Types of hearing loss in adults: an overview
As we age, it's not uncommon for our hearing to deteriorate. Hearing loss can be gradual or sudden and can have a profound impact on daily life. It can lead to difficulty communicating, strain on relationships, and even depression. In this article, we'll explore the types of hearing loss in adults, the top six causes of hearing loss, and how to diagnose, treat, and manage the condition. First, it is important to understand the types of hearing loss.
Sensorineural Hearing Loss
Sensorineural hearing loss is the most common type of hearing loss in adults and is caused by damage to the inner ear (cochlea) or the nerve pathways that transmit sound from the inner ear to the brain. This type of hearing loss can be caused by age, exposure to loud noise, genetics, and disease. Sensorineural hearing loss can result in difficulty hearing high-pitched sounds, a reduction in overall hearing ability, and even ringing in the ears (tinnitus).
Conductive Hearing Loss
Conductive hearing loss is caused by a problem with the outer or middle ear that prevents sound from reaching the inner ear. Causes of conductive hearing loss include blockages in the ear canal, perforated eardrums, and problems with the bones in the middle ear. Conductive hearing loss can result in a muffled or flat sound and can usually be treated medically or surgically by an ear, nose and throat (ENT) specialist or GP.
Mixed Hearing Loss
Mixed hearing loss is a combination of sensorineural and conductive hearing loss. This type of hearing loss can result in a combination of symptoms, including difficulty hearing high-pitched sounds and a muffled or flat sound.
These hearing losses are a result of a number of causes.
Age-related hearing loss
Age-related hearing loss, also known as presbycusis, is the most common cause of hearing loss in adults. As we age, the hair cells in our inner ear begin to deteriorate and are usually gradual affecting both high and low pitch sounds. This type of hearing loss usually occurs gradually, is permanent and affects both ears equally. It is important to seek prompt treatment as presbycusis can lead to social isolation, depression, and other health problems. A diagnostic hearing assessment by an experienced Audiologist can determine the extent of your hearing loss and help you find the right treatment solution. Treatment for this is often through a prescription of hearing devices, cochlear implants (for severe to profound hearing loss), and sound amplification devices which can all be effective in managing age-related hearing loss.
Noise-induced hearing loss
Noise-induced hearing loss is caused by exposure to persistent loud noises, such as music or concerts, loud machinery and workplace tools, or even firearms. This type of hearing loss can be sudden or gradual and can result in difficulty hearing high-pitched sounds, ringing in the ears (tinnitus), and a reduction in overall hearing clarity and definition. To diagnose noise-induced hearing loss, an experienced Audiologist will conduct a comprehensive hearing test. They will take a detailed history to understand your noise history, work environment and any hobbies that involve exposure to loud noises. The Audiologist can raise an ACC claim for noise induced hearing loss if you meet the criteria. While there is no cure for noise-induced hearing loss, there are several management strategies that can help minimize its effects. Wearing earplugs or earmuffs can help protect your ears from further damage, and avoiding loud noises where possible can also be helpful. In many cases, hearing devices may be recommended to improve your ability to hear.
Otitis media
Otitis media is an infection of the middle ear that can cause conductive or mixed hearing loss. This type of hearing loss is often sudden and can be severe. An ENT specialist and Audiologist will assess your medical history and conduct a hearing test and a comprehensive examination of the ear drums to determine if you have otitis media. Treatment options include antibiotics to manage the infection and in some cases, surgery such as grommets to reduce middle ear infection and repair any damage to the middle ear. Hearing devices may be recommended to manage hearing loss.
Ototoxic drug-induced hearing loss
Ototoxic drug-induced hearing loss is caused by some medications such as certain antibiotics, pain medication and chemotherapy drugs that are toxic to the inner ear. This type of hearing loss can be sudden and severe and temporary or permanent, depending on the type and duration of medication use. To diagnose ototoxic drug-induced hearing loss, an experienced Audiologist will conduct a comprehensive diagnostic hearing test and take a comprehensive medical history to ask about any medications you are currently taking. If ototoxic drug-induced hearing loss is caused by a temporary medication, the hearing loss may resolve once the medication is switched or discontinued. It is important to contact your GP who will have your current prescriptions, discuss with your medical oncologist if undergoing chemotherapy and include an ear, nose and throat (ENT) specialist who may be able to prescribe medication to restore hearing. If the hearing loss is permanent, hearing aids may be recommended to improve your ability to hear. It's important to discuss the potential side effects of any medication with your doctor before starting treatment.
Meniere's disease
Meniere's disease is a condition that affects the inner ear and can cause a fluctuating hearing loss, ringing in the ears (tinnitus), dizziness or vertigo, and a feeling of fullness in the ear. The cause of Meniere's disease is still not well understood, but it is thought to be related to an increase in fluid pressure in the inner ear. To diagnose Meniere's disease, an experienced Audiologist will conduct a comprehensive hearing test and complete a comprehensive medical history about any symptoms you are experiencing, such as dizziness or ringing in the ears. A referral to an ENT may be required for additional assessment such as CT or MRI scans. Treatment options include medications to manage symptoms, a low-sodium diet, and in some cases, surgery. Hearing devices can also be effective in managing the hearing loss and tinnitus for individuals experiencing Meniere’s disease.
Genetics
Hearing loss can also be inherited and passed down from generation to generation. This type of hearing loss can be present at birth or develop later in life and can result in difficulty hearing high-pitched sounds, ringing in the ears and balance or vertigo symptoms. An experienced Audiologist will conduct a thorough medical history and request information that may show a familial link or genetic history. A diagnostic hearing test will be performed to understand the type of hearing loss which often presents with a mid pitch sensorineural ‘cookie bite’ configuration. Treatment is often in the form of hearing devices which can improve hearing clarity and definition.
Trauma-induced hearing loss
Trauma to the head or neck can cause hearing loss. A head injury, such as a concussion, can result in hearing loss by damaging the inner ear or the nerve pathways that transmit sound from the inner ear to the brain. This type of hearing loss can be sudden or gradual and can result in difficulty hearing high-pitched sounds, ringing in the ears (tinnitus), and a reduction in overall hearing ability.
This type of hearing loss can be sudden and severe. An ENT, GP and an experienced Audiologist will assess your medical history and conduct a diagnostic hearing test to determine if you have trauma-induced hearing loss. An ENT may request CT and MRI scans of the ear and brain to determine the extent of damage and causes for the hearing loss. Treatment options may include surgery to repair damaged outer and middle ear structures. Hearing devices are also effective in managing hearing loss and tinnitus for these individuals rehabilitation.
Hearing loss is a complex diagnosis and requires an experienced Audiologist to provide a comprehensive diagnosis and management strategies.
Related reading
