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Hearing loss

Definition

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

Alternative Names

Decreased hearing; Deafness; Loss of hearing; Conductive hearing loss; Sensorineural hearing loss; Presbycusis

Considerations

Symptoms of hearing loss may include:

  • Certain sounds seeming too loud
  • Difficulty following conversations when two or more people are talking
  • Difficulty hearing in noisy areas
  • Trouble telling high-pitched sounds (such as "s" or "th") from one another
  • Less trouble hearing men's voices than women's voices
  • Problems hearing when there is background noise
  • Hearing voices as mumbled or slurred

Other symptoms include:

Causes

Conductive hearing loss (CHL) occurs because of a mechanical problem in the outer or middle ear. This may be because:

  • The three tiny bones of the ear (ossicles) are not conducting sound properly.
  • The eardrum is not vibrating in response to sound.

Causes of conductive hearing loss can often be treated. They include:

  • Buildup of wax in the ear canal
  • Damage to the very small bones (ossicles) that are right behind the eardrum
  • Fluid remaining in the ear after an ear infection
  • Foreign object that is stuck in the ear canal
  • Hole in the eardrum
  • Scar on the eardrum from repeat infections

Sensorineural hearing loss (SNHL) occurs when the tiny hair cells (nerve endings) that detect sound in the ear are injured, diseased, do not work correctly, or have died. This type of hearing loss often cannot be reversed.

Sensorineural hearing loss is commonly caused by:

Hearing loss may be present at birth (congenital) and can 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

The ear can also be injured by:

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.

When to Contact a Medical Professional

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 Office Visit

The health care provider will take your medical history and do a physical exam.

Tests that may be done include:

The following surgeries may help some types of hearing loss:

The following may help with long-term hearing loss:

Cochlear implants are only used in people who have lost too much hearing to benefit from a hearing aid.

References

Baloh RW, Jen J. Hearing and equilibrium. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 24th ed. Philadelphia, PA: Saunders Elsevier; 2011:chap 430.

Hildebrand MS, Husein M, Smith RJH. Genetic sensorineural hearing loss. In: Cummings CW, Flint PW, Haughey BH, et al, eds. Otolaryngology: Head & Neck Surgery. 5th ed. Philadelphia, PA: Mosby Elsevier; 2010:chap 147.

Arts HA. Sensorineural hearing loss in adults. In: Cummings CW, Flint PW, Haughey BH, et al, eds. Otolaryngology: Head & Neck Surgery. 5th ed. Philadelphia, PA: Mosby Elsevier; 2010:chap 149.

Lonsbury-Martin BL, Martin GK. Noise-induced hearing loss. In: Cummings CW, Flint PW, Haughey BH, et al, eds. Otolaryngology: Head & Neck Surgery. 5th ed. Philadelphia, PA: Mosby Elsevier; 2010:chap 151.

Bauer CA, Jenkins HA. Otologic symptoms and syndromes. In: Cummings CW, Flint PW, Haughey BH, et al, eds. Otolaryngology: Head & Neck Surgery. 5th ed. Philadelphia, PA: Mosby Elsevier; 2010:chap 156.

El Dib RP, Matthew JL, Martins RHG. Interventions to promote the wearing of hearing protection. Cochrane Database Syst Rev. 2012;4:CD005234.  DOI: 10.1002/14651858. CD005234.pub5.


Review Date: 5/18/2014
Reviewed By: Ashutosh Kacker, MD, BS, Professor of Clinical Otolaryngology, Weill Cornell Medical College, and Attending Otolaryngologist, New York-Presbyterian Hospital, New York, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
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