A Guide to Hearing Loss

Realizing that you no longer hear as well as you used can be alarming and even scary. When some people begin to not hear as well as they used to, they may first think that it’s a fluke or a sign of illness. While that may be true in some cases, there are many other cases where not being able to hear well anymore is due to hearing loss.

One of the major things to realize about hearing loss is that it is very common. Approximately 1/3 of all people ages 65-75 in the United States have some type of hearing loss. For those older than 75, the number increases to about 1 in every 2 people.

To recognize whether you have hearing loss, let’s take a look at some of the signs and symptoms, as well as the causes, types, and treatment.

Hearing Loss Signs & Symptoms

There are several signs and symptoms that may indicate you are experiencing true hearing loss, not hearing loss due to illness or loud surroundings. If you are experiencing one or more of the following symptoms, you may want to visit your healthcare provider for a hearing test.

  • Muffled speech and other sounds
  • Trouble hearing words and conversations, especially in noisy areas
  • Asking others to speak more slowly, clearly, and loudly more often
  • Constantly needing to turn up the volume on the television or other devices
  • Asking people to speak into your “favorite ear” because one ear is giving you hearing trouble
  • A feeling of having clogged ears
  • Trouble hearing people speak over the phone
  • Trouble hearing children’s voices or high-pitched sounds
  • Trouble hearing sounds of nature like birds chirping or rain hitting the roof
  • Tinnitus or ringing of the ears

While these are all signs and symptoms of hearing loss, many people first complain about people mumbling or talking too fast. This may not be the case at all. But, when someone is experiencing hearing loss, it may seem as though this is the case.

People experiencing hearing loss may also begin to withdraw from conversations or social settings because they become embarrassed that they can’t hear well. This can lead to depression and other problems.

If someone is having trouble hearing in a social setting they may also try to fake the fact that they can hear. You may notice they constantly nod their heads in agreement and answer yes even when they can’t hear or understand the situation. They will also take social cues from other people in the conversation and feed off their reaction to also make it appear as though they know what’s going on.

If you notice a loved one doing this or if you know you do this yourself, it’s time to see your doctor and ask for a hearing test.

Hearing Loss Causes

If you’re experiencing hearing loss, you may wonder why it is happening to you. Several reasons include:

  • Aging
  • Exposure to Loud Noises
  • Cardiovascular Disease
  • Medication Side Effects
  • Excessive Ear Wax
  • Injury
  • Infections

Aging is the most common cause of hearing loss because all parts of the ear, especially the cochlea and its associated nerve pathways to the brain are affected by general wear and tear. In the beginning, this may result in sensitivity to high-pitched sounds. This can affect how you understand speech, especially in noisy conditions.

Exposure to loud noises is generally thought to be the second most common cause of hearing loss because loud noise can damage the cochlea. If you’re exposed to loud noise for a long period of time, the greater the chance that you’ll experience permanent hearing loss. Noise-induced hearing loss is no longer associated with just noisy occupations, loud music, or being on the battlefield. It can also be linked to listening to loud music using earbuds and earphones with smartphones. This is why many younger people are now also experiencing some level of hearing loss.

Cardiovascular disease can also affect hearing loss because the blood supply to the inner ear can become reduced or stop altogether. When either of these things happens, you may experience some level of hearing loss.

Some medications, called ototoxic drugs, are known to cause hearing loss. These types of drugs are usually only used for life-threatening illnesses. Taking aspirin in regular, high doses has also been linked to hearing loss. But, the hearing loss can usually be reversed once the person stops taking the aspirin.

There are also auditory processing disorders that can affect hearing. These types of disorders happen when the brain has problems processing the information contained in sound.

Hearing Loss in Veterans

According to the U.S. Department of Veterans Affairs, hearing loss is the top service-related medical issue for military veterans with more than 2.7 million veterans currently receiving disability benefits for hearing loss or tinnitus, a ringing in the ears. That number only takes into account the number of veterans that have actually been documented with hearing loss. There may be many more out there who have never reported their hearing loss.

While some hearing loss comes with age, for veterans much of the hearing loss they experience is due to noise exposure, often from gunfire, roadside bombs, and heavy equipment. For some, a single explosion with sounds exceeding 140 decibels can cause irreparable damage on the spot.

If you are a veteran and are experiencing hearing problems, research VA medical clinics in your area. They offer a full range of hearing services, including hearing tests to determine your condition.

