Normal Hearing Process Versus Presbycusis

Professional Nursing I
September 5, 2022
Similarities & Differences
September 5, 2022

Normal Hearing Process Versus Presbycusis


Hearing is one of the five senses that humans use to study their environment. The active interpretation of information does this by transforming sound into meaningful information. Due to the increased use of personal listening devices globally, the hearing problem has become a common challenge globally, with 466 million people in the world with hearing-related complications representing 6.1% of the world (Ahn et al., 2020). This study aims at analyzing the normal hearing process, causes of Presbycusis, and how having Presbycusis affects one’s life.

How Normal Hearing Occurs

When sound vibrations are made, they get into the outer ear and move to the eardrum through the ear canal. The eardrum then vibrates according to the incoming sound waves and sends the vibrations to malleus, stapes, and incus bones (Kurabi et al., 2017). The sound is amplified in these bones and transferred to the Cochlea’s inner hair. An elastic partition called basilar membrane runs through the membrane and splits it into upper and lower parts, which serve as key hearing structures (Kurabi et al., 2017). When the fluid in the cochlea ripples due to vibrations, they form a traveling wave in the basilar membrane, and hair cells within the basilar membrane detect the pitches. As the hair cells experience stereo cilia, they open up, allowing chemicals to rush into cells and create electric signals carried to the brain by auditory nerves and are turned into a sound that humans can understand.

The snail-shaped organ in the ear full of fluid called the Cochlea has an elastic partition that goes from through the Cochlea, forming the upper and lower basilar membrane. The fluid in the Cochlea responds to vibrations from the oval window whereby as it moves, 25000 nerves are set into motion (Ahn et al., 2020). The various frequencies of complex sounds are analyzed and sorted out, and the physical energy of those vibrations is converted into electrical pulses that are transmitted to the brain. The basilar membrane is responsible for analyzing different sound pitches because it has progressively wider and more flexible fibers from the Cochlea’s base to the apex. Therefore each part vibrates differently to a particular sound frequency, whereby high-frequency sounds cause maximum vibrations to the area of the basilar membrane that is close to the base of Cochlea (Ahn et al., 2020). Medium frequencies impact the center of the membrane, while low frequencies affect the apex of the membrane. These pitches are sent to the mind that interprets them in a way that humans can understand.

Causes of Presbycusis

Presbycusis is the loss of hearing which occurs gradually as people grow old. It mainly involves the loss of high-pitched sounds while still able to hear low-pitched sounds. Inner ear disorders cause Presbycusis due to the gradual changes in the inner ear resulting from both cumulative effects of repeated exposure to noisy offices, construction sites, traffic sounds, or other forms of repeated noise (Tu & Friedman, 2018). It occurs due to the loss of hair cells which act as sensory receptors in the inner ear and can also be due to hereditary factors or normal aging. When the sensory hair is lost, the ears fail to vibrate and create electric pulses of sound. Changes in blood supply in the ear caused by heart disease, diabetes, high blood pressure, or other circulatory problems can also cause Presbycusis.

One source of Presbycusis involving a problem with the outer/middle ear may include the reduced function of the three tiny bones in the middle ear called the malleus, stapes, and incus bones. They help in boosting and transferring sound vibrations to the Cochlea (Tu & Friedman, 2018). Therefore, if the sound is not amplified in the middle ear, the person may experience hearing loss.

A source of Presbycusis involving a problem with the inner ear may include genetic mutation in the mitochondrial DNA. A genetic mutation causes damage to the hearing sensory receptors, leading to the lack of conversion of sound waves into electronic pulses (Kurabi et al., 2017). This leads to hearing problems which especially happen with high-pitched sounds compared to low-pitched sounds.

Having Presbycusis

Presbycusis is a condition whereby sound often seems less clear and has a low volume, leading to difficulty in hearing. When affected by Presbycusis, one may experience speech from others as slurred or mumbled. They may also have difficulties in differentiating high-pitched sounds such as “s” and “th” and telling them apart (Tu & Friedman, 2018). Having Presbycusis may also lead to conversation problems, especially when having a conversation in noisy backgrounds. Presbycusis makes it easier to hear male voices than female voices, and certain sounds may seem overly loud or annoying (Ahn et al., 2020). Finally, one may start hearing roaring, ringing, or hissing sounds in one of their ear or both, which is an indication of Presbycusis.

One of the activities that Presbycusis may limit includes watching television because the sounds will be too low for them to hear. The normal sounds become too low and may sometimes be misinterpreted, making it difficult to follow television shows (Ahn et al., 2020). The other activity which may be affected may be communicating or conversing with people in noisy places like restaurants or during a family meal. This is because the background sounds are likely to affect the hearing process making it difficult to hear people in such noisy places (Kurabi et al., 2017). Presbycusis also reduces social and emotional interactions whereby people with this disorder will avoid communicating with other people because they have hearing loss, leading to depression, isolation, and loneliness.

Presbycusis also affects the work-life of individuals by hindering them from hearing, especially if they work in offices that use the open office layout plan. This is because the background noises will make it difficult for them to hear hence causing hearing problems (Ahn et al., 2020). It is also difficult to attend functions such as employee seminars because of hearing loss, limiting one’s hearing capability. This may lead to a lack of career improvement because continued learning is essential in career development (Kurabi et al., 2017). Interpersonal communication is also important in the work environment, and therefore, with Presbycusis, it is easy to be sidelines and face discrimination in the workplace. Some employees may overlook a person due to their hearing problems which may lead to bad relations and the feeling of isolation in the work environment.


This study has found that hearing is a process that involves the functioning of both the outer and inner ear. The outer ear captures sound vibrations and turns amplifies them to the inner ear. When amplified sound vibrations reach the inner ear, they are transformed into electric pulses by the sensory receptors in the basilar membrane and sent to the brain for interpretation. Hearing loss affects various activities that a normal person could perform, such as having communication in noisy halls, having conversations, and watching television.


Ahn, J. H., Oh, S.-H., Jang, H., Lee, J.-B., & Chung, J. W. (2020). Impact of hearing loss on the performance of auditory processing measured by questionnaires in Korean adolescents. Scientific Reports10(1). Web.

Kurabi, A., Keithley, E. M., Housley, G. D., Ryan, A. F., & Wong, A. C.-Y.. (2017). Cellular mechanisms of noise-induced hearing loss. Hearing Research349, 129–137. Web.

Tu, N. C., & Friedman, R. A. (2018). Age-related hearing loss: Unraveling the pieces. Laryngoscope Investigative Otolaryngology3(2), 68–72. Web.