Definition of Hearing loss:

Hearing loss is being partly or totally unable to hear sound in one or both ears.

See also:

• Hearing loss - infants
• Hearing loss of aging
• Sensorineural deafness

Considerations:

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.

Common Causes:

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:

• Measles
• Meningitis
• Mumps
• Scarlet fever

The ear can be injured by:

• Pressure differences between the inside and outside of the eardrum, often from scuba diving
• Skull fractures (can damage the structures or nerves of the ear)
• Trauma from explosions, fireworks, gunfire, rock concerts, and earphones

Other causes are:

• Age-related hearing loss (presbycusis)
• Acoustic neuroma
• Meniere's disease
• Use of certain medicines
• Working around loud noises every day (can damage the cells needed to hear)

Home Care:

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.

Call your health care provider if:

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 health care provider's office:

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:

• Audiometry (a hearing test used to check the type and amount of hearing loss)
• CT scan of the head (if a tumor or fracture is suspected)
• MRI of the ear and brain (see: MRI of the head)
• Tympanometry

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.