Hearing Loss

Hearing Loss: Types, Causes, Symptoms, Treatment & Prevention

Hearing problems often show up quietly. At home, you might notice a parent turning up the TV louder every week. Or a grandmother asking, “what did you say?” during family chats. At first, these things feel normal. Over time, they point towards hearing loss.

This condition is not only for the elderly. Kids with repeated ear infections, teenagers who blast music on earphones, or people working in noisy factories can also face it. For some, it’s temporary. For others, it becomes lifelong. The good part is that with awareness and timely care, life can still be comfortable.

Understanding Hearing Loss

Hearing loss is the failure of your ears to hear things properly. It may happen on the same ear or both. There are those who cannot hear the high tones and those who cannot hear the lower tones.

Doctors refer to it as a hearing disorder. When it is permanent and severe, then it may be said to be deafness. No matter what the name is, the difference is felt; it becomes harder to speak, there is less safety on the road, and social self-confidence can be lowered.

Types of Hearing Loss

There are different types of hearing loss. Knowing which one you have makes treatment easier.

Sensorineural Hearing Loss

This is the most common form. It happens when the inner ear or the hearing nerve gets damaged.

Causes

• Ageing
• Long-term loud noise exposure
• Family history
• Illnesses like diabetes or thyroid problems

Symptoms

• Difficulty hearing in crowded places
• People’s voices sound unclear
• Needs higher TV or phone volume
• Struggles with soft or high-pitched sounds

Treatment
Usually permanent. Managed with hearing aids, implants, and therapy. Sensorineural hearing loss does not go away on its own, so early care is important.

Conductive Hearing Loss

This happens when sound cannot move freely through the ear canal or the middle ear.

Causes

• Earwax buildup
• Ear infections
• Fluid in the ear
• Physical injury

Treatment
Often treatable. Doctors may remove wax, treat infection, or do minor surgery. This makes conductive hearing loss different because recovery is possible.

Mixed Hearing Loss

This is a mix of both conductive and sensorineural.

Why it matters
Treatment has to be planned carefully. Doctors usually solve the conductive part first, then use devices for the nerve-related damage. Mixed hearing loss is less common but needs close follow-up.

Hearing Loss vs. Deafness

Degree of hearing loss is based on how loud a sound needs to be for a person to hear it. The term dBHL describes hearing loss in decibels. Degree of hearing loss ranges from-

• MILD- 21- 40 dB- Difficulty hearing and understanding quiet/soft conversations, especially situations with a lot of background noise (restaurants, classrooms, etc.)
• MODERATE- 41- 55 dB- Difficulty understanding speech, higher volume levels are required for hearing TV and radio
• MODERATELY SEVERE- 56-70 dB- Speech has to be louder than normal, group conversations are difficult
• SEVERE – 71-90 dB- Difficulties with speech, comprehension becomes impossible without amplification
• PROFOUND- 91 dB and greater- Amplified speech or devices are still ​​​difficult ​or impossible to hear and understand

Categories of Hearing Loss

• Prelingual vs Post lingual: A prelingual hearing loss occurs before a child acquires language and post lingual hearing loss occurs after a child has learned and understood some language.
• Unilateral vs bilateral: Unilateral refers to hearing loss in one ear while bilateral refers to hearing loss in both ears.
• Symmetrical vs asymmetrical: Symmetrical is when the severity and pattern of hearing loss is the same in both ears while they may be different in both the ears in asymmetrical hearing loss.
• Progressive vs Sudden: progressive refers to the deterioration in hearing over a period of time. Sudden refers to a quick fall in hearing thresholds within a very short period of time.
• Fluctuating vs Stable: Hearing loss that shows minimal or negligible changes over time is considered stable while hearing thresholds that keep going up and down over time is known to be fluctuating in nature.
• Congenital vs Acquired: If a child is born with hearing loss it is congenital. If the loss occurs after birth, during developmental or later years it is said to be acquired.

Degree of Hearing Loss / Levels of Deafness

The degree of hearing loss shows how serious the problem is:

• Mild – Cannot hear soft voices in groups.
• Moderate – Needs people to speak louder.
• Severe – Cannot follow speech without a device.
• Profound – Relies mostly on lip reading or sign language.

These levels help doctors decide when hearing aids are required.

Common Symptoms of Hearing Loss

Here are some warning signs of hearing loss:

• Often asking people to repeat themselves
• Having trouble following a conversation, especially while talking on the telephone or in a noisy environment
• Thinking that people are mumbling
• Turning up the TV/music volume beyond usual levels
• Difficulty in hearing certain high-pitched sounds, like birds singing

Symptoms of Hearing Loss in Babies and Children

• When the baby does not startle to loud noises
• Baby does not turn to the source of a sound after 6 months of age
• Do not acquire first words like “mamma” by age one
• Do not react when you call out their name
• Children are slower to learn to speak than other children their age
• Develop unclear speech
• Do not follow commands or instructions and use gestures to communicate
• Turn up the TV volume

Causes of Hearing Loss

General causes

• Ageing
• Loud sound exposure at work or through music
• Ear infections
• Head injuries
• Family history

Causes of hearing loss in adults

• Natural ageing (presbycusis)
• Continuous use of loud earphones
• Conditions like diabetes or hypertension
• Hereditary reasons

These are the main causes of hearing loss in adults, though lifestyle choices often make them worse.

