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Overview
What is hearing loss?

Hearing loss is a sudden or gradual decrease in how
well you can hear. Depending on the cause, it can
range from mild to severe and can be reversible,

temporary, or permanent. Hearing loss is also known
as hearing impairment, which includes being born
without hearing (congenital hearing loss). This topic
focuses only on gradual hearing loss.

Gradual hearing loss affects people of all ages and is the third most common long-term (chronic) health problem in older Americans.1 It affects up to 40% of people age 65 and older and up to 80% of people older than 85.2

If you have hearing loss, you may not be aware of it, especially if it has
developed gradually. Your family members or friends may be the first to notice.
For example, they may notice that you are having difficulty understanding what
people are saying, especially when many people are talking at the same time or

there is background noise, such as a radio playing.

Hearing loss can affect what and how much you do in the workplace and at home and can also affect your
personal safety. Because it may result in less social interaction, hearing loss may contribute to loneliness,
depression, and loss of independence. However, hearing aids and other devices are available to help you hear.

What causes hearing loss?
In adults, the most common causes of hearing loss are:
Noise. Noise-induced hearing loss can affect people of all ages and most often develops gradually over

many years. Over a long period of time, the noise you experience at work, during recreation (such as listening to very loud music), or even during common chores (such as using a power lawn mower) can lead to hearing loss.

Age. In age-related hearing loss (presbycusis), changes in the inner ear that occur as you grow older cause
a gradual but steady hearing loss. The loss may be mild or severe, but it is always permanent.
Other causes of hearing loss includeear w ax buildup, an object in the ear, injury to the ear or head, ear infection,
a ruptured eardrum, and other conditions that affect the middle or innerear.
What are the symptoms?
Common symptoms of hearing loss include muffled hearing and a feeling that your ear is plugged. You may have
difficulty understanding what people are saying, and you may listen to the television or radio at higher volume than
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Health Home> Ears & Hearing > Hearing Loss
Hearing Loss
By Monica Rhodes
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in the past and avoid conversation and interaction with other people. Other symptoms may include ringing,
roaring, hissing, or buzzing in the ear (tinnitus). Or you may have ear pain, itching, or irritation, or fluid leaking
from the ear. You may also have a feeling that you or your surroundings are moving when there is no movement

(vertigo).
How is hearing loss diagnosed?

Your doctor will diagnose hearing loss by asking questions about your symptoms and past health and by doing a physical exam. If your doctor thinks you have hearing loss, he or she may use a "whisper" test or tuning fork to test your hearing. If these tests suggest or show hearing loss, your doctor will do a more complete hearing (audiologic) test to see whether you have hearing loss, how severe the loss is, and which part of the ear is affected.

How is it treated?

You treat noise-induced or age-related hearing loss by using hearing devices (such as hearing aids) and learning how to live with reduced hearing, such as paying attention to people's gestures, facial expressions, posture, and tone of voice. In other types of hearing loss, treating the problem that caused the hearing loss, such as removing earwax or taking medicine for an infection, results in the return of normal hearing.

Can you prevent hearing loss?
You can prevent noise-related hearing loss by avoiding loud noise such as that made by machines in the

workplace, power tools, very loud music, and very loud motorcycles. Wear hearing protection, such as earplugs or earmuffs, if necessary. To protect yourself from hearing loss because of injury, avoid putting objects in your ear, wear seat belts when you drive, and wear helmets when you bike, ski, or participate in similar activities in which there is the potential for ear injury.

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Decision Points focus on key medical care decisions that are important to many health
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Should I get a hearing aid?
Frequently Asked Questions
Learning about hearing loss:

What is hearing loss?
What causes hearing loss?
Can I prevent hearing loss?
What are the symptoms of hearing loss?
How does noise affect hearing?
What is age-related hearing loss?
Can ear infections cause hearing loss?
Can ear injuries cause hearing loss?

Can certain medicines cause hearing loss?
How does the ear work?
Being diagnosed:
Who can diagnose hearing loss?
How is hearing loss diagnosed?
Getting treatment:
How is hearing loss treated?
What is a cochlear implant?
What are hearing protectors?
What are hearing aids?
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Should I get a hearing aid?
Living with hearing loss:

What can I do for hearing loss?
What types of noises are harmful?
How can I slow down hearing loss?

Cause
In adults, the most common causes of hearing loss are:
Noise.Noise-induced hearing loss can affect people of all ages and most often develops gradually over many
years. Over time, the noise experienced at work, during recreation (such as riding motorcycles), or even
common chores (such as using a power lawn mower) can lead to hearing loss.
Age. In age-related hearing loss (presbycusis), changes in the nerves and cells of the innere ar that occur as
you get older cause a gradual but steady hearing loss. The loss may be mild or severe, but it is always
permanent.
Other causes of hearing loss include:
Earwax buildup or an object in the ear. Hearing loss because of earwax is common and easily treated.
Ototoxic medicines (such as certain antibiotics) and other substances (such as arsenic, mercury, tin, lead,
and manganese) that can damage the ear.
Injury to the ear or head. Head injuries can also damage the structures in the ear and cause a sudden
hearing loss.
Ear infection, such as a middle ear infection (otitis media) or an infection of the ear canal (otitis externaor
swimmer's ear).
Fluid in the middle ear after a cold or thef lu, or after traveling on an airplane.
Otosclerosis, a condition that affects the bones of the middle ear.
Acoustic neuroma, a noncancerous tumor on the nerve that helps people hear.
M\u00e9ni\u00e8re's disease. M\u00e9ni\u00e8re's disease may result in temporary or permanent hearing loss.
Noncancerous (benign) growths in the ear canal, such as exostoses, osteomas, and glomus tumors.

Exostoses are bone growths that often develop when the ear canal is repeatedly exposed to cold water or cold air. Osteomas and glomus tumors are noncancerous tumors. These all can cause hearing loss if they block the ear canal. A glomus tumor that occurs elsewhere in the head can also affect hearing.

Other medical conditions that do not affect the ear directly may also cause hearing loss.
An interruption of the blood flow to the inner ear or parts of the brain that control hearing may lead to hearing
loss. This may be caused by heart disease,s t r ok e, high blood pressure, ord ia b et es.
Autoimmune hearing loss can occur in one or both ears and can come and go or get worse over 3 to 4
months. An autoimmune disease, such as rheumatoid arthritis, may be present.
What happens in hearing loss?
We hear sounds when sound energy goes through the ear's three main structures. In hearing loss, one or more of
these structures is damaged. These structures are the:
External ear canal.
Middle ear, which is separated from the ear canal by the eardrum.
Inner ear, which contains the cochlea, the main sensory organ of hearing.
Which part of the ear is affected determines the type of hearing loss.
In conductive hearing loss, sound energy is blocked before it reaches the inner ear. Examples of conductive
hearing loss includeear w ax or a growth blocking sound, such as occurs in otosclerosis.

In sensorineural hearing loss, sound reaches the inner ear, but a problem in the inner ear or the nerves that
allow you to hear (auditory nerves) prevent proper hearing. Examples of sensorineural hearing loss include both
noise-induced and age-related hearing loss. More than 90% of hearing loss is sensorineural, and of this group,

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