Main
- Hearing loss — persistent reduction in hearing: a person has more difficulty distinguishing quiet sounds and speech, asks people to repeat themselves and turns up the volume.
- Consult an audiologist or an ENT doctor: if there is no audiologist, the initial appointment is conducted by an otorhinolaryngologist, who examines the ear.
- Examination includes audiometry and tympanometry: they show the acuity of hearing at different frequencies and the mobility of the eardrum.
- Sudden hearing loss, pain, ear discharge and dizziness: require an urgent visit to a doctor; a gradual reduction — a routine appointment.
- For persistent hearing loss, a hearing aid is selected: with reversible causes, for example earwax blockage, hearing may recover after its removal.
What is hearing loss
Hearing loss is a persistent reduction in hearing, in which a person has more difficulty distinguishing quiet sounds and the speech of those around them. Below is an explanation of what exactly is disrupted in the auditory system, which circumstances trigger this condition and who is affected by it more often.
What happens in the body
Sound travels from the auricle to the auditory nerve, and a failure can occur at any part of this pathway. First, the sound wave enters the external auditory canal, where its passage may be obstructed by a build-up of earwax. The vibrations are then transmitted through the eardrum and the chain of auditory ossicles in the middle ear. Next, the signal reaches the inner ear, where it is converted into nerve impulses. If the hair cells of the inner ear or the auditory nerve itself are damaged, the brain receives distorted or weakened information. Because of this, a person asks others to repeat themselves, turns up the volume on the television and has difficulty making out speech in a noisy company. Persistent hearing loss affects one or both ears and over time makes communication with loved ones more difficult.
What causes it to develop
- Earwax plug: a build-up of earwax blocks the auditory canal and prevents the sound wave from reaching the eardrum.
- Ear infections and past illnesses: inflammation in the middle ear or the after-effects of an infection disrupt the transmission of sound and the function of the inner ear.
- Loud noise: prolonged exposure to noise at work or regular listening to loud music gradually damages the sensitive cells of the inner ear.
- Age-related changes: over the years, the auditory cells and nerve fibres wear out naturally, and speech intelligibility decreases.
- Hereditary predisposition: if hearing loss has occurred in close relatives, the risk of experiencing it is higher than in other people.
- Taking certain medicines: some medications can have a negative effect on the auditory nerve, so it is important to tell the doctor about all the medicines you are taking.
Who is affected more often
Hearing loss is more common in older people, as well as in those whose work or daily life involves constant noise. With age, the inner ear gradually loses sensitivity, and a person begins to have more difficulty making out the speech of the person they are talking to, especially in places with background sounds. In workers in noisy industries, builders, musicians and lovers of loud music through headphones, the strain on hearing is higher than in others. Past ear illnesses and heredity also play a role: if parents or grandparents experienced hearing loss early, it is worth paying closer attention to one's own condition. In children, hearing loss is often associated with past infections and with the developmental characteristics of the auditory system. Noticing the problem can be difficult, because the loss often increases gradually and the person themselves gets used to the new volume level. Relatives should pay attention to frequent requests to repeat things and complaints about unclear speech.
What symptoms can occur?
Hearing loss is noticed by the way everyday perception of sounds and the speech of those around you changes. It is important to distinguish gradual changes in time from conditions where help is needed without delay.
How it is noticed at the very beginning
At the very beginning, hearing loss shows itself in that a person more often asks the other person to repeat things and asks them to say it again. The television or telephone gradually starts to sound louder than usual, although previously the volume seemed sufficient. In a noisy environment, conversation is harder: voices merge, and you have to strain to make out the words. Sometimes noise or ringing in the ears is added, and the ear feels blocked, as if after water. Such changes are easily put down to tiredness, lack of sleep or age-related changes, so they go unnoticed for a long time. Over time, asking people to repeat themselves becomes more frequent, and conversation in company or in the street becomes increasingly tiring. If those close to you notice that you have to be called more loudly, it is worth booking an appointment with an audiologist or an ENT doctor to have your hearing checked.
