How Hearing Loss Happens

Good Vibrations

What we know as sound is a series of vibrations. Sound travels through the air and hits the eardrum, causing it to vibrate. The eardrum’s vibrations are then amplified through the middle ear by three small bones called ossicles. Deep in the ear, the vibrations are turned into nerve impulses. The brain translates these nerve impulses into what we hear as sound. Because hearing consists of a series of steps, many factors can impact hearing at any point in these steps.

Although hearing loss indeed occurs with age, hearing loss can also happen at any time in a person’s life if any of the steps are disrupted. The National Institutes of Health (NIH) reports that in the United States, 30 million people ages 12 and over have hearing loss. Hearing loss can impact all parts of a person’s life. For instance, individuals who have unaided hearing loss earn an average of $20,000 less than those individuals who wear a hearing aid or have implants. There are over 100 causes of hearing loss. Below is a review of the most types and causes of hearing loss. 

Types of Hearing Loss

The types of hearing loss are typically classified by where the disruption occurs within the ear.

Conductive Hearing Loss

Conductive hearing loss occurs because of issues concerning the middle ear and its small bones (ossicles), the ear canal, and eardrum.

Sensorineural hearing loss (SNHL) 

Sensorineural hearing loss stems from problems within the inner ear. These types of hearing loss are usually nerve related. 

Mixed Hearing Loss

Mixed hearing loss is due to both conductive hearing damage (outer and middle) and sensorineural damage (inner ear/auditory nerve). 



Otosclerosis is a conductive type of hearing loss that occurs in the middle ear. An overgrowth develops in one or more of the bones in the ear, which prevents the bones from amplifying vibrations. Osteosclerosis often occurs in people with a family history and can be treated through surgery. 

Ménière’s disease

The cause of Ménière’s disease, an inner ear issue, is unknown. Ménière’s disease causes sensorineural hearing loss due to a buildup of fluid within the ears. Ménière’s often affects people in the 30 to 50 age range. Symptoms are dizziness, ringing in the ear, sound sensitivity, and a feeling of fullness within the ear.  

Autoimmune Inner Ear Disease

Autoimmune Inner Ear Disease occurs quickly, though immediate medical intervention can help minimize hearing loss. In the case of an autoimmune disease, the body’s immune cells mistakenly attack other cells in the body. 

Acoustic Neuroma

Acoustic neuroma is a noncancerous type of tumor which grows on the cranial nerve responsible for carrying acoustic signals to the brain. Acoustic neuroma causes dizziness and gradual hearing loss.

Head Injuries 

Accidents, especially severe impacts near the ear, can cause hearing loss. An explosion or impact, for instance, can injure the eardrums. Any insertion into the ear can also result in hearing loss, as in the case of an injury with a cotton swab.

Sudden Sensorineural Hearing Loss

Progressive loss of hearing over three days or less in one ear is considered a medical emergency. Possibly caused by a virus.

Loud Noise 

Sounds can injure the ear and cause sensorineural hearing loss. Although a sudden, extremely loud noise can cause hearing loss, most are usually from consistent long-term exposure to loud noise.


Many medications, both prescription and over the counter, may cause hearing loss as a side effect.

It’s essential to tell a health professional if hearing loss occurs during medication treatment. Examples of some medications that may cause hearing loss are:

  • Antibiotics
  • Chemotherapy 
  • Aspirin (in large doses)
  • Antimalarials
  • Diuretics 


Presbycusis is the term used for age-related hearing loss. The years of use that comes with age can compromise hearing, causing a decline in the ability to hear. Around the age of 60, age-related hearing loss can become noticeable. The voices of others, especially high pitched voices, can sound weak or muffled.


Glands secrete earwax in the outer ear canal, and it serves a useful purpose—it prevents foreign particles like germs, dust, and dirt from reaching inside the ear.  Therefore, sometimes not having enough earwax can result in an ear infection.

Having too much earwax, though, can lead to pain, ringing in the ears, and hearing loss. A washcloth or tissue can be used to remove earwax that is visible at the very opening of the ear canal. Nothing should ever be placed within the ear canal to remove earwax. In these cases, a health professional should be consulted. 

Ear Infections

Ear infections are common in children due to their physical development. Most infections occur in the middle ear (otitis media). In adults, however, ear infections are less frequent and may pose a serious health risk. Most ear infections resolve on their own without the need for medical interventions. However, if a fever or ear drainage is present, a health professional should be consulted.

How to Prevent Hearing Loss

Hearing loss can be prevented by protecting the ears from loud noises and injury. Cotton swabs and foreign objects should not be placed into the ear canal. Protection for the head and ears should be used when performing activities that may cause injury: riding a motorcycle, skateboarding, etc. In loud environments, like a rock concert or construction site, earplugs or earmuffs should be used to prevent hearing loss. Also, including a hearing test as part of an annual physical allows physicians to spot hearing loss effectively. If you experience hearing loss, report it to a health professional to prevent further damage.

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