The ability to hear and communicate effectively impacts all aspects of your life including relationships, success in school and work, and overall quality of life. Hearing loss is the thirdmost common chronic health condition for adult Americans (National Center for Health Statistics, 20121 ). Hearing loss can occur at any age. Although hearing loss might occur suddenly, it most often develops over several years or decades. Some of the reasons for changes in hearing include aging, use of some types of medications, exposure to loud sounds, serious infections, accidents, and others.
Although most hearing loss in adults is permanent, some types of hearing loss are medically treatable or surgically correctable. The most common treatment for permanent hearing loss in adults is hearing aids; however, only a fourth of those who can benefit from a hearing aid use one. Most individuals wait about seven years to investigate treatment options after they begin to suspect having a hearing problem. Reasons for waiting include not thinking that the hearing loss is bad enough to need attention, not knowing what services are available, concern over cost, the social stigma of hearing loss, and a lack of self-awareness.Types of Hearing Loss
You may suspect that you have a hearing loss, but to determine the best treatment the audiologist also needs to determine the type of hearing loss. It is not possible for you to determine the type or degree of hearing loss you have, even using online screening tools. Screening tools can alert you that your hearing might not be normal, but anyone concerned about hearing should consult an audiologist for an audiologic evaluation (hearing test). The audiologist can propose a hearing device for treatment, but the plan of care also may include other recommendations (e.g., auditory training, improving communication skills/communication strategies, and/or assistive and alerting devices).
The audiologist will classify hearing loss into one of three categories:
- Sensorineural hearing loss is the most common form of hearing loss. It is sometimes referred to as “nerve deafness” but it usually does not involve the nerve. Instead, it involves the sensory cells in the inner ear and their connections to the hearing nerve. The sensory cells of the inner ear, called hair cells, convert incoming sound signals into electrical impulses that the hearing nerve conveys to the brain. When these cells are damaged or stop fully functioning, hearing loss results. It can become difficult to hear in noisy situations when the delicate connections to the nerve are affected, even when a hearing test appears normal. Sensorineural hearing loss most commonly affects a person’s ability to hear higher pitches, causing the listener to perceive that people are mumbling, or they will often state that they “can hear, but can’t understand.”
Sensorineural hearing loss often occurs slowly over time and generally affects both ears to the same degree. In rare instances it is possible to have a sudden hearing loss that affects only one ear. Sensorineural hearing loss is typically permanent and, in the majority of cases, can’t be corrected with medication or surgery. Fortunately, sensorineural hearing loss can be managed with hearing aids and implantable technologies, as well as other assistive accessories. (1)
- Conductive hearing loss is less common in adults and often can be treated with medications or through surgery. This type of loss is typically the result of sounds failing to travel effectively to the inner ear. Conductive problems can cause mild or moderate hearing losses but rarely result in total hearing loss. However, some forms of conductive hearing loss can be permanent, even with medical or surgical treatment. In these cases, hearing aids or other implantable technologies can be used to improve hearing. Causes of conductive hearing loss include cerumen (ear wax) impaction, middle ear fluid or infection, tumors/growths, and history of ear surgeries.
- Mixed hearing loss is a combination of conductive and sensorineural hearing loss. These are generally more complex to treat and may require a combination of medical, surgical, and audiologic treatments.
Table 1. Types of Hearing Loss
| Sensorineural Hearing Loss | Conductive Hearing Loss | Mixed Hearing Loss | |
| Description | Hearing loss that typically impacts overall volume and the ability to understand speech clearly | Hearing loss that typically decreases volume of sound (like wearing an earplug) | May involve a combination of decreased volume and clarity |
| Who Is Affected | All ages | All ages | All ages |
| Location in the ear | Inner ear and/or hearing nerve | Outer ear and/or middle ear | Combination of outer and/or middle ear and inner ear to hearing nerve |
| Cause | Aging, exposure to loud sounds, infections, medications, genetics, and others | Growths or tumors, ear infections, eardrum perforations, malformations of ear structures, earwax | Combination |
| Treatment | Management with hearing devices and auditory training | Possible medical or surgical intervention; may be followed by management with hearing devices | Possible medical or surgical intervention; might be followed by management with hearing devices |