Hypoacusis, or hearing loss, is a hearing condition affecting millions of people worldwide. It’s a reduced ability to hear, which can be partial or total, in one or both ears. This health problem doesn’t just affect a person’s ability to communicate — it can also affect their emotional and social wellbeing, leading to isolation and a lower quality of life.
In this article, we’ll explain in detail what hypoacusis is, its main causes, the most common symptoms, and the various treatment options available for improving hearing.
What is hypoacusis?
Hypoacusis is a hearing disorder involving a loss of hearing sensitivity, which can be mild, moderate, severe or profound, depending on the degree of loss. This condition can develop gradually over time, or appear suddenly, and affects people of all ages, although it’s more common in older people.
Unlike deafness, which involves a total loss of hearing, hypoacusis can still allow affected people to perceive certain sounds, although with less clarity or volume.
When we talk about hypoacusis, whatever the type, sounds that used to be heard clearly fall, in some cases, above the person’s hearing threshold, and depending on the degree, will be perceived with less clarity or volume — although in the most severe cases they stop being perceived altogether.
Classification
Hypoacusis is classified by the type of hearing loss and the part of the ear affected:
- Conductive hearing loss: This type occurs when there’s difficulty getting sound to pass through the outer or middle ear towards the inner ear. This can be due to physical blockages, such as earwax build-up, middle ear infections (otitis), a perforated eardrum, or congenital ear malformations. It’s more common in children and, in many cases, can be successfully treated with medication or surgery.
- Sensorineural hearing loss: This type of hearing loss results from damage to the inner ear (cochlea) or to the auditory nerve that carries sound signals to the brain. The most common causes include ageing (presbycusis), prolonged exposure to loud noise, viral infections, autoimmune diseases, and certain ototoxic medications. Sensorineural hearing loss is usually permanent and, although it can’t always be reversed, it can be managed with devices such as hearing aids or cochlear implants.
- Mixed hearing loss: As the name suggests, this type combines elements of both conductive and sensorineural hearing loss. In other words, there are problems in both the middle ear and the inner ear, which makes diagnosis and treatment more complex.
Causes of hypoacusis
Hypoacusis can be caused by many different factors, some of which are avoidable, while others result from medical or hereditary conditions. Here are the most common causes of hypoacusis:
- Congenital and genetic factors: Some people are born with hypoacusis due to genetic factors or problems in ear development during pregnancy. Maternal infections such as rubella, the use of certain medications during pregnancy, or complications during birth can also cause hypoacusis in newborns.
- Ageing: Age-related hearing loss, known as presbycusis, is one of the most common forms of hypoacusis. As we age, the hair cells in the inner ear, responsible for transmitting sound to the brain, can deteriorate, leading to a gradual loss of hearing.
- Noise exposure: Prolonged exposure to loud noise, such as that produced by heavy machinery, concerts, headphones at high volume, or firearms, can damage the cells of the inner ear, resulting in sensorineural hearing loss. This type of hearing loss builds up over time and is often irreversible.
- Ear infections: Recurring middle ear infections (otitis media) can cause fluid build-up or scarring on the eardrum, interfering with sound transmission and potentially leading to conductive hearing loss.
- Ototoxic medications: Certain medications, including some antibiotics, chemotherapy drugs and anti-inflammatories, can be ototoxic — meaning they can damage the inner ear and cause hypoacusis.
- Trauma and injuries: A head injury, a perforated eardrum, or exposure to a very loud sound (such as an explosion) can cause immediate, severe hearing loss.
Symptoms of hypoacusis
Symptoms of hypoacusis can be subtle at first and worsen over time. It’s important to watch for the following signs, which could indicate hearing loss:
- Difficulty following conversations: People with hypoacusis often struggle to understand speech, especially in noisy environments. They may feel that others are speaking quietly or that words are blurring together, which means they often have to ask for things to be repeated.
- Turning up the volume on electronic devices: It’s common for people with hypoacusis to need to turn up the volume on the TV, radio or phone more than usual to hear clearly.
- Tinnitus (ringing in the ears): Tinnitus, or the perception of ringing or buzzing sounds in the ears, is a common symptom associated with hypoacusis, especially the sensorineural type.
- Social isolation: Because of the difficulty communicating, people with hypoacusis may avoid social gatherings or group activities, which can lead to feelings of loneliness and depression.
- Dizziness or unsteadiness: Although less common, some people may experience balance problems or dizziness, especially if the hearing loss is related to inner ear problems.
Diagnosis and treatment
Early diagnosis is essential to prevent further hearing deterioration and improve quality of life. A hearing specialist, such as an audiologist, carries out a complete hearing assessment to determine the degree and type of hearing loss. Common tests include:
- Pure-tone audiometry: This test measures, via both air and bone conduction, the patient’s ability to hear tones at different frequencies and intensities, helping determine the level of hearing loss.
- Impedance testing, tympanometry and the stapedial reflex: Assesses middle ear function, checking the mobility of the eardrum and the tiny ear bones. The stapedial reflex is the inner ear’s natural protection against loud sounds, which lets us check for problems in the movement of the ossicular chain when the ear is stimulated with a loud sound.
- Video-otoscopy: Allows assessment of the ear canal and eardrum, and checks for wax or blockages.
- Speech audiometry: A test to check the patient’s understanding, to see whether higher volume improves understanding or triggers recruitment — where understanding actually gets worse.
- Uncomfortable Loudness Level (UCL): Measures the volume level at which a sound becomes uncomfortable for the patient. This is a very important test for properly fitting hearing aids.
Treatment options
Treatment for hypoacusis depends on the type and severity of the hearing loss.
Options include:
- Hearing aids: These are the most common treatment for moderate sensorineural and conductive hypoacusis. Modern hearing aids are digital devices that amplify sound and are designed to adapt to each person’s specific hearing needs.
- Cochlear implants: Recommended for people with severe or profound hypoacusis who don’t respond to hearing aids. Cochlear implants are electronic devices that directly stimulate the auditory nerve, providing a sensation of sound.
- Surgery: In cases of conductive hypoacusis caused by physical blockages or ear malformations, surgery can be an effective option. For example, inserting ventilation tubes (grommets) in the middle ear to drain fluid in cases of chronic otitis media.
- Hearing rehabilitation: Includes therapies and programmes that help people with hypoacusis adapt to their hearing loss, improve their communication, and better manage their environment.
- Medical treatment: In cases of ear infections or inflammatory conditions, treatment with antibiotics or steroids may be needed to prevent further hearing damage.
Hypoacusis is a common condition that can have a significant impact on the daily lives of those affected. However, with early diagnosis and proper treatment, it’s possible to improve hearing and quality of life. If you suspect you might have hypoacusis, or notice any symptoms in a loved one, don’t hesitate to seek help at a specialist hearing centre. Timely treatment can make a real difference to your hearing health and overall wellbeing.
At our hearing centre in Valencia, our team of specialists is ready to carry out a complete hearing assessment and offer you the best personalised solutions to improve your hearing.
Don’t let hearing loss affect your quality of life. Come and meet us at C/ Juan Llorens 7 and discover how we can help you hear better every day.
