Hearing Loss

Hearing loss generally develops slowly over many years; the effects become apparent only gradually.

This makes it difficult for those affected to recognise that they are actually suffering from a hearing impairment. Relatives, friends or colleagues are often the first to realise that something is wrong. 

There are three main types of hearing loss which include sensorineural hearing loss, conductive hearing loss and mixed hearing loss.

Types of hearing loss

Caused by disorders of the outer and/or middle ear. Sound simply isn’t conducted properly from the outer ear or middle ear to the inner ear. This may be due to physical obstructions e.g. wax build-up or abnormalities e.g. perforated eardrum or damaged and/or defective ossicles that reduce the normal entry of sound waves through the auditory system to the nerves in the inner ear. Some conductive hearing losses can be temporary and can possibly be rectified by medical intervention.

Possible causes:

  • Blockage of the outer ear e.g. wax.
  • Collection of fluid in the middle ear - 'glue ear' (otitis media with effusion).
  • Middle ear infections (acute otitis media).
  • Otosclerosis - a condition where the ossicles of the middle ear harden with calcium deposits and become less able to vibrate.
  • Damage to the ossicles e.g. serious infection or head injury.
  • Perforated eardrum - can be caused by an untreated ear infection, head injury or a blow to the ear, or from poking something in your ear!

As the description suggests this combines two areas. Sensory hearing loss i.e. the fault lies within the inner ear and neural hearing loss which is related to failings with the auditory neural pathway. The inner ear is unable to properly transmit sound to the brain. The hair cells inside the inner ear (especially those for high frequency hearing) have withered due to age, noise, disease or medications and no longer pick up the nerve impulses properly.

This kind of loss is permanent, since hair cells do not re-grow and normally affects both ears. Sensorineural hearing losses affect our sensitivity to sounds as well as our ability to discriminate between sounds.

Possible causes:

  • Age-related hearing loss (presbyacusis) - This is a natural decline in your hearing. Many people get this as they get older because of damage to the hair cells in the cochlea. See the video below about age-related hearing loss, as featured on Channel 4's Embarrassing Bodies Programme.
  • Damage to the hair cells by loud noises (acoustic trauma). This is more likely to happen if you work in a noisy place.
  • Genetics - Approx. one in every thousand babies are born with a moderate to profound hearing loss. Genetic factors are thought to be the cause of at least half of these cases.
  • Medication - Many routine prescribed drugs can cause Ototoxicity which in turn causes a permanent hearing loss, e.g. Quinine, aspirin, warferine and many more taken in high doses over time cause this damage.
  • Infections such as measles, mumps or meningitis.
  • Ménière's disease - causes hearing loss, dizziness and tinnitus (a persistent ringing in the ears).
  • Certain cancer treatments - such as chemotherapy and radiation therapy, can cause hearing loss.
  • Acoustic neuroma - This is a benign (non-cancerous) tumour affecting the auditory nerve causing deafness and tinnitus.
  • Cholesteatoma (benign skin growth) in the middle ear, causing deafness and vertigo (sensation of movement when you're standing still).

Quite simply where a patient presents with both a conductive hearing loss and a sensorineural hearing loss.

Hearing loss warning signs

Hearing loss is commonly referred to as an invisible health condition and early signs are often overlooked. Unlike other medical conditions, you can’t actually see the signs of hearing loss.

Because the changes often occur gradually, it is quite common for individuals with hearing loss to find ways to cope and grow accustomed to reduced hearing acuity.

Family and friends are often the first to notice.

The following questions can help identify common warning signs of hearing loss:

  • Do you have difficulty following conversations?
  • Do you ask others to repeat themselves?
  • Do you complain that people mumble or speak too fast?
  • It is difficult for you to hear and understand women and children?
  • Do you have ringing in your ears?
  • Do you have a favourite ear?
  • Do you have trouble hearing on the telephone?
  • Do you find yourself turning up the volume of your television?
  • Do others complain that you keep the volume of your television too loud?
  • Do you avoid noisy places?
  • Do you ever feel embarrassed about misunderstanding what others say to you?
  • Do you feel tired after listening in challenging environments?


