What is hearing loss

Hearing loss is the inability to hear partially or totally in one or both ears. Generally, sound is indicated by 'frequency' and 'intensity'. In 'frequency', our ears can normally hear between 20 to 20,000 Hertz. When hearing threshold or the least hearing ability of a person is over 25 dB (decibel), then it can be termed as hearing loss or impairment. Hearing loss treatment involves diagnosis of the type and degree of hearing loss and based on the type and degree of hearing loss the treatment would be either medical or rehabilitative

Causes of hearing loss

We are regularly exposed to various types of sounds.
Hearing loss or problem can occur from one or multiple reasons; the most common factors as well as specific causes leading to hearing loss among adults and children are:
Children: Genetic; Prematuriy; Infection; Drugs
Adults: Noise induced; Ototoxic; Immune diseases; Heredity; Physical trauma; Ageing( Presbycusis)

Common symptoms of hearing loss

If hearing loss interferes with activities of daily living or if you have to frequently have to ask your conversation partner to repeat themselves, you might be on the verge of hearing loss


  • Do you require frequent repetition?
  • Do you have trouble following group conversations?
  • Do you have your TV /radio volume turned up to high?


  • Do you feel stressed out from straining to hear?
  • Do you feel annoyed because you can’t hear?
  • Do you withdraw from social situations?


  • Do you have a family history of hearing loss?
  • Do you take Medication?
  • Do you experience Tinnitus?
Types of hearing loss

The type of  hearing loss can be identified by  a professional Audiologist detecting the area or section of the ear  which is the cause

Conductive hearing loss

Hearing loss in the outer or middle ear is termed as conductive hearing loss which generally can be treated with medication; surgery  or the use of hearing aids.

Sensori-Neural hearing

This type of hearing loss is due to problems arising out of the inner  ear or Auditory nerve disorders.

Though it is a permanent problem, hearing restoration is possible with the help of medical treatment; surgery hearing aids or other hearing devices . The treatment will  be unique  to the condition.

Mixed Hearing loss

This is a combination  of Conductive and Sensori- Neural hearing loss.Here too,  hearing aids or other hearing devices can help in hearing restoration

Tinnitus- causes and treatment

This is the medical term for “ ringing in the ears.” It is the perception of sound in the ear in the absence of objective sound and may be heard in one ear or both.

It is often described as buzzing,whistling, roaring,humming, hissing or whooshing. It can be continuous or intermittent

Tinnitus is not generally a  serious medical condition but it can be very distressing and cause sleep disturbance

It is  not a disease but is a symptom resulting from a range of underlying causes. 

There is one type of Tinnitus that requires urgent medical attention and that is pulsatile tinnitus.

If nausea or dizziness accompany Tinnitus , visit your doctor

 Some causes of Tinnitus

  • It can result from foreign objects or wax in the external ear.
  • It is often associated with hearing loss and is more common in the elderly. However it may be a symptom in congenital hearing loss
  • People who have been exposed to loud noise and have incurred noise induced hearing loss are prone to Tinnitus
  • Injuries to the head and neck
  • Emotional distress
  • A side effect of certain medications may be Tinnitus

At the moment, there is no known permanent cure for Tinnitus –  but it can be managed .

What to do if you have Tinnitus

  • Consult and Ear, Nose and Throat surgeon or our GP
  • Visit your Audiologist- determine if you have a hearing loss which may explain the Tinnitus.
    • Very often hearing aids can help reduce the Tinnitus to manageable levels.
  • Take precautionary measures to avoid loud noise to protect your ears if you are in a noisy environment
  • Check your medication as it may be a side effect of the drugs you are taking and discuss this with your doctor
Prevention of hearing loss

One of the most common types of injuries that occur in the workplace is hearing damage.

It is often not noticed at first

There are legal requirements that are laid out by OSHA which covers occupational health exposure.

However it is not only the workplace that is of concern. People listening to very loud music (eg at concerts) for prolonged periods are also at risk. In addition listening to loud music with ear buds also puts one’s hearing at risk.

Hearing damage may not be noticeable at first. But is the one UNDISPUTED result of noise damage.

So- a simple warning : Turn the volume button LEFT to reduce the risk

 Two types of Hearing Hazards

  • Sudden loud noise
  • Prolonged loud noise

Sudden loud noise can cause immediate hearing damage  and often people are unable to prepare for it.

The closer one is to the  sound source the more damage it will cause.

Prolonged noise exposure  depends on how long and how loud the exposure is.

Exposure to noise over 85dB for 8 hours a day is dangerous and workers need to wear hearing protection and have annual hearing tests to monitor any changes

Noise protectors  such as earplugs or ear muffs are effective ways of protecting hearing.

There are many types on the market and should be chosen as the right type for the right situation

Types of substances which causes hearing loss

There are a number of substances that can have adverse effects on your hearing

The technical term is called  “Ototoxic” ie. they cause damage to the ear..Specifically, they damage the small hair cells within your ear

  • How does Hearing get affected?
    The  blood thins and that means the ears are supplied with less Oxygen
  • Some medications actively attack the hair cells in the Inner Ear
  • Nerves responsible for transporting signals from the ears to the brain can be targeted

Some Ototoxic substances are:

Tobacco or other nicotine products. Smoking has numerous effects on your ears eg compromising the blood needed by the auditory hair cells.

