Hearing loss is the partial or complete loss of hearing in one or both ears, ranging from mild to profound. There are many causes, and it can affect anyone at any age, but it's most common in people older than 60. Hearing loss in older adults is known medically as presbycusis.
How common is it? Statistics show that about 16% of U.S. adults have hearing loss, making it twice as common as diabetes or cancer. About 20% of men and 13% of women report they have at least some trouble hearing.
Hearing loss is usually incurable but treatable. By learning more about the symptoms, types, causes, tests, treatments and prevention of hearing loss, it is easier to understand how it impacts you or your loved one—and what you can do about it.
The symptoms of hearing loss can vary depending on the type, cause, and the degree of loss.
For people with age-related hearing loss, it's typical to experience what's known as high-frequency hearing loss. Higher-pitched sounds, such as women's voices and birds chirping, may be harder to hear.
In general, people who have hearing loss may experience any or all of the following:
• Difficulty understanding everyday conversation
• A feeling of being able to hear but not understand
• Having to turn up the TV or radio
• Asking others to repeat often
• You no longer hear birdsong, or hear it rarely
• Avoidance of social situations that were once enjoyable
Hearing loss that occurs gradually as you age (presbycusis) is common. Almost half the people in the United States older than age 65 have some degree of hearing loss.
Hearing loss is defined as one of three types:
Conductive (involves outer or middle ear)
• Sensorineural (involves inner ear)
• Mixed (combination of the two)
Aging and chronic exposure to loud noises both contribute to hearing loss. Other factors, such as excessive earwax, can temporarily reduce how well your ears conduct sounds.
You can't reverse most types of hearing loss. However, you and your doctor or a hearing specialist can take steps to improve what you hear.
Causes of hearing loss include:
Damage to the inner ear. Aging and exposure to loud noise may cause wear and tear on the hairs or nerve cells in the cochlea that send sound signals to the brain. When these hairs or nerve cells are damaged or missing, electrical signals aren't transmitted as efficiently, and hearing loss occurs.
Higher pitched tones may become muffled to you. It may become difficult for you to pick out words against background noise.
Gradual buildup of earwax. Earwax can block the ear canal and prevent conduction of sound waves. Earwax removal can help restore your hearing.
Ear infection and abnormal bone growths or tumors in the outer or middle ear, any of these can cause hearing loss.
Ruptured eardrum (tympanic membrane perforation). Loud blasts of noise, sudden changes in pressure, poking your eardrum with an object and infection can cause your eardrum to rupture and affect your hearing.
Risk factors
Factors that may damage or lead to loss of the hairs and nerve cells in your inner ear include:
Aging. Degeneration of inner ear structures occurs over time.
Loud noise. Exposure to loud sounds can damage the cells of your inner ear. Damage can occur with long-term exposure to loud noises, or from a short blast of noise, such as from a gunshot.
Heredity. Your genetic makeup may make you more susceptible to ear damage from sound or deterioration from aging.
Occupational noises. Jobs where loud noise is a regular part of the working environment, such as farming, construction or factory work, can lead to damage inside your ear.
Recreational noises. Exposure to explosive noises, such as from firearms and jet engines, can cause immediate, permanent hearing loss. Other recreational activities with dangerously high noise levels include snowmobiling, motorcycling, carpentry or listening to loud music.
Some medications. Drugssuch as the antibiotic gentamicin, sildenafil (Viagra) and certain chemotherapy drugs, can damage the inner ear. Temporary effects on your hearing — ringing in the ear (tinnitus) or hearing loss — can occur if you take very high doses of aspirin, other pain relievers, antimalarial drugs or loop diuretics.
Some illnesses. Diseasesor illnesses that result in high fever, such as meningitis.
The Environmental Protection Agency's (EPA) safe noise level is 70 decibels. The louder the noise, the less time it takes to cause permanent hearing damage.
Prevention: The following steps can help you prevent noise-induced hearing loss and avoid worsening of age-related hearing loss:
Protect your ears. Limiting the duration and intensity of your exposure to noise is the best protection. In the workplace, plastic earplugs or glycerin-filled earmuffs can help protect your ears from damaging noise.
Have your hearing tested. Considerregular hearing tests if you work in a noisy environment. If you've lost some hearing, you can take steps to prevent further loss.
Avoid recreational risks. Activities such as riding a snowmobile, hunting, using power tools or listening to rock concerts can damage your hearing over time. Wearing hearing protectors or taking breaks from the noise can protect your ears. Turning down the music volume is helpful too.
Diagnosis
Tests to diagnose hearing loss may include:
Physical exam. Your doctor will look in your ear for possible causes of your hearing loss, such as earwax or inflammation from an infection. Your doctor will also look for any structural causes of your hearing problems.
General screening tests. Yourdoctor may use the whisper test, asking you to cover one ear at a time to see how well you hear words spoken at various volumes and how you respond to other sounds. Its accuracy can be limited.
App-based hearing tests. Mobileapps are available that you can use by yourself on your tablet to screen for moderate hearing loss.
Tuning fork tests. Tuning forks are two-pronged, metal instruments that produce sounds when struck. Simple tests with tuning forks can help your doctor detect hearing loss. This evaluation may also reveal where in your ear the damage has occurred.
Audiometer tests. During these more-thorough tests conducted by an audiologist, you wear earphones and hear sounds and words directed to each ear. Each tone is repeated at faint levels to find the quietest sound you can hear.
If you have hearing problems, help is available. See your physician as soon as you realize you are having trouble hearing. Treatment depends on the cause and severity of your hearing loss and may include: wax removal, surgery, hearing aids, or implants.
Here is to your good health,
Cathy