If you are hard of hearing, one of the most difficult problems which you may experience is comprehension of speech. You may know that someone is speaking to you, but many times, if you have nerve deafness, you miss a lot of the words in the course of the conversation. This is made much worse whenever there is any background noise such as in a crowded room with a lot of people talking in the background. You may notice that you hear better and understand better when you can look directly at the person with what you are speaking.
What may be even more distracting is when you turn up the radio or TV to try to hear better, it may make matters even worse because the level of distortion becomes worse. You may not noticed that if you have nerve deafness (sensori-neural deafness), you have more trouble with women's voices. This is in to a large extent, due to the fact that women's voices are higher pitched than men's voices. Children's voices represent a similar problem relative to pitch but in addition, they tend to talk quickly, and are constantly moving about. Also, especially with smaller children, they may not always enunciate clearly since they are just learning language. You may notice that when watching a movie or the TV that if the person speaking is on screen and looking at the camera, that you have better understanding that if the speaker is off screen. With nerve deafness, you may not noticed that in large rooms with poor acoustics, that you have more difficulty.
As a result of all of being hard of hearing, you may find that you would rather stay at home than go out and expose yourself to all of these problems. Also, if you have nerve deafness and trouble understanding speech, your family may be less understanding than strangers. They think that you are not listening or simply ignoring them.
The reason that these problems arise with nerve deafness is related to the fact that there are two parts to our hearing mechanism. One is whether or not we are able to hear the sound while the second and equally important part is, we can process the sound we hear in order to understand what we hear. In mechanical forms of hearing loss (conductive hearing loss), such as occurs when you have a hole in your eardrum or wax blocking your ear canal, your ability to understand is normal and if the sound is turned up loud enough, you understand normally. However, with nerve deafness and impairment of comprehension, even when the sound is turned up loud, understanding is not usually improved and may be worse.
An additional problem which is frequently present in people with nerve deafness is the presence of tinnitus, a ringing, roaring, buzzing or similar sound which you perceive in your ears or head but which other people do not hear. This also interferes with hearing and understanding speech.
The cause of nerve deafness is related to the deterioration of the hearing nerve cells. Two common causes are noise exposure and the aging process itself. There are many other causes, but the scope of this article does not permit discussion of any in detail. There may be other associated symptoms such as dizziness.
If you are experiencing some or all of the above problems then you should see your ENT doctor for evaluation, hearing tests and any other needed tests to determine the cause of your difficulty. In some situations, the hard of hearing problem is indicative of more serious conditions in addition to the nerve deafness. Help is available.