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Hearing Loss - The types, the symptoms, the causes & the facts

Updated 11/05/2022

Hearing Loss Visual

Hearing Loss Information

Hearing loss types, symptoms, causes & treatments

 

Main hearing loss facts in the UK*

 

Hearing loss definition

A hearing loss is an example of a barrier to communicating as you would do with 'normal' hearing.  Hearing loss is quite common and can be caused by many factors, but historically age and noise are generally the two most common causes. 

The true definition of hearing loss is when your ability to hear speech and other sounds is greatly reduced.  Realistically hearing loss cannot be cured but can be successfully treated with hearing aids dispensed by an audiologist.

  

What are the levels of hearing loss?

Hearing loss is separated into categories and levels.  These classifications are mild hearing loss, moderate hearing loss and severe hearing loss or profound hearing loss.  To put it into perspective, if you have mild hearing loss – the quietest sounds you can hear (with your better ear) are anywhere between 25 and 40dB. 

If you have moderate hearing loss – the quietest sounds will be between 40 and 70 dB.  If you have a severe to profound hearing loss this range would be between 70 and 95 (or higher) dB.

 

Human hearing range

To give you an idea of the human hearing range:  Humans hear sounds in a frequency range from 20 Hz to 20 kHz, however, the upper limit in average adults is often closer to 15–17 kHz.  Let's take a more in-depth look at each level of hearing loss below. 

These hearing loss categories are normally specified using a measured audiometric average of 500, 1000, 2000 and 4000 Hz.

►Click here to go to types

►Click here to go to causes

►Click here to go to treatments

 

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The main types of hearing loss

 

Mild hearing loss

What is mild hearing loss?  When you have mild hearing loss, you are unable to distinguish sounds that are quieter than 25 decibels (dB) for adults and 15 decibels for children.  Sounds such as whispered conversations, water dripping, the rustling of leaves and birds chirping are some examples of sounds you can lose when you have mild hearing loss.

With mild hearing loss, you may also struggle to hear low-pitched and high-pitched frequency sounds. However, most people with mild hearing loss lose the ability to hear high-pitched sounds first.  Although this level of hearing loss' sounds rather tame - it still requires urgent medical assistance, as it can lead to other medical problems if untreated.

 

Moderate hearing loss

What is moderate hearing loss?  Generally, quiet sounds heard by your better ear is between 35 - 49 dB.  Moderate hearing loss is generally when you have issues hearing in many situations and struggle to keep up and understand speech in conversation.  People with moderate hearing loss are usually treated with and benefit from wearing hearing aids.

 

Moderately severe hearing loss

What is moderately severe hearing loss?  Generally, quiet sounds heard by your better ear is between 50 - 64 dB. People who suffer from moderately severe hearing loss have problems hearing in most situations when not using digital hearing aids.

 

Severe hearing loss

What is severe hearing loss?  Generally, quiet sounds heard from your better ear is between 65 - 79 dB.  Those with severe hearing loss are classed as very hard of hearing and struggle to hear all frequency sounds. 

Severe hearing loss requires you to wear powerful hearing aids or implants.  They might also additionally rely on lip-reading and sign language, as well as wearing hearing aids.

 

Profound hearing loss

What is profound hearing loss?  Generally, quiet sounds are heard between 80 dB and above in your better ear.  Those with profound hearing loss have extremely weak hearing and require very powerful hearing aids or implants.  They also rely on lip-reading and sign language.

 

Hearing Loss Visual

The main effects of hearing loss

 

The consequences of hearing loss vary with each individual.  However, most people with a hearing impairment can suffer from anxiety, depression, social, psychological, and physical problems due to their hearing loss.  It is important to remember that we are generalising here, and this is not the case for everyone with hearing loss. 

Audiologists, ENT clinics, hearing coaches and hearing organisations are a brilliant source of research, support, advice, treatment and rehabilitation.

We will discuss the reason why early diagnosis of hearing loss is essential further down this article – but if you take the proactive approach to your hearing concerns, you will improve the chance of a successful solution.  Hearing loss provides a barrier to communication which is very much needed to feel connected to the world and essential to the state of our mental health. 

