Types & causes of hearing loss

Hearing loss occurs when your brain isn’t receiving the signals it needs to determine sound. This is due to a problem somewhere along the auditory pathway, anywhere between your outer ear and your brain, where sound is processed and interpreted.

Hearing Loss can be split into two types; sensorineural and conductive:

A sensorineural hearing loss occurs when there is damage to the hair cells in the cochlear (part of the inner ear), or there is damage to the hearing nerve. Sensorineural hearing loss is permanent and will not improve over time.

A conductive hearing loss occurs when there is something stopping the sound getting to your inner ear. This can be caused by many things, the most common being ear wax. Conductive hearing loss can be temporary or permanent dependent on what is causing the blockage of sound transmission.

Age related damage (also known as presbyacusis) is the most common cause of sensorineural hearing loss. It is estimated that more than 40% of people over the age of 50 have hearing loss, and that rises to more than 70% for those over 70¹.

This damage occurs through gradual wear and tear of the tiny hair cells in your cochlear.

Dependent on your lifestyle, and how well your brain processes sound, the impact of age related hearing loss can vary. Often it affects the higher frequency sounds, like ‘s’, ‘f’, and ‘th’, which means that speech can lose its clarity, and making it difficult to hear in background noise.

Sudden hearing loss can affect one or both ears. It can happen instantly or over the course of a few weeks, and may happen along with tinnitus or balance problems.

Recovery from sudden hearing loss will depend on the cause and how badly you are affected, alongside how quickly you seek treatment.

Whilst it is very rare sudden hearing loss will occur, it should be treated with extreme caution if it does.

If you suddenly lose hearing in one or both ears, you should contact NHS 111 or your GP as soon as possible.

It may not be serious, but it can be a symptom of a medical emergency, and, if this is the case, there is a very short window of opportunity for treatment. If you cannot see a GP or call 111 for any reason, you should go to A&E.

Noise related hearing loss is the second most common type of hearing loss in the UK, and is caused by exposure to loud noises for a long time, or loud bursts of sound.

This could include things like working in noisy environments, listening to music at very loud levels, or gunshots and explosions.

If you have hearing loss caused by exposure to noise, your audiologist will normally be able to identify this on your hearing test as a small dip in your high frequencies. The signs of noise induced hearing loss are similar to those of age-related loss, and the treatment, using hearing aids, is the same.

Learn more about how you can help prevent noise induced hearing loss with the use of specialist hearing protection.

There are many other potential causes of hearing loss, including but not limited to genetic hearing loss, ototoxic hearing loss, and acoustic neuroma. Diagnostic testing, alongside appropriate questions around medical history and lifestyle, can help determine cause, as well as appropriate referrals to specialists, if required.

If you experience any of the following, you may have a hearing loss:

• People sound like they are mumbling.
• You are often having to ask people to repeat themselves.
• Difficulty understanding speech in places with background noise.
• Difficulty understanding people when you can’t see their face.
• Conversations with more than two people can be tricky.
• Tiredness from having to concentrate.
• Other people say your TV or music is too loud.
• Difficulty hearing on the telephone.
• Tinnitus (ringing or buzzing sounds in ears).

For those who have hearing loss, it can be frustrating; as voices can sound muffled, it can be difficult to hear in background noise, and group conversations can be challenging. When left untreated hearing loss can lead to a person withdrawing from social situations or experiencing emotional distress, loneliness, and depression.

Hearing loss can also be difficult for friends and loved ones, as it can make communicating with the person harder, and things like the TV may have to be turned up to a volume that isn’t comfortable for themselves.

There is research that also shows that hearing loss can increase the risk of dementia by up to five times. This evidence also suggests that use of hearing aids may reduce these risks².

Sadly, the evidence suggests that people wait on average 10 years before seeking help for their hearing loss. This demonstrates the need for greater awareness around hearing health, and normalising getting your hearing checked, so that intervention can be made earlier.

In most cases, where hearing loss that isn’t going to improve, hearing aids can significantly improve your ability to hear. Hearing aids are available in many different forms, including styles that sit behind the ear; inside the ear; and completely down the ear canal. Learn more about the different types and styles of hearing aids.

Hearing aids use microphones to pick up sounds, and process these sounds digitally based on your hearing loss. They can make quieter sounds much easier to hear, and improve conversations or listening in background noise. Many hearing aids are now compatible with mobile phones, or other accessories which can support your hearing, even in the most complex of environments.

Although hearing aid technology has improved massively over the last few years, they form part of a solution, alongside coaching, counselling, and hearing tactics to support you in different hearing environments.

If you think you may have hearing loss, and perhaps identify with some of the common signs mentioned above, the first thing you can do is to book in for our AltoScreen hearing check.

During your appointment, the audiologist or hearing care professional will discuss with you any situations you are having hearing difficulty, check the health of your ears, and perform a brief hearing scan test to identify if you do indeed have a hearing loss. Alternatively, you can use our free online hearing test.

If hearing loss is identified, or if you are already aware that you have a hearing loss, an AltoDiscover hearing assessment is recommended with our audiologist.

AltoDiscover is a ‘gold standard’, comprehensive assessment of your hearing health. By completing this assessment, we will be able to understand the nature of your hearing loss, how well your brain processes sound, the health of your ears, and understand how the hearing loss is impacting on your life and wellbeing.

If appropriate, the audiologist will make a personalised recommendation for hearing aid solutions to support your hearing. Should a referral be required to a GP or other medical professional, this will be done on the day.

1. RNID prevalence estimates using Office for National Statistics population data (2018).
2. https://rnid.org.uk/about-us/research-and-policy/facts-and-figures/

Article by Adam Bostock