Understanding hearing loss

How the ear works

Understanding how your ear works may help you to understand your hearing loss better. Although it can seem complicated, the ear is just a clever messenger system that turns sound waves into signals your brain can understand. It has three main parts:

Outer Ear - Sound waves are captured by the outer ear and travel down the ear canal to the eardrum.

Middle Ear - When the sound hits the ear drum it causes it to vibrate. That vibration is then transmitted to the ossicles; three tiny bones often called hammer, anvil and stirrup. The ossicles amplify the sound, sending it to the cochlea.

Inner Ear - The cochlea, a spiral shaped structure which is filled with fluid and tiny hair-like cells, receives these vibrations and converts them into electrical signals. These signals are then carried to the brain where they are interpreted as sound.

Hearing Loss explained

Hearing loss and deafness is what happens when sounds are not communicated to the brain. This is caused by a problem in the hearing system, and there are a number of reasons why this happens; some treatable and some permanent.

Hearing loss falls into 2 main categories, sensorineural and conductive, although it is possible to have both and this is called mixed hearing loss.

Sensorineural

Sensorineural hearing loss is caused by damage to the hair-like cells within the cochlea, damage to the auditory nerve or sometimes both.

Unfortunately, these cells and nerve fibres can’t repair themselves, making sensorineural hearing loss a permanent condition in most cases. However, it can often be treated with hearing aids or cochlea implants.

Symptoms: These can vary depending on the cause and the severity of hearing loss. Common symptoms can include:

  • Difficulty hearing high and low pitched sounds
  • Difficulty understanding speech, especially with background noise
  • Trouble hearing the television or radio
  • Tinnitus
  • Dizziness
  • Balance problems
  • You can’t differentiate between certain sounds (like ‘s’ or ‘th’ sounds)

 

Causes: Some of the most common causes of hair cell and auditory nerve damage include:

  • Aging (most common) - natural wear and tear
  • Loud noises over extended periods or sudden loud noises
  • Genetics
  • Infections
  • Ototoxic drugs
  • Brain injury or head trauma
  • Ménière’s disease

Conductive hearing loss

Conductive hearing loss is caused when something stops sound passing from the outer ear to the inner ear. Some conditions cause hearing loss very gradually, over many years and are not always obvious.

It can be temporary or permanent and range from mild to severe depending on the cause.

Symptoms: They can vary depending on the exact cause and severity, but may include:

  • Muffled hearing
  • Sudden or steady loss of hearing
  • Full or “stuffy” sensation in the ear
  • Dizziness / balance issues
  • Draining of the ear
  • Pain or tenderness in the ear
  • Noticing that your own voice sounds louder

 

Common causes:

  • Infections of the outer or middle ear (otitis externa, otitis media), Exostosis (surfer’s ear), Glue ear
  • Blockages such as ear wax build up, foreign objects, tumors, cysts or growths
  • Structural abnormalities like Otosclerosis
  • Damaged ossicles
  • Perforated eardrum

 

Support: You can get support and more information about hearing loss from RNID and NHS.UK.

Tinnitus

Tinnitus is a condition where people hear noises that do not come from an outside source.

You may hear these sounds in one or both ears, or in your head. They may come and go, or you might hear them all the time.

About 1 in 6 people have tinnitus occasionally and around 1 in 50 people have severe tinnitus.

Symptoms:

  • Ringing
  • Buzzing
  • Roaring
  • Clicking
  • Hissing
  • Humming

 

Causes: It's not always clear what causes tinnitus, but it's often linked to:

  • Some form of hearing loss - most cases are linked to sensorineural hearing loss but can sometimes be conductive hearing loss.
  • Ménière's disease
  • Conditions such as diabetes, thyroid disorders or multiple sclerosis
  • Anxiety, depression or stress
  • Certain medications - tinnitus can be a side effect of some chemotherapy medicines, antibiotics, non-steroidal anti-inflammatory drugs (NSAIDs) and aspirin
  • For some, tinnitus does not appear to have any cause

 

Support: You can get support and more information about tinnitus from Tinnitus UK, RNID and NHS.UK.

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