Patient education: Hearing loss in adults (The Basics)

What is hearing loss? — 

This is when a person cannot hear as well as usual in 1 or both ears. Some people with hearing loss can hear some but not all sounds. Others cannot hear at all. In many cases, hearing loss gets better. Sometimes, it is a lifelong condition.

What are the symptoms of hearing loss? — 

It depends on what is causing the hearing loss. Symptoms can include:

●Hearing less sound than usual

●Hearing no sound at all

●Hearing ringing, buzzing, or roaring

●Feeling like the ear is plugged

What causes hearing loss? — 

It depends on the type of hearing loss. Types include:

●Sensorineural hearing loss – This can happen if there is a problem in the inner ear or if nerves in the ear are damaged. Causes include:

•Age – Age-related hearing loss is a condition that causes you to slowly lose your hearing in both ears.

•Noise – Being around a lot of noise without ear protection can lead to hearing loss over time.

•Problems in the inner ear – For example, an infection of the cochlea can lead to hearing loss in adults (figure 1). Other problems in the inner ear can also affect hearing.

●Conductive hearing loss – This happens when sounds can't get to the inner ear because of problems in the middle or outer ear (figure 1). Examples include:

•Ear wax impaction – This is when ear wax builds up enough to affect hearing.

•A cold, the flu, or allergies – These can cause parts of the ear to be swollen or filled with fluid.

●Mixed hearing loss – This is when both sensorineural and conductive hearing loss happen at the same time.

Certain injuries and tumors can cause hearing loss of any type.

Rarely, certain chronic conditions can lead to hearing loss. These include diabetes and certain autoimmune disorders. "Autoimmune" means the immune system (the body's infection-fighting system) attacks healthy tissue instead of infections.

Will I need tests? — 

Yes. Your doctor or nurse will ask about your symptoms and do an exam. They will look inside your ear using a special tool called an "otoscope." They will check if anything looks swollen, blocked, damaged, or infected. Then, they will decide which tests you should have.

Tests can include:

●Office tests – The doctor can check your hearing by whispering or using special tools.

●An audiogram – A hearing specialist, called an "audiologist," does this test. You will put on a headset. Then, the audiologist plays sounds in 1 ear at a time. They ask you to react when you hear the sounds. The test shows:

•What type of hearing loss you have

•How severe it is

•Whether both ears are affected the same way

●Imaging tests – These create pictures of the inside of the ear. They help doctors check how certain parts inside the ear are shaped. If these did not form correctly, or if they are damaged, it can cause hearing loss.

In some cases, the doctor might order blood tests to check for certain conditions that can lead to hearing loss. This can help them figure out what is causing your hearing loss and how to treat it.

How is hearing loss treated? — 

It depends. In many cases, hearing loss gets better on its own.

For many types of temporary hearing loss, treatment depends on the cause. Examples include:

●Antibiotics to treat an ear infection

●Decongestant medicines if you have a cold or viral infection

●Medicines to reduce swelling in the ear

●Removing excess ear wax

Some types of hearing loss, such as age-related hearing loss, are permanent. Others can get better over time. There are tools and skills to help people who are deaf or hard of hearing. These include hearing aids, cochlear implants, and sign language.

What can I do on my own? — 

You should:

●Take all your medicines as instructed.

●Go to all your doctor's appointments.

Can hearing loss be prevented? — 

Sometimes. Some forms of hearing loss can be prevented. To protect your hearing:

●The most important thing you can do is avoid loud noises. If you need to shout over a noise, it is loud enough to harm your hearing. If you must be around loud noises, always wear ear protection. Ear protection includes earplugs, earmuffs, and noise-canceling headphones.

●Make sure the volume on your headphones is not too loud. You should be able to hear when people are speaking to you. If you can't, turn down the volume.

●Pay attention to the noise level of loud devices when you buy them. Many of these devices, such as power tools and hair dryers, include the noise level on the label. When possible, choose devices that are no louder than 85 decibels, or "dB." (Decibels are the units used to measure sound.)

●Do not clean your ears using cotton swabs (Q-Tips) or other tools. This can push ear wax deeper into your ear. It can also damage the inside of your ear.

When should I call the doctor? — 

Call your doctor or nurse if:

●Your hearing loss gets worse.

●You hear new ringing in your ears.

●You have any other changes in your hearing.

●You feel dizzy.

It is important to call your doctor or nurse for advice as soon as you notice any of these symptoms. For some types of hearing loss, the sooner you get treatment, the more likely your hearing is to get better.

More on this topic

Patient education: Age-related hearing loss (presbycusis) (The Basics)
Patient education: Tinnitus (ringing in the ears) (The Basics)
Patient education: Ear infections in adults (The Basics)
Patient education: Outer ear infection (The Basics)
Patient education: Ear wax impaction (The Basics)
Patient education: Eustachian tube problems (The Basics)

Patient education: Tinnitus (ringing in the ears) (Beyond the Basics)
Patient education: External otitis (including swimmer's ear) (Beyond the Basics)