Condition & Treatment — Audiology & Hearing Aids
Hearing Loss
Hearing loss can come on so gradually that you notice it before you can quite describe it — or it can happen suddenly, which is its own kind of emergency. Either way, the first real step isn't a hearing aid. It's a diagnostic hearing test that tells us what type of hearing loss you have and what's causing it.
Hearing loss — the short version
- What it is
- Reduced hearing from a problem in the outer/middle ear (conductive), the inner ear or hearing nerve (sensorineural), or both (mixed).
- How it's diagnosed
- A diagnostic hearing evaluation with our audiologist, plus an ear exam with Dr. Fewins when a medical cause is possible.
- Treatment depends on type
- Some conductive causes can be treated medically or surgically; sensorineural hearing loss is usually managed with hearing aids.
- Sudden hearing loss
- A sudden drop in hearing, especially in one ear, should be evaluated promptly — don't wait to see if it improves on its own.
Trouble hearing isn't one problem — it's a symptom with several very different underlying causes, some fixable, some not. A diagnostic hearing test is what sorts out which one applies to you.
Types of hearing loss
Hearing loss isn't one condition — it's a symptom that falls into three categories, and the category matters more than the severity when it comes to what can be done about it.
Conductive
Sound isn't reaching the inner ear efficiently — caused by earwax blockage, middle-ear fluid, an ear infection, a perforated eardrum, or a fixed middle-ear bone. Often treatable medically or surgically.
Sensorineural
The inner ear or the hearing nerve itself isn't working normally — most often from aging, noise exposure over time, or genetics. Usually permanent, and typically managed with hearing aids.
Mixed
A combination of both — a conductive problem layered on top of an existing sensorineural loss. Common in patients who also have chronic ear disease.
Common causes
- Age-related hearing loss (presbycusis). A gradual, usually symmetric, high-frequency hearing loss that comes with age — the most common cause of adult hearing loss overall.
- Noise exposure. Cumulative loud-noise exposure over years, or a single very loud event, can permanently damage the inner ear.
- Earwax buildup or middle-ear fluid. A conductive cause that's often reversible once the blockage or fluid is addressed.
- Chronic or recurrent ear infections. Repeated infections or long-standing fluid can affect hearing, particularly in children — see our Pediatric ENT page.
- Sudden sensorineural hearing loss. An unexplained, rapid drop in hearing, usually in one ear — a genuine urgent situation that should be evaluated right away, since early treatment matters.
- Family history and genetics. Some hearing loss runs in families or is present from birth.
When to arrange a hearing evaluation
Difficulty following conversation, frequently asking people to repeat themselves, increasing the TV volume or noticing a difference between ears are good reasons for a diagnostic hearing test.
A sudden change in hearing needs prompt medical assessment—even when it feels like a blocked ear. Do not wait for a routine callback. If you cannot reach an appropriate clinician promptly, seek urgent medical care.
Arrange hearing care or read about ear pressure and eustachian tube dysfunction.
How hearing loss is diagnosed
A diagnostic hearing evaluation with Kim Miller measures how well you hear across a range of pitches and volumes in each ear separately, and can also assess how well your ears transmit and process sound. When a medical cause is possible — infection, fluid, wax, a structural problem — Dr. Fewins examines the ear directly. Together, the exam and the test results determine which type of hearing loss you have and what's driving it, which is what decides the treatment plan.
Treatment options
- Treating the underlying cause. When hearing loss is conductive — from earwax, fluid, infection, or certain structural problems — addressing that cause medically or surgically can improve or restore hearing, sometimes without a hearing aid at all.
- Hearing aids. The primary treatment for sensorineural hearing loss, and often used alongside medical treatment for mixed hearing loss. Kim Miller fits and programs hearing aids based on your specific test results, lifestyle, and budget, then follows up to fine-tune them.
- Hearing aids with tinnitus features. For patients with both hearing loss and tinnitus, some hearing aids include masking or sound-therapy features that can ease the tinnitus while addressing the hearing loss.
- Referral for further evaluation. Sudden hearing loss, hearing loss with dizziness, or hearing loss in only one ear sometimes warrants further evaluation to rule out less common causes, which Dr. Fewins will discuss with you directly if it applies to your situation.
Is a hearing evaluation right for you?
Worth getting checked
- You or people around you have noticed a change in how well you hear
- You've had ringing, buzzing, or hissing in your ears
- You've had a sudden change in hearing, especially in one ear — don't wait on this one
- You've never had a baseline hearing test and want to know where you stand
Address first, or a different visit
- Ear pain, drainage, or a feeling of fullness with no hearing change — start with an ear exam
- Dizziness without any hearing change — see our balance & dizziness information
- A child's hearing concern tied to recurrent ear infections — see Pediatric ENT
Frequently asked questions
How do I know if I actually need a hearing test?
If you or people around you have noticed trouble following conversation, especially in groups or background noise, needing the TV or phone louder than before, or ringing in your ears, a diagnostic hearing evaluation will give you a real answer instead of a guess. It's also worth checking after any sudden hearing change, which should be evaluated promptly.
Is all hearing loss treated with a hearing aid?
No. Some conductive hearing loss — from earwax, fluid, or certain structural problems — can be treated medically or surgically, sometimes restoring hearing without a hearing aid at all. Sensorineural hearing loss is usually permanent and is where hearing aids are the main treatment. Your evaluation determines which situation applies to you.
Will my insurance cover a hearing test or hearing aids?
Diagnostic hearing evaluations are often covered, particularly when ordered to evaluate a medical symptom. Hearing aid coverage varies widely by plan. Our team verifies your specific benefits before you're billed for anything.
How long does it take to adjust to hearing aids?
Most people need a few weeks to adjust to how sound is presented again, and fitting is a process rather than a single visit — follow-up appointments to fine-tune the settings are a normal, expected part of it, not a sign something is wrong.