What are the different types of hearing loss? Causes and treatment options

According to figures from the Royal National Institute for Deaf People (RNID), around 12 million people in the UK experience hearing loss, tinnitus, or deafness. However, the condition comes on so gradually that many may not even notice, resulting in feelings of isolation, frustration, and even depression. Understanding your hearing loss can be empowering, helping you take control and identify the best treatment options. This knowledge can lead to a significant improvement in your well-being and quality of life. 

Hearing loss has several causes, including age, noise damage, and ear infections. It could run in your family or be a side effect of medication. While promising treatments are on the horizon, untreated hearing loss can impact your social life, making it difficult to enjoy a trip to the movies or dinner with friends.  

Let’s take a look at the main types of hearing loss and your treatment options, including hearing aids for mild to profound hearing issues. 

A recap on what hearing loss is 

First, what exactly counts as hearing loss? Simply put, hearing loss occurs when sound signals no longer reach the brain. Damage to the ear's mechanisms can prevent them from working effectively, resulting in changes in the hearing system. 

Hearing loss may happen gradually with ageing or result from injury, illness, or prolonged exposure to loud noises. Circulatory issues like high blood pressure and some prescription drugs can also cause hearing loss. If you experience sudden hearing loss, you should seek treatment immediately. 

You may not even notice if you have gradual hearing loss. In fact, sometimes your friends and loved ones will notice the signs first. Indicators of hearing loss include: 

• Needing to turn up the sound on the TV 

• Asking others to speak loudly or more slowly 

• Asking people to repeat themselves or misunderstanding what they say 

• Difficulty in following a conversation, especially in a crowded place 

• Muffling of sounds, including speech 

• Steering clear of some social situations 

• Feeling stressed or tired after concentrating while listening 

If you notice a reduced ability to hear sounds and speech, booking a hearing check is essential. Early diagnosis and treatment are not just important. They could be pivotal in preventing further hearing loss, significantly impacting your overall well-being. 

How many types of hearing loss are there? 

This is a difficult question to answer, as hearing loss can vary from person to person. However, it is generally categorised into two basic types: sensorineural and conductive. It’s also possible to experience both simultaneously, which is known as mixed hearing loss.  

Sensorineural hearing loss results when the nerve pathways from the inner ear (cochlea) to the brain become damaged. Conductive hearing loss, on the other hand, results from damage or a blockage to the outer or middle ear and prevents sound from reaching the inner ear. 

Causes of hearing loss include: 

• Ageing 

• Genetics 

• Exposure to loud noises 

• Infection and illness 

• Head injury 

• Benign tumour 

• Circulatory problems 

• Some prescription drugs 

• Ear wax 

Additionally, you may experience bilateral hearing loss — which means in both ears — or unilateral hearing loss, which occurs in one ear. Older adults may experience high-frequency hearing loss, making hearing high-pitched noises more challenging. 

What are the main types of hearing loss? 

Let’s take a closer look at the two main types of hearing loss: sensorineural and conductive. Here’s what you need to know about their cause and treatment options. 

Sensorineural hearing loss 

Are you having trouble following a conversation with friends in a noisy restaurant? Sensorineural hearing loss could be the culprit if you have difficulty hearing quiet sounds. The hearing nerve itself, or the hair cells around it, can be damaged with age. This results in permanent hearing loss. You may also experience sensorineural hearing loss after prolonged exposure to loud noise. 

You must see an audiologist immediately if you experience sudden sensorineural hearing loss. Any delays in treatment could decrease the chances of medication being effective.   

Treatment options for sensorineural hearing loss 

Unfortunately, there is no surgical treatment for sensorineural hearing loss. However, hearing aids can help, making hard-to-hear sounds audible. 

Conductive hearing loss 

If sounds are becoming muffled, you could be experiencing conductive hearing loss. This affects the outer or middle ear, preventing sound waves from reaching the cochlea.  

Conductive hearing loss causes include ear wax, ear infections or a perforated ear drum. It’s most common in children due to recurrent infections or pushing small objects into the ear canal. 

Conductive hearing loss treatments 

For most cases of conductive hearing loss, treating the underlying cause delivers results. Your audiologist will suggest treatments like ear wax removal and antibiotics to deal with fluid in the ear or other infections. Surgery suits some people, while others may find hearing aids helpful in transmitting sound. 

