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Hearing Loss and Deafness

Hearing Loss and Deafness

Definition

Deafness means complete hearing loss. Partial loss of hearing is often called hearing loss rather than deafness. Deafness can occur in one or both ears.
There are three primary types of hearing loss:
  • Conductive—hearing loss caused by the inability of the sound to reach the inner ear
  • Sensorineural—hearing loss caused by disorders of the inner ear or auditory nerve. This type of loss is usually permanent.
  • Mixed—hearing losses that are a combination of both conductive and sensorineural loss
The Ear
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Causes

The conditions that can cause or be associated with hearing loss include the following:
  • Ear infections
  • Middle ear fluid
  • Earwax
  • Hole in the ear drum
  • Trauma , including birth trauma
  • Nose or throat problems, such as:
    • Nasal allergies
    • Sinus problems
    • Blockage of the tubes leading from the ears to the throat
  • Family history
  • Noise
  • Ear disorders, such as:
  • Infections, such as:
  • Bacterial infections, such as:
  • Tumors involving the:
    • Ear
    • Brain
  • Neurological disorders, such as:
  • Hypothyroidism —underactive thyroid
  • Ototoxic drugs that damage the ear, such as:
    • Aspirin—usually reverses when aspirin is stopped
    • Quinine—usually reverses when quinine is stopped
    • Certain antibiotics—usually is not reversible when stopped

Risk Factors

Deafness may occur at any age. Risk factors that increase your chances of deafness include:
  • Premature birth
  • Increased age
  • Taking ototoxic medications
  • Exposure to loud noise on the job, such as:
    • Loud industrial noise
    • Use of heavy equipment
    • Being a musician
  • Exposure to recreational loud noise, such as:
    • Guns used during target practice
    • Loud music

Symptoms

Hearing loss usually comes on gradually, but may come on suddenly. Symptoms may include:
  • Difficulty hearing
  • Ringing in the ears, also called tinnitus
  • A sensation of spinning
  • Ear pain
  • Feeling of ear fullness, such as that caused by earwax or fluid
Symptoms of deafness in infants may be noted at these stages:
  • 1 to 4 months: lack of response to sounds or voices
  • 4 to 8 months:
    • Disinterest in musical toys
    • Lack of verbalization, such as babbling, cooing, and making sounds
  • 8 to 12 months: lack of recognition of child’s own name
  • 12 to 16 months: lack of speech
All children, including newborns, should be screened for hearing loss.

Diagnosis

You will be asked about your symptoms and medical history. A physical exam will be done. As part of the diagnosis, your doctor may try to determine the following:
  • Location of the problem
  • Degree of loss
  • Cause—not always possible to identify the exact cause of hearing loss; this information can help guide treatment
Your ears may be tested. This can be done with:
  • Otoscopy
  • Tympanometry
  • A brainstem auditory evoked response test
  • Bone vibrator—also called a tuning fork test
  • Audiogram —also called a hearing test
Images may be taken of your bodily structures. This can be done with:

Treatment

Treatment for deafness depends on the type of hearing loss. Options may include:
  • Medical treatment, such as removal of earwax or use of antibiotics to treat an ear infection
  • In selected cases of sudden hearing loss, medical treatment with steroids may be effective.
  • Hearing aids to help amplify sounds
  • Surgery, such as:
    • Stapedectomy—for treatment of otosclerosis
    • Tympanoplasty —for a perforated eardrum
    • Tympanoplasty tubes—for persistent middle ear infections or fluid
    • Cochlear implant —a surgically implanted electronic device that helps provide sound to a person with severe sensorineural hearing loss. Although the devices do not completely restore hearing, improvements in implant technology continue to be made.
  • Learning sign language or lip reading to improve communication skills

Prevention

To help prevent deafness, avoid loud noise. In cases when loud noise cannot be avoided, you can reduce exposure to loud noises by wearing ear protection. Also, taking steps to reduce injuries or disease may prevent certain types of deafness.
There is currently no effective way to prevent congenital or genetic deafness. Hearing screening for newborns can help ensure that hearing loss in young babies is detected and treated at the earliest possible stage.

RESOURCES

American Academy of Audiology http://www.audiology.org

National Institute on Deafness and Other Communication Disorders http://www.nidcd.nih.gov

CANADIAN RESOURCES

Canadian Academy of Audiology http://www.canadianaudiology.ca

Canadian Association of the Deaf http://www.cad.ca

References

Deafness and hearing loss. World Health Organization website. Available at: http://www.who.int/topics/deafness/en. Accessed September 17, 2014.

Deafness and hearing loss research. The Scripps Research Institute website. Available at: http://www.scripps.edu/discover/deafness.html. Accessed September 17, 2014.

Hearing, ear infections, and deafness. National Institute on Deafness and Other Communication Disorders website. Available at: http://www.nidcd.nih.gov/health/hearing/Pages/Default.aspx. Accessed September 17, 2014.

Hearing loss. American Speech-Language-Hearing Association website. Available at: http://www.asha.org/public/hearing/Hearing-Loss. Accessed September 17, 2014.

Plaza G, Herráiz C. Intratympanic steroids for treatment of sudden hearing loss after failure of intravenous therapy. Otolaryngol Head Neck Surg. 2007 Jul;137(1):74-8.

What is hearing loss? NIH SeniorHealth website. Available at: http://nihseniorhealth.gov/hearingloss/hearinglossdefined/01.html . Accessed September 17, 2014.

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