Hearing loss Causes, Types, Symptoms, Diagnosis, Treatment and FAQs

What is the hearing loss?

Hearing loss is the loss of hearing in one or both ears, ranging from mild to profound. There are many causes, and it can affect anyone at any age, but it’s most common among people older than 60. Hearing loss may occur in one or both ears.

In children, hearing problems can affect the ability to learn spoken the language and in adults, it can create difficulties with social interaction and at work. In some people, particularly older people, hearing loss can result in loneliness. Hearing loss can be temporary or permanent.

Hearing loss may be caused by a number of factors, including genetics, aging, exposure to noise, some infections, birth complications, trauma to the ear, and certain medications or toxins. A common condition that results in hearing loss is chronic ear infections.

Certain infections during pregnancy, such as cytomegalovirus, syphilis, and rubella, may also cause hearing loss in the child. Hearing loss is diagnosed when hearing testing finds that a person is unable to hear 25 decibels in at least one ear.

Testing for poor hearing is recommended for all newborns. Hearing loss can be categorized as mild (25 to 40 dB), moderate (41 to 55 dB), moderate-severe (56 to 70 dB), severe (71 to 90 dB), or profound (greater than 90 dB). There are three main types of hearing loss: conductive hearing loss, sensorineural hearing loss, and mixed hearing loss.

Hearing loss may be gradual or sudden. Hearing loss may be very mild, resulting in minor difficulties with conversation, or as severe as complete deafness. The speed with which hearing loss occurs may give clues as to the cause.

• If hearing loss is sudden, it may be from trauma, acute inflammation, or a problem with blood circulation. Gradual onset is suggestive of other causes such as aging or a tumor.
• If you also have other associated neurological problems, such as tinnitus (ringing in the ears) or vertigo (spinning sensation), it may indicate a problem with the nerves in the ear or brain.
• Hearing loss may be unilateral (only 1 ear) or bilateral (both ears). The unilateral hearing loss is most often associated with conductive causes, trauma, and acoustic neuromas.
• Pain in the ear is associated with ear infections, trauma, and obstruction in the canal. Ear infections may also cause a fever.
• Difficulty understanding everyday conversation
• A feeling of being able to hear but not understand
• Having to turn up the TV or radio
• Asking others to repeat often
• Avoidance of social situations that were once enjoyable
• A sense of exhaustion after a day of listening to other people
• Increased difficulty communicating in noisy situations like restaurants, lively family gatherings, in the car or in group meetings
• Tinnitus, or ringing and/or buzzing sounds in the ears

Advanced age is the most common cause of hearing loss. One out of three people age 65-74 has some level of hearing loss. After age 75, that goes up to one out of every two people.

Researchers don’t fully understand why hearing declines with age. It could be that lifetime exposure to noise and other damaging factors slowly wear down the ears’ delicate mechanics. Your genes are also part of the mix.

Noise wears down hearing if it’s loud or continuous. The Centers for Disease Control (CDC) reports that about 22 million American workers are exposed to dangerous noise levels on the job. This includes many carpenters, construction workers, soldiers, miners, factory workers, and farmers.

How hearing loss can occur

Causes of hearing loss include:

• Damage to the inner ear. Aging and exposure to loud noise may cause wear and tear on the hairs or nerve cells in the cochlea that send sound signals to the brain. When these hairs or nerve cells are damaged or missing, electrical signals aren’t transmitted as efficiently, and hearing loss occurs.Higher pitched tones may become muffled to you. It may become difficult for you to pick out words against background noise.
• The gradual buildup of earwax. Earwax can block the ear canal and prevent conduction of sound waves. Earwax removal can help restore your hearing.
• Ear infection and abnormal bone growths or tumors. In the outer or middle ear, any of these can cause hearing loss.
• Ruptured eardrum (tympanic membrane perforation). Loud blasts of noise, sudden changes in pressure, poking your eardrum with an object and infection can cause your eardrum to rupture and affect your hearing.

How to Cope with Hearing Loss

If you notice signs of hearing loss, talk to your doctor. If you have trouble hearing, you should:

• Let people know you have a hearing problem.
• Ask people to face you and to speak more slowly and clearly. Also, ask them to speak louder without shouting.
• Pay attention to what is being said and to facial expressions or gestures.
• Let the person talking know if you do not understand what he or she said.
• Ask the person speaking to reword a sentence and try again.
• Find a good location to listen to. Place yourself between the speaker and sources of noise and look for quieter places to talk.

The most important thing you can do if you think you have a hearing problem is to seek professional advice. Your family doctor may be able to diagnose and treat your hearing problem. Or, your doctor may refer you to other experts, like an otolaryngologist (ear, nose, and throat doctor) or an audiologist (a health professional who can identify and measure hearing loss).

Diagnosis for Hearing Loss

Patients who suspect something is wrong with their hearing will initially go and see their doctor.

