Types of Hearing Loss and What You Can Do About It

The auditory system is divided into the outer ear, middle ear and the inner ear. The outer ear consists of the pinna which is visible on the side of your head, and the ear canal. These structures help in funneling the sound and in identifying where the sound is coming from. The middle ear is an air-filled space consisting of six walls and tiny bones called the ossicles. This space transmits the sound from the environment, where the sound travels through air medium into the inner ear, where sound travels through fluid medium. The inner ear comprises of the cochlea, which contains the main site of hearing. The inner ear also consists of the auditory nerve that transmits the neural impulses from your ears to your brain.

Anatomy of the Human Ear. Source: Commons.wikimedia.org

Any problem in these auditory structures could impair your hearing.

Hearing loss is thus classified into different types, based on the structures affected:

1. Conductive hearing loss

This type of hearing loss affects the conductive pathway involving outer and middle ear. This could be caused due to:

• Build-up of ear wax

• Infection of ear canal

• Fluid in the middle ear

• Infection of the middle ear

• Rupture of ear drum

• Foreign body in the ear

• Extra growth of bone in the middle ear (otosclerosis)

• Absence of pinna and/or ear canal

What can you do about it?

Conductive hearing loss most often can be reversed by addressing the underlying cause. In cases of infections and ear drainage, it is advisable to consult an ENT doctor. The ENT doctor may prescribe medications or perform surgery. Your hearing levels will be assessed before and after treatment so as to keep a track of improvement in hearing.

2. Sensorineural hearing loss

This is the most common type of hearing loss in adults and occurs when there is a problem in the cochlea or your auditory nerve. It is most commonly seen in aging adults. Some of the causes of sensorineural hearing loss are:

• Aging

• Exposure to loud noise for an extended period of time

• Exposure to sudden loud sound like a bomb blast, cracker, etc

• Ototoxicity due to some drugs/medicines

• Head trauma

• Family history of hearing loss

• Viral infection to the cochlea or auditory nerve

What can you do about it?

Damage to cochlear structures is often irreversible through medications, with a few exceptions.

• Hearing aids

Wearing hearing aids can help amplify the sounds around you and compensate for the hearing loss you have.

• Cochlear implants

If hearing aids prove to be unhelpful for your hearing, cochlear implantation can be done with the help of an ENT surgeon, where a small implant is placed inside your ear surgically. A cochlear implant surpasses the cochlea and electrically stimulated your auditory nerve. Hence, it compensates for the cochlear loss present, and is very effective in those individuals with a dead cochlea or profound hearing loss.

3. Mixed hearing loss

Mixed hearing loss refers to a combination of sensorineural hearing loss and conductive hearing loss. This could happen when there is a pathology in the cochlea and a pathology also in the outer/middle ear.

A middle ear infection that started out as a conductive hearing loss could spread further to infect the cochlea, damaging it permanently. Further progression of the infection could also infect the structures of the brain, which could be fatal. It is therefore of utmost importance to address ear discharge immediately.

What can you do about it?

• Address the conductive component by consulting an ENT.

• Address the sensorineural component with the help of hearing aids, once the conductive loss has been addressed completely.

4. Single sided deafness

Single sided deafness (SSD), as redundant, refers to sensorineural hearing loss in one ear, and normal or near normal hearing in the other. Most often, the cause of hearing loss in unknown.

What can you do about it?

• Use hearing aids in one ear or CROS hearing aids.

• Cochlear implantation to side of the affected ear.

If you feel that you may have hearing loss, consult an audiologist immediately. A detailed assessment is necessary to determine the best management strategy for you. Your audiologist will be able to understand and address your hearing problems in an effective manner, rather than you jumping to conclusions.