Hearing Loss

Hearing loss occurs when any part of the ear or hearing pathway is damaged or not functioning properly. Sound waves normally travel through the outer ear, cause the eardrum to vibrate, move through tiny bones in the middle ear, and stimulate hair cells in the inner ear that send electrical signals to the brain. Problems at any stage can cause hearing loss.

The severity of hearing loss is measured in decibels (dB) and ranges from mild (difficulty hearing soft sounds) to profound (inability to hear even very loud sounds). The configuration describes which frequencies are affected - some people have difficulty with high-pitched sounds while others struggle with low frequencies. The pattern may be stable, progressive, or fluctuating.

Hearing loss profoundly impacts communication, relationships, work performance, and mental health. People with untreated hearing loss often experience social isolation, depression, cognitive decline, and increased risk of falls. Early detection and treatment can prevent many of these complications and significantly improve quality of life.

Age-Related Causes

• Presbycusis: Gradual hearing loss with aging
• Hair cell degeneration: Natural wear over time
• Nerve changes: Age-related neural decline
• Blood flow changes: Vascular aging effects

Noise-Induced

• Occupational exposure: Construction, military, music
• Recreational noise: Concerts, headphones, firearms
• Single traumatic event: Explosion, gunshot
• Chronic exposure: Years of loud environments

Medical Conditions

• Ear infections: Otitis media, otitis externa
• Meniere's disease: Inner ear fluid disorder
• Otosclerosis: Abnormal bone growth
• Acoustic neuroma: Benign tumor on hearing nerve
• Autoimmune disorders: Attack inner ear
• Diabetes: Damages blood vessels and nerves
• Cardiovascular disease: Affects blood flow to ears
• Thyroid problems: Can affect hearing

Other Causes

• Earwax buildup: Blocks sound transmission
• Foreign objects: In ear canal
• Perforated eardrum: From injury or infection
• Medications: Some antibiotics, chemotherapy, aspirin
• Head trauma: Skull fractures, concussion
• Genetic factors: Inherited hearing loss
• Infections: Meningitis, measles, mumps
• Birth complications: Premature birth, low birth weight

Common Symptoms

• Asking people to repeat themselves frequently
• Turning up TV or radio volume
• Difficulty understanding speech in noise
• Trouble hearing high-pitched sounds
• Muffled or distorted sound quality
• Difficulty locating sound sources
• Withdrawal from conversations
• Avoiding social situations
• Fatigue from straining to hear
• Misunderstanding conversations

Associated Symptoms

• Tinnitus: Ringing, buzzing, or hissing in ears
• Dizziness: Balance problems common
• Ear pain: May indicate infection
• Ear fullness: Pressure sensation
• Discharge: From infection or injury
• Headache: From straining to hear
• Nausea: With vertigo

Impact on Daily Life

• Communication difficulties
• Relationship strain
• Work performance issues
• Safety concerns (alarms, traffic)
• Social isolation
• Depression and anxiety
• Cognitive decline risk
• Reduced quality of life

Medical History

• Onset and progression
• One or both ears
• Associated symptoms
• Noise exposure history
• Family history
• Medications
• Medical conditions
• Previous ear problems

Physical Examination

• Otoscopic exam (ear canal and drum)
• Tuning fork tests
• Whisper test
• Balance assessment
• Neurological exam if needed

Hearing Tests

• Pure tone audiometry: Measures hearing at different frequencies
• Speech audiometry: Word recognition testing
• Tympanometry: Middle ear function
• Acoustic reflex testing: Nerve pathway function
• Otoacoustic emissions: Inner ear hair cell function
• Auditory brainstem response: Nerve and brain pathways
• CT or MRI: For structural abnormalities

For People with Hearing Loss

• Face the speaker directly
• Ask for quieter environments
• Request speakers slow down
• Use visual cues and context
• Confirm important information
• Be open about hearing loss
• Position yourself strategically
• Use assistive technology

For Family and Friends

• Get attention before speaking
• Face the person directly
• Speak clearly, don't shout
• Reduce background noise
• Rephrase rather than repeat
• Use gestures and visual cues
• Be patient and understanding
• Include in conversations

• Protect from noise: Use earplugs in loud environments
• Follow 60/60 rule: 60% volume for 60 minutes with headphones
• Regular hearing tests: Annual checks after 50
• Manage health conditions: Control diabetes, blood pressure
• Avoid ototoxic drugs: When possible, discuss alternatives
• Clean ears safely: No cotton swabs in canal
• Treat infections promptly: Prevent complications
• Workplace safety: Use hearing protection
• Healthy lifestyle: Exercise, don't smoke
• Vaccinations: Prevent measles, mumps, rubella
• Prenatal care: Prevent congenital hearing loss
• Limit alcohol: Excessive use can damage hearing

Schedule an Appointment For:

• Gradual hearing loss
• Difficulty understanding speech
• Ringing in ears (tinnitus)
• Family concerns about hearing
• Ear fullness or pressure
• Need for hearing evaluation
• Hearing aid consultation

Seek Immediate Care For:

• Sudden hearing loss (emergency within 72 hours)
• Hearing loss after head injury
• Hearing loss with vertigo
• Hearing loss with facial weakness
• Severe ear pain with hearing loss
• Discharge of blood or fluid
• Foreign object in ear