What is hearing loss?
Hearing loss can make it difficult to understand, follow or participate in conversations. You may struggle to track what people are saying on TV or the telephone, and you may miss out on the pleasant sounds of nature. Significant hearing loss can affect your ability to work and enjoy life.
How common is hearing loss?
More than 1 in 10 Americans have some degree of hearing loss. It’s the most common sensory processing disorder. These disorders affect how your brain processes information from senses, such as hearing, vision, taste and touch.
Who might have hearing loss?
Hearing loss affects all ages, genders, races and ethnicities. Hearing loss in older adults is common, affecting 1 in 3 people older than 65, and half of people over 75. Age-related hearing loss is called presbycusis.
Hearing loss also affects infants and children. An estimated 2 in 1,000 infants are born with some type of hearing loss. Hearing loss in children is one of the most common birth defects. A condition that is present at birth is called a congenital condition.
What are the types of hearing loss?
You can have hearing loss in one ear (unilateral) or both (bilateral). The type depends on where damage occurs within the hearing system.
Types of hearing loss include:
- Conductive: Something blocks sound from passing through the outer ear (ear canal) or middle ear (area containing the three tiny ear bones: malleolus, incus and stapes). The block may be an ear infection, earwax or fluid in the ear. Loud noises may sound muffled, and soft sounds can be hard to hear. Medicine or surgery often helps.
- Sensorineural: Hearing loss affects the inner ear (cochlea) or auditory nerve. Loud noises, diseases or the aging process often cause it. Children are prone to this type due to congenital conditions (present at birth), trauma during childbirth, head injuries or infections. Sensorineural hearing loss is often permanent. Hearing aids and hearing assistive devices can help.
- Mixed: Some people have both conductive and sensorineural hearing loss. A head injury, infection or inherited condition can cause mixed hearing loss. You may need treatments for both types of hearing loss.
What’s the difference between hearing loss and deafness?
A person with hearing loss can still hear sounds well enough to participate in conversations. They can improve their hearing ability through hearing aids or other treatments.
Someone who is deaf can hear very little or nothing at all. Hearing aids and devices don’t help. A person who is deaf may use sign language to communicate.
Symptoms and Causes
What causes hearing loss?
Loud noises frequently cause hearing loss. Sometimes this exposure is sudden and short-term. Attending a loud concert or being close to a gun blast can damage hearing.
Long-term noise exposure affects many professions. Farmers, construction workers, musicians and military members are most at risk. Occupational hearing loss is a top work-related illness in the U.S.
Other risk factors that raise your likelihood of hearing loss include:
- Congenital conditions such as cytomegalovirus (CMV).
- Coronary artery disease (heart disease), high blood pressure (hypertension) and strokes.
- Damage or trauma from an accident or injury — even something as simple as inserting a cotton swab too far into the ear.
- Ear infections, earwax buildup or ruptured eardrum.
- Exposure to chemicals.
- Family history of hearing loss.
- Medications to treat cancer, heart disease and infections.
- Tumors (acoustic neuroma).
What are the symptoms of hearing loss?
Hearing loss can happen gradually. You might not even notice you’re losing your hearing.
Most people don’t have any pain with hearing loss. Instead, you might notice you:
- Ask people to repeat themselves often.
- Can’t follow a conversation (especially on the telephone or at a restaurant) or think other people mumble.
- Can’t hear certain high-pitched sounds, like birds singing.
- Need to turn up the volume on the TV or radio.
- Experience ringing in the ears (tinnitus), pain (earache), a fluid sensation or pressure inside the ear.
- Have balance problems or dizziness.
Signs of hearing loss in children include:
- Not startling at loud noises.
- Not turning toward sounds or when you say the child’s name (after a child is 6 months of age).
- Responding to some but not all sounds.
- Saying “huh?” a lot.
- Speech delays, such as not saying “dada” or “mama” by age 1.
Diagnosis and Tests
What healthcare providers diagnose and treat hearing loss?
