Hearing advice
About hearing loss
Why it goes unnoticed for so long
Studies show that even today, fewer than 30% of individuals in Western countries who clinically require hearing aids are actually using them.
Untreated hearing loss can lead to social isolation, reduced confidence, balance issues and an increased risk of cognitive decline. Research indicates it takes over 8 years for most individuals to address their hearing loss.
While hearing loss is mostly age-related, it can also result from hereditary factors, noise exposure, head trauma, certain diseases, genetics and infections. Often, multiple factors contribute to a person's hearing loss.
For many, age-related hearing loss is the leading cause of difficulties, typically starting around 35 years of age, with initial signs appearing between 60 and 70. While not applicable to all, nearly all individuals over 85 years of age will have a hearing loss requiring intervention.
Common signs of hearing loss
- The sensation of people mumbling or not talking clearly
- Tinnitus, being the sensation of phantom sounds such as clicking or buzzing
- Increasing the TV volume louder than others would like
- Difficulty understanding people who are not facing you
- Increased effort or mental attention required when listening to others
- Brain fatigue after a full day, or speech becoming harder to comprehend
- Sustained avoidance of social events and places where background noise is present
- Poor tolerance to loud sounds
Types of hearing loss
Hearing loss is not one condition. The type you have determines whether it can be reversed, whether surgery is an option, and which treatments will actually help.
Sensorineural hearing loss
Sensorineural hearing loss (SNHL) is the most common type of permanent hearing loss. It accounts for around 90% of the hearing loss cases we see in our clinic.
Permanent. Not treatable through surgical intervention.
Read moreConductive hearing loss
Conductive hearing loss happens when sound cannot pass efficiently through the outer or middle ear. Unlike sensorineural loss, some conductive hearing loss can be reversed.
Sometimes reversible. Surgical intervention may partially or fully restore hearing in some cases.
Read moreMixed hearing loss
Mixed hearing loss is a combination of sensorineural hearing loss and conductive hearing loss. After sensorineural hearing loss, this is the most common type of hearing loss we see in our clinic.
Partly reversible in some cases, depending on the conductive component.
Read moreNoise-induced hearing loss
Noise-induced hearing loss (NIHL) is hearing loss resulting from prolonged exposure to loud sounds, which causes irreversible damage to the sensitive hair cells within the cochlea, ultimately resulting in sensorineural hearing loss.
Permanent, but largely preventable through hearing protection.
Read moreSudden sensorineural hearing loss
Sudden sensorineural hearing loss (SSNHL) is a rapid, frequently unexplained loss of hearing that typically affects one ear and occurs within a span of 72 hours. It needs immediate medical attention.
Usually permanent. Outcomes depend heavily on how quickly treatment starts.
Read moreWhy treating hearing loss early matters more than people think
When discussing hearing loss, people often think of the ears, but it is largely a brain activity. When we stop and think about it, we actually hear with our brains. Our ears simply capture the sound for us.
Early treatment of hearing loss significantly improves the social aspects of our lives, and dramatically increases the chance of long-term positive outcomes with hearing aid use, while also reducing the risk of depression and social isolation.
Hearing aids not only help us hear better, they keep the brain's auditory pathways engaged and healthy, reducing deterioration rates over time. If hearing loss is left untreated it can lead to an increased risk of cognitive decline. In fact the evidence is now clear: treating hearing loss is the single most modifiable life factor we can address to reduce our risk of cognitive decline.
Addressing hearing loss at any age is crucial, but delaying treatment can make it harder to adapt to hearing aid use, due to poor tolerance to increased sound stimuli after years of the brain being adapted to silence. Late intervention can also lead to decreased auditory nerve integrity, and long-term inability in speech understanding, even once hearing aid use is introduced. It is for these reasons that treating hearing loss within a reasonable timeframe is vital: 1 to 5 years after we first notice it, not 20.
By prioritising early detection and treatment, people can help maintain healthy brains and remain socially engaged in older age.
Reference on cognitive decline and hearing: Ageing Research Reviews.