From there, the VA will recommend the best tools to help you hear better. This may range from implantable devices to a wide variety of hearing aids. The VA has contracts with several major hearing aid manufacturers to provide free and low-cost help based on eligibility. Many of the hearing aids veterans get through these companies come with a six-month trial period so that they can try them out and adjust to them.

To see what benefits you’re eligible for as a veteran, register at your local VA hospital or health center or online at the VA’s benefits website. After you register either online or in-person and your eligibility is verified, you can make an appointment with a VA audiologist to begin the process.

Hearing Loss Types

If you are diagnosed with hearing loss, your doctor will most likely tell you which type of hearing loss you have. Hearing loss is generally classified as one of three common types. Each type affects different parts of the ear and each has its own common causes and specific treatments.

It’s important to know what type of hearing loss you may be dealing with so that you can get the right treatment and the right type of hearing aid help.

Sensorineural Hearing Loss

Sensorineural hearing loss is the most common, accounting for 90% of hearing loss in patients. This type of hearing loss involves hearing loss that stems from the inner ear (cochlea and associated structures). The common causes of sensorineural hearing loss include:

  • Aging
  • Injury
  • Excessive noise exposure
  • Viral infections
  • Shingles
  • Meningitis
  • Diabetes
  • Stroke
  • High fever
  • Ménière's disease (a disorder of the inner ear that can affect hearing and balance)
  • Acoustic tumors
  • Heredity
  • Obesity
  • Smoking
  • Hypertension

If you suffer from sensorineural hearing loss, you’ll notice that you have difficulty with sound volume and clarity. This is especially true when it comes to understanding what people are saying. All sounds are muffled, including speech.

Although it’s not common, some people experience sudden sensorineural hearing loss, more commonly known as deafness. This can happen instantly or over a course of up to three days.

Not everyone with this condition will be permanently deaf. According to the National Institute on Deafness and Other Communication Disorders, about half of those with sudden sensorineural hearing loss will regain some or possibly all of their hearing within one or two weeks of the onset.

Conductive Hearing Loss

Conductive hearing loss is associated with the difficulty that can arise when transferring sound waves anywhere along the path of the outer ear or middle ear. It is usually associated with some type of obstruction in the ear. If you have conductive hearing loss you are likely experiencing problems with the volume of sounds. It will also likely be harder to hear faint sounds and you may realize that sounds that are loud to others are not loud to you.

Common causes associated with conductive hearing loss include:

  • Wax buildup
  • Ear canal infections
  • Dislocation of the middle ear bones
  • Foreign object in the ear canal
  • Abnormal bone growth in the middle ear
  • Abnormal growth or tumors

A hearing test done by your healthcare provider can determine if you are suffering from conductive hearing loss.

Mixed Hearing Loss

When there are signs of both sensorineural and conductive hearing loss a patient will be diagnosed with mixed hearing loss. If you’re suffering from mixed hearing loss, your healthcare professional will likely recommend treating the conductive component first because the underlying sensorineural component can present a high-frequency loss.

While sensorineural, conductive, and mixed are the most common types of hearing loss, there are also auditory processing disorders that can affect hearing. These types of disorders happen when the brain has problems processing the information contained in sound. People dealing with these disorders also have problems understanding speech and trying to figure out where sounds are coming from.

Hearing Loss Treatment

While some people may try to cope with hearing loss and avoid medical treatment, the best recommendation is to see your doctor so that they can determine whether you have hearing loss or another medical issue. Hearing loss is typically something that can be dealt with and treated effectively.

Hearing loss can be sudden and become noticeable within a few days or may take months or years to develop. In either case, a hearing test can determine if you have hearing loss and whether you are a good candidate for a hearing aid. From there, your healthcare professional can help you decide which type of hearing aid is best for you. If you experience sudden hearing loss, this is classified as a medical emergency and you should seek attention immediately.

For those diagnosed with sensorineural hearing loss, a doctor may recommend hearing aids, cochlear implants, or hybrid cochlear implants as a course of treatment. It will depend on the severity of your hearing loss. If you are diagnosed with conductive hearing loss your doctor may recommend bone conduction hearing aids, bone-anchored hearing devices, or middle ear implants to improve your hearing.

All of these decisions are made on a case by case basis. It’s best to see your healthcare professional so that they can determine if you are suffering from hearing loss and the best way to treat it so that you can hear clearly once again.

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