Article by Hearing Partners, contributed by Megat Ikmal, Clinical Audiologist at Hearing Partners
Hearing loss is a condition affecting millions worldwide. According to the Ministry of Health Malaysia, at least 21.57% of the population suffers from hearing loss1.
Broadly categorised as either acquired or congenital, this condition can be developed over time or present from birth. While congenital hearing loss is permanent, acquired hearing loss can be permanent or temporary.
Temporary hearing loss can be acquired from situations like earwax blockage or middle ear infections. It may resolve on its own or require treatment to address the underlying cause. On the other hand, permanent hearing loss is irreversible, with no effective medical treatments to restore hearing.
Understanding the distinctions between these types of hearing loss is crucial in navigating the impacts and seeking appropriate interventions. Keep reading to learn more.
Key Takeaways
- Hearing loss is a reduced ability to hear sounds clearly and may affect one ear or both ears, developing either gradually or suddenly.
- The three main types of hearing loss are sensorineural, conductive, and mixed, depending on which part of the ear is affected.
- Common causes of hearing loss include prolonged noise exposure, ageing, inner ear damage, and earwax build-up.
- Speaking loudly, difficulty hearing in noisy environments, and frequently asking others to repeat themselves may be signs of hearing loss in adults.
- Hearing loss can range in severity from mild to profound.
- Management and treatment options for hearing loss may include earwax removal, hearing aids, cochlear implants, surgery, or medication, depending on the cause.
What Is Hearing Loss?
Hearing loss is the reduced ability to hear sounds clearly or at normal levels. It can affect one (unilateral hearing loss) or both ears (bilateral hearing loss), and may develop gradually or occur suddenly. Hearing loss can make it difficult to follow conversations, especially in noisy environments, and may lead to misunderstandings or listening fatigue.
What Are the Types of Hearing Loss?
There are three primary types of hearing loss, each associated with damage to different parts of the ear.
Sensorineural hearing loss
Conductive hearing loss
Conductive hearing loss occurs when damage or obstruction in the outer or middle ear affects the transmission of sound waves to the inner ear. This disruption in the sound pathway causes sounds to be perceived as softer than normal. Unlike sensorineural hearing loss, conductive hearing loss can be treated with surgery or medication to address the underlying issue in the outer or middle ear.
Mixed hearing loss
Damage to the middle and inner ear results in mixed hearing loss, a combination of sensorineural and conductive hearing loss. This condition can stem from causes of both types of hearing loss. Treatment for this condition effectively depends on identifying and addressing the specific contributing factors.
What Are the Causes of Hearing Loss?
The causes of hearing loss depend on the type of hearing loss you are diagnosed with.
| Sensorineural hearing loss | Conductive hearing loss |
|---|---|
| Outer ear canal Middle ear |
What Are the Common Signs of Hearing Loss?
Symptoms of hearing loss can manifest at different paces and might be tricky to spot. The following signs are based on guidelines from the Ministry of Health Malaysia.
| Adults | Children | Babies |
|---|---|---|
Degree of Hearing Loss
The degree of hearing loss is based on how loud sounds need to be for the individual to hear them. It’s measured in decibels (dB) and can be grouped into four levels: mild, moderate, severe and profound.
- Mild (21 – 40 dB)
For those with mild hearing loss, following conversations in noisy settings can be difficult. They may struggle to understand speech clearly, commonly missing softer sounds and speech nuances.
- Moderate (41 – 70 dB)
Individuals experiencing moderate hearing loss might compensate by adjusting their environment, such as raising the television volume. Communication may become challenging at this stage and feelings of isolation may develop. Without sound amplification devices like hearing aids, quality of life may deteriorate.
- Severe (71 – 90 dB)
At this stage, environmental sounds can be challenging to perceive even with a hearing aid. Effective communication often requires additional strategies, such as lip-reading, sitting close to speakers, and asking them to speak slowly and clearly. These tactics help improve speech understanding and ensure meaningful interactions despite the hearing loss.
- Profound (>90 dB)
Even with a hearing aid, individuals with profound hearing loss find listening challenging. They often rely on communication strategies similar to those used by individuals with severe hearing loss.
How to Diagnose Hearing Loss
An Ear, Nose and Throat (ENT) doctor or audiologist will carry out the following tests to diagnose hearing loss.
