Hearing Loss

Hearing loss is a reduced ability to hear sounds, which may affect one or both ears and range from mild to profound. Some people notice they struggle to follow conversations in noisy places, ask others to repeat themselves, or turn the television up louder than before.

Hearing loss is broadly grouped into two types. Conductive hearing loss happens when sound cannot pass freely through the outer or middle ear, for example because of earwax, fluid or an eardrum problem. Sensorineural hearing loss involves the inner ear or the hearing nerve and is often permanent. Some people have a mix of both.

Gradual hearing loss is most often related to getting older or to repeated exposure to loud noise, both of which can damage the delicate structures of the inner ear. Earwax build-up and ear infections are common, usually reversible causes. A perforated (burst) eardrum, changes in pressure, and certain medicines can also affect hearing.

Hearing loss can sometimes accompany other ear conditions, such as labyrinthitis or Meniere's disease, where it occurs alongside dizziness or ringing in the ears. Less commonly, it can be present from birth or follow an injury.

Sudden hearing loss, where hearing drops quickly in one or both ears over hours or a few days, should be treated as urgent. It can sometimes be reversed if assessed and managed promptly, so it should not be put off in the hope it will pass.

Ask for an urgent medical appointment or seek same-day advice if you lose hearing suddenly, or if hearing loss comes with other symptoms such as earache, discharge, dizziness or weakness of the face. Prompt review by an ear, nose and throat specialist gives the best chance of a good outcome.

A clinician usually starts by asking about your symptoms and looking inside your ears to check for earwax, infection or an eardrum problem. Simple checks can suggest whether the loss is conductive or sensorineural.

Formal hearing tests, carried out by an audiologist, measure how well you hear sounds at different pitches and volumes and help confirm the type and degree of hearing loss. Depending on the findings, further tests or scans may be arranged to look for an underlying cause.

Treatment depends on the cause. Reversible causes are addressed directly: earwax can be removed, infections may be treated with the appropriate medicine, and some middle-ear problems can be corrected. When these are resolved, hearing often returns.

When hearing loss is permanent, the focus shifts to making sounds clearer and supporting communication. Hearing aids amplify sound and are suitable for many people. For more significant loss, implanted devices such as cochlear implants may be an option. An audiologist can recommend and fit the most suitable solution and offer advice on communication strategies and assistive technology.

Not all hearing loss can be prevented, but you can lower the risk of noise-related damage by limiting time around loud sounds, keeping the volume down on personal listening devices, wearing ear protection at noisy events or workplaces, and giving your ears time to recover after loud exposure. Treating ear infections promptly and managing earwax sensibly also help.

The outlook varies with the cause. Many people regain hearing once a reversible problem is treated, while those with permanent loss can usually hear and communicate well with hearing aids, implants or other support. Acting quickly on sudden hearing loss is especially important for the best chance of recovery.