A Complete Guide to Hearing Loss

Hearing Loss

Hearing loss refers to a partial or complete inability to hear sound. People experience hearing loss when a part of the ear or auditory system is not functioning properly. If you suffer from hearing loss you might struggle to track what people are saying, and you may find it difficult to keep up or participate in the conversation. This disability can affect your social life, work environment, and mental health as well. 

A gradual loss of hearing is common as you grow older. This hearing loss as you age is referred to as presbycusis. But hearing loss can affect anyone. It is the most common sensory processing disorder affecting thousands of people all around the world. According to WHO, it is estimated that by 2050 one in four people globally will have some form of hearing loss. It’s much more common in older adults, usually after the age of 65. Having said that, hearing loss also affects children; some infants are even born with a congenital form of hearing loss. 

There are different types of hearing loss which are treated in different ways, like hearing aids and surgery. A complete guide for hearing loss, including its causes, symptoms, treatments, and prevention, is given below!

Types of Hearing Loss

Hearing Loss Doesn’t Always Affects Both Ears

Unilateral hearing loss is hearing deficit in only one ear, whereas bilateral hearing loss affects both ears. People with unilateral hearing loss may find it difficult to carry on the conversation in a noisy environment, as it can be more difficult to pinpoint the source of the sound when only one ear is working properly. Contrarily, when there is no or little background noise, the same individuals often exhibit the same communicative abilities as a person with normal hearing. People with bilateral hearing loss, however, have difficulty hearing sound in any environment. They communicate with either sign language or hearing assistive devices. 

Before we delve into the types of hearing loss based on cause, it’s important that you have some basic knowhow of how sound energy is perceived by the body. When you hear anything, your body has actually just processed vibrations which have traveled into your ear from a sound source. Sound vibrations travel through the air into the ear canal and then hit the eardrum in the outer ear, causing it to vibrate - rather like an actual drum. The eardrum is connected to a series of bones, which lie in the middle ear, onto which the drum passes its vibrations. The last of these bones, the incus, is connected to a fluid medium in the inner ear; The sound vibrations are passed onto this fluid, and eventually hit a sensory organ, which stimulates a bunch of nerves that then carry signals to the brain. The brain then interprets the signals, and perceives sound. The parts of this system which carry vibrations are the conducting parts; they carry sound energy. However, the sound receptors (like the hairs in the inner ear), nerves, and the brain, which are all stimulated and don’t carry actual vibrations, constitute the sensory part. Now let’s take a look at the different types of hearing loss, based on which parts of this intricate hearing system are damaged.

Conductive Hearing Loss:

Conductive hearing loss occurs due to problems in the structures of the outer and middle parts of the ear. It is basically due to some impeding factor, which is stopping the efficient transmission of sound vibrations along the hearing apparatus of the ear. This may be ear wax, ear infection, fluid, or obstruction in the ear by outer objects such as cotton tips. Conductive hearing loss mainly causes the volume of sounds to seem lower. In this type of hearing loss, loud sounds feel muffled and soft sounds become difficult to hear. Conductive hearing loss is not permanent and can be prevented by taking good care of your ears and protecting them from excessive noise exposure. Conductive hearing loss can be treated by clearing excessive wax or fluids or surgically inserted devices to help sound waves reach the inner ear. Even wearing hearing aids can restore your hearing as much as possible.

Sensorineural Hearing Loss:

Sensorineural hearing loss occurs due to dysfunction of the inner ear, cochlea, or auditory nerve. This condition usually happens when the air cells in the cochlea are damaged. As humans grow these hair cells tend to lose some of their functions, so your hearing deteriorates as you age. Damaged hair cells cannot be replaced which is why sensorineural hearing loss is usually permanent. This type of hearing loss makes sounds muffled and unclear even loud noises. Sensorineural hearing loss can result from birth defects, exposure to loud noises, head trauma, etc Sensorineural hearing loss is not a life-threatening condition but it interferes with your ability to communicate properly. Hearing aids and hearing assistive devices help by amplifying sounds so you can hear better.

Sensorineural hearing loss and conductive hearing loss.

