Hearing loss

Hearing loss

Overview

Hearing loss that comes on little by little as you age, also known as presbycusis, is common. More than half the people in the United States older than age 75 have some age-related hearing loss.

There are three types of hearing loss:

Conductive, which involves the outer or middle ear.

Sensorineural, which involves the inner ear.

Mixed, which is a mix of the two.

Aging and being around loud noises both can cause hearing loss. Other factors, such as too much earwax, can lower how well ears work for a time.

You usually can't get hearing back. But there are ways to improve what you hear.

Types of hearing loss

There are three types of hearing loss:

Conductive hearing loss: In this hearing loss, something keeps sound from passing through your outer ear (ear canal) or your middle ear.

Sensorineural hearing loss: This hearing loss happens when something damages your inner ear over time. Rarely, sensorineural hearing loss happens very quickly. This is sudden sensorineural hearing loss (SSHL), or sudden deafness. SSHL may happen all at once or over a few days.

Mixed: This happens when you have issues in your middle or outer ear (conductive hearing loss) and your inner ear (sensorineural hearing loss).

Symptoms

Most people lose their hearing gradually. They may not even notice that it’s happening. In general, you may be developing hearing loss if:

You often ask people to repeat themselves.

You have trouble following a conversation, especially when you’re talking on the telephone or in a noisy environment like a restaurant.

You think people are mumbling.

You can’t hear certain high-pitched sounds, like birds singing.

You need to turn up the volume on your television, computer or tablet.

You have tinnitus (ringing in your ears).

Your ear hurts (earache).

You feel as if there’s pressure or fluid inside your ear.

You have balance problems or dizziness.

What are symptoms of hearing loss in babies and children?

Babies with hearing loss may seem to hear some sounds but not others. They may:

Not startle to loud noises.

Not turn to the source of a sound after 6 months of age.

Not say single words like “mama” or “dada” by age 1.

Not react when you say their name.

Older children with hearing loss may:

Say “huh” a lot.

Be slower to learn to speak than other children their age.

Have unclear speech.

Not follow directions.

Turn up the volume on television or tablets.

Causes

Many things can cause hearing loss. For example, short-term or sudden exposure to very loud noise — like attending a loud concert — can affect your hearing.

Conductive hearing loss causes include:

Earwax that’s built up in your ear.

Fluid in your middle ear from colds or allergies.

Middle ear infection (otitis media).

Swimmers’ ear (otitis externa).

Eustachian tube issues that traps fluid in your middle ear.

Ruptured eardrum.

Ear tumors.

Something stuck in your ear. For example, your child, faced with a side dish of peas, may decide to put one in their ear.

Congenital conditions (conditions present at birth) that affect how babies’ middle or outer ears are formed.

Sensorineural hearing loss causes include:

Aging.

Illnesses like coronary artery disease (heart disease), high blood pressure (hypertension), strokes or diabetes.

Ototoxicity.

Certain genetic (inherited) conditions.

Being hit in the head.

Noise-induced hearing loss. Long-term exposure to loud noise, like working in a very noisy environment like factories and construction sites.

Congenital infections like cytomegalovirus (CMV).

Mixed hearing loss in a combination of conductive and sensorineural hearing loss. That means it affects your outer and middle ear as well as your inner ear. For example, if you take medications that affect your inner ear and you accidentally rupture your eardrum in your middle ear, you have mixed hearing loss.

Diagnosis

Tests to diagnose hearing loss may include:

Physical exam. A health care provider looks in your ear for possible causes of your hearing loss, such as earwax or an infection. The way your ear is formed might cause hearing problems, as well.

Screening tests. A whisper test, which involves covering one ear at a time while listening to words spoken at many volumes, can show how you react to other sounds.

App-based hearing tests. You can use a mobile app on your tablet to screen yourself for hearing loss.

Tuning fork tests. Tuning forks are two-pronged, metal instruments that make sounds when hit. Simple tests with tuning forks can help find hearing loss. They may also show where the ear damage is.

Audiometer tests. A specialist in hearing loss, known as an audiologist, does these more-thorough tests. Sounds and words are directed through earphones to each ear. Each tone is repeated at low levels to find the quietest sound you can hear.

Treatment

You can get help for hearing problems. Treatment depends on the cause of the hearing loss and how bad it is.

Options include:

Removing earwax. Earwax blockage is a cause of hearing loss that can be fixed. A health care provider might remove earwax using suction or a small tool with a loop on the end.

Surgery. Some types of hearing loss can be treated with surgery. For repeated infections that cause fluid in the ear, a care provider might put in small tubes that help ears drain.

Hearing aids. If hearing loss is from damage to the inner ear, a hearing aid can be helpful. A hearing specialist, known as an audiologist, can talk about how hearing aids can help and what kinds there are. Audiologists also can fit you with a hearing aid.

Cochlear implants. When a regular hearing aid isn't likely to help much, a cochlear implant might be an option. A cochlear implant isn't like a hearing aid that makes sound stronger and directs it into the ear canal. Instead, a cochlear implant goes around the parts of the inner ear that don't work to spur the hearing nerve.

An audiologist and a health care provider trained in the ears, nose and throat (ENT) can tell you the risks and benefits.

Type of Doctor Department : An Otolaryngologist, An audiologist