Hearing Loss
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What is Hearing Loss?
Hearing loss refers to a reduction in the ability to hear sounds clearly. It can occur in one or both ears and may be temporary or persistent, depending on the underlying cause. While some people notice changes gradually, others may experience them more suddenly.
According to the World Health Organization, over 1.5 billion people live with some degree of hearing loss worldwide. Hearing loss can range from mild to complete, with classifications commonly used in clinical practice including: mild, mild with ringing, moderate, moderate with ringing, moderately severe, moderately severe with ringing, severe, severe with ringing, profound, and profound with ringing
The first step for individuals who suspect a hearing problem lies in understanding what hearing loss is. Because hearing plays a key role in communication and daily function, recognising changes early may help with timely assessment and management.
What are the Types of Hearing Loss?
Hearing loss can be classified according to which part of the auditory system is involved.
Conductive Hearing Loss
Conductive hearing loss occurs when sound cannot pass efficiently through the outer or middle ear due to obstruction, fluid, swelling, or structural changes.
Sensorineural Hearing Loss
Sensorineural hearing loss affects the inner ear or the nerve pathways that transmit sound to the brain. It may arise from ageing, noise exposure, sudden inflammation, or other medical conditions and is generally permanent.
Mixed Hearing
Loss
Mixed hearing loss involves both conductive and sensorineural components. Management often requires addressing causes from both parts of the auditory system.
What Causes Hearing Loss?
Medical literature highlights a wide range of factors that may contribute to hearing difficulties across different parts of the auditory system. Research such as Hearing Loss in Adults (PMC) and Hearing Loss – StatPearls (NCBI Bookshelf) describes causes involving the outer, middle, or inner ear, as well as the auditory nerve and pathways to the brain.
Causes of Conductive Hearing Loss (Outer and Middle Ear)
Earwax Obstruction
A build-up of earwax can block sound from reaching the eardrum. If self-cleaning mechanisms are unable to clear it, hearing may become muffled. When needed, professional care such as ear wax removal in Singapore may help.
Otitis Externa (Ear Canal Infection)
Also known as “swimmer’s ear”, this condition involves inflammation of the ear canal. Swelling, discharge, or discomfort may interfere with how sound travels towards the eardrum.
Perforated Eardrum
A hole in the eardrum may arise from infection, sudden pressure changes, or trauma. This can lead to temporary hearing loss and may also cause ear discharge or pain.
Otitis Media (Middle Ear Infection)
Fluid or infection behind the eardrum may reduce its ability to vibrate. While commonly seen in children, adults may also experience episodes, especially when recovering from colds or sinus congestion.
Cholesteatoma
A cholesteatoma is a skin growth in the middle ear that may gradually damage nearby structures. If untreated, it can cause hearing loss and other complications.
Eustachian Tube Dysfunction
When the middle ear cannot equalise pressure effectively, hearing may feel blocked or muffled. This often occurs during flu, allergies, or sinus congestion.
Ossicular Chain Issues
Injury, dislocation, or abnormal bone growth (such as otosclerosis) may affect the movement of the tiny bones responsible for transmitting sound.
Causes of Sensorineural Hearing Loss (Inner Ear to the Brain)
Age-Related Changes
Ageing may cause gradual changes in the cochlea and hearing pathways, often affecting the ability to hear high-frequency sounds.
Noise Exposure
Continuous exposure to loud sounds, such as machinery, concerts, or high-volume earphones, may damage the sensory hair cells in the inner ear.
Viral or Bacterial Infections
Infections such as mumps, measles, meningitis, influenza, or shingles can affect the inner ear.
Cardiovascular Factors
Conditions that reduce blood flow to the inner ear, such as hypertension, diabetes, and vascular disease, may influence hearing.
Ototoxic Medications
Some medications may affect inner ear function. These are typically used for serious medical conditions and are monitored closely.
Meniere’s Disease
This condition may cause fluctuating hearing loss, tinnitus, and dizziness due to changes in inner ear fluid balance.
Genetic Factors
Some forms of hearing loss have a hereditary component and may appear in childhood or adulthood.
