When the ear is not working properly, sound information has a tougher time getting to the brain. This is hearing loss.
Hearing loss can be both psychologically and socially debilitating. Understanding speech, especially in noisy environments, becomes more difficult and requires more effort and energy. Feelings of social isolation frequently occur.
Very mild hearing loss may be barely perceptible or not perceptible at all, but severe or even “profound” hearing loss may make speech communication impossible. There are two general types of hearing loss that are indicative of two different categories of problems.
Conductive Hearing Loss
One type of hearing loss is a problem with the vibrations of sound reaching the inner ear, and is called “conductive hearing loss.”
Conductive hearing loss can be caused by too much ear wax in the outer ear, an ear infection in the middle ear, or malfunction or disruption of the ear bones. One easy way to demonstrate a conductive hearing loss is to push on the front tab of the ear canal (called the tragus) and close it off. We do that when loud sounds are bothering us, because it blocks the vibration of sound from getting further into the ear to some degree. Causes of conductive hearing loss are frequently correctable.
Sensorineural Hearing Loss
The other type of hearing loss is a problem with the hair cells or hearing nerve, and is called “sensorineural hearing loss.” When hair cells are damaged they do not grow back, and when hearing nerve cells die they are not replaced. Damage to these cells can occur with excessive loud noise exposure, strokes, and tumors involving the hearing nerve, but is most commonly associated with typical age-related hearing loss. Sensorineural hearing loss can also occur suddenly in one ear. This type of hearing loss can feel like the ear is blocked, but there is no physical blockage.
While we can sometimes determine the cause of sudden sensorineural hearing loss, often we cannot, but there are treatments involving steroids that can improve the chances that the hearing returns in that ear. This is an emergency, because these treatments need to be given within days of when the hearing loss began in order to be effective.
Determining the best way to help your hearing loss is a very individual experience that requires the combined efforts of the audiologist and the physician, but there are a few generalizations.
Cochlear Implant - For individuals with severe or profound hearing loss, a cochlear implant may be a good option. A cochlear implant is a device placed surgically in the inner ear to bypass the damaged parts and can often restore useful hearing. A cochlear implant actually compensates for nonworking, dysfunctional, or damaged parts of the inner ear, unlike a hearing aid which amplifies sound through the ear canal.
Otosclerosis
Otosclerosis is a condition in which an abnormal sponge-like bone grows in the middle ear. This abnormal growth prevents the small bones in the ear from working properly, resulting in hearing loss. The condition can progress to more significant hearing loss.
Symptoms of Otosclerosis
The abnormal growth in the middle ear affects the ability of sound waves to reach the inner ear. Hearing loss is usually progressive over time, and can occur in both ears. Sudden changes in hearing are unlikely to occur in otosclerosis.
Treatment
When otosclerosis is mild, or the condition is in its early stages, no intervention may be needed. If hearing loss is impacting your quality of life, hearing aids can be helpful. Due to the progressive nature of otosclerosis as hearing loss worsens over time, surgery may be necessary. If your hearing loss is extensive, a microsurgical procedure called a stapedectomy may be recommended to restore hearing.
During a stapedectomy, a portion of the stapes bone is removed and a titanium prosthesis is placed in lieu of the removed bone. The procedure is performed through the ear canal under general or local anesthesia and typically takes less than 90 minutes. Hearing loss is typically improved immediately and permanently with a stapedectomy.
Single-Sided Deafness
Single-sided deafness or unilateral hearing loss is where there is impaired hearing (partial or complete) in one ear and normal hearing in the other ear. Known causes of single-sided deafness include sudden loss of unknown origin, acoustic neuroma, measles, mumps, Meniere's disease, meningitis, labryrinthitis, physical trauma, and hereditary conditions.
Regardless of the length of symptoms, treatment options exist for single-sided deafness. For a sudden hearing loss, often an MRI is obtained and steroids are administered. For a long-term loss, a bone-anchored hearing aid (BAHA) offers a permanent solution.
Bone-anchored hearing aid (BAHA) - This FDA-approved implant works by transmitting sound directly to the cochlea (inner ear) on the opposite side of the skull. The BAHA device is strategically placed behind the deaf ear so that sound is transmitted through the skull to the opposite side of the head to reach the patient’s functioning inner ear. The BAHA device helps restore the sensation of hearing on both sides.
Steroids - Steroids have long been the gold standard therapy when it comes to sudden single-ear deafness. Oral steroids (given by mouth) such as prednisone can be beneficial. Steroids injected directly into the ear may also be helpful. Steroid injections are injected through the ear drum into the middle ear, where they are absorbed into the inner ear. This procedure is quick, relatively painless, and can be performed in our office.
Other conditions that may cause hearing loss: