I have one ear that's down a little, but the other one's okay.

*Everything is relative. Nearly all patients who believe that they have one ‘good’ ear actually have two ‘bad’ ears. When one ear is slightly better than the other, we learn to favour that ear for the telephone, group conversations, and so forth. It can give the illusion that ‘the better ear’ is normal when it isn't. Most types of hearing loss affect both ears fairly equally and about 90 per cent of patients are in need of hearing aids for both ears.

Hearing loss affects only old people and my hearing loss is normal for my age.

*Only 35 per cent of people with hearing loss are older than 64. Hearing loss affects all age groups. Unfortunately, many people don't confront the challenge head-on. But, do you realise that well-meaning doctors tell this to their patients every day? It happens to be ’normal’ for overweight people to have high blood pressure. That doesn't mean they should not receive treatment for the problem.

If you're hearing impaired, it just means sounds aren't loud enough.

*Hearing isn't only about loudness or decibel level. Typically, hearing loss has more to do with the frequency of the sound-that is, its pitch-than its loudness. In fact, loud conversation may be painful.  In fact loudness will not make distorted sound any clearer, and may make the situation worse. When hearing loss occurs, it's harder to hear higher pitches-especially when there is background noise to complicate the picture, such as conversation in a noisy restaurant. That's why amplifying incoming sounds alone isn't as effective in treating hearing loss as amplifying selectively.

My hearing loss  cannot be helped.

*In the past, many people with hearing loss in one ear, with a high frequency hearing loss, or with nerve damage have all been told they cannot be helped, often by their family physician. This might have been true many years ago, but with modern advances in technology, nearly 95 per cent of people with a sensorineural hearing loss can be helped with hearing aids.

Only people with  serious hearing loss need hearing aids.

*The need for hearing amplification is dependent on your lifestyle, your need for refined hearing and the degree of your hearing loss. If you are a lawyer, teacher or an engineer, where very refined hearing is necessary to discern the nuances of human communication, then even a mild hearing loss can be intolerable. If you live in a rural area by yourself and seldom socialise, then perhaps you are someone who is tolerant of even moderate hearing losses.

Hearing aids will make everything sound too loud.

*Hearing aids are amplifiers. At one time, the way that hearing aid was designed, it was necessary to turn up the power in order to hear soft speech (or other soft sounds). Then, normal conversation indeed would have been too loud. With today's hearing aids, however, the circuit works automatically, only providing the amount of amplification needed based on the input level. In fact, many hearing aids today don't have a volume control.

Unusual sounding speech means the person is mentally retarded.

*Speech development depends greatly on one's ability to hear him or herself talk. For the deaf person, the foundation for learning speech which hearing people take for granted is not there. The situation has nothing to do with intelligence.

All deaf people can read lips.

*While some deaf people are very skilled lip readers, 90 per cent of deaf people do not read lips proficiently.  This is because many speech sounds have identical mouth movements (for instance, the words "paddle" and "battle.") and are difficult to discern.  On the average, lip readers are catching approximately 25-30 per cent accurately.

A cochlear implant restores normal hearing for persons who are deaf.

*A cochlear implant does not restore normal hearing, they only provide additional hearing information but it is not sound as we hear it. It is a communication tool but not a "cure" for deafness. Cochlear implants can provide more access to speech information than previously received from a hearing aid. Practice with the implant, supplemented with listening therapy are effective means to obtain the maximum benefit from this device.

Children outgrow the internal device of cochlear implant and require an additional surgery after their bodies grow. 

*The cochlea is fully formed at birth and the skull structures have achieved almost full growth by the age of two. The electrode array is designed to accommodate the skull growth in children. The surgically implanted unit is designed to last a lifetime. The externally worn speech processor, which is responsible for coding the speech and sending the information to the internal unit, is software-dependent and can readily accept new and improved speech-coding technology as it becomes available. Additionally, the speech processor may be upgraded as technology improves.

Implant users can only identify environmental noises, not speech.  
                         
*Cochlear implants provide a wide range of sound information and performance on speech perception testing does vary among individuals; however, with time and appropriate rehabilitation, most users understand more speech than they did with their hearing aids and many are able to communicate by regular telephone or enjoy music!

The author is a senior consultant in ENT, Apollo Hospitals and can be contacted at 99002 36819 or Email: drkumaresh@drkumaresh.com