Mixed Hearing Loss:

People who have symptoms of both conductive and sensorineural hearing loss are said to have mixed hearing loss. This condition usually happens when there is blockage or damage to the outer ear, middle ear, or inner ear. Head injury or infection may cause mixed hearing loss. To treat mixed hearing loss, you need treatments for both types of hearing loss. 

High-Frequency Hearing Loss

High-Frequency Hearing Loss is another type of hearing Loss. When the hair-like structures in the inner ear are damaged then this type of hearing loss occurs. High-frequency hearing loss causes issues with hearing high-pitched sounds and people have difficulty hearing sounds such as doorbells, phone beeps, birds and animal sounds, etc. Exposure to loud sounds is a common cause of ear damage. People might have difficulty discriminating between sounds when there is background noise. High-frequency hearing loss is usually permanent and it is usually treated by using hearing aids that target high-frequency sounds. You can prevent high-frequency hearing loss by avoiding sounds with high pitch or frequency. 

Levels of Deafness:

There are four levels of hearing loss. 

Mild Hearing Impairment:

People with mild hearing loss can detect sounds between 25 to 29 decibels. With mild hearing loss, people have trouble hearing quiet conversations especially when there is background noise. 

Moderate Hearing Impairment:

People with moderate hearing loss can detect sounds between 40 to 69 dB. Without hearing aids it is difficult for them to understand and follow a conversation. Understanding speech requires a higher volume level. 

Severe Hearing Impairment:

A person with severe hearing impairment hears sounds above 70 to 89 dB. People with hearing loss at this threshold can hear only loud speech or noise. The right hearing aids are necessary for them to be able to communicate. And they might have more difficulty engaging in a group conversation.

Profound Hearing Impairment:

People with profound hearing loss cannot hear sounds below 90 dB. Some people with profound hearing impairment cannot hear anything at all. Most patients rely on lip reading or sign language to communicate with others. 

Symptoms of Hearing Loss:

Symptoms of hearing loss depend a lot on the cause of hearing loss. Hearing loss often happens gradually and you don’t even notice you are losing your hearing. People with hearing loss might;

• Have Difficulty understanding everyday conversation
• Ask others to repeat what they are saying 
• Not be able to follow a conversation properly
• Not be able to hear certain high-pitched sounds like birds singing
• Turn the volume of the tv or radio up often
• Experience pain, fluid sensation, pressure, or ringing inside the ear
• Feel frequent dizziness
• Experience headache, numbness, or weakness
• Feel muffling of speech and other sounds
• Have difficulty understanding words
• Start to avoid social settings
• Feel a sense of exhaustion 

Causes of Hearing Loss:

The following are the factors that increase the risk of developing hearing loss.

Aging:

Aging is one of the most common causes of hearing loss. As people get older their senses start to deteriorate. Hearing loss due to age is usually found in people above 60 years of age.

Genetics:

Your genetic makeup can increase your chance of getting hearing loss. If hearing loss runs in your family you are at more risk of developing hearing loss. Some children are born without being able to hear, due to gene mutations. 

Loud noises:

Excessive exposure to loud noises can seriously affect your hearing ability. Damage to the inner ear can occur from long-term exposure to loud sounds, or even from a sudden short blast of noise such as a gunshot. 

Occupational noise:

If your occupation involves exposure to constant loud noise, such as in the army, mining, railway work or construction, you are at more risk of developing hearing loss than people who don't have such an occupation.

Occupation noises as a major cause of hearing loss.

Illnesses:

Certain illnesses can also be a cause of hearing loss. Such as head trauma, brain hemorrhage, Meniere's disease, osteosclerosis, or autoimmune diseases.

Medications: 

Certain medications, which are used for chemotherapy and other life saving treatments, can also be a cause of temporary or permanent damage to the ears. These drugs are labeled ototoxic; some of them can cause vestibulotoxicity too, which additionally affects one’s sense of position and balance. High doses of aspirin, painkillers, and antimalarial drugs can be ototoxic, which often symptomatically presents as tinnitus in the ear.

Recreational noises:

Exposure to explosive noises, such as those generated by firearms and jet engines, can result in immediate hearing loss. Recreational activities like snowmobiling and motorcycling produce dangerously high noise levels which can be detrimental to the ears. 

