When To See Your Gp
See your GP if you’re having problems with your hearing, or your child is showing signs of hearing difficulty. If you lose your hearing suddenly, in one or both ears, you must see your GP as soon as possible.
Your GP can check for any problems and may refer you to an audiologist or an ENT surgeon for further tests.
You can also visit the Action on Hearing Loss website for an online hearing test.
Read more about diagnosing hearing loss
The Prevalence Of Hearing Impairment In Germany
According to epidemiological studies, the prevalence of hearing impairment that is severe enough to require treatment is about 19% in Germany . This figure is arrived at when hearing impairment is operationally defined as a diminution of hearing ability by at least 40 dB in five test frequencies from 0.5 to 4 kHz. Thus, in 2001, there were about 13.2 million persons with hearing impairment living in Germany. The actual number may be even higher, however, because children up to age 14 were not included in the study, and also because the WHO sets a lower threshold for the definition of hearing impairment.
Congenital bilateral hearing loss
The prevalence of congenital, permanent, bilateral hearing loss is 1.2 per 1000 neonates.
No study has yet addressed the question of the relative prevalence of the various types of hearing impairment .
The most common type of hearing impairment in childhood is transient conductive hearing loss due to a tympanic effusion. 10% to 30% of children suffer from this problem before their third birthday, with a prevalence as high as 8%. Congenital, permanent, bilateral hearing loss is much rarer, with a prevalence of 1.2 per 1000 children. In adulthood, the most common type of hearing impairment is the sensorineural hearing loss of old age , which affects 40% of all persons aged 65 or older. The next most common types are permanent conductive or combined hearing loss due to chronic otitis media and hearing impairment due to acoustic trauma .
Is Sensorineural Hearing Loss Usually Slow Moving
When we talk about sensorineural hearing loss or conductive hearing loss, you could feel a little confused and we dont hold it against you . So, heres a basic breakdown of what were talking about:
- Sensorineural hearing loss: This kind of hearing loss is usually due to damage to the nerves or stereocilia in the inner ear. When you consider hearing loss caused by intense sounds, youre thinking of sensorineural hearing loss. In most instances, sensorineural hearing loss is essentially irreversible, although there are treatments that can keep your hearing loss from further degeneration.
- Conductive hearing loss: When the outer ear has blockage it can cause this kind of hearing loss. This could consist of anything from allergy-driven inflammation to earwax. Usually, your hearing will return when the primary obstruction is cleared away.
Its common for sensorineural hearing loss to happen slowly over time while conductive hearing loss takes place somewhat suddenly. But occasionally it works out differently. Sudden sensorineural hearing loss is somewhat uncommon, but it does happen. And SSNHL can be particularly damaging when it isnt treated correctly because everyone thinks its a strange case of conductive hearing loss.
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When You Get Sensorineural Hearing Loss Is It Usually Slow Moving
The difference between conductive hearing loss and sensorineural hearing loss may seem hard to understand. So, heres a quick breakdown of what were talking about:
- Sensorineural hearing loss: This kind of hearing loss is normally due to damage to the nerves or stereocilia in the inner ear. When you think of hearing loss caused by loud noises, youre thinking of sensorineural hearing loss. Even though you might be able to treat sensorineural hearing loss so it doesnt become worse in most instances the damage is permanent.
- Conductive hearing loss: This form of hearing loss results from a blockage in the outer or middle ear. This could consist of anything from allergy-driven inflammation to earwax. Conductive hearing loss is usually treatable .
Commonly, conductive hearing loss happens rather suddenly, whereas sensorineural hearing loss moves somewhat slowly. But occasionally it works out differently. Unexpected sensorineural hearing loss is relatively uncommon, but it does happen. If SSNHL is misdiagnosed as a type of conductive hearing loss it can be especially harmful.
