Hearing Loss: Causes, Symptoms, Diagnosis, Treatment, and Prevention
Hearing loss affects the ability to hear sounds, and it can range from mild to profound, permanent or temporary. Hearing loss can affect one or both ears, and it can affect quality of life, communication, and social interactions.
Causes of Hearing Loss
There are many possible causes of hearing loss, but they can be broadly classified into two types: conductive and sensorineural.
-
When sound waves cannot reach the inner ear because of a problem in the outer or middle ear, it is called conductive hearing loss. Earwax buildup, ear infections, fluid in the middle ear, a perforated eardrum, foreign objects in the ear, or abnormal growths or tumors in the ears can cause conductive hearing loss.
-
When the inner ear (cochlea) or the nerve pathways that carry sound signals to the brain are damaged, sensorineural hearing loss occurs. Among the common causes of sensorineural hearing loss are aging, noise exposure, genetics, infections, head or ear injuries, certain medications, or certain diseases, such as Meniere's disease and acoustic neuroma.
Symptoms of Hearing Loss
The symptoms of hearing loss may vary depending on the type, degree, and cause of the hearing loss. Some common symptoms of hearing loss are:
-
Difficulty hearing or understanding speech, especially in noisy environments or over the phone
-
Asking others to repeat themselves or speak louder or clearer
-
Turning up the volume of the TV, radio, or other devices
-
Feeling that others are mumbling or speaking softly
-
Missing or misinterpreting sounds or cues
-
Having trouble locating the source or direction of sounds
-
Experiencing ringing, buzzing, hissing, or other noises in the ears (tinnitus)
-
Feeling isolated, frustrated, or depressed due to communication difficulties
Diagnosis of Hearing Loss
When you suspect that you or someone you know has hearing loss, you should seek professional help as soon as possible. A hearing specialist, such as an audiologist or an otolaryngologist (ear, nose, and throat doctor), can perform a comprehensive evaluation of your hearing and determine the type, degree, and cause of your hearing loss. The following tests may be used to diagnose hearing loss:
-
You will wear headphones and listen to a series of beeps or tones, pressing a button or raising your hand when you hear each sound. Pure-tone audiometry measures the softest sounds that you can hear at different pitches or frequencies.
-
In speech audiometry, you will wear headphones and listen to a series of words or sentences. You will repeat what you hear or choose the right answer from a list.
-
A small probe will be inserted into your ear canal to create a slight pressure change. This will measure how your eardrum moves and how much sound is reflected back to you.
-
A small probe will be inserted into your ear canal and a series of clicks or tones will be played to measure the inner ear's response to sound. It stimulates the hair cells of your cochlea, which produce faint sounds called otoacoustic emissions, which can be detected by a microphone and analyzed by a computer.
-
During an auditory brainstem response (ABR), electrodes will be placed on your scalp and ears, and headphones will play a series of clicks or tones to measure the activity of the auditory nerve and brainstem. As a result, electrical signals are generated in your auditory pathway that are recorded by the electrodes and analyzed by a computer.
Treatment of Hearing Loss
The treatment of hearing loss depends on the type, degree, and cause of the hearing loss, as well as your personal preferences and needs. Some of the possible treatment options are:
-
Electronic devices that amplify and process sound are known as hearing aids. They are made up of a microphone, an amplifier, a speaker, and a battery. They can be worn behind the ear, in the ear, or in the canal. You can adjust them according to your hearing loss and listening situation. Additionally, Bluetooth or other wireless technologies can be used to connect them to other devices such as phones, TVs, or computers.
-
An auditory nerve is stimulated directly by cochlear implants, which are surgically implanted devices that bypass the damaged inner ear. An external part contains a microphone, a processor, a transmitter, and a battery, and an internal part contains an electrode array and a receiver. Using a magnetic connection, the external part picks up sound and converts it into electrical signals for the internal part to process. As the electrical signals are delivered to the electrode array, the auditory nerve is stimulated, which then sends the signals to the brain, where they are interpreted as sound.
-
Surgically implanted hearing systems (BAHS) transmit sound to the inner ear through the skull bone. An external part consists of a sound processor and a snap, while an internal part consists of a titanium implant and abutment. The external part snaps onto the abutment and picks up sound and converts it into vibrations, which are transmitted to the internal part via the snap. In the inner ear, vibrations are converted into sound by the implant, which vibrates the bone of the skull.
-
Middle ear implants (MEIs): These are surgically implanted devices that stimulate the middle ear structures to produce sound. An external part includes a microphone, a processor, a transmitter, and a battery, while an internal part contains a receiver and a transducer. Using a magnetic connection, the external part converts sound into electrical signals that are transmitted to the internal part. Transducers transmit electrical signals to the middle ear structures, such as the eardrum and the ossicles. They vibrate the middle ear structures, converting them into sound in the inner ear.
-
Some medications may be prescribed to treat or prevent hearing loss caused by infections, inflammation, or autoimmune diseases. It is important to consult your doctor before taking any medications, and to monitor your hearing regularly, since some medications, such as antibiotics, chemotherapy drugs, or painkillers, may cause or worsen hearing loss as a side effect.
-
In order to correct or improve certain causes of hearing loss, certain surgical procedures may be performed, such as earwax removal, eardrum repair, ear tube placement, stapedectomy, tumor removal, or cochlear implantation. Infection, bleeding, nerve damage, or hearing loss may also result from surgery. The benefits and risks of surgery need to be discussed with your doctor and you must follow the post-operative instructions carefully.
Prevention of Hearing Loss
Some types of hearing loss may be prevented or delayed by taking some simple measures, such as:
-
Protecting your ears from loud noises, such as using earplugs, headphones, or earmuffs, or avoiding or limiting your exposure to noisy environments, such as concerts, factories, or traffic
-
Keeping your ears clean and dry, such as using a soft cloth or a cotton swab to gently wipe the outer ear, or using a hair dryer on a low setting to dry the ear canal after swimming or showering
-
Checking your ears regularly for signs of infection, such as pain, redness, swelling, discharge, or fever, and seeking medical attention if you notice any of these symptoms
-
Having your hearing tested periodically, especially if you are older than 50, have a family history of hearing loss, or have other risk factors, such as diabetes, hypertension, or smoking
-
Following your doctor’s advice and instructions regarding your medications, hearing devices, or surgery, and reporting any changes or problems with your hearing or ear health
You can suffer from hearing loss at any age. There can be a variety of causes, symptoms, and impacts. Nevertheless, you can improve your hearing and your quality of life with proper diagnosis, treatment, and prevention. Don't hesitate to contact your hearing specialist or your doctor if you have any questions or concerns about your hearing. Their goal is to make your life better by helping you hear better.
