What Is Hearing Loss?

Hearing loss refers to a partial or total reduction in the ability to hear, which may occur suddenly or gradually. It can affect one or both ears and may be mild or severe, temporary or permanent, and reversible or irreversible. The most common cause is age-related hearing loss—presbycusis—which affects approximately 25% of individuals aged 65–75 and up to 50% of those over 75. Hearing loss may also result from congenital conditions, illnesses like Ménière’s disease, or injury.

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Causes of Hearing Loss

Hearing loss can result from various causes, many of which involve damage to the inner ear. Some common causes include:

  • Chronic exposure to loud noise (e.g., music, industrial machinery)
  • Wax buildup in the ear canal
  • Family history of hearing loss
  • Fluid buildup from ear infections
  • Foreign objects in the ear
  • Ototoxic medications (drugs that damage hearing)
  • Injury or illness, such as eardrum perforation or damage to the tiny bones (ossicles) in the ear

Types of Hearing Loss

There are three main types of hearing loss, each with distinct causes and treatment options:

Conductive Hearing Loss

This type occurs when sound is blocked from reaching the inner ear, usually due to an issue in the outer or middle ear. Causes may include wax buildup, infections, or structural abnormalities. Surgery is often an effective treatment.

Sensorineural Hearing Loss

Sensorineural hearing loss is caused by damage to the inner ear or auditory nerve—often due to aging or noise exposure. It affects sound clarity more than volume and is typically treated with hearing aids.

Mixed Hearing Loss

This form combines both conductive and sensorineural components. It involves issues in both the outer/middle and inner ear and is commonly treated with bone-anchored hearing aids or a combination of therapies.

Symptoms of Hearing Loss

Hearing loss may develop so gradually that individuals don’t recognize it until someone else points it out. Common symptoms include:

  • Muffled or distorted speech
  • Difficulty understanding conversations, especially in noisy environments
  • Feeling like the ears are plugged
  • Tinnitus (ringing in the ears)
  • Constant need to increase volume on the TV or radio

Hearing loss can affect communication, relationships, and daily functioning. In some cases, it may lead to social withdrawal, depression, or anxiety.

Diagnosis of Hearing Loss

Diagnosis begins with a physical examination, followed by specific hearing tests. These may include:

  • Tuning fork tests to assess the function of the eardrum and middle ear
  • Audiometry, using an audiometer to measure hearing sensitivity across different pitches and volumes

These tests help determine the type and extent of hearing loss.

Treatment of Hearing Loss

Treatment depends on the underlying cause of the hearing loss:

  • Earwax buildup may be resolved with ear irrigation or lavage
  • Ear infections may be treated with antibiotics or decongestants
  • Age-related or inner ear damage is often managed with hearing aids, although adjustment may take time
  • Eardrum perforations may require tympanoplasty, a surgical repair procedure
  • Severe or congenital hearing loss may be treated with cochlear implants, which provide a sense of sound through electrical stimulation

In addition to medical treatments, individuals with significant hearing loss may benefit from lip-reading, sign language, or learning to interpret facial expressions and body language to enhance communication.