Earwax buildup:  

The gradual build-up of earwax can temporarily affect how well your ears conduct sounds. Earwax blocks the ear canal and also prevents the conduction of sound waves. Earwax removal can help restore your hearing in this case. 

Hearing Loss Prevention:

You cannot prevent hearing loss that occurs from birth or an illness or accident. There are however some measures that when taken care of reduce the risk of doing more damage to your hearing.

• One of the most common causes of hearing loss and which is highly preventable is noise exposure. You can try to limit your exposure to loud events and environments such as concerts. If you are suffering from some sort of hearing loss, try to prevent it from getting worse by avoiding excessive noise exposure.

• Try keeping the volume on your smart devices low especially while wearing headphones. When you are wearing headphones try to block out the environmental sounds and focus on the sounds you want to hear instead of trying to drown them with high volume.

• Make a habit of using hearing protection devices such as earplugs, earmuffs, or noise-cancellation headphones. These devices cover your ears and provide protection against lighter levels of noise.

• Wearing hearing aids is another option. They amplify the sound waves so that speech understanding and hearing can be improved. People with hearing loss are constantly putting stress on the brain trying to hear and understand the sounds. With hearing aids, this struggle lessens. 

Hearing Loss Diagnosis:

Hearing loss is a gradual process and many people don’t realize it until it really starts affecting their communication. The earlier you are able to detect you are having issues hearing, the better it is to get diagnosed and look into treatments. The moment you feel it's difficult to hear, you should be taking a hearing test. 

There are different tests that doctors or audiologists perform to diagnose the type and degree of hearing loss. Some doctors will ask a series of questions about your hearing and difficulties understanding what they are dealing with. Doctors primarily do a physical test by inspecting the ear to see what’s causing hearing loss. They examine your ear canal and eardrum using an instrument called an otoscope. There is a tuning fork test where the doctor strikes a fork near your ear in different frequencies to see how well you can hear. This can also reveal the part of your ear there may be an issue with. An audiologist might test your hearing with an audiometer which detects how hard of hearing you might be; or by asking you to listen and repeat words, so that speech comprehension can also be tested. Another test for hearing loss is an audiometer test where the patient wears headphones and sounds are directed into one ear at a time. The patient has to signal every time a sound is heard. This way audiologist checks where and at what frequency the hearing agility stops. The doctor also tests to see the reason behind hearing loss like infection, illness, etc. If there seems a possibility of injury or tumor CT scan or MRI might be suggested.

Nowadays online hearing tests on smartphones are also available. They are simple, painless, cost-effective, and widely available for everyone. Online Hearing Tests are also available in apps which you can install on your Android or iPhone. Such apps give you the ability to conduct hearing tests yourself at home. Although consulting a doctor is no doubt a professional way to go, using apps to test your hearing is also reasonable in these global times. It's more cost-effective than visiting the doctors. With a doctor's checkup, you have to go for follow-up appointments. A hearing test app however is free for anyone to use. With an audiologist, it may sometimes happen that even after getting your hearing tests done you are still not comfortable so you have to visit again which gets time-consuming and costly. You can test your hearing through the app at any time and as many times as you want.  With the app, you can also test your hearing in a comfortable environment of your own home. Hear+Hi offers our “My Hearing Acuity” App available from Google or Apple APP store. Once you download the app you can take the test as many times as you want and record your progress as well. The app provides with similar results as the doctor’s.

Once the diagnosis or tests are done you can see what treatments suit your needs the best. 

Hearing Loss Treatments 

Hearing loss treatment depends on the type and degree of your hearing loss. For example, in the case of sensorineural hearing loss, when the hair cells are damaged they cannot be repaired. Some options available for the treatment of hearing loss are described below.

Ear Wax Removal:

Some people may experience temporary loss of hearing due to earwax which causes a blockage in the ear canal. It's a good idea to get the earwax removed by a specialist to make yourself hear better.

Hearing Assisting Devices:

Technology has created assistive hearing devices to help people with hearing loss to make their life a little easier. There are amplified telephones for listening which have different features such as Bluetooth, amplifier, etc. to help people with hearing loss hear better. There are alarm clocks available that provide an extra loud alarm combined with a bed shaker to help hearing loss patients. Another useful device for hearing loss people is certain types of doorbells and chimes. Wireless door chime uses bright light that flashes anytime the bell rings and it alerts you about the arrival of the visitor. 

