Hearing Loss and Ear diseases : Types, Symptoms, Prevention and Treatment

How does the Ear function?

The outer ear, middle ear, and inner ear are the three main parts of the ear. The hearing starts when sound waves cross from the outer ear to the thin skin between the middle and outer ear, called the eardrum. When the waves of sound reach the eardrum, there is a vibration.

The ossicles in the middle ear consist of three bones: hammers, anvils, and stirrups. When sound waves travel towards the inner ear, the eardrum and ossicles work together to increase vibrations.

The waves travel through the cochlea fluids when the sound waves reach the inner ear. The snail-shaped structure in the inner ear is called the cochlea. Thousands of miniature hairs are attached to the nerve cells present in the cochlea.

The function of these hairs is to change the vibrations of sound waves to electrical signals that travel to the brain. The brain interprets these signals, which are called sounds. Different sounds in these tiny hairs create different reactions, which signal different sounds to the brain.

What is hearing loss?

Hearing loss occurs when someone is unable to wholly or partially hear sound in one or both of their ears. The National Institute on Deafness and Other Communication Disorders revealed that twenty-five percent of people between the ages of sixty-five and seventy-four experience this hearing loss.

There are many names for hearing loss, such as follows:

• Deafness
• Loss of hearing
• Decreased hearing
• Conductive hearing loss

Types of hearing loss

Simple ageing or exposure to loud noises over time is often blamed for hearing loss. A few types of hearing loss can be treated by surgery or medicines, while others are more permanent, and only hearing aids and implants can help.

There are three basic groups in which the hearing loss can be divided into:

• Conductive hearing loss : It is a mechanical problem in the ear. Sound waves have trouble moving from the outer ear to the eardrum and middle ear bones. Surgery and medicines might help in such cases.
• Sensorineural hearing loss (SNHL) : It is permanent and caused by nerve damage in the inner ear. A cochlear implant or hearing aid might make things easier.
• Mixed hearing loss : It is the combination of both types of hearing loss.

1. Conductive Hearing Loss

Any disease or problem in the structure of the outer or middle ear that causes such hearing loss.

Causes of Conductive hearing loss:

• Too much earwax: This is also known as cerumen obstruction. Using a cotton swab pushes the wax deeper inside the ear, which can cause hearing problems. During an office visit, doctors can remove the wax.
• Swimmer’s ear: This is also called otitis externa. Water causes this infection of the outer canal of the ear. If the ear starts swelling, the person might lose some hearing.
• Something struck in the ear canal: Beads, tiny buttons, or pieces of cotton from ear swabs may get stuck in the ear. Doctors often observe this in children. If a bug gets stuck in the ear, there may be hearing trouble and a very itchy feeling in the ear, but such cases are very rare.
• A hole in the eardrum: If there is a perforation in the eardrum, there is a high chance of hearing loss. Such conditions can affect the ear’s ability to pick up sound vibrations, as in normal conditions.
• Birth defects: During birth, the outer canal of the ear may be malformed. This type of defect is called atresia. The canal might be missing or may have failed to open. In such cases, surgery can reconstruct the ear.
• Otosclerosis: An abnormal bony growth might be present in the bones of the middle ear. This condition prevents sound waves from vibrating in response to sound.
• Cholesteatoma: When the eardrum collapses, a clump of noncancerous tissues might form in the middle ear’s skin. Such cases are very serious and can cause heavy damage to the ear.

2. Sensorineural Hearing Loss

This is a very common type of permanent hearing loss. In such conditions, sound may appear muted or garbled, and there might be unclear faint sounds. Conversations can be hard to hear when present in a crowded place. Loud noises, for example, might cause a person’s voice to appear muffled.

