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Hearing loss is a decreased ability to hear.
There are two main categories of hearing loss:
- Conductive hearing loss is caused by something interfering with the sound passing to the inner ear
Sensorineural hearing loss is caused by damage to:
- The cochlea—the major organ in the ear responsible for hearing
- The 8th cranial nerve—the major nerve pathway and/or area of the brain responsible for hearing
Causes of conductive hearing loss may include:
- Impacted ear wax
- Fluid in the middle ear
- Ear infections
- Perforation of ear drum
- Changes the bone structure of the ear, a condition called otosclerosis
- Congenital anomaly causing complete closure of the ear canal
Causes of sensorineural hearing loss is unknown in most people. Some causes may include:
- Otosclerosis affecting the inner ear
- Vascular disease that affects blood flow to the ear
- Previous brain, ear surgery, or viral infection causing damage to the inner ear
Hearing loss is more common in older adults.
Factors that may increase your risk of hearing loss include:
- Family history
- Exposure to excess noise
- Exposure to medications, such as antibiotics, diuretics, or heart medications:
- Having certain health conditions, such as
- Not receiving all recommended immunizations
Hearing loss may cause a decreased ability to hear:
- Higher pitched sounds
- Lower pitched sounds
- All sounds
- Speech when there is background noise
Hearing loss may also cause:
- The sensation of spinning when you are not — vertigo
- Ringing sounds in the ears
- Problems with balance
- In children, hearing loss may cause difficulty learning to speak.
When Should I Call My Doctor?
Call your doctor if you notice hearing loss. You should especially call if you also have:
- Ear pain
- Ringing or other sounds in your ear
- Problems with speech or balance
- Sensitivity to sound
If you think you have an emergency, call for emergency medical services right away.
You will be asked about your symptoms and medical history. A physical exam will be done.
You may have ear tests done. These may include:
- Weber test or Rinne test—To help distinguish conductive from sensorineural hearing loss
- Audiometric tests —A direct test of hearing
- Tympanometry—This test measures the pressure in the middle ear and examines the middle ear's response to pressure waves
- Electrocochleography—This tests the function of the cochlea and the auditory nerve.
Images may be taken of your ears. This can be done with:
The electrical response of your brain to sound may be tested. This can be done with brain stem auditory evoked response testing.
When hearing loss is caused by other medical conditions, it may be possible to improve hearing by treating those conditions. Other treatment includes:
Non-surgical treatment options are not invasive and may help improve your hearing. Options include:
- Earwax removal
- Changing or stopping medications that affect your hearing
- Modifying any dietary deficiencies
- Hearing aids
- Assisted listening devices that enhance the abilities of your hearing aid or cochlear implant to make sounds clearer and easier to hear
Surgery may be done in some cases of conductive hearing loss to correct the middle ear problem, such as in otosclerosis , ossicular damage or fixation, and ear infections.
A cochlear implant directly stimulates part of the brain and uses a tiny computer microprocessor to sort out incoming sound.
If you have hearing loss, some changes may help you maximize your ability to hear. Follow these guidelines when talking to other people:
- Face the person that you are talking to. This will allow you to see their facial expressions and watch their lips move.
- Ask other people to speak loudly and more clearly.
- Turn off background noise, such as the TV or radio.
- In public places, choose a place to sit that is away from noise.
- Work with a special trainer to learn how to lip read. Lip reading involves paying close attention to how a person’s mouth and body are moving when they talk.
To help prevent hearing loss, take these steps:
- If you smoke, talk with your doctor about the best ways to quit .
- Adequately treat ear infections.
- Get all appropriate immunizations.
- Treat all medical conditions as directed by your doctor.
- Avoid exposure to excess noise.
- Use adequate ear protection when using noisy equipment.
Last reviewed August 2014 by Michael Woods, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.