Again we are generalising here, but the most common form of treatment is hearing aids, which not only help you to simply hear better - but also to better understand your soundscape and greatly reduce the risks of developing dementia. 

 

What are the different types of hearing loss?

Hearing loss is classified as sensorineural hearing loss, conductive hearing loss or mixed hearing loss.  Here we break down each type of hearing loss:

 

Sensorineural hearing loss:  This type of hearing loss is due to the tiny hair cells in the inner ear being damaged.  Sensorineural hearing loss can be linked to age-related hearing loss (also known as Presbyacausis) and noise-induced hearing loss – caused by long periods of exposure to loud noise.

Conductive hearing loss:  Conductive hearing loss is a type of hearing loss is when the ears’ ability to conduct sound from the outer ear through the middle ear into the inner ear is blocked or reduced.

Mixed hearing loss:  If there are issues with conducting sound and there is damage to the inner ear hair cells it is called mixed hearing loss – therefore, this type of hearing loss is a combination of sensorineural hearing loss and conductive hearing loss.

Auditory Processing hearing loss:  This is an auditory processing disorder and a form of hearing loss, unlike the other main three kinds. It is when there is no other form of hearing loss present, the ears are fully capable of receiving sound, but the brain has problems processing and understanding it.

 

Types of hearing loss

Other types of hearing loss

 

Bilateral hearing loss:  A hearing loss in both ears, which sometimes is caused by children with Pendred syndrome - a genetic disease that causes this type of hearing loss.

Unilateral hearing loss:  Also known as single-sided deafness or hearing loss in one ear.  Hearing loss in one ear treatment is usually a CROS hearing aids system.

Asymmetric hearing loss:  This is when the hearing loss you have in both ears is significantly different.

Hidden hearing loss:  Hidden hearing loss is defined as a hearing loss that's not detectable on standard hearing tests/audiograms, which highlight issues within the ear. 

High-frequency hearing loss:  This means high-pitched sounds are harder to hear. It can affect anyone of any age - but high-frequency hearing loss is more commonplace in older adults with age-related hearing loss and those who are exposed to loud noises.

 

Here are some symptoms of hearing loss and signs of hearing loss to look out for:

  1. Difficulty understanding words – especially in noisy environments.
  2. Muffled speech and sound.
  3. Trouble hearing consonants.
  4. Frequently asking people to repeat themselves or to speak more slowly and loudly.
  5. Constantly having to turn up the volume on audio.
  6. Withdrawal from conversations.
  7. Avoiding social gatherings.

 

Why is early treatment and diagnosis for hearing loss essential?

If you delay getting a hearing aid, you could be causing more damage to your future hearing health. Over time, without amplification, your perception of sound can change.  This is because when you hear a sound your ears have detected a vibration in the air and transmitted it via the inner ear to the auditory nerve. This nerve carries signals to the brain which then processes it into the noise and speech sounds that create the soundscape around you.

In order for the auditory cortex to function it needs to be used. Just like any other muscle in the body.  Your brain is no different - if you have hearing loss that is untreated your brain starts to get weak.  If you stop using a part of it or signals can no longer reach it, it will send it elsewhere.  

Studies show that people who have untreated hearing loss and the hearing nerve and auditory cortex haven't been used - were unable to process the sound in recognisable words.  People with normal hearing have an active brain that can pick out speech sounds from challenging background noise, distinguish them and understand them.  Therefore, early diagnosis of hearing loss is vital.

 

The difference between 'normal' hearing and hearing loss

In a different study, MRI scans of people with severe hearing loss were compared with those of people with normal hearing. These scans showed that the auditory cortex was smaller in participants with hearing loss. This backs up the theory that unused parts of the brain start to shrink or disappear when they are not used.

Once brain cells are lost, they are not replaced.  Whilst everyone’s brain begins to shrink as they age, the scans of people with normal hearing had a larger auditory cortex. This means that there was no change in their ability to recognise and process sounds.

 

Hearing Loss

The stigmas surrounding hearing loss

Why don’t people get hearing aids straight away?

