Causes of severe hearing loss

In normal hearing, sound waves enter your outer ear and cause your ear drum and middle ear bones to vibrate. The sound waves then travel through your inner ear, which is a shell-shaped, fluid-filled tube called the cochlea. As the fluid moves, it sets in motion thousands of tiny hairs that convert the sound vibrations into nerve impulses. Those impulses are then sent to your brain where they are processed into sounds you can recognize. Hearing loss happens when there's a problem with the structures of the ear that process sound.

Any of the following conditions can lead to severe hearing loss:

Age. As people get older, the structures in the ear become less elastic. The tiny hairs get damaged and are less able to respond to sound waves. Hearing loss can progress over the course of several years.

Loud noise. The blare of power tools, airplanes, or loud music on headphones for example,  can damage the hair cells in the cochlea. Hearing loss depends on the loudness of the sound and the length of the exposure.

Ear infections. During an ear infection, fluid can build up in the middle ear. Usually the hearing loss from an ear infection is mild and temporary. But if ear infections aren't treated, they can lead to serious long-term problems.

Perforated eardrum. An ear infection, loud sounds, head trauma, or intense pressure in the ear from flying in an airplane or scuba diving can rupture the ear drum (the membrane separating the ear canal and the middle ear), leaving a hole that may or may not heal. Depending on the size of the hole, there may be mild or moderate hearing loss.

Cholesteatoma. This is a skin growth that occurs in the middle ear behind the eardrum. It is usually due to repeated infection.  Cholesteatomas grow over time and can lead to hearing loss by destroying the middle ear bones or, rarely, the inner ear.

Illnesses or infections. Measles, mumps, tertiary syphilis, and meningitis are just a few of the conditions that can cause hearing loss.

Meniere’s disease. Symptoms of this inner ear disorder include dizziness, fluctuating hearing loss, ringing in the ear, or fullness in the ear. Hearing loss in Meniere’s disease usually gets worse, but only involves one ear.

Tumours. Both cancerous and noncancerous tumours can cause severe hearing loss. People who have a tumour might also have facial numbness or weakness and ringing in the ear.

A foreign object in the ear. When objects get stuck in the ear, they can block hearing. Earwax can sometimes build up and harden in the ear, hampering your ability to hear.

Malformed ear. Some people are born with poorly formed ear structures, which prevent them from hearing well.

Medications. Some types of drugs -- including the aminoglycoside class of antibiotics, large quantities of aspirin, chemotherapy drugs and macrolide antibiotics -- can cause hearing loss.

Genes. Scientists have identified certain genes that make people more prone to severe hearing loss.

Autoimmune disorders. Lupus and rheumatoid arthritis, as well as Cogan’s syndrome, Wegener’s granulomatosis, and Behcet’s disease can cause severe hearing loss.

Treatment options

Technological and medical advances have led to many new treatment options for hearing loss. The choice depends in part on the kind of hearing loss you have. Options include:

  • Removable Hearing Aids

    Hearing aids amplify sounds and make it easier for the inner ear to detect. The electronic parts of hearing aids are typically either analog or digital. Analog hearing aids convert sound into electrical signals, which are then amplified. They work like a microphone attached to an amplifier and can be programmed for different environments, such as a small room or a crowded restaurant.  Digital hearing aids convert sound into numbers, which are then converted back into sound. They work like an mp3 player and can be programmed to amplify only the frequencies where you have hearing loss. In general, digital hearing aids are more flexible. But they also cost more.  Both analog and digital hearing aids come in many different models to choose from.
  • Implants

    Middle ear implants are devices that vibrate inside your ear. Cochlear implants help people who have such severe hearing loss that hearing aids don’t help. Implants trigger the nerves inside the ears. They don’t cure hearing loss, but they can give someone the sensation of sound.

Sources: www.earinstitute.co.za; www.mayoclinic.org; www.webmd.com

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