Hearing

What is hearing (auditory processing)?

Hearing — or auditory processing — refers to the awareness of sounds and placing meaning to those sounds. It involves a complex series of steps in which several parts of your ear and auditory nervous system work together harmoniously.

What are the parts of my auditory system?

Your auditory system (hearing system) consists of many different parts, including your:

• Outer ear.
• Middle ear.
• Inner ear.
• Auditory nervous system.

Successful hearing requires all of these parts to function properly.

Outer ear

Your outer ear consists of your pinna and your ear canal. Your pinna is the visible, external part of your ear. It funnels sound into your ear canal like a reverse megaphone.

Middle ear

Your middle ear consists of your eardrum (tympanic membrane) and your ossicles (tiny, sound-conducting bones called the malleus, incus and stapes). Your eardrum sits at the very end of your ear canal. Your ossicles — located on the other side of your eardrum — carry sound vibrations to your inner ear.

Inner ear

Your inner ear contains a spiral-shaped structure called the cochlea (which means snail shell). Tiny hair cells line the inside of your cochlea. When sound vibrations reach these hair cells, they transmit signals to your auditory nerve.

Auditory nervous system

Your auditory nerve runs from your cochlea to a station in your brain stem (known as the nucleus). From that station, neural impulses travel to your temporal lobe — where your brain attaches sound to meaning.

How does hearing work?

Your hearing process involves all of the auditory system parts mentioned above. Here’s a step-by-step guide to this complex process:

1. Sound waves travel through your ear canal to your eardrum and cause it to vibrate.
2. The vibrations travel from your eardrum to your ossicles (tiny bones in your middle ear).
3. Your ossicles send the vibrations to your cochlea (a spiral cavity in your inner ear that’s lined with hair cells).
4. The tiny hair cells vibrate and send messages to your auditory nerve (the nerve that connects your ears to your brain).
5. Your brain receives this information and translates it into sound. In other words, your brain is where your sense of hearing comes to life.

What conditions can impact my ability to hear?

Many conditions, illnesses and diseases can affect your hearing, including:

• Aging: Hearing naturally weakens as you grow older. Noise exposure, illnesses and certain medications can all contribute to age-related hearing loss.
• Ear trauma: Pushing cotton swabs or other objects into your ear can result in a ruptured eardrum. A hard slap on your ear can cause trauma, and head trauma can cause fractures within your ear.
• Disease: Cardiovascular diseases and diabetes can increase your risk for hearing issues by decreasing the blood supply to your ear and your auditory system.
• Medication: Some medications, such as cancer treatment drugs, can contribute to hearing loss.
• Sound exposure: Long-term exposure to excessively loud sounds will damage the structures in your inner ear and cause hearing loss. It can happen gradually over time (for example, working for many years in a factory), or it can happen instantly (when using things like firearms or firecrackers). The greater the exposure, the greater the hearing loss. Noise-induced hearing loss, however, is 100% preventable by using hearing protection devices like earplugs or earmuffs.
• Earwax: Earwax (cerumen) in your ear canal is normal and healthy. But sometimes too much earwax can build up and block sound from getting to your eardrum. Eventually, this can result in hearing loss. Professional earwax removal by a healthcare provider can help restore hearing in these instances.

When should I call my healthcare provider?

Visit a hearing care provider immediately if you experience sudden hearing loss, even if it’s only in one ear. Seeking medical attention within the first 72 hours is essential to reduce your risk of complications, including permanent hearing loss.

Hearing care specialists are different from your primary care physician (PCP). They include:

• Audiologist: A healthcare provider trained to diagnose and treat nonmedical hearing and balance problems.
• Otolaryngologist (ENT): A physician who treats problems with your ears, nose and throat.
• Otologist: A specialist who focuses on ear health and the medical and surgical management of ear or hearing issues.

If you notice a change in your ability to hear or understand, or if it seems like everyone is mumbling, schedule an appointment with a hearing care specialist. Hearing loss can occur gradually so it’s good practice to have your hearing tested on a regular basis. This is especially true if you have a family history of hearing loss.

How do hearing care specialists check for hearing loss?

A hearing care specialist will give you a hearing test called an audiogram. During this test, your provider plays sounds through headphones. You’ll press a button when you hear a sound. The results measure your ability to hear. Tests take place in your provider’s or audiologist’s office in a soundproof booth.

How can I keep my hearing healthy?

To protect your hearing, you should:

• Use hearing protection (earplugs or earmuffs) during loud activities such as concerts, riding motorcycles or snowmobiles, or working with loud machinery.
• When listening to music through headphones or earbuds, keep the volume level low enough that you can hear people speaking around you. Another good rule is not to exceed 80% volume for more than 90 minutes a day.
• Don’t stick anything into your ear canal, including cotton swabs or hairpins. These objects could become lodged in your ear canal or cause an eardrum rupture.
• Avoid smoking, which can impair circulation and harm your hearing.
• Get regular exercise to help prevent health issues like diabetes or high blood pressure that can cause hearing problems.
• Manage any chronic illnesses to prevent further damage.

What is auditory perception?

Auditory perception is the ability to identify and interpret sounds — and attach meaning to them.

What is the purpose of hearing?

Hearing helps you stay aware of your surroundings and connect to the world around you.

A note from Cleveland Clinic

Hearing is one of the five basic human senses. It’s a complex process that you use every day but probably don’t think about too often. Many people have hearing difficulties. In fact, more than 37 million adults in the U.S. have some degree of hearing loss. Today, there are many treatments and devices that can improve your hearing, such as hearing aids, cochlear implants and bone anchored implants. There are also resources to help people with profound hearing loss communicate effectively. If you have difficulty hearing, ask a healthcare provider about your options.