A rule of thumb
Other causes of hearing loss
Hearing loss caused by certain diseases
Certain diseases and conditions can lead to hearing loss, including autoimmune diseases, genetic disorders, diabetes, kidney disease, and viral infections such as shingles and chickenpox. Meningitis can also lead to hearing loss. In many instances the impairment may not be permanent: diabetes and kidney disease can lead to temporary hearing loss. However, in cases involving viral or bacterial infections, as well as birth defects and genetic disorders, the hearing loss is typically permanent. Where it is permanent, hearing aids and assistive listening devices are usually the treatment options.
Inner ear disease
Inner ear disease can arise from genetic predispositions, viral and bacterial infections, autoimmune disorders and occasionally head trauma. It is associated with fluid imbalance and transfer problems within the inner ear. Symptoms typically manifest as fluctuating hearing loss, vertigo and sometimes tinnitus. The most prevalent inner ear diseases we see in our clinic include labyrinthitis and Ménière's disease. While there is no cure for most cases, it can usually be managed effectively through medications, hearing aid use and lifestyle changes.
Ear infections and hearing
Ear infections and hearing loss are related in individuals with a history of ear infections during childhood, or those experiencing recurrent infections in adulthood. These individuals face a higher risk of long-term hearing loss, primarily manifesting as conductive hearing loss. Hearing loss associated with active ear infections can often be addressed through surgical intervention. However, individuals who have moved past ear infections might suffer irreversible damage to their middle ear system or eardrum, leading to a lifelong dependency on hearing aids.
Questions about hearing loss
I can hear most sounds and voices clearly, but people still comment on my hearing. Doesn't that mean my hearing is mostly okay?
When addressing hearing loss it is important to recognise that specific frequencies can be affected while others remain completely intact. In cases of age-related hearing loss, individuals often struggle with high-frequency sounds, whereas their low frequency hearing may be functioning nearly exactly the same as it did when they were in their 30s. This can lead to an inaccurate perception of overall hearing capability.
A useful analogy is to compare hearing to vision. Those of us who use prescription glasses can see certain things quite clearly even without them. However, this does not imply that we do not require corrective lenses to enhance specific aspects of our sight. The same principle applies to hearing.
What are the most common early signs of noise-induced and age-related hearing loss?
The most common early signs follow a very similar pattern, including tinnitus, along with increased difficulty understanding speech in noisy situations. Certain pitches of voices will also become more difficult to hear.
Research indicates a higher incidence rate of tinnitus as an early-onset symptom associated with noise-induced hearing loss, particularly in comparison to age-related hearing loss. Nevertheless, early-onset tinnitus can certainly manifest in both categories of hearing loss.
I don't want to wear hearing aids. What will happen if I leave my hearing loss untreated for life?
In cases of mild hearing loss left untreated, the outcomes will be mainly social and communication based, with little to no impact on the function of the brain. However, since nearly all hearing loss cases progress with age, and many are more severe in nature, consider the long-term effects of neglecting a moderate hearing loss over someone's entire life, starting in their 60s.
Initially, the individual may simply avoid social situations with background noise, which as a whole may not be such a big issue. However, as the hearing loss advances, even quieter environments become challenging, further increasing social barriers.
Neglecting a hearing loss of this level will also in many cases have a negative impact on brain health. While many know that ignoring hearing loss affects hearing, many overlook the side of untreated hearing loss that results in integrity loss to neural pathways. Put simply, when these pathways are starved of sound stimuli, integrity is lost quicker than it would have been had hearing remained. This results in difficulty processing speech signals and, subsequently, permanent difficulty following normal conversations.
Logically, these issues contribute to heightened risks of cognitive decline, now well documented by science as an outcome of untreated hearing loss.
Why do I feel my hearing is mostly fine but others are commenting on it?
The reason people with hearing loss often feel their hearing is better than it really is relates to two key things: brain acclimatisation, and not having a reference point.
Brain acclimatisation refers to the process by which the brain adjusts to not hearing and acts to normalise its new environment. Due to neuroplasticity, the brain is extremely effective at normalising our sensory landscape, especially with hearing loss, because in most cases it is a very gradual process.
Not having a reference point refers to how hearing works: we don't hear what we don't hear. If we cannot hear something, we simply do not hear it, and not hearing something is not obvious evidence of a hearing loss. When it comes to our eyes we have a reference point, but we have no defined reference point for hearing, at least not in a clear and obvious manner.
Not sure whether what you are noticing is hearing loss?
A free hearing checkup will tell you. It includes a hearing test, costs nothing, and carries no obligation to buy anything at all.