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Types and causes of hearing loss.

Find out what could be causing your problem.

Different types of hearing loss

The human ear is a marvelous organ. It’s parts include 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 (e.g. using hearing aids) depends on what causes 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

Anatomy of the ear

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

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 (loud noises, etc.). 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.

Poisoning of the nerve cells (ototoxicity)

"Ototoxicity" means a harmful substance (for example, certain drugs) 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 (e.g. a car backfire 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 kinds of situations.

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 (e.g. swabs, debris, etc.)

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/s by a specialist.

Caution: Do not try to unblock your ears with cotton swabs. 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 due to water contaminated with germs (e.g. 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 ENT specialist.

Middle Ear


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.

Eardrum perforation (hole in the eardrum)

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

Treatment: Injuries to the eardrum often heal by themselves. For this to work, the ear must be kept dry even when 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 (connects nasal cavity to ear). These infections can severely impair hearing.

Treatment: Drug treatment by your GP or an ENT specialist.

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