Signs and symptoms may include:


* Muffled quality of speech and other sounds
* Difficulty understanding words, especially against background noise or in a crowd of people
* Asking others to speak more slowly, clearly, and loudly
* Needing to turn up the volume of the television or radio
* Withdrawal from conversations
* Avoidance of some social settings
 

How your hearing works


Hearing occurs when sound waves reach the structures inside your ear, where the sound wave vibrations are converted into nerve signals that your brain recognizes as sound.

Your ear consists of three major areas:  The outer ear, middle ear, and inner ear. Sound waves pass through the outer ear and cause vibrations at the eardrum. The eardrum and three small bones of the middle ear - the hammer, anvil, and stirrup - amplify the vibrations as they travel to the inner ear. There, the vibrations pass through fluid in the cochlea, a snail-shaped structure in the inner ear. Attached to nerve cells in the cochlea are thousands of tiny hairs that help translate sound vibrations into electrical signals that are transmitted to your brain. The vibrations of different sounds affect these tiny hairs in different ways, causing the nerve cells to send different signals to your brain. That's how you distinguish one sound from another.