Impaired hearing

Why does hearing loss occur?

Hearing loss can occur for many different reasons, and it can affect both adults and children. This means that you may have difficulty hearing normally, even when there is not a lot of background noise. There are several factors that can lead to hearing loss, and they can be temporary or permanent.

1. Age-related hearing loss (presbyacusis):

One of the most common causes of hearing loss is natural aging. As we age, the tiny hair cells in the inner ear that help us perceive sound can become damaged or die. This can lead to a gradual loss of hearing, especially at high frequencies, which can make it harder to understand speech.

2. Noise damage:

Prolonged exposure to loud noise, such as music, noise from machines or loud concerts can damage the hair cells in the inner ear. When these cells are damaged, they cannot regenerate, which can lead to permanent hearing loss. Noise damage is one of the most common causes of hearing loss among young adults.

3. Ear infections and fluid in the ear:

Temporary hearing loss can occur if there is fluid or inflammation in the middle ear, for example due to an ear infection. The fluid can prevent sound from reaching the inner ear and create a kind of "blockage" that makes it difficult to hear clearly. This can often be treated with medication or antibiotics.

4. Earwax:

Too much earwax in the ear can block sound from reaching the eardrum, which can lead to temporary hearing loss. Earwax can be safely removed by a doctor or ear specialist.

5. Injuries to the ear or head:

Trauma or injury to the ear or head can damage the structures responsible for picking up and sending sounds to the brain. If the damage affects the inner ear, auditory nerve or eardrum, it can lead to hearing loss.

6. Hereditary factors:

Some people are born with hearing loss or develop it later in life due to genetic factors. Hereditary diseases can affect the parts of the ear needed to pick up and process sound.

7. Medical Conditions:

Certain diseases and conditions, such as diabetes, high blood pressure or infections can affect hearing. In some cases, medications, especially certain antibiotics or chemotherapy drugs, can also have side effects that damage hearing.

8. Tumors and other diseases of the ear or brain:

Although rare, tumors or other growths in the ear or brain can affect hearing. This can be more serious and require medical treatment.

How can hearing loss be helped?

The treatment depends on the cause of the hearing loss. In some cases, hearing loss can be treated with medication, surgery or hearing aids. It is therefore important to have a thorough examination by a doctor if you experience hearing problems, so that the cause can be found and treated in the best possible way.

Conclusion:

Hearing loss can occur for many different reasons, from age-related hearing loss to infections or noise damage. If you experience problems with your hearing, it is important to get help quickly so that you can get the right treatment and possibly improve your quality of life.

Watch Sundhed.dk's animation film about what happens in the ear with hearing loss.

A doctor specializing in diseases of the ear, nose and throat (otolaryngologist) or an audiologist (hearing specialist) uses several different methods to examine for impaired hearing. The examination will typically involve both a thorough interview about your symptoms and a series of tests to assess how your ears are working. Here is a description of how the examination usually takes place:

1. Anamnesis (medical history)

First, the specialist will ask you about your symptoms and medical history. This may include questions such as:

- When did you start noticing problems with your hearing?

- Are there any specific situations where you have difficulty hearing (eg in noisy environments when talking to certain people)?

- Have you experienced ear pain, ringing in the ears (tinnitus), dizziness or other symptoms that could be related to your hearing problems?

- Is there any family history of hearing loss or other ear problems?

- Have you been exposed to loud noise or have you had ear infections in the past?

This information helps the doctor understand what type of hearing loss you may have and what further investigation is needed.

3. Hearing test (Audiometry)

To assess how much your hearing is impaired, the specialist will often send you on to an audiologist to do a hearing test. This may include different types of tests where you will be asked to respond to sounds at different frequencies and volumes:

Tone audiometry: 

You will hear a range of sounds (tones) at different frequencies (ie high and low tones) and at different strengths (ie loudness). You will be asked to press a button or signal when you can hear the sounds. This helps determine the type and degree of hearing loss you have.

Speech audiometry:

You will be asked to repeat words or phrases that you hear through headphones. This can help assess how you understand speech at different volume levels.

Sound conduction and bone conduction:

In some cases, the doctor may use bone conduction earphones, which are sent through the bones of the skull instead of the ear canal. This can help determine whether the problem is in the outer or middle ear (sound conduction) or in the inner ear or auditory nerve (sensorineural hearing loss).

