Holes In Hearing! You said what?

The inner ear or cochlea contains approximately 3000 inner hair cells located in its fluid filled compartment that can be stimulated by sound pressure movements .   These sensory units are individually tuned to  bands of select frequencies encompassing a wide pitch range .  Aging, hereditary factors, noise exposure, ear trauma, and medications can potentially cause  near total loss of these hair cells in very small regions along the cochlea.  These areas  are often referred to as “dead regions” and/or “holes”.  Obviously, such damage will affect one’s ability to understand everyday speech.  The bad news is these holes cannot be stimulated due to lack of sensory capability ; the good news is that with proper amplification and training, hearing can be improved by spreading the sound waves to alternate zones with hair cells that can be  recruited for useful speech understanding.  Even the brightest researchers studying auditory function cannot  determine the exact cues a given individual will utilize during everyday conversation.  It is essential that professionals take into account the complexity of nature’s gift of hearing.  We should believe what our patients are reporting, whether or not we can alleviate every complaint.  Unfortunately, a good deal of magical thinking seems to permeate our clinical bag of tricks when it comes to hearing impairment. 

Bottom Line:  visit an audiologist trained in the measurement and psychology of hearing should you wish to determine your particular audio profile.  Don’t allow yourself to be treated as if you are the group average.  Few of us are! 

Journal of the Acoustical Society of America, Volume 120, #6, December 2006, pp—4019-4030