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Hearing loss is a sudden or
gradual decrease in how well you can hear. Depending on the cause, it can be
mild or severe, temporary or permanent.
Congenital hearing loss
means you are born without hearing. This topic focuses on gradual hearing loss,
which happens over time and can affect people of all ages.
If you have hearing loss, you may not be aware of it,
especially if it has happened over time. Your family members or friends may
notice that you're having trouble understanding what others are saying.
There are ways you can deal with hearing loss. And hearing aids and other
devices can help you hear.
In adults, the most
common causes of hearing loss are:
Other causes of hearing loss include
earwax buildup, an object in the ear, injury to the
ear or head, an ear infection, a
ruptured eardrum, and other conditions that affect the
middle or inner ear.
Common symptoms of hearing
Other symptoms may include:
Your doctor will do
a physical exam and ask about your symptoms and past health. He or she also may
look in your ears with a lighted device called an otoscope.
your doctor thinks that you have hearing loss, he or she will do hearing tests to
check whether you have hearing loss and find out how severe it is. You may be referred to an audiologist to do the tests. These tests
Noise-induced or age-related
hearing loss can be treated with hearing devices, such as hearing aids. Other
devices can help alert you to sounds around the house like the phone or
doorbell. If hearing aids don't work for you, cochlear implants may be an option.
You also can learn ways to live with reduced hearing,
such as paying attention to people's gestures, facial expressions, posture, and
tone of voice.
In other types of hearing loss, you can treat the
problem that caused the hearing loss. For example, you may remove earwax or
take medicine for an infection to help your hearing come back.
Health Tools help you make wise health decisions or take action to improve your health.
Learning about hearing loss:
Living with hearing loss:
In adults, the most common causes of
hearing loss are:
Other causes of hearing loss include:
Other medical conditions that do not affect the ear
directly may also cause hearing loss.
hearing loss include:
Other symptoms that may occur with hearing loss
People who have hearing loss are sometimes not aware of it. Family members or friends often are
the first to notice the hearing loss. Evaluate your hearing by taking a
hearing loss self-test.
We hear sounds when sound energy goes through the ear's three main structures. In hearing loss, one or more of these structures is damaged. These structures are the:
Which part of the ear is affected determines the type of hearing loss.
A mixed hearing loss, in which both the conductive and sensorineural systems are affected, can also occur.
Another type of hearing loss is central hearing loss. In this type of hearing loss, the ear works, but the brain has trouble understanding sounds because the parts that control hearing are damaged. It may occur after a head injury or stroke. This type of hearing loss is rare.
Undiagnosed and untreated hearing loss can contribute to depression, social isolation, and loss of independence, especially in older adults.
Call 911 or other emergency services immediately if:
Call a doctor immediately if
Call your doctor if you:
If you think you have a hearing problem, you might choose to see an audiologist.
Watchful waiting is when you and
your doctor watch symptoms to see if the health problem improves on its own.
Although hearing loss is not usually dangerous, it can affect your personal
safety. It can also reduce how much you can do in the workplace and at home and
limit you socially. It is important that you talk to your doctor or an audiologist about hearing
Hearing loss can be diagnosed by:
If your doctor suspects or diagnoses hearing loss, he or
she may have you see an ear, nose, and throat specialist (otolaryngologist) or an
Your doctor will diagnose
hearing loss by asking questions about your symptoms
and past health (medical history) and by doing a physical exam. He or
she may find during a routine visit that you have some hearing loss.
You will also have a
physical exam of the
ears. Your doctor will use a lighted instrument (an
otoscope) and may find problems in the ear canal, eardrum, and middle ear,
If your exam, history,
or symptoms suggest a hearing problem, your doctor may refer you to an audiologist to do hearing tests.
Depending on the suspected cause of hearing loss, you
may also have other tests:
Some hearing problems can delay your child's
speech and language development. Early screening for hearing loss can help
prevent many learning, social, and emotional problems that can be related to
speech and language development.1 The
United States Preventive Services Task Force
recommends that all newborns be screened for hearing loss.2 All 50 states require newborn hearing tests for all babies
born in hospitals. Talk to your doctor about whether your child has been or
should be tested.
Signs of noise-induced hearing loss are
appearing at earlier ages and in children. Be sure your child has
regular hearing exams.
Treatment for temporary or
hearing loss usually depends on the cause of the
hearing loss. Treatment for permanent hearing loss includes using hearing
devices or hearing implants.
Although you and your family may view permanent hearing
loss as part of aging, proper treatment is important. Hearing loss may
contribute to loneliness,
depression, and loss of independence. Treatment cannot
bring back your hearing, but it can make communication, social interaction, and
work and daily activities easier and more enjoyable.
Treatment for reversible hearing loss depends on its cause. It is often treated
successfully. Hearing loss caused by:
In permanent hearing loss, such as
noise-induced hearing loss, hearing devices can often
improve how well you hear and communicate. These devices include:
You can prevent some types of
Being exposed to loud
noise over and over is one of the most common causes of permanent hearing loss.
