Hearing loss has a lot of different causes and manifestations. It can be sudden or gradual. It can occur in one ear or both ears. It can be temporary or permanent. It happens to people of all ages and is associated with the aging process. Before discussing causes and treatments for hearing loss, it is important to understand how hearing works.

How We Hear

There are three sections of the ear: the outer ear, middle ear and inner ear. Each section helps move sound through the process of hearing. When a sound occurs, the outer ear feeds it through the ear canal to the eardrum. The noise causes the eardrum to vibrate. This, in turn, causes three little bones inside the middle ear (malleus, incus, stapes) to move. That movement travels into the inner ear (cochlea), where it makes tiny little hairs move in a fluid. These hairs convert the movement to auditory signals, which are then transmitted to the brain to register the sound.

Causes of Hearing Loss

Hearing loss occurs when sound is blocked in any of the three areas of the ear. The most common cause of hearing loss — and one of the most preventable — is exposure to loud noises. Infections, both of the ear or elsewhere in the body, are also a major contributor to hearing loss.

• In the Outer Ear: Earwax build-up, infections that cause swelling, a growth in the ear canal, injury or birth defects can restrict hearing in the outer ear.
• In the Middle Ear: Fluid build-up is responsible for the most common infections and blockages in the middle ear. Fluid in the middle ear prevents the bones from processing sounds properly. Tumors, both benign and malignant, can also result in hearing loss in the middle ear.
• In the Inner Ear: The natural process of aging diminishes hearing from damage to the cochlea (mechanism for converting sound vibrations to brain signals), vestibular labyrinth (which regulates balance), or the acoustic nerve (nerve that sends sound signals to the brain). Additionally, inner ear infections, Meniere's disease and other nerve-related problems contribute to hearing loss in the inner ear.

Other causes of hearing loss include:

• Presbycusis: Age-related hearing loss, such as having difficulty hearing in noisy places, having trouble understanding what people are saying or not registering softer sounds.
• Heredity and Genetic Causes: There is a wide variety of diseases and syndromes that are either genetic or hereditary that can cause hearing loss. Some, like rubella (German measles) occur when a pregnant mother has the disease, which causes hearing loss in the baby. Other, rarer types of hereditary and genetic causes include CHARGE Syndrome, Connexin 26 disorder, Goldenhar Syndrome,Treacher Collins Syndrome, Usher Syndrome, Waardenburg Syndrome and otosclerosis (growth of spongy bone tissue in the middle ear).

Most causes of outer ear hearing loss can be remedied. But problems of the middle and inner ear can lead to permanent hearing loss, which is why it is important to seek medical attention quickly if you are experiencing a problem hearing.

Types of Hearing Loss

There are five types of hearing loss:

• Conductive hearing loss: Caused by conditions that block the transmission of sound through the outer ear and eardrum to the middle ear.
• Sensorineural hearing loss: Inner ear damage that occurs as part of the natural process of aging.
• Mixed hearing loss: Mixed hearing loss refers to people who have both conductive and sensorineural hearing loss. Most people experience more than one type of hearing loss.
• Central hearing loss: This occurs when the central nervous system fails to send a readable signal to the brain, which is called a central auditory processing disorder. People with central hearing loss generally can hear all sounds, but can’t separate or process them.

Hearing loss is measured in four degrees: mild, moderate, severe or profound. The degree of hearing loss drives the selection of the best form of treatment on a case-by-case basis.

Hearing Loss Treatments

The location, type and degree of hearing loss impact the choice of treatments for any hearing problem. The most common treatment options include:

• Antibiotics, decongestants and pain medication to overcome ear infections.
• Myringotomy, a piercing of the eardrum to allow for fluids to drain out of the outer ear.
• Insertion of a tube into the Eustachian tube (part of the anatomy that connects the middle ear to the back of the throat) to keep it open and allow for normal fluid drainage. This technique may be recommended for people who get frequent ear infections.
• Hearing aids.
• Surgery to remove benign or malignant tumors or correct bone- or nerve-related problems.

If you experience sudden or prolonged hearing loss with dizziness, fever or pain, please contact our office right away and schedule an appointment with one of our otolaryngologists. We'll conduct a physical examination as well as a hearing test to determine the type and severity of your hearing loss. We'll then recommend the best treatment.

Ear Infection

The ear is made up of three sections: the outer ear, middle ear and inner ear. Each of these areas is susceptible to infections, which can be painful. Young children have a greater tendency to get earaches. While most ear pain resolves itself in a matter of days, you should get a physical examination to understand the type of infection, prevent it from spreading and obtain treatment to help alleviate the pain.

Outer Ear Infection (Otitis Externa)

Also known as Swimmer's Ear, outer ear infections result from an inflammation, often bacterial, in the outer ear. Generally, they happen when water, sand or dirt gets into the ear canal. Moisture in the air or swimming makes the ear more susceptible to this type of ear infection. Symptoms include: severe pain, itching, redness and swelling in the outer ear. There also may be some fluid drainage. Often the pain is worse when chewing or when you pull on the ear. To reduce pain and prevent other long-term effects on the ear, be sure to see a doctor. Complications from untreated otitis externa may include hearing loss, recurring ear infections and bone and cartilage damage. Typically, your doctor will prescribe eardrops that block bacterial growth. In more severe cases, your doctor may also prescribe an antibiotic and pain medication. Most outer ear infections resolve in seven to 10 days.

Middle Ear Infection (Otitis Media)

Middle ear infections can be caused by either bacterial or viral infection. These infections may be triggered by airborne or foodborne allergies, infections elsewhere in the body, nutritional deficiencies or a blocked Eustachian tube. In chronic cases, a thick, glue-like fluid may be discharged from the middle ear. Treatment is contingent on the cause of the infection and ranges from analgesic eardrops, medications to the surgical insertion of a tube to drain fluid from the middle ear or an adenoidectomy.

Inner Ear Infection (Otitis Interna)

Also known as labyrinthitis, inner ear infections are most commonly caused by other infections in the body, particularly sinus, throat or tooth infections. Symptoms include dizziness, fever, nausea, vomiting, hearing loss and tinnitus. Always seek medical attention if you think you may have an inner ear infection.

If you suspect you or your child may have an ear infection, please contact our office and schedule an appointment with one of our otolaryngologists.