What Is Hearing Loss?

How hearing works

Hearing begins when sound waves travel through the ear canal and make the eardrum vibrate. Those vibrations move through the middle ear to the inner ear, where the cochlea converts them into electrical signals. The auditory nerve carries those signals to the brain, which interprets them as sound.

A problem anywhere along this pathway can affect hearing. That is why a professional evaluation may include questions about symptoms and health history alongside carefully selected hearing tests.

The three main types of hearing loss

Conductive hearing loss happens when sound cannot travel efficiently through the outer or middle ear. Earwax buildup, middle-ear fluid, ear infections, a perforated eardrum, or changes involving the small middle-ear bones can contribute. Some causes may be medically treatable.

Sensorineural hearing loss involves the inner ear, especially the sensory cells of the cochlea, or the auditory nerve. Aging, repeated loud-noise exposure, some medications, genetic factors, illnesses, and injuries can contribute. It is often permanent, though hearing technology and rehabilitation can help many people communicate more effectively.

Mixed hearing loss is a combination of conductive and sensorineural hearing loss. For example, someone may have an underlying inner-ear hearing loss as well as a condition affecting the outer or middle ear.

Common causes and signs

Age-related hearing loss is common, and repeated or intense exposure to loud sounds can cause noise-induced hearing loss. Hearing changes can also be associated with genetics, infections, head injuries, certain medications, and conditions involving the ear or auditory system. Hearing loss can affect people at many stages of life, not only older adults.

Signs may include asking people to repeat themselves, increasing television or phone volume, struggling to follow conversation in restaurants, feeling that people are mumbling, missing alerts or doorbells, relying on visual cues, or avoiding social situations because listening takes more effort. Feedback from family or friends can be another important reason to seek an evaluation.

How hearing loss is evaluated

A hearing professional can assess hearing through a conversation about your concerns, an ear examination, and hearing tests. Testing can show how you detect different pitches and sound levels and can help describe the degree and type of hearing loss.

Depending on your symptoms and results, additional testing or medical evaluation may be recommended to better understand a possible cause. An online hearing check can raise awareness, but it cannot inspect the ear, control the testing environment, or replace a diagnostic evaluation.

Treatment and support options

The right approach depends on the type, degree, and possible cause of hearing loss. Some ear conditions may need medical treatment or safe earwax removal. Hearing aids, over-the-counter hearing aids for eligible adults with perceived mild to moderate hearing loss, cochlear implants for some people with severe-to-profound loss, assistive listening technologies, communication strategies, and rehabilitation may also be discussed.

A hearing evaluation does not obligate you to choose a device or treatment. A good care conversation should connect your results with the situations that matter to you, such as work meetings, family meals, phone calls, music, and time in noisy places.

When to seek prompt medical care

Sudden hearing change or loss should not be ignored, especially if it affects one ear. Seek prompt medical evaluation for sudden hearing changes, particularly with dizziness, ear fullness, or tinnitus. Sudden sensorineural hearing loss can develop over hours or several days and may be time-sensitive.

Seek urgent or emergency care for hearing changes accompanied by severe dizziness, weakness, facial drooping, confusion, trouble speaking, a severe headache, difficulty walking, or a significant head or ear injury. This article cannot assess symptoms or provide a diagnosis.