Physical examination
The doctor will typically conduct a physical examination that includes inspecting the ear canal, tympanic membrane (eardrum), nose, and nasopharynx. Additionally, a neurologic exam may be carried out to assess nerve function related to auditory processing and transmission.
Hearing tests
Hearing tests, or audiometry tests, will be conducted to identify the type and severity of the hearing loss. Different tests may be recommended for adults as well as babies and children, depending on their symptoms and the physical examination.
In cases of suspected conductive hearing loss, a tympanometry test may be recommended to evaluate middle ear function and assess the integrity of the eardrum. These tests are crucial in diagnosing hearing issues accurately and guiding appropriate treatment strategies.
Radiological imaging
In some cases, radiological imaging techniques such as Computed Tomography (CT), Magnetic Resonance Imaging (MRI), or other scans may be recommended to detect acoustic neuroma, a benign tumour that can potentially lead to hearing loss.
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What Are the Treatment and Management Options for Hearing Loss?
Effective treatment or management of hearing loss depends significantly on the type and severity of the condition. From simple interventions such as earwax removal to devices such as hearing aids, audiologists tailor treatment plans to address individual hearing needs.
Earwax removal
To address conductive hearing loss caused by earwax buildup, earwax removal via ear irrigation or microsuction is necessary. This clears up the obstruction within the ear canal and restores hearing.
Hearing aids
Hearing aids are devices designed to improve hearing for individuals with sensorineural or conductive hearing loss by detecting and amplifying sounds in the environment. They’re effective across various degrees of hearing impairment, enhancing clarity and enabling better auditory perception.
Cochlear implants
Cochlear implants are advanced devices surgically placed in the inner ear to address sensorineural hearing loss. These devices bypass damaged auditory components to stimulate the auditory nerve directly. They can be worn by individuals of all ages and are primarily recommended for moderate to severe hearing loss.
However, due to its invasive nature, this procedure is considered only when individuals demonstrate limited benefit from hearing aids and have poor speech intelligibility scores.
Medication
Medications like topical antibiotics are commonly prescribed for ear infections. If a medication is found to cause hearing loss, it may be discontinued or replaced with a safer alternative.
Surgery
Surgery may be used to address conditions such as recurring ear infections, otosclerosis or perforated eardrums. Each surgical procedure focuses on addressing the root cause of the condition being treated.
FAQs About Hearing Loss
Does hearing loss only affect the elderly?
Age is frequently associated with hearing loss, as natural ageing processes can affect auditory function. However, hearing loss is not exclusive to older individuals and can impact people of all ages.
According to the World Health Organisation (WHO), more than 1 billion young adults are susceptible to permanent and preventable hearing loss2. This is primarily due to unsafe listening behaviours, such as prolonged exposure to loud noises.
What is noise-induced hearing loss?
Noise-induced hearing loss is hearing damage caused by exposure to loud sounds over time or from a single intense noise event, like an explosion. It occurs when the sensitive structures in the inner ear are damaged by excessive sound levels.
Noise-induced hearing loss is usually permanent, but it can be prevented by protecting your ears, lowering volume levels, and using hearing protection when needed.
What are the possible complications of hearing loss?
Untreated hearing loss can lead to several complications. This includes communication difficulties, which can result in strained relationships with others, decreased social interaction and engagement, and loss of confidence. In younger children, learning or educational difficulties are possible complications as well.
Can hearing loss be prevented?
Steps can be taken to prevent hearing loss. Here are some do’s and don’ts when it comes to preserving auditory health:
| Do’s | Don’ts |
|---|---|
Can hearing loss be reversed?
Some types of hearing loss can be reversed, but many cannot and are managed instead. Reversible hearing loss is often linked to temporary causes such as earwax build-up, fluid in the ear, or infections. Once the underlying issue is treated, hearing may return to normal.
However, permanent hearing loss, especially sensorineural hearing loss, usually cannot be reversed. In these cases, management options include:
- Hearing aids
- Cochlear implants
- Medication
- Surgery
Early assessment helps determine whether the hearing loss is temporary or permanent and ensures the right support is provided.
Megat Ikmal is a Clinical Audiologist at Hearing Partners. He has a Bachelor of Audiology with Honours from the International Islamic University Malaysia (IIUM) and is registered under the Malaysian Allied Health Professions Council MAHPC(AUD)00572. He is experienced in conducting adult and paediatric hearing tests as well as electrophysiological assessments.
References
1Referenced from the Ministry of Health Malaysia
2Referenced from the World Health Organisation (WHO)