The State Of The Evidence For Treatments Of Hearing Impairment
Randomized trials have been performed on middle-ear surgery and on the provision of implantable hearing aids and cochlear implants. Poorer evidence is available from clinical trials on the pharmacotherapy of acute inner-ear disorders, in particular sudden sensorineural hearing loss. It can now be said that nearly every kind of permanent hearing loss is treatable.
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Causes Of Hearing Loss
Hearing loss is the result of sound signals not reaching the brain. There are two main types of hearing loss, depending on where the problem lies.
- Sensorineural hearing loss is caused by damage to the sensitive hair cells inside the inner ear or damage to the auditory nerve. This occurs naturally with age or as a result of injury.
- Conductive hearing loss happens when sounds are unable to pass from your outer ear to your inner ear, often because of a blockage such as earwax or glue ear.
These causes are explained below.
Theories Of The Etiology Of Idiopathic Ssnhl
The etiology remains unknown in the majority of patients who present with SSNHL and therefore their hearing loss is classified as idiopathic . Numerous hypotheses of the pathophysiology of idiopathic SSNHL have been proposed. The most widely accepted theories are vascular compromise , cochlear membrane rupture , and viral infection .
However, the clinical course and radiographic findings characteristic of most cases of idiopathic SSNHL are not consistent with a vascular etiology. In cases of sensorineural hearing loss resulting from a known intravascular insult, the loss is permanent, whereas, hearing loss in the majority of cases of idiopathic SSNHL is reversible . Potentially as a reflection of the amount of damage and permanence of the hearing loss following occlusion of the cochlear vasculature, cochlear fibrosis occurs over the subsequent weeks , and this fibrosis can be seen in radiologic studies of patients with hearing loss following known vascular occlusion . In idiopathic SSNHL, cochlear fibrosis is not typically observed . Thus, though a vascular etiology may explain a few cases of idiopathic SSNHL, it is not the cause of most cases of this disorder.
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Hearing Loss In Adults
People over age 50 may experience gradual hearing loss over the years due to age-related changes in the ear or auditory nerve. The medical term for age-related hearing loss is presbycusis. Having presbycusis may make it hard for a person to tolerate loud sounds or to hear what others are saying.
Other causes of hearing loss in adults include:
What To Expect At Your Office Visit
The goal of treatment is to improve your hearing. The following may be helpful:
- Telephone amplifiers and other assistive devices
- Safety and alert systems for your home
- Sign language
- Speech reading
A cochlear implant may be recommended for certain people with severe hearing loss. Surgery is done to place the implant. The implant makes sounds seem louder, but does not restore normal hearing.
You will also learn strategies for living with hearing loss and advice to share with those around you for talking to someone with hearing loss.
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How To Treat Sensorineural Hearing Loss
People with sensorineural hearing loss cannot regain their hearing, but most people can benefit from hearing aids. A more severe or profound sensorineural hearing loss can be treated with hearing implants. A few cases of sensorineural hearing loss can be treated by means of surgery.
A hearing test carried out by a hearing professional will detect if you have a sensorineural hearing loss.
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Is Sensorineural Hearing Loss Normally Slow Moving
The difference between conductive hearing loss and sensorineural hearing loss may seem hard to understand. So, heres a basic breakdown of what we mean:
- Conductive hearing loss: When the outer ear becomes blocked it can cause this kind of hearing loss. This might be due to earwax, swelling from allergies or lots of other things. Conductive hearing loss is commonly treatable .
- Sensorineural hearing loss: This type of hearing loss is commonly caused by damage to the nerves or stereocilia in the inner ear. Your thinking of sensorineural hearing loss when your considering hearing loss from loud noise. In the majority of instances, sensorineural hearing loss is effectively permanent, although there are treatments that can keep your hearing loss from further degeneration.
Usually, conductive hearing loss comes on rather suddenly, whereas sensorineural hearing loss moves somewhat slowly. But that isnt always the case. Although sudden sensorineural hearing loss is not very common, it does exist. And SSNHL can be particularly damaging when its not treated correctly because everyone thinks its a strange case of conductive hearing loss.
