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Types and causes of hearing loss.

The ear is a complicated and sensitive organ. It allows us to perceive noises and find our way around a particular space. If our ability to hear deteriorates, this has a corresponding adverse effect.

Different types of hearing loss

The cause of hearing loss can be manifested in various parts of the ear: the outer ear, the middle ear, the inner ear or even in the auditory nerve. Depending on the type of hearing loss, accompanying symptoms can include tinnitus, noise sensitivity or dizziness. In almost all cases, hearing loss is permanent and it is often difficult to predict how it will develop. Treatment possibilities and the option of correcting or at least reducing hearing loss by technical means (e.g. using hearing aids) are also very much dependent on its cause.

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

Anatomy of the ear

Possible hearing loss causes.

Here's a list of some possible causes of hearing loss based on different areas of the ear.

Age-related hearing loss (presbyacusis)
Age-related hearing loss starts for most people between the age of 45 to 65 and can be exacerbated by external factors (such as exposure to loud noises). Age-related hearing loss primarily affects the higher frequencies and usually occurs in both ears. It is caused by damage to the fine hair cells in the cochlea, leading to reduced signal transmission to the auditory nerve.
Remedy: Drug therapy or surgical treatment is not possible. However, a hearing aid can be of great assistance to someone with this type of hearing loss.

Poisoning of the nerve cells (ototoxicity)
Physicians use the technical term "ototoxicity" to denote the harmful effect of substances (for example, certain drugs) on the inner ear, in particular on the sensory cells of the hearing and balance organs, or the corresponding brain nerves.
Remedy: As nerve cells are affected, this is usually permanent damage. However, a hearing aid can be beneficial to someone with this type of hearing loss.

Acoustic trauma
Acoustic trauma is when there is damage to the inner ear by a very loud noise, e.g. a car backfire or an explosion. Symptoms associated with acoustic trauma include feeling like your ears are blocked, hearing loss and/or tinnitus.
Remedy: Normally, hearing is restored within hours or days. However, permanent damage is possible. A hearing aid is beneficial in these kinds of situations.

Foreign bodies in the auditory canal
An injury to the outer ear or blockage in the auditory canal can also be caused by foreign bodies.
Remedy: Removal of the foreign body by a physician.

Excessive earwax
The auditory canal can be blocked by improper cleaning or excess production of earwax, which can result in reduced hearing.
Remedy: Professional cleaning of the blocked ear/s by a physician.
Caution: Do not use cotton swabs as they can push the earwax even deeper into the ear and can cause further damage.

Inflammation of the outer ear (otitis externa)
Infections in the outer ear affect the external auditory canal and occasionally also the auricle. Bacterial infections are usually caused by water contaminated with germs (e.g. in indoor swimming pools). This is why it is also referred to as "bathing otitis". It can lead to pain, itching, and reduced hearing.
Remedy: Drug treatment of the infection by your GP or an ENT specialist.

Otosclerosis
Otosclerosis is a disease of the bone surrounding the inner ear. It leads to ossification through inflammatory processes and has a negative effect on the mobility of the stapes (the smallest human bone). The result is a gradual hearing loss. This condition is often accompanied by ringing in the ears (tinnitus).
Remedy: Not medically treatable however sometimes, a surgical procedure can reduce the associated hearing loss.

Eardrum perforation (hole in the eardrum)
The eardrum is sensitive and may be damaged by foreign bodies, infections (e.g. middle ear infection) or intense pressure (e.g. when diving). Sometimes a perforation is also caused by a blow to the ear or a loud bang. A hole in the eardrum leads to hearing loss.
Remedy: The good news is that injuries to the eardrum often heal by themselves. For this to work, the ear must be kept dry under all circumstances, even, for instance, when washing your hair. If the eardrum does not heal by itself, the perforation must be remedied by surgical procedure.

Otitis media (middle ear infection)
Middle ear infection caused by viruses or bacteria is usually very painful. Germs enter the ear via the bloodstream or from the nasal cavity through the Eustachian tube. Hearing is severely impaired during infection.
Remedy: Drug treatment by your GP or an ENT specialist.

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