Types, Cause & Treatment

Types, Cause & Treatment

Hearing loss means you have a decreased sensitivity to sounds that one normally hears. You can’t reverse hearing loss. However, you and your doctor or hearing healthcare provider can take steps to improve what you hear.

If you have difficulty hearing, you are not alone. Hearing loss is one of the fastest growing health epidemics in Canada. According to Statistics Canada, in 2002 more than one million Canadians reported having some degree of hearing loss. In 2012, this number tripled to more than three million Canadians. Worldwide, over 360 million people have hearing loss!

Hearing loss that occurs gradually as you age (presbycusis) is most common. A significant number of adults over the age of 65 have some degree of hearing loss. For those older than 75, the number of people with some hearing loss is almost 1 in 2.

Hearing loss is not just age-related; it is affecting people at younger and younger ages. In fact, a small percentage of individuals are born with a hearing loss. In Canada, about six in every 1,000 newborns have hearing loss. In the neonatal intensive care unit at Montreal’s Ste-Justine Hospital, four in 100 babies are born with hearing loss.

In 2006, 5% of Canadians aged 15 and older reported having a hearing limitation. Over 83% of hearing limitations were mild in nature, while the remaining 16.8% were classified as more severe.

Hearing loss is often called an invisible condition. Others may not be able to ‘see’ that you have hearing loss, but after spending some time in conversation, they will likely realize the impact that hearing loss is having on your quality of life. It is interesting to note that your conversation partners often suspect hearing loss before you realize it yourself.

Hearing loss is more than just an inconvenience. Even mild hearing loss can have serious social, health and economic consequences.

The most common causes of hearing loss are aging and prolonged loud noise exposure. However, hearing loss can also result from a number of other things including: an accident, illness, exposure to certain drugs/chemicals or genetics at birth.

There are three types of hearing loss: Conductive, Sensorineural and Mixed (which is a combination of conductive and sensorineural hearing loss).

  1. Conductive hearing loss occurs when there are problems with the outer and/or middle ear. Such problems will prevent the entire sound signal from reaching the inner ear. The most common causes of a conductive hearing loss are fluid in the middle ear (ear infection), a perforated eardrum, wax (cerumen) build up or damage to the tiny bones in the middle ear (ossicles). 10% of adults with hearing loss have the conductive kind.
  2. Sensorineural hearing loss is caused by damage to the inner ear. The damage may be to the hair cells of the cochlea or damage to the fibres of the auditory nerve. The most common causes of a sensorineural hearing loss are age and noise exposure. Over years of use and/or abuse the cochlea feels the effects of ‘wear and tear’ on its system. Even if sounds are perfectly processed through the outer and middle ear, they may not be effectively transmitted through the inner ear and to the brain. 90% of adults with hearing loss have the sensorineural kind. The recommendation for most types of sensorineural loss is treatment with hearing aids. People with severe to profound sensorineural hearing loss may also consider treatment with cochlear implants.
  3. Mixed hearing loss occurs when a person has both a conductive hearing loss and a sensorineural hearing loss. An example of this may be a 68 year old person that worked in a loud factory for years and has sensorineural hearing loss, but who also has an ear infection (conductive hearing loss). Often times, the conductive component of the hearing loss can be medically treated and resolved, while the remaining sensorineural portion of the hearing loss is treated with hearing aids.

Hearing loss is complex. We all hear differently and as such, we may have different degrees of hearing loss and how we actually hear can also be different.

Signs of hearing loss can be subtle and surface slowly, or early signs of hearing loss can be significant and come on suddenly. Either way, there are common indications and hearing-impaired signs.

You might have hearing loss if you:

  • Have trouble hearing clearly, especially when there is background noise
  • Find group conversations are difficult to follow
  • Play the volume on the TV or radio too loudly
  • Think everybody is mumbling or that sounds are muffled
  • Frequently ask people to repeat themselves
  • Have trouble hearing when a speaker isn’t facing you
  • Find telephone conversations are becoming more difficult
  • Avoid social situations because you aren’t confident in your hearing

Have your hearing tested by a qualified hearing healthcare practitioner? You may choose to do this at a private clinic or one located in a hospital. To have a hearing test completed in a hospital, a referral from your doctor will likely be required due to funding regulations. Some private clinics charge for the hearing test and others will offer this as a complimentary incentive.

At your first appointment, you will be asked some medical questions and also about the kinds of hearing difficulties you are experiencing. After the hearing test, a recommendation will be made. If you do have hearing loss, hearing aids will likely be recommended. If there is any aspect about your hearing loss that warrants medical investigation, a referral to your family doctor or an ENT will be made.

There are a few important things to keep in mind when purchasing hearing aids. Ensure that you are comfortable with the location (ease of access, hours of availability, easy to make appointments) and also the staff (professional, understanding, accommodating) because this will be a long-standing relationship. Several appointments are recommended when one acquires hearing aids, and a minimum of annual visits are recommended thereafter. Also, be sure to understand everything that is covered (and what is not covered) with the price of the hearing aids.

Each province and territory differs in the delivery of hearing health care and which professionals are involved in the process. You should make sure to find out who is responsible for the cost of a hearing test and hearing aid before you initiate your visit to a hearing healthcare clinic.


 Untreated hearing loss can result in:

  • Impaired memory
  • Depression
  • Danger to personal safety
  • Less alertness to environment
  • Less adaptability to learning new tasks
  • Reduced overall psychological health
  • Increased anxiety
  • Fatigue

Compared to those with untreated hearing loss, hearing-aid users participated in more social activities, they have less difficulty communicating, less anxiety and feel in better overall physical health.

Tinnitus is a condition that affects 10 to 15 percent of adults. It is often described as ringing, buzzing or pulsing noises in the ear. Many people who suffer from tinnitus also have hearing loss. Often, when the hearing loss is treated with hearing aids, the effects of the tinnitus are minimized. It is suspected that tinnitus is related to nerve damage in the inner ear or damage higher up in the brain. It is normal to experience occasional tinnitus in one or both ears. However, constant tinnitus can be extremely aggravating, leading to stress, anxiety, depression, poor concentration, irritability and more. About 5% of the population reports severely intrusive tinnitus that affects their day-to-day lives. If you have tinnitus and need help, several therapeutic approaches and support groups are available.

Hyperacusis is a condition that affects 5% of the population and 50% of adults with tinnitus. It is defined as an increased sensitivity to everyday sounds. Examples of such sounds that cause a person with hyperacusis discomfort are: alarms, cutlery on a plate, dishes clanging, children crying and clapping. The response to these sounds can range from simple sensitivity to extreme pain. If you have hyperacusis and need help, several therapeutic approaches and support groups are available.

Auditory processing disorders (APD) are commonly investigated in children who are labelled as ‘poor listeners’. These children may have normal hearing abilities, but there is some disconnect between what is heard and what is understood. Even though this is currently a ‘hot topic’ for school-aged children, APD also occurs in the adult population. The difficulty in diagnosing APD is that it is not identified by a routine hearing test. For a diagnosis of APD, advanced testing is required. Just as with children, adults with APD have a brain that interprets what it hears as if there were some delay or distortion in the sound. This makes listening, learning and memorization very difficult. If you believe you have APD and need help, several therapeutic approaches and support groups are available.