Hearing Loss: Signs, Common Causes and When to Be Seen

What it involves

MedlinePlus says hearing disorders make it hard, but not impossible, to hear, and that they can often be helped. There are two main kinds: damage to the inner ear or the auditory nerve, which is usually permanent, and a blockage that keeps sound from reaching the inner ear, which can often be reversed.

Who this is for

• Patients who keep turning up the television or asking people to repeat themselves
• Patients who struggle to follow conversation in a noisy restaurant
• Patients with a sudden change in hearing, ringing, or a plugged feeling in one ear
• Adult children worried about a parent who seems to be withdrawing from conversations

What to expect

• Questions about how quickly the change came on, whether one or both ears are affected, and exposure to loud noise
• A look in the ear canals to check for wax, fluid, or an eardrum problem
• A review of medicines and conditions such as diabetes that can affect hearing
• A plan that may include treating a simple cause or a referral for a formal hearing test with an audiologist or ear specialist

Why hearing changes

MedlinePlus lists heredity, diseases such as ear infections and meningitis, trauma, certain medicines, long-term exposure to loud noise, and aging as possible causes. The tiny hair cells inside the inner ear pick up sound and turn it into nerve signals, and because they do not regrow, damage to them is permanent. Smoking and conditions such as diabetes are linked to age-related loss as well.

Everyday signs to notice

MedlinePlus describes age-related hearing loss as a slow process, with signs such as these:

• Difficulty hearing people around you, or frequently asking them to repeat themselves
• Needing to raise the television volume
• Problems hearing in noisy places
• Trouble telling apart sounds such as "s" and "th", or understanding higher-pitched voices
• Ringing in the ears

The fixable causes come first

Because blockage-type loss can often be reversed, a provider starts by looking in the ears. MedlinePlus says earwax buildup, fluid, or a punctured eardrum can keep sound from reaching the inner ear. The earwax guide explains the most common of these, and the ear pain and infection guide covers fluid and infection.

Ringing and balance

Hearing trouble and ringing often travel together, and the tinnitus guide explains what a provider considers when the ringing is the main complaint. Hearing and balance share parts of the inner ear, so unsteadiness can also be part of the picture, as the dizziness guide describes.

What help looks like

MedlinePlus says age-related hearing loss has no cure, so treatment aims at improving everyday function. Hearing aids, telephone amplifiers and other assistive devices, speech reading, and sign language for severe loss are all listed, and a cochlear implant may be recommended for severe loss. A provider may refer you to an ear, nose, and throat doctor and an audiologist, who run the formal hearing tests.

Why not wait

MedlinePlus warns that untreated hearing problems can get worse, and notes that hearing loss may lead people to avoid leaving home. It encourages getting help from a provider along with family and friends so you can stay connected and active. A sudden change, or hearing loss in just one ear, is a good reason to be seen sooner.

Sources

• MedlinePlus — Age-related hearing loss
• MedlinePlus — Hearing Disorders and Deafness