Deafness is the partial or complete inability to hear. Some people are born without hearing, which is known as congenital deafness. Other people suffer from conductive hearing loss, which is due to a problem delivering sound energy to the cochlea. Causes for conductive hearing loss include blockage of the ear canal, a hole in the tympanic membrane, problems with the ossicles, or fluid in the space between the eardrum and cochlea. Another group of people suffer from sensorineural hearing loss, which is the most common form of hearing loss. Sensorineural hearing loss can be caused by many factors, such as aging, head or acoustic trauma, infections and diseases (such as measles or mumps), medications, environmental effects such as noise exposure (noise-induced hearing loss, as shown in Figure 5.20), tumors, and toxins (such as those found in certain solvents and metals). Figure 5.20 Environmental factors that can lead to sensorineural hearing loss include regular exposure to loud music or construction equipment. (a) Musical performers and (b) construction workers are at risk for this type of hearing loss. (credit a: modification of work by "GillyBerlin_Flickr"/Flickr; credit b: modification of work by Nick Allen) Given the mechanical nature by which the sound wave stimulus is transmitted from the eardrum through the ossicles to the oval window of the cochlea, some degree of hearing loss is inevitable. With conductive hearing loss, hearing problems are associated with a failure in the vibration of the eardrum and/or movement of the ossicles. These problems are often dealt with through devices like hearing aids that amplify incoming sound waves to make vibration of the eardrum and movement of the ossicles more likely to occur. When the hearing problem is associated with a failure to transmit neural signals from the cochlea to the brain, it is called sensorineural hearing loss. One disease that results in sensorineural hearing loss is Ménière's disease. Although not well understood, Ménière's disease results in a degeneration of inner ear structures that can lead to hearing loss, tinnitus (constant ringing or buzzing), vertigo (a sense of spinning), and an increase in pressure within the inner ear (Semaan & Megerian, 2011). This kind of loss cannot be treated with hearing aids, but some individuals might be candidates for a cochlear implant as a treatment option. Cochlear implants are electronic devices that consist of a microphone, a speech processor, and an electrode array. The device receives incoming sound information and directly stimulates the auditory nerve to transmit information to the brain. Link to Learning Watch this video about cochlear implant surgeries to learn more. What Do You Think? Deaf Culture In the United States and other places around the world, deaf people have their own language, schools, and customs. This is called deaf culture. In the United States, deaf individuals often communicate using American Sign Language (ASL); ASL has no verbal component and is based entirely on visual signs and gestures. The primary mode of communication is signing. One of the values of deaf culture is to continue traditions like using sign language rather than teaching deaf children to try to speak, read lips, or have cochlear implant surgery. When a child is diagnosed as deaf, parents have difficult decisions to make. Should the child be enrolled in mainstream schools and taught to verbalize and read lips? Or should the child be sent to a school for deaf children to learn ASL and have significant exposure to deaf culture? Do you think there might be differences in the way that parents approach these decisions depending on whether or not they are also deaf?