Early Signs and Symptoms

The early signs of hearing loss in adults are easy to miss:

• Asking “what?” too often
• Trouble following phone calls
• Feeling tired after long conversations
• Increasing TV volume regularly
• Avoiding social gatherings

If these sound familiar, it’s time to see an audiologist.

Common Hearing Tests (Adults and Children)

• Otoscopic evaluation: It is the initial step, a basic routine procedure carried out with a tool known as otoscope to visualize and examine the ear canal and eardrum.
• Pure Tone Audiometry: It is the main diagnostic procedure used to assess and identify the type degree and configuration of hearing loss.
• Play audiometry: Used for paediatric population where responses are elicited by engaging the child in play activity.
• Conditioned audiometry: Where the child is conditioned to respond upon hearing the sound signal.
• Visual reinforcement audiometry: Used in children where visual stimuli are used when child responds to signal.
• Behavioral Observation Audiometry: Used in very young children, difficult to test population or malingering clients where clinicians look for behavioral responses to the provided sound signal. 
• Tymapanometry/ immmitance audiometry/ impedance audiometry: Tests to identify the condition of the middle ear.
• Speech Audiometry: Tests how loud speech needs to be for the client to hear it and checks how the client understands and distinguishes different speech sounds Results of speech audiometry helps in selection and efficiency of hearing aids.
• Brainstem Evoked Response Audiometry BERA/ABR: Identifies hearing thresholds in specific frequency range. 
• Oto Acoustic Emissions OAE: Tests the functioning of outer hair cells and detection of hearing loss. 

Hearing Loss Treatment

Conductive hearing loss:

• Medication and Surgery. Some types of hearing loss can be treated with surgery. For repeated infections that cause fluid in the ear, a care provider might put in small tubes that help ears drain and provide appropriate medication.

Sensorineural hearing loss:

• Hearing aids. If hearing loss is from damage to the inner ear, a hearing aid can be helpful. A hearing specialist, known as an audiologist, can talk about how hearing aids can help and what kinds there are. Audiologists also can fit you with a hearing aid.
• Cochlear implants. When a regular hearing aid isn't likely to help much, a cochlear implant might be an option.

Mixed Hearing loss: A combination of medical treatment and hearing aids.

Factors that Lead to Hearing Loss

• Aging -is one of the most common factors that affect hearing. Usually occur due to aging of hair cells in the inner ear.
• Loud noise-exposure to loud noise as in factories or traffic for extended periods of time can cause damage to the ears leading to hearing loss.
• Hereditary- genetic inheritance as in conditions like otosclerosis may affect the middle ear thereby leading to hearing loss
• Medicines-intake of ototoxic drugs for extended period could potentially damage hearing

Preventing Hearing Loss

You cannot stop ageing, but you can prevent hearing loss from getting worse.

• Use ear protection in noisy jobs
• Keep the earphone volume at safe levels
• Treat infections quickly
• Go for routine check-ups
• Control sugar and blood pressure levels

These small steps are the basis of hearing loss prevention.

Preparing for Your Appointment

What happens typically during an audiological examination is detailed below:

• Detailed discussion about your work and lifestyle
• Talking about hearing difficulties, your listening needs and your medical history.
• An examination of your ears.
• A detailed hearing test.
• Discussion of results and future steps

Concluding Notes

The different degrees and types of hearing loss and hearing aid requirement have been discussed in details. It is important to understand with the help of an audiologist what kind of hearing aid is best suitable for you. Try to keep regular follow ups with your hearing care specialist to track further developments in your hearing ability. 

FAQs

1. How do I know if I have sensorineural or conductive hearing loss?

Only an audiologist can confirm. In simple terms, sensorineural hearing loss affects clarity, while conductive hearing loss makes things sound blocked or softer.

2. Is hearing loss permanent, or can it be cured?

Short-term conditions such as earwax or infection are correctable. Cases that cannot be reversed, such as nerve damage, can be managed using devices.

3. What is the most common cause of hearing loss in children?

Frequent ear infections. If not treated, they affect speech and learning.

4. How many levels of hearing loss are there?

Four levels: mild, moderate, severe, and profound.

5. What is called for a temporary hearing loss?

It’s usually called temporary conductive hearing loss. It improves once the blockage or infection is treated.

6. What level of hearing loss requires a hearing aid?

Moderate and above usually need hearing aids, but doctors decide based on lifestyle and comfort.

Disclaimer

It is an informational blog and not a substitute to medical advice. A certified ENT or audiologist should always diagnose it. The authoritative agencies like the WHO and CDC have information on all kinds of hearing loss and remedies.