Hearing loss can be temporary or permanent and can affect all age groups. Ageing, ear infections and loud noises all cause hearing loss.
Hearing loss affects around one out of six people in the UK. Most of these people are over 60 and have lost their hearing gradually as part of the natural ageing process. More than half of people over 60 in the UK have some degree of hearing loss. However, hearing loss can also happen at a younger age.
Your ear consists of three parts: the outer ear, middle ear and inner ear.
The outer ear is the visible part of your ear. It collects sound waves, which travel down your ear canal to your eardrum. The sound waves cause your eardrum to vibrate. This vibration is passed on to your middle ear, which consists of three small bones called ossicles. The ossicles amplify and conduct the vibrations to your inner ear.
Your inner ear contains the cochlea and the auditory nerve. The cochlea is full of fluid and contains tiny hair cells. Vibrations cause the hair cells in your cochlea to move. Movement of these hair cells produces electrical signals that travel along the auditory nerve to your brain, where they are converted into meaningful information, such as language or music.
There are two main types of hearing loss.
You may have a combination of conductive and sensorineural hearing loss – this is known as mixed hearing loss.
You may have hearing loss in one ear only (unilateral) or both ears (bilateral).
In adults, hearing loss may be very gradual, for example in age-related hearing loss. You may start to notice you find it difficult to hear and understand people when you're in a noisy place. Hearing loss can also be very sudden, for example if it’s caused by a viral infection of the inner ear. Some people find that their hearing loss is associated with a continual ringing in their ears (tinnitus).
If you have an infection, you may have some other symptoms, such as earache and discharge from your ears.
Hearing loss can affect the speech and language development in children.
If you, or your friends and family, think that your hearing is getting gradually worse, see your GP. For example, you may have started to notice that you have difficulty hearing what is being said when you are in a group.
If you have sudden hearing loss in one or both ears, seek immediate advice, as treatment may need to be started very quickly.
The following are possible causes of conductive hearing loss.
The causes of conductive hearing loss can often be treated, so it’s usually only temporary.
Sensorineural hearing loss happens when the hair cells within your cochlea are damaged. The following are some possible causes.
Sensorineural hearing loss is usually permanent as once the hair cells in your cochlea are damaged, they can’t be repaired.
Your GP will ask you about your symptoms and examine you. He or she may also ask you about your medical history.
Your GP may do a hearing test, or he or she may refer you to either an otolaryngologist (a doctor who specialises in ear, nose and throat disorders), an audiologist (a specialist in hearing) or an audiovestibular physician (a doctor who specialises in hearing, balance and communication problems).
You may have the following tests.
If your hearing loss has a sensorineural cause, a number of other tests can be done to pinpoint where the problem lies.
If one ear is hearing better than the other, your doctor may organise a scan – usually an MRI scan. This is to rule out rare causes of hearing loss such as an acoustic neuroma or cholesteatoma.
You may find it easier to hear and understand people if you:
If you have a bacterial infection of your middle ear, it can sometimes be treated with antibiotics. Always ask your GP for advice and read the patient information leaflet that comes with your medicine.
If your outer or middle ears are blocked by ear wax or fluid caused by an ear infection, a nurse will often be able to remove the blockage with a syringe after it has been softened.
If there is no cure for your hearing loss, for example if it’s caused by ageing, a hearing aid for one or both of your ears may help. Hearing aids can work for both conductive and sensorineural hearing loss. Many different types of hearing aid are available, and your audiologist will advise you as to which type best suits your needs.
If you have a large perforation of your ear, you may need to have surgery to repair it.
An acoustic neuroma may only need monitoring. However, if needed, it can be removed with surgery or treated with radiotherapy. Ossicles affected by otosclerosis can sometimes be treated with surgery.
If a hearing aid doesn’t help (eg in profound deafness), your doctor may suggest you have a cochlear implant. This is a device that turns sounds into electrical signals, which directly stimulate your auditory nerve allowing you to hear.
Produced by Natalie Heaton, Bupa Health Information Team, April 2013.
For answers to frequently asked questions on this topic, see FAQs.
For sources and links to further information, see Resources.
This information was published by Bupa's Health Information Team and is based on reputable sources of medical evidence. It has been reviewed by appropriate medical or clinical professionals. Photos are only for illustrative purposes and do not reflect every presentation of a condition. The content is intended only for general information and does not replace the need for personal advice from a qualified health professional. For more details on how we produce our content and its sources, visit the about our health information page.
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