All about Hearing Loss

Hearing loss or hearing impairment is becoming ever more prevalent in our noisy world. It is on the increase across the world and it is believed that the onset of hearing loss is happening at a younger and younger age. Let's look at hearing loss, what it is, how it happens and what the symptoms are.

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Hearing Problems, Hearing Impairment, Hearing Loss?

First of all a hearing loss does not immediately equate to a hearing impairment, a mild hearing loss or hearing outside of the parameters we call normal may not actually cause an impairment. When I first qualified as a hearing professional it was generally felt that we should not treat a mild hearing loss. The accepted thought at the time was that even if a person had a mild hearing loss, if it was not past a certain degree it probably would not be classed as an impairment.

However, that belief is beginning to change, with recent study findings in relation to the connection between hearing loss and neurocognitive disorders such as dementia. The evidence at present is correlative, which means there is a correlation between the two, correlative evidence does not mean that they are connected without doubt or that one causes the other. The weight of study evidence is gathering though and the opinion of the profession is starting to become that all hearing losses should be treated as early as is possible. 

What is the definition of hearing impairment?

A hearing impairment is any hearing loss that prevents someone from receiving all of the sounds they normally would through the ear. If the loss is mild, the person may have difficulty hearing faint or distant speech. If the loss is moderate, a person may have difficulty hearing speech in complex sound situations. If the loss is severe, a person may have difficulty hearing speech clearly. If a loss is profound, a person may have difficulty hearing speech at all. 

What are the three types of hearing loss? 

Hearing loss can be caused by many different causes, a few of which can be successfully treated with medicine or surgery, depending on the disease process. Most forms of hearing loss can not be treated other than with hearing aids. There are generally three types of hearing loss that are discussed. 

  • Conductive Hearing Loss: A conductive loss is caused by diseases or obstructions in the outer or middle ear that usually affect all frequencies of hearing.  Some conductive hearing losses are temporary, some are chronic or long term. Conductive loss can often be medically treated sometimes with surgery, temporary conductive losses (usually caused by mid ear infections) are often treated with medication. For conductive hearing loss of a more chronic nature a hearing aid is generally a fantastic solution delivering real benefit.
  • Sensorineural Hearing Loss: A sensorineural loss results from some damage to the inner ear (cochlea). Sometimes referred to as a nerve related hearing loss or nerve deafness. The loss can range from mild to profound and often affects certain frequencies more than others. The only treatment for sensorineural hearing loss at present is hearing aids.
  • Mixed Hearing Loss: A mixed loss is as it sounds a mix of both conductive and sensorineural hearing losses that occurs in both the inner and outer or middle ear. Mixed hearing loss tends to be pretty rare. 

Let's look at those a little closer

What can cause a conductive hearing loss?

  • A malformation of the outer ear, ear canal, or middle ear structures will cause a conductive hearing loss (this may be corrected surgically)
  • Fluid build up in the middle ear caused by colds or upper respiratory tract infections will cause a temporary hearing loss (temporary, should pass with the condition that caused it)
  • Ear infection, formally called otitis media, (an infection of the middle ear that causes an accumulation of fluid) will interfere with the movement of the eardrum and ossicles. (this can be temporary, but chronic ongoing otitis media can cause permanent damage)

What is the cause of sensorineural hearing loss?

  • Damage to the structures of the inner ear (cochlea), it can be caused by age, disease, noise or genetic causes
  • Damage to the the nerve that runs from the inner ear to the brain (auditory nerve), can be caused by disease, tumour or genetic causes
  • Damage to the auditory centre of the brain, varying causes such as disease or stroke

Mixed loss is generally a mixture of both conditions and causes

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