What causes hearing loss, and when and how it can be treated

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By Jennifer Shinn
University of Kentucky

Hearing loss can occur when any part of the ear or hearing system is not working correctly. The National Institutes of Health (NIH) estimates that 37.5 million American adults ages 18 and older report some trouble hearing.

It’s important to know the different types of hearing loss and when to seek medical care for hearing.

Conductive hearing loss occurs when sound is unable to travel correctly from the outer ear through to the inner ear. This can be caused by wax, ear infections or other issues like a hole in the eardrum or abnormalities of the bones within the middle ear.

Sensorineural hearing loss involves damage to the inner ear, hearing nerve and/or brain. This type of hearing loss is often caused by aging or noise exposure.

Patients who have a combination of both conductive and sensorineural are considered to have mixed hearing loss.

Hearing loss is usually gradual but in certain instances can be sudden. If sudden, a patient should seek medical care immediately.

Leading causes of hearing loss

For children, genetics accounts for 50 percent of hearing-loss cases. It can also be caused by intrauterine infections such as cytomegalovirus, lack of oxygen at birth, severe jaundice, extended stay in a neonatal intensive care unit, chronic middle ear fluid and infections, meningitis, and chemotherapy.

Adult hearing loss is often age-related. The NIH determines age as the strongest predictor of hearing loss among adults aged 20 to 69. The greatest amount of hearing loss is seen in the 60-69 age group.

There are many things that may cause hearing loss. Common factors that may cause hearing loss include noise exposure, genetics, viral infections and damage to the eardrum.

Common signs and symptoms of hearing loss

Hearing loss can occur in different ways, but some common symptoms may include the following:

• Asking people to repeat themselves.
• The perception that people are mumbling.
• Difficulty hearing in noisy environments.
• Listening to the television or radio at increased levels.
• General increased difficulty with communication.
• Social isolation.
• Ringing in the ears (tinnitus).
• Sensitivity to loud noises.

Anyone who suspects a decline in hearing should be evaluated by a specialist. An audiologist is the primary health care provider who evaluates, diagnoses and manages hearing loss and hearing balance disorders. Audiologists will diagnose the type and degree of hearing loss and provide recommendations for treatment options.

Hearing loss treatment

When medical and surgical management is not indicated, treatment for a patient’s hearing loss can often be managed by hearing aids. This is a non-surgical option. The NIH reports that 28.8 million U.S. adults could benefit from using hearing aids.

Cochlear implantation is a surgical option for patients who don’t benefit from hearing aids.

If you suspect you have hearing loss, contact an audiologist for a hearing evaluation.

Jennifer Shinn, Ph.D., is chief of audiology and professor in the UK Department of Otolaryngology.