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Types & Causes of Hearing Loss

The ear is a very complex organ comprising three parts: the outer ear, the middle ear and the inner ear. Hearing loss can result from an obstruction or damage to any of these three parts.

Sound transmission process:
Pinna catches sound waves and directs them into the ear canal. Ear canal carries the sound waves to the eardrum (tympanic membrane).
Sound waves cause the eardrum (tympanic membrane) to vibrate. The bones in the middle ear (malleus, incus and stapes) pick up these vibrations.
Vibrations pass through the oval window to the cochlea, setting the fluid inside in motion. This causes special nerve cells to turn the sound waves into electrical impulses. The auditory nerve sends these electrical impulses to the brain where they are heard as sound.
Ear Structure Diagram

The severity of a hearing impairment is categorized according to how much louder a sound must be made over the usual levels before the listener can detect it. Normal hearing people can hear sounds as soft as 25 dB HL. Hearing level exceeds this normal range is considered as hearing loss. The degree of hearing loss is universally classified into 5 categories: mild, moderate, moderately severe, severe and profound.

  • Normal Hearing
    Able to hear soft sounds and understand speech clearly
  • Mild hearing loss
    Unable to hear soft sounds, difficult in understanding speech in noisy environments.
  • Moderate hearing
    Unable to hear moderately loud sounds, difficult in understanding speech, can be improved with suitable hearing instruments.
  • Moderately severe hearing loss
    Increasing difficulty in hearing and speech understanding. Communication can be improved with the use of hearing instruments.
  • Severe hearing loss
    Able to hear loud sounds but communication without hearing instrument is impossible.
  • Profound hearing loss
    Some profoundly hearing loss people cannot hear anything at all, at any level of decibels.
Able to hear soft sounds and understand speech clearly
Hearing impairment comes from different biologic causes. Type of hearing loss could be classified into 3 types according to the causes: Conductive hearing loss, sensorineural hearing loss and mixed hearing loss.
Conductive Hearing loss
Conductive hearing loss results from an abnormality of the outer or middle ear, which results in a loss of loudness. Some common causes include infection in the middle ear, perforated ear drum, excessive ear wax blockage and otoscelerosis, etc.
Sensorineural Hearing Loss
Sensorineural hearing loss is caused by damage to the inner ear or hearing nerve, which results in a loss of loudness and clarity of speech perceived. A sensorineural loss can result from virus infection, disease, aging, certain drugs and excessive noise, etc.
Mixed hearing loss
Mixed hearing loss is caused by damage to the outer/middle ear and the inner ear. Typically, sound waves are not conducted efficiently through the middle ear, and once they reach the inner ear the vibrations cannot be picked up or sent to the brain. Therefore, a mixed hearing loss is the combination of a conductive and sensorineural hearing loss.

Solutions for Hearing Loss

The impact of hearing loss varies from person to person. It greatly depends on the degree and configuration of hearing loss. However, hearing loss would, at least to certain extent, results in distorted or incomplete communication which leads to greater isolation and withdrawal. In turn the individual's life space and social life becomes restricted. While for those who are still in the workforce, uncorrected hearing loss has a negative impact on overall job effectiveness, opportunity for promotion and perhaps lifelong earning power.

We would guide you through the following three types of solutions for hearing loss:

Medical Treatment Medication and surgery
Medical Treatment Medication and surgery are recommended for many types of hearing problems, particularly conductive hearing loss. It is always highly recommended to seek medical consultation or hearing evaluation as early as possible once sudden hearing deterioration was noted. Recovery of the hearing loss depends not only upon the early diagnosis of the cause of the hearing loss, but also on the early initiation of appropriate treatment.
Hearing Aid Fitting
If your hearing impairment does not originate from a medical problem, which can be treated with medicine or surgery, a hearing aid evaluation can be performed. Although hearing aids do not provide normal hearing to the user, they can help improve a hearing impaired person's ability to communicate effectively. Hearing technology has seen some incredible advances during the last few years. Digital hearing aids are programmed by audiologists via computers. Complex calculations provide the ultimate flexibility in providing individualized solutions to hearing loss. Adapting to a hearing aid takes patience. The process has to be done step by step, never all at once at full strength. Meanwhile, support from friends and family members are also critical for a successful fitting process.
Usage of Assistive Listening Device (ALD)
An ALD is any type of device that can help you function better in your day-to-day communication situations. It can be used with or without hearing aids to overcome the negative effects of distance, background noise, or poor room acoustics. There are basically four types of ALDs: 1) FM Systems; 2) Telephone Amplifiers; 3) Listening & Alerting Device; & 4) TV & Audio Device. To obtain personalized advice on hearing aid and/or ALD, please consult our audiologists.


