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Ask the Audiologist

Understanding Hearing Loss: What causes it and if I have hearing loss will it get worse?

By Ali Carmichael, Au.D.
Audiology Consultants, P.C.

For most people hearing loss is a medical condition they are aware of and in most situations, they may even know someone with hearing loss, however, people are very rarely taught about the causes of hearing loss that can happen across their lifespan. Hearing loss can affect anyone, at any age, and for various reasons.

Common Causes of Hearing Loss

Age-Related Hearing Loss (Presbycusis):

Age-related hearing loss, or presbycusis, is part of the aging process. It typically begins around the age of 60, although for some people it can happen earlier. Presbycusis comes from changes in the inner ear, leading to a gradual decrease in hearing ability. Researchers are unsure of the root cause of age related hearing loss, but it is believed to be linked with other conditions that are common for older individuals like high blood pressure or diabetes. While it is often slowly progressive, the rate at which it worsens can vary from person to person. This is one reason many audiologists recommend periodic testing (every two to three years) when a hearing loss is first identified.

Noise-Induced Hearing Loss:

Exposure to loud noises, whether from occupational settings (e.g., construction, manufacturing, military) or recreational activities (e.g., concerts, firearms), can cause noise-induced hearing loss. Prolonged or repeated exposure to loud sounds can damage the inner ear, leading to a permanent hearing loss. The more noise and the longer you’re in it, the more severe the hearing loss can get. When around excessive noise it is always important to use properly fit hearing protection (ear plugs or ear muffs).

Genetics/Heredity:

Sometimes hearing loss runs in families because certain genetic conditions can play a large role in hearing loss. This means that if your mother, father, or grandparents had difficulty with their hearing there is a greater chance you may get hearing loss as well. These conditions can develop a loss at any age and can be progressive, although this can vary from condition to condition.

Middle Ear Infections:

Middle ear infections, particularly repeat or untreated ones, can damage the small bones of the middle ear, leading to hearing loss. If there is concern of a middle ear infection, seeking an evaluation by a medical provider can often help to prevent permanent damage. Infections left untreated can cause long-term hearing concerns.

Viral Infections:

The other type of infection that can affect the hearing system are viral infections that attack the inner ear. This type of hearing loss most commonly happens suddenly. If a sudden hearing loss occurs it is extremely important to seek medical help immediately (ideally within the first 48 hours), the window for treatment to be most effective is very small.

Unusual Bony Growths:

These, often benign, growths in the ear canal are often caused by exposure to extremely cold water over time. They are far more common in the northern parts of the United States in places where people often swim in cold rivers or lakes. Over time, these growths can continue to increase in size and potentially block off the opening to the ear, obstructing the sound’s path to the inner ear. If a bony growth is identified, it is best to have an Ear, Nose, and Throat Physician look at it to determine risk of progression.

Ototoxic Medications and Ototoxic Agents:

Certain medications, known as ototoxic drugs, have the potential to harm the structures of the inner ear and cause hearing loss or tinnitus. The impact can vary from temporary to permanent, depending on the drug, dosage, and individual factors. The most common ototoxic medications are some antibiotics given via injection, certain chemotherapy medications, loop diuretics, and high doses of some pain management medications. Some workplace chemicals are also known to be toxic to the hearing system. All chemicals should have listed side effects that the user should be aware of.  In some cases, hearing loss caused by ototoxicity can be progressive. When combined with noise exposure that progression can be more rapid. It is recommended to have consistent hearing tests when taking a known ototoxic medication.

Trauma:

An injury to the head or ear can also cause damage to the hearing system, resulting in hearing loss. The severity of the loss varies greatly depending on the degree of the trauma and the specific parts of your anatomy that are affected. It is extremely important to have a medical evaluation following any kind of head injury. Immediate medical attention and treatment can help prevent additional damage and improve outcomes.

Hearing loss is different for everyone, with various causes and rates of progression. It is important to remember that early identification and intervention are key to managing hearing loss effectively. Regular hearing tests, appropriately hit hearing protection with noise exposure, and seeking prompt medical attention for ear-related issues can all help to maintain better hearing health. Seeing a local hearing professional for help in managing hearing loss is the best way to ensure a better quality of life.

Ali Carmichael is an audiologist at Audiology Consultants, P.C.  For more information, visit audiologyconsultants.com.