Types of hearing loss

A detailed examination

When we talk about hearing loss, many people think only of deafness. But did you know that there are many types of hearing loss, and that they can affect us all? Below, we’ll take a closer look at the topic of ‘types of hearing loss’.

What is hearing loss?

Put simply, hearing loss is a reduction in hearing that occurs either suddenly or gradually. It can have various causes and manifest in many ways. You may suddenly find you can no longer hear high-pitched sounds, or you may struggle to hold conversations in noisy environments.

Hearing loss affects not only the volume but also the clarity of sounds and speech. In some cases, it can also lead to tinnitus, a persistent ringing or buzzing in the ear. It is important to consult a specialist at the first signs to discuss possible treatment options.

The two main types of hearing loss

Generally speaking, hearing loss can be divided into two main types:

Conductive hearing loss affects the outer or middle ear. In this case, sound is not effectively transmitted to the inner ear.

Sensorineural hearing loss, on the other hand, affects the inner ear or the auditory nerve.

Conductive hearing loss

Conductive hearing loss is a specific form of hearing loss that occurs when the process of sound transmission from the outer ear through the ear canal to the middle ear - including the central structures of the eardrum and the three essential ossicles (malleus, incus and stapes) - to the inner ear is disrupted. This phenomenon prevents sound from reaching its destination efficiently and without significant loss, which can lead to hearing impairment.

The causes of this type of hearing loss are varied and can be of many different kinds. Some of the common reasons include:

• Infections: These are particularly infections that lead to inflammation of the middle ear. Such inflammation can impair the ear’s normal functions and lead to hearing problems.
• Blockages in the ear canal: Such blockages can be caused by foreign objects, excessive earwax or even tumours. These physical obstructions can prevent the normal flow of sound, leading to conductive hearing loss.
• Problems with the eardrum: This can occur due to perforations, scarring or other damage to the eardrum, which impairs its ability to effectively transmit sound waves.
• Malformations of the ossicles: In some cases, an abnormal structure or malformation of the small ossicles responsible for transmitting sound waves can also lead to conductive hearing loss.

It is important to note that conductive hearing loss is not permanent in many cases and can be improved through appropriate medical or surgical treatments. These treatments aim to address the underlying issues that prevent normal sound conduction, thereby enabling an improvement in hearing ability.

Sensorineural hearing loss

Sensorineural hearing loss, also known as sensorineural deafness, is a specific type of hearing loss where the problem is located deep within the ear. More specifically, the problem lies in the sensory structures of the cochlea, also known as the inner ear, or in the auditory nerve. Both are central to the transmission of sound signals from the ear to the brain, where they are interpreted as auditory information.

There are a number of typical causes that can lead to sensorineural hearing loss:

Unfortunately, the sad truth is that this type of hearing loss is often permanent. Unlike many other cells in the body, hair cells and the auditory nerve do not have the ability to regenerate or renew themselves. Consequently, the hearing loss caused by this damage is often irreversible. However, various treatment options are available, including hearing aids and cochlear implants, which can help minimise the effects of this type of hearing loss and improve the quality of life for those affected.

• Age-related wear and tear of hair cells: As we age, the hair cells in the cochlea undergo natural wear and tear. As these cells play a vital role in sound perception, their degeneration leads to a reduced ability to effectively detect and transmit sound.
• Noise exposure: Prolonged or intense noise exposure can place a significant strain on the hair cells and lead to their damage or complete failure. Workers in noisy industries are particularly at risk.
• Infections: Certain infections can affect the inner ear and lead to damage to the hair cells or the auditory nerve. These include some viral and bacterial infections that can directly affect the inner ear.
• Ototoxic medications: Some medications are known for their harmful effects on hearing and can lead to sensorineural hearing loss. These include certain antibiotics, loop diuretics and some cancer drugs.
• Sudden sensorineural hearing loss: In rare cases, a sudden loss of hearing can lead to sensorineural hearing loss. The exact causes of such sudden hearing loss are often unknown, but it is a medical emergency requiring immediate attention.
• Autoimmune hearing loss: Autoimmune diseases can affect various organ systems, including the delicate hearing organ. In autoimmune hearing loss, the immune system mistakenly attacks structures in the inner ear. This can lead to progressive hearing loss. This rare but serious condition is often undiagnosed or confused with other forms of hearing loss. Early diagnosis and targeted treatment are crucial to preventing permanent damage to hearing.

Combined hearing loss

In some cases, people with hearing problems may have a particularly complex form of hearing loss known as combined hearing loss. This form of hearing loss is characterised by the fact that it involves elements of both conductive hearing loss and sensorineural hearing loss. Strictly speaking, both the sound pathway through the ear and the inner ear’s ability to correctly interpret the sound and transmit it to the brain are impaired.

This can lead to significant hearing loss and pose a particular challenge in treatment, as both aspects of the hearing process are affected. Nevertheless, there are various medical and technical approaches to managing this complex form of hearing loss and improving the quality of life for those affected.

How can you recognise hearing loss?

Hearing loss can sometimes be difficult to identify, particularly in the early stages or when the degree of hearing loss is mild. In many cases, hearing loss is not obvious and can take subtle forms, making it difficult to recognise the presence of an impairment. It may be the case that certain sounds, particularly those at low volumes or specific frequencies, are difficult to hear or even inaudible.

Some of the first signs of hearing loss may include the feeling that people around you are mumbling, difficulty following conversations in noisy environments, or frequently asking for the volume of the television or radio to be turned up. Furthermore, a tendency to withdraw from social interactions due to difficulty following conversations may also be an indication of possible hearing loss.

An audiogram, a type of hearing test, can help determine the degree and type of hearing loss. This test uses different frequencies and volumes of sounds to determine a person’s specific hearing ability.

Treatment options for hearing loss

The choice of appropriate treatment for hearing loss depends heavily on the specific type and degree of hearing loss a person is experiencing. Various therapeutic measures are available that aim to improve an individual’s ability to perceive sound and thus enhance their quality of life.

One of the most common solutions for people with hearing loss, particularly sensorineural hearing loss, is the use of hearing aids. Hearing aids are high-tech devices that pick up sound waves and amplify them so that they can be more easily perceived by the parts of the ear that are still functioning. They can be individually tailored to a person’s specific hearing needs, with different models available for varying degrees and types of hearing loss.

In cases of severe hearing loss where hearing aids are insufficient, a cochlear implant may be a possible option. Cochlear implants are advanced medical devices that are surgically inserted into the ear and use electrical impulses to take over the function of the damaged or non-functioning parts of the inner ear. These impulses are then sent directly to the auditory nerve, thereby bypassing the damaged areas and enabling the brain to receive sound information.

In some cases, other treatment options may also be available. These include surgical procedures to treat certain types of conductive hearing loss, drug therapy to treat certain types of hearing loss caused by infections or inflammation, and audiological rehabilitation, which offers techniques and strategies to improve hearing skills and communication abilities.

Support in everyday life: TV hearing amplifiers

Another innovative solution for improving hearing quality in everyday life is TV hearing amplifiers such as the OSKAR from faller audio. Thanks to special dialogue optimisation, the OSKAR enables users to better understand dialogue and speech on the television, making it the perfect complement to a hearing aid. This means that watching television becomes a relaxed and enjoyable experience once again, even for people with hearing loss.