Hearing Loss

What Is Hearing Loss?

Hearing loss is the condition that results when any part of your ear isn’t working the way it should. It’s the third most common health problem in the U.S, and it can affect the quality of your life and relationships. About 48 million Americans have lost some hearing.

You can have three different types of hearing loss, depending on where your hearing is damaged. Your hearing loss can be:

  • Conductive if it involves your outer or middle ear
  • Sensorineural if it involves your inner ear
  • Mixed if it involves a combination of the two

Certain conditions, including age, illness, and genetics, may play a role in hearing loss. Modern life has added a host of ear-damaging elements to the list, including some medications and many sources of loud, ongoing noise.

With so many untreatable cases of hearing loss, prevention is the best way to keep hearing long-term. If you've already lost some hearing, there are ways to stay connected and communicate with friends and family.

Hearing Loss Symptoms

In many cases, hearing fades so slowly you don't notice it. You may think people are mumbling more, your spouse needs to speak up, or you need a better phone. As long as some sound still comes in, you could assume your hearing is fine. But you may become more and more cut off from the world of speech and sounds.

Doctors classify hearing loss by degrees.

  • Mild hearing loss: One-on-one conversations are fine, but it's hard to catch every word when there's background noise.
  • Moderate hearing loss: You often need to ask people to repeat themselves during conversations in person and on the phone.
  • Severe hearing loss: Following a conversation is almost impossible unless you have a hearing aid.
  • Profound hearing loss: You can't hear other people speaking unless they’re extremely loud. You can't understand what they're saying without a hearing aid or cochlear implant.

Early on, high-pitched sounds, such as children's and female voices, and the sounds "S" and "F" become harder to make out. You may also:

  • Have trouble following a conversation when more than one person speaks at once
  • Think other people are mumbling or not speaking clearly
  • Often misunderstand what others say and respond inappropriately
  • Get complaints that the TV is too loud
  • Hear ringing, roaring, or hissing sounds in your ears, known as tinnitus

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Hearing Loss Causes

Your ear has three main areas that play a part in hearing. Sound waves go through your:

  • Outer ear where they cause vibrations in your eardrum.
  • Middle ear, which gets the vibrations next. They’re boosted by three small bones.
  • Inner ear, which houses the cochlea, a snail-shaped fluid-filled structure. It has tiny hairs that change the amplified vibrations into electrical signals and send them to your brain, where you hear them as sound.

Advanced age is the most common cause of hearing loss. One out of three people between 65 and 74 has some level of hearing loss. After age 75, that goes up to one out of every two people.

Researchers don't fully understand why hearing declines with age. It could be that lifetime exposure to noise and other damaging factors slowly wears down the ears' delicate mechanics. Your genes are also part of the mix.

Noise wears down hearing if it's loud or continuous. The CDC reports that about 22 million American workers are exposed to dangerous noise levels on the job. This includes many carpenters, construction workers, soldiers, miners, factory workers, and farmers.

Musicians are also at risk for noise-induced hearing loss. Some now wear special earplugs to protect their ears when they perform. The earplugs allow them to hear music without harming their ears' inner workings.

Certain medications can impair hearing or balance. More than 200 drugs and chemicals have a track record of triggering hearing and balance side effects in addition to their disease-fighting abilities.

Sudden hearing loss, the rapid loss of 30 decibels or more of hearing ability, can happen over several hours or up to 3 days. (A normal conversation is 60 decibels.) Sudden hearing loss usually affects only one ear. Although there are up to three new cases per every 10,000 people each year, doctors are not able to discover the cause in most cases.

Illnesses such as heart disease, high blood pressure, and diabetes put ears at risk by interfering with the ears' blood supply. Otosclerosis is a bone disease of the middle ear, and Ménière's disease affects the inner ear. Both can cause hearing loss.

Trauma, especially a skull fracture or punctured eardrum, puts ears at serious risk for hearing loss.

Infection or earwax can block ear canals and lessen hearing.

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Hearing Loss Diagnosis

To figure out how much of your hearing you’ve lost, your doctor can do the following tests:

  • Physical exam to look in your ear for earwax buildup, infection, or structural problems.
  • General screening tests that involve covering one ear at a time to see how well you hear spoken words at different volumes.
  • Tuning fork tests using two-pronged metal instruments that make a sound when you tap them. Your doctor can tell how well you hear them. The test can also help pinpoint where in your ear the hearing loss is.
  • Audiometer tests where you wear earphones and listen for sounds directed into your ear. This test is done by an audiologist and can measure the level of sound you can hear more accurately than other screening tests.