What Is Sensorineural Hearing Loss
Sensorineural hearing loss is one of the three main types of hearing loss. It occurs with damage to the inner ear or nerves, specifically the auditory-vestibular nerve, also known as cranial nerve 8, which transmits information to the brain from our ears about hearing and balance. According to a 2019 article published in American Family of Physicians, entitled âHearing Loss in Adults: Differential Diagnosis and Treatment,â sensorineural hearing loss is the most common type of hearing loss among adults and its effects are permanent.
According to researchers from the same study, there are several factors that contribute to or cause SNHL:
- Loud noises
- Ototoxic medicines, diseases, or viral infections
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About Sensorineural Hearing Loss
Your ear is made up of three partsthe outer, the middle, and the inner ear. Sensorineural hearing loss, or SNHL, happens after inner ear damage. Problems with the nerve pathways from your inner ear to your brain can also cause SNHL. Soft sounds may be hard to hear. Even louder sounds may be unclear or may sound muffled.
This is the most common type of permanent hearing loss. Most of the time, medicine or surgery cannot fix SNHL. Hearing aids may help you hear.
Sensorineural Hearing Loss Symptoms
SNHL can occur in one ear or both ears depending on the cause. If your SNHL onsets gradually, your symptoms might not be obvious without a hearing test. If you experience sudden SNHL, your symptoms will come on within several days. Many people first notice sudden SNHL upon waking.
Sensorineural hearing loss can lead to:
- trouble hearing sounds when theres background noise
- particular difficulty understanding childrens and female voices
- dizziness or balance problems
- obstruction by foreign objects
- deformations in the outer or middle ear
Both types of hearing loss can cause similar symptoms. However, people with conductive hearing loss often hear muffled sounds while people with SNHL hear muffled and distorted sounds .
Some people experience a mix of both sensorineural and conductive hearing loss. Hearing loss is considered mixed if there are problems both before and after the cochlea.
Its important to get a proper diagnosis if youre dealing with hearing loss. In some cases, its possible to regain your hearing. The quicker you receive treatment, the more likely you are to minimize damage to the structures of your ear.
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Functional Outcomes Of Delayed Diagnosis And Intervention
Without early intervention, children with hearing loss demonstrate predictable irreversible deficits in communication and psychosocial skills, cognition and literacy -. There is clear evidence that auditory deprivation in early infancy leads to structural and functional reorganization at a cortical level similar to amblyopia in an infant with visual deprivation. The impact on the childs speech and language is directly proportional to the severity of hearing loss and the time delay in diagnosis and intervention . In a detailed review of the psychological and functional outcomes of deafness on the child and adolescent, Mason and Mason reported that this group demonstrates impaired socioemotional development including low academic achievement, underemployment, increased social maladaption and psychological distress. In unscreened populations, children with severe to profound hearing loss typically graduate from high school with the language and reading level of a nine- to 10-year-old child . These limitations in literacy, with the associated impact on socioeconomic and vocational status , are reflective of the critical importance of timely sensory input to the developing brain of young children and also to the inter-relatedness of hearing, speech, reading and writing at a neurocortical level.
Sudden Sensorineural Hearing Loss
Sudden sensorineural hearing loss , commonly known as sudden deafness, occurs as an unexplained, rapid loss of hearingusually in one eareither at once or over several days. Nine out of ten people with SSHL lose hearing in only one ear. It should be considered a medical emergency. Delaying diagnosis and treatment may render treatment less effective or ineffective.
Experts estimate that SSHL strikes one person per 100 every year, typically adults in their 40s and 50s. The actual number of new cases of SSHL each year could be much higher because the condition often goes undiagnosed.
