Around one in six adults in the UK has hearing loss, with most affected by one of two types: conductive or sensorineural hearing loss.
Sensorineural hearing loss is the most common type and occurs when a part of your hearing system called the inner ear doesn’t work properly. Conductive hearing loss occurs when sound is prevented from travelling from your outer ear to your inner ear, usually due to a blockage in your middle ear.
As hearing loss is often gradual, especially age-related hearing loss (presbycusis), many people aren’t aware of it until they have a hearing test.
This is why it is important to look out for signs of hearing loss, such as needing to turn your TV or phone volume up higher, misunderstanding people more often, especially in noisy situations, and having to ask people to repeat themselves more frequently. If you’re at risk of hearing loss, it’s even more important to pay attention to these signs.
Some risk factors for hearing loss are beyond your control, particularly in the case of sensorineural hearing loss. Genetic conditions and ageing can both lead to sensorineural hearing loss. Other risk factors for this type of hearing loss include certain medications (eg the antibiotic gentamicin and the chemotherapy drug cisplatin) and exposure to loud sounds.
Risk factors for conductive hearing loss, where there is a blockage between your outer ear and inner ear, which prevents sound from getting through, include head trauma, repeated ear infections, persistent glue ear in children, and cholesteatoma where the bones in your middle ear that conduct sound are damaged.
Hearing loss can significantly reduce your quality of life, often in ways that you may not anticipate. It can make work and education more challenging but can also affect your personal relationships. As it becomes harder to follow conversations, you may find yourself avoiding social situations and becoming isolated.
Hearing loss is also linked to an increased risk of dementia. Although the exact mechanism of how hearing loss increases dementia risk isn’t yet clear, research suggests several factors contribute: social isolation as a result of hearing loss, your brain needing to work harder to understand speech and a decrease in sensory stimulation to your brain.
These consequences of hearing loss are not inevitable. Getting a hearing test and/or seeking professional help can ensure you get the necessary treatment to improve your hearing, and consequently, your quality of life.
Treatment for hearing loss depends on the specific underlying cause.
Treating sensorineural hearing loss
Sensorineural hearing loss is often treated with hearing aids. Hearing aids don’t need an invasive procedure and, consequently, can be fitted and worn straight away. Although they will not restore your hearing back to normal levels, they will make it easier for you to understand sounds.
If you have profound (very severe) sensorineural hearing loss, you may be suitable for a cochlear implant. This small electrical device is placed in your inner ear to mimic the function of your cochlea, a spiral-shaped structure inside your inner ear that sends signals to your auditory nerve, which your brain then interprets as sound.
Treating conductive hearing loss
As with sensorineural hearing loss, conductive hearing loss can often be treated with hearing aids. In certain cases, you may have the option of wearing hearing aids or having surgery eg otosclerosis, where there is an abnormal bone growth in your middle ear, can be treated with hearing aids or with surgery to remove and replace part of the bone in your middle ear. Surgery may also be recommended if you have a perforated ear drum, which hasn’t healed on its own.
All surgery comes with risks, such as bleeding, infection and nerve damage.
Risks specifically associated with ear surgery include dizziness and tinnitus, although these complications are usually temporary.
Middle ear surgery comes with the risk of damage to a branch of your facial nerve called the chorda tympani, which can cause a temporary or permanent change in your sense of taste, specifically the presence of a metallic taste on your tongue.
In rare cases, ear surgery may worsen your hearing loss.
Whichever type of ear surgery you have, your surgeon will advise you on the potential risks and benefits.
Although ear surgery is delicate, it is most often successful and usually quick; even major ear surgery (eg a cochlear implant) takes under an hour.
Miss Emma Stapleton is a Consultant Ear, Nose and Throat Surgeon at Spire Manchester Hospital and clinical lead for the Manchester Cochlear Implant Programme at NHS Manchester Royal Infirmary. Clinically, she treats a wide range of ear conditions, including hearing loss, tinnitus, hearing implants (including cochlear implants, middle ear implants and bone conduction implants), stapedectomy, eardrum repair and cholesteatoma surgery.
If you're concerned about symptoms you're experiencing or require further information on the subject, talk to a GP or see an expert consultant at your local Spire hospital.
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