If you suspect hearing loss, you may see an:
- Audiologist: These specialists conduct hearing exams and hearing needs assessments to discuss your unique listening and communication needs. They help with determining the appropriate hearing devices, which often include hearing aids, in addition to other types of hearing device technology (cochlear implants and osseointegrated implants). Most audiologists have doctorates in audiology (Au.D.). Audiologists are not medical doctors.
- Hearing aid specialist: These specialists pass a state exam and receive state licenses to conduct hearing tests. They can fit you for hearing aids.
- Otolaryngologist: These medical doctors are also known as ear, nose and throat (ENT) specialists. They prescribe medications and perform surgeries to treat ear problems and hearing loss.
Audiologists or hearing aid specialists often work with otolaryngologists. As a team, they can address all your hearing issues to help improve your hearing.
How is hearing loss diagnosed?
Your provider will ask about your symptoms and do a physical exam. They check for signs of infection or other issues that could cause hearing loss.
To measure hearing loss, a healthcare provider performs an audiogram. This hearing test measures which types of sounds you can hear. The test measures:
- Configuration: How well you hear high-pitched and low-pitched sounds.
- Degree: Measured in terms of normal, slight to severe or profound hearing loss.
- Type: Constructive, sensorineural or mixed.
If you have an injury or a possible tumor, you may get a CT scan or MRI.
Management and Treatment
What are the complications of hearing loss?
Having hearing loss can make you feel disconnected from the world around you. You may become frustrated, irritable or angry. People with severe hearing loss can become anxious or depressed. Children with hearing loss may struggle in school and get poor grades. Studies also show a link between hearing loss in older adults and dementia.
How is hearing loss managed or treated?
Hearing loss treatments often depend on the type and degree of hearing loss. Treatments include:
- Hearing assist devices: These devices help restore hearing. Hearing aids are devices worn on or inside the ear to amplify sound. Healthcare providers surgically implant cochlear implants into the inner ear to treat inner ear hearing loss.
- Hearing rehabilitation: Also called audiologic rehabilitation, this therapy helps you adjust to hearing loss and hearing aids. A therapist also can help you learn to use visual cues and lip reading to improve communication.
- Listening devices: Devices can make it easier to hear the telephone, television or videos on your computer.
- Medications: Hearing loss caused by ear infections may improve with antibiotics. Corticosteroids can ease the swelling of cochlear hair cells after exposure to loud noise. If medications are causing your hearing loss, your provider may prescribe a different drug.
- Surgery: Your provider may place ear tubes in the eardrum. Ear tubes treat chronic middle ear infections that contribute to hearing loss. Providers also perform surgeries to remove tumors, repair birth defects and place cochlear implants.
Does insurance cover the cost of hearing aids?
Medical insurance may provide coverage for hearing devices — check your plan for specific coverage.
How can I prevent hearing loss?
Noise exposure is one of the most common and preventable causes of hearing loss. To help prevent noise-induced hearing loss:
- Limit your exposure to loud events and environments.
- Wear sound-reducing earplugs (inside the ears) or earmuffs (outside the ears).
- Lower the volume (if possible) on power tools, electronic devices, earbuds and toys.
Outlook / Prognosis
What is the prognosis (outlook) for people who have hearing loss?
Certain types and causes of hearing loss are treatable. You may regain most, or all, hearing with treatment. Sensorineural and age-related hearing loss is usually permanent. Most people with this type of hearing loss benefit from hearing aids.
When should I call the doctor?
You should call your healthcare provider if you have hearing loss or you experience:
- Balance problems.
- Chronic ringing in ears (tinnitus).
- Severe earache.
- Sudden hearing loss or deafness.
A note from Cleveland Clinic
It can be frustrating and depressing to go through life missing out on conversations or hearing muffled sounds. Hearing loss affects a lot of people. You shouldn’t be embarrassed to seek out help. Today’s hearing devices are smaller and very discreet. Your healthcare provider can determine the best way to improve your hearing so you can be in tune with the sounds around you again.
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