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Evaluation Of Hearing Loss
In children with hearing loss, additional testing should include an ophthalmologic examination because many genetic causes of deafness also cause ocular abnormalities. Children with unexplained hearing loss should also have an ECG to look for long QT syndrome Long QT Syndrome and Torsades de Pointes Ventricular Tachycardia Torsades de pointes is a specific form of polymorphic ventricular tachycardia in patients with a long QT interval. It is characterized by rapid, irregular QRS complexes, which appear to be twisting… read more and possibly also genetic testing.
What Are The Treatment Options
If you are experiencing hearing loss, you should see an ENT specialist who can make the correct diagnosis. This is important because the treatment for hearing loss depends on the cause. Once a diagnosis is made, your physician will be able to talk to you about all treatment options. A critical part of the evaluation will be a hearing test performed by an audiologist to determine the severity of your hearing loss, as well as whether it is conductive, sensorineural, or a combination of both.
Your ENT specialist may recommend specific treatment options based on the results of your hearing test, or other potential tests such as a CT or MRI imaging scan. Treatment options can include:
- Continuing observation with repeated hearing tests
- Medical therapycorticosteroids may be used to reduce cochlear hair cell swelling and inflammation after exposure to loud noises diuretics may be used for Ménières disease
- Low-sodium diet
- Evaluation and fitting of a hearing aid or other assistive listening devices
- Preferential seating in class for school children
- Surgery to correct the cause of the hearing loss
- Surgery to implant a hearing device
SNHL can be treated with the use of conventional hearing aids or an implantable hearing device. Again, your ENT specialist and/or audiologist can help you decide which device may work best for you depending on your hearing test results and your lifestyle.
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Differential Diagnosis And Treatment Of Hearing Loss
JON E. ISAACSON, M.D., and NEIL M. VORA, M.D., Milton S. Hershey Medical Center, Hershey, Pennsylvania
Am Fam Physician. 2003 Sep 15 68:1125-1132.
Hearing loss is a common problem that can occur at any age and makes verbal communication difficult. The ear is divided anatomically into three sections , and pathology contributing to hearing loss may strike one or more sections. Hearing loss can be categorized as conductive, sensorineural, or both. Leading causes of conductive hearing loss include cerumen impaction, otitis media, and otosclerosis. Leading causes of sensorineural hearing loss include inherited disorders, noise exposure, and presbycusis. An understanding of the indications for medical management, surgical treatment, and amplification can help the family physician provide more effective care for these patients.
More than 28 million Americans have some degree of hearing impairment. The differential diagnosis of hearing loss can be simplified by considering the three major categories of loss. Conductive hearing loss occurs when sound conduction is impeded through the external ear, the middle ear, or both. Sensorineural hearing loss occurs when there is a problem within the cochlea or the neural pathway to the auditory cortex. Mixed hearing loss is concomitant conductive and sensorineural loss.
Other Types Of Sensorineural Hearing Loss
Sensorineural hearing loss occurs if the sensitive hair cells inside the cochlea are damaged, or as a result of damage to the auditory nerve . In some cases, both may be damaged.
Hearing loss caused by age and exposure to loud noises are both types of sensorineural hearing loss.
Sensorineural hearing loss can also be caused by:
- the genes you inherit some people may be born deaf or become deaf over time because of a genetic abnormality
- viral infections of the inner ear such as mumps or measles
- viral infections of the auditory nerve such as mumps or rubella
- acoustic neuroma a non-cancerous growth on or near the auditory nerve
- meningitis an infection of the protective membranes that surround the brain and spinal cord
- encephalitis inflammation of the brain
- multiple sclerosis a neurological condition affecting the central nervous system
- a head injury
- malformation of the ear
- stroke where the blood supply to the brain is cut off or interrupted
Some treatments and medicines, such as radiotherapy for nasal and sinus cancer, certain chemotherapy medicines or certain antibiotics can also damage the cochlea and the auditory nerve, causing sensorineural hearing loss.
People with diabetes, chronic kidney disease and cardiovascular disease are also at increased risk of hearing loss.
Sensorineural hearing loss is permanent and hearing aids are often required to improve hearing in these cases.
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