How Does Hearing Occur?

Sound waves from the external environment are collected by the auricle and transmitted to the eardrum along the external auditory canal. Eardrum; separates the outer ear from the middle ear. The vibrations of sound waves in the eardrum cause movement in the ossicles in the middle ear, which are called hammer, anvil and stirrup, respectively.

These ossicles form the connection between the eardrum and the inner ear. In other words, they transmit the vibrations formed in the eardrum to the inner ear. Sound waves received by the organ responsible for hearing and balance, called the labyrinth in the inner ear, are transmitted to the brain along the auditory nerve. The brain analyzes the incoming sound waves and the hearing function is realized.

What are the Causes of Hearing Loss?

It is necessary to classify the causes of hearing loss according to the region in which the disease is seen.

Causes Related to the Outer Ear:

-Ear wax (plug)

-Foreign body in the external ear canal

– Absence of auricle or congenital deformity

-Congenital closure of the external ear canal

– External ear infections

-External ear tumors

Middle Ear Related Causes:

-Eardrum perforation

-Middle ear inflammation

-Low pressure in the middle ear (due to eustachian tube obstruction)

-Calcification of middle ear ossicles

-Middle ear tumors

Causes Related to Inner Ear and Auditory Nerve

-Inner ear inflammation (labyrinthitis)

-Damage to hearing cells in the inner ear

-Sudden hearing loss

-Noise-induced hearing loss

-Hearing loss due to old age

-Meniere’s Disease (increased pressure in the inner ear fluids)

-Tumors involving the auditory nerve

Which Tests Are Done?

External Ear Canal Examination: The first procedure to determine the cause of hearing loss is the examination of the ear. A disease in the outer ear or eardrum can be easily seen during this examination. The image of the eardrum gives information about the condition of the middle ear, especially in middle ear infections. In cases where the examination is normal, it is thought that the cause of hearing loss may be related to the inner ear, but some tests are performed to determine this.

These examinations;

-Pure Sound Audiometry: It shows the type of hearing loss (conductive, sensorineural or mixed), its degree, which frequencies are retained. The information obtained here gives very valuable information about the degree of hearing loss.

-Speech Audiometry: It gives us information about pathologies in the middle ear, cochlea, auditory nerve, central auditory system and auditory pathways.

Tympanometry: It is a test we use to measure middle ear pressure.

-Acoustic Reflex Test: We look at the stapes reflex to show calcifications in the ear ossicles.

-Computed tomography (CT) or magnetic resonance (MR): It is used to determine the cause of hearing loss, especially related to the inner ear.


Tinnitus is defined as the involuntary perception of sound without an external acoustic stimulus. tinnitus; It can be in the form of ringing, buzzing, ringing, wave sound, machine noise, roar, water or wave sound. In general, the incidence of tinnitus is 10-15% of the adult population. There are many conditions that cause tinnitus and are associated with tinnitus. Although the most common known cause is hearing loss, it is accompanied by the following conditions.


– Ear related causes; infection, ear, brain and brain stem tumors, inner ear origin hearing loss, otosclerosis, ear wax, age and noise-related hearing loss.

-Causes related to the central nervous system; meningitis, migraine, multiple sclerosis and epilepsy.

-Blows and traumas to the head and neck.

-Cardiovascular system disorders (hypertension, orthostatic hypotension).

-Psychogenic causes; anxiety, depression, emotional trauma.

 The treatment, on the other hand, is to determine the frequency and severity of tinnitus, especially with the pure tone audiometry available in our clinic. After the threshold is determined, the patient is asked whether the ringing has disappeared with the mask applied, and the patient is directed for appropriate treatments.

Tinnitus Threshold Test

With the pure tone audiometry available in our clinic, the frequency and severity of tinnitus are determined. After the threshold is determined, the patient is asked whether the ringing has disappeared with the mask applied, and the patient is directed for appropriate treatments.