The Ultimate Guide to Hearing Loss

If you suspect hearing loss in yourself or a loved one, here’s some great news: today’s medical technology offers better solutions than at any time in history.

Suspecting hearing loss can be frightening. But remember that the sooner you get evaluated, the greater your chances of hearing better today, and possibly of slowing the progression of your hearing loss.

First, though, you’ll need to know what to look for. You probably have a lot of questions. What are some common symptoms of hearing loss? Is hearing loss inevitable as you get older? What medical tests will be ordered for you? Will you ever recover your hearing?

We’ve covered all this and more in our Essential Starter’s Guide to Hearing Loss. Read on for everything you need to know.

Hearing Loss Symptoms

Many early signs of hearing loss relate to hearing the spoken word. That’s because speech is very specific, with certain sounds that tend to “blur out” depending upon the frequency. (Higher-pitched sounds like a child’s voice might be lost, for example, while bass tones like rumbling traffic may be easier for you to detect.)

Another reason is that we find speech so valuable. Words are how we express ourselves and understand others. In fact, for many people, the motivation for getting checked for hearing loss starts with not being able to clearly understand loved ones.

Here are common symptoms of early hearing loss. You may experience only one or two, or you may have most of them. Everyone is different.

• A sense that people “talk too fast” for you to catch all the words
• A muffled sensation in the ears
• Sudden onset of tinnitus (ringing in the ears)
• Not hearing household sounds, such as a dripping faucet or phone text alerts
• Others around you complaining that the TV is too loud
• Difficulty hearing others on the phone
• Frequently asking others to repeat what they’ve said
• Having trouble making out the speech of women and children (higher voices/frequency)
• Having a “favorite” ear and turning your head so that ear is facing sound/voices
• Avoidance of social situations because it’s difficult for you to make out what people are saying

Common Causes of Hearing Loss

Hearing loss can have some surprising causes. It can also accumulate over time so that you don’t even notice it’s happening. It’s only when you have significant symptoms that you realize something may be amiss.

Any of these can cause mild, moderate or severe hearing loss:

• Direct injury to the ear
• Some types of brain injury
• A history of exposing yourself to high levels of noise (about 80 dB or above)
• Working in or next to a very noisy environment
• Some viral or bacterial illnesses (meningitis, shingles or measles, for example)
• For some, the aging process
• Tumors inside the ear
• Certain medications
• Heredity
• Obesity or underweight (note: correlation v. causation has not been determined)
• Stroke
• An excessively high fever
• Smoking (note: correlation v. causation has not been determined)
• Cardiovascular disease

Different Types of Hearing Loss

There are actually four different types of hearing loss.

They are:

Conductive Hearing Loss

Conductive hearing loss means the sound is not traveling correctly into the ear, or between parts of the ear (from the middle ear to the inner ear, for example).

Conductive hearing loss can be caused either by damage to the ear (especially scarring) or by a blockage in the ear. Occasionally, it can be due to a genetic malformation of the ear. Some, but not all, forms of conductive hearing loss can be improved via simple in-office medical treatments.

Common causes of conductive hearing loss include:

• Perforated eardrum
• Excessive buildup of earwax
• Ear infection with fluid accumulation
• Allergies
• Abnormal bone growth, especially in the ossicle

Sensorineural Hearing Loss

Sensorineural hearing loss occurs when tiny hair-like cells, called stereocilia, in the inner ear don’t perform correctly. It is the most common type of permanent hearing loss.

Stereocilia are essential because they detect sound physically, and because they help us maintain our balance. There are two types:

• Auditory stereocilia, responsible for hearing
• Vestibular hair cells, located in the inner ear and responsible for both hearing and balance

If the auditory stereocilia are damaged, the loss can often be compensated for using hearing aids. However, vestibular hair cell hearing loss is permanent. (Research is being conducted on ways vestibular hearing loss might be corrected in the future.)

Mixed Hearing Loss

Mixed hearing loss is exactly what it sounds like: the patient has both conductive and sensorineural hearing loss.

Usually, but not always, the sensorineural hearing loss is permanent, while the conductive aspect can be either corrected or compensated for. Usually, this is via hearing aids and assisted hearing devices.

Auditory Neuropathy

Auditory neuropathy involves sound getting to the brain. In this situation, the auditory nerve doesn’t send the sound from the cochlea to the brain correctly.

Sound loss may be mild, moderate or profound. With mild to moderate auditory neuropathy, people often complain of not being able to hear speech adequately, especially if there’s background noise. The level of hearing loss may fluctuate day-to-day. For some people, hearing aids can help.

Auditory neuropathy is rarer and is generally caused by one of these issues:

• A genetically malfunctioning auditory nerve
• Loss of oxygen during/at birth
• Jaundice immediately after birth
• Certain neurological issues

Tests for Hearing Loss

One thing that puts people off from investigating mild hearing loss is that they’re nervous about taking tests. Actually, initial hearing loss tests tend to be entirely non-invasive and comfortable. But they’re essential so your doctor has the information she needs to help you.

You’ll probably start off with an intake exam with your primary care provider, or you may be referred immediately to an audiologist. Either way, your doctor will first look into your ears for blockage signs (such as earwax or fluid). She will also ask you a series of questions regarding your experiences.

She may make some low-level sounds behind your ears – whispering, for example - and ask you to repeat what she’s said or what you heard.

