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12/13/2017 Hearing LossDecibels or Percent

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HOME HEARING LOSS HEARING LOSSDECIBELS OR PERCENT

Hearing LossDecibels or Percent


by Neil Bauman, Ph.D.

Question: From time to time, I see people writing, I have 78% hearing loss in my right ear and 95% in
the left. What does this percent mean? I thought sound was measured in decibels (dB), not percent?
If this is the case what percent is 115 dB?R. D.

Answer: Excellent questions. You have good reason to be confused because you cannot equate
decibels to percentages no matter what anyone tells you.

Decibels vs. Percent


Sound intensities are indeed measured in decibels (dB). There are two reasons why you
canneverequate decibels to percentages. First, the decibel scale is open-ended like that of the
Richter scale used for measuring earthquake intensities. To calculate a percent you need to know the
maximum value possible. In both of these scales there is no limiting maximum value. Therefore,
youcannotcalculate a percentage. Any attempt to do so is just a bunch of meaningless gibberish!

Second, the decibel scale is logarithmic, while the percent scale is linear. Numbers that appear to be
similar have vastly differing meanings. They are as different as trying to compare apples to elephants!

When people (ignorantly) talk about having a 50 percent hearing loss they likely mean that they have
a 50 dB loss. Where did the idea come from that we can measure hearing loss in percentages? Here is
how Brad Ingrao, an outstanding audiologist, explained it.

To measure sound intensity (the way audiologists measure it) you need to do a
mathematical calculation that is so strange that 20 + 20 = 26 dB (SPL).

To make a scale that makes sense to most people (including us knucklehead audiologists),
a different equation is used to convert sound intensity using the Sound Pressure Level
(SPL) scale to the Hearing Level (HL) scale that goes from 0 dB HL (normal threshold) to
120 dB HL (pain).

If we forget about hearing losses greater than 100 dB (like most people tend to do), we
get 0 dB to 100 dB as the usable (dynamic) range of hearing for the average normal ear.

Since doctors and audiologists tend to under-estimate their patients ability to


understand such things (or they dont understand it themselves), the erroneous concept
of dB = % evolved.

There you have it folks. It seems health care professionals think we are too stupid to understand
much, so they let us believe error rather than teach us the truth.

We can put a stop to this nonsense right now. Lets understand how this decibel scale works and why
using a percentage value to describe our hearing losses is so very wrong.

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First we need to understand that a decibel is not a given intensity (loudness) of sound, but rather, it is
aratioof how many times louder (or softer) a sound is than a given reference sound level.

This means that 0 dB is not the absence of sound, but is an arbitrary zero. We de ne it as the faintest
sound that a young sensitive human ear can hear. Furthermore, because the decibel scale is
logarithmic, every 10 dB increase in sound intensity is actually aten-foldincrease. Therefore, a
sound intensity of 20 dB is not twice as loud as a sound intensity of 10 dB, but is 10 times as loud, and
a sound intensity of 30 dB is 100 times as loud as a sound intensity of 10 dB. Similarly, a sound
intensity of 50 dB would be 10,000 times as loud (10 x 10 x 10 x 10) as a sound of 10 dB. This is how
the decibel scale works. It is totally unlike the linear percent scale.

Now lets see the fallacy of trying to compare this funny decibel scale to the percent scale. To
illustrate this, lets assume (remember this assumption were making here is totally wrong) that 0 dB
is equal to 0 percent hearing loss and that 100 dB equals a 100 percent loss. This would then mean
that 50 percent would equal a 50 dB hearing loss, right? Wrong! Not by a long shot! A
50percenthearing loss would equal, believe it or not, only a 3 dB loss! Looking at it the other way, a
50decibelloss is not just half as loud, like it would be in a percentage scale, but would only be one
thousandth of one percent as loud!

Here is another example. I have a 70 dB loss. This is not equal to a 70 percent loss by any means. In
actual fact it means that the softest sound I can hear needs to be 10,000,000timeslouder than the
softest sound a person with normal hearing can hear. One out of ten million is de nitely not a 70 per
cent loss but would be a loss of 99.9999999%! Quite a difference, isnt it? Now you can see why we
must never use percentages when talking about our hearing losses. They just do not equate. They are
absolutely meaningless!

Percent Used to Describe Discrimination


Although we cannot use percentages to describe our hearing losses, we correctly use percentages to
describe our ability to discriminate sounds. To determine our ability todiscriminatebetween words,
our audiologist sets the volume at our most comfortable listening level. She then has us listen to a list
of words and we repeat back what we think we heard. The number we get right, converted to a
percentage, becomes our discrimination score.

Therefore, if I understood 80 out of 100 words in my right ear, my discrimination is 80% for that ear. I
may have an entirely different result for my other ear. Consequently, we can correctly describe our
ability tounderstandwhat we hear as a percentage. A person could correctly say that his
discrimination is 78% in his right ear and 95% in his left ear. But this has nothing to do with
theseverityof our hearing losses as such.

Percentage and Hearing Disability


If your hearing loss resulted from an accident on the job, there is a formula that is used to calculate
the percent disability pension for which you may be eligible. Dont get mixed up. This isnotyour
hearing loss expressed as a percentage. Rather, this formula calculates how much your degree of
hearing loss supposedly impacts your ability to remain employed at full wages.

For example, plunking your hearing loss levels into the formula may yield a result of 75%. This means
that with your particular hearing loss, you may be entitled to a 75% disability pension. Again, this
isnotyour average hearing loss expressed as a percentage. If you are interested in how they calculate
a percentage disability for any given hearing loss, see my article you can read it at How Much Are
You Worth as a Hard of Hearing Person?.

Classifying Our Hearing Losses


Hearing health care professionals classify hearing into several categories such as normal, slight, mild,
moderate, moderately severe, severe, profound and deaf. Not all of them use all of these categories,
nor do they all use the same hearing loss ranges in each one. In the past, most used this simple scale.

Simple Hearing Classi cation Hearing Threshold

Normal hearing down to 20 dB

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Mild hearing loss 21 to 40 dB


Moderate hearing loss 41 to 60 dB
Severe hearing loss 61 to 90 dB

Profound hearing loss greater than 90 dB

Today, research has shown that even hearing losses of only a few decibels can cause signi cant
hearing problems. As a result, many hearing health care professionals have ne-tuned this scale to
better re ect this reality. (Note that these ranges are arbitrary and may vary slightly among
authorities.)

Todays Hearing Classi cation Hearing Threshold


Normal hearing -10 to 15 dB

Slight hearing loss 16 to 25 dB


Mild hearing loss 26 to 40 dB

Moderate hearing loss 41 to 55 dB


Moderately severe loss 56 to 70 dB
Severe hearing loss 71 to 90 dB

Profound hearing loss 91 to 120 dB


Deaf greater than 120 dB

Describing Our Hearing Losses


Unless you have a at curve on your audiogram, how can you accurately describe your hearing loss?
Your hearing loss could be different at every frequency so one word could be meaningless.

The best way is to be speci c. If I have the typical ski slope hearing loss, I could describe it as, I have
a 30 dB loss at 500 Hz, dropping to 100 dB at 4,000 Hz. A more general way, but still accurate, would
be to describe it as, I have a mild loss in the low frequencies, dropping to profound in the higher
frequencies.

The next best way to describe our hearing losses is to average the 4 frequencies that carry most of
the speech information to arrive at a single gure. Use the following four frequencies500 Hz, 1,000
Hz, 2,000 Hz and 3,000 Hzand average the hearing loss at these frequencies to come up with one
gure. However this method falls down if we only have a bit of hearing left in the very low
frequencies. Incidentally, it is not right to take the average of our best and worst gures. That could
give a very wrong impression of our hearing losses.

If you want a very simple way to describe your hearing loss, the most accurate (and simple) is to say
you have either a mild, moderate, severe, or profound hearing loss. Your audiologist can tell you
which category your hearing is generally in. (Remember, you could be mild in the low frequencies and
profound in the highsbut to oversimplify, you can reasonably accurately re ect
yourpracticalhearing loss by using one of these categories.) It is much more meaningful, and far
more accurate than trying to use a meaningless percentage. Lets get back to using these standard
audiological terms and stamp out this absurd percent business.

Comments

YOPENDRA PATREY says

November 7, 2015 at 9:52 AM

I have loss Rt ear 103DB and Lt ear 35 DB what is the % of hearing loss ?

Reply

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NEIL BAUMAN, PH.D. says

November 7, 2015 at 10:08 AM

Hi Yopendra:

You dont measure hearing loss in percentages. That was the whole point of this
article. You simply say you have a profound loss in your right ear and a mild loss in
your left ear.

Cordially,

Neil

Reply

MUBEEN says

October 29, 2016 at 8:41 AM

Dr my son has found profound hearing loss in audiology test he is jst 2 years old
plz tell us what shall we do for his father treatment ? Whether he wll become
deaf we fear so

Reply

NEIL BAUMAN, PH.D. says

October 30, 2016 at 4:38 PM

Hi Mubeen:

If your son has a profound loss at 2 years old, Id have him evaluated for a
pair of cochlear implants. That would seem to be the most effective
treatment at this time.

Cordially,

Neil

Reply

AJAY says

January 25, 2017 at 10:12 AM

Hello Doc,

I got sudden hearing loos in 2011 and after that my right ear has very low
hearing power. During that time my doctor told that i have no opetion for the
same. I will appricate and thankful if will help me to know if still i have some
hope.

Reply

NEIL BAUMAN, PH.D. says

January 25, 2017 at 10:29 AM

Hi Ajay:

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12/13/2017 Hearing LossDecibels or Percent

You dont say, but I assume that you have a sensorineural (inner ear)
hearing loss. If so, after 6 years, Id say the hearing loss is permanent and
nothing much can be done to help you other than to wear a hearing aid in
that ear.

Cordially,

Neil

Reply

TANAY CHAKRABORTY says

October 28, 2017 at 3:23 PM

Today Audiogram tested by medical and its refers that I have 56.6 dBHz.
Can it be recovered as I cannot hear anything with my left ear sir. But my Right ear is
totally ok and its working ne.

Reply

NEIL BAUMAN, PH.D. says

October 29, 2017 at 11:14 AM

Hi Tanay:

If you left ear has a hearing loss of 56 dB, then you can hear with that ear. You
are not totally deaf in that ear. It may seem like it compared to your other ear,
but you still hear a lot of sounds.

You havent told me anything about the events surrounding your hearing loss,
whether your hearing loss is conductive for sensorineural, etc., so I cant even
hazard a guess whether your hearing will come back or not.

Cordially,

Neil

Reply

KESHAV PATHAK says

December 15, 2015 at 12:55 PM

Im hearing impaired with 97.5 % in both ears. What will db??

Reply

NEIL BAUMAN, PH.D. says

December 15, 2015 at 2:54 PM

Hi Keshav:

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Your hearing loss in dB is shown on your audiogram. What does it say?

Cordially,

Neil

Reply

INDRA says

December 17, 2015 at 5:45 AM

My both ears eardiume in hole.And audiology report is moderate hearing losses.my hearing
capacity so in chart both ear 40db to 45 db.can I apply physical handicapped certi cate
.please give me answer.

Reply

NEIL BAUMAN, PH.D. says

December 17, 2015 at 6:00 AM

Hi Indra:

Your hearing loss not bad enough to warrant receiving SSDI. Presumably all you need
to do is have the holes repaired by surgery and/or get hearing aids to bring your
hearing up to near normal.

Cordially,

Neil

Reply

JAGDISH says

December 18, 2015 at 2:06 AM

can a hearingloss of 77 db and 57 db resp In right and left ear (mixed


hearingloss) can be regarded as physicaly handicapped under amended
categories under handicap act?
-Jagdish

Reply

JAGDISH says

December 18, 2015 at 3:12 PM

can a hearingloss of 77 db and 57 db resp In right and left ear (mixed


hearingloss) can be regarded as physicaly handicapped under amended
categories under handicap act?
-Jagdish

Reply

NEIL BAUMAN, PH.D. says

December 20, 2015 at 9:35 AM

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Hi Jagdish:

Which handicap act are you talking about? And for which country?

That degree of hearing loss is de nitely handicapping if you dont


have the appropriate accommodations for your hearing loss. But that
doesnt mean you cant work productively.

Cordially,

Neil

JAGDISH says

December 18, 2015 at 2:10 AM

Can a mixed loss occured due to removal of infectedbones in the ear be cured?

Reply

NEIL BAUMAN, PH.D. says

December 20, 2015 at 9:28 AM

Hi Jagdish:

I dont think they can x the conductive part of your middle ear to restore hearing, but
a bone conduction hearing aid can bypass the middle ear and let you hear via your
inner ear. This will only work as well as your sensorineural hearing permits. If the
sensorineural component of your mixed loss is only mild, then bone conduction could
work quite well for you. You could investigate getting a BAHA (bone anchored hearing
aid).

Cordially,

Neil

Reply

JSGDISH says

December 20, 2015 at 10:44 AM

Thank you sir for very good information on the basis of very brief record and that too
in the absence of patient. I was talking about indian person with disability act 1995. as per
which loss in 60 db or more in better ear in conversation al range of frequency is regarded
as impaired . at the same time they also de ne 40% loss as impaired it looks discrepancies.
also my another question isabout tinitus in the left ear. 6 to 7 types of the sounds comes

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from it I. of rail engine, owing water, scisdor cutting hairs , shitties, night insects and one or
two more which I could not identi ed can they stopps by any surgicsl operation?

Reply

NEIL BAUMAN, PH.D. says

December 21, 2015 at 6:16 AM

Hi Jagdish:

Sorry, I dont know anything about the Indian disability laws so cant help you there.

Hearing 7 different tinnitus sounds at the same time is not all that common, but it
does happen. Around 16% of the people with tinnitus hear 3 or more sounds at a time.

There is only one surgical procedure for tinnitus and that is to cut the auditory nerve
leaving you totally and permanently deaf on that side. But there is no guarantee that it
will stop your tinnitus. In at least 50% of the cases where they did that, it made no
difference to the tinnitus. So that is not something you want to consider.

There are many tinnitus treatments out there. The most effective center around
sound therapy and psychological therapy. Doing one of each at the same time works
the best for most people.

Cordially,

Neil

Reply

JAGDISH says

January 2, 2016 at 8:54 AM

Your guidence is really very valuable sir.i am getting pleassure in asking you questions on
this topic.do have any trouble sir? i will ask only if you permit.

Reply

NEIL BAUMAN, PH.D. says

January 2, 2016 at 3:39 PM

Hi Jagdish:

Ask your questions. If I have time, Ill answer them.

Cordially,

Neil

Reply

JAGDISH says

January 12, 2016 at 4:50 AM

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sir ,
while taking audiogram, the earphones are either touched close to ear in
testing air conduction and behind ear bones to test
bone conduction.can
whatever response grtting
for any frequencies can be
obtained from a certain
distance, say 5 or 10 feet?

also, in sperch discrimination test,words are said in islated form. can whatever the result
obtained may be same if these word
s are tested in a long sentences said in consersational sppech?

Reply

NEIL BAUMAN, PH.D. says

January 12, 2016 at 6:23 AM

Hi Jagdish:

The reason hearing tests are done with earphones tight against the ears is so that the
results will be the same for everyone and the same results can be reproduced by any
audiologist.

They could have just as easily decided that all hearing testing was to be done at 5 or
10 feet and if everyone used that standard then the results would be reproducible by
any tester. However, as the distance increases, the higher frequency sounds wont be
heard because high-frequency sounds do not travel well through airso youd only be
testing how well you could hear low and mid frequency sounds.

If you wanted to extrapolate the results from headphones out to 5 or 10 feet, you
could do so using the inverse squares law that says that the volume of the sound is
iversely proportional to the square of the distance.

