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Hearing loss

Hearing loss is a common condition and can affect people of all ages. It's not unusual to lose our hearing as we get older, but children can also be affected. Hearing loss may have a clear cause, such as glue ear in children, or it may need further investigation, such as a hearing test, in order to diagnose the cause. There are many causes of hearing loss including age, infections, blockages such as earwax and damage to the eardrum.

The right treatment for your hearing loss will depend upon its cause. And some conditions will not need any treatment as your hearing will return on its own.

Hearing loss is caused by a variety of conditions affecting the hearing organ or its nerve connection to the brain.

It may be caused by problems affecting the transmission of sound through the eardrum and bones of hearing (ossicles) to the cochlea (the organ of hearing), or it may be due to problems in the cochlea and the auditory nerve that connects the cochlea to the brain.

Conductive hearing loss is caused when something interferes with the transmission of sound from the ear canal to the cochlea. Sensorineural hearing loss is caused when there is a problem with the cochlea, or the nerve connection from the cochlea to the brain.


What Causes Hearing Loss?

Conductive hearing loss can be due to problems in the ear canal, ear drum (tympanic membrane) or the middle ear bones (ossicles). These three bones are called the Hammer, Anvil and Stirrup (or Malleus, Incus and Stapes).

The commonest type of hearing loss in children is due to glue ear (link). Rarely children may be born with poorly formed middle ear bones, or these structures can be damaged through ear infection.

Conductive hearing loss in adults is less common, but can be due to problems with the bones of hearing or occasionally glue ear. Wax in the ear canal can also cause slight conductive hearing loss.

Infection which damages the ossicles can also lead to conductive hearing loss affect the ossicles.

Sensorineural hearing loss is due to loss of sound sensing cells in the cochlea (hair cells) or damage to the nerves that take hearing signals to the brain. There are many causes of this type of hearing loss. Age related hearing loss is sensorineural, and due to loss of hair cells with ageing. It is the commonest cause of hearing loss in adults.

Sensorineural loss can also be due to very loud noise exposure at work and play, some prescribed medications and some infections.

Children can also suffer from sensorineural hearing loss, and for some children it is an inherited disorder which may even be present at birth. It can vary from a mild hearing loss to severe deafness.

Infections are one of the main causes of hearing loss. Most infections clear up on their own and you probably won't need to do anything except take paracetamol to help any pain or fever. If an infection doesn't clear up then antibiotics may help.

In some cases, the infection may spread to a space inside the middle ear called the mastoid cavity. If this area becomes infected it may cause hearing loss. Occasionally, the infection can lead to a skin growth in the ear. If this happens, then a surgery (known as mastoid surgery or mastoidectomy) may be needed to remove the infection or skin growth. This is a routine surgery so you should not be too concerned.

Blockages in the ear are also a common cause of hearing loss. The blockage may be a build up of mucus or fluid - often caused by an infection - or it may be earwax. Our ear, nose and throat specialists may look inside your ears using a small hand-held device with a light on the end (an otoscope). This is a fast and painless examination.

Blockages caused by an infection will usually disappear when the infection passes. But our specialists can also remove blockages using microsuction. This is a short, gentle and safe treatment that we do here at the clinic.

It's not usual to experience hearing loss as we get older. But, damage to the inner ear can also affect our hearing and even loud noises can have an affect upon it.

In many cases hearing aids can be very helpful for managing your hearing loss. These devices they have improved enormously over the last few years. Some of the latest designs can only be seen by looking directly into the ear and are comfortable and safe to wear. If our ear, nose and throat specialists feel that you will benefit from a hearing aid they will advise you on the best type for you.

If the cause of your hearing loss is not clear, then we can carry out a routine hearing test.

Tympanometry is a simple test to see if the ear is blocked. A very small tube is placed at the entrance of your child's ear and air is gently blown down it into the ear. This test will not hurt your child and is very helpful in diagnosing conditions such as glue ear.

Pure tone audiometry (PTA) is a non-invasive, painless test used to assess the hearing in both ears. During this test, a machine called an audiometer produces sounds at various volumes and frequencies (pitches). Your child listens to the sounds through headphones and presses a button when they hear them.

Whatever the cause of your hearing loss, our ENT specialists can help. They'll discuss your symptoms.

Hearing loss can be due to a mixture of conductive and sensorineural causes. Some types of sensorineural hearing loss require urgent treatment so you should see a specialist as soon as you can if …

  • You lose your hearing suddenly over a few hours or days
  • Your hearing loss is associated with ear discharge, dizziness or earache


What are the symptoms?

Most of us first notice difficulty in conversation when there is background noise or when more than one person is talking. Often friends will complain that they don’t listen or that they turn the television volume up too loud. We may become increasingly withdrawn and frustrated that we cannot socialise easily.

Children can become inattentive, or ignore instructions or appear naughty. Listening to the television at high volumes is common and some times the child’s teachers will complain. Young children with delayed speech development should always be assessed for hearing loss.


Investigations and Treatment

Your doctor or specialist will arrange for you to have a hearing test.

Many tests are available, and special test techniques can be used to assess children, including newborns.

This will help establish the nature and severity of the hearing loss. The severity of the hearing loss is graded mild, moderate, severe and profound. Treatment depends on the severity of the hearing loss and whether it is conductive or sensorineural.

In conductive hearing loss there may be an infection which needs to be treated and may include surgery, both to treat the infection and also restore the hearing.

In cases where hearing loss is due to a problem with the ossicles surgical hearing restoration is usually possible. This may involve using metal or plastic implants or reusing your existing ossicles to restore the hearing mechanism.

In many cases hearing aids will be recommended. The technology is always improving to make them more discrete and offer better sound quality and for some patients with specific types of hearing loss a surgically implanted hearing device may be the answer.

With modern surgery and high technology devices ENT surgeons are able to offer even the most severely deaf patients useful hearing. The good news is that there is now a hearing restoration solution available for almost everyone with hearing loss.