Mixed hearing loss 

Do sounds seem very quiet in volume but also tricky to understand? You could be experiencing mixed hearing loss. This happens when the outer ear can't correctly conduct sound (conductive hearing loss), and the inner ear can't process the sounds it receives (sensorineural hearing loss). 

Typical causes of mixed hearing loss include age, genetics, prolonged exposure to loud sounds, infections and ear wax build-up.  

How to treat mixed hearing loss 

The good news is that various treatments are available for your mixed hearing loss, including hearing aids, cochlear implants, antibiotics, and ear wax removal, all of which can effectively manage your mixed hearing loss and give you hope for better hearing.  

What’s the difference between unilateral hearing loss and bilateral hearing loss?  

Put simply, unilateral hearing loss refers to hearing loss in one ear. On the other hand, bilateral hearing loss affects both ears. Knowing the difference can help you better understand your hearing loss and its impact on your daily life. 

Unilateral hearing loss can be age-related or due to illness or infection. It can also be mild to profound. You’ll notice a difference in sound levels, making it more challenging to distinguish speaking from background noise. You might also experience difficulty knowing where sounds are coming from. Unilateral hearing loss is usually easier to spot because sounds are louder in one ear than the other. 

Bilateral hearing loss causes are similar to sensorineural or conductive hearing loss. It can occur gradually over time or come on suddenly. You probably have bilateral hearing loss if you find following conversations in noisy environments challenging or need to turn up the volume on the TV. Hearing loss in both ears can be tricky to spot, so it’s worth seeking the advice of an audiologist and booking a hearing test. 

A hearing professional will diagnose sensorineural, conductive or mixed hearing loss and help you explore your treatment options. 

Does tinnitus count as hearing loss?  

Over 7 million people in the UK live with tinnitus, which causes ringing, whistling, and buzzing noises, even though the sound has no exterior source. It’s a sensation that comes and goes and can be mild or persistent.  

Fortunately, tinnitus can disappear by itself and is a symptom rather than a cause of hearing loss. Some people with tinnitus don’t experience hearing loss at all. On the other hand, an estimated 80% of people with severe hearing loss in the UK also experience tinnitus.  

Tinnitus causes 

What causes tinnitus isn’t entirely known. For instance, there’s a link between stress and tinnitus that can make the condition worse. It’s generally linked to inner ear damage and overexposure to loud noise. Ear infections and wax build-up may also be factors. 

Tinnitus causes have also been linked to medical conditions, including: 

• Cancer treatments 

• Cardiovascular disorders 

• Head and neck injury 

• Hypothyroidism and diabetes  

  
  

Tinnitus treatment 

Tinnitus can’t be cured, but you can manage the symptoms. First and foremost, limit your exposure to loud noises. If you suffer from pulsatile tinnitus associated with blood circulation, improving your health can help to minimise the intensity.  

Other treatments include: 

• Sound therapy to mask or filter out tinnitus noises 

• Hearing aids with tinnitus control features 

• Cognitive Behavioural Therapy (CBT) to help with anxiety and stress 

• Ear wax removal 

• Treating underlying conditions like circulatory issues 

Finding the right hearing aid or treatment for your type of hearing loss  

If you suspect you have hearing loss, first get a GP checkup. Your doctor can treat causes like infection or ear wax or recommend surgery or implants. Otherwise, they can refer you to an audiologist for a hearing check. 

If you need a hearing aid, there are a plethora of devices on the market. A hearing professional will recommend the most suitable style for your level of hearing loss: 

• Behind-the-ear (BTE) devices suit most types of hearing loss but are the least discreet. Receiver-in-the-ear (RITE)aids replace the plastic tube and earmould with a thin wire and receiver. 

• In-the-ear (ITE) devices are suitable for most types of hearing loss. These hearing aids sit in the ear's opening and are more discreet than BTE devices. 

• In-the-canal (ITC) hearing aids are virtually invisible. However, their lack of power makes them unsuitable for severe hearing loss. Completely-in-the-canal (CIC) and invisible-in-the-canal (ITC) aids are even smaller. 

• CROS and BiCROS hearing aids are suitable for unilateral hearing loss.   

  
  

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