Causes of Sensorineural hearing loss:

• Ageing: This happens when a person grows older. Doctors call this type of age-related hearing loss presbycusis. It is hereditary and starts when a person has trouble hearing high-pitched sounds.
• Noise exposure: This term is also known as acoustic trauma. Exposure to loud noises for an extended period might damage your ears—for example, loud tools, engines, weapons, and musical events. So, ear protection is recommended in such scenarios.
• Head injury: Both types of hearing loss can be caused
• Sudden changes in air pressure: Things like scuba diving or riding in an aeroplane when it lands or takes off could cause fluid within the internal ear to shift, inflicting an escape or rupture. It may lead to inner ear nerve damage.
• Acoustic neoplasm: This noncancerous neoplasm affects the nerve that sends signals between the internal ear and the brain. Hearing loss, the most common symptom, is slow to occur and happens in precisely one ear.
• Autoimmune inner ear disease: This rare condition causes varying levels of hearing disorder in each ear that progressively worsens over weeks to months. You may also have ringing in the ears and a feeling of fullness in the ears.
• Meniere’s disease: This chronic condition will cause a hearing disorder that comes and goes, in conjunction with ringing within the ears (tinnitus) and giddiness.

Other causes of sensorineural hearing loss include:

• Diseases of the central nervous system
• Ear structure problems
• The growth of bone in your tympanic cavity is known as an inherited disorder

This type usually happens slowly. It can also happen suddenly, but that’s rare. When it happens, doctors believe a virus infection of the internal ear or hearing nerve is also responsible.

Hearing loss typically affects one ear. If yours comes on suddenly, it’s a medical emergency. Medicine may be able to treat it.

3. Infections

Infections like the subsequent also can harm the nerves of the ear and cause SNHL:

• measles
• meningitis
• mumps
• Scarlet fever

4. Ototoxic Medications

Some medications, referred to as toxic medications, may additionally cause SNHL. According to ASHA, over two hundred over-the-counter and prescription medications can cause deafness. If you’re taking medications for cancer, cardiovascular disease, or a significant infection, talk with your doctor regarding the hearing risks involved.

Causes of Mixed Hearing Loss

• Mixed hearing loss may also occur. It happens when semiconducting deafness and SNHL occur at the same time.

Symptoms and warning signs to watch out for

Hearing loss typically occurs over time. At first, you will not notice any changes in your hearing. However, if you experience any of the following symptoms, you should contact your doctor:

• Hearing loss that interferes with your daily activities
• Hearing loss that becomes worse or that doesn’t escape
• Hearing loss that’s worse in one ear
• Sudden hearing loss
• Ringing in the ear
• Severe hearing loss
• Having ear pain along with hearing problems
• Headaches
• Numbness
• Weakness

You should request emergency medical treatment if you expertise headaches, numbness, or weakness on the side of any of the following:

• Chills
• Quick breathing
• Neck stiffness
• Vomiting
• Sensitivity to light
• Mental agitation

These symptoms might occur with grave conditions that warrant immediate medical attention, like an infectious disease.

Age-related hearing impairment

As you age, your body experiences a number of changes in the way it functions. Hearing loss might be one of these changes. Hearing loss due to ageing could be a common condition that impacts several older adults. Almost one in two adults over age sixty-five experience some deafness.

Age-related hearing loss is also known as presbycusis. Although age-related deafness is not a grievous condition, it can significantly impact the quality of life if left untreated.

Causes of age-related hearing loss

• Age-related hearing loss occurs gradually over time.
• Various changes within the labyrinth will cause the condition.

These include:

• changes in the structures of the inner ear
• changes in blood flow to the ear
• impairment in the nerves responsible for hearing
• changes in the way that the brain processes speech and sound
• damage to the tiny hairs in the ear that are responsible for transmitting sound to the brain

Age-related deafness may also be caused by alternative problems, including:

• diabetes
• poor circulation
• exposure to loud noises
• use of certain medications
• family history of hearing loss
• smoking

Symptoms of age-related hearing loss

Symptoms of age-related deafness usually begin with an Associate in Nursing inability to hear high-pitched sounds. You may notice that you have difficulty hearing the voices of females or children. You may even have issues hearing background noises or hearing others speak clearly.

Other symptoms that may occur include:

• Certain sounds seem overly loud
• Difficulty hearing in noisy areas
• Ringing in the ears
• Asking people to repeat themselves
• Being unable to understand conversations over the telephone

Always notify your doctor if you have any of these symptoms. They could be signs of other medical conditions and should be checked out by a doctor.

