Hearing loss is a decreased ability to hear. There are 2 types of hearing loss, conductive and sensorineural. The type of hearing loss depends on the cause.
Anatomy of the Ear
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Conductive hearing loss is caused by the interference or inability of sound to travel along the pathway from the outer to the middle or inner ear.
Sensorineural hearing loss is caused by damage to:
The cochlea—the major organ in the ear responsible for hearingThe 8th cranial nerve—the major nerve pathway and/or area of the brain responsible for hearing
Hearing loss can be the result of genetics, aging, infection, blockage, disease, or injury. In many cases, the cause of sensorineural hearing loss is unknown.
Hearing loss is more common in older adults. Factors that may increase your chance of hearing loss include:
Problems that affect the ear, such as: Impacted earwaxRecurrent or poorly treated
ear infectionsPerforated eardrumFluid in the middle ear
Inner ear disorders, such as
Meniere’s disease or labyrinthitis
Changes the bone structure of the ear—otosclerosisBirth defects affecting the structure of the earTumors
Other factors, such as: Family history or certain genetic disordersOccupational or environmental exposure to excessive noiseCardiovascular diseases that affect blood flow to the ear and brainCertain medications, such as loop diuretics, nonsteroidal anti-inflammatory drugs (NSAIDs), or antibioticsHistory of infections, such as mycoplasma or meningitisStrokeTrauma
Previous brain or ear surgeryNeurological disorders, such as migraine headaches or multiple sclerosisAutoimmune disorders, such as systemic lupus erythematosus or Cogan syndrome (rare)Not receiving all recommended immunizationsObesity
Hearing loss may cause a decreased ability to hear: Higher pitched soundsLower pitched soundsAll soundsSpeech when there is background noise
Hearing loss may also cause:
The sensation of spinning when standing still—vertigoRinging or other sounds in the ears—tinnitusProblems with balanceIn children, hearing loss may cause difficulty learning to speak.
Call your doctor if you notice hearing loss. You should especially call if you also have: Ear painVertigoTinnitusProblems with speech or balanceSensitivity to sound
You will be asked about your symptoms and medical history. A physical exam will be done.
A complete evaluation of the ears will be done. Tests may include: Weber test or Rinne test—To help distinguish conductive from sensorineural hearing lossAudiometric tests—A direct test of hearingTympanometry—This test measures the pressure in the middle ear and examines the middle ear's response to pressure wavesElectrocochleography—This tests the function of the cochlea and the auditory nerve.
Images may be taken of your ears and surrounding structures. This can be done with: CT scanMRI scan
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 options include:
Non-surgical treatment options are not invasive and may help improve your hearing. These include: Earwax removalModifying any dietary deficienciesHearing aidsAssisted listening devices that enhance the abilities of your hearing aid or cochlear implant to make sounds clearer and easier to hear
Oral or injected corticosteroids may be used to help treat certain types of hearing loss. They are used to: Decrease inflammation and promote fluid drainageSuppress the effects of the immune system
If medications are suspected as a cause of hearing loss, your doctor will alter your prescriptions to see if hearing improves.
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.
It is common to feel isolated and removed in social situations. This can lead to feelings of depression or social anxiety. Part of managing hearing loss may include counseling or a support group.
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. Procedures may include: Stapedectomy—The stapes bone is removed or drilled, and replaced with a prosthetic.Tympanoplasty—Repair of a ruptured eardrum or the correction of a defect of the middle ear bones.Myringotomy—Incision of the eardrum to allow entrapped fluid to drain. Tubes may be placed in the ear to promote continuous drainage.
directly stimulates part of the brain and uses a tiny computer microprocessor to sort out incoming sound.
It can be for certain types of hearing loss that affect the inner ear.
To help reduce the chance of hearing loss:
If you smoke, talk with your doctor about the best ways to
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.
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Last reviewed August 2015 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.
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