What is Hearing Loss

Hearing loss is a common problem caused by noise, aging, disease, and heredity. People with hearing loss may find it hard to have conversations with friends and family. They may also have trouble understanding a doctor’s advice, responding to warnings, and hearing doorbells and alarms.

A person is said to have hearing loss if they are not able to hear as well as someone with normal hearing, meaning hearing thresholds of 20 dB or better in both ears. It can be mild, moderate, moderately severe, severe or profound, and can affect one or both ears.

Hearing loss vs tinnitus

Although severe tinnitus can interfere with your hearing, the condition does not cause hearing loss. Tinnitus is a symptom associated with many ear disorders. A common cause of tinnitus is inner ear damage. Tiny, delicate hairs in your inner ear move with the pressure of sound waves.

Hearing loss causes

Health conditions common in older people, such as diabetes or high blood pressure, can contribute to hearing loss. Viruses and bacteria (including the ear infection otitis media), a heart condition, stroke, brain injury, or a tumor may also affect your hearing.

Hearing loss, is the loss of sound sensation and discrimination ability. It can be sudden or gradual. This loss can also be divided into two categories as either congenital (inborn from birth) or acquired hearing loss.

Congenital hearing loss is an hearing deficit since birth.

Acquired hearing loss happens later after birth. Some of the commoner causes are aging, trauma, long term exposure to loud noise, surgery of the ear/brain, infections in the middle or inner ear, and ototoxic drugs.

Hearing loss treatments

  • Removing wax blockage. Earwax blockage is a reversible cause of hearing loss.
  • Surgical procedures. Some types of hearing loss can be treated with surgery, including abnormalities of the eardrum or bones of hearing (ossicles).
  • Hearing aids.
  • Cochlear implants.

The treatments vary depending on the type, site/s and severity of hearing loss. This is best assessed and diagnosed by an Ear, Nose & Throat Specialist. 

The appropriate treatment may be conservative observation, hearing aid and /or ear surgery. For children with persisting “glue ear” especially when in both ears with notable signs of language and /or attention problems, a ventilation tube (grommet) can be placed into the eardrum by surgery. For patients with a perforated eardrum, this can be repaired by surgery.

For patients with bilateral complete deafness, a cochlear implant sound processor should be considered. This re-stimulates the deaf ear using an electrode array and some very clever speech software processing. The new sound that is heard will indeed be different. Speech and hearing rehabilitation exercises to re-learn these sounds would be required. Children do better than adults with these cochlear implants. Studies have shown that a child’s brain has a higher neuro-plasticity than an adult, and therefore a greater capacity to adapt to new sounds and learning development.

Hearing loss in children

Hearing loss in children is more commonly seen than in adults. This is because acute suppurative otitis media, which is an infection of the middle ear cavity, is the commonest infection of childhood. It occurs after an upper respiratory infection. The majority of these infections subside completely but it is not uncommon that some persists as a collection of a straw-colored fluid in the middle ear. This fluid has the consistency of “glue”, and when present, prevents the eardrum from moving normally. Hence children with acquired “glue-ear” will have a reduction in their hearing similar to water getting into their ear/s after a shower. This condition can exist in one or both ears.

In children, hearing losses should be investigated and treated as early as possible. This is especially true for children aged up to 7 years old as our speech and language development occurs in the first seven years of life. It is accepted that speech and language rehabilitation becomes more difficult and less successful, the later the hearing loss is diagnosed, and after optimal treatment.

Hearing loss in adults

Hearing loss may be acquired later in life. Causes include the long term sequelae of childhood ear infections like a perforated eardrum or cholesteatoma and hearing loss secondary to aging, ototoxic drugs application, noise-induced loss, barotrauma, occupation related noise exposure, ear surgery or intracranial brain surgery, intracranial tumours, unexplained sudden hearing loss, etc.

Hearing loss in one or both ears

Hearing loss can happen in either one (unilateral) or both ears (bilateral). Different hearing problems may co-exist in the same ear or in both ears. The severity of the hearing loss for each ear may vary from a mild loss (cannot hear someone whispering into your ear) to a profound hearing loss (cannot hear someone shouting into your ear) and anything in between.

Patients with a unilateral hearing loss, normal hearing ability may exist on the other side. These sufferers tend to hear only in one ear, and therefore fail to be able to stereo-localise sounds as other normal individuals i.e. they cannot tell the direction of sounds. They also particularly have problems in any noisy environment, such as in a meeting, restaurant, bar, etc. Here the voice of the speaker they are trying to listen to, competes with the noise of the background, which drowns it out. Hence it is hard for them to concentrate on one sound source and listen clearly. Certain adaptations in lifestyles are essential like cocking their heads to one side so the better hearing ear hears what is being said, walking always with friends / family standing on the side of their good ear, attending meeting early to sit in a position that would be advantageous to hearing better in the meeting, etc.

For patients with bilateral hearing loss, usually caused by noisy working environment over time and aging, they require a louder volume of sound stimulus in order to hear better. Turning the television, hifi, or radio up louder appears to do the trick but their family, friends and neighbours may, and do, find it disturbing.

The information on this website is for general educational purpose only. Readers should consult their physician before considering treatment, and should not interpret their condition solely based on the information above.