3 common causes of hearing loss and what to do about them

Posted on 6 March 2023

Hearing loss can severely impact your quality of life, but there are more options than you may realise – and the quicker you act, the better.  

Hearing loss can be debilitating and occur at any age – even in children, says Mariet du Plooy, diagnostic audiologist at Mediclinic Kloof and Mediclinic Medforum in Pretoria. It’s important to evaluate hearing ability in newborns and children, she adds, as even temporary hearing loss can affect their speech and language development.  

Signs someone is struggling with hearing loss: 

• Asking people to repeat themselves 
• Difficulty hearing other people clearly, especially in noisy places or in small group gatherings 
• Misunderstanding what people say 
• Struggling to follow conversations  
• Listening to music or watching TV loudly  
• Withdrawing from conversations or avoiding social gatherings.  

Symptoms such as tinnitus (ringing in the ear/s), fullness or pressure in the ear/s and vertigo (dizziness) can also be associated with hearing loss. Consult a diagnostic audiologist and/or an ear, nose and throat (ENT) surgeon if you have these symptoms.

The 3 main types of hearing loss:   

1.  Sensorineural hearing loss (SNHL) 
   

   This is the most common. It is a result of inner-ear (cochlear and hair cell) damage. “Problems with the nerve pathways from your inner ear to your brain can also cause SNHL”, says Du Plooy. Soft sounds may be hard to hear, while louder sounds may be unclear, or sound muffled. “These hearing losses are usually permanent and can often deteriorate further.”  SNHL can be congenital (present from birth) or due to ageing and can have various causes, including exposure to loud noises, injury, infections and more. 
   Sometimes medical treatment or surgery may be an option, but in many cases, they cannot fix SNHL. Hearing aids, implantable devices or cochlear implants with aural rehabilitation are generally the preferred treatment options. 
   If you suddenly experience hearing loss, you should undergo a full audiometric evaluation as soon as possible. “Remember that the brain is the area that is hearing speech and interpreting language,” explains Du Plooy. “When it’s not stimulated it tends to atrophy and become ‘lazy’ to listen. Stimulating it with hearing amplification as soon after diagnosis as possible will keep the auditory system ‘listening fit’ and makes the adaption to hearing devices easier.” 

    

2.  Conductive hearing loss (CHL)
   

   “CHL implies that the conduction of sound through the outer or middle ear is disrupted,” says Du Plooy. “This can occur due to something as simple as a wax build-up in the ear canal, or something more challenging like ossification of the stapes (middle ear bones).” CHL could also be caused by narrowing of the ear canal due to excessive exposure to cold water, middle ear infection, eardrum perforation, trauma or congenital malformation of the outer or middle ear.  If medical treatment or surgery is not appropriate, conductive losses can sometimes be treated by hearing aids and/or implantable hearing devices.   
    

3. Mixed hearing loss

   
   Mixed hearing loss occurs when there is both a conductive component and sensorineural component present. This means there may be damage in the outer-, middle-, or inner ears or nerve pathway to the brain. Anything that causes CHL or SNHL can lead to mixed hearing loss. The two together might make your hearing worse than it would be with only one of these problems. “The treatment of mixed hearing loss is a stepped process,” says Du Plooy. “Following a comprehensive audiological examination, an ENT surgeon will treat the conductive component, after which a hearing aid or implantable hearing device is evaluated to amplify the residual SNHL.”

    

To avoid hearing loss, protect your ears from loud noise. Use earphones on a lower volume and wear protection in loud environments like concerts and construction sites.