Symptom: Hearing Impairment

What Is Hearing Loss?

Hearing loss is when you are unable to partially or completely hear sound in one or both of your ears. In most people, hearing loss begins after age 20 (MedlinePlus). Hearing loss typically occurs gradually over time, but by the time a person reaches 65, hearing loss can be quite significant. The National Institute on Deafness and Other Communication Disorders (NICDC) reported that, in 2010, 30 percent of those between the ages of 65 and 74 said they had hearing loss (NICDC).

Hearing loss is also known as:

  • decreased hearing
  • deafness
  • loss of hearing
  • conductive hearing loss
  • How Hearing Works

    There are three main parts to the ear: the outer ear, middle ear, and inner ear. The hearing process includes these basic steps.

  • Hearing begins when sound waves pass through the outer ear to the eardrum (a thin piece of skin between your outer and middle ear).
  • When the sound waves reach the eardrum, the eardrum vibrates.
  • The eardrum and the three bones of the middle ear (the hammer, anvil, and stirrup, together called the ossicles) then work together to increase the vibrations as the sound waves travel onward to the inner ear.
  • When the sound waves reach the inner ear, they travel through the fluids of the cochlea. The cochlea is an inner-ear structure sometimes described as being snail-shaped (Mayo, 2011).
  • In the cochlea are nerve cells with thousands of mini hairs attached to them. These hairs help to convert the sound wave vibrations into electrical signals that are then communicated to your brain.
  • Your brain then interprets these electrical signals as sound. Different sound vibrations create different reactions in these tiny hairs; thereby signaling different sounds to your brain.
  • What Are the Common Underlying Causes of Hearing Loss?

    The American Speech-Language-Hearing Association (ASHA) reports that there are three basic types of hearing loss, each caused by different underlying factors. The three most common causes of decreased hearing include conductive hearing loss, sensorineural hearing loss (SNHL), and mixed hearing loss (ASHA).

    Conductive Hearing Loss

    This type of hearing loss occurs when sounds are not able to travel from the outer ear to the eardrum and the bones of the middle ear. When this type of hearing loss occurs, you may find it difficult to hear soft or muffled sounds. Conductive hearing loss can be treated through medical interventions and is not always permanent. Treatment may include antibiotics or surgical interventions, such as a cochlear implant. A cochlear implant is a small electrical machine (placed under your skin behind the ear) that translates sound vibrations into electrical signals that your brain can then interpret as meaningful sound.

    Conductive hearing loss can be caused by:

  • ear infections (otitis media)
  • allergies (serous otitis media)
  • swimmer’s ear (otitis externa)
  • a buildup of wax in the ear
  • a foreign object that has become stuck in the ear
  • benign tumors
  • scarring of the ear canal due to recurrent infections
  • Sensorineural Hearing Loss (SNHL)

    This type of hearing loss happens when there is damage to inner ear structures or in the nerve pathways to the brain. This type of hearing loss is usually permanent. SNHL makes even distinct, normal-to-loud sounds seem muffled or unclear.

    SNHL can result because of:

  • birth defects that alter the structure of the ear
  • aging
  • working around loud noises
  • trauma to the head or skull
  • infections that damaged the nerves of the ear, such as measles, meningitis, mumps, or scarlet fever
  • acoustic neuroma (a noncancerous tumor that grows on the nerve that connects the ear to the brain, known as the vestibular cochlear nerve)
  • Meniere’s disease (disorder of the inner ear that can affect hearing and balance)
  • Some medications, called ototoxic medications, may also cause SNHL. According to the American Speech-Language-Hearing Association, there are over 200 medications (over-the-counter and prescription) that may cause hearing loss. If you are taking medications for cancer, heart disease, or a serious infection, talk with your doctor about the hearing risks involved with each (ASHA).

    Mixed Hearing Loss

    Mixed hearing loss may also occur. This happens when both conductive hearing loss and SNHL occur at the same time.

    When Should You Call Your Doctor?

    Hearing loss typically occurs over time. At first, you may not notice any changes in your hearing. However, if you experience any of the following symptoms, you should contact your doctor:

  • hearing loss that interferes with your daily activities
  • hearing loss that becomes worse or that does not go away
  • hearing loss that is worse in one ear
  • sudden hearing loss
  • ringing in the ear
  • severe hearing loss
  • having ear pain along with hearing problems
  • headaches, numbness, or weakness
  • If you experience headaches, numbness or weakness, coupled with chills, quick breathing, neck stiffness, vomiting, sensitivity to light, or mental agitation, you should seek emergency medical treatment. These symptoms may be associated with life-threatening conditions, such as meningitis, that warrant immediate medical attention.

    How Can the Symptoms of Hearing Loss Be Treated?

    If you develop hearing loss that is due to a buildup of wax in the ear canal, you can remove the wax at home. Over-the-counter solutions, including wax softeners, can be used to remove wax from the ear. Syringes can also be used to push warm water through the ear canal to remove the wax. If a foreign object is stuck in the ear canal, you may (depending on the object) be able to remove the object at home. However, in this case, it would be wise to consult your doctor before attempting to remove the object—you do not want to unintentionally damage your ear.

    For other causes of hearing loss, you will need to see your doctor. If your hearing loss is caused by an infection, your doctor may need to prescribe antibiotics. If your hearing loss is caused by other conductive hearing problems, your doctor may refer you to a specialist to receive a hearing aid or a cochlear implant.

    What Are the Complications of Hearing Loss?

    Hearing loss has been shown to negatively impact a person’s quality of life and mental state. If you develop hearing loss, you may have difficulty understanding others. This can increase your anxiety level or cause depression. Treatment for hearing loss may improve your life significantly. It may restore self-confidence while also improving your ability to communicate with friends and family members.

    How Can You Prevent Hearing Loss?

    Not all cases of hearing loss can be prevented. However, there are several steps that you can take to protect your hearing:

  • Use safety equipment if you work in areas with loud noises, and wear earplugs when you swim and go to concerts. Statistics from 2010 showed that 15 percent of individuals ages 20 to 69 experienced hearing loss due to loud noise (NIDCD).
  • Have regular hearing tests if you work around loud noises, swim often, or go to concerts on a regular basis.
  • Avoid prolonged exposure to loud noises and music.
  • Seek help for ear infections, as they may cause permanent damage to the ear if left untreated.
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    Signs and Symptoms

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