Types and causes of hearing loss

Understand more about causes of hearing loss

Types of hearing loss

The human ear is made up of the outer ear, the middle ear, the inner ear and the auditory nerve. Hearing loss can be due to problems in any of these areas.

Depending on the type of hearing loss, your symptoms may include tinnitus, noise sensitivity or dizziness. Hearing loss is almost always permanent, and it’s hard to predict how it will develop. The treatment or correction of hearing loss by technical means (such as using hearing aids) will depend on what has caused your hearing loss in the first place.

“Not being able to see isolates you from objects. Not being able to hear isolates you from people.” Immanuel Kant

Did you know?

Hearing loss isn’t always age-related. It can also be caused by loud noise, infection, poisoning, injury or genetic factors. Read more interesting facts about hearing and hearing loss.

What’s causing my hearing loss?

A list of possible causes of hearing loss for each area of the ear.

Inner ear

Poisoning of the nerve cells (ototoxicity)

“Ototoxicity” means a harmful substance (for example, certain drugs) has caused damage to your inner ear. This usually affects special sensory cells or nerves related to hearing and balance.

Treatment: Since nerve cells are affected, ototoxicity usually leads to permanent damage. A hearing aid can be beneficial to someone with this type of hearing loss.

Acoustic trauma

Acoustic trauma occurs when a very loud noise damages the inner ear (such as a car backfiring or an explosion). Symptoms include feeling like your ears are blocked, hearing loss, and/or tinnitus.

Treatment: Normally, hearing may be restored within hours or days. Permanent damage is possible. A hearing aid is beneficial in these cases.

Age-related hearing loss (presbyacusis)

Age-related hearing loss starts for most people between the age of 45 to 65, and can be worsened by external factors such as loud noises. It usually affects high-frequency noise and typically occurs in both ears.

Age-related hearing loss is caused by damage to special cells (fine hair cells) in the part of your ear called the cochlea. This results in reduced sound signal transmission to the auditory nerve.

Treatment: This problem can’t be fixed by drug therapy or surgery. A hearing aid can make a big difference for someone with this type of hearing loss.

Outer ear

Foreign bodies in the auditory canal

An injury to the outer ear or blockage in the auditory canal can be caused by foreign bodies such as cotton buds or debris.

Treatment: Removal of the foreign body by a specialist.

Excessive earwax

Your auditory canal can be blocked by improper cleaning or excess earwax production. This can result in reduced hearing.

Treatment: Professional cleaning of the blocked ear or ears by a GP or hearing care professional.

Caution: Do not try to unblock your ears with cotton buds. This can push the earwax even deeper inside and cause more damage.

Inflammation of the outer ear (otitis externa)

Infections in the outer ear affect the external auditory canal and perhaps the auricle (outer part of your ear). Bacterial infections may be caused by water contaminated with germs (such as in indoor swimming pools). This is why it’s also sometimes called “bathing otitis”. It can lead to pain, itching and reduced hearing.

Treatment: Drug treatment of the infection by your GP or an ear, nose and throat (ENT) specialist.

Middle ear

Eardrum perforation (hole in the eardrum)

The eardrum is fragile and may be damaged by foreign bodies, infections (such as middle ear infection) or intense pressure (as experienced when diving). A perforation may also be caused by a blow to the ear or a loud bang. A hole in the eardrum can lead to hearing loss.

Treatment: Injuries to the eardrum often heal by themselves. For this to occur, the ear must be kept dry, even when showering and washing your hair. If the eardrum does not heal by itself, the perforation must be repaired by a surgical procedure.

Otitis media (middle ear infection)

Middle ear infection caused by viruses or bacteria can be very painful. Germs enter the ear through the bloodstream or through the eustachian tube (which connects the nasal cavity to the ear). These infections can severely impair hearing.

Treatment: Drug treatment by your GP.


Otosclerosis is a disease of the bone surrounding the inner ear. It leads to a process called ossification, which negatively impacts the mobility of the stapes (a tiny bone in your ear). The result is gradual hearing loss. This condition may be accompanied by ringing in the ears (tinnitus).

Treatment: Not medically treatable, but sometimes a surgical procedure may reduce the hearing loss.

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