Hearing Loss

What is hearing loss?

Hearing loss happens when something affects your hearing system. If you have hearing loss, you may have trouble understanding, following or participating in conversations. It may be hard for you to hear telephone conversations, to take part in online meetings or follow dialogue when you’re watching television.

Hearing loss can affect your ability to work, communicate with others and generally enjoy life. Most often, hearing loss can’t be reversed. But audiologists — healthcare providers who specialize in diagnosing and treating hearing loss — can help. They can recommend treatments like hearing aids or cochlear implants that reduce hearing loss.

Is hearing loss common?

Yes, it is. More than 1 in 10 people in the United States have some degree of hearing loss:

• An estimated 60,000 people have hearing loss in one ear (unilateral hearing loss).
• About 1 in 3 adults over 65 and nearly half adults 75 and older have age-related hearing loss.
• About 2 in 1,000 babies are born with some type of hearing loss.

Types of hearing loss

There are three types of hearing loss:

• Conductive hearing loss: In this hearing loss, something keeps sound from passing through your outer ear (ear canal) or your middle ear.
• Sensorineural hearing loss: This hearing loss happens when something damages your inner ear over time. Rarely, sensorineural hearing loss happens very quickly. This is sudden sensorineural hearing loss (SSHL), or sudden deafness. SSHL may happen all at once or over a few days.
• Mixed: This happens when you have issues in your middle or outer ear (conductive hearing loss) and your inner ear (sensorineural hearing loss).

What are hearing loss symptoms?

Most people lose their hearing gradually. They may not even notice that it’s happening. In general, you may be developing hearing loss if:

• You often ask people to repeat themselves.
• You have trouble following a conversation, especially when you’re talking on the telephone or in a noisy environment like a restaurant.
• You think people are mumbling.
• You can’t hear certain high-pitched sounds, like birds singing.
• You need to turn up the volume on your television, computer or tablet.
• You have tinnitus (ringing in your ears).
• Your ear hurts (earache).
• You feel as if there’s pressure or fluid inside your ear.
• You have balance problems or dizziness.

What are symptoms of hearing loss in babies and children?

Babies with hearing loss may seem to hear some sounds but not others. They may:

• Not startle to loud noises.
• Not turn to the source of a sound after 6 months of age.
• Not say single words like “mama” or “dada” by age 1.
• Not react when you say their name.

Older children with hearing loss may:

• Say “huh” a lot.
• Be slower to learn to speak than other children their age.
• Have unclear speech.
• Not follow directions.
• Turn up the volume on television or tablets.

What usually causes hearing loss?

Many things can cause hearing loss. For example, short-term or sudden exposure to very loud noise — like attending a loud concert — can affect your hearing.

Conductive hearing loss causes include:

• Earwax that’s built up in your ear.
• Fluid in your middle ear from colds or allergies.
• Middle ear infection (otitis media).
• Swimmers’ ear (otitis externa).
• Eustachian tube issues that traps fluid in your middle ear.
• Ruptured eardrum.
• Ear tumors.
• Something stuck in your ear. For example, your child, faced with a side dish of peas, may decide to put one in their ear.
• Congenital conditions (conditions present at birth) that affect how babies’ middle or outer ears are formed.

Sensorineural hearing loss causes include:

• Aging.
• Illnesses like coronary artery disease (heart disease), high blood pressure (hypertension), strokes or diabetes.
• Ototoxicity.
• Certain genetic (inherited) conditions.
• Being hit in the head.
• Noise-induced hearing loss. Long-term exposure to loud noise, like working in a very noisy environment like factories and construction sites.
• Congenital infections like cytomegalovirus (CMV).

Mixed hearing loss in a combination of conductive and sensorineural hearing loss. That means it affects your outer and middle ear as well as your inner ear. For example, if you take medications that affect your inner ear and you accidentally rupture your eardrum in your middle ear, you have mixed hearing loss.

What are the complications of hearing loss?

Having hearing loss can make you feel disconnected from the world around you. You may become frustrated, irritable or angry. People with severe hearing loss can become anxious or depressed. Children with hearing loss may struggle in school and get poor grades. Studies also show a link between hearing loss in older adults and dementia.

How is hearing loss diagnosed?

Your healthcare provider will ask about your symptoms and do a physical exam. They’ll check for signs of infection or other issues that could cause hearing loss. They may do a CT scan (computed tomography scan) or MRI (magnetic resonance imaging) if you hurt your ear or they think you may have a tumor. Your provider may refer you to an audiologist (or you may contact one on your own) who’ll do specific hearing tests.

Common hearing tests include:

• Pure-tone testing: This common hearing test finds the quietest volume you can hear at each pitch. You’ll wear headphones or earplugs to hear the sounds and speech. You’ll also wear a device on your head for bone conduction testing. The combination of testing with headphones/earplugs and bone conduction testing helps your audiologist determine which type of hearing loss you have.
• Otoacoustic emissions test (OAE): Audiologists use this test to check your inner ear function.
• Tympanometry: This test checks how well your eardrum moves. Audiologists may do tympanometry tests to see if you have a ruptured eardrum, fluid in your middle ear or wax in your ear canal.