In speech discrimination again they use standardized word lists and given at the
persons most comfortable listening level. This gives reproducible results no matter
who does the testing.

The words are all single syllable words so you cant try to guess the word from the
surrounding syllables. Since sentences contain a lot of redundant sounds, if you miss
one syllable or word, you can often guess what the missing sound had to be. Thus, this
would not be a test of how well you can actually understand any given sound, but a
test of your reasoning powers.

The DO use sentences to test how much of language you understand. This is often
done in evaluating your hearing for eligibility in getting a cochlear implant, for
example. And to show how much better you hear with a CI after you have been
implanted. But this is different from a discrimination test.

Cordially,

Neil

Reply

JAGDISH says

January 17, 2016 at 11:10 AM

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Sir,
I have done my last audiometry some month back.these are done on same day at two
different audiologists.in rst , it shows hearng loss of 77 db (mixed) in left ear and 58 db
(mixed)in right ear. in second audiometryon the same day,it shows sensory neural loss in
left ear >120 db and conductive in ght ear of 60 db. why so much difference. they couldnt
explaind well for this . so the question.i have operated on both ears 4 times for extensive
chlosteotoma (Radical mastoiductomy) hearing aid is not useful in left ear. better extent in
right ear but somtimes itis also not so good from right ear also. why this ?

Reply

NEIL BAUMAN, PH.D. says

January 20, 2016 at 8:08 AM

Hi Jagdish:

Those two readings the same day should be much closer together than they are. I
suspect that one or both were not doing valid testing. Perhaps they dont know how
are not properly trained. Perhaps their audiometers are not properly calibrated.
Perhaps the headphones were not tting snug to your ears when they were doing the
testing. Etc., etc.

Id go to the most reputable audiologist or hearing aid dispenser you can nd and see
what this new testing reveals. And be sure to tell them your ear history so they can
take that into account when doing the testing.

Cordially,

Neil

Reply

SIAM BIN KHURSHID says

January 19, 2016 at 10:21 PM

Respected Sir,
My recent audiogram report is as follows:

Right Ear:
1) 0.25kHz=50dB
2)0.5kHz=60dB
3)1kHz=85dB
4)2kHz=115dB
5)4kHz=115dB
6)8kHz=110dB

Left Ear:
1)0.25kHz=40dB
2)0.5kHz=50dB
3)1kHz=80dB
4)2kHz=75dB
5)4kHz=105dB
6)8kHz=110dB

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Sir,I am using Widex Hearing Aids,model-Bravissimo BV-18,Channel#3.

Sir,do you recommend a new hearing aid?If yes,then what type of hearing aid?

Thanking you,
Siam

Reply

NEIL BAUMAN, PH.D. says

January 20, 2016 at 8:03 AM

Hi Siam:

Im not an audiologist and do not t hearing aidsso I cant answer your question. You
need to ask an audiologist or hearing aid dispenser this question.

Cordially,

Neil

Reply

SIAM BIN KHURSHID says

January 19, 2016 at 10:28 PM

Respected Sir,

There is severe wax accumulation in my both ears for the last years.Doctors cleaned my
wax using water but still wax is still remaining.I mean I can feel that too much wax has
accumulated and caused blockage.One doctor suggested me to use 10 percent sodi bicarb
solution,my wax removed and I was at ease.Unfortunately,wax again appeared maybe due
to my tinnitus problem.

Thanking you,
Siam

Reply

NEIL BAUMAN, PH.D. says

January 20, 2016 at 8:02 AM

Hi Siam:

If wax accumulates in your ears, you need to have your ears cleaned out more often. If
you wear hearing aids, they can cause wax problems for two reasons. First, the ear
molds can irritate the lining of your ear canals so they secrete even more wax. Second,
the ear molds push the wax further down the ear canal. Normally, wax moves towards
the ear canal entrance and falls outbut ear molds prevent that and thus wax
accumulates.

You may have to clean your ears out every week or so.

Finally, tinnitus does not cause ear wax, but ear wax can cause tinnitus by reducing
the amount of sound that reaches your ears and thus your brain.

Cordially,

Neil

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Reply

ABIGAIL SOLSTAD says

January 27, 2016 at 12:04 AM

My mother has told me I have a sixty percent hearing loss. I just want to know how I would
label it, as severe, moderate, such. No, I am positive this is not a 60 dB measurement.

Reply

NEIL BAUMAN, PH.D. says

January 27, 2016 at 7:44 AM

Hi Abigail:

You cant label a percent hearing loss, because there is NO SUCH THING! If your
mother didnt assume that a 60 dB average loss was a 60% loss, then you need to have
a proper audiological evaluation done and look at the decibel loss by frequency in
order to determine whether your loss is mild, moderate, severe or profound. Thats
how you do it.

Cordially,

Neil

Reply

JIM GREEN says

February 12, 2016 at 11:06 AM

I had several recrackers go off near me on New Years Eve, the worst of which was about
10 from my left ear. I developed continuous tinnitus about a week later, which is more
profound in my left ear though noticeable in both.

My audiogram showed a sub-normal range in my right ear, dipping to -15 dB at 4kHz and
-20 dB at 6-8kHz. The left ear showed sensorineural hearing loss of -18 dB with a notch to
-30 dB in the 2kHz range. This range corresponds with the tone of the tinnitus in my left
ear.

Given that I have not had some noise exposure in my life (loud music on headphones as a
teenager) but nothing excessive or consistent in the 20 years since, would you estimate
that this is more likely to be a temporary threshold shift, or a permanent one? If my hearing
is going to recover, about how long would that process take? I am a 39 year old male.

I have had tinnitus for one month and apart from a couple brief instances of minor relief, I
would say it has not been improving since its initial onset.

Thank you very much for your time.

Reply

NEIL BAUMAN, PH.D. says

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February 12, 2016 at 12:37 PM

Hi Jim:

Just a point of clari cation. When you read an audiogram, hearing loss is expressed in
positive numbers. In other words, if your audiogram line is BELOW the 0 dB line,
those numbers are positive numbers. However, if your hearing is so good that the line
goes ABOVE the 0 dB line, those are negative numbers. I know it seems backwards,
but that is the way it is.

Typically, a temporary threshold shift lasts from a few minutes to a few hours to a few
days. Just as typically, I wouldnt expect hearing to come back after longer than a
week. Since that was about 6 weeks ago now, I think you have a permanent hearing
loss now.

My rule of thumb for sudden hearing losses, is that the hearing you have after 30 days
is what youll be left with.

Its good that your tinnitus has a couple of brief episodes of relief. This indicates to me
that if you learn to ignore your tinnitus, you may nd those episodes will become
longer and occur more often as you habituate to your tinnitusat which point in will
not bother youjust be there when you listen for it.

Cordially,

Neil

Reply

KELLI says

February 17, 2016 at 5:01 PM

Hi. After reading your article, this will seemingly be a stupid question. However, I am 48 yrs
old. At age 3 or so, I was diagnosed with moderate to severe hearing loss due to nerve
damage received bc of mother contracting German measles while pregnant with me.
My diagnosis at time was 100% loss in right ear and 60-70% loss in left ear. My childhood I
wore hearing aids until the constant hum/buzz in my only good ear became a distraction. I
am currently unable to afford a dr visit let alone the cost of hearing aids. I understood
through your article there is not a conversion from percentages to decibels. But, also, as
Ive aged, my hearing has gotten progressively worse. It is beginning to affect my ability to
work. (Most of my life Ive been employed as a paralegal.
Is there a way for me to get help to see if I would even qualify for disability at this point or in
the future of my hearing continues a downward progress?
I thank you, in advance, for any assistance or guidance.

Reply

NEIL BAUMAN, PH.D. says

February 18, 2016 at 11:03 AM

Hi Kelli:

I wouldnt go the disability route yet. There is one more place you should go before
you go in that direction and that is go to your state of ce of vocational rehabilitation
(they may use a different name depending on your state). If you need hearing aids or

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cochlear implants in order to keep working, or to even get a job, they will provide the
hearing aids and/or whatever you need. They will help you in this whole process, so
give them a try.

Cordially,

Neil

Reply

MRS.SHEELA says

April 21, 2017 at 10:52 AM

Dear Dr.I am 44 age old,my left ear has 65% hearing and right ear is 55%
hearing.But i could not continue my teaching professional,is this possible
to recovery my ears.for medical aspects

Reply

NEIL BAUMAN, PH.D. says

April 21, 2017 at 4:05 PM

Hi Mrs. Sheela:

If your hearing loss is a conductive loss, then an ear specialist may be able to
recover your lost hearing. However, if you have a sensorineural hearing loss,
then that is out of the question. The solution then is to get hearing aids so you
can hear better again.

Cordially,

Neil

Reply

JANICE says

February 23, 2016 at 10:26 AM

Dr. Bauman,
How frustrating is it to be asked what percentage hearing loss someone has especially
following this particular article?
Sincerely,
A Menieres patient with a sense of humor

Reply

NEIL BAUMAN, PH.D. says

February 24, 2016 at 6:04 PM

Hi Janice:

It could be frustrating if I let it be. But I just assume they didnt understand, or didnt
really read the article and answer their question if I have the time.
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Cordially,

Neil
Also with a sense of humor. You know the old saying- If at rst you dont succeed..
never try sky diving!

Reply

LINDSEY says

March 14, 2016 at 5:50 AM

My ten year old daughter was recently found to have moderate hearing loss in both ears by
the audiologist after failing her hearing test at her well check visit. This came as a shock and
as it was explained to me it is due to a problem with her nerves in the inner ear. Her Audio
gram showed right ear air conduction test as follows, 45db-125hz
40db 250hz
40db 500hz
35db 750hz
45db 1k
50db 1.5k
45db 2k
40db 3k
45db 4k
45db 6k
45db 8k and bone conduction
40db 500hz
45db 1k
45db 2k
45db 4k

Her left ear


Air conduction
50db-125hz
45db-250hz
40db-500hz
45db-750hz
45db-1k
55db-1.5k
55db-2k
55db-3k
55db-4k
50db-6k
60db-8k
Bone conduction
40db-500hz
45db-1k
55db-2k
50db-4k

No wax blockage
No damage to outer, middle ear, both ears and ear drums look good.

What should we expect next. At this time no clear reason for loss. We are also not sure if it
has been degenerative as we missed the last two years of well checks.

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Sorry so long.

Reply

NEIL BAUMAN, PH.D. says

March 14, 2016 at 7:41 AM

Hi Lindsey:

You daughters hearing loss is not likely caused by the nerves in her inner ears
thats a poor way of explaining it. The loss is most likely caused by the nerve ENDINGS
called hair cells that have died. The nerves are typically in great shapejust that if the
hair cells at the ends of each nerve die, then there is no way to get the sound signal
into the nerve to be transmitted to the brain.

She has a at sensorineural hearing loss with no conductive component. Furthermore


the hearing loss is basically the same in both ears (symmetrical). Flat losses are not all
that common, especially in sensorineural hearing losses, but it is good in this sense. It
makes it easy to hear if sounds are just ampli ed more. She doesnt need extra sound
ampli cation in either the low or high frequencies like most hard of hearing people do.
So that is a bit of a blessing right there.

You did not say anything about her discrimination scores. This is important to know as
well. If she has close to 100% discrimination, then she should do very well with either
sound eld ampli cation at school or wear hearing aids.

Do I understand correctly that she had normal hearing about 2 years ago (at her last
testing) and it has failed in the past 2 years or so?

It would help to know what caused her hearing loss so you can guard against that
cause in the future. Loud noise exposure is highly unlikely, so is a viral cause. I also
doubt if ototoxic drugs caused such a loss, although that is one possibility. Has she
taken any antibiotics in the past two years or so that might have caused it? It could
also be genetic. Is there any hearing losses running in the family on either side?

Id suggest having her tted with hearing aids and have hearing tests every 6 months
to a year to learn whether her hearing is stable or not.

Cordially,

Neil

Reply

JIMMY PISCIOTTA says

March 18, 2016 at 6:23 PM

Hi NEIL BAUMAN, PH.D I have hearing loss in both ears and tinnitus, i have speech
discrimination scores of 88% in right ear and 80% in left ear, and 9.375% hearing disability
in both ears and it looks like 40db at 2k 50db at 3k and 60db at 4k, 70 dB at 8K. What kind
of hearing loss is this. Thank you.

Reply

NEIL BAUMAN, PH.D. says

April 1, 2016 at 8:54 AM

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Hi Jimmy:

What you are describing is the typical moderate, ski-slope, sensorineural hearing loss.
This kind of hearing loss typically occurs as you get older.

Cordially,

Neil

Reply

ANN says

March 24, 2016 at 5:53 PM

I had a cold that led to SSHL in left ear unfortunately couldnt get an appointment with ENT
until yesterday. Put me on Prednisone is it too late? Hearing loss is in 70 to 80 dcb loss. Btw
the ear became blocked 30 days ago. Help

Reply

KAMLESH says

April 1, 2016 at 3:34 AM

I am suffering 71% left ear and 100% right ear profound hearning loss kindly plz suggest me
how can i modify my decibel with this report

Reply

NEIL BAUMAN, PH.D. says

April 1, 2016 at 6:16 AM

Hi Kamlesh:

The simple answer is, You cant. All you need is a copy of your audiogram. The
correct decibel gures will be on it.

Cordially,

Neil

Reply

JIMMY PISCIOTTA says

April 1, 2016 at 3:09 PM

Thank you, Just so you know I am 50 years old, The Tinnitus is the worst part of it..The noise
is a killer is their anything for the Tinnitus?? I worked in high noise environment for 28
years Thanks again

Reply

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GURJEET says

April 14, 2016 at 2:15 PM

respected sir
please tell me that there is a any solution for recover hearing loss..??

Reply

NEIL BAUMAN, PH.D. says

April 16, 2016 at 7:28 AM

Hi Gurjeet:

It depends on the cause of your hearing loss. For the most common kind of hearing
loss, basically you have to wear hearing aids. There is nothing at this time that doctors
can do to restore hearing medicallybut they are working on it.

Cordially,

Neil

Reply

MUJTABA says

April 18, 2016 at 11:45 AM

I have 50dBHL hearing on 250 and 500Hz.30 on 1000 to 2000.and 20dBHL on 2000 to
4000 on right ear.
I have 40 on 250 to 500.30 on 500 to 1000.and 20 on 1000 to 2000Hz.I have speech
problem.I want to ask you how I can improve my hearing.I am feeling head spin even my
hairs are falling.What is the problem.There was no accident happens in my life.

Reply

NEIL BAUMAN, PH.D. says

April 19, 2016 at 8:22 AM

Hi Mujtaba:

You have a mild to moderate reverse slope hearing loss. You say you also have vertigo
(things spin). This is consistent with having Menieres disease. You should go to an ear
specialist and see if he agrees with this assessment.

If you do have Menieres disease, there is a simple cure that will get rid of the vertigo
and stop further hearing loss. You need to go to an upper cervical spine chiropractor
and have your top two vertebrae properly aligned. You can learn more about this by
reading my article at http://hearinglosshelp.com/blog/atlas-adjustments-alleviate-
menieres-disease/ .

Cordially,

Neil

Reply

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SALLY M. WEIL says

April 18, 2016 at 1:54 PM

Dr. Bauman,
You answer questions with kindness and caring. I am impressed. I am 75 yrs. old. When I
sleep, my left side (facial and ear) are cold and I have to cover that side with blanket or a
sheet.
Left ear=84 and right ear= 80. I do not have hearing aids yet.

Reply

NEIL BAUMAN, PH.D. says

April 19, 2016 at 8:33 AM

Hi Sally:

Thanks for the kind words.

If your pure tone averages (PTA) are 84 and 80 dB, then you have a severe hearing
loss and need hearing aids if they will help you.

