Hearing loss affects millions of people in Pakistan, and most of them wait years before doing anything about it. Part of the reason is stigma. Part of it is not knowing what kind of loss they have, or what can be done about it.
This article covers the three types of hearing loss, how audiograms are read, and which solutions fit which situation.
The three types of hearing loss
Sensorineural
Damage to the hair cells in the inner ear or to the auditory nerve. Causes include ageing, prolonged exposure to loud noise, some medications, infections, and genetics. This type is usually permanent, and it is the most common reason people need hearing aids.
Conductive
Sound is blocked before it reaches the inner ear — earwax compaction, fluid behind the eardrum, a perforated eardrum, or middle ear infection. Many conductive losses are treatable medically or surgically, which is why a medical assessment comes before any device discussion.
Mixed
A combination of the two. Treatment usually means addressing the conductive part first, then fitting amplification for what remains.
What an audiogram measures
An audiogram is a graph of your hearing threshold at each frequency, measured in decibels (dB HL), usually from 250 Hz to 8000 Hz. A pure-tone test finds the quietest sound you can hear at each frequency, and the shape of that curve tells the audiologist a great deal:
- High-frequency loss (the curve drops on the right) makes speech unclear even when it is loud enough. Consonants like s, f, t, and k disappear first. This is the classic age-related pattern.
- Low-frequency loss (the curve drops on the left) makes sound feel muffled and quiet, and it is often conductive.
- Flat loss means similar thresholds across frequencies.
- Asymmetry — a big difference between ears — needs medical review.
Degrees are usually described like this:
| Degree | Threshold | In daily life |
|---|---|---|
| Normal | Up to 25 dB | No difficulty |
| Mild | 26–40 dB | Trouble in noise, missed consonants |
| Moderate | 41–55 dB | Conversations need repetition |
| Moderately severe | 56–70 dB | Speech only audible when loud |
| Severe | 71–90 dB | Needs powerful amplification |
| Profound | 90 dB+ | May need implant-level solutions |
Speech audiometry adds a second measure: how well you understand words once they are loud enough. Two people with identical audiograms can score very differently, and that score affects what a hearing aid can realistically deliver.
Matching styles to your loss
- Mild to moderate: RIC or custom in-canal aids. Discretion is usually possible.
- Moderate to severe: RIC with a more powerful receiver, or a BTE.
- Severe to profound: BTE with a custom earmould, or a cochlear implant assessment if speech understanding is very poor.
- One-sided loss: a CROS or BiCROS setup, where the poorer ear sends sound to the better ear.
Canal shape, wax production, and manual dexterity matter as much as the audiogram. A tiny aid you cannot insert is not discreet, it is useless.
What hearing aids can and cannot do
They can make speech audible and clearer, restore awareness of environmental sound, and reduce the effort of listening. Most people adapt over four to six weeks rather than instantly, because the brain has to relearn which sounds matter.
They cannot restore normal hearing, remove the effects of noise damage, or work perfectly in every situation. In a very noisy room, even the best device leaves you working harder than someone with typical hearing. Knowing that in advance prevents the disappointment that makes people give up on aids in month two.
When to see an ENT specialist
See a doctor rather than a hearing aid seller if you have:
- Sudden hearing loss in one or both ears (this is a medical emergency — hours matter)
- Hearing loss in one ear only
- Discharge, pain, or a feeling of pressure in the ear
- Dizziness or balance problems alongside hearing loss
- Hearing loss after a head injury
- Tinnitus in one ear only
For everything else, an audiologist can test, advise, and fit. Start with what a hearing test involves and what it costs, then look at price ranges before you commit to anything.
If you already have an audiogram, our team can read it and suggest specific models. Send a photo of it to WhatsApp.
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