Hearing loss, also known as hearing impairment, is a partial or total inability to hear.A deaf person has little to no hearing.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 cause work related difficulties.In some people, particularly older people, hearing loss can result in loneliness.Hearing loss can be temporary or permanent. |
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| Common signs of hearing loss |
- Asking others to repeat themselves
- Turning up the TV or radio to volume levels others find loud
- Having trouble understanding conversation in noisy places
- Feeling like other people mumble or slur their words
- Having trouble hearing women's and children's voices
- Having trouble hearing on the telephone
- Feeling more irritable or depressed
- Avoiding social situations that were once enjoyable
- Having difficulty following a fast-moving conversation
- Missing important information in meetings
- Being told by others that you have hearing problems
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| Types of Hearing Loss |
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Conductive hearing loss - when hearing loss is due to problems with the ear canal, ear drum, or middle ear and its little bones (the malleus, incus, and stapes).
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Sensorineural hearing loss (SNHL) - when hearing loss is due to problems of the inner ear, also known as nerve-related hearing loss.
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Mixed hearing loss - refers to a combination of conductive and sensorineural hearing loss. This means that there may be damage in the outer or middle ear and in the inner ear (cochlea) or auditory nerve.
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| Causes of hearing loss |
Age : There is a progressive loss of ability to hear high frequencies with aging known as presbycusis. For men, this can start as early as 25 and women at 30. Although genetically variable it is a normal concomitant of ageing and is distinct from hearing losses caused by noise exposure, toxins or disease agents |
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Noise : Noise exposure is the cause of approximately half of all cases of hearing loss, causing some degree of problems in 5% of the population globally.The National Institute for Occupational Safety and Health (NIOSH) recognizes that the majority of hearing loss is not due to age, but due to noise exposure. |
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Genetic : Hearing loss can be inherited. Around 75–80% of all these cases are inherited by recessive genes, 20–25% are inherited by dominant genes, 1–2% are inherited by X-linked patterns, and fewer than 1% are inherited by mitochondrial inheritance. |
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| Perinatal problems |
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Fetal alcohol spectrum disorders are reported to cause hearing loss in up to 64% of infants born to alcoholic mothers, from the ototoxic effect on the developing fetus plus malnutrition during pregnancy from the excess alcohol intake.
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Premature birth can be associated with sensorineural hearing loss because of an increased risk of hypoxia, hyperbilirubinaemia, ototoxic medication and infection as well as noise exposure in the neonatal units. The risk of hearing loss is greatest for those weighing less than 1500 g at birth.
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Heredity : Your genetic makeup may make you more susceptible to ear damage from sound or deterioration from aging. |
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Occupational noises : Jobs where loud noise is a regular part of the working environment, such as farming, construction or factory work, can lead to damage inside your ear. |
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Recreational noises : Exposure to explosive noises, such as from firearms and jet engines, can cause immediate, permanent hearing loss. Other recreational activities with dangerously high noise levels include snowmobiling, motorcycling or listening to loud music. |
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Some medications : Drugs, such as the antibiotic gentamicin and certain chemotherapy drugs, can damage the inner ear. Temporary effects on your hearing — ringing in the ear (tinnitus) or hearing loss — can occur if you take very high doses of aspirin, other pain relievers, antimalarial drugs or loop diuretics. |
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Some illnesses : Diseases or illnesses that result in high fever, such as meningitis, may damage the cochlea |
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| Diagnosis |
Case history : A case history (usually a written form, with questionnaire) can provide valuable information about the context of the hearing loss, and indicate what kind of diagnostic procedures to employ. Case history will include such items as: |
- major concern
- birth and pregnancy information
- medical history
- development history
- family history
- workplace environment
- home environment
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| Physical exam : Your doctor will look in your ear for possible causes of your hearing loss, such as earwax or inflammation from an infection. Your doctor will also look for any structural causes of your hearing problems. |
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| General screening tests : Your doctor may ask you to cover one ear at a time to see how well you hear words spoken at various volumes and how you respond to other sounds. |
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| Tuning fork tests : Tuning forks are two-pronged, metal instruments that produce sounds when struck. Simple tests with tuning forks can help your doctor detect hearing loss. A tuning fork evaluation may also reveal whether hearing loss is caused by damage to the vibrating parts of your middle ear (including your eardrum), damage to sensors or nerves of your inner ear, or damage to both. |
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| Audiometer tests : During these more-thorough tests conducted by an audiologist, you wear earphones and hear sounds directed to one ear at a time. The audiologist presents a range of sounds of various tones and asks you to indicate each time you hear the sound. |
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| Treatment Options |
| Removing wax blockage. Earwax blockage is a reversible cause of hearing loss. Your doctor may remove earwax by loosening it with oil and then flushing, scooping or suctioning out the softened wax. |
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Surgical procedures : Surgery may be necessary if you've had a traumatic ear injury or repeated infections that require the insertion of small tubes that help the ears drain.
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| Hearing aids : If your hearing loss is due to damage to your inner ear, a hearing aid can help by making sounds stronger and easier for you to hear. An audiologist can discuss with you the potential benefits of using a hearing aid, recommend a device and fit you with it. |
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| Cochlear implants : If you have severe hearing loss, a cochlear implant may be an option for you. Unlike a hearing aid that amplifies sound and directs it into your ear canal, a cochlear implant compensates for damaged or nonworking parts of your inner ear. If you're considering a cochlear implant, your audiologist, along with a medical doctor who specializes in disorders of the ears, nose and throat (ENT), can discuss the risks and benefits with you. |
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