nner ear[edit]

The inner ear is a small but very complex organ.

Main article: Inner ear

The inner ear consists of the cochlea, which is a spiral-shaped, fluid-filled tube. It is divided
lengthwise by the organ of Corti, which is the main organ of mechanical to neural transduction.
Inside the organ of Corti is the basilar membrane, a structure that vibrates when waves from the
middle ear propagate through the cochlear fluid – endolymph. The basilar membrane is tonotopic, so
that each frequency has a characteristic place of resonance along it. Characteristic frequencies are
high at the basal entrance to the cochlea, and low at the apex. Basilar membrane motion
causes depolarization of the hair cells, specialized auditory receptors located within the organ of
Corti.[5] While the hair cells do not produce action potentials themselves, they release
neurotransmitter at synapses with the fibers of the auditory nerve, which does produce action
potentials. In this way, the patterns of oscillations on the basilar membrane are converted
to spatiotemporal patterns of firings which transmit information about the sound to the brainstem.[6]

Neuronal[edit]

The lateral lemnisci (red) connects lower brainstem auditory nuclei to the inferior colliculus in the midbrain.

Main article: Neuronal encoding of sound

The sound information from the cochlea travels via the auditory nerve to the cochlear nucleus in
the brainstem. From there, the signals are projected to the inferior colliculus in the midbrain tectum.
The inferior colliculus integrates auditory input with limited input from other parts of the brain and is
involved in subconscious reflexes such as the auditory startle response.
The inferior colliculus in turn projects to the medial geniculate nucleus, a part of the thalamus where
sound information is relayed to the primary auditory cortex in the temporal lobe. Sound is believed to
first become consciously experienced at the primary auditory cortex. Around the primary auditory
cortex lies Wernickes area, a cortical area involved in interpreting sounds that is necessary to
understand spoken words.
Disturbances (such as stroke or trauma) at any of these levels can cause hearing problems,
especially if the disturbance is bilateral. In some instances it can also lead to auditory
hallucinations or more complex difficulties in perceiving sound.

Hearing tests[edit]
Main articles: Hearing test and Audiometry
Hearing can be measured by behavioral tests using an audiometer. Electrophysiological tests of
hearing can provide accurate measurements of hearing thresholds even in unconscious subjects.
Such tests include auditory brainstem evoked potentials(ABR), otoacoustic emissions (OAE)
and electrocochleography (ECochG). Technical advances in these tests have allowed hearing
screening for infants to become widespread.
Hearing can be measured by mobile applications which includes audiological hearing test function
or hearing aid application. These applications allow the user to measure hearing thresholds at
different frequencies (audiogram). Despite possible errors in measurements, hearing loss can be
detected.[7][8]

Hearing loss[edit]
Main article: Hearing loss
There are several different types of hearing loss: Conductive hearing loss, sensorineural hearing
loss and mixed types.

 Conductive hearing loss

 Sensorineural hearing loss
 Mixed hearing loss
There are defined degrees of hearing loss:[9][10]

 Mild hearing loss - People with mild hearing loss have difficulties keeping up with
conversations, especially in noisy surroundings. The most quiet sounds that people with mild
hearing loss can hear with their better ear are between 25 and 40 dB HL.
 Moderate hearing loss - People with moderate hearing loss have difficulty keeping up with
conversations when they are not using a hearing aid. On average, the most quiet sounds heard
by people with moderate hearing loss with their better ear are between 40 and 70 dB HL.
 Severe hearing loss - People with severe hearing loss depend on powerful hearing aid.
However, they often rely on lip-reading even when they are using hearing aids. The most quiet
sounds heard by people with severe hearing loss with their better ear are between 70 and 95 dB
HL.
 Profound hearing loss - People with profound hearing loss are very hard of hearing and they
mostly rely on lip-reading and sign language. The most quiet sounds heard by people with
profound hearing loss with their better ear are from 95 dB HL or more.
Causes[edit]
 Heredity
 Congenital conditions
 Presbycusis
 Acquired
o Noise-induced hearing loss
o Ototoxic drugs and chemicals
o Infection