It usually develops slowly and without pain or other symptoms, and you may not
notice that you have hearing loss until it is severe.
Be sure your child has regular
hearing exams and follows the suggestions below to
prevent hearing loss.
can take to lower your risk of
noise-induced hearing loss include the following:
your risk of other types of
If you have
hearing loss, you may find that it takes extra effort
and energy to talk with others. Hearing may be especially difficult in settings
where there are many people talking or there is a lot of background noise. The
increased effort it takes to be with other people may cause stress and fatigue,
and you may begin to avoid social activities, feel less independent, and worry
about your safety.
Hearing devices you may want to use
Many other communication devices, such as pagers, fax
machines, email, and custom calling features offered by phone companies, can
be helpful. To get more information about selecting and using listening,
alerting, and telecommunicating devices, talk to an audiologist.
A person with hearing loss may feel cut off from conversations and social
interaction. The extra effort and stress needed to take part in conversations
can be tiring for all people involved. If you live with someone who has hearing
loss, you may improve your communication by:
The American Academy of Otolaryngology—Head and Neck
Surgery (AAO-HNS) is the world's largest organization of physicians dedicated
to the care of ear, nose, and throat (ENT) disorders. Its Web site includes
information for the general public on ENT disorders.
The American Hearing Research Foundation helps pay for
research into hearing and balance disorders and also helps to educate the
public about these disorders. On their website you can find general
information on many common ear disorders, including descriptions, causes,
diagnoses, and treatments. References are also included as a source for further
information. The American Hearing Research Foundation also publishes a
newsletter, available by subscription, as well as a number of pamphlets on a
variety of topics.
The American Speech-Language-Hearing Association (ASHA)
promotes the interests of and provides services for professionals in audiology,
speech-language pathology, and speech and hearing science. ASHA also advocates
for people who have communication disabilities. The website has information on
related health topics, self-help groups, and finding a professional in your
The National Institute on Deafness and Other
Communication Disorders, part of the U.S. National Institutes of Health,
advances research in all aspects of human communication and helps people who
have communication disorders. The website has information about hearing,
balance, smell, taste, voice, speech, and language.
The Noise and Hearing Conservation section of the OSHA
Web site provides information on U.S. government noise standards, general
information on noise-induced and work-related hearing loss, and how to protect
CitationsJoint Committee on Infant Hearing, American Academy of Pediatrics (2007). Year 2007 position statement: Principles and guidelines for early hearing detection and intervention programs. Pediatrics, 120(4): 898–921. Also available online: http://pediatrics.aappublications.org/cgi/reprint/120/4/898.U.S. Preventive Services Task Force (2008). Universal screening for hearing loss in newborns: Recommendation statement. Available online:Other Works ConsultedAgrawal SK, et al. (2008). Occupational hearing loss. In AK Lalwani, ed., Current Diagnosis and Treatment in Otolaryngology–Head and Neck Surgery, pp. 732–743. New York: McGraw-Hill.American Academy of Pediatrics (2008). Recommendations for preventive pediatric health care. In Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, 3rd ed., p. 591. Elk Grove Village, IL: American Academy of Pediatrics. Also available online: http://brightfutures.aap.org/pdfs/Guidelines_PDF/20-Appendices_PeriodicitySchedule.pdf.Centers for Disease Control and Prevention (2010). Risk of bacterial meningitis in children with cochlear implants. Available online: http://www.cdc.gov/ncbddd/hearingloss/meningitis.html.Gluth MB, et al. (2008). Cochlear implants. In AK Lalwani, ed., Current Diagnosis and Treatment in Otolaryngology—Head and Neck Surgery, pp. 877–887. New York: McGraw-Hill.Joint Committee on Infant Hearing, American Academy of Pediatrics (2007). Year 2007 position statement: Principles and guidelines for early hearing detection and intervention programs. Pediatrics, 120(4): 898–921. Also available online: http://pediatrics.aappublications.org/cgi/reprint/120/4/898.National Institute on Deafness and Other Communicative Disorders (2010). Ten Ways to Recognize Hearing Loss. Available online: http://www.nidcd.nih.gov/health/hearing/10ways.asp.Niparko JN, et al. (2010). Spoken language development in children following cochlear implantation. JAMA, 303(15): 1498–1506.Sweetow RW, Cascia T (2008). Aural rehabilitation and hearing aids. In AK Lalwani, ed., Current Diagnosis and Treatment in Otolaryngology—Head and Neck Surgery, pp. 705–712. New York: McGraw-Hill.U.S. Preventive Services Task Force (2008). Universal screening for hearing loss in newborns: Recommendation statement. Available online:Yu KCY, Cheung SW (2008). Implantable middle ear hearing devices. In AK Lalwani, ed., Current Diagnosis and Treatment in Otolaryngology–Head and Neck Surgery, pp. 873–876. New York: McGraw-Hill.
April 13, 2011
Sarah Marshall, MD - Family Medicine & Steven T. Kmucha, MD - Otolaryngology
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