If the left side of your face gets cold when you sleep on your right side, does the
opposite also apply, your right side gets cold when you lay on your left side? Im
wondering if your neck is out and that is interfering with blood ow to your head. Or
perhaps your pillow is the wrong height and doing that.

Cordially,

Neil

Reply

SALLY M. WEIL says

April 22, 2016 at 1:51 PM

My right side does not experience this cold feeling if I sleep on the left. Also, I forgot to
mention that I have a dull headache during the night always on the left side. This cold
feeling and dull headache has been on going for about 2 years now. I get severe heart burn,
so often times a use two pillows. Any thing you suggest will be so appreciated. Thank you.
You are kind and I am grateful.
Sally

Reply

NEIL BAUMAN, PH.D. says

April 23, 2016 at 6:45 AM

Hi Sally:

What happened two years ago before you began getting this cold feeling? Im thinking
that various vertebrae in your neck are out of proper alignment. This could explain the
headaches, cold feeling and heartburn.

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If I were in your shoes, I go to a special kind of chiropractor called an upper cervical


spine chiropractor and have him check you out for proper alignment. That would be
my rst step. (Conventional chiropractors dont have the skills to do this well.)

To nd an upper cervical specialist go to http://www.upcspine.com/ , then click on


Practitioners in the menu bar and choose North America and then your state (Im
assuming you are in the USA) and youll see a list of the upper cervical spine
chiropractors in your state. Each chiropractor has a 10 15 line listing. Near the
bottom of each listing is a line called Upper Cervical Approach/Technique Used: and
following that is one of about 10 different techniques. Im particularly partial to the
Blair Method so if you can nd a Blair chiropractor within reasonable driving
distance (a couple hundred miles) that would be my rst choice. But the others are
also good. Pick someone that has 15 or 20 years experience, not a newly-minted
upper cervical specialist, as they dont have the depth of experience your situation
may require.

It may also be that your pillow is the wrong height for you. Did you change pillows two
years ago?

Cordially,

Neil

Reply

SACHIN says

May 24, 2016 at 3:38 AM

Sir,
Wheather the middle ear construction surgery done after mastiodoctomy surgery for
overcoming moderate- sever conductive -mixed etc. can be safe? what are succeess rates ?

Reply

NEIL BAUMAN, PH.D. says

May 24, 2016 at 6:48 AM

Hi Sachin:

That is something you need to ask your ear specialist. Hes the only one that knows
the condition of your middle ear now after the surgery.

Cordially,

Neil

Reply

CHRIS says

June 8, 2016 at 12:44 PM

My Audiologist completed a hearing test and diagnosed I have 240 dab loss in right ear and
250 db loss is left ear.

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What does this mean

Reply

NEIL BAUMAN, PH.D. says

June 8, 2016 at 1:02 PM

Hi Chris:

You have something wrong. Those gures are meaningless. Audiometers only
measure down to around 100 dB give or take a bit. Are you sure that the gures are
not 24 and 25 dB?

Cordially,

Neil

Reply

SIMONE PAT says

June 14, 2016 at 2:33 PM

Hi,
I enjoyed your article, it was very informative. I had two hearing tests, a week apart. In the
rst one, I tested moderate hearing loss in both ears, a week later, I tested at a different
facility, severe hearing loss in the left ear, moderate in the right, with the ski slope. The
doctor noted noise induced hearing loss. Is it declining that fast or are there descrpincies in
the tests on a daily bases. My hearing has gotten signi cantly worse in the last ten years. I
hope I can stay where I am and not experience profound hearing loss in the next decade. Im
47 years young. Thanks- worried.

Reply

NEIL BAUMAN, PH.D. says

June 14, 2016 at 4:52 PM

Hi Simone:

Personally, Id get a third test to validate either of the other two. You could be losing
hearing that fast, but I rather doubt it. There should not be discrepancies of more than
abut 5 dB or at the most 10 dB between various testers. Audiometers have to be
certi ed accurate every year at least.

If your hearing loss is from noise, you could expect it to slowly drop even more. So you
need to protect your ears from noise in the future.

Cordially,

Neil

Reply

VETRI SELVAN says

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June 16, 2016 at 8:46 AM

sir,
my right ear was discharging since my childhood.few years back i have consult ENT
doctor.later they found i have been suffered by bilateral CSOM at right ear.the doctor said
that you have do one ear surgery .last year i have undergone my mastoid dectomy
surgery..my ear discharge was stopped fully.again i got the little ear discharge and also foul
smell were came .kindly guide me for further diagnosis.

Reply

NEIL BAUMAN, PH.D. says

June 17, 2016 at 12:58 PM

Hi Vetri:

You need to go back to your doctor for further treatment.

Cordially,

Neil

Reply

MALCOLM says

June 17, 2016 at 12:31 PM

Hi My Boots audiologist told me I have 80% hearing loss in the high frequency and normal
in the low frequency, so how would that work in db?

Reply

NEIL BAUMAN, PH.D. says

June 17, 2016 at 12:57 PM

Hi Malcolm:

That statement was totally ridiculous, because you cant measure hearing loss in
percentages. You audiologist obviously thinks you are so stupid you couldnt
understand it if he told you the truth, so he invented a ctitious meaningless number
to satisfy you.

Now to TRY to answer your question, If your hearing is normal in the low frequencies,
that means it is somewhere between 0 and 25 dB.

ASSUMING he is equating 80% with 80 dB (which is not true at all) but lets assume
that, then in the high frequencies you have an 80 dB loss. So I imagine you have the
standard ski-slope kind of loss.

Cordially,

Neil

Reply

MALCOLM says

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June 17, 2016 at 5:06 PM

Hi Neil, Thanks for that, I think he doesnt really know what he is talking about
and just wants to og me a hearing aid. yes your right it is the standard ski slope
kind of loss, so thanks again for the comments now I know what to do.
Malc

Reply

WAYNE says

June 21, 2016 at 12:08 PM

You say that there is no such thing as percentage hearing loss, this is utter rubbish , as
yesterday my Audiologist said that i have 45% hearing for a person of my age (48), this is
the only way she explained it to me, she did not give it as a decibel equivilent,. She has given
me a hearing aid for both ears, what then is your de nition as to my level of hearing loss, ie
mild, moderate or severe, also what is the equivilent in decibels for my level of hearing at
45%.

Reply

NEIL BAUMAN, PH.D. says

June 21, 2016 at 1:58 PM

Hi Wayne:

The only rubbish going on here is what your audiologist told you. Very simply, your
audiologist lied to youjust proving my point that they think you are too stupid to
understand the truth if they told you the average decibel loss you have. So she pulled
a totally meaningless percentage out of her hat and told you that.

If you want to know what your hearing loss is, look at your audiogram. You have one,
dont you? It is your right to have one so you can ask for a copy. I always do. Then you
would know what your hearing loss is in decibels.

There isnt an equivalent between percentages and decibels. It is absolutely


impossible to calculate since the dB scale is open ended just like the Richter scale is
for earthquakes. You never hear anyone saying that it was a 45% earthquake when it
reads 4.5 on the Richter scale. That would be meaningless. And saying you have a 45%
haring loss is just as ridiculous. It is totally meaningless. The Richter scale and the
decibel scale are both logarithmic with no upper limits so you cannot calculate a
percentage. You NEED an upper limit to equal 100%and when you dont have one,
you cant calculate the percentage. Besides percentages really only work with linear
scales, not with logarithmic scales.

Having said that, what your (stupid/ignorant/lazy) audiologist might have done is
assume that 1 dB equals 1%, so she equates 45 dB with 45%but this is just not true.
If you had a 120 dB loss, then is she going to say you have a 120% loss? Theres no
such thing.

If you had a 40 dB loss and she equated it to 40% loss, then if later you had a 50 dB
loss shed equate it to 50%. But the truth is that the difference isnt just 10%, but 10
TIMES as much or 1000% greater, not just 10% greater. Thats why you just cant do it.

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Cordially,

Neil

Reply

N MOHAN RAO says

July 9, 2016 at 1:52 AM

Sir i have done audiometry test my ear ,after that i cant hear my right ear ie. 100% hearing
loss but my another ear is absolutely all rightso overall i can hear about 50%, plz inform
me that i am in catageory of Physical handicap or not?

Reply

NEIL BAUMAN, PH.D. says

July 11, 2016 at 12:52 PM

Hi Mohan:

Yes, any hearing loss is a physical handicap, but as far as getting disability
compensation for it, since you have normal hearing in the other ear, you are not
eligible (in the USA) because it does not affect your ability to take care of yourself and
do your job.

Cordially,

Neil

Reply

DIANA says

July 17, 2016 at 8:11 AM

Hi, I have severe hearing loss in both ears. I wear behind the ear hearing aids. Hearing loss
is hereditary. I also have mastroid (sp) surgery as well as drum repair. In one of your
comments you were talking about getting Blair method upper cervical.
I have been suffering migraines
since being a teen at the back of my neck. Im 35 now. Upper back pain. I also have a
backward S curve in my upper spine that I was told I was born with tscoliosis. I frequently
have cold numb ngers toes and lips.
I know Ill always wear aids. Do you think getting adjusted would help with the other stuff
going on?

Reply

NEIL BAUMAN, PH.D. says

July 17, 2016 at 9:31 AM

Hi Diana:

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If I were in your shoes, Id certainly try a Blair chiropractor. He isnt going to hurt you
and there is a very good possibility that he will be able to help you to some degree.
Since you were born this way, it may not be possible to get your spine the way it
should be, but any adjustment in the right direction would be a blessing. For example,
you may get rid of the cold ngers and toes, or reduce the number of your migraines,
etc.

Just be aware that since this is so longstanding, you may need numerous treatments
until the adjustments hold. Its easy for things to slip back into their old ways until
muscles, ligaments and tendons adapt to the way they are supposed to be.

You need to ask your Blair chiropractor what he can do for you and what you can
reasonably expectthen decide whether you want to proceed with the treatments.

Cordially,

Neil

Reply

SRIRAM HARIPRASAD says

July 28, 2016 at 3:37 AM

Sir,
My left ear is closed even without any hole and didnt have any hearing .. its an disability by
birth. And my right ear shows 13db in test so I think its normal. as one of my ear is not
working.. That means 50% disability..
I want to know whether iam disable? And would I get a disability certi cate? Please reply

Reply

NEIL BAUMAN, PH.D. says

August 5, 2016 at 8:47 AM

Hi Sriram:

If you have normal hearing in one ear, which you do, you are de nitely not eligible for
disabilityat least here in the USA.

Cordially,

Neil

Reply

LAXMAN says

July 28, 2016 at 5:56 AM

sir i am not hear left ear total deaffnes and right ear 45 to 80 decibel heared please i get
disability certi cate

Reply

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NEIL BAUMAN, PH.D. says

August 5, 2016 at 8:45 AM

Hi Laxman:

Hearing loss by itself is typically not approved for disability status (SSDI) in the USA. I
dont know what it might be in your country if you are not in the USA.

Rather than seeking disability, it is much better to seek ways to improve your
hearingusing hearing aids, assistive listening devices, coping strategies and if
necessary cochlear implants. Then you can live a ful lling life in spite of your hearing
loss.

Cordially,

Neil

Reply

STEPHANIE says

August 3, 2016 at 11:15 AM

Hi, My daughter has a cholesteatoma and her last hearing test was 20 in her Good ear and
60 in her bad ear. Would this cause her problems in her daily life or could this be classed
as mild. My Daughter is 10. Thank you for taking time to read this

Reply

NEIL BAUMAN, PH.D. says

August 5, 2016 at 6:53 AM

Hi Stephanie:

Im assuming the cholesteatoma is only in her bad ear, correct? If so, why is her
hearing only 20 dB in her good ear? It should not be that bad at only 10 years of age.

Actually, studies have shown that even a 15 dB loss can signi cantly affect a childs
work at school. Therefore, dont let the terms slight or mild hearing loss lull you into a
false sense of security. This is a signi cant loss for a child, not to mention the 60 dB
loss in her bad ear.

I assume that she has a conductive (middle ear) loss from the choleateatoma, but she
may have an underlying sensorineural (inner ear) hearing loss too.

In any case, if hearing aids will help her, you should consider have her tted with
hearing aids in both ears. That should make a signi cant difference in how well she
hears under good listening conditions. She probably will need other assistive listening
devices when in poor listening situations.

Cordially,

Neil

Reply

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RICHARD T says

August 4, 2016 at 10:30 AM

Hello , back in 2008 I was diagnosed with hodgkins lymphoma. One of the Chemos was
Adriamycin, one of many side effects was hearing loss. I can say I am free and clear :). But
my hearing has gone down hill , as of 07/20/2016 my hearing is at 81DB and 76DB and
steadily getting worse. At only 47yrs old I do have my health but my hearing is NOT.. With
this being said were does my hearing stand compaired to normal to deafness >? I have been
working since the age of 17 and fear it will effect my job position since it involves talking
and listening >? Help

Reply

NEIL BAUMAN, PH.D. says

August 5, 2016 at 6:42 AM

Hi Richard:

The way they classify hearing loss is:

-10 25 dB Normal
26 40 dB Mild
41 55 dB Moderate
56 70 dB Moderately severe
71 90 dB Severe
91 120 dB Profound
121+ dB Deaf

So your hearing is in the severe category (like mine). Once you reach he prodound
category you are essentially deaf although you will still hear some loud close sounds.

As you now know, a severe hearing loss means you dont hear much normal speech
unless it is very close. Thus, you NEED to get and wear properly tted hearing aids
while they will still help you. When your hearing drops further, and especially when
your discrimination (or word recognition) drops to around 40%, then it is time to
consider getting a cochlear implant.

Neither of these solutions will be perfect, but using them and supplementing them
with assistive listening devices in poor listening situations will let you live a fairly
normal life as a hard of hearing person.

Cordially,

Neil

Reply

SRIRAM HARIPRASAD says

August 6, 2016 at 6:40 AM

Sir,
I have only one ear working.. And the other ear is closed with out any hole or outer
features But you said that iam ineligible for disability but why sir?? combined working of 2
ears is perfect hearing, as I didnt have an ear how iam not disable??
Also I have a friend whose thumb ngers in both hands are slightly long but he is now
eligible for disability..

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Why so??
Please reply

Reply

NEIL BAUMAN, PH.D. says

August 6, 2016 at 8:53 AM

Hi Sriram:

In the USA, to be eligible for disability, you have to have a condition such that you
cannot look after yourself normally. In your case, you have one good ear so you can
talk to people, hear on the phone, etc., etc. Therefore, you are not eligible. Sure having
only one ear makes it harder to hear in noise and you cannot tell where sounds are
coming from, but it does not prevent you from looking after yourself and leading a
reasonably normal life.

Cordially,

Neil

Reply

ADDY says

August 7, 2016 at 1:12 PM

Im 12 years old and have 30% hearing loss in my right ear due to a ruptured eardrum. Im
starting to notice it worsing yet I dont want to have hearing aids. Im in seventh grade!
What should I do

Reply

NEIL BAUMAN, PH.D. says

September 3, 2016 at 7:11 AM

Hi Abby:

What Id do rst is go to an ENT doctor and nd out why your hearing is getting worse.
Maybe you have a middle ear infection because of the hole in your ear drum. If your
ear drum has not healed up naturally, it probably would be a good idea to have it
repaired surgically.

If you only have a 30 dB loss (there is no such thing as a percent loss no matter who
tells you that) you may not really need a hearing aid as long as the hearing in your
other ear is normal, unless you realize that you are not hearing things you should be
hearing.

One thing that can help you hear better is to sit on the right side of the classroom so
your good ear hears into the room. And have your friends sit on your left side so you
can hear them better.

