Hearing loss, explained

by | Hearing Health

Hearing loss is the term used to describe when you lose some or all of your hearing. You can suffer from hearing loss in one or both ears. It can happen quickly sometimes, but most of the time it happens slowly over time. Hearing loss ranges from mild through to moderate, severe or what is known as “profound”.

How is hearing loss measured?

The numbers used to measure sound are decibels (dB). It’s not likely that sounds below 75dB will hurt your hearing or make it worse. When the sound level goes above 75dB, however, the chance that it will cause hearing damage also goes up. The chance of losing your hearing depends on the loudness and time you’re exposed to extreme noise.

A hearing loss range in decibels (dB) can show how much hearing loss someone has. Loss in the range of 16-40dB can be used to describe mild to moderate hearing loss in people. Hearing loss that is severe and profound in people can be 71 to 91dBs or more.

Who is most likely to suffer from hearing loss?

Older people are more likely to have hearing loss because they may have built up damage over the years. It is thought that about one in three people over the age of 65 have trouble hearing.

But older people aren’t the only ones at risk. Anyone can experience hearing loss if they are exposed to loud noise for prolonged periods. As a general rule, a place is likely noisy enough to damage your hearing if you have to raise your voice to be heard. Noise exposure builds up over time, and each time you are exposed to loud noise, it makes your hearing worse.

Hearing loss can happen from being exposed to too much loud noise, so the fact that more young people are using loud personal stereos may be making hearing loss more common.

Here are some common examples of noises and the decibel numbers that go with them:

An empty field is 30dB quiet, a family talking at home is 50dB loud, a vacuum cleaner is 70dB loud, a food blender is 90dB loud, a jackhammer is 100dB loud, and a chainsaw is 120dB loud.

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How your ears process sound

Sound waves are picked up by the upper part of the ear and sent down the ear canal to the tympanic membrane, which is also known as the eardrum. There is a thin membrane about 10 mm wide that lines the middle ear from the ear canal. This is the eardrum. Hearing aids can move back and forth because the eardrum is very sensitive to changes in air pressure. The eardrum moves because of sound waves.

The middle ear is on the other side of the diaphragm. This is made up of a chain of very small bones called ossicles. One end is connected to the eardrum, and the other end is linked to space in the inner ear. Vibrations of the eardrum make the ossicles move, which moves the fluid inside the inner ear.

Inside the inner ear is the cochlea. It has tiny hairs on its surface that help turn soundwaves into electrical signals that are sent to the brain through the auditory nerve. These hairs vibrate in different ways when you hear different sounds, which sends different electrical messages to your brain.

The parts of an ear

The outer ear, the middle ear, and the inner ear are the three separate parts of the ear. Conductive hearing loss is hearing loss that is caused by damage to the outer or middle ear. Sensorineural hearing loss is when the inner ear, the auditory nerve, or the part of the brain that controls hearing gets hurt. It is called “mixed hearing loss” when both types happen at the same time.

The outer ear is made up of the external ear and the external auditory canal. Changes in the outer ear, like earwax or an illness in the outer ear, can lead to hearing loss.

The middle ear is where the diaphragm and the cochlea meet. The ossicles (malleus, incus, and stapes) are in the middle ear. A middle ear infection, fluid buildup behind the eardrum, a burst eardrum, or hardening of the ossicles (otosclerosis) can all lead to hearing loss in the middle ear.

The inner ear has the cochlea and the balance organs inside it. Some changes in the inner ear could be brought on by:

  • Damage to the hair cells that line the cochlea that comes with getting older;
  • Some medicines, which can hurt the inner ear or the nerves that connect to it;
  • Meniere’s disease, in which too much fluid builds up in the inner ear;
  • Too much exposure to loud noises;
  • These include infections like meningitis, measles, and mumps, and an acoustic neuroma, which is a growth on the hearing nerve that is not harmful.

    Other less common factors in hearing loss are:
  • Not enough blood getting to the brain’s inner parts, which can be caused by a stroke, heart disease, high blood pressure (hypertension), or other health problems.

