Hearing loss is a serious health problem that can negatively affect individuals’ daily lives. Various functional disorders in the ears or auditory nerve pathways can lead to this condition. Additionally, external factors such as diseases, medications, or environmental influences can trigger hearing loss. Genetic predisposition is, by itself, a very important factor.

Doctor Audiologist Emel Uğur

Dr. Audiologist Emel Uğur was born in 1982 in Çanakkale. During her 15-year tenure at Istanbul Training and Research Hospital, she primarily worked on Pediatric Audiology (Hearing Loss in Infants and Children), Otological Diseases (Ear Diseases and Hearing Health), and Vestibular System Disorders (Vertigo and Imbalance). In 2015, she joined the Acıbadem Healthcare Group.

About Me

What is Hearing Loss?

Hearing loss is the inability to process sounds correctly or a reduction in hearing sensitivity. This condition results from various disorders in the anatomical structure of the ear and the auditory pathways. Functional impairments usually occur due to the following reasons:

• Anatomical problems: congenital structural abnormalities, benign or malignant tumors or infections and their sequelae, acquired anatomical disorders (calcifications, dislocations, etc.)
• Physiological factors: imbalances in body fluids and electrolytes.
• Physical effects: high sound levels or pressure changes, traumas
• Chemical causes: certain medications.

Hearing loss is prevalent in the general population and is not exclusive to any age group. It can occur at any moment in life due to various causes. Prolonged exposure to high noise levels, traumas, etc., are other important factors that trigger hearing loss. Hearing loss is known as a reduction in sound perception, either partial or complete. The greater the degree of hearing loss, the higher the level of impairment, thereby reducing an individual’s hearing capacity.

What are the Causes of Hearing Loss?

Damage occurring in the hearing organs or auditory pathways can trigger this condition. Hearing loss can sometimes be linked to genetic factors; it is more common in individuals with a family history of hearing issues. As one ages, natural changes in the inner ear structure can lead to hearing loss. Additionally, certain diseases may also affect hearing ability:

• Chronic middle ear infections,
• Abnormal bone growth in the inner ear,
• Inner ear disorders such as Meniere’s disease.

Exposure to high sound levels can also accelerate hearing loss. Working in noisy environments for extended periods increases this risk. Medications and medical treatments can sometimes cause hearing loss. Chemotherapy and certain antibiotics can damage sensory cells.

What are the Types of Hearing Loss?

Hearing loss occurs in various forms, and each type has a different treatment approach. First, conductive hearing loss is considered:

• Conductive hearing loss: It results from the inability of the external or middle ear to properly transmit sound. Ear infections or foreign objects can cause this condition. This type is generally treated with medication or surgical intervention.

The second type is sensorineural hearing loss:

• Sensorineural hearing loss: It occurs due to damage in the inner ear or issues with the auditory nerves. This is the most commonly observed type and can be caused by factors such as aging, exposure to loud sounds, diseases, or the side effects of certain medications.

Finally, mixed hearing loss should be considered:

• Mixed hearing loss: This is a combination of both conductive and sensorineural hearing losses. It is characterized by the coexistence of issues from both types.

How is Hearing Loss Diagnosed?

The first step is a detailed physical examination. During this process, ENT specialists perform a physical exam and, if there is a condition such as earwax that might interfere with testing, they address it by performing earwax aspiration. Some findings considered during the otoscopic examination include:

• Earwax adherent to the tympanic membrane,
• Foreign objects in the ear canal,
• Inflammation of the eardrum or external auditory canal,
• Perforations in the eardrum or inflammatory fluid accumulated behind the eardrum.

Following these observations, various auditory tests are performed to determine the degree and type of hearing loss. These tests include:

• Pure tone audiometry,
• Speech audiometry,
• Tympanometry,
• Acoustic reflex tests,
• Otoacoustic Emissions, etc.

With these tests, air and bone conduction, speech comprehension levels, middle ear pressure, and the acoustic responses of the stapedius muscle are evaluated.

What are the Causes of Sudden Hearing Loss?

Sudden hearing loss generally occurs as a result of exposure to high-intensity sounds. Such sounds may originate from sources like heavy machinery, concerts, or gunfire. Many factors, such as infections or metabolic disorders, can lead to sudden hearing loss. However, there isn’t always an identifiable cause; sometimes the cause cannot be determined. The symptoms of sudden hearing loss appear rapidly and can sometimes lead to permanent damage. Therefore, it is treated as an audiological emergency. On the other hand, some cases result in temporary hearing loss and can improve with appropriate intervention.

The common causes of sudden hearing loss are as follows:

• Listening to loud music
• Use of heavy machinery
• Use of firearms
• Tumors
• Infections

Is Surgical Treatment for Hearing Loss Possible?

