The Face Hole Series
The Difference Between Hearing and Listening
A brief overview of how hearing works
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As an Ear, Nose, and Throat doctor in New York City, I see a lot of patients who think they have hearing loss. They can’t hear conversations at business dinners or have to ask people to repeat themselves at parties. These aren’t necessarily older patients, by the way. Most of them are young and healthy with no history of hearing loss.
Last week, one such patient came in at her husband’s request.
“He keeps complaining he has to yell from the other room to get my attention. Why can’t I hear him?” she asked.
“Because you are married,” I joked.
She didn’t think it was funny.
So I did what I normally do, which is check for earwax. (I also check for fluid in the middle ear and other boring things we don’t have to get into here.) Much to my disappointment, there was no glob to remove that would magically restore her hearing.
Next, I gave her a hearing test. It too was normal.
“So what’s going on?” she asked.
You’re probably wondering the same thing.
In order to explain, I have to first tell you how hearing works.
Sound travels through the air in waves, like in the picture above. When sound gets to your ear, it makes your eardrum vibrate at the frequency of the soundwave. High-pitched sounds cause a fast vibration (think Mariah Carey) and low-pitched sounds cause a slow vibration (think Barry White).
On the other side of the eardrum, there are three tiny ear bones, called ossicles. Their Latin names are malleus, incus, and stapes, but I prefer their common names (hammer, anvil, and stirrup) because they sound like something Thor would use. These ear bones make a “chain,” connecting the eardrum to the hearing organ, or cochlea. So when the eardrum vibrates, the chain of tiny bones also vibrates, which then vibrates a part of the cochlea called the round window.
There is no easy way to explain the cochlea because it’s not a simple organ, but here are the basics. The cochlea is spiral-shaped…
