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Hearing Loss

  • What is hearing loss?

    Hearing loss refers to reduced hearing from a problem in 1 or more parts of the ear and can affect people of all ages. Sound waves usually move through the external ear canal and vibrate the eardrum. The vibration then passes through the middle ear bones to the cochlea (cavity of the inner ear for hearing). The cochlea sensory cells receive the vibrations and send signals to the auditory nerves (hearing nerves) and to the brain, which recognises these signals as sounds.

    There are 3 types of hearing loss:

    • Conductive hearing loss – occurs when sound waves are not passed properly from the outside environment to the cochlea
    • Presbycusis – hearing loss that occurs with ageing
    • Sensorineural hearing loss – occurs when the cochlea or auditory (hearing) nerves are damaged
  • Different causes that lead to hearing loss include:

    • Drugs, such as certain antibiotics and cancer drugs, which can damage some of the hearing nerves or the sensory cells of the cochlea, leading to otitis media (a group of inflammatory diseases of the middle ear).
    • Problems affecting the external ear canal, eardrum, middle ear bones or middle ear space:
      1. Chronic diseases or injury can cause the eardrum to burst or cause the middle ear bones to move out of place, be damaged or be stuck.
      2. Otitis media (middle ear infection) can be caused by ageing, inner ear viral and bacterial infections (mumps, measles, influenza) or Meniere disease (inner ear disorders that affect balance and hearing), which damages the sensory cells in the cochlea due to acute or chronic exposure to loud noises.
      3. The external ear canal can become blocked by wax or foreign objects, or can become infected.
  • Hearing loss can occur suddenly or gradually, and it can affect 1 or both ears. Symptoms include:

    • Difficulty understanding what other people are saying, especially with background noise
    • Earache and ear discharge due to ear infections
    • Often asking for directions or conversations to be repeated
    • Tinnitus (ringing in the ears)
    • Speaking louder than normal
    • Vertigo (spinning sensations)
    • Withdrawal from conversations
  • The treatment of hearing loss depends on the root cause. A doctor will assess your condition and suggest the best treatment based on the cause of hearing loss:

    • If caused by ear wax build-up or a foreign object in the ear canal, an ear, nose and throat (ENT) surgeon can remove it under a microscope.
    • If caused by an external ear infection, topical antibiotics may be prescribed.
    • If caused by a burst eardrum, surgical repair may be needed to fix the eardrum if it is not repaired within three months or if the patient suffers from frequent ear infections and associated ear discharge.
    • If caused by certain medications, they will be stopped or replaced by the doctor.
    • If caused by presbycusis (ageing), there is no cure. The ENT specialist might recommend a hearing aid or offer treatment options aimed at protecting the hearing as much as possible to slow down further loss of hearing.

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