How it is diagnosed

If you have symptoms of age-related deafness, see your ear doctor to diagnose your condition. They will perform a full physical examination to rule out alternative causes of deafness. 

They may also look inside your ears using an otoscope. If your doctor can not find another explanation for your symptoms, they may diagnose you with age-related hearing loss. They may refer you to a hearing specialist or an audiologist. The audiologist can perform a hearing test to help determine how much hearing loss has occurred.

Treatment of Hearing loss

There is no cure for age-related hearing loss. If you’re diagnosed with this condition, your doctor will work with you to improve your hearing and quality of life. Your doctor may recommend:

• Hearing aids to help you hear better
• Assistive devices, such as telephone amplifiers

In some cases, your doctor may recommend a cochlear implant. It is a small electronic device that is surgically implanted into your ear. Cochlear implants can make sounds somewhat louder but do not restore normal hearing. This option is only used for people who are severely hard of hearing.

Age-related hearing loss is a progressive condition, which means it gets worse over time. Even though hearing loss gets worse over time, using assistive devices such as hearing aids can improve quality of life.

Talk with your doctor about your treatment options. Ask what you can do to minimise the impact of hearing loss on your everyday life. You may also wish to consider treatment to prevent the time period, anxiety, and social isolation that often occur with this condition.

Preventing hearing loss

You may not be in a position to stop age-related deafness. However, you can take steps to keep it from getting worse. If you have expertise in age-related deafness, try these tips:

• Avoid repetitive exposure to loud sounds.
• Avoid repetitive exposure to loud sounds.
• Control your blood sugar if you have diabetes.

Seek prompt treatment from your doctor if you develop symptoms of age-related deafness. As your deafness increases, you are more likely to lose your ability to understand speech. However, if you request early treatment, you will keep this ability or minimise the loss.

Disease and conditions that lead to hearing loss

Eardrum Rupture

A membrane rupture could be a tiny hole or tear in your membrane or myringa. The tympanic membrane is a thin tissue that divides your middle ear and the outer canal of the ear. This membrane vibrates when sound waves enter your ear, continuing through the bones of the centre ear. Because this vibration permits you to listen, your hearing will suffer if your membrane is broken. A busted membrane is additionally known as a myringa. In rare cases, this condition will cause permanent deafness.

Sudden Sensorineural Hearing Loss (SSHL)

Sudden sensorineural deafness (SSHL), also called abrupt hearing loss, occurs quickly after losing hearing, generally solely in one ear. It can happen instantly or over many days.

During this time, the sound gradually becomes muffled or faint. Frequencies measure sound waves. Decibels are the intensity or loudness of the sounds we hear. Zero is the lowest dB level, which is close to complete silence. A loss of thirty decibels in three connected frequencies is considered SSHL.

It means that a deafness of thirty decibels would build a traditional sound, sort of a whisper. The condition most typically affects people between the ages of thirty and sixty.

About fifty per cent of individuals with unilateral SSHL (only one ear is affected) recover for a period of time if they get prompt treatment. About fifteen per cent of individuals with the condition have deafness that gets worse gently over time.

However, advances in technology used for hearing aids and tube-shaped structure implants are boosting communication for folks plagued by deafness. SSHL could be a severe medical condition and needs prompt medical attention. Call your doctor quickly if you think that you’re experiencing SSHL. Early treatment can save your hearing.

Middle Ear Infection

A cavity infection, also called otitis media, occurs when a virus or bacteria causes the area behind the eardrum to become inflamed. The condition is most common in children. According to the Lucile Packard Children’s Hospital at Stanford, middle ear infections occur in 80 percent of children by the time they reach age 3. Most cavity infections occur throughout the winter and early spring. Often, cavity infections disappear with no medication. However, you should obtain medical treatment if the pain persists; otherwise, you will have a fever.

Otitis Media with Effusion

The salpinx drains fluid from your ears to the rear of your throat. If it clogs, otitis with effusion (OME) will occur. If you have OME, the middle part of your ear fills with fluid, which can increase the risk of ear infection. OME is very common. According to the Agency of Healthcare Research and Quality, about 90 percent of children will have OME at least once by age 10.