Signs that occur most often
- Constant asking to repeat: a person often asks for what was said to be repeated, because they cannot make out individual words and lose the meaning of the phrase as a whole.
- Turning up the volume: the television, telephone or radio sounds louder than usual, and those around you ask for it to be turned down, while it still seems quiet to you.
- Difficulties with background noise: in a café, on transport or in the street, voices merge, and conversation requires noticeable effort that was not there before.
- Noise or ringing in the ears: an extraneous sound appears without an external source, it makes it hard to concentrate and often accompanies hearing loss.
- A feeling of a blocked ear: the ear feels full or muffled, as if after water, and this changes the loudness of your own voice.
- Dizziness: in some forms, dizziness is added to the hearing loss, and then a visit to the doctor should not be put off.
When to seek help urgently
Examinations and tests
Examination for hearing loss is structured so as to understand its cause and degree. The doctor takes a history, examines the ear and performs hearing tests, and the scope of the examination is selected individually.
How the examination begins
The examination begins with a conversation, during which the doctor asks in detail about how long ago and under what circumstances the hearing problems appeared. The patient tells whether they can hear the speech of the person they are talking to in a quiet room and whether they have to ask again during a telephone conversation. The doctor clarifies whether tinnitus is troubling them, whether there have been head injuries, past infections and the use of medicines that affect hearing. Then they examine the ear to see the condition of the external canal and the eardrum. Such an examination helps to notice earwax, inflammation or damage to the eardrum that prevent sound from reaching the inner ear. After that, hearing tests are performed to assess the acuity of hearing and the mobility of the eardrum. The collected information allows the doctor to distinguish reversible forms of hearing loss from persistent ones and to choose a suitable direction of care.
What is prescribed and what it shows
What is worth preparing for the appointment
- Discharge summaries: take medical documents about past visits so that the doctor can see the history and does not prescribe again what has already been done.
- Previous audiograms: the results of earlier hearing tests show whether hearing has changed over time and how quickly.
- List of medicines: write down the names of the medicines you take, since some of them affect hearing and this is important to take into account.
- Observations of close ones: ask relatives to note in which situations you ask again and in which you hear normally.
- Questions for the doctor: formulate in advance what you want to clarify about your hearing so as not to forget at the appointment.
Which doctor should I see?
This section explains which doctor to consult when hearing decreases, what happens at the first appointment and what areas of care make up the treatment. We will also look separately at how much of the result depends on regular follow-up with a specialist.
Which specialist manages this condition
Hearing loss is managed by an audiologist, and if there is no such specialist in the locality, the initial appointment is conducted by an ENT doctor. The audiologist assesses how a person hears speech and individual sounds, and determines whether the perception of sound or its conduction along the auditory pathways is affected. The ENT doctor examines the ear, nose and throat, because the cause of hearing loss is often related to these areas. At the first appointment, the doctor asks when and under what circumstances the hearing changed, and how noticeable this is at home and at work. Then they examine the outer ear and the eardrum, and check how the person perceives whispered and conversational speech. If there is no specialist nearby, the ENT doctor performs the examination and, if necessary, refers the patient to an audiologist to clarify the form of the disorder. The approach to care depends on the cause and form of hearing loss, so in reversible conditions hearing may be restored, while in persistent ones ways are selected to improve the perception of sounds and communication.
What treatment consists of
- Removal of earwax plug: a procedure performed by a doctor if hearing has decreased due to a build-up of earwax in the ear canal, and after which the perception of sounds often returns.
- Treatment of the underlying condition: care is aimed at the cause that triggered the hearing impairment, and without addressing it other measures give limited results.
- Physiotherapy: methods of physical influence that the doctor may recommend for certain forms of the disorder to support the functioning of the auditory system.
- Fitting of a hearing aid: in persistent hearing loss, the specialist selects a device and adjusts it so that the person can better distinguish speech and the sounds around them.
- Surgery when indicated: surgical intervention is considered in individual cases when other methods do not give the desired effect and there are medical grounds.
- Follow-up with a specialist: regular examinations allow changes in hearing to be noticed in time and care to be adjusted, so visits should not be postponed for long.
