Hearing loss is always a symptom of a disease of the hearing organ. It can be acute or chronic. Around one fifth of the adult population suffers from hearing loss.
The ear consists of three parts:
- the outer ear
- the middle ear and
- the inner ear
The outer ear comprises the pinna and the external auditory canal.
The pinna receives sound from the environment and transmits it to the middle ear via the auditory canal. This is where the eardrum and the three auditory ossicles - the malleus, incus and stapes - and the middle ear cavity are located.
When the sound from the external auditory canal hits the eardrum, it begins to vibrate. The eardrum transmits the vibrations to the ossicles, which pass them on to the inner ear.
The inner ear contains the cochlea, also known as the cochlea, and the internal auditory canal. The auditory canal transmits the vibrations to the cochlea, where they trigger different excitations depending on the pitch of the sound. These then reach the auditory cortex of the brain via the auditory nerve. This evaluates the impulses.
The human ear @ bilderzwerg /AdobeStock
Hearing loss can have different causes.
Experts distinguish between:
- conductive hearing loss
- sensorineural hearing loss and
- sound processing hearing loss
In this form, the transmission of sound from the outer ear to the inner ear does not work.
This can have various causes.
Acute triggers
- Blockage of the ear canal (e.g. due to earwax)
- Inflammation in the ear canal
- Tearing or puncturing of the eardrum (e.g. due to ear cleaning)
- Interrupted connection between the ossicles (e.g. due to injuries in the middle ear)
Chronic triggers
- Congenital sound conduction disorder (e.g. due to maldevelopment of the pinna, auditory canal or middle ear)
- Increased bone growth in the ear canal
- Chronic inflammation of the middle ear
- Otosclerosis (fixation of the stapes due to inflammatory remodeling processes)
- Change in the middle ear mucosa (e.g. due to a chronic ventilation disorder of the eustachian tube)
- Narrowing of the ear canal (e.g. due to scars or inflammation)
- Tumors in the ear canal
With this type of hearing loss, the inner ear no longer processes sound correctly.
Acute triggers
- sudden hearing loss
- High noise above 140 decibels
- Infections that also affect the inner ear (e.g. meningitis, AIDS, measles or blood poisoning)
- Side effects of medication
- Damage to the inner ear (e.g. due to skull fracture)
- Rupture of the membranes between the middle ear and inner ear
- Stressful situations
Chronic triggers
- Congenital malformations
- Exposure to noise above 85 decibels for several hours a day
- Various diseases (e.g. kidney and thyroid dysfunction or diabetes mellitus)
- Meniere's disease (increased pressure in the inner ear and resulting damage to the sensory cells)
In this form, the brain can no longer properly process the signals coming from the ear.
There can also be various causes for this:
Hearing loss can vary in severity. The degree can be determined according to the volume and pitches that the affected person can no longer hear.
Hearing loss is only present from a hearing loss of 20 decibels. If the hearing ability deviates less than 20 decibels from the normal hearing threshold, experts still speak of normal hearing loss.
Minor hearing loss is associated with a hearing loss of around 20 to 40 decibels. As a result, those affected can no longer hear the ticking of a wristwatch, for example.
In the case of moderate hearing loss, the hearing loss is around 41 to 60 decibels. This means that those affected can no longer hear ambient noises properly, such as birdsong.
A hearing loss of 61 to 80 decibels is referred to as severe hearing loss. The person affected can no longer hear conversations.
If the hearing loss is over 81 decibels, this is residual hearing or deafness. The person affected can then no longer hear even very loud noises, such as music at a concert.
Woman with hearing aid behind the ear @ studioworkstock /AdobeStock
If the hearing loss occurs suddenly and with other symptoms such as pain or fever, you should see a doctor.
The ear, nose and throat specialist is responsible for this. It is also important to consult a doctor if the hearing loss progresses slowly. If the brain no longer receives the affected impulses for a longer period of time, it will forget how to process them. Then even hearing aids no longer help.
The first step in the diagnosis is for the doctor to take a medical history (initial consultation). He will ask you about previous illnesses and your current living conditions in order to find out what has caused the hearing loss.
He will then carry out various tests, such as the tuning fork test, to examine the auditory canal. He will also determine which pitches you can still hear.
The treatment of hearing loss depends on the causes:
If the ear canal is blocked by earwax, for example, cleaning will help . The ENT specialist can use a suction device for this. If the eardrum is intact, the ear canal can also be rinsed out with warm water.
If an infection is the cause of the hearing loss, you will be given medication. Antibiotics are used in the case of a bacterial infection.
If there is swelling in the inner ear, you will be given decongestant medication.
In some cases, surgery is necessary. This is the case if, for example, the eardrum is defective or the stapes is not working properly. A surgeon can cover the eardrum with the body's own muscle skin and replace the stapes with an adapted prosthesis.
If the hearing loss is irreversible, for example in the case of age-related or noise-induced hearing loss, only a hearing aid can help .
There are behind-the-ear devices and in-the-ear devices. The latter are only suitable for people with mild to moderate hearing loss. They are very small and barely visible.
A behind-the-ear device is used for severe hearing loss. Although these are somewhat more conspicuous due to their position, very discreet versions are now also available.