Now lets talk about wearing hearing aids. If you have trouble seeing you wear glasses
and think nothing of it. So whats the problem with wearing hearing aids if you cant
hear well? Think of them as earglasses. I wear two hearing aids because I am
functionally deaf. This means I dont hear speech if I dont have them on. Yet when I
tell people I have a hearing loss, Ive had people look at me to see whether I am

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wearing hearing aidsand not see them even though they are looking for them and Im
bald so I cant hide them.

What Im saying is that most people will never notice that you are wearing a hearing
aid IF that is what you are worried about. But the WILL notice if you dont hear them
and thus respond inappropriately.

So if wearing a hearing aid (or aids) will help you, go for it. Once you feel comfortable
wit them, youll be glad you did.

Cordially,

Neil

Reply

RAY says

August 8, 2016 at 1:47 PM

Hi Dr. Bauman,

My Daughter has CHARGE syndrome and we recently received a sedated ABR to test her
hearing. My daughter came back with mild to moderate hearing loss with a DB of 45.

That being said, the audiologist is not recommending hearing aids. Nevertheless, I have
requested the aids in order for her speech and language to properly develop.

The Audiologist stated that a DB of 15 is required for speech and language to develop. She
also stated that hearing aids will not get my daughters hearing down to the required DB 15.

How accurate is this?

Any help you can provide is greatly appreciated.

Thank you,
Ray

Reply

NEIL BAUMAN, PH.D. says

August 9, 2016 at 7:54 AM

Hi Ray:

I really need more information in order to properly help you regarding your daughter.
Im assuming that since they did an ABR, she is an infant, correct? Infant hearing
testing isnt as accurate as it is later when they are older.

If she has an average of 45 dB loss, that is signi cant in a child and ampli cation is
normally indicated. Why did the audiologist not recommend hearing aids? What made
her say that?

I dont think you understood her when she said that 15 dB is required for speech and
language to develop. What she probably meant is that if hearing loss is worse than 15
dB, it impairs speech and language development as compared to children who hear
better than 15 dB. But you can learn speech and language with a 70 dB loss like I had
and my speech is totally normal.

Furthermore, in school, a child with a hearing loss greater than 15 dB does not do as
well in school as those with hearing better than 15 dB according to some studies. A 15
dB loss is called a slight loss, but it is anything but slight in a childs development.
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Hearing aids typically give you back about half your hearing loss. So in my case I now
have about an 80 dB loss. Therefore, when I wear my hearing aids, my loss is more like
40 dB. Not normal by any means, but ever so much better than what I have without
hearing aids.

Thus, with hearing aids, your daughter could expect to have a 22 dB loss or
thereaboutsagain not perfect but a lot closer to the 15 dB limit than before. Thus,
unless there is some reason to the contrary, ampli cation (hearing aids and/or
assistive devices) would be a great help to her.

Some questions that need to be answered is whether your daughter has a conductive
(middle ear) loss, sensorineural (inner ear) loss or a mixed (combined) loss. For
example, if she had a pure conductive loss, then a bone conduction hearing aid would
be the way to go. If it is all sensorineural hearing loss, then a conventional hearing aid
would work.

Some of these questions cant be answered yetshe needs to get older so she can give
some feedback, but early intervention, if it helps, is the way to go. That is why I want
to know the audiologists reasons for not recommending a hearing aid.

Cordially,

Neil

Reply

GREG CULLEN says

August 17, 2016 at 2:11 AM

Hopping you can help me please . My Right ear has a loss of 65 db at 6k .My left is 50 db at
6k , could you please tell me my percentage of hearing loss . Thank you very much

Reply

NEIL BAUMAN, PH.D. says

August 18, 2016 at 11:19 AM

Hi Greg:

You need to reread my article. Then youd know you cant express hearing loss in
percentages. You can express your degree of disibality from hearing loss in
percentages though. But to do that, I need to know you hearing loss at the main test
frequencies, not just one frequency.

Cordially,

Neil

Reply

BETTE J says

September 5, 2016 at 12:56 PM

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Excellent article!
In May of this year I started having problems with my right ear-I am 68 and had never had a
ear infection, not even as a child, I nally got into see a very wonderful ENT, in August of
this year. He had to go in and do a debridement of the eardrum-the infection has now
cleared after multiple courses of antibiotics, oral and drops. I am told that I have a small
hole in the eardrum, ear still feels full and hearing is down, He told me I will have a 20
decibel hearing loss, I am wondering how long before my eardrum heals and will this
fullness feeling ever go away! Drives me crazy some days. Thank You

Reply

NEIL BAUMAN, PH.D. says

September 5, 2016 at 3:22 PM

Hi Bette:

With a hole in your eardrum, your ear shouldnt feel full since any excess air/ uid can
come out the hole. However, if you middle ear and Eustachian tube are still full of
gunk then you could get that feeling. You could also have the psychological feeling of
fullness because of your hearing loss. Your brain says, Surely I should be able to hear
better if this ear wasnt blocked, so you get the feeling it is full or blocked but in
this case it is not a physical feeling, but a psychological feeling.

I dont know how long it will take for your eardrum to heal. Thats a question you
should ask your doctor. I suspect in could be 2 or 3 months or more.

Cordially,

Neil

Reply

NITESH says

September 8, 2016 at 8:57 AM

From last 10-15 days i am having a slight problem in hearing on telephones from my right
ear.. 2 day back i also had cold the this problem went more
yesterday i went to audiologist and my results are as
Left ear
250 hz 25 db
500 hz 25 db
1000hz 60db
2000 hz 75 db
4000 hz 80db
8000 hz 95 db

Right ear
is ok

Please advise me as the audiologist told me the problem is critical and treated as medical
emergency.

after this i consulted my Dr who have given me medicine


RZL
trinergic -L

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12/13/2017 Hearing LossDecibels or Percent

Omnacortil 20
lifestar

Reply

NEIL BAUMAN, PH.D. says

October 2, 2016 at 2:11 PM

Hi Nitesh:

It sounds to me like the cold virus got into your ear. The standard treatment here is to
give a steroid such as Prednisone or Prednisolone and if they suspect a virus and it is
still soon enough, an anti-viral.

Omnacortil is a brand of Prednisolone, so you have received the standard treatment.

Cordially,

Neil

Reply

MONICA SMITH says

September 14, 2016 at 12:33 PM

My child failed his hearing test at school 4 times (the 1000 decibal tone), in his right ear. If I
am reading this correctly, this tone would be kinda loud, correct? he sees the ENT on Friday,
I am just very concerned and thought maybe you could help.

Reply

NEIL BAUMAN, PH.D. says

October 2, 2016 at 2:26 PM

Hi Monica:

You mean the 1000 Hertz frequency. (There is nothing so loud that could produce
1000 decibelseven a rocket right at the launch pad is only around 200 dB.)

For school testing, Im sure the tone they hear is not very loud. I dont know for sure
what level they use, but I suspect it will be less than the level of normal speech. So it
should not be dangerously loud at all.

Cordially,

Neil

Reply

SABIN ADHIKARI says

September 20, 2016 at 10:05 PM

iam a bo of age 22 years ..i have 45 hearing threshold ..docter told me thati have whole in
my ear drum .and needs a minor surgery called tympanoplast .how much hearing power will

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i get after tympanoplast ..does it improve greatly or only 4 ,5 decible ..after tympanoplast
..please suggest me what to do ..problem is seen in my left ear. is it a serious case ?? and
what would be your su=ggestion to me..

Reply

NEIL BAUMAN, PH.D. says

September 30, 2016 at 7:40 PM

Hi Sabin:

Having the surgery (tympanoplasty) is a good idea whether you got any hearing back
or not because the hole in your ear drum is an avenue for infection to get into your
middle ear.

I dont know how much hearing you would get back with the surgery because you
havent said whether your hearing loss is conductive (in which case you may get back a
lot) or sensorineural (in which case it wouldnt affect your hearing at all. Youd still
have the same degree of hearing loss.) Or you could have a combination of both.

Cordially,

Neil

Reply

CHRISTINE MOSER says

October 6, 2016 at 3:09 PM

Why is it so very dif cult for audiologists to nd the right hearing aid for someone who has
profound hearing loss (90-95db)?

Seems some of the ones that do or have worked are no longer being sold. For example, I
have 2 Sumo XP hearing aids made by Oticon. The life expectancy is 5-6 years. They
recently stopped making them. So, my audiologist swore by Sumo DM being similar. For me,
its not anywhere near similar as the XP. The audiologist totally narrows my options down
to almost nothing. Well, next step would be cochlear implantation. Not even sure if they
can fail?

Reply

NEIL BAUMAN, PH.D. says

October 7, 2016 at 2:11 PM

Hi Christine:

Each audiologist has their own favorite hearing aids they carry. They dont necessarily
know about other makes of hearing aids that may help you.

But it may be true that you are almost out of options now if your hearing loss is
profound.

The success rate with cochlear implants is very highdepending on what statistics you
see upwards of 98%. But anything manmade can fail. In the case of CIs, the failure rate
is very low.

Cordially,

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Neil

Reply

DYER says

October 11, 2016 at 1:01 PM

hello sir. i am 32 years old from Ethiopia. i am deaf in one ear while the other ear can detect
sound of 50 db. really. I have experienced head trauma earlier in my live at age of 6 years
and i become ill which caused me to loss my hearing capabilities. now i have extreme and
none stop ear ringing which makes me more problematic and e suspect that i am losing
more decibels as time progress with out showing any sign of illness or disease in my ear. so
please could pleas tell me ways in the ear loss hearing with out visible signs or pain or
illness? how can i keep my hearing power. also tinnitus hurts me so much. thank you.

Reply

NEIL BAUMAN, PH.D. says

October 22, 2016 at 11:17 AM

Hi Dyer:

Im not surprised you have tinnitus since tinnitus often accompanies hearing loss.

The most common cause of losing more hearing is because of exposing your ears to
loud sounds. That will slowly and surely continue to damage your hearing. So can
taking any of a number of drugs that cause hearing loss, tinnitus and other ear
problems. So you need to protect your ears from loud sounds and from ototoxic drugs.

Even so, you may have damaged the underlying structures in your inner ears, and the
result is hearing loss will continue no matter what you do.

Your tinnitus is obviously bothering you. One thing you can do is try to mask your
tinnitus with other sounds. These sounds will also help take your mind off your
tinnitus. You need to learn to ignore your tinnitus by focusing on the loves of your life.

Ive had tinnitus for more than 65 years, but I refuse to let it bother me, although it is
there all the time. Just treat it as a non-threatening background noise and dont focus
on it just like you ignore a lot of other background sounds.

Cordially,

Neil

Reply

DONNY says

October 15, 2016 at 5:03 PM

Hi mr. Bauman,

I started making housemusic since I was like 17. Around my 21th I got an earinfection on
my right ear after which I clearly noticed a loss in higher frequencies. After a small test at
the ENT a mild loss was con rmed in the high frequencies around 6-8k (assuming after the

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8k a large part was lost too, but can still hear up to like 15k). So ok, after this I was warned
and was a sign I had to watch out more with the volume of my headphones. However, after
another earinfection on my left ear about 2.5 years ago (which was my good ear) I created
a small tinnitus and also notable loss of frequencies in the high in a period of about a few
days time. 2 weeks later the ENT told me I suffered from a middle earinfection. I was
devastated, because making music means quite a lot to me. ATM I study music at university
and hope to get a job in the industry. Luckily Im still able to hear good enough that my
music/mixing/working doenst suffer because of it, but it has got me really worried because
these 2 events happened in a span of a few days and both got my hearing notable worse,
although not that worse that its the end of the world. I now do a yearly hearingtest at the
ENT.

The ENT told me however that the hearing loss I suffered (mild/modearate. about 30db loss
at 6k Left and Right and 40 R/50 L resp. at 8k) was a clear sign of noise induced hearing
loss. Which I nd strange because the way I experienced it was that my hearing clearly
dropped in the high frequencies after both the earinfections. My question is, how are these
2 events related? I am 100% sure that both my ears got noticable worse after these
earinfections, but it was just strange to me that my ENT told me it was noise-related.

Also, I have to admit I am just sooo worried that an event like this will happen again. It feels
like im at a limit in my hearing that if it gets any worse, it will make my music suffer, and I am
in my last year of university studying.right, music. So my last question is: should I be
worried? and what can I do to prevent earinfections from f*cking up my ears in the future?
Next to that Im doing as much as I can to prevent noise induced hearing loss, like dont make
music at too loud levels, take a break often, wearing made earplugs to events etc.

Thanks!

Reply

NEIL BAUMAN, PH.D. says

October 22, 2016 at 10:53 AM

Hi Donny:

I dont see any problem in your having both hearing loss from noise (the 4 kHz noise
notch) and hearing loss from ear infections, especially if the virus got into your inner
ears. As hearing loss in the higher frequencies progresses, it tends to hide the noise
notch and your audiogram begins to look more like a ski-slope loss.

If you want to prevent ear infections, you need to make sure your immune system is
robust. Things that shoot down your immune system are eating too much sugar,
excessive stress and not getting enough sleep. It sure wouldnt hurt to boost your
vitamin C and vitamin D3 intake. Most peoples vitamin D3 is much too low and this
leads to sickness/infections. It should ideally be in the range of 50 to 70 ng/ml. Most
people are down around 20 ng/ml or so and that is much too low for optimal health.

Cordially,

Neil

Reply

DONNY says

October 24, 2016 at 6:20 PM

Dear mr. Bauman,

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First of all thanks for your answer! Its really nice to have someone with your
knowledge answering my questions as it is of deep concern for me ! Also I do
think your tip of the Vitamin D is a good one. I will certainly pay more attention
to that as I do feel my eating pattern can be better.

Now I have one more question: Do you think I have to worry too much about my
future if I want to work in the musicindustry, given my problems? ATM im just 26
yrs old, but I would not know for sure if I would be able to work and let it have an
effect on my mixes in that way or another, let alone hope to have a carreer for a
few decades ?

Reply

NEIL BAUMAN, PH.D. says

October 24, 2016 at 9:03 PM

Hi Donny:

I cant really answer that question as I dont know how you now perceive
music pitch, timbre, etc. as compared to a person with normal hearing.
There are a number of musical instruments I cant even hear so Id never be
able to mix them and make them sound good.

Why dont you contact Richard Einhorn? He is a composer, record producer


and sound engineer that lost some of his hearing suddenly in 2010. He can
tell you how he does it now and what devices he uses so he can still hear
and enjoy music. Tell him I suggested you contact him. He knows me. Go to
http://www.richardeinhorn.com and youll see his public email address. Let
me know how it goes.

Cordially,

Neil

Reply

DONNY says

October 25, 2016 at 8:31 PM

Hi Neil,

Thank you so much! I will contact him. His name does ring a bell, Im
sure one of my classmates knows him too!

Now I have one nal question. So rst of all, I know that clearing your
ears too much can make your eardrum go weak if you do it for a long
time. I had my hearing tested on this a while ago, and luckily I didnt
have any issues with pressure and the Eustachiustube (this was
con rmed through tympanometry. My left ear is my bad ear for
higher frequencies (over 10k). However, when I clear my ears I hear
frequencies for some reason I wasnt able to hear before for a while
with my left ear, and then after a few minutes it becomes bad again
(and I can hear it close again). Is this a sign that the haircell nerves
that perceive the high freqs are still somewhat intact, but that the
problem is some air/pressure-related issue in my left ear? Might be a
bit nonsense-question but to me these frequencies matter a bunch to
me as it allows me to hear the air in the mix much clearer.

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And Im sorry if I ask too much, its just that I naly found someone
with the knowledge to answer my questions that only my ENT would
be able to answer!

NEIL BAUMAN, PH.D. says

October 25, 2016 at 11:07 PM

Hi Donny:

Where did you hear that clearing your ears too much can make your
eardrum go weak? Ive never heard that. You clear your ears every
time you yawn or swallow and thats a lot of times a day. Your
eardrums are designed to be cleared a lot.

