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The Rontal Clinic

Hearing Loss

Hearing loss, or deafness, is the partial or total loss in one or both ears of the ability to transform sound vibrations into the electrical energy understood by the brain. Despite the ear’s delicate nature, it is remarkably resilient. Still, aging, illness, and injury can impair your ability to hear properly.

More than 28 million Americans have a hearing loss. And roughly 50 percent of American seniors have a hearing loss by age 65. Unfortunately, many patients avoid confronting the problem, and there is usually a delay of 5-7 years between a loss of hearing and a professional diagnosis. Given the ever-improving technology in amplification, this represents a great deal of lost time with poor hearing.

In hearing, sound is gathered by the outer ear, amplified by the eardrum and three tiny bones in the middle ear and transduced into an electrical nerve signal by the inner ear. This signal is sent via the hearing nerve to the brain. When the impulse reaches the auditory cortex of the brain, we experience the sensation of hearing.

Injury or disease at any point in the anatomy results in hearing loss. Thus, there are four basic types of hearing loss:

Conductive Hearing Loss

Conductive hearing loss (CHL) refers to a mechanical failure to move sound vibration from the outside world through the outer and middle ear to the inner ear. The simplest example is the plugging of your ear canal. Wax impaction in the ear canal and fluid build-up in the middle ear are perhaps the most common examples of dampening the transmission of sound through the ear. Otosclerosis is a less common, often inherited disease resulting in conductive loss.

CHL affects the lower frequencies and makes it especially difficult to hear vowel sounds. Since vowels contain the "power of speech" the person perceives speech and other sounds as being much "quieter" than normal. If the sound is loud enough, a person with a CHL can hear and understand clearly. Conductive hearing losses can often be treated.

Sensorineural Hearing Loss

Sensorineural hearing loss (SNHL) is the most common type of hearing loss and is caused by damage to the inner ear and/or the auditory nerve. Noise exposure, diseases, certain medications and aging can destroy parts of the inner ear and cause permanent hearing loss. Once damaged, the inner ear cannot be repaired. A "cochlear implant" is available for some who have a profound hearing loss and do not gain benefit from conventional hearing aids. Sometimes, SNHL is accompanied by intolerance to loud sounds.

In contrast to conductive hearing losses, SNHL hearing loss usually affects high frequencies the most, which impairs a person’s ability perceive consonant sounds.

Mixed Hearing Loss

A mixed hearing loss occurs when you have both CHL and SNHL. For example, if a child who has permanent SNHL gets a middle ear infection, he or she will experience both a conductive and a sensorineural hearing loss.

Retro-Cochlear Hearing Loss

Retro-cochlear hearing loss is caused by problems of the hearing nerve or the part of the brain that receives signals from the hearing nerve. With retro-cochlear hearing loss, you may have poorer ability to recognize speech than might be suspected based on your ability to hear pure tones. An acoustic tumor may be involved and may lie on the auditory nerve, brainstem or in the brain.

The diagnosis of a hearing loss is made by taking a careful history, performing an accurate exam, and thoughtfully utilizing diagnostic testing, including audiometry (a hearing test), computed tomography (CT) and magnetic resonance imaging (MRI). At The Rontal Clinic, we have audiometry, a state-of-the-art Sieman’s CT scanner and a hearing aid outlet – Oakland Hearing Aid Center – on-site, eliminating the need for multiple trips to the office and an expedited diagnosis and treatment.

Hearing Aids

Hearing loss can be frustrating and isolating. You can not easily hear those around you, you can feel cut off, even ignored. Perhaps you feel embarrassed to ask others to repeat themselves over and over, quickly, resulting in frustration. Thankfully, many types of hearing loss can be improved with hearing aids.

Our major goal is to return you to the speaking world. We want to you to enjoy your family and friends rather than avoiding the company of others to escape the frustration of communication. 

We developed Oakland Hearing Aid Company with this goal in mind. Unlike obtaining hearing aids from a warehouse convenience store, for instance, we combine the examination and opinion of a Board-Certified ENT doctor in our practice with the examination and opinion of our Board-Certified audiologists to prescribe and dispense hearing aids. We offer a range of options and make every attempt to utilize insurance coverage and propose a device that fits your budget. We also continue to advocate politically for improved insurance coverage for hearing aids.

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