Causes of Hearing Loss

In this piece, we will divide the causes based on the location of the hearing impairment: inner and outer ear. We will then address other factors impacting hearing loss, and the next steps after identifying these concepts.

Inner Ear:

First, we will look at causes of hearing loss impacting the inner ear. Loss of hearing in this location is affecting the hair receptors that transmit sound waves to the brain. As these receptors are fragile, a number of things could damage them. This type of hearing loss is called sensorineural.

One of the most common causes is the natural aging process. As these cells do not regenerate, these hairs die off as we age. We begin with thousands of hair cells. Another cause is noise. Excessive noise damages hair cells, meaning less receptors are viable to pass along messages to the brain. This can be sudden loud noises, such as explosions, loud music, etc., or gradual noise exposure. This would entail consistently being exposed to noises over a long period of time. Loud work environments are prime examples of consistent exposure leading to damaged hair cells. 

For hearing loss of this kind, it is important to be proactive and protect. This can be done by using protective ear plugs, ensuring that in ear music levels are low, and perhaps removing oneself from excessively noisy environments. Hearing loss of this kind is gradual and not painful, so changes to hearing might not be obvious over time. An audiogram, or hearing test, will accurately show changes, and those in your surroundings may notice having to repeat themselves or elevating volume of speech when communicating with you. 

Middle/Outer ear:

Next, we will look at causes of hearing loss influencing the outer and middle ear. Many of these losses are caused by obtrusions that interrupt the sound waves from reaching the middle ear. Hearing loss of this kind is known as conductive.

A common cause is excessive earwax. Wax can block the canal and thus impair hearing. It is important for removal to be conducted by a professional, as more damage can be done by self removal. Other obstructions in which small objects have been lodged in the ear have the same effect.

Another cause of hearing loss is a perforated eardrum. The eardrum is located in the middle ear and acts as a ‘drum’, amplifying and resonating sound waves as they pass through. Perforations can be caused by inserting q-tips in the ear canal, which is one reason why it is important for professionals to remove objects and wax. Other inserted objects can create the same problem. Sudden loud noises might be strong enough to damage the eardrum, such as explosions. 

A few other examples of hearing loss caused by alterations to the middle or outer ear are the ear shapes or structures, changes in pressure, and infections. Ears are designed as a funnel, capturing noises and ushering them through the canal. Birth defects, abnormal bone growth, or small canals impact our hearing. Ear infections can block noise from entering the canal as well. Changes in pressure, whether incorporated once or over frequent changes, impacts how sound is passed. An example of this would be flying. Many of these factors work co-dependently with each other, meaning the level of impact and intensity varies from each individual.

Other factors:

• We will briefly touch on other aspects that impact our ability to hear. These are:

• Genetics. History of hearing loss or hereditary disorders play a role in how we will be impacted.

• Autoimmune disease. This is when the body attacks itself instead of protecting. Some autoimmune diseases impact the ears. If this is the cause, it is important to see a doctor immediately.

• Infections. Addressed above in the middle ear category, infections can impact multiple factors of our hearing. As with autoimmune diseases, it’s vital to see a doctor and likely a specialist as soon as possible to reduce the prospect of permanent hearing loss. There is a small window to address this early on, and oftentimes antibiotics are prescribed.

• Medications. Before using medications, be aware of the side effects.

• Head injury. This would affect how noise is perceived in the brain.

• Stroke.

How to treat/where to go from here:

Understanding what type of hearing loss we experience and why it happened is important to receiving the correct treatment plan. These treatments are different based on the underlying cause. Ignoring or using standard protection measures without knowing the issue will not solve pre-occuring loss, and can in some cases be detrimental to future hearing possibilities.

It is always wise to consult a specialist if you or others have felt that your hearing has changed. The first step is to see a general practitioner, or family doctor. Walk-in clinics will provide the same care if you do not have a pre-existing doctor. From there, they may refer you to a hearing specialist, such as practitioners or audiologists, for further testing and understanding. Depending on the cause and type of hearing loss, doctors specialized in these fields such as ENTs and otolaryngology.