HEARING LOSS: CAUSES AND TREATMENT FOR ALL AGES

Hearing loss can develop gradually or suddenly, in one or both ears. It may affect communication, work, learning and quality of life. Treatment depends on its type and underlying cause.

What are the main types of hearing loss?

• Conductive hearing loss: sound is not transmitted efficiently through the outer or middle ear. Causes include earwax blockage, middle-ear fluid, eardrum perforation and otosclerosis.
• Sensorineural hearing loss: usually involves the cochlea and, less often, the hearing nerve. It may be associated with age, noise exposure, inherited factors or other conditions.
• Mixed hearing loss: combines conductive and sensorineural components.

What commonly causes hearing loss?

• Age-related hearing changes (presbycusis).
• Exposure to loud noise at work, concerts or through personal audio devices.
• Earwax, middle-ear infections, glue ear and structural problems involving the eardrum or middle ear.
• Inherited or congenital hearing conditions.
• Selected ototoxic medicines, injury and, more rarely, tumours affecting the vestibulocochlear nerve.

What are the warning signs?

Signs include difficulty understanding speech in background noise, turning up the television, asking people to repeat themselves and sometimes tinnitus. In children, delayed speech, reduced responses to sounds or learning difficulties may suggest a hearing problem.

How is hearing assessed?

Assessment includes otoscopy and age-appropriate pure-tone and speech audiometry, tympanometry or objective tests such as otoacoustic emissions. Unilateral or asymmetric sensorineural hearing loss may require further investigation.

Why is sudden hearing loss urgent?

Hearing loss that develops suddenly over hours or a few days is a medical urgency. It might be caused by simple earwax blockage, but it may also represent sudden sensorineural hearing loss, for which early assessment and treatment are important. Seek urgent ENT assessment, ideally the same day, with prompt audiometry. Do not wait for symptoms to resolve on their own. Associated neurological symptoms require emergency hospital evaluation.

What treatments can help?

• Treating the cause: earwax removal, treatment of selected middle-ear conditions or appropriate surgery when indicated.
• Hearing aids: can markedly improve communication for many people with permanent hearing loss.
• Paediatric hearing support: prompt detection and rehabilitation support speech, language and learning.

How can you protect your hearing?

Reduce the volume and duration of loud sound exposure, use suitable ear protection and take breaks from headphones. Safe exposure time becomes shorter as sound level increases; no fixed percentage-volume “rule” guarantees safety. Hearing assessment is particularly important when symptoms, risk factors or developmental concerns are present.

Accurate diagnosis allows targeted treatment and avoids delay when time-sensitive care is needed.