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Hearing impairment can have significant consequences on one of most important sensory organs. In some cases, hearing loss can be triggered by loud noises or infections, but for most, hearing loss is gradual, age-related and only noticeable as it progresses. Fortunately, impaired hearing can be improved, or even fully corrected, with the use of a hearing aid. Find out how.

First Signs of Hearing Loss

Hearing loss rarely occurs all of a sudden. It usually develops gradually, over a long period of time – and is therefore imperceptible at first. This is because those affected gradually get used to the onset of hearing loss. Because the brain can compensate for the hearing deficiencies for a long time, there are few disadvantages in everyday life during the first phase.

But from a certain point, hearing loss can no longer be readily compensated for. Often, this is noticed by family and friends of the affected person long before they themselves realize they cannot hear normally.
Even those affected by hearing loss who know that they can no longer hear perfectly often still do nothing for a long time. Using the argument "It’s still OK!", they put off a hearing test  with an audiologist or hearing care professional. This is because being aware of your own hearing loss is one thing, but acknowledging it is not so easy.
The problem is that if you wait too long, you risk serious consequences. Researchers have found that after about seven years, our brains simply lose the ability to understand certain sounds. If you wait too long to get help with hearing aids, even though you will once again be able to hear those sounds again, the brain may not be able to correctly interpret what is being heard. 
The following three questions may help you find out if you have hearing loss:
Do you often think people mumble when speaking to you?
Do you find yourself asking people to repeat themselves? Do you say "what?" or "huh?" a lot?  If so, this could be an indication of hearing loss.
Do you have the TV on very loud?
If the people around you tell you that your TV or radio is too loud, then you should take this seriously. It might mean that you are being affected by the onset of hearing loss.
Do you find conversations stressful in noisy environments?
Do you have to concentrate very hard during conversations with one person or multiple people when there's a lot of background noise (restaurant, parties, meetings)? This could be a source of high stressed and exhaustion. The constant fear of making mistakes makes everything worse. This so-called cocktail party effect is a key early indication of the onset of hearing loss.
You can find more information here on whether you might need a hearing aid:

What happens in the event of hearing loss?

The cause of hearing loss may be found at various points in our complicated, sensitive ears: the outer ear, the middle ear, the inner ear or even the auditory nerve. Hearing loss is not always age-related. It can also be triggered by loud noises, infections, medications or injuries, or may be hereditary.
Often it is the higher frequencies that are affected first. Because these are important for hearing the so-called voiceless consonants (f, s, p, t), the understanding of speech especially in high background noise is noticed first. Depending on the type of hearing loss, other symptoms may appear, for example tinnitus, noise sensitivity, or dizziness. In almost all cases, hearing loss is permanent, and it is often difficult to predict how it will progress.

Those affected are often unaware that untreated hearing loss will eventually have an impact on the mind and quality of life. People with untreated hearing loss often complain of chronic fatigue. For them, conversations are so stressful that they would rather avoid social contact, and they increasingly withdraw. The impact of this self-imposed isolation is very serious. Studies show that older people with untreated hearing loss are more likely to develop dementia than those with normal hearing or people using hearing aids.

What can be done about hearing loss?

Whether or not a hearing aid can be used to compensate for or reduce hearing loss depends on the cause. In most cases, fortunately this is possible. When amplifying and modulating background noise, the hearing aid takes into account how the auditory response area in our heads processes sounds and voices. Modern technology therefore makes hearing easier and more comfortable again.
Digital technology separates voices from background noise, for example, making it easier for someone with hearing loss to understand and stay focused on a conversation. In addition, the hearing loss is compensated for so that both ears can work together again optimally, which improves precise directional hearing and therefore orientation. This trick works by the hearing aids on both ears communicating with one another.

Acute hearing loss and tinnitus – due to stress?

In just a single moment, the world sounds quieter in one ear. Listening to voices and music suddenly sounds different – as if you’re wrapped in cotton wool. The phenomenon is called acute hearing loss or sudden sensorineural hearing loss, and should be treated by an ENT doctor as quickly as possible. Although the specific cause is unknown, there are various theories that may explain it.

The quicker acute hearing loss is treated the better the chance of recovery. Although the symptoms may go away on their own or with medical intervention within in a short period of time in half of those affected, subsequent damage remains in some cases, for example in the form of tinnitus or impaired hearing.

Why does our hearing diminish as we age?

Age-related hearing loss (presbycusis) is a natural process. It usually starts between the ages of 45 and 65, and can be worsened by external factors such as high noise levels. Age-related hearing loss mainly affects the higher frequencies, and usually occurs in both ears. It is caused by damage to the fine hair sensory receptor cells in the cochlea. This leads to diminished signal transmission to the auditory nerve. The first signs can be the loss of soft sounds such as the rustling of leaves or hearing your blinker in the car. Difficulty understanding speech in high background noise is also common. Because age-related hearing loss occurs gradually, people often only become aware of it as it progresses.

Presbycusis cannot be treated with medication or surgery; however, hearing aids can be a great help with this form of hearing loss.

Is it genetic?