What depends on the patient themselves
The regularity of follow-up with a specialist directly affects how promptly changes in hearing can be noticed. If a person comes for an examination at the appointed times, the doctor sees the dynamics and changes the approach to care in time. If visits are missed, hearing loss may remain unnoticed, and the fitted device or recommendations cease to match the current situation. The patient themselves notices how they hear speech in noise, a telephone conversation or communication in a group, and these observations should be reported to the doctor. It is important to follow exactly what is recommended and not to postpone a repeat appointment if things worsen. Persistent forms require long-term support, and here the result depends precisely on consistency, not on a single visit. Self-treatment is unacceptable, so any changes in how you feel are better discussed with a specialist rather than trying to correct them on your own. Keep simple notes about when and how your hearing changes — this noticeably helps the doctor at the appointment.
What helps prevent an exacerbation?
It is impossible to completely rule out all forms of hearing loss, but reducing the risk of some of them is quite realistic. Below — about what depends on the person themselves: habits, hearing protection and regular check-ups.
What to change in habits
A careful attitude to hearing begins with giving up prolonged stays in loud environments. At concerts, in clubs, near running equipment and in headphones, the sound often exceeds a safe level unnoticed by the person themselves. Constant exposure to such noise gradually damages the sensitive structures of the inner ear, and the changes accumulate over years. When working in a noisy environment, hearing protection is used — earplugs or special headphones selected according to working conditions. It is no less important to treat infections of the ear, throat and nose in good time: an untreated runny nose or otitis media can affect hearing. Do not try to remove earwax from the ear yourself with cotton buds — this more often pushes it deeper and injures the skin. When the first signs of hearing loss appear, it is worth having a check-up without postponing it until the changes become persistent.
What is worth keeping under control
- Hearing protection: protective equipment during noisy work reduces the load on the ear and helps preserve hearing for years ahead.
- Loud sounds in everyday life: prolonged listening to music in headphones at high volume gradually accumulates damage.
- Infections of the ear and upper respiratory tract: treating them in good time reduces the risk of the process spreading to the structures responsible for hearing.
- Ear hygiene: avoiding removing earwax yourself with cotton buds prevents injuries and pushing the wax deeper.
- Hearing check-ups: regular examination helps notice changes at an early stage, when they are not yet felt.
- First signs: the appearance of tinnitus or difficulties in conversation is a reason to have a hearing check-up without delay.
How often to see a doctor
Regular hearing monitoring is needed even when a person feels well and does not notice any changes. Many changes develop gradually and remain unnoticed by the person themselves for a long time, while those around them notice them earlier. A hearing check-up helps catch the decline at the stage when it does not yet interfere with everyday communication. When working in a noisy environment, such check-ups are especially important, since the load on the ear remains constant. If tinnitus, a feeling of congestion or difficulties when talking on the phone have appeared, a visit to the doctor should not be postponed. Seeking help in good time allows you to discuss further steps with the doctor in time and preserve what can still be preserved. Make it a habit to have a hearing check-up routinely, and not only when complaints appear.
What is worth remembering
Hearing loss rarely appears out of nowhere, and its onset is almost always linked to previous strain on the ears or to age-related changes. That is why the discussion of it should end with a few conclusions that will help the reader make a considered decision.
Key conclusions
Hearing loss is a condition in which a person loses the ability to distinguish some sounds and the speech of those around them. It develops gradually, and the person themselves notices the problem later than their loved ones do. Reduced hearing affects not only conversation but also orientation in space, the sense of balance and the overall feeling of safety. Hearing loss is often confused with absent-mindedness or fatigue, with repeated requests to repeat things being put down to inattention. Meanwhile, persistent hearing loss does not return to its previous level on its own, and waiting for it to pass is pointless. The sooner a person names the problem in their own words and seeks help, the more ways of preserving their hearing remain in reserve. Putting off a visit to the doctor narrows the choice of solutions and makes it harder to find suitable help. That is why at the very first doubts one should rely on facts, not on the hope that everything will sort itself out.
