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Hearing loss has many causes. As we age, it is normal to experience some degree of hearing loss, which occurs gradually. Sudden hearing loss, especially in only one ear, can be a symptom of other illnesses and should be immediately seen by a doctor. Before going further into the types and common symptoms of hearing loss, it’s important to understand the structures involved in the hearing process.
How does the ear work?
There are many structures involved in the hearing process, and they are divided into three areas:
Outer ear: This is composed of the part of the ear that’s visible, called the pinna, which is in charge of gathering sound waves and directing them to the ear canal (the other part of the outer ear).
Middle ear:This is composed of three bones (hammer, anvil and stirrup) contained in an air-filled cavity. The eardrum is a membrane that separates these bones from the outer ear and vibrates with each sound wave. The back of the nose and throat are connected to the middle ear by the auditory tube (or eustachian tube), which opens and closes to equalize the pressure (which needs to be the same on both sides of the eardrum for normal functioning).
Inner ear: This is composed of fluid chambers: the cochlea and the semicircular canals or vestibular labyrinth. Another important part of the inner ear is the hair cells, which act as sensors that convert sound waves into electrical impulses that travel to the brain.
Detecting sound and suppressing background noise is a complex mechanism that involves the auditory nerve and the auditory cortices. Auditory cortices are structures that process and interpret sound information. Auditory impulses from the right ear travel to the left side of the brain, while the ones from the left ear travel to the right side of the brain.
Depending on where hearing loss happens, it can be known as conductive (when it occurs in the outer or middle ear), sensorineural (if it happens in the inner ear), or mixed.
What causes hearing loss?
- Earwax buildup
Earwax production is a mechanism from the body to protect the inner ear. It’s normally eliminated by your body, but sometimes it can build up and block the ear canal. This is easily fixed by an earwax removal process.
- Inner ear damage
Nerve cells in the cochlea can be damaged by exposure to loud noises, but it’s also normal to experience some level of damage due to ageing. Inner ear damage can also be a birth defect, which, depending on the level of damage, can be partially corrected with a mechanism known as a cochlear implant. Not everyone is a candidate for a cochlear implant, but your doctor and audiologist can help you explore your options.
- Abnormal bone growths, tumours and/or ear infections
Ear infections cause inflammation, which can end up permanently damaging the ear structures. Bone growths and tumours block the ear canal, causing hearing loss. Abnormal growths and tumours are part of a bigger health issue, which is why a team of professionals should be involved in the diagnosis and treatment.
- Perforation of the tympanic membrane
Poking your ear can cause a rupture of your eardrum. Other causes of a ruptured eardrum include loud blasts and pressure changes. Common symptoms of a perforated eardrum include sharp pain and a bloody discharge. If you believe your eardrum may be punctured, contact your doctor immediately, as there is a high risk of infection.
- Ageing and heredity
Ear structures, especially nerve cells, deteriorate with time. This deterioration can happen earlier if there’s a family history of early hearing loss. After age 60, it is important to have periodic screenings to rule out hearing loss or to determine a course of action (such as using hearing aids), to avoid further damage.
- Noise
Recreational and occupational noises, such as exposure to firearm blasts, carpentry and engine noises, can lead to damage to your ear structures.
- Illnesses and medication
Some illnesses that cause high fevers may end up hurting the ear’s internal structures due to inflammation. Also, some antibiotics, chemotherapy drugs and pain relievers can have temporary or permanent effects on your hearing capacity. Talk to your doctor if you believe a particular medication affects your hearing capacity.
Symptoms of hearing loss
Understanding some of the signs and symptoms of hearing loss is very important, especially for older adults who may have trouble recognising them. Because hearing impairments can have significant effects on cognitive decline, people responsible for older adults should be attentive to:
- A constant need to turn up the volume of the television or music
- Withdrawal from conversations and avoiding social interactions
- Difficulty understanding normal conversations; asking people to speak slowly or more loudly
- Changes in speech and pronunciation
- Changes in balance: suddenly experiencing falls or bumping into furniture
How is hearing loss diagnosed?
To diagnose hearing loss, and help you understand your options, your doctor will perform a series of tests, including:
- A physical exam: This will determine if you have structural damage, inflammation, infection or earwax buildup
- Audiometer tests: An audiologist will make you hear repeated tones at different levels
- Tuning forks: These metal instruments produce sound and can help determine the level of damage to your ear’s structures
- Whisper test: Your doctor will ask you to cover one of your ears and then speak at various volumes to determine how you respond
Are there treatments available?
Unfortunately, some types of hearing loss are irreversible. Depending on the level and causes of damage, some available treatments include:
- Surgery
When hearing loss is caused by fluid buildup due to persistent infections, your doctor can insert ear tubes to help with draining. If the problem is a result of eardrums or bone abnormalities, surgery can be helpful.
- Earwax removal
If hearing loss comes as a result of earwax buildup, there are techniques to remove it, such as microsuction. It is important to note that earwax removal should always be performed by a doctor, as poking your ears can result in significant damage to your eardrum.
- Hearing aids
When damage is irreversible, hearing aids can help a lot. An audiologist can help you determine the type of hearing aids that are best for your particular situation.
- Complications of hearing loss
Hearing is related to cognitive capacity and balance. For some people, this is a sensitive issue, and they may experience feelings of depression and isolation. It is very important to check with your audiologist and general practitioner to determine a course of action.
Preventing hearing loss
To prevent hearing loss, you can do periodic hearing testing (remember that some problems can be reversed when they are caught early). Also, keep your ears protected with earmuffs or earplugs when you are around loud noises. Keep your music volume down and wear hearing protectors while performing activities such as hunting or using power tools.
Talk to one of our expert audiologists if you believe you are experiencing hearing loss. They can help you determine the problem and find a treatment. Never try to clean or unblock your ears by yourself, as internal structures are extremely delicate and you can cause significant damage.
