Hearing Loss

Hearing loss can develop gradually or suddenly and ranges from mild to profound. Some causes are reversible, while others require hearing aids or implants to manage.

Table of Contents

Quick Facts

  • ICD-10: H90, H91
  • Types: Conductive, sensorineural, mixed
  • Most common: Age-related (presbycusis)
  • Often treatable: Yes

Overview

Hearing loss occurs when sound is not transmitted properly through the outer/middle ear (conductive) or is not processed correctly by the inner ear and auditory nerve (sensorineural).

Types

  • Conductive — problem in the outer or middle ear (earwax, fluid, ear infection, eardrum problems).
  • Sensorineural — damage to the inner ear or auditory nerve.
  • Mixed — both types together.

Causes

Conductive

  • Earwax impaction
  • Middle ear infection (otitis media) or fluid
  • Eardrum perforation
  • Otosclerosis (abnormal bone growth in the middle ear)

Sensorineural

  • Age-related hearing loss (presbycusis)
  • Noise exposure
  • Ototoxic medications (some antibiotics, chemotherapy, high-dose aspirin)
  • Meniere's disease
  • Sudden sensorineural hearing loss (a medical urgency)
  • Acoustic neuroma (rare tumor)
  • Genetic conditions

When to Seek Urgent Care

Sudden hearing loss in one ear is a medical urgency. See an ENT specialist within 24–72 hours — early steroid treatment can sometimes restore hearing.

Diagnosis

  • Audiogram (pure tone audiometry)
  • Tympanometry to assess middle ear function
  • Speech testing
  • Otoscopic examination
  • MRI if asymmetric loss or other neurologic concerns

Treatment

  • Remove earwax
  • Antibiotics for active ear infections
  • Surgery for chronic ear infections, eardrum perforations, or otosclerosis
  • Hearing aids — the mainstay for sensorineural hearing loss
  • Cochlear implants for severe-to-profound loss not helped by hearing aids
  • Bone-conduction or middle-ear implants in selected cases
  • Tinnitus management

Prevention

  • Use ear protection in loud environments
  • Keep personal audio devices at moderate volumes (60% volume, no more than 60 minutes at a time is a common rule)
  • Treat ear infections promptly
  • Avoid inserting cotton swabs into the ear canal

When to See a Doctor

See a doctor for:

  • Sudden hearing loss (urgent)
  • Hearing loss with vertigo, ringing, or pain
  • Difficulty understanding conversations
  • Hearing loss interfering with work, school, or relationships

Related Symptoms

Tinnitus

Often co-occurs with hearing loss

 Sensorineural Hearing Loss

Inner-ear hearing loss

 Conductive Hearing Loss

Outer/middle ear hearing loss

 Ear Pain

May accompany acute hearing changes

Frequently Asked Questions

Why does my hearing seem worse in noisy places?

Age-related hearing loss typically affects higher frequencies first, making consonants and speech harder to pick out from background noise even when overall volume seems adequate.

Will hearing aids restore my hearing?

Hearing aids amplify and clarify sound but don't restore normal hearing. With practice and proper fitting, they typically improve communication significantly.

Is hearing loss inherited?

Some hearing loss is genetic and can be present from birth or develop later in life. Age-related hearing loss also has a strong genetic component.

Can hearing loss cause dementia?

Untreated hearing loss is associated with higher rates of cognitive decline. Treating hearing loss (e.g., with hearing aids) may help reduce this risk.

Medical Disclaimer: This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider with questions about a medical condition. If you are experiencing a medical emergency, call your local emergency number immediately.

References

  • American Academy of Otolaryngology. Sudden Sensorineural Hearing Loss Guideline.
  • World Health Organization. Deafness and hearing loss.