In fact, if you didnt swallow, your audiogram would show you have a
conductive hearing loss and your tympanometry would also re ect
this.

You have it right. When you swallow and clear your ears, the air
pressure is exactly the same both inside and outside your middle ears.
At that point, your hearing is the most sensitive so you hear the faint
high-frequency sounds better. But as time goes on the air differential
between your middle ears and outside changes and your ears become
less and less sensitive to sound until you clear your ears again.

This happens for at least two reasons. One, and this is very noticeable
when ying, is that there really is quite a change in air pressure as you
go up or come down. Two, your middle ear uses up the oxygen in the
air in your middle ear creating a bit of a vacuum (an air pressure
difference) and thus you have to clear your ears to equalize the air
pressure again so you can hear better.

If anything interferes with this mechanism (clogged Eustachian tube


for example), you dont hear as well as you otherwise would.

There is nothing wrong with your hair cells when this happens, it is all
mechanical in your middle ears.

Cordially,

Neil

DONNY says

October 26, 2016 at 4:22 PM

So given your answer would you conclude there is some kind of


(probably very small) problem with my Eustachian Tube? Because I do
notice a difference before I clear my ears and it sounds more balanced
afterwards, even though my tympanometric results where ok
according to my ENT.

And it quite suprises me to hear you say that about clearing the ears! I
know for a fact that a lot of ENTs have said this that clearing your
ears might damage your hearing if you do it for a very long time (my
own ENT also told me this, but that it would have to be a LOT of

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times). By clearing your ears I do mean it like this:


http://www.healcure.org/wp-content/uploads/2015/08/How-to-
unpop-clogged-ears-Breathing-exercises.jpg
So in a manner that does involve a lot more pressure than just
swallowing or jawning does.

NEIL BAUMAN, PH.D. says

October 27, 2016 at 2:55 PM

Hi Donny:

You didnt say you were using the Valsalva maneuver (what you call
clearing your ears). I thought you were meaning swallowing or
yawning. Two totally different things. You have to be speci c or we
end up on different pages.

I dont know why you were always using the Valsalva maneuver.
Yawning or swallowing is generally all that is needed. Seems you were
getting a bit compulsive about it.

Cordially,

Neil

DONNY says

October 27, 2016 at 6:52 PM

Hi Neil,

First of all sorry for not telling you earlier, but with you now telling me
this, its the rst time I ever I hear of the word Valsalva maneuver (I
honestly didnt know it was called like this, always referred to it as
clearing).

I use this because when I clear my ears the normal way you were
talking about, it doesnt feel like it really has an effect. However, when
I use the Valsalva maneuver you were referring to, I t feels as I notice
a big improvement in my left ear compared to my right (even though
its temporary). And you are right about my compulsivityI use it alot
because it just irritates me so much when I hear my music. I dont think
its normal the way Im doing it and Id rather stop it, but it just bothers
me so much when I am making music or mix music that I miss that part
of high frequencies and that Valselva Maneuver does help me in that
way (even though mostly temporary).

DONNY says

October 27, 2016 at 7:37 PM

One addition on my last post:


I found an older thread on a forum which exactly describes my
problem and why I use the Valselva Maneuver so much:

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http://www.healthboards.com/boards/hearing-disorders/58101-
why-valsalva-bene t-temporary.html

Thanks!

Donny

DONNY says

October 31, 2016 at 6:22 PM

Hi Neil,

I dont know if I was really clear with my last comment, but I wanted to
ask you a few more questions concerning this Valsalva Maneuver.

1. Is the statement you made about clearing also apply to the


valsalva? (When you swallow and clear your ears, the air pressure is
exactly the same both inside and outside your middle ears.
So is your hearing actually most representative of how it really is
shorty after this maneuver is used?

2. Is it dangerous in any way to use this maneuver multiple times a day


?

3. Does it mean there is some pressureproblem going on in my


Eustachian Tube if I use this and I notice a drastic improvement in
some frequencies (especially in the tophigh spectrum with the
haircells positioned directly in the cochlea)?

Lastly I really want to emphasize Im sorry if I ask you too much or I


come over pushy. I just want to say Im really thankful for all the help
you already gave and if you feel like dont answering my questions
anymore I totally understand.

Thank you!

Donny

PRINCE says

October 18, 2016 at 10:26 AM

both ear 56db to up to 70db moderate severecan i apply medical certi cate

Reply

NEIL BAUMAN, PH.D. says

October 22, 2016 at 9:05 AM

Hi Prince:

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Im not sure what you mean by a medical certi cate. Yes, you have a moderately
severe hearing loss, but you should still be able to function reasonably well with
hearing aid, assistive devices and proper accommodations.

Cordially,

Neil

Reply

HANNU H says

October 22, 2016 at 7:34 AM

Dear Sir,

Thank you for a very good article. This percentage loss of hearing mixed with decibels is
everywhere

Think that in the beginning there is a small mistake:

every 10 dB increase in sound intensity is actually a ten-fold increase. Therefore, a sound


intensity of 20 dB is not twice as loud as a sound intensity of 10 dB, but is 10 times as loud,
and a sound intensity of 30 dB is 100 times as loud as a sound intensity of 10 dB. Similarly, a
sound intensity of 50 dB would be 100,000 times as loud (10 x 10 x 10 x 10 x 10).

To my mind, as having 10dB a starting point, comparison point 50dB is 10,000 times
(10x10x10x10) as loud, not 100,000 times.

Br,

Hannu H

Reply

NEIL BAUMAN, PH.D. says

October 22, 2016 at 8:35 AM

Hi Hannu:

You are absolutely right. Thanks for pointing this error out. I hate publishing mistakes.
(Its bad enough that I make them.) I must have been thinking of starting at 0 dB, not at
10 dB. Ive corrected it now, so all is well.

Youve got a sharp eye. That article has been up for a number of years and you are the
rst to notice this error.

Cordially,

Neil

Reply

ELLE M says

October 27, 2016 at 9:24 PM

Dear Neil,
I have very loud high pitched tinnitus in both ears continuously that affects my hearing and
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when tested in the UK my audiologist tested both ears at 25. They did not give very much
information on the use of hearing aids with in built sound maskers for tinnitus but this is
something I would like to pursue. I have tried the other avenues for tinnitus already
(distraction, cbt, etc.) I am in the UK so may be able to get them on the NHS or privately.
Thank you for any advice. Kind regards Elle M

Reply

NEIL BAUMAN, PH.D. says

October 28, 2016 at 7:01 AM

Hi Elle:

You have it backwards. Tinnitus does not affect your hearing, but hearing loss
commonly results in tinnitus.

When you say you were tested at 25, I assume you mean your hearing loss is 25 dB.

Hearing aids with built in tinnitus maskers can be quite effective, but you want certain
features in such hearing aids. Here is an excerpt from my book Take Control of Your
TinnitusHeres How 7th edition.

When using hearing aids that have tinnitus therapy options built in, such hearing aids
should be exible enough to work:
In one or both ears
In just one or in multiple programs
At different intensities in each ear
At different intensities in the various programs
With different noise types in each program and/or in each ear.

In addition, such hearing aids should also have a volume control designed such that
the wearer can adjust the volume of the tinnitus therapy signal independently from
the volume level of the hearing aids microphones.

In addition to white noise, some hearing aids offer built-in nature sounds as a tinnitus
therapy option. Such sounds provide a positive, soothing and stress relieving listening
experience. These hearing aids are ideal if you prefer a more natural therapy signal.

There are also hearing aids that have fractal tones built in. For many people fractal
tones are much more pleasant that listening to white noise. Fractal tones are pleasant,
ever-changing musical tones. Widex has hearing aids with fractal tones built in (what
they call Zen tones and Zen therapy). You might want to investigate those hearing aids
too.

Cordially,

Neil

Reply

PADMA says

October 31, 2016 at 5:08 PM

Hi doctor,
My husband is 33yrs and he has bilateral mixed hearing loss.

Diagnosis: Right dry central perforation with extensive tympanosclerosis with ossicular
necrosis.

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Left: left adhesive otitis media with superior retraction with incus necrosis.

He has undergone mastoidectomy with tympanoplasty for both the ears.

post operation Audiogram says,

Right: AC: 50 db ,BC 25db


Left: AC:43db , BC :25 db

1.Can you please let us know whether hearing aids can help him. 2. And hes worried
whether this hearing loss will be progressive even tough ears are operated.
3. Hes not able perform well at his of ce he nds dif culty in managing routine work.
4. Can you please help us what can be done to improve his hearing.

Reply

NEIL BAUMAN, PH.D. says

November 6, 2016 at 11:55 AM

Hi Padma:

From what you have told me, I see no real reason why your husband couldnt wear
hearing aids successfully. He has a moderate hearing loss. He should try out
appropriate hearing aids and see how well they work for him.

I dont know whether his loss will be progressive in the future or not. If the doctors got
all the necrosis and assuming no further cells die, maybe his hearing will remain
stable. This is a question you have to ask his doctors.

There are two or three avenues he should investigate. First, is to see whether hearing
aids will help him. Second is to use assistive devices in those areas where hearing aids
are not effective. And third is to learn the many hearing loss coping strategies
including speechreading.

Cordially,

Neil

Reply

MANIK PAWAR says

November 14, 2016 at 6:58 AM

ASSR Test & BERA Test Can Be Performed In awake Condition For adult of aged 23years. If
yes Then what is the difference Betn PTA And Assr Or Bera Pls tellme.

Reply

NEIL BAUMAN, PH.D. says

November 14, 2016 at 7:45 AM

Hi Manik:

The article Auditory Steady-State Response (ASSR): A Beginners Guide can answer
your questions better than I can and in much greater detail too.

Note: BERA (Brainsteam Evoked Response Audiometry), BAER (Brainstem Auditory


Evoked Response) and ABR (Auditory Brainstem Response) are all synonyms and thus

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mean the same thing.

Cordially,

Neil

Reply

MANIK PAWAR says

November 19, 2016 at 7:23 AM

Thanks for my rst quest answer..PTA Results Can Differ From ASSR Test results For
same person. if yes how it can be

Reply

SHERRY says

November 21, 2016 at 11:30 AM

My daughter Aryannas hearing test came back right ear5srt 100% 45db speech
discrimation dose this mean there some hearing loss not sure how to hear the results

Reply

NEIL BAUMAN, PH.D. says

November 21, 2016 at 4:31 PM

Hi Sherry:

Is that all you were given. To know what her hearing was, I need to see the results as
shown on the audiogramdb by frequency.

However, I can take a stab at the limited information you gave. If her SRT is 5 dB, that
is excellent. Id say there was no hearing loss. And her discrimination is 100%again
excellent.

Cordially,

Neil

Reply

ANNA says

December 7, 2016 at 5:40 AM

Hi Neil,

My 17 year old daughter had a hearing test yesterday and was told she is profoundly deaf
in one year I believe it was 110db. Her other year is ne. They have referred her for an
MRI scan to nd any other concerns. But they have told us that there is nothing they can
do? How can this be with such a severe hearing loss? I was told repeatedly that there is
nothing they can do. Needless to say, we are extremely concerned and I cant nd any

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information on why a perfectly health girl can loose her hearing in a matter of months. They
suggested that she could try a hearing aid, but that wouldnt give her much hearing.

Regards

Anna

Reply

NEIL BAUMAN, PH.D. says

December 7, 2016 at 11:30 AM

Hi Anna:

Typically, hearing loss like your daughter experienced is the result of the death of the
hair cells in the inner ear. Once they are dead, you cant hear anything. The reason
doctors cant do anything is that they cant bring dead cells back to life. Dead is dead.

There are a number of things that could have caused this massive hearing loss. Here
are four. One is various drugs and medications. Two is a viral attack. Three is a genetic
disorder. Four is an autoimmune response.

If they cannot do anything helpful to restore any hearing, then she will have to learn
how to live as a person with one ear. She could get a CROS hearing aid that pipes the
sounds from your deaf side to the other side so she can hear from both sides of her
head.

One trick is to always sit so her deaf ear is to the wall and her good ear faces into the
room. So if her left ear is deaf, then she should sit near the left side of a
classroom/auditorium/church/etc. so her right ear can better hear what people are
saying. (And vice versa if her right ear is deaf.)

Another trick is to have people sit/walk on her good ear side. This will make
communicating ever so much easier.

Cordially,

Neil

Reply

JAMUNA says

December 9, 2016 at 2:27 AM

dear sir,
visual acuity is tested interms of distance.Like that can we test hearing with distance.
For example I heard that clock ticking sound is 20Db.So how far should we stand from a
ticking clock for anyone having 20 db hearing?
can we test at home like this?

Reply

NEIL BAUMAN, PH.D. says

December 9, 2016 at 7:20 AM

Hi Jamuna:

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Your idea sounds good in theory, but in practice, it doesnt work very well. For
example, when they say a clock tickingwhat kind of clock are they talking abouta
very quiet wristwatch (when they used to tick), a much louder mantle clock or what?
Since clocks all tick at different volumes, you rst have to de ne and calibrate the
speci c clock.

Furthermore, hearing is tested in total silence so no other sounds interfere and mask
the sound you are trying to hear. Thus, unless you were in a soundproof room,
whether you hear the ticking clock depends on any ambient noise around you.

In addition, the frequency of the tick matters too. This is because high frequency
sounds do not travel through air as well as low frequency sounds. Thus you would not
be able to hear a high-frequency ticking sound from as far away as you could hear a
low-frequency ticking sound when they were both at exactly the same sound level.

That is why hearing testing is done in a soundproof room and typically with earphones
tight against your ears to eliminate other sounds, the effects of distance, and the
changes of sounds as they travel through air.

After having said all this, if you have a smart phone, there are a number of Apps that
can test your hearing. Some are quite accurate. This would be a quick way to get a
good idea of how good or bad your hearing is, but the only accurate way is to use a
soundproof booth and a calibrated audiometer.

Cordially,

Neil

Reply

JAMUNA says

December 9, 2016 at 7:33 AM

Dear sir
very nice of you.
thanks for your immediate response clarifying all my doubts.
thank u sir.
which is the most accurate website for online hearing test sir?

Thank u once again.


wish you a good day

jamuna

Reply

BHARAT says

December 10, 2016 at 11:11 AM

Respected sir,
My hearing test report shows my hearing loss Rt-43dB, Lt-45dB
Doctor adv. Me a hearing aid for both
My dought is after using this aid, with medicines can I got normal range,

And if any possibility to recover my hearing sensitivity with surgery.

Pls adv me

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Reply

NEIL BAUMAN, PH.D. says

December 11, 2016 at 11:47 AM

Hi Bharat:

I agree with your doctor that getting hearing aids should help you.

Hearing aids dont make your ears work better. They just help you hear better. So
wearing hearing aids isnt going to improve your natural hearing.

If you have a conductive hearing loss, then surgery can often help you hear better. If
your hearing loss is sensorineural, then no surgery can help.

I dont know anything about your hearing loss so I can only answer in generalities. But
the things you can do to prevent more hearing loss are protect your ears from loud
sounds and avoid ototoxic drugs as much as possible.

Cordially,

Neil

Reply

BHARAT says

December 10, 2016 at 11:26 AM

Respected sir,

How to preventive to cannot loss hearing sensitivity?

Reply

DONNIE says

January 30, 2017 at 9:03 AM

I have tinnitus. Multiple time my vertigo would cause to fall and be extremely dizzy. Since I
be going Thur this. I been feeling light headed, always sleepy. What should I do?

Reply

NEIL BAUMAN, PH.D. says

February 6, 2017 at 9:47 PM

Hi Donnie:

Why do you have vertigo and tinnitus? Do you have Menieres disease? Or are you on
any drugs or medications? I need to know more about your situation before I can try
to help you.

