytomegalovirus, herpes, toxoplasmosis, or rubella


  • Concern regarding speech, hearing or development
  • Family history of childhood hearing loss
  • Findings associated with syndrome known to include hearing loss or Eustachian tube dysfunction
  • Post-natal infections associated with hearing loss eg bacterial meningitis
  • Neonatal indicators like hyperbilirubinemia, persistent pulmonary hypertension and ECMO
  • Syndromes associated with progressive hearing loss like neurofibromatosis, osteopetrosis and Usher's syndrome
  • Neurodegenerative disorders such as Hunter syndrome, Friedreich's ataxia and Charcot-Marie-Tooth syndromeo Head trauma
  • Recurrent or persistent otitis media with effusion for at least 3 months

Your child's hearing is the means through which communication will develop. Guard your child's hearing carefully and seek professional help if you are concerned

The Impact Of Treated Hearing Loss On Quality Of Life

(Sergei Kochkin)

People with hearing loss seem to delay a decision to get hearing help because they are unaware of the fact that receiving early treatment for hearing loss has the potential to literally transform their lives. Research demonstrated that hearing aids are associated with impressive improvements in the social, emotional, psychological, and physical well-being of people with hearing loss. Hearing aid usage is positively related to the following quality of life issues:

  • Earning power
  • Communication in relationships
  • Intimacy and warmth in family relationships
  • Ease in communication
  • Emotional stability
  • Sense of control over life events
  • Perception of mental functioning
  • Physical health
  • Group social participation

Just as importantly, hearing loss treatment was shown to reduce:

  • Discrimination toward the person with a hearing loss
  • Hearing loss compensation behaviour (pretending to hear)
  • Anger and frustration in relationships
  • Depression
  • Feelings of paranoia
  • Anxiety
  • Social phobias
  • Self-criticism

If you are one of those people with even a mild hearing loss, consider all the benefits of hearing aids described above. Hearing aids hold such great potential to positively change so many lives

You Should Hear What You Are Missing

Sounds Of Speech

The Sounds Of Human Speech

The vowels and consonants of speech occur at different frequencies and intensities. This can be illustrated on and audiogram as follows:

The area in which the sounds of human speech occur is called the "speech banana". Unfortunately this is also the area in which hearing loss usually occurs