Foreign Objects in the ear

Foreign objects are also inserted into the body accidentally or deliberately, sometimes swallowed, and can become lodged or stuck in varied elements of the body, such as the ears, nose, eyes, and airways. Children are presumably to urge foreign objects lodged in their bodies.

Meniere’s Disease

Meniere’s illness could be a disorder that affects the inner ear or bony labyrinth. The labyrinth is liable for hearing and balance. The condition causes vertigo, the sensation of spinning. It also leads to hearing problems and a ringing sound in the ear. Meniere’s disease usually affects only one ear.

Meniere’s disease is chronic, but treatments and lifestyle changes can help ease symptoms. Many people diagnosed with Meniere’s illness can get into remission after many years of living a cautious lifestyle.

Ear Barotrauma

Ear barotrauma could be a condition that causes ear discomfort due to pressure changes. Every ear has a tube called the eustachian tube that connects the centre of the ear to the throat and nose and helps regulate ear pressure. When this tube gets blocked, you may experience ear barotrauma. In environments where the altitude changes, occasional ear barotrauma is common.

While the condition isn’t harmful in some people, frequent cases may cause further complications. Understanding the differences between acute (occasional) and chronic (recurring) cases is essential to know when to seek medical treatment.

Acoustic Trauma

Acoustic trauma is an injury to the bony labyrinth usually caused by exposure to a high-decibel noise. It can occur after exposure to a single, very loud noise or from exposure to noises at significant decibels over a longer period of time.

Some head injuries can cause acoustic trauma if the eardrum is ruptured or if other injuries to the inner ear occur. The eardrum protects the middle and inner ear and transmits signals to the brain through small vibrations.

Acoustic trauma can damage the way these vibrations are handled, resulting in hearing loss. Sound entering the labyrinth can cause what doctors typically consider a threshold shift, which can trigger hearing loss.

Labyrinthitis

Labyrinthitis is an inner ear disorder. The two proprioception nerves in your labyrinth send information about abstraction, navigation, and balance management to your brain. When one of these nerves becomes inflamed, it creates a condition called otitis.

Chronic Ear Infection

A chronic ear infection is an associated nursing ear infection that doesn’t heal. A revenant ear infection will act as a chronic ear infection. This is also known as recurring acute otitis media. This infection plagues the house behind the tympanic membrane (the middle ear).

The eustachian tube, which drains fluid from the middle ear, can become plugged and lead to an infection. This buildup of fluid within the bodily cavity presses on the tympanic membrane, causing pain. If an infection progresses quickly or is left untreated, it will cause the tympanic membrane to rupture. Eustachian tubes in kids are smaller and more horizontal so they can become plugged more easily. It is one reason ear infections occur often in children.

Outer Ear Infection (Swimmer’s Ear)

An external organ infection is an infection of the outer gap of the ear and, therefore, the auditory meatus, which connects the outside of the ear to the eardrum. This type of infection is medically known as otitis externa.

One common kind of otitis is “swimmer’s ear.” This external organ infection typically results from exposure to water and is common in children, teens, and adults who spend a lot of time swimming.

Preventing hearing loss

Not all cases of hearing loss are preventable. However, there are many steps that you will want to guard your hearing:

• Use safety instruments if you work in areas with loud noises, and wear earplugs when you swim and attend concerts.
• The National Institute on Deafness and Other Communication Disorders report that fifteen percent of individuals ages twenty to sixty-nine experienced hearing impairment because of repeated exposure to loud noises.
• You should have regular hearing tests if you work around loud noises, swim often, or attend concerts on a daily basis.
• Avoid prolonged exposure to loud noises and music.
• Seek help for ear infections. They may cause permanent harm to the ear if they’re left untreated.

