Hearing loss is a common condition, affecting millions of people worldwide every year. Many believe it is only an issue for older people, but that isn't true.
Difficulty hearing can affect anyone at any age.
While it is true that the most common cause of hearing loss is age-related, other factors such as disease, heredity, and environmental factors can also contribute to hearing loss.
Hearing loss can vary in degree and severity and have many causes — aging and chronic exposure to loud sounds being common.
What Is Hearing Loss?
In simple terms, hearing loss is a condition that results when your auditory system isn’t functioning as it should. It is an extremely common condition that affects about 15 percent of adults in the United States — roughly 37.5 million people.
According to the National Institute on Deafness and Other Communication Disorders, age is among the strongest predictors of hearing loss among adults aged 20 to 69 — often referred to as age-related hearing loss.
Hearing loss is also an issue worldwide.
The World Health Organization projects that by 2050 nearly two and a half billion people will be living with some degree of hearing loss.
Hearing loss is much more prevalent than most people might imagine.
But hearing loss also varies by degrees, ranging from mild trouble hearing to severe hearing loss.
A person may struggle to participate in a conversation or have issues hearing the telephone or TV. Depending on the severity of the hearing loss, it can make work and daily life much more difficult.
What Is the Difference Between Hearing Loss and Deafness?
It is important to point out that hearing loss is not synonymous with deafness, which is the complete loss of hearing.
A person experiencing hearing loss can typically hear sounds, though in varying degrees.
A person who is deaf cannot hear sounds at all (or very little) and typically communicates through sign language.
A Brief Look at the Auditory System
Hearing loss directly results from a disruption in the auditory system or parts of the ear.
While our auditory systems comprise numerous parts working together, the most integral parts of the ear are the outer, middle, and inner ear.
Each part plays an important role in converting sound waves into signals that eventually make their way to the brain to be processed.
The outer ear is the visible part of the ear we see; it gathers sound waves and directs them into our ear canals. It is made up of two main parts:
- The pinna, the cup-shaped visible part
- The ear canal that ends at the eardrum
The middle ear is an air-filled cavity and houses the eardrum and a chain of three small bones (malleus, incus, and stapes) known as the ossicles that send vibration to the inner ear.
The inner ear is made up of interconnected, fluid-filled chambers that receive sound vibrations from the middle ear and send them as electrical impulses to the brain through the auditory nerve. The inner ear is made up of:
- The cochlea, a snail-shaped organ
- Semicircular canals, hair cells, and nerves
Five Signs and Symptoms of Hearing Loss
The signs and symptoms of hearing loss vary from person to person and depend largely on the type of hearing loss a person is experiencing.
The severity of symptoms will also vary.
Let’s look at five common symptoms and signs of hearing loss.
1. Struggling To Understand Speech in Noisy Environments
One of the tell-tale signs of hearing loss is the inability to follow along in a conversation, especially in noisy places.
For some, it feels like they’re living life with earplugs in or earmuffs on.
It may sound as if everyone is mumbling when they speak. You may even find yourself withdrawing from conversations.
Noises that used to sound normal can become more difficult to discern. Both the volume and clarity of sounds are affected.
In some cases, individuals may experience a phenomenon known as loudness recruitment, which makes loud noises uncomfortable.
2. Constantly Asking Others To Repeat Themselves
Those experiencing hearing loss may have to ask others to repeat themselves constantly.
The background noise or environment may make it difficult to follow along in a normal conversation.
It may be difficult to hear certain pitches in conversation. For example, high-frequency hearing loss, common among those with age-related hearing loss (presbycusis), may make certain sounds difficult to make out, such as:
- The sound of women's and children’s voices
- Certain consonant sounds
- Higher pitched beeping sounds, like timers or microwave ovens
- Birds chirping outside
3. Needing To Turn the Volume Up
Those experiencing the beginning stages of hearing loss may have to increase the volume on their radio or TV.
What used to be understandable at a certain volume range has now become difficult. Friends and loved ones may also clue you in on this symptom if they constantly remind you to turn down the volume on the TV or radio.
4. Experiencing Issues with Balance
Another common symptom that may point to potential hearing loss is balance issues.
The inner ear plays an instrumental role in our body’s ability to balance itself. The inner ear houses the cochlea, which converts sound waves and transmits electrical impulses to the brain.
Since the inner ear shares the same nerve pathway as the vestibular system (the system responsible for balance), balance issues can also go hand and hand with hearing loss.
5. Experiencing a Ringing Sound in the Ear
A condition known as tinnitus is a ringing in the ear. It is one of the first signs of hearing loss in older people.
The ringing can also sound like hissing, clicking, or buzzing. It can be high or low-pitched.
While tinnitus is not permanent, it is a sign that something is wrong within the auditory system, whether within the ear structures or the auditory nerve. Some conditions that can cause tinnitus include:
- Noise-induced hearing loss from loud noise exposure
- Ear infections
- Ménière’s disease
- Hormonal changes
- Abnormalities in the thyroid
Other Signs and Symptoms of Hearing Loss
- You have difficulty hearing on the phone.
