Hearing Loss
Hearing loss is a reduction in the ability to hear sounds and is one of the most common sensory impairments worldwide. It can range from mild — where following a conversation in a noisy environment becomes difficult — to profound, where almost no sound is perceived. It may affect one ear or both, and can develop gradually or, less commonly, come on suddenly.
Causes
The most prevalent cause is age-related hearing loss, known as presbycusis, which results from the gradual degeneration of the sensory hair cells in the inner ear. Prolonged exposure to loud noise — whether occupational or recreational — is another leading cause and is entirely preventable. Other causes include earwax build-up, ear infections, a perforated eardrum, Ménière's disease, otosclerosis (abnormal bone growth in the middle ear), certain medications known as ototoxic drugs (including some antibiotics and chemotherapy agents), head trauma, and viral infections such as mumps or meningitis. Hearing loss present from birth may result from genetic factors or complications during pregnancy or delivery.
Symptoms
Early signs often include difficulty following conversations — particularly in noisy environments — frequently asking others to repeat themselves, turning up the volume on the television or radio, and a tendency to mishear words. Tinnitus (ringing or buzzing in the ears) sometimes accompanies hearing loss. In children, hearing loss may present as delayed speech and language development, inattentiveness, or poor academic performance.
Diagnosis
A GP will typically perform an initial assessment of the ear using an otoscope and may carry out a simple hearing screen. Formal assessment is conducted by an audiologist, who performs a range of tests including pure tone audiometry to determine the degree and pattern of hearing loss across different frequencies.
Treatment
The most common treatment for permanent hearing loss is the fitting of hearing aids, which amplify sounds and can significantly improve quality of life. For those with severe to profound hearing loss who do not benefit adequately from hearing aids, cochlear implants — which electrically stimulate the auditory nerve directly — may be considered. Where hearing loss is caused by a treatable underlying condition, such as earwax or infection, addressing that condition may restore hearing. Regular follow-up with an audiologist is important for ongoing management.
Choosing where to be treated
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