Diagnose And Screening

Tests to diagnose hearing loss may include:

• Physical exam: Your doctor will examine your ear for wax or inflammation from infection, as well as for structural causes of your hearing issues.
• General screening tests: Your doctor may whisper in your ear and ask you to cover one ear at a time to check how well you hear words spoken at varied volumes and how you respond to other sounds.
• Tuning fork tests: Tuning forks are two-pronged, metal instruments that manufacture sounds once stricken. Simple tests with standardised forks will help your doctor notice any significant hearing impairment. This analysis might also reveal where the injury occurred in your ear.

Treatment options available

If you have hearing problems, help is available. Treatment depends on the cause and severity of your hearing impairment.

Removing wax blockage 

• Earwax blockage may be a reversible cause of hearing impairment. Your doctor could remove the wax using suction or sterilised ear wax removal tools.

Surgical procedures : 

• Some types of hearing impairment are treated with surgery, together with abnormalities of the eardrum or bones of hearing (ossicles). If you’ve had continual infections with persistent fluid formation, your doctor could insert tiny tubes to drain your ears.

Hearing aids

• A hearing aid is helpful if your hearing impairment is because of injury to your receptor. An audiologist can discuss the potential benefits of a hearing aid and suggest the right kind of device.

Cochlear implants

• If you have a severe hearing impairment and typical hearing aids prove ineffective, a cochlear implant may be an option. A cochlear implant bypasses damaged or non-working parts of your inner ear and directly stimulates the hearing nerve. An audiologist, in conjunction with a medical doctor who focuses on disorders of the ears, nose and throat (ENT), will discuss the risks and advantages of cochlear implants with you.

Hearing Loss  FAQS: All Your Concerns Addressed

Q1. What is the first sign of hearing loss?
A1. Most patients with hearing loss initially complain that they are mumbling or speaking too quickly. Hearing loss is often accompanied by Tinnitus (Ringing of the Year). A buildup of cerumen, medication, exposure to loud sounds, and deafness will all cause ringing within the ears or similar symptoms. The ringing could be constant or occasional; however, it’s typically the primary sign of deafness.

Q2. What causes hearing loss?
A2. The most common causes of hearing loss are as follows:

• Ageing
• Injury
• Excessive noise exposure
• Viral infections
• Ototoxic drugs
• Diabetes

Hearing loss can occur due to many factors, but some of the major contributors are age and exposure to noise. Loss of hearing due to age is quite common. The hearing senses begin to weaken around the age of 40, and it gets worse until you reach the age of 80.

Excessive exposure to noise is a consequence of living in disruptive surroundings or voluntarily listening to loud music through earphones, at live concerts, or through a stereo for a long time can contribute to permanent loss. Some of the other causes that can lead to permanent hearing loss include-

• Certain diseases and infections
• Specific syndromes
• Medications and drugs that have negative side effects
• Injuries to the head
• Damage to the ears
• Malformation in the ear
• Genetic causes
• Tumour in the head
• Cholesterol

Q3. Can you go deaf suddenly, or is it always progressive?
A3. Sudden sensorineural hearing loss (SSHL) can cause sudden deafness. This is one reason a person becomes deaf suddenly or very quickly. It mostly happens in only one ear.

Q4. What level of hearing loss is considered a disability?
A4. Hearing loss is classified as mild, moderate, severe, or profound. Severe or profound deafness is classified as a disability as it is often irreversible.

Q5. How to test for hearing loss?
A5. A hearing test is a combination of various examinations, and when they are taken together, these tests can determine if you have a hearing loss and to what extent you are suffering from it. A hearing test will be carried out by a medical professional who will use state-of-the-art equipment to check if you are suffering from any hearing issues. You can even opt for online tests to check your hearing, but it’s always best to visit a doctor for a detailed diagnosis.

Q6. What vitamins can help with hearing?
A6. Vitamin C, E, and glutathione are supplements that can help reduce the chances of hearing loss. These vitamins keep free radicals in check and strengthen the immune system, thereby reducing the chances of ear infections.

Disclaimer & Source Acknowledgement

Some portions of the content on this page, including information related to hearing loss types, symptoms, prevention, and treatment, have been referenced from the official blog of Narayana Health. To read the full article, please visit:
🔗 Narayana Health Blog – Hearing Loss and Ear Diseases