Cordially,

Neil

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KATRINA says

February 8, 2017 at 3:25 AM

My ve year olds audiology report is as follows right ear 250-25 500-25 1000-25 2000-25
4000-20. 6000-20. Left ear 250-35 500-45 1000-40 2000-40 4000-45 8000-35 do you
think she will need hearing aids

Reply

NEIL BAUMAN, PH.D. says

February 8, 2017 at 5:40 AM

Hi Katrina:

She certainly needs a hearing aid in her left ear and it would be wise to have a hearing
aid for her right ear too. You see, 25 dB is the lower limit of normal for adults, but in
children it is 15 dB. They have done studies that show that even a 15 dB loss (unaided)
affects a students performance in school. So either she wears hearing aids, or the
school needs to provide a sound- eld system for her so she doesnt miss as much.

Cordially,

Neil

Reply

MUHAMMAD IMRAN says

February 9, 2017 at 4:56 AM

My son , age 3 years. audiologist test result is one ear is 100db and other is 90db. so what
you advise. hearing aid help? and what kind of hearing aid best. thanks

Reply

NEIL BAUMAN, PH.D. says

February 12, 2017 at 5:59 AM

Hi Muhammad:

You left out some critical information I need. Is the 100 dB and 90 dB your sons worst
hearing and it is better at other frequences, or does he have a at lossthe same loss
across all frequencies.

If it is the latter, then rather than get hearing aids, he needs cochlear implants.

Cordially,

Nel

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AMJAD ALI says

February 9, 2017 at 8:56 AM

Sir I have a hearing loss since 4 year .it is growing day to day.i feel very hard to listen from
both sides of ears. and using hearing machine (AM111).
when use it feels pain in the year and bone of the year.
left:50db to 70db
right :50db to 90db.
please suggest any solution.
my age is 24years.

Reply

NEIL BAUMAN, PH.D. says

February 12, 2017 at 5:57 AM

Hi Amjad:

What is the cause of your hearing loss? Is your hearing loss sensorineural (inner ear)
or conductive (middle ear)?

Are you wearing hearing aids? That is the obvious solution to help you hear better.

Cordially,

Neil

Reply

VARSHA says

February 14, 2017 at 11:30 AM

Hi Dr. Bauman,
it would be very kind of you to go through my reports mentioned below.
I am from india. Here for cert cation under hearing impairment the loss of hearing should b
6odB in better ear.
Please tell if i am eligible for the certi cate.
Also, suggest the possible reason for hearing impariment in my right ear and treatment.
Left ear
60dB-250Hz
55db-500hz
60db-1000hz
55db-2000hz
65db-4000hz
75db-6000hz
80db-8000hz

And,right ear
80db-250hz
90db-500hz
80db-1000hz
80db-2000hz
100db-4000hz
100db-6000hz

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Reply

NEIL BAUMAN, PH.D. says

February 17, 2017 at 7:46 AM

Hi Varsha:

You left out one critical piece of information. At what frequencies do they average the
results?

Here in the USA, they average your hearing over the frequencies of 500, 1000, 2000
and 3000 Hz.

So assuming they use the same frequencies in India, your hearing in your better (left)
ear would be 55, 60, 55 and 60 (I averaged between 2000 and 4000 to get this gure).

The average of 55, 60, 55 and 60 is 57.5 dB, which means your hearing would be just a
tiny bit too good to get a certi cate (assuming this is the proper criteria),

Before I can tell you what the likely cause of your hearing loss is, you need to tell me a
lot more about your hearing losshow long youve had it and anything relating to
hearing. It could have been hereditary, from taking ototoxic drugs, from viruses, etc.,
etc.

Cordially,

Neil

Reply

SANJAY KUMAR says

February 15, 2017 at 6:30 AM

Hi Neil
Please ignore my earlier post as this post explain in broader way.
My daughter aged 10 years has hearing loss in both ears. In right ear 45 db and left ear
-110 db.

I am confused here as one of audiologist suggested that I should go for hearing aid in right
ear only as it is 45 db. Hearing aid will not be effective in left year.
Then I told him, that there are several hearing aid which supports 110 db then why should
not I go for that. Then he suggested that even if I put in left ear, sound will go via right ear.
So as per PTA, we should go rst for right ear.

Now, My thinking is I should go for only left ear as it is profound loss,


So please let me know whether should I go for both ears Or should I go for only left ear as it
is profound.

Reply

NEIL BAUMAN, PH.D. says

February 17, 2017 at 7:55 AM

Hi Sanjay:

You left out one critical piece of informationwhat your daughters speech
discrimination (word recognition) scores are. You see, the amount of hearing loss isnt

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the only criterion for getting hearing aids. Lot me explain.

If you have a profound loss and good discrimination, then a hearing aid in the bad ear
could be a good idea. However, if her speech discrimination is poor in her bad ear,
then all she hears is basically gibberish. Amplifying this gibberish makes it more
dif cult to understand the good speech sounds coming from her better ear. It
overloads her brain and she wouldnt understand as much as she would if she wasnt
wearing a hearing aid in her bad ear.

So you need her discrimination scores before you can make a good decision.

A 45 dB loss will really affect her in school, so she NEEDS a hearing aid in her better
ear to help her hear better (whether she has one in her bad ear or not). Hopefully, her
discrimination in her better ear is good (80% or better).

Cordially,

Neil

Reply

SANJAY KUMAR says

February 20, 2017 at 6:51 AM

Thanks Neil. I dont have her speech discrimination score but she has poor
discrimination in her left ear i.e. bad ear. She cant hear from it as it has profound
loss.
As far I understand from you that there is no hearing aid is required in her left
ear as she has poor discrimination (0% I guess).

Recently I got complain from her school about her academic as she is not doing
well. She understands but not performing well may be due to poor listening .
Children not playing with her and always tease her.
One more thing, I would like to know from you
Will this hearing loss gradually increase with age?
If yes, then how much ?
will hearing aid stop that loss for further increasing?

Please advise.

Thanks

Reply

SABRINA says

February 18, 2017 at 1:03 AM

Hello! I have 30 Db in my left ear with a 100% word recognition. However, my right ear is
80 Db with a word recognition of 8%. My doctor told me that due to this, my right ear is
ineligible for an amplifying hearing aid. She said, even if I hear speech in my right ear, it will
be highly and unrecognizably distorted. Is this true?Does this mean I have severe hearing
loss in my right ear and normal hearing in my left? I think they mentioned it being sudden
sensorineural loss. In crowds, with a lot of background noise, I feel like I cant hear anything.
Also if a phone rings or a baby cries, I can sort of hear it, but I cannot possibly nd where
the sound is coming from. I was wondering if you knew why this was. Thank you!

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Reply

NEIL BAUMAN, PH.D. says

February 18, 2017 at 9:09 AM

Hi Sabrina:

I thought your questions would be better answered in a separate article which Ive
just written. You can see this article Should I Wear a Hearing Aid in My Ear That Has
Poor Discrimination? at http://hearinglosshelp.com/blog/should-i-wear-a-hearing-
aid-in-my-ear-that-has-poor-discrimination/

Cordially,

Neil

Reply

KATHY says

February 19, 2017 at 1:34 AM

Ive had head trauma related hearing loss. I know I need to get tested. The ruptured
eardrum comes from physical abuse in 1998. I dont even try to follow conversations with
background noise anymore. It just frustrates me more to try. Bass sounds hurt badly!!!
What would be the odds of these ear infections, tinnitus, and gradual hearing loss possibly
becoming permanant?

Reply

NEIL BAUMAN, PH.D. says

February 19, 2017 at 6:58 AM

Hi Kathy:

What makes you think you dont have permanent problems now. If your eardrum
ruptured back in 1998thats 19 years ago nowand if it hasnt healed up yet, it
sounds permanent to me. Ear infections are much more common if you have a
ruptured ear drum as bad stuff can get into your middle ear and cause infections. Why
havent you had your eardrum repaired? That should give you better hearing and cut
down on ear infections. And better hearing may cause your tinnitus to lessen.

From the little you have told me, it seems you should go to an ENT specialist and see
what he says.

Cordially,

Neil

Reply

KYLIE says

February 27, 2017 at 11:45 PM

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I have a slight to moderate hearing loss in both ears, (20-28dB). Should I seek treatment for
this , even though it is on the threshold of moderate hearing loss?

Reply

NEIL BAUMAN, PH.D. says

February 28, 2017 at 1:50 PM

Hi Kylie:

20 to 28 dB puts you in the mild hearing loss class. Anything down to 25 dB is


considered normalso you are just over the line from normal. You may nd that
hearing aids are too much sound for your degree of loss.

What you want to do is protect your ears from whatever is causing this loss so it wont
get worse in the future.

Cordially,

Neil

Reply

VAIBHAV DHUMAL says

March 2, 2017 at 10:02 AM

sir,
my left ear is 100% damage and right ear is ne.can i get disability certi cate in india?if yes
then what is the percentage of disability ? plz ans me

Reply

NEIL BAUMAN, PH.D. says

March 2, 2017 at 10:09 AM

Hi Vaibhav:

I dont know the rules for India. Here in the USA you would not be eligible because
you have normal hearing in one ear.

Cordially,

Neil

Reply

RANAE says

March 2, 2017 at 10:51 AM

My hearing loss happened while I was at work and my HR wants my hearing loss in
percentages in order to compensate me. My threshold is 2o in R and 25 in L, my SL is 40db
in both R and L and 100% discrimination PBQ in both R and L. What does this mean and
how do i gure a percentage in order for HR to know how to compensate?

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Reply

NEIL BAUMAN, PH.D. says

March 2, 2017 at 1:11 PM

Hi Ranae:

You havent given me enough information to calculate the degree of hearing loss.
Attach a copy of your audiogram to an email and send it to me personally. My email
address is at the bottom of any page on this website.

Note that for compensation purposes, any loss down to 25 dB is considered normal.

Cordially,

Neil

Reply

ELISSA says

March 4, 2017 at 4:09 AM

Hello! This is a cool article Ive been wondering about the whole percent thing as it
didnt really make sense to me. Both glad and sad that its apparently a ridiculous idea, as
percentages seem like theyd be easier to explain, but oh well.

Anyway, I do have a couple of questions First of all, do you know what the usual SRT is for
a person with normal hearing? I like having comparisons, and while I can compare my
audiogram with other audiograms, I have yet to nd a general statistic listing normal
hearing SRT.
Second,Im 19 and I have mixed hearing loss. (though I think the sensorineural component
may be more prevalent than the conductive component) According to the hearing tests Ive
taken (from my audiologist) my hearing thresholds are:
Right Ear- 40 dB HL from 250 Hz to 1 kHz, 20 dB HL at 1500 Hz, 10 dB at 2 kHz and 3 kHz,
15 dB at 4 kHz, 10 dB at 6 kHz, and 25 dB at 8 kHz.
Left Ear- 40 dB HL from 250 Hz to 1500 Hz, 20 dB HL at 2 kHz, 10 db HL at 3 kHz, 30 dB HL
at 4 kHz, 40 dB HL at 6 kHz, and 50 dB HL at 8 kHz.
The thing is, I dont really feel like I have that much trouble hearing/understanding people
so long as there is little background noise. When I do have dif culty, it is usually with soft
speech, loudspeakers (especially in stores), computer video/audio calls, and noisy situations
(especially if Im not attuned to the voice Im listening to). Also, with the speech banana,
supposedly z and v are at around 30 db somewhere between 250 and 500 Hz, which
should be below my hearing. Yet, if I say either of these sounds, I can hear them, and I can
hear them when Mom says them too. However, I remember we were next to each other in
the car when we checked this so we werent really more than two feet apart And when we
tested it at 6 feet apart I couldnt hear them, so maybe its just a distance thing It is true,
however, that I can hear the s and f sounds in my right ear but not my left. I also have
these socks which have little jingle bells on them, which I can hear in my right ear while I
walk in them, but not my left. So I know for a fact that the high frequency differences are
accurate Basically, Im just wondering why it is that I feel like I understand speech better
than my audiogram says I should. Ive had this loss since I was little at least, so maybe Im
just used to it? Maybe my brain just adapted really well? I was of cially diagnosed when I
was seven, and Im sure I had HL before then, so Im used to this level of hearing (as far as I
know, I never had any speech delays. I also always did well in school, but then all the schools

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Ive ever gone to had small classes, so maybe it was just a better environment). My family
tends to talk loudly anyway, so maybe that had something to do with it. Idk. Ive had it
tested three times within the last year, twice at my audiologists and once at this random
hearing aid booth at the fair, and all three came back with very similar audiogram results, so
I know its most likely an accurate audiogram Anyway Speaking of which, is my loss mild
or moderate? Mildly moderate? Moderately mild? Just mild because of the normally-
hearing frequencies? Seriously, its literally RIGHT on the border.

Final question, just a request for a suggestion, do you think Id bene t more from hearing
aids or from an FM system? My ENT put HA trial after medically cleared on both my
recent audiograms I want to try hearing aids, but Im not completely sure whether or not I
need them since I understand most of the time (though Ill admit I havent really spent an
extended period of time outside of family settings, and HAs would have been really nice to
have when I was at this one friends house where literally the entire family have soft
voices), and Ive heard that they dont always work for reverse-slope loss, which is mainly
what I have.

Sorry this is so long, I tend to write a book when I ask questions Have a great day!

Sincerely,

Reply

NEIL BAUMAN, PH.D. says

March 6, 2017 at 9:16 AM

Hi Elissa:

The SRT for a person with normal hearing approximates the average of their hearing
level at 500, 1000 and 2000 Hz using pure tone testing. Thus it can range from a high
of -10 dB down to 25 dB (which is the bottom end of normal hearing).

You have a mild reverse cookie-bite loss (you hear better in the mid frequencies than
you do in the lows and the highs). It gets its name because the line on your audiogram
looks like a person took a bite out of the bottom of a cookie.

You are right. It quiet situations you function quite well, but as the background noise
increases, you have more and more trouble understanding speech.

Distance is a factor too. Since you have your worst hearing in the high frequencies,
and since high-frequency sounds have little energy they dont travel far though air.
Thus, the further you are from a speaker the fewer (or no) high-frequency sound you
hear. Unfortunately, it is these high-frequency sounds that you no longer hear (or hear
well) that give speech most of its intelligibility. Thus you can hear people talking, but
dont understand what they are saying.

To compensate for this, you have to get close to the speaker and be in a relatively
quiet situation.

One reason you hear speech better than your audiogram says you should is that we
talk in sentences. Sentences have both a predictable pattern and lots of redundancy.
Thus your brain can gure out a lot of what you miss.

That is why they give you the word recognition (discrimination) test where you only
have single-syllable words where you cant gain meaning from other syllables or any
context since there is no context. Thus, you should be able to understand speech
better than your word recognition scores indicate.

To calculate your average hearing loss take the results at 500, 1000, 2000 and 3000
Hz and average them. Yours come out at 30 dB in each ear. The classi cation of

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hearing averages between 26 and 40 dB is mild. So of cially, you have a mild hearing
loss.

Hearing aids work best in quiet situations where you are close to the speaker. As the
distance increases and/or the background noise increases, hearing aids become less
and less useful. That is where you want to switch over to an FM system or other
assistive device. Of course, if you combine your hearing aids with the assistive device
you have an awesome combinationfor example using an FM system and coupling it
to your hearing aids via t-coils, or built-in FM receivers.

Your right ear is more reverse-slope (or sort of reverse cookie-bite, but you left ear is
de nitely reverse cookie-bite.

Hearing aids will help you in some situations and not in others. Thus, I say wear them
when they help you and take them off when they dont, and use assistive devices when
they help you more han your hearing aids do, and when your hearing aids work better,
dont use the ALDs.