Increased risk factors for hearing loss

  • Having problems during pregnancy, like not getting enough air, which can cause growth problems in the baby;
  • Some medicines that can hurt the hearing;
  • Getting older;
  • Smoking;
  • Head injuries;
  • Ear infections that come back often
  • Being around loud noises a lot, like construction sites or live music

Symptoms and signs

Some signs that an adult has hearing loss are:

  • Having trouble understanding conversations;
  • Having to ask people to repeat what they say;
  • Having trouble hearing in noisy places;
  • Having trouble telling the difference between high-pitched sounds;
  • Feeling that other people mumble.
  • Feeling off-balance or dizzy;
  • Hearing or hearing something buzzing in your ear;
  • Having pressure in your ear.

Signs of hearing loss in babies and children

If a baby has hearing loss, symptoms can manifest such as:

  • Not reacting to sudden loud noises;
  • Not turning to face the sound source (especially in babies younger than four months);
  • Not saying single words by the age of one year.

In children, the most common symptoms of hearing loss are:

  • Taking longer to learn how to talk;
  • Increasing the loudness of a TV so that it is very loud;
  • Being loud and asking you to repeat what you say.
  • Different ways to diagnose

Diagnosis

There are a number of ways you may be diagnose with hearing loss.

Physical examination: The body is carefully checked out, with special attention paid to the ears. An otoscope is a tool that your doctor may use to look inside your ear for earwax getting in the way; an infection in the ear canal; an eardrum that bulges, which means there is fluid or an infection in the middle ear; or an eardrum that bursts.

What happens during a hearing test?


To check your hearing, your ears may be covered one at a time during the physical test, and you may be asked to repeat certain words. A tuning fork, which is a metal tool that makes a sound when hit, could be used. To see if you can hear vibrations moving through the air, the tuning fork is hit and held in the air on each side of the head. After that, it is tapped and put against the bone behind the ear to see if sounds can go through the bone. Your doctor can tell if you have conductive or sensorineural hearing loss by looking at the differences between sounds that move through air and those that move through bone.

Hearing tests

An audiologist is a doctor who specialises in hearing and balance problems. They may use an audiometer to officially test your hearing and figure out how bad your hearing loss is. During the test, the audiometer makes different sounds at different volumes and frequencies. You listen to these sounds through headphones and press a button when you hear them. Based on the patient’s age and speaking skills, there are other hearing tests that can be done.

Doctor helping senior patient with hearing aid , close-up. Otolaryngologist putting hearing aid in senior woman’s ear on light background. Adjusting of a hearing aid for an aged woman

Imaging tests like computerised tomography (CT) scans or magnetic resonance imaging (MRI) may also be used to help with the diagnosis if a cancer or fracture is thought to be present.

How is hearing loss treated?

Hearing loss can be treated in a lot of different ways, based on what caused it and how bad it is. The following are some of the most common treatments:

  • Antibiotics or antifungal drugs for people who have lost their hearing because of an illness;
  • Surgery to fix the damaged parts of the ear and return hearing if the loss was caused by an accident;
  • Surgery for long-term ear infections, middle ear fluid, or a growth;
  • A cochlear device can help some people with sensorineural hearing loss hear better. The device is a small electrical circuit that is put under the skin behind the ear and turns sound waves into electrical messages that the brain can then understand as sounds.
  • Corticosteroids, which work to lower the swelling in the structures inside the ear;
  • For Meniere’s disease, a low-sodium diet, diuretics, and corticosteroids are recommended. Wax softeners or washing the ear with warm water can help soften and get rid of buildup.
  • The following are some other devices or methods that may also help people with hearing loss:
  • Using sign language; hearing aids, such as smoke alarms, doorbell alert systems, and alarms that set off lights or movements;
  • Telephone amplifiers to make it easier to talk on the phone; TV and radio listening systems to help you watch or listen without being interrupted by noise in the background

How to support someone diagnosed with hearing loss

When you talk to someone who has trouble hearing, it might help to:

Slow down your speech, be patient, face the person, and stand close to them. Try to make sure that only one person talks at a time, and use hand and body signs to help you talk.

Hearing loss can make life a lot less enjoyable. Problems may be different based on what caused the hearing loss and how bad it is, but here are some common ones:

Child academic success drops; parents experience anxiety, depression, and a sense of being alone; and it’s hard to find and keep reliable work.

How can I prevent hearing loss?

Keeping away from or limiting exposure to loud noises;
Taking care of your ears and following the local immunisation rules for kids’ sicknesses;
Early detection and care of health problems in pregnant women;
Seeing a doctor right away for ear infections and checking on kids who are at high risk, like those with meningitis, right away.

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