Hearing Loss
Signs and Symptoms

There are three main types of hearing loss:

Sensorineural Hearing Loss

Permanent hearing loss occurs when inner ear nerves become damaged and do not properly transmit their signals to the brain. Those who suffer from this condition may complain that people seem to mumble or that they hear, but do not understand, what is being said. The aging process is a very common cause of sensorineural hearing loss. As we get older, the inner ear nerves and sensory cells gradually die. The condition is not often medically or surgically treatable. In most cases, the symptoms can be significantly minimized with hearing aids.

In addition to aging, sensorineural hearing loss may be caused by:

• Injury
• Excessive noise exposure
• Viral infections, such as measles or mumps
• Ototoxic drugs, which are medications that damage hearing
• Meningitis
• Diabetes
• Stroke
• High fever
• Meniere's disease
• Acoustic tumors
• Heredity

Conductive Hearing Loss

These disorders can be either temporary or permanent. They are caused by problems in either the outer or middle ear, which prevent sound from reaching the inner ear. People who experience this condition may find that voices and sounds appear faint. Many forms of conductive hearing loss can be helped medically or surgically. Some common causes of this condition include:

• Infection of the ear canal or middle ear
• Fluid in the middle ear
• Perforation or scarring of the eardrum
• Wax build-up
• Unusual growths or tumors in the ear
• Otosclerosis, a condition in which there is an abnormal growth of bone of the middle ear. This bone prevents structures within the ear from working properly and causes hearing loss. For some people with otosclerosis, the hearing loss may become severe.

Mixed Hearing Loss

Some people have a combination of both sensorineural and conductive hearing loss.

Hearing loss is often gradual and not immediately noticed by the person affected. Sometimes friends or family will notice a person's hearing problems before the person with the hearing loss recognizes it. For instance, family members may complain that the person with hearing loss listens to the television or radio too loud and often ask them to repeat what they've just said. Or, that the person with hearing loss doesn't answer the telephone or doorbell because they didn't hear it ringing.

Although each person may experience symptoms of hearing loss differently, some of the most common symptoms may include:

• Inability to hear people clearly and fully. People may seem to mumble and those experiencing hearing loss may not hear all parts of a conversation. For instance, someone with hearing loss may miss the essence of a story or punch line of a joke that someone just told.
• Frequent requests for repetition or clarification.
• Tendency to need to stare at people when they are talking in order to make it easier to understand what they are saying.
• Fatigue at the end of the day from straining to hear.
• Avoidance of social situations because of difficulty following conversations in noisy environments.
• Tendency to bluff when not hearing someone because of the fear of asking them to repeat themselves.

Reviewed by health care specialists at UCSF Medical Center.