Types of hearing loss

Hearing is a critical part of our daily lives.Hearing loss can abrupt your life profoundly if not diagnosed and treated correctly.It can happen to anyone regardless of your age, lifestyle, social circle, and the profession we are pursuing.

Even a small impairment to our hearing ability can adversely impact your speaking quality, speech comprehension, and communication in social situations.

That makes it essential to understand and identify the symptoms of Hearing Loss as they occur. It will help you reverse the effects with the necessary treatment and live your life to the fullest regardless of hearing loss.

Through this blog, we would discuss:

• what exactly is hearing loss,
• different types of hearing loss that occurs,
• their causes,
• symptoms, and
• available treatment options.

What is Hearing Loss?

Hearing loss is a state where you are unable to hear wholly or partially any sound.It may happen to someone at an early age as well as in old age. Several triggers may cause hearing loss, including the lifestyle factors and neurotic issues in the body.Also, sometimes hearing loss may affect only one ear and sometimes both.

Hearing loss is of four degrees clinically. I.e.

• Mild: You may hear some speech sounds but have difficulty with soft tones.

          Difficulty in hearing from a distance, in noise, in a group.

• Moderate: You may struggle to hear/understand Speech when talking at an average level.

          In addition to the above difficulty

          Difficulty in hearing one as to one in a normal voice, some difficulty on the phone

• Severe: You’ll hear little-to-no Speech when spoken at normal levels and hear only loud sounds.

          Difficulty in hearing normal conversation

• Profound: You can only hear too loud sounds and no speech.

          Not hearing anything except loud sounds

While the symptoms and effects of hearing loss may seem almost similar, certain factors categorize different types of hearing loss. The fundamental difference is in terms of what causes hearing loss and the treatment process of each type.

Which are the different types of Hearing Loss?

There are mainly four types of Hearing Loss. i.e.

• Sensorineural Hearing Loss (SNHL)

Sensorineural hearing loss occurs due to problems of the inner ear, also commonly known as nerve-related hearing loss. When the cochlea’s hair cells are missing or damaged, this is known as sensorineural hearing loss.It could have a genetic cause or be a result of head trauma, exposure to loud noise, or something else in the environment. Sensorineural hearing loss is also a standard part of the aging process and very common with hearing loss in older adults.

• Conductive Hearing Loss (CHL)

Conductive hearing loss happens due to problems with the ear canal, eardrum, middle ear, and little bones – the malleus, incus, and stapes.In this type, the outer or middle ear cannot conduct sound properly.it is mainly a problem of loudness .

• Mixed Hearing Loss

Mixed hearing loss generally happens through conductive damage in your outer or middle ear and sensorineural damage in your inner ear (cochlea) or auditory nerve. It is a combination of both sensorineural and conductive hearing loss. It may result from problems in both the inner and the outer or middle ear.

• Neural Hearing Loss / Auditory Neuropathy Spectrum Disorder

It is not a common type of hearing loss. Neural Hearing Loss happens when the auditory nerve is affected due to tumor or any other kind of damage in someone’s hearing system. Neural Hearing Loss occurs when sound enters the ear usually, but because of damage to the inner ear or the hearing nerve, the brain can understand the noise received. Hence, it is more complicated to treat.

Now, let us understand, in detail, the four types of hearing loss with the causes and treatments.

• Sensorineural hearing loss

It is the most common Hearing Loss type in recent times.It is permanent by nature that occurs when there is damage to the tiny hair cells of your inner ear or the auditory nerve itself, which can prevent or weaken the transfer of nerve signals to the brain.These blocked nerve signals are the ones to carry information about the loudness and clarity of sounds to your mind.

• Causes

If a baby is born with sensorineural hearing loss, then it is most likely because of a genetic issue or maybe an infection passed from mother to fetus while inside the womb.On the contrary, if developed later in life—a more typical case—can be caused by different triggers.

Some common causes for Sensorineural Hearing Loss are

• Typical aging (Also known as age-related hearing loss)
• Exposure to loud noises acquired on the job or lifestyle choices

Some other causes can be

• Heart disease,
• diabetes
• Infections
• Meniere’s disease
• A side effect of any medicines
• Cancerous growths in the inner ear like Acoustic neuroma
• Traumatic injuries that may have damaged the inner ear or auditory nerve
• Autoimmune diseases

• Symptoms

The sensorineural hearing loss can affect both the loudness and the clarity of sound that you hear. Most people will have high-frequency hearing loss, resulting in some or all of the following issues with hearing:

• Others’ Speech may seem slurred or mumbled, or, a feeling of you can hear but not understand
• Challenging to follow a conversation when more than one person is speaking at the same time
• A consistent ringing or buzzing sound in the ears (known as tinnitus)
• Problems hearing in noisy environments (e.g., train stations, construction sites, convention centers, sports arenas, etc.)
• Difficulty in hearing women’s or children’s voices and other high-pitched sounds
• Specific speech sounds are difficult to understand during conversations (e.g., the “s” or “th” sound)
• Noises will seem too loud or too quiet.
• The feeling of being off-balance or dizzy

People with sensorineural hearing loss often explain that they can hear people speaking, just not clearly.

