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4 Common Types of Hearing Problems

Why they occur and what you can do about them

spinner image 4 Common Types of Hearing Problems
Do you have a hearing problem? Find out what you can do to fix it.
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l Do you have a hearing problem? Find out what you can do to fix it.

You can lose your hearing for lots of reasons: age, genetics — and all those blaring rock concerts you attended in your youth.

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More than 48 million Americans have some type of hearing loss. For many people, auditory loss happens so gradually that they barely realize it. Others find that their ears seem to be working fine one day and not so well the next.

Check out these four common types of hearing problems and what you can do about them.

1. You have trouble hearing people in a noisy restaurant.

Why it happens: As you age — especially if you've been exposed to frequent loud noises — you might have presbycusis, a type of gradual hearing loss caused by the death of hair cells in the cochlea, in your inner ear. Those are the cells that translate sound vibrations into brain signals.

"The cochlea contains only 15,000 of these hair cells, and they don't regenerate," says Andrea Boidman, executive director of the Osteo Science Foundation, a research organization in Philadelphia. "When they die, it becomes difficult for people to recognize certain sounds or to hear speech clearly."

Difficulty hearing in noisy places is often one of the first noticeable signs of hearing loss. That's because filtering out background noise is a fairly complex process that requires precise auditory input from both ears. Quiet conversations aren't quite so taxing.

How to fix it: Although you can't repair damaged cells, you can prevent further loss by limiting your exposure to loud noises. Most conversations occur between 40 and 60 decibels; any sound higher than 85 decibels puts you at risk. Common culprits include smartphones, music players and sound speakers that can blast out as many as 105 decibels.

"Listening to just one loud song can cause immediate damage to hair cells," says Monica Okun, an otolaryngologist (ear, nose and throat specialist) at Lenox Hill Hospital in New York. Her advice: If others can hear your music while you're using earbuds, the volume is too loud.

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If your hearing loss is starting to affect your everyday activities, talk to your doctor about a hearing aid. And before you balk, consider this: The newest models are so sleek that they're practically invisible.

"The latest technology effectively reduces background noise while simultaneously enhancing the ability to hear speech more clearly," says Ellen Finkelstein, chief audiologist at East Side Audiology in New York. "People can also hear voices that would be completely inaudible otherwise." For severe hearing loss, you may want to consider cochlear implants. Whereas hearing aids amplify sounds so that damaged ears can detect them, cochlear implants bypass damaged parts and directly stimulate the auditory nerve.

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Red flags: People with kidney or heart disease have a higher than average risk of developing age-related hearing loss. Researchers think that may be because poor kidney function leads to the accumulation of toxins that can damage nerves in the inner ear. And cardiovascular disease can decrease blood flow to the inner ear. "Improving kidney or cardiac function won't reverse hearing loss, but it can prevent it from worsening," Okun says. "I recommend getting a formal hearing test if you have either condition." The reverse may be true, as well; if you have hearing loss, check your kidney and cardiovascular health.

2. You have a feeling of fullness in your ears.

Why it happens: Excess mucus from an infection or allergy can block the eustachian tube, the small canal that connects the throat to the middle ear and regulates airflow, particularly when you swallow or yawn. Besides feeling fullness and muffled hearing, you might also experience popping, pain or tinnitus (ringing in the ears), or have difficulty maintaining balance. A buildup of earwax can cause that feeling of fullness, too.

How to fix it: Most eustachian tube dysfunctions improve when the infection goes away, says otolaryngologist David S. Haynes, Cochlear Implant Program director at Vanderbilt University Medical Center in Nashville. If not, a doctor can prescribe decongestants and antihistamines to help reduce inflammation. As for earwax, any health care provider can remove it with a suction device, irrigation tool or nasal spray, Haynes says. Don't try to do it yourself, though, as you can easily damage your eardrum.  

Red flags: Hearing loss with fullness that's accompanied by significant pain could be otitis externa, or swimmer's ear, an infection of the ear canal that carries sound to the eardrums. The infection is typically caused by water in the ear, which breaks down the skin and provides a breeding ground for bacteria. Otitis externa is usually treated with ear drops that contain an antibiotic.

3. Your hearing loss is sudden.

Why it happens: Swelling or fluid buildup as a result of a virus or ear infection can affect hair cells and nerves, as can taking high doses of certain medications, including aspirin, intravenous antibiotics, chemotherapy drugs and diuretics.

How to fix it: "If an audiogram shows nerve injury, hearing can be recovered if steroids are given within 72 hours of the onset of hearing loss," Okun says. Steroids reduce inflammation and prevent swelling of the auditory nerve, which, if left untreated, can cause permanent hearing loss. Loss of hearing because of use of certain drugs — a condition called ototoxicity — requires an immediate change in your medication if possible.

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Red flags: See your physician if you have sudden hearing loss. In rare circumstances, this could be the sign of a tumor pressing on the auditory nerve. Other uncommon causes include syphilis, Lyme disease, autoimmune disorders and thyroid disease.

4. Hearing loss fluctuates and is accompanied by dizziness, nausea or trouble with balance.

Why it happens: You may have Ménière's disease, an uncommon disorder with no known cause that alters the amount, flow and chemical composition of endolymph, the fluid in the inner ear. According to the Hearing Health Foundation, 1 in 500 people in the United States have the condition.

How to fix it: Ménière's can't be cured, but it can be treated. A low-sodium diet and a prescribed diuretic can help reduce fluid in the inner ear. In rare cases, doctors may recommend injecting a steroid into the middle ear to reduce inflammation, or inserting a tube into the ear to drain excess fluid.

Red flags: Dizziness accompanied by fluctuating hearing loss can also signal other medical conditions, such as a change in blood pressure, cardiovascular problems, dehydration and anxiety. If you're experiencing this type of hearing loss, consult your primary care physician or an ear, nose and throat specialist right away. Sometimes dizziness is not accompanied by hearing loss, which could be a condition known as benign paroxysmal positional vertigo (BPPV). This can usually be helped by a simple series of head turns done under the direction of a health care expert.

This story was updated by freelance writer Cathie Gandel, who specializes in hearing-related health topics.

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