What is it like to have a hearing loss?
Hearing loss is an invisible disability. It can affect any person at any age, and there are many different types and causes of hearing loss.
Hearing aids amplify sound and may give someone with a hearing loss better access to sounds. However, this will not sound the same as hearing with a normally functioning ear. Those that use hearing aids may still struggle at times, especially group situations and in places with background noise.
People with a severe to profound hearing loss find everyday communication extremely difficult; even a simple conversation with one other person can be a major challenge. Individuals that hear normally can listen to simple conversation so easily they can do it with their eyes shut!
Those who hear very little rely on what they see as well as what they hear to make sense of what is being communicated. Lip reading can become an important skill for those who have a hearing impairment. It is surprising how much information one can get from reading facial cues and body language. The world becomes a visual experience.
What causes hearing loss?
Hearing loss can affect any person at any age, and there are many different causes, types and degrees of hearing loss. The diagram below describes briefly how the ear detects and delivers sounds to the brain.
- Sounds enter the ear canal and strike the eardrum.
- The ear drum and bones in the middle ear vibrate.
- The vibrations move through the fluid in the cochlea and cause the tiny hair cells in the cochlea to move. The hair cells detect the movement and change it into the electrical signals.
- These electrical signals are then sent by the hearing nerve to the brain where they are interpreted as sound.
If any part of the ear is damaged or stops working as it should, a hearing loss can occur. A hearing loss can affect the volume as well as the quality of the sound being delivered to the brain.
Damage can occur for a number of different reasons. Some children are born with a hearing loss. Some adults are affected by an age-related hearing loss to a greater degree than others. Sometimes the damage is caused by an infection or disease. In some cases, the cause of a hearing loss is simply unknown.
Sometimes hearing losses can be corrected by a treatment or procedure, depending on the cause. If this is not possible, benefit may be gained from using a hearing aid. However, if a hearing loss deteriorates to a profound level, it is often difficult to aid the hearing with a hearing aid and a cochlear implant may be considered.
What is a cochlear implant and who can have one?
If someone’s hearing loss deteriorates to a profound level, the benefit they get from a hearing aid may be minimal. Hearing aids can only amplify to a certain level and for some people this isn’t enough. This will affect the quality of speech and how well someone can differentiate between words. A cochlear implant may offer a solution.
A cochlear implant is an electronic device made up of two parts: an internal implant and an external sound processor. The internal part is surgically implanted within the cochlea and the sound processor is worn on the outside of the ear like a hearing aid.
The external sound processor detects the sound and delivers the signal to the internal implant by radio waves. The internal implant then converts this signal into tiny electrical impulses which directly stimulate the hearing nerve. The brain interprets these impulses as sound.
Someone may be a candidate for a cochlear implant if:
- They have a severe to profound hearing loss in both ears.
- They no longer receive any benefit from their hearing aids.
- They can no longer hear on the telephone, even whilst wearing their hearing aids.
- They find every day listening situations a challenge.
What will happen during the cochlear implant assessment?
The assessment process is made up of several appointments. Some of the appointments can be quite lengthy and require a lot of discussion. This can be quite tiring for someone who is profoundly deaf, so an extra set of ears is always useful.
When the assessment process is complete the whole team will meet to discuss each case individually and a decision will be made on the suitability for a cochlear implant.
What can someone hear with a cochlear implant?
The implant is not switched on until 3 weeks after the surgery. This allows time for recovery following the surgery. During this time, communication may be challenging so patience is of the utmost importance.
A cochlear implant does not give someone ‘normal hearing’ and what is ultimately heard is different for everyone. The understanding of sounds does not happen immediately after activating the implant. When it is first switched on it sounds very strange. Some people just hear beeping noises and some people say that all speech sounds like a robot or a cartoon character. The sound improves with time and it takes a lot of practice to get the best from an implant.
It is important to remember that although a cochlear implant user should manage better in comparison to their hearing aids, the majority of people still struggle to some extent in more challenging listening situations, such as within groups or where there is an increased level of background noise. Some people with a cochlear implant are able to use the phone and appreciate music, but many cannot. It is by no means guaranteed.
Assertiveness is an important skill for someone who has a hearing loss. This does not come easily to everyone and they may not feel confident enough to explain their hearing difficulties.
Ease of communication is the responsibility of everyone involved in the conversation, not just the person with the hearing loss. Be careful to ensure that the person always feels a part of the conversation. Patience is of the utmost importance and will be greatly appreciated.
If you feel that you or anyone you know would benefit from some further advice on communication tactics, please speak to one of our audiologists or keyworkers who can arrange some specific sessions to discuss this further or give you some information to take home.
- Royal National Institute for Deaf People (RNID)
- Advanced Bionics
South Tees Hospitals NHS Foundation Trust would like your feedback. If you wish to share your experience about your care and treatment or on behalf of a patient, please contact The Patient Experience Department who will advise you on how best to do this.
This service is based at The James Cook University Hospital but also covers the Friarage Hospital in Northallerton, our community hospitals and community health services.