I Can’t Hear You
Working in New York City, I see a lot of patients who think they have hearing loss. They can’t hear conversations at business dinners. They have to ask people to repeat themselves at parties. They struggle to hear phone calls when they are walking down the street. These aren’t necessarily older people, 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 laugh.
“Let me take a look,” I said, proceeding to do what I normally do, which is first check for earwax. Much to my disappointment, there was no sticky glob to remove that would magically restore her hearing. So I looked for other possibilities, like fluid in her middle ear, an external ear infection, or exostoses, which are bony growths in the ear canal that happen from swimming in cold waters. I also made her try to pop her ear so I could check that her eardrum was moving. Everything looked good.
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.
Here’s a lesson on 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 same frequency as the sound wave. High-pitched sounds cause a fast vibration (think Mariah Carey’s whistle tones) and low-pitched sounds cause a slow vibration (think Barry White’s everything tones).
On the other side of the eardrum, inside the middle ear, 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…