 

Perhaps they feel there’s a stigma around wearing hearing aids. They don’t want to be seen as getting old. They don’t realise just how small and discrete modern hearing aids are.  But the longer you ignore any hearing problems, the worse your hearing will get.

Hearing aids can keep the hearing nerves and brain stimulated and healthy. This means that even if your hearing does begin to get worse over time, with the right amplification you will still be able to process sounds and conversation.  Your hearing aids may not be perfect right away, if you’ve had untreated hearing loss for some time it could take a while for your brain to get used to noise again.

 

A fast hearing loss diagnosis is key

The sooner you get help and advice about your hearing loss, and get hearing aids, the easier it will be to get used to them. Early intervention will also prevent further hearing difficulties by ensuring that the hearing nerves and auditory cortex are used to their full potential. 

 

Hearing loss community and support

There are now more online hearing loss communities and forums where you can ask questions, share ideas and connect with others who have hearing loss.  There are also hearing loss organisations and charities that can support you and who organise events to bring people together.  Organisations such as Action on Hearing Loss (now called RNID - The Royal National Institute for Deaf) are a great example of this.

Hearing Loss Causes

What causes hearing loss? 

But first, how do we hear?  To fully understand hearing loss, it's useful to understand how you hear and what decibels are safe.  Our ears are made up of three major areas - the outer ear, middle ear and inner ear.  Sound waves go through the outer ear and cause vibrations at the eardrum, which in turn amplifies these vibrations down to the inner ear.  The vibrations go through fluid in a snail-shaped structure of the inner ear - the cochlea.

Attached to the nerve cells in the inner ear there are thousands of small hairs that assist in translating sound vibrations into electrical signals which are then sent to the brain.  This is when your brain switches them into sound.

Hearing Loss Main Causes

Understanding sound decibels in common noises

It is also important to understand what sound levels are safe and what levels are considered to be risking permanent future damage to your hearing - if exposed to them for a long duration of time.  Therefore, the louder the noise, the less time it takes to cause permanent hearing damage.  In general terms, anything over 75dB is considered high risk. 

Here are a few examples:  Whisper - 60 dB, fridge - 40 dB, general conversation - 60 dB, dishwasher - 70 dB, car commuter traffic - 85 dB, motorbike - 95 dB and live gigs - 110 dB

UK Hearing Loss Causes

The causes of hearing loss

What are the common causes?

 

Hearing loss caused by ear infections / fungal ear infection

There are many common causes of hearing loss.  You can get hearing loss after an ear infection, ear fungus or abnormal bone growth or tumours in the outer or middle ear.  Any of these can cause hearing loss.  This type of hearing loss is usually temporary and decreases in severity after diagnosis and treatment. 

Your doctor might treat your ear infection with a course of antibiotics, which should eventually assist in getting your hearing back to normal.  Sometimes people are prone to getting ear infections, and in this case, doctors might insert a tube in your eardrum and drain out any fluid.

 

Hearing loss caused by loud noises

If you expose your ears to loud noises for a prolonged period of time it can damage the cells in your inner ear.  This long-term damage can also be caused by short, sudden or sharp bursts of noise and is called noise-induced hearing loss.

 

Hearing loss due to age, hearing loss in the elderly & hearing loss caused by damage to the inner ear

When we age the tiny hairs and nerve cells can get damaged over time in the cochlea or inner ear.  This deflects the sound signals to the brain.  If these hairs or nerve cells are damaged or missing - the electrical sounds can't be transmitted properly, causing hearing loss. 

This results in the inability to hear higher-pitched tones and these sounds may become muffled.  You will also find a conversation in noise very difficult to understand.  This type of hearing loss is called Presbycusis.

 

Hearing Loss UK Facts

How ageing effects hearing

Why is ageing one of the main causes?

 

What causes hearing loss with age?

One of the most common forms of hearing loss is ageing or ‘presbycusis’ – which is the lessening ability or inability to hear high-frequency sounds. This is called a high-frequency hearing loss.  So, what causes hearing loss as you age?