What are stages of hearing loss?

If you have a hearing test, your audiologist will share test results and explain what they mean. Often, hearing loss is classified as the degree of loss. The degree of loss is how loud sounds need to be for you to hear them. According to the American Speech-Language-Hearing Association, the degrees of loss are:

• Normal.
• Slight.
• Mild.
• Moderate.
• Moderately severe.
• Severe.
• Profound.

What are hearing loss treatments?

Treatments are different depending on the type of hearing loss you have.

Conductive hearing loss

• Medications, like antibiotics, to treat ear infections.
• Surgeries, including tympanoplasty, to repair a ruptured eardrum, tympanostomy to insert ear tubes or surgery to remove tumors.
• Procedures to remove earwax or other objects in your ear canal.

Sensorineural hearing loss

• Medications, like corticosteroids, to reduce swelling in your cochlea hair cells. (You can damage your cochlea hair cells if you’re exposed to loud noise.)
• Management like hearing aids and cochlear implants.

Mixed hearing loss

• Treatments vary based on the specific issues affecting your outer, middle and inner ear.

Treatment side effects

Side effects vary, but surgeries likely have the most significant side effects:

• Tympanoplasty complications include graft failure, when surgery doesn’t fix your ruptured eardrum.
• Tympanostomy side effects may include tympanosclerosis (scarring of eardrum), repeated ear infections or otorrhea (fluid continuously draining from your ear).
• Ear tumor treatments may cause hearing loss, balance issues and facial weakness.
• Cochlear implant surgery may affect your sense of balance or affect residual hearing, which is hearing you have despite having severe or profound hearing loss. Rarely, cochlear implant surgery causes nerve damage or cerebrospinal leaks.

How can I prevent hearing loss?

There are some types of hearing loss you can’t prevent. For example, many people develop hearing loss as they grow older. That said, noise is the most common cause of hearing loss. You can help prevent noise-induced hearing loss by avoiding situations and environments where you’re bound to encounter very loud noise. If you can’t avoid noisy situations, protect your hearing by:

• Use hearing protection (earplugs or earmuffs) during loud activities like concerts, riding motorcycles or snowmobiles, or working with loud machinery.
• Lower the volume. When listening to music through headphones or earbuds, keep the volume level low enough that you can hear people speaking around you. Another good rule is not to exceed 80% of volume level for more than 90 minutes a day.
• Don’t stick anything into your ear canal, including cotton swabs or hairpins. These objects could become lodged in your ear canal or cause an eardrum rupture.
• Avoid smoking, which can impair circulation and affect your hearing.
• Get regular exercise to help prevent health issues that can cause hearing problems, like diabetes or high blood pressure.
• Manage any chronic illnesses to prevent further damage.

What can I expect if I have hearing loss?

That depends on your situation. Some hearing loss is temporary, like hearing loss that happens because you have a cold, swimmer’s ear, or there’s something stuck in your ear. Sensorineural and age-related hearing loss is usually permanent, but hearing aids or cochlear implants may restore most of your hearing.

How do I take care of myself?

It can be challenging to live with hearing loss, even if you’re already receiving treatment like using hearing aids or cochlear implant surgery.

There may be times when you can’t hear as well as you’d like. If that’s your situation, you may want to let people know you have hearing loss.

Hearing loss can affect your emotional health. Even with treatment, you may feel depressed or anxious. If you do, consider sharing your feelings with a healthcare provider.

When should I see my healthcare provider?

Contact your healthcare provider if you think your hearing loss is getting worse. You may need a different kind of hearing support.

What questions should I ask my healthcare provider?

If hearing tests show you have hearing loss, you may want to ask your provider the following questions:

• What’s causing my hearing loss?
• What can I do to improve my hearing?
• Will my hearing loss get worse?
• Should I consider cochlear implant surgery?

What’s the difference between hearing loss and deafness?

The difference is someone with hearing loss still hears sounds well enough to take part in conversations. They can improve their hearing ability through hearing aids or other treatments. Someone who’s deaf can hear very little or nothing at all. Hearing aids and devices don’t help. A person who’s deaf may use sign language to communicate.

Is hearing loss a disability?

The Americans with Disabilities Act (ADA) protects people with disabilities from discrimination. The ADA considers certain medical conditions to be disabilities if the conditions limit people’s abilities to do everyday activities. Hearing loss is one such medical condition, but the level of hearing loss factors into whether it’s a disability under federal law.

A note from Cleveland Clinic

Hearing loss can be temporary, but many people have hearing loss that doesn’t go away. Hearing loss may make you feel as if you’re missing out on life. You may feel uncomfortable trying to carry on telephone conversations or frustrated because you can’t enjoy your favorite movies or shows. You may feel isolated or depressed. If you think you have hearing loss, talk to a healthcare provider or audiologist. They’ll determine the best way to improve your hearing.