Overview

Causes

Conductive hearing loss is caused by problems that make it hard for sound to travel from the outer to the middle or inner ear, such as:

  • Impacted earwax
  • Fluid in the middle ear
  • Repeated or poorly treated ear infections
  • Perforated eardrum
  • Tumors
  • A foreign object in the ear
  • Birth defects that affect the structure of the ear

Sensorineural hearing loss is caused by damage to the parts of the inner ear that are responsible for hearing. In some people, the cause is not known. In others, it may be due to:

  • The aging process
  • Illnesses, such as Meniere disease or labyrinthitis
  • Certain medicines, such as loop diuretics, nonsteroidal anti-inflammatory drugs (NSAIDs), or antibiotics
  • Trauma
  • Problems with the way the inner ear is formed
  • Work or environmental exposure to a lot of noise

Risk Factors

Hearing loss is more common in older adults. Other things that may raise the risk of hearing loss are:

  • Having other family members with hearing loss
  • Genetic problems
  • Work or environmental exposure to a lot of noise
  • Heart diseases that affect blood flow to the ear and brain
  • Taking certain medicines, such as loop diuretics, nonsteroidal anti-inflammatory drugs (NSAIDs), or antibiotics
  • Stroke
  • Neurological disorders, such as migraine headaches or multiple sclerosis
  • Obesity
  • Not getting all advised immunizations
  • Autoimmune disorders, such as systemic lupus erythematosus or Cogan syndrome (rare)

SymptomsandDiagnosis

Symptoms

Hearing loss may cause a decreased ability to hear:

  • Higher pitched sounds
  • Lower pitched sounds
  • Speech when there is background noise
  • All sounds

Hearing loss may also cause:

  • A feeling of spinning when standing still— vertigo
  • Ringing or other sounds in the ears— tinnitus
  • Problems with balance
  • Problems learning to speak in children

When Should I Call My Doctor?

Call the doctor for any problems hearing. You should also call if there is:

  • Ear pain
  • Vertigo—a spinning sensation
  • Tinnitus—sounds in the ear, such as ringing, roaring, or buzzing
  • Problems with speech or balance
  • Sensitivity to sound

Diagnosis

The doctor will ask about symptoms and past health. A physical exam will be done.

An ear exam will be done. It may include:

  • Weber test or Rinne test to find out which type of hearing loss the person has
  • Audiometric tests to test hearing ability
  • Tympanometry to measure the pressure in the middle ear and how it responds to pressure waves
  • Electrocochleography to test the function of parts of the inner ear that are responsible for hearing

Images may be taken of the ears and surrounding structures. This can be done with:

The electrical response of the brain to sound may be tested. This can be done with brain stem auditory evoked response testing.

Treatments

Treatment

Treating underlying health problems may improve some forms of hearing loss. Other treatment options are:

Nonsurgical Treatment

Methods that may improve hearing are:

  • Earwax removal
  • Modifying any dietary deficiencies
  • Hearing aids
  • Assisted listening devices
  • Lifestyle changes, such as:
    • Facing people when talking
    • Turning off background noise
    • Learning how to lip read

Medications

Medicines that cause hearing loss may be stopped or changed.

Corticosteroids may be used to help treat certain types of hearing loss. They may be given by mouth or injection. They are used to:

  • Ease inflammation and promote fluid drainage
  • Suppress the immune system

Surgery

People who are not helped by other methods may need surgery. Some examples are:

  • Stapedectomy to replace the diseased stapes bone with an artificial device
  • Tympanoplasty to repair a ruptured eardrum or correct a defect of the middle ear bones
  • Myringotomy to drain fluid trapped in the ear
  • Cochlear implant to implant a device that stimulates part of the brain to make sounds clearer and easier to hear

Prevention

The risk of hearing loss may be lowered by:

  • Managing chronic health problems
  • Not smoking
  • Getting all advised vaccines
  • Avoiding excess noise
  • Wearing ear protection when around loud noises, such as at work

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

Edits to original content made by Denver Health.