There are also tablet and smartphone apps you can use on your own to screen for hearing loss.

Hearing Loss Treatments

How you’re treated depends on the type and source of your hearing loss. Prompt medical treatment for sudden hearing loss may raise your chance of recovery.

  • Surgery may reverse hearing loss caused by otosclerosis, scar tissue, or infection, while Ménière's disease is sometimes treatable with medication and a different diet.
  • A ntibiotics can often clear up hearing loss caused by infection.
  • Changing medications may help If you think your hearing loss stems from one you’re taking. Talk with your doctor about different drug options.
  • Removing ear wax with suction or a small looped tool can reverse hearing loss caused by a blockage.
  • A hearing aid helps most people with permanent hearing loss. You typically wear these tiny instruments in or behind your ear to make sounds louder. Things do sound different through a hearing aid, so talk to your doctor to set realistic goals.
  • Other sound-enhancing technologies that may improve your hearing include personal listening systems that allow you to tune in to what you want to hear and mute other sounds. TV-listening systems make it possible for you to hear the television or radio without turning up the volume. Different kinds of phone-amplifying devices as well as captioned phones that let you read what your caller is saying make conversations possible on home and mobile phones.
  • Cochlear implants are used mainly with young children, but they're becoming more popular among older adults with profound hearing loss.

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Hearing Loss Complications

Not being able to hear the world around you can affect your quality of life. It can cause feelings of depression and isolation, especially in older adults. Over time, you can start to have problems with your mental function. Studies that look at treating hearing loss show that as your hearing gets better, so does your brain function, especially your memory.

Living With Hearing Loss

For starters, set up your home so your rooms are well lit and places to sit face each other. When people talk, watch their mouths move as well as their facial expressions.

Remove sources of background noise you don’t need. For instance, turn off the TV when no one's watching it.

Let people know what they can do to help you understand them better:

  • Get your attention before they start talking.
  • Make sure you can see their lips moving.
  • Speak clearly, but don't shout.

Hearing Loss Prevention

Hearing loss is often permanent, so do what you can to protect one of your most valuable natural assets.

Wear earplugs when you're around sounds as loud or louder than traffic. Lawn mowers, power sanders, vacuums, and most concerts are all loud enough to harm unprotected ears. When possible, move away from the source of the noise. For example, cross the street or cover your ears when you walk past a loud road construction site.

If your workplace is noisy, talk to your employer about ear safety. The National Institute for Occupational Safety and Health (NIOSH) recommends that employers install barrier walls or mufflers in noisy plants to protect their workers' hearing.

Be aware that recreational activities also come with high noise levels. Things to watch out for include video arcades, fireworks displays, live music concerts, sporting events, music from your headphones, and even some children’s toys. If you know you’re going to be somewhere noisy, limit your time there and wear ear protection. As a general rule, if you have to shout to be heard 3 feet away, it’s too loud.

WebMD Medical Reference Reviewed by Brunilda Nazario, MD on September 26, 2020

Sources

SOURCES:

American Academy of Audiology: "Hearing and Hearing Loss," "Facts About Hearing Loss." 

American Speech-Language-Hearing Association: "The Prevalence and Incidence of Hearing Loss in Adults," "Causes of Hearing Loss in Adults," "Ototoxic Medications (Medication Effects)," "Adult Aural/Audiologic Rehabilitation."

National Institute on Deafness and Other Communication Disorders: "Hearing Loss and Older Adults," "Sudden Deafness," "Quick Statistics," "Presbycusis."  

National Academy on an Aging Society: "Hearing Loss: A growing problem that affects quality of life."

National Institute for Occupational Safety and Health. "Work-related Hearing Loss."

American Tinnitus Association: "How Loud is Too Loud?"

FDA: "Questions and Answers about Viagra, Levitra, Cialis, and Revatio: Possible Sudden Hearing Loss."

American Academy of Otolaryngology-Head and Neck Surgery: "Hearing Loss."

University of California, San Francisco Medical Center: "Hearing Loss."

UpToDate: "Meniere disease."

Hearing Loss Association of America: "Basic Facts About Hearing Loss."

CDC: “Types of Hearing Loss.”

Mayo Clinic: “Hearing Loss.”

Center for Hearing and Communication: “Recreational noise levels facts.”

 

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