 

Hearing loss causes & genetics

Genetic hearing loss is when your genetic makeup may dictate that you are more at risk of getting ear damage or sound deterioration over time due to heredity issues.  Genetic factors cause some people to be more susceptible to hearing loss than others. 

This is because their genes make them more vulnerable to hearing loss - either through age, noise, medication or infections.  Studies have shown that around 35-55% of hearing loss is caused by age and genetics combined.

Everyone has genes existing in two copies passed down from their mother and father.  The risk of hearing loss usually depends on whether a mutation is dominant or recessive.  A dominant mutation causes hearing loss if only one of the inherited copies from the parent is damaged.  A recessive mutation only causes hearing loss if both copies are damaged.

 

Hearing loss caused by earwax

A gradual buildup of earwax can cause hearing loss.  If not treated and removed it blocks the ear canal and prevents the conduction of sound waves. Earwax removal or micro-suction can help restore your hearing safely and painlessly.

While earwax is important for hearing health, a common problem is too much earwax in the ear canal. In the UK, it is estimated that 2.3 million people have issues with excessive earwax each year. Earwax removal is the most widespread ENT procedure performed in primary care.

 

Hearing loss causes & a ruptured eardrum

A ruptured eardrum, also known as a Tympanic Membrane Perforation, is when loud spurts of sound, sudden changes in air pressure or an infection can cause your eardrum to rupture and affect your hearing.

 

Hearing loss caused by  medication & illness

There are a few types of medications that can potentially damage the inner ear or cause tinnitus and temporary hearing loss.  There are also some illnesses or diseases that result in a high fever and can do harm to the cochlea.

Hearing Loss Treatment

Hearing loss treatment

Can hearing loss be cured?  Some hearing loss is temporary, however, most forms of hearing loss are permanent and need an early diagnosis for treatment to be successful and to help you hear better again. 

Sensorineural is a type of hearing loss that is permanent.  The hair cells that are damaged can't be repaired.  People suffering from this type of hearing loss, are generally advised to wear hearing aids by an audiologist.  In some circumstances, cochlear implants are recommended instead.  Either way, your audiologist will discuss what treatment to take based on your specific hearing loss needs.

Hearing Loss Treatment In The UK

Hearing loss treatment without hearing aid

The digital hearing aids of today are highly advanced and can be personalised to cater to your own unique hearing loss.  Amplifying the sounds you need to hear better, as well as reducing those that you don't.  

Hearing aids can be worn behind the ear or in the ear, it all depends on what level of hearing loss you have - or in some cases - what shape your inner ear canal is for ITE hearing aids to sit comfortably and safely.

Hearing Loss Treatments Available

Types of hearing loss treatments

Conductive hearing loss treatment

 

Conductive hearing loss is generally caused by a condition in the outer or middle ear - this is usually temporary.  It is quite common that a build-up of earwax is the culprit, as well as fluid in the middle ear, a perforated eardrum or 'wet ear'.

This form of hearing loss is commonly treated medically at your ENT clinic.  However, if all efforts to sort the problem are exhausted - or the hearing loss is a mix of both sensorineural and conductive - then other options like hearing aids are usually advised.

 

Hearing loss treatment with hearing aids

How do hearing aids work?  Generally, all hearing aids are constructed the same, but they have big differences in the quality of sound captured and clarity of speech understanding.  For instance, the better the quality of the hearing aid - the more realistic the listening experience will be.  Find out more about how these devices work here

 

I think I have hearing loss.  What should I expect from my hearing test?

 

Hearing aids and hearing loss treatment near me

If you think you have hearing loss or know someone who might - book a free hearing healthcare consultation with one of our audiologists local to you today. Call us free on 0808 253 5093

 

 

*Hearing Link Org statistics

This information was written by Paul Harrison - Audiology Expert

Meet Paul Harrison, Audiology Expert & Founder of Hearing Aid UK

Managing Director & founder of Hearing Aid UK, with over 20 years of audiology experience and a member of the British Society of Hearing Aid Audiologists Council (BSHAA) between 2015-2020.

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