All these are typical signs of a hearing impairment. But don’t worry; hearing loss is not something simply to be endured. You can – and should – do something about it.

Many people find it hard to come to terms with the idea of wearing hearing aids. They put off the decision and only do something about it when the problems associated with poor hearing simply become too much for them.

But please please understand that the earlier you do something about hearing loss, the better it is. Even when hearing is just starting to deteriorate, hearing aids help to maintain neural pathways in your brain responsible for hearing all the sounds around you. The longer you put off hearing aids, the harder it will be for you to get used to them when you do finally wear them, and more importantly, the more you’ll miss out in life. The cognition pathway can deteriorate quickly with unnecessary strain leading to recognised cognition conditions.

Impacts of hearing loss

The thing about hearing loss is that it’s easy to overlook. You can deny it for years, compensating for poor hearing by turning up the volume on your phone or TV and requiring people to repeat themselves.

But on top of the tension this places on personal relationships, there are additional, hidden consequences of untreated hearing loss that are not as apparent but more concerning.

Listed below are six possible consequences of untreated hearing loss.

Hearing loss can cause you to lose out on crucial conversations and common sounds like birds chirping or the sound of rain on the rooftop. Ordinary household sounds continuously fade as your private world of sound narrows.

A study by the National Council on the Ageing in USA discovered that individuals with untreated hearing loss age 50 and older were more likely to report depression, anxiety, and paranoia and were less social when compared with those who used hearing aids.

Hearing loss can create impaired relationships, stress and anxiety, social isolation, and ultimately depression. Hearing loss can be stressful and embarrassing and can have significant psychological effects.

Hearing loss can affect your thinking and memory. In July 2019, a study was published by the University of Exeter and King's College London which showed that people who wear a hearing aid for age-related hearing problems maintain better brain function over time than those who do not.

The rate of decline varies according to the degree of hearing loss, but on average, those with hearing loss developed significant impairment in cognitive ability 3.2 years faster than those with normal hearing.

Listening requires energy, and when you fight to hear certain words or have to constantly fill in the blanks, the additional hassle is tiring. Those with hearing loss describe higher levels of fatigue at the end of the day, especially after long conferences or group activities.

The Better Hearing Institute found that, according to a survey of more than 40,000 households, hearing loss adversely impacted annual household income by an average of as much as $12,000 (approx £8,600). The financial impact was directly related to the level of hearing loss.

The results make good sense. Hearing loss can bring on communication issues and mistakes on the job, limiting productivity, possible career promotion, and in some instances taking people out of the marketplace.

Those with hearing loss can fail to hear alarm systems, sirens, or other signals to potentially dangerous conditions. They’re also more likely to have a history of falling.

According to a study from Johns Hopkins University, hearing loss has been associated with an increased risk of falling. Those with mild hearing loss were nearly three times more likely to have a history of falling and the chance of falling increased as hearing loss became worse.

The truth is hearing loss is not just a trivial inconvenience—it has a number of physical, mental, and social consequences that can considerably decrease an individual’s all-around quality of life. But the good news is that it’s almost all preventable.

Most of the consequences we just reviewed are the result of reduced sound stimulation to the brain. Modern day hearing aids, while not able to restore hearing entirely to normal, nevertheless can furnish the amplification necessary to avert most or all of these consequences.

That’s why most patients are satisfied with their hearing aid’s overall performance. It permits them to easily understand speech, hear without continuously struggling, and take pleasure in the sounds they’ve been missing for many years.

Should I have my hearing tested?

If you think any of the above statements apply to you then we recommend coming to see us for a hearing test. If you would like to book a hearing test with one of our expert Audiologists please call us on 01473 230 330

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