What is Hearing loss

Hearing loss is a partial or total inability to hear. Hearing loss may be present at birth or acquired at any time afterwards. Hearing loss may occur in one or both ears. In children, hearing problems can affect the ability to learn spoken language and in adults it can create difficulties with social interaction and at work.Hearing loss can be temporary or permanent. Hearing loss related to age usually affects both ears and is due to cochlear hair cell loss.  In some people, particularly older people, hearing loss can result in loneliness. Deaf people usually have little to no hearing.

Hearing loss may be caused by a number of factors, including: genetics, ageing, 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.

About half of hearing loss globally is preventable through public health measures. Such practices include immunization, proper care around pregnancy, avoiding loud noise, and avoiding certain medications. The World Health Organization recommends that young people limit exposure to loud sounds and the use of personal audio players to an hour a day in an effort to limit exposure to noise. Early identification and support are particularly important in children.For many hearing aids, sign language, cochlear implants and subtitles are useful. Lip reading is another useful skill some develop.Access to hearing aids, however, is limited in many areas of the world.

As of 2013 hearing loss affects about 1.1 billion people to some degree. It causes disability in about 466 million people (5% of the global population), and moderate to severe disability in 124 million people. Of those with moderate to severe disability 108 million live in low and middle income countries.  Of those with hearing loss, it began during childhood for 65 million. Those who use sign language and are members of Deaf culture see themselves as having a difference rather than an illness. Most members of Deaf culture oppose attempts to cure deafness  and some within this community view cochlear implants with concern as they have the potential to eliminate their culture. The term hearing impairment is often viewed negatively as it emphasizes what people cannot do.

What is Sensorineural Hearing Loss

Your ear is made up of three parts— the outer, the middle, and the inner ear. Sensorineural hearing loss, or SNHL, happens after inner ear damage. Problems with the nerve pathways from your inner ear to your brain can also cause SNHL. Soft sounds may be hard to hear. Even louder sounds may be unclear or may sound muffled.

This is the most common type of permanent hearing loss. Most of the time, medicine or surgery cannot fix SNHL. Hearing aids may help you hear.

Causes of Sensorineural Hearing Loss

This type of hearing loss can be caused by the following things:

  • Illnesses.
  • Drugs that are toxic to hearing.
  • Hearing loss that runs in the family.
  • Aging.
  • A blow to the head.
  • A problem in the way the inner ear is formed.
  • Listening to loud noises or explosions.

What is Conductive Hearing Loss

Your ear is made up of three parts— the outer, the middle, and the inner ear. A conductive hearing loss happens when sounds cannot get through the outer and middle ear. It may be hard to hear soft sounds. Louder sounds may be muffled.

Medicine or surgery can often fix this type of hearing loss.

Causes of Conductive Hearing Loss

This type of hearing loss can be caused by the following:

  • Fluid in your middle ear from colds or allergies.
  • Ear infection, or otitis media. Otitis is a term used to mean ear infection, and media means middle.
  • Poor Eustachian tube function. The Eustachian tube connects your middle ear and your nose. Fluid in the middle ear can drain out through this tube. Fluid can stay in the middle ear if the tube does not work correctly.
  • A hole in your eardrum.
  • Benign tumors. These tumors are not cancer but can block the outer or middle ear.
  • Earwax , or cerumen, stuck in your ear canal.
  • Infection in the ear canal, called external otitis. You may hear this called swimmer’s ear.
  • An object stuck in your outer ear. An example might be if your child put a pebble in his ear when playing outside.
  • A problem with how the outer or middle ear is formed. Some people are born without an outer ear. Some may have a deformed ear canal or have a problem with the bones in their middle ear.

What is Mixed Hearing Loss

Sometimes, a conductive hearing loss happens at the same time as a sensorineural hearing loss, or SNHL. This means that there may be damage in the outer or middle ear and in the inner ear or nerve pathway to the brain. This is a mixed hearing loss.

Causes of Mixed Hearing Loss

Anything that causes a conductive hearing loss or SNHL can lead to a mixed hearing loss. An example would be if you have a hearing loss because you work around loud noises and you have fluid in your middle ear. The two together might make your hearing worse than it would be with only one problem.

 

Hearing loss can be temporary or permanent. It often comes on gradually as you get older, but it can sometimes happen suddenly.

See your GP if you notice any problems with your hearing so you can find out the cause and get advice on treatment.

Signs and symptoms of hearing loss

It’s not always easy to tell if you’re losing your hearing.

Common signs include:

  • difficulty hearing other people clearly, and misunderstanding what they say, especially in noisy places
  • asking people to repeat themselves
  • listening to music or watching television loudly
  • having to concentrate hard to hear what other people are saying, which can be tiring or stressful

The signs can be slightly different if you only have hearing loss in 1 ear or if a young child has hearing loss.

Read more about the signs and symptoms of hearing loss.

When to get medical help

Your GP can help if you think you’re losing your hearing.

  • If you or your child suddenly lose hearing (in 1 or both ears), call your GP or NHS 111 as soon as possible.
  • If you think your or your child’s hearing is getting gradually worse, make an appointment to see your GP.
  • If you’re concerned about a friend’s or family member’s hearing, encourage them to see their GP.

Your GP will ask about your symptoms and look inside your ears using a small handheld torch with a magnifying lens. They can also do some simple checks of your hearing.

If needed, they can refer you to a specialist for more hearing tests.

Causes of hearing loss

Hearing loss can have many different causes. For example:

  • Sudden hearing loss in 1 ear may be due to earwax, an ear infection, a perforated (burst) eardrum or Ménière’s disease.
  • Sudden hearing loss in both ears may be due to damage from a very loud noise, or taking certain medicines that can affect hearing.
  • Gradual hearing loss in 1 ear may be due to something inside the ear, such as fluid (glue ear), a bony growth (otosclerosis) or a build-up of skin cells (cholesteatoma)
  • Gradual hearing loss in both ears is usually caused by ageing or exposure to loud noises over many years.

This may give you an idea of the reason for hearing loss – but make sure you see a GP to get a proper diagnosis. It might not always be possible to identify an obvious cause.

Treatments for hearing loss

Hearing loss sometimes gets better on its own, or may be treated with medicine or a simple procedure. For example, earwax can be sucked out, or softened with eardrops.

But other types – such as gradual hearing loss, which often happens as you get older – may be permanent. In these cases, treatment can help make the most of the remaining hearing. This may involve using:

  • hearing aids – several different types are available on the NHS or privately
  • implants – devices that are attached to your skull or placed deep inside your ear, if hearing aids aren’t suitable
  • different ways of communicating – such as sign language or lip reading

Read more about treatments for hearing loss.

Preventing hearing loss

It’s not always possible to prevent hearing loss, but there are some simple things you can do to reduce the risk of damaging your hearing.

These include:

  • not having your television, radio or music on too loud
  • using headphones that block out more outside noise, instead of turning up the volume
  • wearing ear protection (such as ear defenders) if you work in a noisy environment, such as a garage workshop or a building site; special vented earplugs that allow some noise in are also available for musicians
  • using ear protection at loud concerts and other events where there are high noise levels
  • not inserting objects into your or your children’s ears – this includes fingers, cotton buds, cotton wool and tissues

Read more tips to protect your hearing.