What was that? The impact of hearing loss

Posted on 12 March 2020

Hearing loss can affect anyone, young or old.

Hearing loss can have a silent but deadly effect on your quality of life. As Deidré Stroebel, an audiologist at Mediclinic Milnerton and Mediclinic Panorama, explains, many people remain in denial about hearing loss. You might simply not be aware that your ears aren’t functioning optimally because loss of hearing can be gradual. “If in doubt, have a hearing test conducted by an audiologist,” says Stroebel. “Every person should have a baseline hearing test, so that if anything happens to your hearing, you have a comparison test. If you’re older than 50, it’s a good idea to have a hearing test every year or two.”

Tanya Hanekom, an audiologist at Mediclinic Sandton, adds that no doctor can detect hearing loss simply by looking into your ear with an otoscope. “Your hearing has to be tested by an audiologist, using suitable equipment,” she says. “That’s why hearing loss can go undetected for many years, silently interfering with your quality of life without you even realising it.”

Stroebel explains that hearing loss is caused by a number of different factors. “A conductive hearing loss is caused by a problem in the ear canal/middle ear. A sensorineural hearing loss is sensory loss involving the inner ear and neural loss involving the hearing nerve. Mixed hearing loss can be caused by a combination of problems in the middle and inner ear,” she says.

Conductive hearing loss can be caused by accumulation of earwax in the ear canal, a middle ear infection (otitis media), chronic infection, a growth in the middle ear (cholesteatoma) or an abnormal bone growth near the middle ear (otosclerosis). “Some types of conductive hearing loss can be corrected with a hearing aid,” says Stroebel. “Other types can be treated medically
or surgically, although this may not fully reverse the conductive loss.”

Stroebel adds that sensorineural hearing loss is the most common type of hearing loss and is permanent. Although noise exposure and age-related hearing loss (or a combination of these) are the most common causes, you could also suddenly experience this type of hearing impairment after a viral infection of the inner ear. Sensorineural hearing loss can also be a side-effect of certain medications and cancer treatments. In addition, injections during pregnancy, complications during birth, premature birth, and hereditary predispositions can all cause sensorineural hearing loss in newborns. This type of hearing loss can rarely be reversed by medical or surgical procedures but can often be helped by hearing aids. Signs that you might be suffering sensorineural hearing loss in both ears include difficulty understanding, even when speech seems loud enough. If you have it in only one ear, you may have difficulty
locating the direction of sounds when there is background noise.

“The symptoms and degree of loss, as well as the recommended course of treatment, will differ depending on the type and degree of hearing loss,” says Stroebel. A full diagnostic hearing test can determine this and the audiologist will refer you to other medical professionals if necessary. This could entail a visit to an Ear, Nose and Throat (ENT) specialist for surgery or a GP for treatment for impacted earwax.


Infographic: The different types of hearing tests


7 signs your hearing might be impaired

  • You think people often mumble or don’t speak clearly
  • You prefer music or TV louder than others
  • You often ask people to repeat themselves
  • You experience difficulty hearing when there is background noise, such as in a restaurant
  • You feel irritable in noisy places
  • You experience tinnitus (ringing or buzzing in the ears)
  • You find it easier to withdraw from social settings


Further reading: Tips to protect your hearing


Hearing aid versus cochlear implant

Hearing aid

This small system amplifies sound and comprises a microphone, an amplifier and a receiver. Hearing aids differ in size – from the behind-the-ear types to tiny, almost unnoticeable hearing aids that fit in the ear canal.

Cochlear implant

Unlike hearing aids, which simply amplify sound, cochlear implants convert sound waves to electrical impulses in a way that mimics your natural hearing. Cochlear implants can be life-changing devices if you have severe to profound sensorineural hearing loss. This electrical apparatus is surgically implanted into the bone behind the ear but is visible as it still requires a fairly large component behind the ear. This consists of a microphone (that receives sound), a speech processor (that selects usable sounds), and a coil (that decodes and sends electrical impulses to the electrodes).


Sound advice

Protect your hearing before it’s too late. If you’re exposed to loud noise (music, crowds, drilling, grinding, banging) for extended periods of time, you could irreparably damage your hearing. Wearing earplugs won’t drown out the noise completely – but they can reduce it by up to 30 decibels and can prevent hearing damage. “Half of all cases of deafness and hearing impairment are avoidable through primary prevention,” says Hanekom. “Healthy ear and hearing care practices can suitably deal with early detection of hearing loss, followed by appropriate diagnosis and subsequent medical, rehabilitative or surgical interventions.”


Further reading: How your hearing changes as you age



In the interest of our patients, in accordance with SA law and our commitment to expertise, Mediclinic cannot subscribe to the practice of online diagnosis. Please consult a medical professional for specific medical advice. If you have any major concerns, please see your doctor for an assessment. If you have any cause for concern, your GP will be able to direct you to the appropriate specialists.