Your doctor may remove any blockage if possible and may prescribe medications for an infection. Otherwise, she will refer you to a hearing specialist for further tests, such as:

• Tuning Fork Testing: The specialist uses a two-pronged tuning fork which produces sounds when struck. Depending upon your reactions, the specialist may be able to determine not only hearing loss itself, but where it’s occurring in your ear.
• Audiometer: In this test, you wear a special set of headphones. You raise your hand on the side you’re hearing a sound. The volume and frequency will change so the specialist can determine how severe your hearing loss is, and how loud/soft or high/low-pitched you can currently hear.
• Sound Booth Test: You sit inside a booth that’s equipped with speakers coming from different areas – behind you, in front of you, high up or near the floor. You lift your hand whenever you hear a sound. Sound booths are more often used for infants and young children, as their heads will turn toward the sound.
• Speech Audiometry Test: Because hearing loss is often first detected by difficulty hearing human speech, this test uses recordings of different spoken words. You listen and try to repeat the word. This test can detect even very low levels of hearing loss. You may hear “that” instead of “this,” for example, because the “s” and “i” are high-frequency sounds that are more sensitive for your ears to detect.
• Ultrasound or x-ray: If your hearing specialist suspects a malformation of the bones of the ear, she may give you one of these in order to take a look inside.
• Tympanometry: A comfortable plug that’s placed in the ear creates various pressures. The eardrum response is then measured.

Hearing Loss Treatments

There are so many treatments for hearing loss today that we won’t list them all. (Consult your doctor, as testing for hearing loss improves all the time.) Here are a few of the most common treatments:

• Medical treatment: If the cause of your hearing loss is physical, your doctor may or may not be able to treat you medically. This can include removing ear wax or ear fluid, prescribing antibiotics or hay fever medications, or in rarer cases, surgery.
• Hearing aids: Hearing aids are most often used for moderate to severe hearing loss. Depending upon the type of hearing loss you have, the increase in volume may make you better able to hear sounds and voices.
• Hearing amplification devices: These are often available over-the-counter. They boost volume in some forms of mild to low-moderate hearing loss.
• Assisted hearing devices: These may include special phones, doorbells, the TV, and special visual alerts.
• Cochlear implants: Implants only work for certain people, and amplify but may not clarify sounds. They are typically used for people with specific types of severe hearing loss.

Hearing Loss in Children

Discovering that your child has a hearing disability can be scary. Don’t worry: you’re doing the right thing by looking into it now. The earlier a hearing issue is detected, the more you can help your child.

Children with hearing loss:

• Tend to have conductive hearing loss v. other types of hearing loss more frequently than adults do
• Maybe harder for parents to detect, especially if the child isn’t of talking age yet
• Maybe crankier than other children as they are frustrated from not understanding/being understood
• Might have the best chance at halting the progression of hearing loss or of reversing some forms of mild hearing loss

Symptoms of hearing loss in children may include:

• From birth onward: not startling at loud noises, especially if the noise comes from behind
• Not turning toward the sound of his name by 6-8 months of age
• Answers when you’re facing him but not when you’re behind him
• Shows signs of a speech delay
• Responds inappropriately to commands by toddler age (for example, goes and gets his blanket when you ask him to go get his jacket)
• Has slurred speech
• Turns TV or music up too loudly
• Frequently asks “What?” or “Huh?”
• Pulls at ears frequently
• Is frequently frustrated

If you suspect hearing loss in your baby or young child, visit the pediatrician. Remember, the sooner the better. There may be simple solutions, such as ear wax removal, ear tubes, or other procedures.

Your baby may be referred to an audiologist who specializes in children’s hearing loss. This specialist will give your child non-painful tests made specifically for young children.

In the meantime, there are certain things you can do right now to help your child understand you better. Learn a few simple baby sign language motions so you can start understanding your child better (and so you can understand him). Stand in front of your child while speaking. Speaking more loudly may or may not help; it may only feel more confusing to your child. Ask the pediatrician about this.

Most of all, don’t panic. Today there are more ways than ever to help your child, you, or a loved one hear better and be involved with the ones you love. And that will make all of you happier.

Preventing or Slowing the Progression of Hearing Loss

It’s not always possible to prevent hearing loss. Some forms are congenital. Others tend to progress even with treatment. But there are ways to help minimize the issue and possibly prevent further hearing loss. Here are things you should do:

• Wear quality earmuffs or noise-canceling headphones when in noisy areas, such as road construction or at loud music concerts
• If you work in an environment that’s very loud (factory, lawn maintenance, etc.), wear sound-blocking headphones at all times
• Adjust the music in your earbuds or earphones to a lower level
• See your doctor regularly for basic hearing tests
• If there are others in your family who have suffered hearing loss, ask when it started and what they do for it; this information can greatly help your doctor
• NEVER insert any sharp, long or hard object into your ear (for example, Q-tips)
• Don’t attempt to remove a foreign object from your own ear; see your doctor ASAP
• Treat bacterial or viral illnesses quickly, per your doctor’s instructions

A Sound Future

Medical science constantly advances in detection and treatment of hearing loss. Today you have a better chance than ever before of minimizing hearing loss, or of hearing better than you thought you ever would again.

Don’t put off seeing your doctor. What you do today for your hearing could mean a better future.

We hope this starter’s guide to hearing loss has helped answer some questions for you. Here’s to a great tomorrow!