Hearing aid is not only an amplifier!
How to deal with tinnitus?
Don't underestimate otitis media!
Only 50% of hearing remains? How?
Is it OK to not wear my hearing aids?
Hearing aid is not only an amplifier!

Basically, hearing aid is an electric amplifying device designed to make sounds audible to the individual with hearing loss. A hearing aid is composed by three components: microphone, amplifier and receiver. Thanks to increasing small micro-processor, the latest digital hearing aids are able to transform acoustic signals into a binary code at high speed and with great precision. Complex calculations provide the ultimate flexibility in providing individualized solutions to hearing loss. Many new features and benefits can be found on digital hearing aids, such as: digital zooming, noise reduction.

Hearing aid is not only an amplifier!


很多長者對助聽器都有負面的評論,如: 「耳機令到我耳仔好唔舒服呀、「耳機太大部唔想戴。相信不少乖仔乖女都聽過類似的說話吧!當然我們的聽力學家都常遇到類似情況,我們都會先了解實際原因再作相應處理。例如,當長者表示耳機「時大時細聲 ,可試以下幾項方法去解決問題:

  • 檢查助聽器
  • 為家長做聽力檢查
  • 檢查耳模是否不合適











除助聽器以外,很多家居小工具都可以輔助聽障人士家人朋友的日常溝通。 例如:

  1. 專為聽障人士而設的附加閃燈的特大聲響門鈴;
  2. 震動鬧鐘(另有便攜版);
  3. 可放大對話聲音及來電聆聲的家居電話;
  4. 專為單單溝通而設的私人傳話器等。



How to deal with tinnitus?

Most of us have experienced tinnitus in various degrees. To cope with this problem, firstly, let's understand the basic of tinnitus: tinnitus is not illness, it's only a symptom. The goal of tinnitus treatment is to reduce the annoyance caused by this symptom.

Phonak Hong Kong has developed comprehensive tinnitus assessment services. By analyzing patients' symptom in depth, we can provide professional follow up services, and choose the appropriate treatment method.

How to deal with tinnitus?

Don't underestimate otitis media!

Otitis media is a common disease to children. Since their eustachian tube is not fully developed yet,  they are facing a higher risk of bacteria infection, which will cause occlusion or swelling. If a child's otitis media is not carefully treated; it may damage his/her hearing and hence hinders his/her learning and speech development; in worst case, meningitis may occur.

For the case if adults, although their eustachian tube is completely grown, air-pressure during travelling on plane, diving and other damage to eardrum are still able to cause otitis media. Symptoms of otitis media is listed as the following:

Infant and children Teenagers and adults
  1. Infant and children
  2. Hearing Loss
  3. Crying and anxiety
  4. Fever
  5. Vomiting
  6. Fluids in ears
  1. Pain in ears
  2. Pressure and swelling in ears
  3. Hearing loss
  4. Feeling dizzy and losing sense of balance
  5. Vomiting
  6. Fluids in ears
  7. Fever

Don't underestimate otitis media!

Only 50% of hearing remains? How?

We often see others using percentage to describe one's hearing level. However, this is not an accurate indication for auditory conditions. Everybody has a different level of hearing, which enables receiving sounds of different volumes and frequencies. Thus, a hearing test is essential to determine the type and level of hearing loss, so as to provide right treatment.

弱聽程度 能接收的最低音量範圍 (分貝)
正常/沒有聽力問題 ≤ 25
輕度 26 – 40
中度 41 – 55
中重度 56 – 70
重度 71 – 90
極度 > 90



Only 50% of hearing remains? How?

Is it OK to not wear my hearing aids?

It is common to see people having difficulties when trying to adapt their hearing aids at the beginning. They may find the hearing aid is too loud/too quiet, or the sound is not comfortable for them.

To improve the listening experience, it is important to ask your audiologists to adjust the hearing aids for you. Audiologist will fine tune the hearing aids according to your requirements, so as to provide a sufficient volume gain and protect your residual hearing.

Is it OK to not wear my hearing aids?




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