As you can see, there is not one simple answer.It is up to you to nd what works best
for you in any given situation.

Cordially,

Neil

Reply

ABHIJEET KUMAR says

April 14, 2017 at 4:55 PM

Dear Sir,
I have 12 dB threshold for my right ear whereas it is 48 dB for the left ear. Doctor says that
it is the case of Retracted eardrum in my left ear.
I want to know if the retracted eardrum is curable completely.
Do i have any sort of so called deafness?

Reply

NEIL BAUMAN, PH.D. says

April 15, 2017 at 7:23 AM

Hi Abhijeet:

A 48 dB threshold is another way of saying you have a 48 dB hearing loss which is


considered to be a moderate hearing loss. So yes, you have a moderate degree of
deafness (or hearing loss) in that ear.

Typically, a retracted ear drum is the result of your Eustachian tube not working
properly or your middle ear and/or Eustachian tube is clogged up or blocked.

If you have a cold and mucus gets sucked up your Eustachian tube and blocks air from
getting into your middle ear, that could cause the retraction. Typically things will
revert to normal when the cold goes away and the gunk in your middle ear and
Eustachian tube nally drains out. That could take another two months, so it may not
be right away.

If your Eustachian tube is not working properly, it could be that the nerve that
controls it (the trigeminal nerve) is pinched. A visit to an upper cervical chiropractor

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can x that.

Cordially,

Neil

Reply

ABHIJEET KUMAR says

April 16, 2017 at 1:10 PM

Thank You very much for your kind reply sir.

Reply

SUSAN says

April 25, 2017 at 10:25 AM

Thinking of adopting a 6 year old child who has hearing loss of ABR 70 in one ear and ABR
80 db in the other ear. This child is from China so she cant be seen until adoption. Do you
think hearing aids would greatly help her hearing? Thanks!

Reply

NEIL BAUMAN, PH.D. says

April 29, 2017 at 8:10 AM

Hi Susan:

My hearing is in that range and hearing aids sure help me so I dont see any reason
why they shouldnt help her too. It wont be perfect hearing by any means, so she and
you will have to also practice good hearing loss coping skills. If hearing aids wont help
her, then consider getting her cochlear implants.

I wish you well on your adoption.

Cordially,

Neil

Reply

RUTH says

May 4, 2017 at 5:23 PM

My son just came from school and they underwent a Hearing test. His right ear is circled at
1000/20dB. What does it mean. Please advice

Reply

NEIL BAUMAN, PH.D. says

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June 12, 2017 at 7:22 AM

Hi Ruth:

This just means he has a hearing loss of 20 dB at 1000 Hz. This is considered a mild
hearing loss at that frequency. If this is all the hearing loss he has at this point, its
nothing to worry about.

Cordially,

Neil

Reply

LAURA SMITH says

May 10, 2017 at 3:44 AM

Could you please explain this uk audiogram please?

R BCL 38 HTL 62
L- BCL 33 HTL 58

Also tympanom analyser


Test 1 ytm 226hrtz
0.6 and re ex 1000Hz NR

Test 2 ytm 226hrtz 0.6


Re ex 1000hrtz Yes

My HL has got worse since this testing. It is now mixed bilateral moderate to profound.
MRI scan for mastoid temporal bone was normal, eustachion / nose endoscope was normal.
Could maternal rubella in vitro be the cause of my hl problems and is it likely the cochlea /
cranial nerves are damaged?
I have been offered a bone anchored hearing aid would this devise help me better with
speech intellligibility? My ENT consultant said to trial it rst, but wouldnt a cochlea implant
be a better option if the cochlea/ cranial nerves are damaged?
Thank you.

Reply

NEIL BAUMAN, PH.D. says

June 11, 2017 at 10:33 AM

Hi Laura:

BCL is the abbreviation for bone conduction levelthe softest sound you can hear via
bone conduction testing for that frequency.

HTL is the abbreviation for hearing threshold levelthe softest sound you can hear at
that test frequency.

You have both a middle ear hearing loss (conductive) and an inner ear (sensorineural)
hearing loss. When you have both kinds of hearing loss, it is called a mixed hearing
loss.

Maternal rubella is de nitely a cause of hearing loss. Theres no doubt about that.
There is also no doubt that the nerve endings in your cochlea are damaged. Actually, a
number of them are dead. Sometimes doctors call this nerve deafness. But that is

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really a misnomer. The auditory nerve is not dead. Its the endings of the nerve in the
cochlea that die. Thats why you have the sensorineural hearing loss.

Bone-anchored hearing aids is typically best for people with a conductive loss. They
are less useful for people with more severe sensorineural losses like you have.

If you are so inclined, you can try out a bone-anchored hearing aid and compare it to
the results you get with a conventional hearing aid. Whichever one works better is the
way to go. However, remember that your sensorineural hearing is getting worse and
therefore a bone-anchored hearing aid will be less and less useful in the future.

Cordially,

Neil

Reply

NIKOL says

May 13, 2017 at 12:44 AM

Great article. Very informative and great launching point for me in my where to start
point in terms of my hearing goes.
I do have a couple quick questions. First let me get my audiogram results out of the way so
you get the info. This audiogram was performed July of 2016.
History of TBI due to repeated concussions and head trauma (physical abuse). I am 44. I had
PE tubes put in after the audiogram in hopes it would help with the hearing loss. It didnt. I
still have issues following along in conversations; especially when the speaker is on my
right. As well, on the phone I have issues and I must have the CC turned on the TV or the
volume turned up loud to at least 18 to 20.
Report states:
Hearing test is consistence with a moderate to moderately severe conductive hearing loss
AD with mixed component at 2000 Hz and a mild to moderate mixed hearing loss AS.
Right
250 60 db
500 60 db
1K 70 db
2K 60db
3K 60db
4K 70db
6K 70db
8 K 60db
Left
250 45db
500 45db
1k 50k
2K 50K
3K 50K
4K 60K
6K 50K
8K 60K
Speech Recognition/Discrimination
Left
Test SRT 45db
Test WRS 100%- 85db
Right

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Test SRT 55db


Test 100% 95db
Stimulus Right
NR for all
Stimulus Left
(Ipsilateral) dB HL 500-NR, 1000 95, 2000 -NR

My questions (I will try to make it brief as I have been told I am much like a politician trying
to bid for of ce and lengthy)
1) Given the information (e.g. audiogram, Speech Recognition/discrimination, age, etc),
would a hearing aid for at least the worst of the two ears be considerable option for me? Or
should I get a second audiogram to update the results to see if there are any changes since
the last?
2) Do the test results for the speech recognition vary by age? What do those numbers
mean? I was only told you have hearing loss. My ENT has since retired so I must nd a new
doctor. He was hard of hearing himself.
3) Overall, is this too bad? As well, is this something that I would put on my list of medical
issues for a SSDI claim along with other issues? (I would not rely on this as a stand along
issue as I dont think would be a standalone issue even though it is a pain in the hind end to
not understand what people say and lean in to hear people).

Thank you in advance for you time.

Reply

NEIL BAUMAN, PH.D. says

June 11, 2017 at 9:06 AM

Hi Nikol:

You have a moderate to moderately-severe hearing loss. The good news is that even
though you have a signi cant hearing loss, your discrimination scores are 100%. That
means the when speech is loud enough for you to hear, you understand it 100%.

thus you are a good candidate for wearing hearing aids and should have good success
wearing them. You actually need two hearing aids, one in each ear for best results.

Your speech discrimination (or word recognition as it is sometimes called) vary mostly
with the kind of hearing loss and the degree of hearing loss you have rather than with
age. however, as you age you typically lose your higher frequencies. When this
happens, you will nd your speech discrimination scores typically dropping.

You have what is called a at loss which is very easy to t hearing aids to.

You are correct that your degree of hearing loss would not normally be a factor in an
SSDI claim. Since you have other health issues, it might not hurt to put it in, but I dont
know that it would make any difference in the outcome.

I think youll nd that getting to hearing aids will really make a difference in how well
you understand people. At the very least, try some out and see how they work for you.
I think youll be pleased at how well you will hear then.

Cordially,

Neil

Reply

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VIRENDRA says

May 20, 2017 at 12:41 AM

respecetd sir
my left ear is in mild hearing loss range and right ear with severe hearing loss.Am i comes in
HH category??if yes,what is the % of HH .???

Reply

NEIL BAUMAN, PH.D. says

June 11, 2017 at 8:09 AM

Hi Virendra:

Yes, you have a hearing loss, so you are hard of hearing. Whether you have a mild loss
like you have in your one year, or severe loss like you have in your other ear, either
way, you are hard of hearing.

You cant calculate hearing loss in percentage. What you can calculate is the percent
disability you have because of a given degree of hearing loss. However, you have not
given me enough information to be able to do that.

Cordially,

Neil

Reply

BOOPATHY says

June 12, 2017 at 11:38 AM

Hello doctor,I recently had a hearing test..in the report ,I am having a right ear 23db and left
ear 37dbiam of age 23..this loss can be curable or permanent?

Reply

NEIL BAUMAN, PH.D. says

June 13, 2017 at 6:06 AM

Hi Boopathy:

You havent given me near enough information for me to answer your question. For
example, is your hearing loss due to exposing your ears to loud sounds? Was it caused
from taking one of the various drugs that can cause hearing loss? Is your hearing loss
hereditary?

Also, those gures of 23 dB and 37 dB, is that the average hearing loss for those ears?
It would be much better to tell me your actual hearing loss by frequency as shown on
your audiogram.

When did this hearing loss happen?

Cordially,

Neil

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BOOPATHY says

June 13, 2017 at 8:31 AM

For the past one month I am facing hearing loss doctor

Reply

BOOPATHY says

June 13, 2017 at 8:35 AM

Also in the report they mentioned high-frequency mild to severe hearing


loss with mixed components

Reply

JOHN H says

August 11, 2017 at 11:23 PM

I have had several hearing tests this year. On one of the test results
are several scores that I do not understand. Under a column listed as
Speech are the following numerical scores.
Right Left
SRT 30 30
PBQ 92% 100%
PS Level 70 70
I understand the audiogram.
Thank you in advance.

NEIL BAUMAN, PH.D. says

August 13, 2017 at 11:19 AM

Hi John:

SRT stands for Speech Reception Threshold. This is the softest


volume of speech where you can just identify half the of words
correctly. This is the test where you repeat the spondee words (words
with equal stress on each syllable) such as railroad, hotdog, cowboy,
ice-cream, etc. Your SRT level is 30 dB.

PB stands for Phonetically Balanced discrimination or word


recognition test. This is the test where the volume is set at your most
comfortable level (MCL) and you repeat a series of single syllable
words that cover all the speech sounds in the English language.
Typically, this is a list of 25 words. Your score is expressed as a
percentage. In your case, your right ear missed two words (leaving
you with a discrimination score of 92% and your left ear got them all
right.

The discrimination testing was done at a level of 70 dB in each ear.

Cordially,

Neil

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SCOTT says

August 18, 2017 at 10:41 AM

Hello Dr. Bauman.


First, thank you for very clearly explaining why percentages are meangingless and are often
misinterpreted by the general public. You much more eloquently articulated what I, as not a
doctor, have not been able to when working with clients in my job. I do, however, have a
question for you. I have a bilateral profound hearing loss at low and high frequency , with a
severe loss in both ears at the mid range. My question is that I use a ComPilot with my
hearing aids in order to further amplify sounds to a level that I can work with and to also
isolate noise. Im also totally blind, so its important for me to get the most out of my
residual hearing. Anyway, my question is, could my using the ComPilot for 12 hours a day
further destroy my hearing? Thank you again for the article, and for sharing your medical
expertise on this board!

Reply

NEIL BAUMAN, PH.D. says

September 5, 2017 at 8:40 AM

Hi Scott:

Since you run your ComPilot through your hearing aids, theoretically, it should not
harm your residual hearing. Thats assuming, of course, that your hearing aids are set
to limit loud sounds to below dangerous levels.

However, when you have a profound loss, you need to amplify sounds to dangerous
levels just to be able to hear. So I think that these loud levels can, over time, damage
your residual hearing. However, whats the alternative? Not hear? What I do is a
combination of both. When I talk to people I need the volume so I can understand
them. And that can be too loud for my ears health. So what I do is I dont wear my
hearing aids much. That way, my ears have lots of rest so their accumulated noise
exposure each day is kept to a minimum. Remember, it is volume times time that is
important. So limit the time you have to hear at full volume. When it is quiet around
you, of course your hearing aids are not going to be blasting your ears so you are ok
then.

In your case, since you are blind, you cant use your eyes for your ears like I can. Thus,
you have to wear your hearing aids to be aware of what is going on around you. Thats
just the way it is.

But even if over time you do lose more residual hearing, Plan B is that you could get
cochlear implants and hopefully hear again.

Cordially,

Neil

Reply

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SUNNY KUMAR says

August 20, 2017 at 2:55 PM

Sir,
My child, age 12 month, baby boy has development delay and found hearing loss in BERA
test. BERA test shows profound hearing loss, means child is not able to hear at 90db in both
year but Doctor suggest me for ASSR test which shows that child can hear at 70db in left
ear and 80db in right ear. Now I am confuse that which hearing aid to use, can hearing aid
help to my child. I have not buy the hearing aid yet but want to buy very soon, your advice
will help me alot. What is the meaning of BERA and ASSR test, why the difference in these
two test?

Reply

NEIL BAUMAN, PH.D. says

September 5, 2017 at 8:02 AM

Hi Sunny:

BERA stands for Brainstem Evoked Response Audiometry. Another common name is
ABR (Auditory Brainstem Response). It uses a series of clicks at slow speeds to evoke
brainstem responses.

ASSR stands for Auditory Steady-State Response. It uses a series of repeated sounds
at high repetition rates.

Both record bioelectric activity from electrodes arranged in similar recording arrays.
In both, the output is auditory evoked potentials.

With BERA, results are subjectively interpreted by the person doing the testing. In
contrast, ASSR uses sophisticated statistical modeling to come up with the results.

BERA is good for mild-moderate-severe hearing loss. ASSR is good for severe-
profound losses.

So, putting this all together, since your child likely has a severe-profound hearing loss,
the ASSR results should be more accurate.

Either way, your child has a very signi cant hearing loss. It is possible that hearing aids
will help him, but at the same time, he may have much better results if he gets
cochlear implants.

Before Id rush out and buy hearing aids, Id have him evaluated for cochlear implants
and then make your decision.

Cordially,

Neil

Reply

VARALA says

August 29, 2017 at 12:32 PM

Sir .
May I know what is Hard Of Hearing ?
Any measures for this .?!

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Reply

NEIL BAUMAN, PH.D. says

August 31, 2017 at 8:36 AM

Hi Varala:

Hard of hearing is just a term to describe people with some degree of hearing loss.

Hearing loss is divided into several classes, depending on the severity of the loss.
These classes range from slight to mild, to moderate, to moderately-severe, to severe
to profound and nally deaf.

Here is how they are de ned.

-10 to 15 dB Normal Hearing


16 to 25 dB Minimal (slight) Hearing Loss
26 to 40 dB Mild Hearing Loss
41 to 55 dB Moderate Hearing Loss
56 to 70 dB Moderately Severe Hearing Loss
71 to 90 dB Severe Hearing Loss
91 + dB Profound Hearing Loss

Cordially,

Neil

Reply

ARSLAN ANWAR says

September 13, 2017 at 7:15 AM

have a nice day sir


i am from pakistan .my daughter reports show profound degree hearing loss up to 100 db .
i contect many docters but thay dont satisfay me .what can i do plz help me and reply me as
soon as possible .bundle of thanks

Reply

NEIL BAUMAN, PH.D. says

October 4, 2017 at 10:10 AM

Hi Arslan:

If your daughter has a hearing loss around 100 dB, then hearing aids probably wont
help her much if at all. Id suggest you consider getting her cochlear implants. With
that degree of hearing loss there is probably nothing doctors can do to help her apart
from cochlear implants.