Alcohol has similarly destructive effects on the ear and hearing.. It impacts the cochlea which can compromise both hearing and balance.

As we know Alcohol can have deleterious effects on the brain over time with the Auditory Cortex being a frequent victim

Certain medications have ototoxic properties.


There are about 200 commonly prescribed ototoxic medications but they usually fall under certain categories eg chemotherapy agents or blood thinners.

There are others as well

Aspirin and Quinine are 2 of the most commonly available ototoxic medications

They are both blood thinners which means that the oxygen brought to your ears is lessened. This can asphyxiate hair cells.


This is a massive umbrella term , But aminoglycosides is especially known for Ototoxicity
Many chemotherapy agents can affect the inner ear hair cells which if damaged cannot be restored

Ear wax

Ear wax is a natural secretion of the glands of the ear.

It helps lubricate the ear and protect it from infection.

But if..

The ears are blocked with wax or there is ear pain; itching; ringing in the ears and hearing loss due to the wax being impacted it needs to be removed.

The wax needs to be removed by a professional trained to do so eg  doctor; audiologist; nurse .

Certain oils or drops may be prescribed to soften the wax before it is removed.

Frequently Asked Questions (Click on question to reveal the answer)

  • I have been told that Hearing loss is associated with deteriorating brain function. Can you please explain.

    As we get older, we may experience some level of decline in our mental functioning. It may be mild or more serious.  A normal part of aging includes forgetting details, taking longer to learn new things and difficulty paying attention. It may not be possible  to stop it — but  the literature tells us that we may be able to slow it down.

    By understanding the link between hearing loss and brain fitness can help you get started on the road to better overall health.

    Some suggested reasons  for this link are:

    1. One has to do with cognitive load. With untreated hearing loss, the brain gets overworked by constantly straining to understand speech and sound. An overworked brain doesn’t work efficiently.
    2. Another has to do with brain structure. Brain cells can shrink from lack of stimulation, including the parts of the brain that receive and process sound.
    3. The last theory is social isolation. When a person has trouble hearing conversations and socializing, they may prefer staying home instead. However, the more isolated a person becomes, the less stimuli their brain receives.
  • Are there any other conditions linked with hearing loss?

    Medical research links  Hearing loss with a variety of other conditions, including:

    Heart and cardiovascular disease


    Falling & Dizziness


  • What are common signs of hearing loss?

    • If people seem to be mumbling
    • Having difficulty hearing speech in a crowd or in background noise
    • Missing key words in a sentence
    • Not knowing where the sound is coming from
    • Needing to turn up the volume on your Tv/phone/radio
    • Asking people to repeat themselves
  • When is the best time for a hearing test?

    Sooner than you think – the biggest risk is not knowing . The earlier you treat hearing loss the better chance you have of  taking the steps to correct the problems you are facing

    Why? Because when the hearing nerves and the centre of the brain responsible for hearing is deprived of sound it begins to atrophy aka auditory deprivation. It then becomes more difficult to solve the problem.

  • Are hearing aids the best solution for hearing loss?

    Not necessarily= there are various kinds of hearing loss and each condition will require an individual solution- some will require medical intervention and some will require hearing aids

  • Is it easy to use hearing aids?

    It depends on many factors- age, motivation, type of hearing loss, level of technology, cognitive ability etc

    In general wearing hearing aids requires a period of adjustment. The  journey towards hearing health takes you  to a wonderful place. There may be obstacles along the way .But we will help you along the process. You will begin to get benefit immediately, but after two months you will realise just how much the quality of your life has improved.

    After 6 months you will be wishing you would have done it sooner

Our Hearing Matters At All Stages Of Life

Q: When is the right time for a hearing test?

A: Sooner than you think

Q: What is the biggest risk of hearing loss ?        

A: Not knowing that you have a hearing loss              

Q: Who needs a hearing test?           

A: Everyone 

Our hearing supplies us with vital information as well as causing us to experience emotions and recall memories. It enables us to enjoy the laughter of children, or the caring words whispered by a loved person either. Or what about nature’s comforting sounds: the evening song of a blackbird, the wind in the autumn leaves, the waves on the beach or the cracking sounds of a cosy bonfire

  • Babies learning to speak- if you can’t hear, you can’t learn to speak easily.
  • School going children- are at risk for ear infections .These may temporarily interrupt hearing but permanently impact on the learning process.
  • Teenagers- are at risk of noise damage due to listening to music at high volume
  • Working population- to ensure work efficiency
  • The ageing population-World Health Organisation tells us that “old age hearing begins at …age 39! Over the age of 65, hearing loss is the third biggest chronic condition.
  • For our own safety: When walking near busy roads; to be alert for a cry for help; To be able to hear sounds that alert to danger like sirens and other traffic signals
  • Social interactions : Chatting with friends, interacting with grandchildren; Talking on the phone; watching TV together with others, participating in dinner conversations at a restaurant

The good news

With wonderful technology there is help available. Connect with family and friends again

Be in touch, stay in tune and remain independent.

Don’t retire, rewire

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