Hearing loss is unique to the individual, like a fingerprint. One treatment plan does not suit every individual. The otolaryngologists and audiologists at North Shore ENT work together closely to diagnose hearing loss and develop an appropriate management plan. The plan is developed using a combination of medical history, physical examination, and results from specialized auditory assessments.

Hearing loss is classified as conductive, sensory, neural, or central depending on the location of the defect within the hearing mechanism.


Conductive hearing loss occurs when sound fails to transmit through the outer or middle ear. Common causes of conductive hearing loss are:

  • Impacted earwax
  • Perforated eardrum
  • Middle ear fluid
  • Middle ear infections
  • Abnormalities involving the middle ear bones

Conductive hearing loss causes a reduction in the loudness of sound and are often medically or surgically correctable. Hearing aids can be helpful in cases where medical or surgical intervention is not preferred.


Sensory hearing loss occurs when there is damage to the receptor hair cells in the inner ear, or “cochlea.” When these cells are healthy, they increase the loudness of sound, contribute to the clarity of speech, allow for a separation of speech and noise, and help prevent loud sounds from becoming uncomfortable. A sensory hearing loss therefore results in a loss of loudness, difficulty with speech clarity, trouble separating speech from background noise, and increased sensitivity to loud noises. Sensory hearing losses often are the result of:

  • Heredity
  • Aging
  • Noise exposure
  • Certain illnesses
  • Some medications

Sensory hearing losses typically are not medically or surgically correctable and are often treated with hearing aids and other assistive devices. Cochlear implants can be used in cases of severe to profound sensory hearing loss. This type is often mistakenly labeled as “nerve loss” and is the most common type of hearing loss.


Neural hearing loss results when the auditory nerve fails to accurately transmit impulses from the receptor cells of the inner ear to the brainstem. Another possible cause is a failure in the chemical transmission between intact inner ear receptor cells and the auditory nerve. conditions that result in neural hearing loss are:

  • Auditory neuropathy/auditory dyssynchrony
  • Auditory nerve tumors

Neural hearing losses are not treatable with hearing aids. Auditory neuropathy is sometimes treatable with cochlear implants


Central hearing loss refers to the inability of the brain to make appropriate use of auditory information. It results in difficulty with speech processing and understanding and can interfere with speech development in children. Auditory processing disorders in children may be mistaken for behavioral disorders.

Central hearing losses are not treatable with hearing aids but some may benefit from assistive listening devices that help to separate speech from background noise.


North Shore ENT is pleased to offer our patients hearing aid services through Sound Choice Inc. Sound Choice is a privately-owned, independent hearing aid dispensing practice. We feel you will receive excellent care from our audiologists working with Sound Choice Inc. For more information about Sound Choice, please visit their website.What is the procedure for obtaining hearing aids?The first step in obtaining hearing aids is a comprehensive audiological evaluation. Your audiologist will make recommendations for hearing aids, if necessary, based on the degree and type of hearing loss you have.

The next step is to schedule a hearing aid evaluation. At that time, your audiologist will ask you about your lifestyle and your listening needs to determine the appropriate style and type of hearing aids. The audiologist will take impressions of your ears for the custom ear mold or hearing aid shell (if necessary, depending on the type of hearing instrument).

Approximately two weeks later, you will have a hearing aid fitting appointment. Your audiologist will program the hearing aids and show you how to use and care for them. Generally a follow-up appointment is scheduled for one or two weeks after the fitting.

Do I need to wear two hearing aids? 

When you have hearing loss in both ears, you will generally hear better with hearing aids in both ears. Your brain uses information from both of your ears in order to give you the best representation of the auditory information. There is a natural benefit for speech understanding in background noise when both ears are listening at the same level; we are able to “squelch” the unwanted noise. Finally, in order to be able to localize sound (tell where it is coming from), both ears need to be listening at the same level. This is not only a comfort issue, but a safety issue as well.

Which Hearing Aid is Best for Me?

No one hearing aid solves the concerns that are unique to the hearing impaired population. Hearing aid manufacturers have different strengths: a power circuit for a severe hearing loss, a shell for someone with a tiny ear canal or high-frequency emphasis. It is important to choose a hearing health care professional who dispenses multiple brands of hearing aids.

Your hearing healthcare professional will help to choose the best aid for you by reviewing your hearing test, listening to your individual concerns and addressing your unique listening challenges.

The reactions to personal amplification are varied. Although it may not be possible to eliminate all of the issues related to your hearing loss, our goal is to tip the scales toward positive benefits. A satisfied patient is the best form of advertising!

As an independent company, Sound Choice utilizes a variety of the world’s finest hearing aid manufacturers. These working relationships are based on years of experience.

To learn more about hearing aids, please visit the Sound Choice website, or call Sound Choice at 978-777-2448.


Sensory hearing loss results in deficits that cannot always be addressed using hearing aids alone. In some cases a patient may not be a good candidate for hearing aids but can obtain benefit from assistive devices. In children especially, assistive devices such as FM listening systems are critical in the classroom. If you have a hearing loss and cannot wear hearing aids or do not obtain sufficient benefit from hearing aids alone, ask your audiologist about appropriate assistive devices. Assistive listening devices have the advantage of improving the listener’s ability to hear the desired signal in background noise or at a distance. Most hearing impaired people experience most of their difficulty in background noise, so assistive listening devices are useful for the majority of hearing aid patients.Here are some types of assistive devices:

  • FM Systems transmit the speaker’s voice via FM from a remote microphone directly to the listener’s ear. They can couple directly to hearing aids or can be used on their own without hearing aids.
  • Infrared Devices also transmit the desired signal directly to the listener’s ear using infrared light. Infrared technology is often used in TV listening devices and public theaters.
  • Hard wired Devices are useful for improving signal to noise ratio at close distances. They’re a good choice for patients with relatively inactive lifestyles who cannot use hearing aids due to poor speech understanding ability. They can also be used with television.
  • Telecommunication Devices include amplified, hearing compatible telephones, portable telephone amplifiers, telecoil-equipped hearing aids, neckloops, TTYs, and Bluetooth couplers for cellular telephones.


We offer a full line of protective devices for occupation and recreational noise exposure and water protection. Your audiologist will work with you to determine which device is most appropriate, based on your environment.Custom Noise ProtectionCustomized earplugs are essential for those patients (with and without hearing loss) who are exposed to loud levels of noise. Products are available for shooters, industrial workers, musicians, and more. Specialty Ear MoldsCustomized earplugs may be fit to prevent water from entering the ear canal. Patients with pressure-equalization tubes (“ear tubes”) and those who are prone to chronic infections will benefit from custom-made plugs. Customize your Bluetooth™ headset or iPod™ to improve your wearing comfort.