Not every type of hearing loss has a medical or surgical solution. However, in cases where there is a loss of function in the middle ear ossicles (due to calcification, dislocation), passive middle ear prostheses can be applied. This method is especially preferred when the malleus, incus, and stapes are damaged due to infection or calcification. In sensorineural hearing losses, the primary treatment is the use of hearing aids. In advanced and profound hearing loss, various implantation methods, starting with cochlear implants, are employed. The placement of an implant that directly transmits sound to the auditory nerve can significantly improve hearing function.

What Measures Can Be Taken to Prevent Hearing Loss?

Noise is one of the greatest threats to hearing health. Therefore, it is very effective to use ear protection when in noisy environments. Additionally, it is beneficial to avoid venues and entertainment places where loud music is played as much as possible.

• Use ear protectors in noisy places.
• Stay away from noisy venues and entertainment places.
• If tinnitus occurs after noise exposure, be sure to consult a hospital and obtain an audiological evaluation.
• Undergo hearing tests at regular intervals.

Frequently Asked Questions

Which type of hearing loss cannot be treated?

Sensorineural (neural) hearing losses cannot be treated medically. In such types of hearing loss, there is irreversible permanent damage to the hair cells in the inner ear. Because nerve cells cannot regenerate, there is no treatment for these types of hearing loss. However, secondary problems resulting from hearing loss can be managed with hearing aids and implants. The range of causes for sensorineural hearing loss is wide; it can be genetic, or it may result from viral infections, acoustic trauma, head injuries, medications, or chronic inner ear conditions such as Meniere’s disease. Even age-related changes alone can be a direct cause of hearing loss.

Can hearing loss be stopped?

In cases of noise-induced hearing loss, particularly in temporary threshold shifts, sudden hearing loss, and in the early stages of endolymphatic hydrops/Meniere’s disease, if treatment is initiated within 72 hours of the onset of hearing loss, it is sometimes possible to regain hearing. However, this is not the case for all types of hearing loss.

Even when the progression of hearing loss cannot be prevented, prompt initiation of hearing aid use helps preserve the individual’s auditory processing abilities. Thus, even if hearing loss worsens, the ability to understand what is heard continues to be maintained. The earlier hearing aid use is started, the less the cognitive and psychosocial effects; it is not merely about saving the day but making long-term investments.

What is the decibel level of a 40% hearing loss?

Because sound intensity is a logarithmic variable, hearing loss cannot be measured in percentages. Therefore, international classifications used worldwide define the degree of hearing loss as “very mild, mild, moderate, moderately severe, severe, and profound.” Although approximations such as 40%-60% may be used for ease of understanding by patients, hearing loss is never evaluated in percentage terms in any official medical report or academic platform.

When evaluating hearing loss, the arithmetic average of the patient’s minimum hearing level (hearing thresholds) is calculated. This calculation roughly determines the degree of hearing loss. Additionally, the audiometric configuration, which indicates at which frequency and level the hearing loss occurs, helps analyze the auditory handicap associated with the hearing loss.

At what level of hearing loss is a hearing aid prescribed?

The effects of hearing loss are individual. The patient’s hearing test results are not the sole determinant. In addition, the patient’s age, cognitive development, academic performance, and social life are taken into account when prescribing a hearing aid.

Contrary to popular belief, using a hearing aid when hearing loss is mild does not worsen the condition. If hearing loss is going to progress, it will, and it cannot be stopped. To prevent and/or reduce its effects, a hearing aid is prescribed even for mild hearing loss.

For infants and children with hearing loss, if the hearing loss is permanent, a hearing aid is provided immediately. This ensures that their language development can progress in line with their peers. In children, since proper and adequate learning cannot occur without hearing, a hearing aid is prescribed based on their academic performance. A hearing aid is essential for our infants and children to reach their full potential. If we want to raise children who are self-sufficient and can express themselves accurately and effectively, hearing aids should be provided as soon as hearing loss is detected.

In adulthood, hearing loss can occur due to various reasons. It is commonly believed that mild hearing loss does not require a hearing aid; however, it should be remembered that most audiological tests are conducted in silence. Real life is noisy. Therefore, test results reflect optimal hearing conditions. Based on various characteristics, including the audiometric configuration, a hearing aid may be prescribed even for mild hearing loss.

It is undisputed that if hearing loss is moderate or greater, the individual cannot hear everyday conversations. Therefore, hearing aid use is initiated immediately.

Can one retire due to hearing loss?

It is possible to retire due to hearing loss, but certain specific conditions must be met. The hearing loss must be at a very advanced level and uncorrectable by surgery or hearing aids. Health reports must confirm this condition. Additionally, a disability rate of 40% or higher is required. Once a disability report is obtained, one can apply for disability retirement. The reports and the documented disability rate are of great importance in this process.