Hearing Loss

Hearing loss is a condition that results in reduced hearing ability. Patients retain some level of hearing, which is why it is considered partial deafness. Depending on the patient’s ability to hear, it is classified into three levels:

• Mild hearing loss: commonly associated with aging and usually develops gradually. It causes difficulty hearing in noisy environments.
• Moderate hearing loss: it becomes difficult to hear properly without the use of hearing aids.
• Severe or profound hearing loss: hearing is virtually impossible in most situations without the use of a hearing aid or implant.

Depending on which part of the auditory system is not functioning properly, there are three types of hearing loss:

• Sensorineural hearing loss: the inner ear organs (cochlea, vestibule, and semicircular canals) do not function correctly. Sound is detected, but the nervous system does not transmit it to the brain.
• Congenital hearing loss: present at birth. It may be inherited or due to abnormal fetal development during pregnancy.
• Acquired hearing loss: occurs after birth due to external factors.
• Conductive hearing loss: the damage affects the middle or outer ear, preventing the capture of external sounds.
• Mixed hearing loss: the problem affects both the sensorineural system (inner ear) and the conductive organs (outer and middle ear).

Partial deafness negatively impacts patients' quality of life, especially children, who may struggle to produce sounds and learn to speak properly if they cannot hear well. For this reason, early detection and a multidisciplinary approach are essential to ensure the most normal development possible in young children.

Symptoms

Symptoms can vary depending on the patient’s age, and the degree and type of hearing loss. The most common symptoms include:

• Difficulty hearing everyday sounds.
• Trouble hearing conversations or specific loud sounds.
• Some sounds are perceived as louder than they really are, causing discomfort (background noise, engines, alarms, doorbells, etc.).
• Tinnitus (ringing in the ears).
• Hearing muffled sounds.
• In young children, speech or learning difficulties such as:
• Speaking in a voice that is too loud or too soft.
• Not pronouncing certain sounds (those the child cannot hear).
• Difficulty reading or understanding mathematical concepts.
• Social isolation.

Causes

Hearing loss can result from various causes. The most common include:

• Presbycusis (age-related hearing loss).
• Continuous exposure to loud noises.
• Earwax buildup.
• Ménière’s disease.
• Ear infections, especially otitis media or meningitis.
• Head trauma.
• Tympanic membrane perforation.
• Tumor on the auditory nerve.
• Congenital anomalies or malformations.
• Certain medications (aminoglycoside, glycopeptide or macrolide antibiotics, beta-blockers, loop diuretics, or cytostatics).

Risk Factors

Several factors increase the risk of developing hearing loss:

• Aging.
• Prolonged exposure to loud noise.
• Genetic predisposition.
• Long-term use of ototoxic medications.
• Certain illnesses (otitis media, meningitis, tumors…).

Complications

When not properly treated, hearing loss can hinder communication with others, leading to isolation, frustration, loneliness, and in turn, more serious mental health issues. In children, it may also impact language development.

Prevention

Although some types of hearing loss cannot be prevented, in many cases hearing health can be maintained by attending regular check-ups and protecting the ears when exposure to loud noises cannot be avoided.

Which doctor treats hearing loss?

Hearing loss is diagnosed by otolaryngologists (ENT specialists) and neurologists, and is often first detected in pediatric or primary care consultations. Speech therapists also play a key role in treatment.