One of the hardest things about being an Audiologist is having to tell people that they have a hearing loss. Most people come to see me after they are already suspecting a hearing loss. There are certain signs of hearing loss that they may have started to notice. But, having their suspicions confirmed that they indeed do have hearing loss can be disheartening.
One of the first questions I get from people is whether or not their hearing loss is permanent. They want to know whether a certain medication or procedure can simply restore their hearing to normal? Well, in most cases the answer to that question is “yes, your hearing loss is permanent”. But, not always! Whether a hearing loss is permanent or not depends on what is causing the hearing loss.
There are several different causes of hearing loss. First, I will discuss some causes of hearing loss which may be reversible.
Wax Build-up in the Ear Canal There is supposed to be some wax (cerumen) in the ear canal. It acts as a protective mechanism to keep debris out of the ear canal and protects the ear drum. Some people produce more wax than others. This may depend on race, genetics, and/or diet. In most cases, wax will work its way out of the ear naturally. However, for those people who produce a significant amount of wax, a build-up in the ear canal can occur. Using Q-tips to attempt to clean the ear canals can make the build-up worse. If a wax occlusion occurs in the ear canal, your hearing can be affected. Once the wax is cleaned out (by a professional) then your hearing should improve if there is no other cause of hearing loss.
Foreign Body in Ear Canal Just like with wax, if anything is stuck in the ear canal, it will hinder transmission of sound to the ear. This will cause a temporary change in hearing. Once the foreign body has been removed, hearing should return to normal.
Hole in the Ear Drum A perforation of the ear drum can cause a temporary hearing loss. This may occur due to a trauma or infection such as:
an object puncturing the ear drum (another reason not to use Q-tips)
a blunt force trauma to the side of the head or explosion
quick change in ear pressure (such as when diving or flying)
build-up in pressure behind the ear drum from a middle ear infection.
Depending on the size of the hole, it is likely to heal on its own. Certain precautions will need to be taken, such as keeping water out of the ear to allow proper healing. In more severe cases, a procedure known as a tympanoplasty can be performed to patch the ear drum. In most cases, once the ear drum is healed the hearing will return as well.
Ear Infections Ear infections can occur in the ear canal (outer ear) or behind the ear drum (middle ear). Outer ear infections can be fungal or bacterial and are usually treated with a series of ear drops. Middle ear infections occur more commonly in children and are treated using antibiotics, or placing a tube in the ear drum to allow the fluid to drain. In either case, a hearing loss caused by an outer ear or middle ear infection will improve once the infection has cleared.
Other Middle Ear Disorders There are a few other ear problems that can occur with the ear, that usually causes a temporary hearing loss. A stiffening of the bones of the middle ear, called otosclerosis, can cause a change in hearing. This can be corrected with a surgical procedure which will likely improve hearing, however this is never a guarantee.
Another middle ear disorder, known as a cholesteatoma, is a build-up of tissue in the middle ear space. This may be genetic or may be a result of chronic untreated ear infections. The cholesteatoma may be removed via surgery, however the longer it goes untreated, the greater likelihood of the hearing loss becoming permanent.
Idiopathic Sudden Sensory Hearing Loss This is a sudden change in hearing (within 3 days). The causes of a sudden hearing loss may include an inner ear viral infection, vascular compromise to the inner ear, or other inner ear dysfunction. The treatment will range depending on the likely cause such as anti-inflammatory agents or vasodilators. The outcome for hearing to return is usually good, depending on how quickly it is treated.
In most of the above cases of temporary hearing loss, the problem occurs to one ear or the other. On the other hand, most cases of permanent hearing loss occur to both ears. Here are some of the causes of a permanent hearing loss.
Birth Defect In some cases of prematurity or complications, a baby can be born without certain ear mechanisms. This will result in a permanent hearing loss that may be able to be corrected only with hearing technology.
Noise-induced Hearing Loss Extended exposure to loud noises, such as gunfire, explosions, music, or machinery can affect hearing. Noise damages the tiny hair cells in the inner ear. Once these are damaged, they cannot be restored. At first, the noise exposure may cause a temporary hearing change, but the more exposure the more likely the hearing loss will become permanent.
Aging The most common cause of hearing loss is from aging. The term used for hearing loss due to aging is called presbycusis. This is usually a very gradual loss of hearing over time. It can be genetic. This is a permanent hearing loss. People experiencing age-related hearing loss can benefit from hearing aids, and the sooner you get them the better.
Ototoxicity In most cases ototoxicity can cause a permanent hearing loss. This is medication-induced hearing loss. The most common medications which can cause hearing loss are chemotherapy agents, certain intravenous antibiotics, or loop diuretics. Talk to your doctor about having your hearing monitored if you begin any of these medications.
Permanent hearing loss is most commonly called sensorineural hearing loss. This describes the part of the ear in which the hearing loss is occurring. Sensory refers to the Cochlea (inner ear organ) and neural refers to the hearing nerve which runs to the brain. In a permanent hearing loss, any portion of the inner ear or nerve can be disordered.
This may include hearing aids, assisitive listening devices, or implantable devices, depending on the degree of your hearing loss.
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