Hearing loss is being partly or totally unable to hear sound in one or both ears.
Decreased hearing; Deafness; Loss of hearing; Conductive hearing loss
It is common to lose a little bit of hearing after age 20.
Hearing problems often start slowly over time. They rarely lead to total deafness.
There are many causes of hearing loss. Hearing loss can be divided into two main categories:
- Conductive hearing loss (CHL) occurs because of a mechanical problem in the outer or middle ear. The three tiny bones of the ear (ossicles) may not conduct sound properly. Or, the eardrum may not vibrate in response to sound. Fluid in the middle ear can cause this type of hearing loss.
- Sensorineural hearing loss (SNHL) is due to a problem with the inner ear. It most often occurs when the tiny hair cells (nerve endings) that move sound through the ear are injured, diseased, do not work correctly, or have died.
CHL can often be reversed. SNHL cannot be reversed. People who have both forms of hearing loss are said to have mixed hearing loss.
Hearing loss may be caused by fluid that stays in the ear after an ear infection. Ear infections are common in children.
Other ear problems that can cause hearing loss:
- Buildup of wax in the ear canal
- Foreign object stuck in the ear canal
- Hole in the eardrum
- Scar on the eardrum from repeat infections
Hearing loss that is present at birth (congenital) may be due to:
- Birth defects that cause changes in the ear structures
- Genetic conditions (more than 400 are known)
- Infections the mother passes to her baby in the womb (such as toxoplasmosis, rubella, or herpes)
Infections that can damage the brain or nerves of the ear:
The ear can be injured by:
Other causes are:
You can often flush wax buildup out of the ear (gently) with ear syringes (available in drug stores) and warm water. Wax softeners (like Cerumenex) may be needed if the wax is hard and stuck in the ear.
Take care when removing foreign objects from the ear. Unless it is easy to get to, have your health care provider remove the object. Don't use sharp instruments to remove foreign objects.
See your health care provider for any other hearing loss.
When to Contact a Medical Professional
Call your health care provider if:
- Hearing problems interfere with your lifestyle
- Hearing problems do not go away or become worse
- The hearing is worse in one ear than the other
- You have sudden, severe hearing loss or ringing in the ears (tinnitus)
- You have other symptoms, such as ear pain, along with hearing problems
- You have new headaches, weakness, or numbness anywhere on your body
What to Expect at Your Office Visit
The health care provider will take your medical history and do a physical exam.
Medical history questions may include:
- Is the hearing loss in both ears or one ear?
- Is the hearing loss mild or severe?
- Is all of the hearing lost (you cannot hear any sound)?
- Do words sound garbled?
- Do you have trouble understanding speech?
- Do you have trouble finding the source of a sound?
- How long has the hearing loss been present?
- Did it occur before age 30?
- What other symptoms do you have?
- Is there tinnitus (ringing or other sounds in the ear)?
- Is there ear pain?
- Is there dizziness?
- Do you have other family members with hearing loss?
The health care provider will carefully examine your ears.
Tests that may be done include:
If hearing loss does not go away, surgery may be done to improve hearing. If you have sensorineural hearing loss, a hearing aid may help you hear. Cochlear implants are only used in people who are completely deaf and would not benefit from a hearing aid.
Hildebrand MS, Husein M, Smith RJH. Genetic sensorineural hearing loss. In: Cummings CW, Flint PW, Haughey BH, et al, eds. Otolaryngology: Head & Neck Surgery. 5th ed. Philadelphia, Pa: Mosby Elsevier;2010:chap 147.
Arts HA. Sensorineural hearing loss in adults. In: Cummings CW, Flint PW, Haughey BH, et al, eds. Otolaryngology: Head & Neck Surgery. 5th ed. Philadelphia, Pa: Mosby Elsevier;2010:chap 149.
Lonsbury-Martin BL, Martin GK. Noise-induced hearing loss. In: Cummings CW, Flint PW, Haughey BH, et al, eds. Otolaryngology: Head & Neck Surgery. 5th ed. Philadelphia, Pa: Mosby Elsevier;2010:chap 151.
Bauer CA, Jenkins HA. Otologic symptoms and syndromes. In: Cummings CW, Flint PW, Haughey BH, et al, eds. Otolaryngology: Head & Neck Surgery. 5th ed. Philadelphia, Pa: Mosby Elsevier;2010:chap 156.
Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington School of Medicine; and Seth Schwartz, MD, MPH, Otolaryngologist, Virginia Mason Medical Center, Seattle, Washington. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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