The doctor will talk to the patient and ask several questions regarding the symptoms, including when they started, whether or not they have gotten worse, and whether the individual is feeling pain alongside the hearing loss.

The doctor will look into the ear using an otoscope. This is an instrument with a light at the end. The following may be detected during the examination:

• a blockage caused by a foreign object
• a collapsed eardrum
• an accumulation of earwax
• an infection in the ear canal
• an infection in the middle ear if a bulge is present in the eardrum.
• cholesteatoma, a skin growth behind the eardrum in the middle ear.
• fluid in the ear canal
• a hole in the eardrum

The doctor will ask questions about the person’s experiences with hearing, including:

• Do you often find yourself asking people to repeat what they said?
• Do you find it hard to understand people on the telephone?
• Do you miss the doorbell when it rings? If so, does this happen frequently?
• When you chat with people face-to-face, do you have to focus carefully?
• Has anybody ever mentioned to you that you might have a problem with your hearing?
• Do you find more people mumble today than they used to?
• internal you hear a sound, do you often find it hard to determine where it is coming from?
• When several people are talking, do you find it hard to understand what one of them is telling you?
• Are you often told that the television, radio, or any sound-producing device is too loud?
• Do you find male voices easier to understand than female voices?
• Do you spend most of each day in a noisy environment?
• Have you often found yourself misunderstanding what other people say to you?
• Do you hear rushing, hissing, or ringing sounds?
• Do you avoid group conversations?

If you answered “yes” to most of the above questions, see a doctor and have your hearing checked.

Hearing loss treatments

It depends on the type and source of your hearing loss. Prompt medical treatment for sudden hearing loss may raise your chance of recovery. Surgery may reverse hearing loss caused by otosclerosis, scar tissue, or infection, while Ménière’s disease is sometimes treatable with medication and a different diet.

Hearing loss caused by infection can often be cleared up with antibiotics.

Hearing loss is a well-understood medical condition that has many tried-and-true treatment options. Finding the right treatment is a joint venture between you and your hearing care professional, and if done properly, takes into consideration the following factors:

• Type of hearing loss
• The severity of hearing loss
• Cause, if known
• Your lifestyle
• Your age and your communication needs
• Your cosmetic preferences
• Your budget

If you think your hearing loss stems from medication use, talk with your doctor about drug options.

Most people with permanent hearing loss can benefit from a hearing aid. You typically wear these tiny instruments in or behind your ear to make sounds louder. Things do sound different through a hearing aid though, so you should talk with your doctor to set realistic goals.

Risk factors of Hearing Loss

Factors that may damage or lead to loss of the hairs and nerve cells in your inner ear include:

• Aging. The degeneration of inner ear structures occurs over time.
• Loud noise. Exposure to loud sounds can damage the cells of your inner ear. Damage can occur with long-term exposure to loud noises, or from a short blast of noise, such as from a gunshot.
• Heredity. Your genetic makeup may make you more susceptible to ear damage from sound or deterioration from aging.
• Occupational noises. Jobs where loud noise is a regular part of the working environment, such as farming, construction or factory work, can lead to damage inside your ear.
• Recreational noises. Exposure to explosive noises, such as from firearms and jet engines, can cause immediate, permanent hearing loss. Other recreational activities with dangerously high noise levels include snowmobiling, motorcycling, carpentry or listening to loud music.
• Some medications. Drugs such as the antibiotic gentamicin, sildenafil (Viagra) and certain chemotherapy drugs, can damage the inner ear. Temporary effects on your hearing — ringing in the ear (tinnitus) or hearing loss — can occur if you take very high doses of aspirin, other pain relievers, antimalarial drugs or loop diuretics.
• Some illnesses. Diseases or illnesses that result in high fever, such as meningitis, may damage the cochlea.

Complications for Hearing Loss

Hearing loss can have a significant effect on your quality of life. Older adults with hearing loss may report feelings of depression. Because hearing loss can make conversation difficult, some people experience feelings of isolation. Hearing loss is also associated with cognitive impairment and decline.

The mechanism of interaction between hearing loss, cognitive impairment, depression and isolation is being actively studied. Initial research suggests that treating hearing loss can have a positive effect on cognitive performance, especially memory.

Prevention of Hearing Loss

The following steps can help you prevent noise-induced hearing loss and avoid worsening of age-related hearing loss:

• Protect your ears. Limiting the duration and intensity of your exposure to noise is the best protection. In the workplace, plastic earplugs or glycerin-filled earmuffs can help protect your ears from damaging noise.
• Have your hearing tested. Consider regular hearing tests if you work in a noisy environment. If you’ve lost some hearing, you can take steps to prevent further loss.
• Avoid recreational risks. Activities such as riding a snowmobile, hunting, using power tools or listening to rock concerts can damage your hearing over time. Wearing hearing protectors or taking breaks from the noise can protect your ears. Turning down the music volume is helpful too.

Frequently Asked Questions About Hearing Loss

How can I recognize hearing problems?