Hearing loss

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 much 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 noises, such as music, machinery noises, or loud concerts, can damage the hair cells in the inner ear. Once these cells are damaged, they cannot repair themselves, 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, such as 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:

Excessive 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 an ear specialist.

5. Injury 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. Inherited diseases can affect the parts of the ear that are 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 you help with hearing loss?

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 get a thorough examination by a doctor if you are experiencing 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 are experiencing 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 about what happens in the ear when hearing loss occurs.

An ear, nose and throat specialist (otolaryngologist) or an audiologist (hearing specialist) uses several different methods to test for hearing loss. The examination will typically involve both a thorough discussion about your symptoms and a series of tests to assess how your ears are working. Here is a description of how the examination is usually done:

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 first notice problems with your hearing?

- Are there any specific situations where you have difficulty hearing (for example, 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 a family history of hearing loss or other ear problems?

- Have you been exposed to loud noises 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 necessary.

2. Ear examination

The doctor will typically look into your ears using an otoscope or a large overhead ear microscope – an instrument with a small camera and light that provides a clear view of the ear canal and eardrum. This examination may reveal:

- Earwax, which can block sound and cause temporary hearing loss.

- Signs of infection or inflammation, which can affect hearing.

- Damage to the eardrum (such as a hole or scar tissue).

- Signs of fluid in the middle ear (such as with otitis media).

3. Hearing test (Audiometry)

To assess the extent of your hearing loss, the specialist will often refer you to an audiologist for 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 series of sounds (tones) at different frequencies (i.e. high and low tones) and at different intensities (i.e. 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 well you understand speech at different volumes.

Sound conduction and bone conduction:

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

Impedance audiometry (tympanometry)

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

Tinnitus (ringing in the ears) test

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

Further tests (if necessary)

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

MRI scan or CT scan:

If your doctor suspects that your hearing loss is due to a tumour, 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 for infections or inflammatory conditions.

- Use of hearing aids or other assistive devices.

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

Conclusion

A hearing loss examination is a multi-step process, and the specialist will use a combination of an interview, physical examination, and hearing tests to determine the cause of the problem. It is important to have any hearing problems diagnosed early, as treatment can improve hearing and prevent the problem from getting worse.

When Should People with Hearing Loss Use Hearing Aids?

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

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

1. When Hearing Loss Affects Daily Life

If you struggle to hear conversations, especially in noisy environments such as restaurants, at work, or at home, it may be a sign that your hearing loss is affecting your ability to communicate effectively. If you frequently ask people to repeat themselves or feel left out of conversations, a hearing aid can help improve your hearing and communication.

2. When You Have Difficulty Hearing High or Low Sounds

If you have trouble hearing certain frequencies—such as high-pitched speech (e.g., voices of women or children) or low tones (such as the hum of cars or doorbells)—a hearing aid can help amplify the sounds you struggle to hear. This is especially relevant for age-related hearing loss, where high-frequency sounds are often the first to deteriorate.

3. When You Start to Isolate Yourself

Hearing loss can lead to social isolation. If you avoid situations that require communication, such as social gatherings, phone calls, or meetings, because it is too difficult to hear or keep up with conversations, this may be a sign that hearing aids could be beneficial. When hearing loss affects your social life, it is often time to consider assistive devices like hearing aids.

4. When You Feel Tired or Stressed from Trying to "Hear More"

Constantly straining to hear can lead to fatigue, headaches, and stress. If you often feel exhausted after trying to listen, or if you start avoiding situations where you need to concentrate on hearing, a hearing aid can reduce this effort and make it easier to hear without draining your energy.

5. When Hearing Loss Affects Your Safety

In some cases, hearing loss can be dangerous, especially if it means you cannot hear warning sounds such as car horns, fire alarms, or doorbells. If your hearing loss affects your ability to react quickly to your surroundings, a hearing aid can help increase your awareness of important sounds that are crucial for your safety.

6. When a Doctor Recommends It

An audiologist or an ear specialist will typically recommend a hearing aid if a hearing test shows that your level of hearing loss could benefit from one. This can be a way to improve both hearing and quality of life. Often, the doctor or audiologist will discuss how a hearing aid can enhance your hearing and provide the best solution for your needs.

Summary

It is not necessarily a question of whether you have hearing loss—many people experience some degree of hearing impairment as they age—but rather how much it affects your life. If your hearing loss makes it difficult to hear in daily situations, if you feel tired from constantly straining to listen, or if it impacts your social life or safety, a hearing aid may be a good solution. It is important to speak with a professional about your symptoms so you can receive the proper assessment and support in deciding whether a hearing aid would be beneficial for you.