Hearing loss is incredibly common, affecting millions of people of all ages. Yet, when you or a loved one notices a change in hearing, the first step is often the hardest: Who should you call? Should you book an appointment with an audiologist or an ear, nose and throat (ENT) doctor? Understanding the roles of these specialists — and where advanced solutions like cochlear implants fit in — can help you get the right treatment faster.
This guide breaks down how hearing works, the differences between audiologists and ENTs and which concerns are typically addressed by each. We’ll also explain when cochlear implants might be an option for people who need additional support than traditional hearing aids can offer.
How Hearing Works: The Basics
To understand why hearing fails, it helps to visualize how the ear is built and how we hear. Your ear acts as a complex funnel and translator for sound. It has three main distinct parts:
- Outer ear: This includes the part you can see and the ear canal. It captures sound waves and directs them inward.
- Middle ear: This space contains the eardrum and three tiny bones. They vibrate when sound hits them, pushing the sound toward the inner ear.
- Inner ear: This houses the cochlea, a snail-shaped organ filled with fluid and lined with microscopic hair cells. These cells turn physical vibrations into electrical signals that your brain recognizes as sound.
When this system works smoothly, sound travels from the air to your brain in an instant. However, a blockage or damage at any point in this journey can disrupt hearing.
Types of Hearing Loss
Hearing loss is generally categorized into two main types. Knowing which one you have is key to finding the right doctor.
Conductive Hearing Loss
This happens when sound is blocked from moving through the outer or middle ear. It acts like a physical barrier. Common culprits include earwax buildup, fluid trapped behind the eardrum or infections. The good news is that conductive hearing loss can often be fixed with medicine or minor surgery.
Sensorineural Hearing Loss
This is the most common type of hearing loss. It occurs when there is damage to the inner ear (the cochlea) or the pathway to the brain. Aging, loud noise exposure and genetics often play a role in sensorineural hearing loss.Although this type of hearing loss usually cannot be completely reversed, hearing aids offer significant improvement for many people. In severe cases where hearing aids aren’t enough, cochlear implants become a vital option.
What Is an Audiologist?
Think of an audiologist as your primary partner for hearing health and rehabilitation. They are licensed professionals with advanced degrees who specialize in evaluating, diagnosing and managing hearing and balance issues.
What they do:
- Perform detailed hearing tests to map out exactly what you can and cannot hear.
- Fit and program hearing aids to your specific prescription.
- Help with assistive listening devices.
- Provide counseling to help you communicate better in difficult environments.
When to see one:
Most people start with an audiologist if they notice a gradual decline in hearing. If you find yourself constantly asking people to repeat themselves or turning up the TV volume, an audiologist is a great starting point.If tests show that hearing aids aren’t helping enough — especially with severe hearing loss — they will refer you to an ENT to discuss advanced surgical options.
What Is an ENT (Otolaryngologist)?
An ENT (otolaryngologist) is a medical doctor and surgeon. They specialize in conditions affecting the ear, nose and throat. While audiologists focus on hearing function, ENTs diagnose and treat ear diseases using medical and surgical approaches.
Some ENTs specialize further in the ear and are called otologists/neurotologists. They complete an additional two-year fellowship to manage complex ear conditions and surgeries.
You should consider seeing an ENT specialist if you experience:
- Sudden hearing loss (this is a medical emergency).
- Ear pain, drainage or recurring infections.
- Dizziness, vertigo or balance disorders.
- Physical abnormalities in the ear.
ENTs and audiologists work hand-in-hand. For complex cases, such as candidates for cochlear implants, you will likely see both.
A Simple Guide: Who Should I Call?
If you are unsure where to start, use this simple rule of thumb:
- Go to an audiologist if: Your hearing has faded slowly over time. They can assess your hearing levels and fit you with hearing aids if needed.
- Go to an ENT if: Your hearing loss happened suddenly, or if you have pain, dizziness or fluid draining from your ear. These are signs of a medical condition that needs a doctor’s attention.
Remember, your care team often includes both specialists working together.
Understanding Cochlear Implants
When hearing aids are no longer powerful enough to provide clarity, cochlear implants could be another option. These are not just stronger hearing aids; cochlear implants are sophisticated medical devices designed for moderate-to-profound sensorineural hearing loss.
How they differ from hearing aids:
A hearing aid simply turns up the volume on sound. A cochlear implant bypasses the impaired part of the inner ear and sends sound signals directly to the hearing nerve.
The device has two parts:
- External processor: Worn behind the ear, it captures sound.
- Internal implant: Surgically placed under the skin, it receives signals from the processor and sends them to the brain.
Who Can Benefit from a Cochlear Implant?
Cochlear implants are an option for both children and adults. Thanks to advances in technology, more people are now eligible for cochlear implants than ever before, making this life-changing option available to a wider group of individuals. Cochlear implants are generally considered for those who have:
- Moderate-to-profound sensorineural hearing loss in one or both ears.
- Limited success with high-quality, properly fitted hearing aids.
- Difficulty understanding speech, even with amplification.
- Ongoing communication challenges.
Determining candidacy is a thorough process. It involves hearing tests with an audiologist, a medical exam with an ENT and sometimes imaging scans. The decision is individualized, and your healthcare provider will ensure you understand the potential benefits and the commitment required for rehabilitation.
Is Cochlear Implant Surgery Safe?
Yes, cochlear implant surgery is a well-established, safe procedure, routinely performed at leading medical centers like Stony Brook Medicine. As with any surgery, there are minor risks, such as infection or temporary balance issues, but serious complications are rare.
- Patients typically meet with their surgeon beforehand to discuss the procedure in detail.
- It is an outpatient procedure, meaning you go home the same day.
- The real work begins after surgery, during the “mapping” (programming) phase and rehabilitation, where your brain learns to interpret these new signals.
Your Path to Better Hearing
Hearing loss can feel isolating, but you don’t have to navigate it alone. Whether you need the diagnostic expertise of an audiologist or the surgical skill of an ENT, help is available.
For many, the journey begins with a simple hearing test. By understanding your options and knowing which specialist to see, you are taking charge of your health and your connection to the world around you.
For expert hearing and speech care, connect with the team at Stony Brook Speech-Language and Hearing. Schedule your appointment today by calling (631) 444-4191. Take the next step toward better hearing and communication with trusted specialists right here on Long Island.