Cordially,

Neil

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BONITA says

September 23, 2017 at 4:58 AM

Greets!
Up until just very recently, I often spoke of my hearing loss in a percentage without
realizing how erroneous that is. Thanks for this article explaining why!

I was hoping you could help clarify/con rm what type of hearing loss I have and at what
level. A brief history: Ive always had some level of hearing loss and began wearing hearing
aids at age 8-9 when it was becoming super noticeable to my parents (I was incredibly shy,
so they thought my quietness was due to that, not that I couldnt hear). The most I know is
that my ENT specialist couldnt determine the cause, although I did have an illness that
resulted in nerve damage and temporary partial paralysis in my face which may have had an
impact on my hearing (?). Ive had tinnitus for as long as I can remember, from moderate to
quite severe that it becomes debilitating and I have a history of chronic ear infections as a
child with a handful of signi cant infections as an adult. The hearing loss was most severe in
the higher frequencies for both ears, but my left ear was overall worse than my right for
most of my life. I wore hearing aids in both ears up until my early 20s. I couldnt afford
hearing aids from ages 23 to 38 so did best I could with lip/speech reading and cupping my
ears to help direct/amplify sound. I felt my hearing uctuated, with my right ear always
being my good ear to hear with until another illness a few ears ago wiped out the hearing in
that ear completely and I am now profoundly deaf on the right side. Again, ENT specialist
and an MRI couldnt determine what damage was caused. I have had a Bi-CROS system for
the past 5 years that is due to be replaced soon. I typically nd hearing aids do not help now
at age 43 as much as they did when I was younger ampli cation doesnt do much for
clari cation and most people get frustrated thinking I should be able to understand
because I have a hearing device.

Here is my most recent audiogram for my Left Ear (right not tested dead ear), as best as I
can read it as its a bit messy:

Bone Conduction
250Hz @ 30dB HL
500Hz @ 40dB HL
1000Hz @ 45dB HL
2000Hz @ 55dB HL
3000Hz @ 80dB HL
4000Hz @ 75dB HL

Air Conduction
250Hz @ 55dB HL
500Hz @ 55dB HL
1000Hz @ 60dB HL
2000Hz @ 65dB HL
3000Hz @ 85dB HL
4000Hz @ 90dB HL
6000Hz @ 100dB HL
8000Hz @ 95dB HL (with arrow pointing down)

My word recognition score was 72% @ 90dB.


My MCL was 85 and my UCL was 100+.

Audiologist Note: 5-10dB decrease overall (from last test I assume)

So, it seems to me that there is a difference of 15dB between bone and air conduction tests
at the lower frequencies, but as the frequencies get higher they become closer together as
they both slope down to the right. I have no clue what exactly that means. What would you
classify my overall hearing at? Obviously, my right ear is profoundly deaf but my left would
be moderately-severe to profound at high frequencies? How is the overall classi ed with
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such a slope? Also, at what level can the term deaf be used in your opinion? Finally, what
speci c conclusions can be made from the speech audiometry that was performed (Im not
sure why the SRT part was not done at this testing, but I do recall typically becoming
frustrated and not doing well in the past).

Thanks in advance for any feedback you might be able to give! Clearly, Im looking forward
to a continual decline to my hearing so any suggestions for coping with this fact and/or the
tinnitus is appreciated.

Reply

NEIL BAUMAN, PH.D. says

October 3, 2017 at 10:53 AM

Hi Bonita:

I was the same as youvery shy because of my severe hearing loss. Im actually quite
an outgoing person, but when I am in a situation where I cant hear, I act shy and
basically dont speak (or else people will think I can hear since my speech is normal).

You have what is called a mixed loss since you have both a conductive (middle ear)
component and a sensorineural (inner ear) component to your hearing loss. The
separation between your bone conduction (conductive) and air conduction
(sensorineural) readings is know as the air-bone gap. As you know it is more or less
(depending on the frequency) about 15 dB.

You can classify your hearing loss as a ski-slope loss or high-frequency loss ranging
from moderate (or moderately-severe since you are right on the 55 dB boundary that
separates them) to profound. If you want a single word to describe your hearing, you
calculate it by taking your hearing at 500 Hz, 1K, 2K and 4KHz. These gures in your
case are 55, 60, 65 & 90. The average of these is 67.5 dB which falls into the range of
moderately-severe (56-70 dB).

Thus, you can say you have a moderately-severe hearing loss, or more accurately you
could say you have a sloping moderately-severe to profound mixed hearing loss.

Deaf is normally de ned as hearing below 90 dB. However, if you cant hear a person
speaking to you from 3 or 4 feet away, you could say you are functionally deaf. This is
the term I use for my own hearing as I cant even understand a person from that far
away without my hearing aids.

Under ideal conditions, you only understand 72% of what you hear. And since you are
seldom in ideal listening conditions (silent room with person speaking at 85 dByour
most comfortable listening level) your speech comprehension will be less than that.

Since speech discrimination testing is done using single-syllable words, and since
English is often composed of two or more syllables, you can often gure out the word
if you hear one or two of the syllables. Furthermore, English sentences have structure
and redundancy built in. Thus, often you can understand speech better than your
word recognition score would indicate. But in noisy situations, you wont even get
that much.

As your hearing declines, youll need a more powerful hearing aid. When your hearing
aid no longer signi cantly helps you, its time to consider getting cochlear implants.

If your tinnitus is bothering you, you will nd a wealth of information on how to take
control of it in my book Take Control of Your Tinnitusparticularly chapter 16. In
your case, as is in mine, I have tinnitus 24/7, but I do not let my tinnitus bother me
even though it is there. You can learn to do the same.

Cordially,

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Neil

Reply

LAXMANSING says

September 24, 2017 at 9:24 AM

I left ear total deafness profound but 40 DB hearing level in right ear severe please guide
me i know hard of hearing disabled person or no

Reply

NEIL BAUMAN, PH.D. says

October 3, 2017 at 11:25 AM

Hi Laxmansing:

If you have 40 dB hearing loss in your right ear, you have a mild to moderate hearing
loss. That means you will have some dif culty in understanding speech, particularly in
noisy situations. But that does not mean you are disabled, as such. You can still
communicate. Getting a hearing aid will make things easier for you.

Cordially,

Neil

Reply

VINEET says

October 1, 2017 at 6:59 AM

Hi doctor,
I having query regarding my 2.5 yrs old son. He is not speaking meaningful words so doctor
suggested for BERA test . When we visited doctor said he could make out that my son is
listening without doing BERA test so he asked not to do it. Now again I visited child
specialist he asked about BERA test. Whats your advice. Please share.thanks.

Reply

NEIL BAUMAN, PH.D. says

October 1, 2017 at 11:42 AM

Hi Vineet:

You can crudely test your childs hearing yourself. Stand behind him at varying
distances and speak to him and see if he turns around or responds to you. If he
doesnt, you know he has a pretty signi cant hearing loss. Thats how my dad
discovered I had a severe hearing loss.

If he responds (appears to be listening) that doesnt mean he understands what he is


hearingjust that he is hearing something. The sounds may have to be louder before
he can understand speech.

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If you clap your hands or slam a door or bang on pots and pans and there is no
response, you know he has a very signi cant loss.

The BERA test is not harmful or invasive, so I cant see why your doctor doesnt think
one is necessary. It will give a very good indication of your childs hearing loss. If I were
you, Id go for itespecially if the above tests show your son isnt hearing normally.

Cordially,

Neil

Reply

ER. NILESH says

October 19, 2017 at 4:03 AM

sir,
my left ear disability is 64% approved by doctor and right ear is ne.i can get disability
certi cate in india. in our tax document it mention that (permanent deafness with hearing
impairment of 71 decibels and above? ), what is the meaning of this, plz ans me.

Reply

NEIL BAUMAN, PH.D. says

October 19, 2017 at 9:50 AM

Hi Er:

It means that your hearing loss average at 500, 1000, 2000 and 4000 Hz must be
greater than 71 dB. You can get these gures off your audiogram.

Cordially,

Neil

Reply

MIR HASSAN says

October 21, 2017 at 10:31 AM

hi Doctor.
my PTA report is
Right ear
-125 = 60db
250 =50db
500 =50db
1k =45db
2k =35db
4k =75db
8k =65k

left ear:
-125 =55db

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250 =50db
500 =50db
1k =60db
2k =45db
4k =30db
8k =35db
sir it is permanent or recovery is possible please help me.

average loss in db of left ear is 46.5 and right ear average db is 55.. what is the percentage
and recovery is possible and what should i do now??

and doctor told me that your hear is internally damage,, the connection between mind and
sound signal i.e nerve problem so recovery is not possible and your hearing loss is
permanent.. what you say??

Reply

NEIL BAUMAN, PH.D. says

October 23, 2017 at 9:43 AM

Hi Mir:

Your average hearing loss is 46 dB in your right ear and 52 dB in your left ear.

Based on the results of your audiogram, you have a 33% hearing disability. This just
means that given the degree of your hearing loss, you would expect to earn 33% less
in wages than a person with normal hearing.

You havent told me anything about your hearing losswhat caused it, etc. Therefore, I
can only guess that you have a sensorineural (inner ear) hearing loss from what you
say your doctor said.

Typically, such hearing losses are permanent as your doctor told you. Thus, you need
to learn how to live successfully as a hard of hearing person.

If I were you, Id get hearing aids and use them in hearing situations where they help
you. In situations where there is too much noise so they dont help you, just take them
off. That is what I do.

Cordially,

Neil

Reply

SANJAY says

November 5, 2017 at 12:53 PM

Hi Doctor,
I just got back from Audiometry tests.Left Ear-68 DBHL Right Ear-68 DB.HL
Although 7 years back my tests results were :
Left Ear:60 Db
Right Ear: 55 DB
I have had this hearing problem since birth
I have some confusion regarding this and hope you clear my head regarding this
1.) During Audiometry Test, i had cold and throat infection. Will this affect the test results.
And also i believe its not very accurate considering the huge deviation.

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So I m planing to take the test again sometime in future


2.) However If i take again, and assume that results again shows like 7 years back, say my
better ear has 55 DBHL. Could i apply for Disability certi cate. Here the law states that in
order to get certi cate, you need to be have 40 % or above hearing impairment.
But to be considered as hearing impaired, you need to have above 60 DBHL. I nd this realy
confusing
Here is the link stating the law
Could you please take pains to help me out :
http://www.ncpedp.org/sites/all/themes/marinelli/documents/Rights%20of%20Persons%20with%20Disabilities%20(RPWD)%20Act%202016.pdf

Reply

SANJAY says

November 6, 2017 at 10:51 AM

Hi Doctor,
Just came back from Audiometry tests:
Left Ear: 68DBHL
Right Ear:68DBHL

However 7 years ago, the test results were as follows:


Left Ear: 60 DBHL
Right Ear: 55 DBHL

I m planning to take the test again since i feel this is not accurate considering there was a
huge deviation from 7 years ago. However there are couple of things which i want to clear
out with you

1.) When the test was taken, I had mild cold and throat infection. So will this affect the test
result ?

2.) According to the law here, in order to avail disability certi cate, you need to have 40 %
percent impariment in the better ear.
But to be considered as hearing impaired, you need to have 60 DBHL or more. I nd this
really confusing.(40 % or 60 DBHL) After I retake the test from the quali ed
authority,assume that the Better ear has 55 DBHL , am i eligible ?
They have even classi ed percentage with DBHL. Would you please take pains to follow
this link: http://www.rehabcouncil.nic.in/writereaddata/hi.pdf
I really hope to get reply from you. Please help me out.
Thanking you for the same

Reply

NEIL BAUMAN, PH.D. says

November 7, 2017 at 9:38 AM

Hi Sanjay:

Since you have a 68 dB loss in both ears, you qualify as being classi ed as being hard
of hearing for the purposes of your laws. It says this equates to a 40% hearing
impairment which means youd qualify for a 40% pension or stipend.

BUT it also states that for this to happen you ALSO need to have a speech
discrimination score of between 40 and 50 percent in your better ear. You havent
mentioned what your speech discrimination scores are. You need to nd these gures
on your audiogram. Sometimes they are called word recognition. They are the only

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gures on your audiogram that are expressed in percentages. The rest are all in
decibels (dB).

So if your speech discrimination in your better ear is 50% or greater, then youd
qualify.

Cordially,

Neil

Reply

SANJAY says

November 7, 2017 at 1:42 PM

Thanks a lot Doc !


Thats the problem here. We dont do speech discrimination here. Just get done over with
Audiometry.

Also, could you please clarify whether having cold/throat infection may affect my
Audiometry test result?
Since there is a huge deviation from it from the previous test result

Reply

NEIL BAUMAN, PH.D. says

November 8, 2017 at 4:17 PM

Hi Sanjay:

If you dont do speech discrimination, why does your law require it for a Disability
Certi cate? You havent had a proper hearing evaluation if they dont test your speech
discrimination.

Yes, a cold could make your results look worse than they really are when you dont
have a cold.

Cordially,

Neil

Reply

DEV says

November 19, 2017 at 7:18 AM

Hello,

My Son 18 months old has done BERA test and Result says
Independent Simulation of Right and Left Ears at 105dbnHL with altenative Clicks, Using
Ear Buds, No Consistent Potential are noted despite several Clicks.
Threshold studies not possible, Technical Factors were excluded .

Can you please guide us on below points:


1. Can BERA test Results be wrong , should we try for retest.

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2. Is there any other Test required which would help to clear out things that the problem is
in Inner Ear or something else.
3. Can mentioned result be due to Swelling / Wax or any other reason.
4. Is Cochlear Implant only solution or is the same can be treated with Medicines or any
other solution.

Please guide me.


Request you help for the same

Regards,

Reply

NEIL BAUMAN, PH.D. says

November 22, 2017 at 12:11 PM

Hi Dev:

Yes, any test can be wrong for any number of reasons. If you dont think the test is
consistent with what your son can hear, by all means get him retested at some other
facility. If both test results are similar, then thats a sure sign that they were pretty
accurate.

There are lots of other tests, but they require the child to be old enough to respond
accurately. Thats the beauty of the BERA test, it doesnt require any input from the
child.

If your son has a profound hearing loss, or is deaf, then, in my opinion, cochlear
implants are the only viable alternative at this time.

Cordially,

Neil

Reply

HITESH BHOMAWAT says

November 27, 2017 at 6:46 AM

Hi, Dr Bauman,
I was unable to hear properly from my left ear & my reports of both the ears from
audiologist was like this.
Report comments:
Puretone average [in dbHL]
Rt: 45 dbHL moderate conductive hearing loss.
Lt: 60 dbHL moderately severe conductive hearing loss.

Bilateral As type tympnogram with re exes absent suggestive of middle ear pathology.
Please tell that what should i do , will it get clear by operation of ears or any other help that
you can suggest.

Regards

Reply

NEIL BAUMAN, PH.D. says

December 2, 2017 at 5:31 PM

http://hearinglosshelp.com/blog/hearing-lossdecibels-or-percent/ 72/75
12/13/2017 Hearing LossDecibels or Percent

Hi Hitesh:

Since you have a conductive hearing loss, and since conductive hearing losses can
often be xed medically, you should see an ear specialist and see what he thinks. If you
have a condition called otosclerosis, often they can use a prosthetic device to replace
the stapes bone in your middle ear that let you hear normally again. Sometimes this
seems to last forever, but other times the auto sclerosis continues and the device
works less and less well after a few years and may have to be replaced again.

Cordially,

Neil

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