hearing loss

Conditions of the Inner, Middle, and External Ear
What is hearing loss?
Hearing loss is a sudden or gradual decrease in your ability to hear. Depending on the cause, it can range from mild to severe and can be temporary or permanent. Hearing loss is also known as hearing impairment, which includes being born without hearing (congenital hearing loss). This topic focuses only on gradual or sudden hearing loss.
Gradual hearing loss affects people of all ages and is especially common in older adults. Hearing loss interferes with social interaction in 25% of adults age 65 to 74 and 50% of adults age 75 and older. 1
If you have hearing loss, you may not be aware of it, especially if it has developed gradually. Family members or friends are often the first to notice the hearing loss. For example, they may notice that you are having difficulty understanding what is being said, especially when there are competing voices or background noise.
Hearing loss can impact your personal safety and your productivity in the workplace and at home. However, hearing aids and other devices can help you live a full life by helping you adapt to reduced hearing.
What causes hearing loss?
In adults, the most common causes of hearing loss are:
• Noise. Noise-induced hearing loss can affect people of all ages and most often develops gradually over many years. Over a long period of time, the noise experienced at work, during recreation (such as riding motorcycles), or even during common chores (such as using a power lawn mower) can lead to hearing loss.
• Age. In age-related hearing loss, or presbycusis, changes in the nerve tissue and cells of the inner ear that occur as you grow older cause a gradual but steady hearing loss. The loss may be mild or severe, but it is always permanent.
Other causes of hearing loss include earwax buildup, an object in the ear, injury to the ear or head, ear infection, a ruptured eardrum (tympanic membrane perforation), otosclerosis (a condition affecting the bones of the middle ear), acoustic neuroma (a noncancerous tumor on the cochlear, or auditory, nerve), and Ménière's disease.
What happens in hearing loss?
In hearing loss, one or more of the ear's three main structures is damaged. These structures are the:
• External ear canal.
• Middle ear, which is separated from the ear canal by the eardrum.
• Inner ear, which contains the cochlea, the main sensory organ of hearing.
Which part of the ear is damaged determines the type of hearing loss.
• In conductive hearing loss, sound is blocked from passing into the inner ear.
• In sensorineural hearing loss, sound reaches the inner ear, but a problem in the inner ear prevents proper hearing.
A mixed hearing loss, in which both the conductive and sensorineural systems are affected, can also occur.
Undiagnosed and untreated hearing loss can contribute to depression, social isolation, and loss of independence, especially in older adults.
How is hearing loss diagnosed?
Hearing loss is diagnosed through a medical history and a physical examination. If hearing loss is suspected, your health professional may do initial screening tests in the office. If these initial tests suggest or reveal hearing loss, a more thorough hearing (audiologic) evaluation will be done to assess whether you have a hearing loss, how severe the loss is, and which part of the ear is affected.