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Hearing Loss: Types, Causes and Treatments


At Santa Cruz Ear, Nose and Throat Medical Group, we understand how important hearing is to your quality of life. That’s why our professionals take your hearing health seriously. When you visit our office, we work to treat your hearing loss from start to finish. Understanding the different types and causes of hearing loss help us find you the best treatment!

Hearing loss is a common disorder caused by a variety of factors including noise, aging, disease and heredity. Hearing is an intricate sense involving the ear's ability to detect sounds and the brain's ability to interpret those sounds as meaningful. Factors that determine how much a person’s quality of life is negatively impacted by hearing loss include:

  • Degree of the hearing loss
  • Configuration of the hearing loss across different frequencies
  • Whether impairment is in one or both ears
  • Areas of the auditory system not functioning normally—e.g. the middle ear, inner ear, neural pathways or brain
  • Ability to recognize speech sounds
  • History of exposures to loud noise or harmful environmental/drug toxins
  • Age

Symptoms of hearing loss

Early signs hearing loss can be subtle and develop slowly, or hearing loss can be considerable and occur suddenly. Either way, there are common indications and signs of impaired hearing. It is important to identify hearing loss as soon as possible because early treatment is often more beneficial.

You should suspect hearing loss if you …

  • Frequently ask people to repeat themselves
  • Find conversations involving more than 2 people difficult to follow
  • Find it difficult to tell which direction noise is coming from
  • Think that other people sound muffled or like they're mumbling
  • Have difficulty hearing in noisy situations – e.g. restaurants, malls, conferences or crowded meeting rooms
  • Have trouble hearing women’s and children’s voices
  • Listen to TV or radio at a volume higher than others need
  • Answer or respond inappropriately in conversations
  • Have ringing, buzzing or whistling sound in your ears, i.e., tinnitus
  • Read lips or intently watch people's faces when they speak to you
  • Regularly feel tired or stressed from having to concentrate while listening

Three types of hearing loss

Hearing loss can either be conductive, involving to the outer or middle ear, or sensorineural, affecting the inner ear or auditory nerve. Some people suffer from both, which is called a mixed hearing loss.

Conductive hearing loss

Conductive hearing loss is due to problems with the ear canal, eardrum, or middle ear and its three tiny bones (the malleus, incus and stapes). A conductive hearing loss occurs when there is a problem conducting sound from the external and middle ear into the inner ear.

Causes of conductive hearing loss

One of the most common causes of conductive hearing loss is a blockage in the external ear, usually caused by a wax (cerumen) buildup in the ear canal. Other causes of conductive hearing loss can be infections in the ear canal such as swimmer’s ear, a perforated or ruptured eardrum, cysts and tumors, or foreign objects in the ear canal.

In the middle ear conductive hearing loss often occurs due to chronic middle ear infections, or ‘glue ear’ where fluid builds up in the middle ear, so the eardrum cannot move. Conductive hearing loss can also be caused by diseases or damage in the middle ear.

Treatment of conductive hearing loss

Most problems that result in conductive hearing loss are temporary and can be cured with appropriate medical treatment, so it is important to seek medical attention as soon as possible.


Sensorineural hearing loss (SNHL)

Sensorineural hearing loss is due to problems of the inner ear. It is also known as nerve-related hearing loss and results from damage to the tiny hair cells in the inner ear (cochlea).

Causes of sensorineural hearing loss

Causes of SNHL can be age, noise and diseases. Everyone loses the tiny hair cells in the cochlea throughout life, while hearing gradually decreases. However, the hair cells can also be damaged by excessive noise. Sensorineural hearing loss is becoming more common

as a result of prolonged exposure to high intensity noise either in the work environment or from listening to loud music. You can also suffer from sensorineural hearing loss following diseases such as mumps, meningitis, multiple sclerosis, Meniere’s disease or if you have taken certain drugs.

Sensorineural hearing impairment may also occur if your mother had rubella (German measles) during pregnancy, or if your birth rate was unusually low. Sensorineural hearing loss can also be inherited and you may lose your hearing ability due to head/ear injuries. If you experience a sudden sensorineural hearing loss (or any sudden hearing loss) you should contact a physician immediately.

Treatment of sensorineural hearing loss

Sensorineural hearing loss is permanent, but most people find hearing aids quite beneficial.


Mixed hearing loss

A mixed hearing loss is a combination of conductive and sensorineural hearing loss. With a mixed hearing loss there is damage to the outer and middle ear’s ability to conduct sound to the inner ear and the brain, and damage to the inner ear or auditory nerve.

Causes of mixed hearing loss

There are several causes of mixed hearing loss, including Illness, drugs, genetic causes, head trauma and/or malformation of the inner ear.

Treatment of mixed hearing loss

The conductive hearing loss can often be corrected with medical or surgical treatment while the sensorineural component is usually managed with hearing aids. If you think you have a mixed hearing loss you should seek medical advice.


What is noise-induced hearing loss (NIHL)?

Sounds can be damaging when they are too loud, even for a short period of time, or when they are both loud and prolonged. NIHL can be immediate or it can take a long time to be noticeable. It can also be temporary or permanent, and it can affect one ear or both ears. Recreational activities that can put you at risk for NIHL include:

  • Target practice and hunting
  • Snowmobiling
  • Listening to music at high volume through ear buds or headphones
  • Playing in a band or attending loud concerts

Harmful household noises may come from sources including lawnmowers, leaf blowers and workshop tools. Regardless of how it might affect you, one thing is certain: noise-induced hearing loss can be prevented!

Hearing conservation

Exposure to loud noise will inevitably cause hearing loss over time. Loud noise damages or destroys the nerves in the inner ear and is oftentimes accompanied by “tinnitus” or permanent ringing in the ear.


Audiometric testing

As we age, many people develop a mild hearing loss, mostly in the higher pitches (frequencies). Annual audiometric testing by an audiologist or qualified hearing care professional can detect early stages of hearing loss; a severe or significant hearing loss can indicate excessive noise exposure. Test results show hearing level at different pitches or frequencies, including those of the human voice. The second and subsequent tests are compared to the first year’s results or baseline.


Protecting your hearing from noise

The use of proper hearing protection can help reduce the damage caused by noise exposure. Hearing protection comes in a wide variety of styles ranging from very basic over-the-counter earplugs and earmuffs, to custom-fit hearing protection. Invest in quality custom earmolds or other protective devices recommended by an audiologist or hearing care provider; wear them anytime will potentially be exposed to loud noise. Some situations when you should wear hearing protection include attending concerts or sporting events, shooting firearms, working around machinery, using power tools and mowing the lawn.

If you’re ready to take control of your hearing health, call our office to schedule your visit today! Our professionals are ready to help you on your journey to better hearing.