“While hearing loss can be gradual, it can have long-standing, devastating consequences. In some studies, people have reported loss of hearing as being worse than even loss of vision because of the isolation. Many types of hearing loss can be reversed, but some can’t. It is important to see your doctor to see what options there may be for you in your particular situation.” - Drew Sutton, MD, Board-Certified Otolaryngologist
Hearing loss is something that many people experience, but for everyone, it can be slightly different. For some, hearing loss can slowly accumulate over time until it results in being hard of hearing. For others, this process can seemingly occur over a couple of days and reduce your auditory acuity.
When hearing loss happens, the first question many people ask is if it is reversible. The answer to this question is more complex than a simple yes or no answer because there are many forms of hearing impairment that can decrease your ability to understand others and have full hearing ability.
Below is a closer look at the ways the ability to hear can be diminished as well as whether they can be treated or not. Understanding how hearing can go awry and the possible treatments can be helpful for your specific form of hearing loss.
Conductive Hearing Loss
Conductive hearing loss is a diminished ability of the ears to sense sounds in the immediate environment. Conductive hearing loss has to do with an issue residing in the outer and middle ear. This can include issues with the outer ear, ear canal, eardrum, middle ear bones, eustachian tubes, and the tympanic cavity.
When compared to other forms of hearing loss, conductive hearing loss is typically one that responds better to treatment and can be fully reversible in some cases. Below is a closer look at the causes and treatments of conductive hearing loss.
Causes of Conductive Hearing Loss
Conductive hearing loss can have several different causes. Essentially anything that disrupts energy transfer from the sound waves properly interacting with the eardrum and middle ear bones can contribute to conductive hearing loss. Below is a closer look at the potential causes from outermost to innermost.
The first potential cause of conductive hearing loss is impacted earwax. Earwax, also known as cerumen, is a naturally secreted wax that helps to protect the ear canal. With its sticky, antibacterial, and antifungal properties, cerumen plays an important role in protecting the ears. Under normal circumstances, actions such as chewing will naturally cause old ear wax to travel out of the ear and more to be produced.
With earwax impaction, earwax accumulates to a point where it begins to block the ear canal, and therefore muffling sounds much like how earplugs work.
The next potential cause going through the ear is a problem with the tympanic membrane, also known as the eardrum. The eardrum is a thin tissue membrane that moves based upon the pressure differences created by sound. The tympanic membrane separates the outer ear from the middle ear and has air-filled spaces on either side.
One potential cause for problems is a pressure differential of the outer and inner ear. You have likely experienced this form of hearing loss while on an airplane. Before your ears equalize or pop, you most likely notice that your hearing is muffled. This muffled hearing is caused by a pressure difference that leads to the eardrum being pushed taught by the side with more pressure, decreasing its ability to move with the sound.
Another potential problem can be caused by an eardrum rupture where a hole forms in the membrane. Without a solid seal, hearing can be diminished.
The last part of the ear can cause conductive hearing loss in the middle ear. Three tiny bones within the ear are connected to the tympanic membrane and convey the motion of the membrane to the cochlea, which is the inner ear. The middle ear bones occupy a space between the eardrum and cochlea known as the tympanic cavity.
One of the most common forms of hearing loss in the middle ear is when fluid build-up occurs within the tympanic cavity. Fluid conducts very differently than air, and a build-up of fluid in the middle ear can significantly reduce hearing ability. A structure known as the eustachian tube is responsible for draining this cavity, but it can become clogged for many reasons, including upper respiratory tract infection and swollen adenoids.
Treatments for Conductive Hearing Loss
With many forms of conductive hearing loss, a large number can respond well to treatments. Treatments can range in cost and complexity, but generally, conductive hearing loss responds the best to treatment and, in some cases, can provide you instant relief and completely reverse your hearing loss.
Hearing loss due to the outer ear and ear canal is the kind of hearing loss that has the best chance of being completely resolved after treatment. For earwax impaction, the best mode of treatment is an earwax extraction, where a trained medical professional extracts the earwax from the ear canal. With the wax removed, hearing typically completely returns.
Tympanic membrane issues are a little more complex, but they too are fairly treatable for the most part. When the tympanic membrane is suffering from the pressure differential, treatments mainly revolve around restoring pressure balance.
In the case of a tympanic perforation, it will typically heal on its own within three months, but surgery may be required in certain cases. These injuries can result in permanent hearing loss, but people can make a full recovery for the most part. In some cases, the skin from the ear canal can grow past the hole in the eardrum and form a skin cyst called a cholesteatoma which can cause further problems such as infection and hearing loss. Cholesteatomas must be removed surgically.
The last potential cause related to fluid build-up in the middle ear can also respond well to treatment. Also known as otitis media with effusion, this condition can be caused by an underlying infection or can occur simply due to a eustachian tube blockage. A course of antibiotics and potentially decongestants can help resolve these issues and allow for the complete reversal of hearing loss in most cases.
Sensorineural Hearing Loss
Sensorineural hearing loss differs from conductive in that it involves the transfer of physical sound into nerve impulses. Sensorineural hearing loss is much less responsive to treatments and is more likely to result in permanent hearing loss.
Below is a closer look at some common causes of sensorineural hearing loss and ways to prevent and ways that sensorineural hearing loss is treated.
Causes of Sensorineural Hearing Loss
Sensorineural hearing loss is hearing loss due to the inner ear and auditory nerve. Many things can damage sensorineural hearing, such as medications, loud noise exposure, genetics, and more.
One potential cause of sensorineural hearing loss is by taking medication with known toxicity for the ears. These medications have qualities that make them ototoxic or potentially harmful to the ears. There are over 200 ototoxic medications.
Suppose you are taking any medications that describe the hearing loss as a side effect. In that case, you should be extra diligent in taking them as prescribed and be aware of potential changes in hearing to ensure you catch any potentially lasting side effects earlier rather than later.
Another potential cause of sensorineural hearing loss is exposure to loud noises. The cochlea is a highly sensitive organ that can discern the smallest differences between sounds and provide you with a detailed sound resolution. Loud sounds can damage this delicate machinery and result in permanent hearing loss.
Sounds under 70 decibels are generally recognized as safe, but above that, each increase in sound level can increase the chances of developing hearing loss. Reducing your exposure to loud noises is a great way to decrease your chances of developing mild sensorineural hearing loss later in life.
Treatment for Sensorineural Hearing Loss
Sensorineural hearing loss is typically not reversible and represents the more permanent side of hearing loss. With many treatments for sensorineural hearing loss, the focus is on mitigating the symptoms and getting back some sense of hearing, even if it isn’t exactly like it once was.
The main treatment for sensorineural hearing loss is hearing aids. Hearing aids are assistive devices that go in your ears. In the ears, the hearing aid takes the sounds you would traditionally hear and amplifies them.
This is accomplished with an onboard microphone that takes in the auditory stimuli, an amplifier that increases the intensity of the sound, and a speaker that sends a more intense version of the original sound to the ear. With louder sounds, people are more likely to be able to hear and listen better.
In summary, hearing loss can certainly be reversed in certain cases, while some people’s hearing loss is permanent. Conductive hearing loss is a form of hearing loss that involves the outer and middle ear and is the most receptive form of hearing loss to treatment. On the other hand, sensorineural hearing loss tends to be long-lasting and has little to no way of reversing it.