3. Hearing test (Audiometry)

To assess how much your hearing is impaired, the specialist will often send you on to an audiologist to do a hearing test. This may include different types of tests where you will be asked to respond to sounds at different frequencies and volumes:

Tone audiometry: 

You will hear a range of sounds (tones) at different frequencies (ie high and low tones) and at different strengths (ie loudness). You will be asked to press a button or signal when you can hear the sounds. This helps determine the type and degree of hearing loss you have.

Speech audiometry:

You will be asked to repeat words or phrases that you hear through headphones. This can help assess how you understand speech at different volume levels.

Sound conduction and bone conduction:

Impedance audiometry (tympanometry)

This test examines how the eardrum responds to changes in air pressure in the ear. It can help detect problems such as fluid in the middle ear (such as otitis media) that can affect hearing. The test can also show whether there are problems with the middle ear's movable bones (ossicles), which transmit sound to the inner ear.

Tinnitus examination (ringing in the ears)

If you have tinnitus (ringing in the ears), the doctor may also do tests to assess how this affects your hearing. There are different types of tests for tinnitus, including questionnaires and studies that assess your response to specific sounds.

Further investigations (if necessary)

Depending on the results of the initial tests, the specialist may decide to send you on for further investigations, such as:

MRI scan or CT scan:

 If the doctor suspects that reduced hearing is due to a tumor, injury or disease in the brain or ear, you may be referred for a scan.

Treatment options

Once the examination is complete, the specialist will explain what is causing your hearing loss and discuss possible treatment options. Depending on the cause, treatment may include:

- Removal of earwax.

- Medical treatment of infections or inflammatory conditions.

- Use of hearing aids or other aids.

- Surgical interventions if there is an underlying anatomical cause (e.g. perforated eardrum or tumor).

Conclusion

An examination for impaired hearing takes place in several steps, and the specialist uses a combination of interview, physical examination and hearing tests to find out what is causing the problem. It is important to have any problems with hearing investigated early, as treatment can improve hearing and prevent the problem from getting worse.

When should people with hearing loss have hearing aids?

Hearing aids are a useful tool for many people who experience hearing loss, but not everyone with hearing loss necessarily needs a hearing aid. The decision to get a hearing aid depends on several factors, including the degree of the hearing loss, which situations it affects and how it affects one's quality of life.

Here are some conditions that may indicate it may be time to consider a hearing aid:

1. When the hearing loss affects daily life

If you have difficulty hearing conversations, especially in noisy environments, such as in restaurants, at work or at home, it may be a sign that your hearing loss is starting to affect your ability to communicate effectively. If you often have to ask people to repeat themselves, or if you feel excluded from conversations, a hearing aid can help improve your hearing and communication.

2. When you experience difficulty hearing high or low sounds:

If you have problems hearing certain frequencies, such as high tones in speech (such as women's or children's voices) or low tones (such as low-frequency sounds such as cars or doorbells), a hearing aid can help amplify the sounds you have difficulty hearing. This applies especially to age-related hearing loss, where hearing of high frequencies is often the first to deteriorate.

3. When you start isolating yourself

Hearing loss can lead to social isolation. If you avoid situations where you have to communicate, such as social gatherings, phone calls or meetings, because it becomes too difficult to hear or follow the conversations, this may be a sign that hearing aids may be a good solution. When the hearing loss affects your social quality of life, it is often time to consider aids such as hearing aids.

4. When you feel tired or stressed from having to "hear more"

Straining to hear all the time can lead to fatigue, headaches and stress. If you often feel exhausted after trying to listen, or if you begin to avoid situations where you have to concentrate on hearing, a hearing aid can reduce this effort and make it easier to hear without requiring as much energy .

5. When hearing affects your safety

In some cases, hearing loss can be dangerous, especially if it means you can't hear warning sounds like car horns, fire alarms or doorbells. If your hearing loss affects your ability to respond quickly to the outside world, a hearing aid can help increase your awareness of sounds that are important to your safety.

6. When a doctor recommends it

An audiologist or an ear doctor will typically recommend a hearing aid if a hearing test shows that your hearing loss is within a level where a hearing aid can help. This can be a way to improve both hearing and quality of life. Often the doctor or audiologist will discuss with you how the hearing aid can improve your hearing and give you the best solution for your needs.

In summary

It is not necessarily a question of whether one has reduced hearing – many people have some degree of hearing loss as they get older – but of how much it affects one's life. If your hearing loss makes it difficult to hear in everyday situations, if you feel tired of having to make an effort to hear, or if it affects your social quality of life or safety, a hearing aid may be a good solution. It is important to talk to a professional about your symptoms so that you can get the right assessment and support to decide whether a hearing aid will be helpful for you.