Hearing Aids:

Hearing aids or cochlear implants are the foremost devices that people use to improve their hearing. Hearing aids are of different types and depending on the extent of your hearing loss different hearing aids options are available for everyone to choose from.

Hearing aids; Hearing Loss Best Treatment

Hearing aids are devices worn in or behind the ear. The hearing aids amplify the sound signals so hearing aid wearers can hear the sounds better. For inner ear hearing loss, Cochlear implants are surgically implanted into the inner ear to help improve speech comprehension.  Amplification of sounds may be a solution for conductive hearing loss depending on the status of the hearing nerve. Hearing aids do not cure deafness or hearing loss; they just amplify the sounds so the person can hear better. Hearing aids are not suitable for people with profound hearing impairment.

Medications:

Moderate to severe hearing loss cannot be treated by medications but the mild hearing loss might improve by antibiotics. Antibiotics or antifungal medicines treat chronic ear infections or chronic middle fluid. Corticosteroids can be used to reduce hair cell swelling and inflammation after your ear has been exposed to loud noise. 

Surgery:

Surgical intervention can restore hearing to a certain extent but it's not always effective. Various surgeries might be required to help people improve their quality of life. Surgery might be needed to place ear tubes in the ear drum which treats chronic middle ear infections. Surgeries are also performed to remove tumors or repair birth defects. For inner ear fluid compartment rupture or leakage, which can be toxic to the inner ear, there has been variable success with emergency surgery.

Effects of Untreated Hearing Loss: 

Healing loss seems to have far-reaching implications for the patients and their loved ones as well. Untreated hearing loss impacts people’s quality of life and their mental state negatively. People with hearing loss often feel disconnected from the world. They feel angry, depressed, frustrated, anxious, and irritated about not being able to understand others. Hearing loss may cause auditory deprivation in people, which is under-stimulation of the brain. Medically, people suffering from hearing loss are also prone to other health issues. Hearing loss is often associated with cognitive impairment and decline as well. 

If you have a loved one suffering from hearing loss, help them in any way you can. Treating hearing loss may restore your self-confidence and in turn your social life. Treating hearing loss can also have a positive impact on your physical and cognitive health as well. 

Conclusion 

It can feel frustrating and depressing to be missing out on life having hearing loss. It's a lot more common than you believe. It can be said that certain types of hearing loss can be treated to regain all or most of your hearing. It's important to get a proper diagnosis if you are dealing with hearing loss. The quicker you receive treatment, the more likely you are to minimize the damage to your ear and maximize your quality of life. Don't be embarrassed if you are suffering from hearing loss. Ask for help and it will be provided to you. 

FAQs

What Is The Difference Between Hearing Loss And Deafness?

A person who has hearing loss is still able to listen to some sounds to somewhat participate in conversations. They can improve their hearing through hearing aids. They have a reduced ability to hear sounds.  But people who are deaf can hear very little or almost nothing. Hearing aids and devices don't help a lot in the case of deafness. Even when the sound is amplified, they cannot comprehend speech by hearing.

What Diet And Food Should Be Followed To Prevent Hearing Loss?

Doctors recommend eating magnesium-rich foods to keep ears healthy and help prevent hearing loss. Some foods which are high in magnesium are dark chocolate, bananas, potatoes, seeds such as pumpkin and flex, nuts like almonds, cashews, avocados, kale, salmon, legumes, and spinach. Having a overall healthy diet helps keeping you ears healthy as well.

Can Hearing Loss Be Reversed?

Fully restoring or reversing your hearing loss is possible in very limited and rare cases. Sudden hearing loss that might occur or difficulty in hearing due to earwax buildup is usually reversible and can restore your hearing. Otherwise once the auditory nerve is damaged cannot be prepared. Hearing aids and other treatments may help improve your overall hearing and understanding of speech. 

How Common Is Hearing Loss?

Hearing loss is more common than you might have thought. Roughly one in eight people in the United States and more than 1.5 billion people around the globe live with some form or degree of hearing loss. According to a new study, this amount is expected to nearly double in the coming decade.