• Treatment

There are no medical or surgical methods to repair the hair cells of the inner ear or the auditory nerve if it is damaged. However, you can treat the sensorineural hearing loss with a proper cochlear implant or use of hearing aids, depending on the severity of the damage. Assistive listening devices such as alerting devices, vibrating alarm clocks, and captioned phones may provide you a complete hearing solution. For people who have severe-to-profound hearing loss, power hearing aids can be helpful.

• Conductive hearing loss

Conductive Hearing Loss is not as common as sensorineural hearing loss. It occurs if there is an obstruction or damage to the outer or middle ear, which may prevent the sound from being conducted to the inner ear. Varying with the cause, Conductive Hearing Loss may be temporary or permanent on case to case basis.

• Causes

Depending on if the outer or middle ear is affected will differentiate the causes of conductive hearing loss.

Outer ear

• Narrowing of the ear canal (Stenosis)
• Wax impaction
• Exostoses (bone-like protrusions developing inside the ear canal which may cause potential cause blockages)
• Otitis externa (swimmer’s ear)
• Obstructions by foreign bodies inserted into the ear
• Microtia

Middle ear

• Injury breach in the tympanic membrane (eardrum) cause
• Ear infections or rapid air pressure change
• Tympanosclerosis (thickening of the tympanic membrane)
• Otitis media (ear infection) or a buildup of fluid in the middle ear
• Blockages in the Eustachian tube (connects the middle ear with the back of the nose and the throat)
• Otosclerosis(affects the tiny middle ear bone known as the stapes)
• Abnormal growths or tumors forming within the middle ear (e.g., cholesteatoma, glomus tumors)
• Ossicular chain discontinuity (connection breaks between the middle ear’s bones caused by injury or substantial trauma)

• Symptoms

Because the sensitive inner ear is intact with the auditory nerve, one who has conductive hearing loss has difficulty with the overall loudness of sounds primarily, but not the clarity.

Individuals with this kind of damage often find that turning up the radio or television volume enough to improve their hearing ability.

The consistent symptoms of conductive hearing loss are

• More natural time understanding in one ear than the other
• One or both the ears paining
• The sensation of pressure in one or both the ears
• Difficult or frustrating conversation on the telephone
• A foul odor from the ear canal
• It feels like one’s voice sounds louder or different

• Treatment

Sometimes medical or surgical procedures can improve the hearing ability for those with conductive hearing loss.

For example, conductive damages due to foreign objects, abnormal growths, wax impaction, or ear infections can generally improve with medical treatments, like extraction of earwax, antibiotics, or surgical procedures.

Conductive hearing losses caused by other abnormalities(e.g., exostoses, otosclerosis, stenosis of the ear canal, and ossicular chain discontinuity) can be more difficult to treat medically or surgically and considered as permanent hearing loss. These conductive losses are treatable using standard hearing aids. Otherwise, bone-anchored implantable devices are also another option.

• Mixed hearing loss

Mixed hearing loss is where you see a combination of the sensorineural hearing loss and the conductive hearing loss.

• Causes

Commonly it occurs when the ear sustains some substantial trauma. Mixed Hearing Loss can also happen gradually over time.

An example case is a person with a long-standing conductive hearing loss who might experience age-related hearing loss.

Alternatively, a person having age-related hearing loss may have a temporary hearing loss due to infection or maybe a wax impaction in the ear.

• Symptoms

The symptoms of mixed hearing loss can be any combination of what is listed above under the two types of hearing loss.

• Treatment

The correct treatment option for mixed hearing loss will depend on whether the damage is more sensorineural or conductive.

If a conductive component causes a more significant portion of the injury, it may be a surgical procedure with other medical treatments that will prove to be more effective in correcting the hearing concerns.

And, if a more substantial part of the damage is sensorineural, then considering hearing aids or implantable devices may be the best option.

• Neural Hearing Loss / Auditory Neuropathy Spectrum Disorder

Neural Hearing Loss / Auditory Neuropathy Spectrum Disorder occurs to an individual only when the Auditory nerve in the hearing system is either damaged or missing.

It is a rare condition than the other types of hearing loss.

• Causes:

It is caused mainly due to damaged or missing auditory nerves in the hearing system of an individual.

• Symptoms:

Symptoms for auditory neuropathy may vary entirely between two persons. Also, it may fluctuate.

Some of the symptoms are

• mild to severe level hearing loss
• sounds keep fading in and out
• difficult to understand spoken words
• normal hearing with poor speech perception
• Noisy environment worsens the speech perception

• Treatments:

When there is a missing or tiny hearing nerve or severely abnormal inner ear (cochlea), Hearing aids or cochlear implants cannot help because the nerve cannot pass on sound information to the brain.

In many cases, however, an Auditory Brainstem Implant (ABI) may be an option. The auditory brainstem implant directly stimulates the brainstem’s hearing pathways, bypassing the inner ear and hearing nerve.

It doesn’t restore normal hearing.

But it helps most people distinguish sounds such as telephone rings and car horns.

Some people have proper word recognition, while others get more general sound cues.

Combined with lip reading, the signals can improve your communication with others.

It is essential and helpful if you diagnose hearing loss at an early stage.

If you think that you or anyone you care about might be suffering from hearing loss, make sure to be tested with a professional right away to get the proper treatment that suits your needs.

You may also try the online hearing loss test to detect if you need a visitation or assistance.

Almost every hearing loss type is treatable with hearing aids, implantable devices, and assistive listening devices with advanced technology.

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