Hearing Loss

Hearing loss is when you can’t hear sound as well as people with normal hearing. It’s a common condition that can affect people of all ages. It happens when something prevents sound from traveling through your hearing system. You can have hearing loss in one or both ears.

Hearing loss types

The three main types of hearing loss are:

• Sensorineural hearing loss: Damage to your inner ear keeps the hearing nerve from sending a full sound signal to your brain. This is the most common type of hearing loss.
• Conductive hearing loss: Something in your outer or middle ear keeps a full sound signal from passing on to the inner ear. An ear infection is an example of something that can cause this type of hearing loss.
• Mixed: This happens when you have issues in both your middle ear and inner ear. With mixed hearing loss, sound doesn’t fully reach your inner ear. At the same time, your inner ear can’t send signals to your brain.

Hearing loss may be mild, moderate, severe or profound (deafness). It can be temporary or permanent. Treatment can’t reverse permanent hearing loss. But devices like hearing aids and cochlear implants may improve your hearing.

Symptoms of hearing loss

Anyone can have hearing loss, from babies to people age 65 and older. Babies and young children may have different symptoms than adults.

Babies with hearing loss may seem to hear some sounds but not others. They may:

• Not startle or react to loud noises
• Not turn to the source of a sound after 6 months of age
• Not say single words, like “mama” or “dada,” by the time they turn 1
• Not react when someone says their name

Older children may:

• Have unclear speech
• Seem to ignore others when they speak
• Not follow directions
• Learn to speak later than other children their age

Hearing loss symptoms in adults include:

• Asking people to repeat what they say
• Trouble understanding conversation while in noisy places
• Turning up the volume on devices that carry sound, like earbuds, car speakers, TVs, computers or tablets
• Ringing in the ears
• Pressure or pain in the ears
• Balance issues or dizziness

What usually causes hearing loss?

Hearing loss most often happens when something damages your inner ear or the hearing nerve in your inner ear. This is called sensorineural hearing loss.

Aging and exposure to loud sounds are the most common causes. Others include:

• Certain inherited disorders
• Health issues, like diabetes, heart disease, high blood pressure, and some bacterial or viral infections
• Injury
• Reaction to certain medications
• Smoking

With conductive hearing loss, sound can’t fully reach your inner ear. Earwax buildup and middle ear infections are the most common causes. Other causes include:

• Congenital conditions (conditions present at birth) that affect how babies’ middle or outer ears are formed
• Ear tumors
• Foreign objects in your ear
• Fluids in your ear from allergies, a cold or eustachian tube issues
• Ruptured eardrums
• Swimmer’s ear

With mixed hearing loss, different issues affect both your inner ear and middle ear.

Your risk of hearing loss may be higher if close biological family members have an inherited form of it. But most cases of hearing loss aren’t hereditary.

What are the complications of hearing loss?

Hearing loss may:

• Affect language development in children
• Be a risk factor for dementia or falls
• Lead to depression and anxiety

How is hearing loss diagnosed?

Your healthcare provider will ask about your symptoms and do a physical exam, with a special focus on your ears. They may do a CT scan or MRI if you injured your ear or to check for a tumor.

Your provider may recommend that you see an audiologist (hearing specialist) for hearing tests, including:

• Comprehensive audiogram: This is a series of tests that look at your ability to hear sounds and words and check for possible hearing loss.
• Tympanometry: This test checks the function of your eardrum and middle ear.
• Electrophysiology tests: These tests measure the function of your inner ear and the neural pathway to your brain. Audiologists use this testing with babies and sometimes with adults who are unable to participate in routine hearing tests.

Are hearing tests different for babies and children?

Babies and young children up to age 5 may have behavioral hearing tests. The tests check hearing by evaluating how your child physically reacts to sound.

Hearing loss stages

Audiologists classify hearing loss by degree of loss. This is how loud sounds need to be for you to hear them. According to the American Speech-Language-Hearing Association, the degrees of loss are:

• Normal
• Slight
• Mild
• Moderate
• Moderately severe
• Severe
• Profound

What are hearing loss treatments?

Your audiologist will recommend the treatment that’s right for you. Some treatment options are:

• Hearing aids
• Assistive listening devices
• Hearing implants, like cochlear implants, bone-anchored implants and auditory brainstem implants

Auditory verbal therapy may also be recommended to help you make sense of the sound you’re hearing with your hearing devices.

What can I expect if I have hearing loss?

Some hearing loss is temporary, like when it’s from a cold, swimmer’s ear or something stuck in your ear. But hearing loss from inner ear damage is permanent. Hearing aids and cochlear implants may improve hearing, but they can’t reverse hearing loss.

How do I manage hearing loss?

Communication techniques, along with treatments like hearing aids or cochlear implants, can help you manage hearing loss. It’s important to tell people about your hearing loss and how it affects you. These communication techniques may help:

• Ask people to look at you as they speak.
• Stand or sit within six feet of the person you’re speaking with.
• Pick quiet spots for conversation.
• Watch body language and facial expressions for cues.
• Ask others to reword their statement when you miss a word or a sentence.