- You feel stressed or tired from having to concentrate while listening.
- You must read lips to understand what people are saying to you.
- You find it hard to tell where sounds are originating.
- Your voice sounds different to you.
What Are the Types of Hearing Loss?
Hearing problems are not one size fits all as there can be many causes of hearing loss. However, hearing loss generally fits into three categories: sensorineural, conductive, and mixed hearing loss. Let’s take a look at each.
Sensorineural Hearing Loss
Sensorineural hearing loss is the most common type of hearing loss. Generally, sensorineural hearing loss results from normal aging and falls under the category of age-related hearing loss, also known as presbycusis.
While sudden sensorineural hearing loss can happen, this type of hearing loss typically happens gradually over time.
Other causes for sensorineural hearing loss can include:
- Side effects from medications
- Ménière’s disease
- Autoimmune inner ear disease
- Cochlear otosclerosis
- Benign tumors
Conductive Hearing Loss
While sensorineural hearing loss typically results from aging, conductive hearing loss is often the result of trauma or obstruction of the ear structures.
Whether by trauma or obstruction, sounds cannot pass through the outer and middle ear resulting in hearing loss. This type can result in temporary or permanent hearing loss.
Conductive hearing loss causes include:
- A buildup of earwax (cerumen) that impacts the ear canal and obstructs sound.
- Obstruction by small items that occlude the ear canal, more common among small children.
- Any type of trauma that causes fractures to the small bones in the middle ear.
- Ear infections like swimmer’s ear can also cause conductive hearing loss due to fluid buildup, usually temporary.
- Ruptured eardrums resulting from loud noises, poking the eardrum with an object, or sudden changes in pressure.
Mixed Hearing Loss
The third category of hearing loss is known as mixed hearing loss. It is a combination of conductive and sensorineural hearing loss.
For example, someone with age-related hearing loss (sensorineural) can have a blockage or physical damage to the outer, middle, or inner ear (conductive).
Degrees of Hearing Loss
It is important to note that there are also degrees of hearing loss, which range from mild to profound.
These levels of hearing loss are confirmed through a hearing test with a health care provider, such as an audiologist. Measurements for how loud sounds need to be for you to hear them are measured using a range of decibels (dB).
- A mild to moderate degree of hearing loss ranges from 26 to 55 dB, making soft sounds difficult to hear.
- Moderately severe to profound hearing loss ranges from 56 dB or more. Profound hearing loss can result in the inability to hear any speech sounds.
What Are the Risk Factors for Hearing Loss?
There are several risk factors for hearing loss. Let’s take a look at a few.
Some common risk factors that can lead to hearing loss are:
- Normal aging. Your inner ear structures degenerate over time.
- Genetics. Heredity can make you more susceptible to inner ear deterioration from aging.
- Exposure to Loud Noises. Loud noises and sounds can damage the cells of your inner ear. Consistent, long-term exposure to these loud noises can lead to noise-induced hearing loss.
- Illness and Medications. Certain illnesses, such as those that result in high fever like meningitis, can damage the cochlea, leading to hearing loss. Certain medications can also lead to damage to the inner ear.
How Is Hearing Loss Diagnosed?
Healthcare providers who work within the audiology field, such as hearing care specialists, usually diagnose hearing loss through a hearing test.
A hearing specialist may perform a simple screening test for hearing loss (such as a whisper test) or a more advanced hearing exam using audiometers.
During audiometer tests, you wear earphones and listen for sounds or words directed to each ear.
Physical exams can also be done, especially if hearing loss results from trauma.
Aside from gathering general health information, a doctor will examine your ear for possible hearing loss causes such as earwax impaction, infection, or structural issues.
If you are experiencing a sudden loss of hearing due to trauma, it is important to seek emergency medical attention immediately.
How Is Hearing Loss Treated or Managed?
The type of hearing loss treatments will depend on the type and degree of hearing loss you are experiencing. Treatments can include, but are not limited to:
- Assistive Hearing Devices. Devices that can help restore hearing include hearing aids worn on the inside of the ear to amplify sound or cochlear implants surgically implanted into the inner ear.
- Audiologic Rehabilitation. This hearing rehabilitation therapy helps individuals adjust to assistive hearing devices. This therapy can also help some people utilize visual cues like lip reading.
- Medications and Surgery. In some cases, hearing loss can be remedied by medications like antibiotics for ear infections or surgery, including cochlear implants, tumor removals, or trauma repair.
Hearing loss can make you irritable and frustrated and leave you feeling disconnected from the world around you.
While hearing loss is most commonly a result of aging, it can also vary in cause and degree, being temporary for some and permanent for others.
Thankfully, you can be aware of some tell-tale signs and symptoms to help you recognize the earlier warning signs of hearing loss.
References, Studies and Sources:
Quick Statistics About Hearing | NIDCD
Deafness and hearing loss | WHO
Loudness Recruitment – an overview | ScienceDirect Topics
What Is Tinnitus? — Causes and Treatment | NIDCD