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Hearing Loss

Hearing loss falls into two general categories: conductive and sensorineural.

Conductive Hearing Loss

Hearing is the process of conducting sound waves from the air outside the ear to the sensory structures of the inner ear. Your inner ear transforms sound into nerve impulses and transmits them to the brain.

Conductive hearing loss interferes with this process. This interference may result from blockages, such as earwax and fluid buildup in the middle ear (immediately behind the eardrum). Damage to your eardrum may prevent proper conduction of sound into the middle ear. Other conditions may prevent parts of your middle ear from conducting sound to the inner ear. Conductive hearing loss can often be reversed.

Sensorineural Hearing Loss

Even when the outer structures of the ear transmit sound effectively through the middle ear to your inner ear, the inner ear may lose its ability to transform sound waves into nerve impulses. The cochlea, (a structure shaped like a snail shell) in the inner ear, contains a special fluid and is lined with large numbers of hair cells. Transmitted sound moves this fluid, the cells move in response, and their movement becomes nerve impulses passed on to the brain.

Loss of these hair cells causes sensorineural hearing loss. Loud noise and age may cause the loss of hair cells. Sensorineural hearing loss cannot generally be reversed, but treatments may restore some hearing ability. 

Many people with hearing loss receive successful treatment. Indiana University Health otolaryngologists are experts in correctly diagnosing your hearing loss and providing care that may improve or reverse it. We have techniques that may recover partial hearing for those with severe hearing loss.

IU Health specialists have particular expertise in cochlear implants. These devices transmit sound information directly to the auditory nerve. Cochlear implants may restore some hearing to people with severe sensorineural hearing loss. Patients come to IU Health from throughout Indiana for thorough hearing testing and possible treatment with these implants.

Our multidisciplinary focus brings our doctors together with other professionals, such as audiologists, to provide comprehensive, patient- and family-centered care. We involve you and your family in decisions so your treatment is tailored to your particular needs and preferences.

We also participate in research on cochlear implants to expand our understanding of how these devices affect hearing and sound perception. Adults with implants may recover the ability to have conversations, even on the phone. Children with these devices may achieve oral communication as their primary mode of communication, but there is some variability in outcomes and levels of language development. We are studying this phenomenon to learn what can be done to improve these outcomes.

How We Can Help

How We Can Help

Hearing Loss Treatment Information

Treatments for hearing loss vary depending on the cause of the condition.

Conductive Hearing Loss

Conductive hearing loss can sometimes be partially or fully reversed. We can remove earwax and other objects blocking your ear canal, allowing sound to reach your eardrum unimpeded. In some cases, the eardrum itself may be damaged. This may be caused by injury to your head or ear, or by sudden changes in air pressure that cause your eardrum to burst. Although it may often heal itself, we may repair your eardrum surgically to restore hearing.

Infections sometimes cause pressure in the middle or inner ear. We may treat these with drugs to reduce the pressure. Ventilation tubes inserted into the eustachian tubes (passages that lead from the ear to the back of the throat) are another treatment we may use to relieve pressure inside your ear.

Two other causes of conductive hearing loss are otosclerosis and cholesteatoma. Otosclerosis is bony overgrowth that limits the movement of tiny bones in your middle ear. This reduces transmission of sound to your inner ear. We rebuild this structure to improve hearing. Cholesteatoma is a condition in which eardrum tissue has grown over the bones in the middle ear, hindering sound transmission. We correct this condition surgically.

Sensorineural Hearing Loss

This is the most common form of hearing loss. It is often gradual and can be part of the natural process of aging (presbycusis) or the result of continued exposure to loud noise. Typically, sensorineural hearing loss involves loss of hair cells in the cochlea. This damage reduces the ear’s ability to transform sound waves into nerve impulses. As a result, the brain loses perception of sound.

Hearing aids can overcome some sensorineural hearing loss by amplifying sound directly into your ear canal. For severe sensorineural hearing loss, we may use a cochlear implant. This is a pair of devices, one outside the body, the other implanted in the head near the ear.

The external device receives sound and translates it into electrical impulses. These impulses are transmitted to the internal device, which then sends them directly to your auditory nerve. Hearing with a cochlear implant is different from hearing through the ear, but adults with sensorineural hearing loss usually learn to understand sounds and speech.

Cochlear implants may not be as effective for children who have not developed language ability or for adults who were born deaf or who became deaf before acquiring language. This often means they cannot develop an understanding of spoken language or translate speech into meaning. The implant still functions, but the brain is unable to recognize how the electrical impulses translate into language.

We are actively conducting research into ways to make cochlear implants better for children. Severe hearing loss hinders learning. We want to help children with severe hearing loss use their implants to overcome their difficulties.


Hearing Loss Locations & Physicians

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Hearing Loss Support Services

Hearing loss has complex effects on your life and relationships. You may be able to help yourself overcome these challenges by learning more about hearing loss and using available support services.