Some forms of hearing loss are genetic. They are caused by mutations in the genes that affect the development and function of the ear. Nowadays, it is known that, of the approximately 30,000 genes in humans, about 500 can influence hearing. Gene research continually leads to new findings in this area. For example, Prof. Claes Möller from the University of Örebro in Sweden has found that a modified or mutated gene is characterized by the production of either too much or too little protein.
Of all the congenital forms of hearing loss, two-thirds can be ascribed to such a gene mutation. In the other third, it is a syndrome, e.g. Usher Syndrome, in which patients have a combination of symptoms, also including visual impairment, amongst others.
The researchers’ main aim is to find out which gene is responsible for which type of hearing damage, so that those affected can be helped by gene therapies in the future.

How can this be prevented?

In order to hear, we not only need our ears, but also an intact and trained auditory response area in the brain. This is because, in the so-called auditory cortex, the acoustic pulses are interpreted and transmitted to the conscious mind. Did you know that our sense of hearing stimulates our brains more than our sense of sight? The problem is that when the brain is no longer sufficiently "trained" due to hearing loss over a longer period, nerve endings are broken down.
As a result, the brain not only loses the ability to hear, but also ages faster overall; for every 10 decibels of hearing loss, the risk of dementia increases by more than 20 percent. Timely treatment with hearing aids can help prevent this. We recommend a yearly hearing test from the age of 50.

Hearing loss in numbers

  • 48 million people in the U.S. live with hearing loss – that’s almost one in every five people
  • Around 1.1 billion people worldwide are affected by hearing loss, which is approximately 16 percent of the world’s population
  • Only 2 or 3 in every 1,000 newborn babies is affected by significant hearing loss
  • One in three people over 60 years of age is affected by hearing loss
  • A third of all those with hearing loss are of retirement age
  • 65 percent of people with hearing loss have mild hearing loss, 30 percent have moderate hearing loss, and only 5 percent have serious or profound hearing loss
  • Only one in five people who would benefit from a hearing aid actually uses one
  • On average, people with hearing loss wait a full 10 years until they do something about it

The basis used is the World Health Organization (WHO) definition, which states that a person with hearing loss of more than 25 decibels (dB) has hearing damage.

Reasons behind increased hearing loss

More and more people worldwide are being affected by hearing loss. The causes of this epidemic are directly linked to modern civilization and our lifestyle. The most important factors are:
Thanks to modern medicine and high standards of living, life expectancy is continuing to rise. The probability of developing hearing loss also increases with age. One in two people over 70 years of age is affected by hearing loss.
Traffic, construction sites, industrial plants, loud music and warning signals are only some of the permanent sources of noise that affect us in any city. It’s predominantly young people that frequently strain their hearing by listening to loud music through headphones. This constant exposure to sound has fatal consequences for human hearing. The sensitive sensory cells in the inner ear can never entirely recover, and degrade prematurely.
Insufficient Ear Protection
Despite clear noise protection regulations, thousands of people expose themselves to damaging noise levels in the US every day without any protection, both at work (e.g. machine noise) and in their free time (loud music). In these situations, it would be very easy for them to protect themselves against these damaging noise levels.

Do hearing aids help all types of hearing loss?

Most people with hearing loss can benefit from treatment from hearing aids.
In principle, a distinction is made between three types of hearing loss: 
  • conductive hearing loss
  • sensorineural hearing loss
  • mixed - both conductive and sensorineural

An important tip: If you feel that your hearing may have deteriorated recently, then don’t hesitate to visit a hearing care professional, because, regardless of the cause of your hearing loss, early diagnosis gives you a significant advantage.
Conductive hearing loss usually relates to blockages, inflammation, or disease in the outer or middle ear. Depending on the cause, medication, syringing, or surgical intervention may help.

The most common category is sensorineural hearing loss, and the cause is found in the inner ear, in the region of the cochlea (damaged sensory cells) or – in rarer cases – in the auditory nerve. The sound does reach the inner ear, but it is not correctly transmitted from there.
In in the case of mixed - conductive and sensorineural hearing loss a person could be afflicted by a sensorineural hearing loss and also suffer from a ear infection that is causing an additional hearing loss that is conductive as an example.

The good news for those with any type of hearing loss is that you can usually compensate for this by using a modern hearing aid. This can noticeably improve your hearing.

Do hearing aids help with mild hearing loss?

Most sounds in our daily lives – speech, music, the telephone ringing – are within a frequency range of 500 to 3000 Hertz (Hz). If your hearing curve falls below a threshold of 25 decibels (dB) in this range, then you have mild hearing loss. Even in this range, using a modern hearing aid is definitely advisable, since it can noticeably improve your hearing.
Treatment with a hearing aid may also be advisable if, despite not yet having reached the above-mentioned indicative limit, the person affected does have some psychological strain. Therefore, it’s not just the measurement that is the deciding factor; an individual’s subjective feeling is important too.

You can test the hearing aid together with the audiologist. Click here to find out how easy it is to get used to a hearing aid.

Additional Articles

What is acute hearing loss?
Tinnitus – Causes and Symptoms
Getting a Hearing Test