Benign Tumours
A slow-growing tumour such as an acoustic neuroma may cause gradual hearing loss, tinnitus, or balance symptoms on one side.
Neurological Changes
Certain conditions affecting the brain’s hearing pathways may alter sound processing.
What are the Common Symptoms of Hearing Loss?
Difficulty Hearing Conversations
Speech may feel unclear, especially with soft or fast speakers.
Needing Higher TV or Radio Volume
You may notice a preference for louder settings.
Trouble Hearing in Noisy Settings
Background noise at restaurants or social gatherings may make conversations harder to follow.
Asking People to Repeat Themselves
You may feel that others are mumbling or not speaking clearly.
Muffled Hearing
Sounds may feel blocked or less sharp.
Tinnitus (Ringing Sound)
Ringing, buzzing, or humming may be present in one or both ears.
How Audiologists in Singapore Diagnose Hearing Loss
Medical History Review
Your doctor will discuss your symptoms, lifestyle factors, past infections, and noise exposure.
Physical Ear Examination (Otoscopy)
An otoscope is used to examine the ear canal and eardrum for blockage, infection, or structural changes.
Hearing Tests (Pure-Tone Audiometry)
This measures how well you hear across different frequencies.
Tympanometry
Assesses middle ear pressure and eardrum movement.
Speech Audiometry
This evaluates how well you understand words at various sound levels.
When Imaging May Be Needed
CT or MRI scans may be ordered if inner ear inflammation, tumours, or structural causes are suspected.
Understanding Your Results
Test findings help determine the type and severity of hearing loss and guide management options.
What Complications Can Occur if Hearing Loss is Left Untreated?
Communication Difficulties
You may find it harder to keep up with conversations at home, work, or social settings.
Social Withdrawal
Some individuals may avoid gatherings due to difficulty hearing in groups.
Impact on Learning (Children)
Hearing issues may affect language, speech development, and school performance.
Increased Listening Fatigue
Straining to hear can lead to tiredness and a reduced ability to focus.
Possible Association with Cognitive Strain
Research suggests that unassisted hearing loss may increase cognitive load over time.
Treatment Options for Hearing Loss
Treatment for Conductive Hearing Loss
Depending on the cause, management may include:
- Removal of earwax
- Treatment of infections
- Managing middle ear fluid
- Repairing the eardrum or middle ear bones if needed
Some individuals may benefit from hearing support devices if changes persist.
Treatment for Sensorineural Hearing Loss
Management varies depending on whether the cause is sudden or progressive. Options may include:
- Medication or urgent evaluation for sudden sensorineural hearing loss
- Hearing aids to support daily communication
- Assistive listening devices for specific environments
- Assessment for cochlear implant suitability when hearing loss is severe
These options are discussed based on individual needs and test results.
FAQs about Hearing Loss
Can hearing loss be reversed?
Some causes, such as earwax blockage or middle ear infections, may improve with appropriate treatment. Sensorineural causes tend to be permanent, but support options such as hearing aids or listening devices may help with daily hearing needs.
How can I prevent hearing loss?
Limiting loud noise exposure, managing chronic health conditions, and maintaining good ear hygiene can support long-term hearing health. Regular hearing checks are helpful for adults as they age.
What tests might I undergo during a hearing assessment?
Tests may include pure-tone audiometry, speech audiometry, tympanometry, and specialised options such as the OAE test or ABR test, depending on your needs.
Do I need imaging scans for hearing loss?
Not always. CT or MRI is considered if a structural cause or nerve-related issue is suspected.
Is tinnitus the same as hearing loss?
Not necessarily. While tinnitus can occur with hearing loss, it may also arise from other factors. If tinnitus persists, a hearing assessment may help identify related issues.
Consult a Hearing Loss Specialist in Singapore
If your symptoms persist or if you experience sudden changes in hearing, it may be helpful to consult a doctor. A medical evaluation can determine the underlying cause and guide suitable care options.
Learn more about our services at our ENT clinic in Mount Alvernia.