How can I prevent and manage hearing loss?

What are the types of hearing loss?

There are three main types of hearing loss: conductive, sensorineural and mixed (read more below).

The type of loss relates to the location of the hearing disorder within the ear. The ear can be divided into three sections – the outer ear, the middle ear and the inner ear.

• The outer ear consists of the pinna and the ear canal (external auditory meatus). The ear drum (tympanic membrane) divides the outer ear from the middle ear.
• The middle ear contains three small bones or ossicles called the malleus, incus and stapes. The middle ear is an air-filled cavity. A canal called the Eustachian tube links the middle ear with the back of the nose. This tube helps to ensure that the air pressure in the middle ear is the same as that in the environment. There are two small openings between the middle ear and the inner ear. These openings are called the oval window and the round window, and they are both covered by membranes.
• The inner ear contains the cochlea, a snail-shaped organ that converts sound waves into electrical impulses that are then sent along the auditory nerve to the brain. The inner ear also contains the balance (vestibular) organs, the semicircular canals and otoliths.

What is conductive hearing loss?

This type of hearing loss occurs when there is a disorder in the outer and/or middle ear. Some common causes of conductive hearing loss are:

• A build-up of wax (cerumen) blocking the ear canal
• A hole (perforation) in the ear drum
• Fluid in the middle ear
• Damage to the middle ear bones

What is sensorineural hearing loss?

Sensorineural hearing loss occurs when there is a disorder in the inner ear and/or auditory nerve. Most sensorineural hearing losses arise from damage to the delicate hair cells in the cochlea. The two main causes of this type of loss are prolonged exposure to loud sounds and degeneration that occurs as part of the ageing process.

What is mixed hearing loss?

A person has a mixed hearing loss when there is both a conductive and a sensorineural hearing loss in the same ear. For example, a person could have a conductive hearing loss due to a perforated ear drum caused by a middle ear infection and a sensorineural hearing loss due a cochlear disorder caused by working in a noisy factory without using adequate hearing protection.

How can you develop hearing loss from noise?

Hearing loss caused by exposure to loud sounds is called Noise-induced hearing loss (NIHL). This type of hearing loss can arise from exposure to loud sounds in the workplace, during recreational activities or when working with loud equipment at home. Recreational activities that can put you at risk of NIHL include video gaming, listening to loud music through ear buds, ear pods and headphones, and attending noisy events such as live music and loud sporting events. At home, some appliances like lawn mowers, leaf blowers, whipper snippers and carpentry tools often exceed safe noise levels.

Damage to your hearing from exposure to loud sound is permanent but preventable. You can protect your hearing by understanding the hazards that noise exposure presents and by putting in place some strategies to reduce the risk.

When is a sound hazardous?

Whether a sound is hazardous to hearing depends on three factors:

• The loudness of the sound
• How close you are to the noise source
• The time spent in the noisy environment

The louder the sound, the shorter the time it takes for NIHL to occur.

The safe time limit for noise exposure is determined by the volume of the noise. For example, the safe exposure time for a sound at 85 dBA is 8 hours. After that, for every 3 dB increase in sound level, the safe exposure time is halved. So, if the sound is increased to 88 dBA, the safe exposure period for the same sound reduces to 4 hours; and if the sound is increased to 91 dBA, the safe period is only 2 hours.

How can you minimise your risk of noise-induced hearing loss?

• Be aware of hazardous noise in your environment. You can monitor the loudness level of sounds by downloading a free sound level meter app.
• Select devices with inbuilt listening safety features so that you can monitor your exposure.
• Set your listening device volume level to no more than 60% of its maximum level. If using an app to monitor the sound level, stay below an average of 80dBA.
• Wear ear protectors such as ear plugs when exposed to loud noise.
• If you can’t reduce the noise level or protect your ears from the noise, move away from the noise source.
• Take regular breaks away from the noise. This gives your cochlear hair cells time to recover.
• If you notice any changes in your hearing or noises in your ears or head (tinnitus), make an appointment to see an audiologist for a hearing evaluation.

Can I reverse hearing loss?

This depends on the type of hearing loss. Many conductive hearing disorders and the conductive component of mixed hearing losses can be successfully treated either medically or surgically. In most cases, sensorineural hearing loss is permanent.

How can I manage my hearing loss?

The first step is to see an audiologist for a diagnostic hearing test.

How can an audiologist help?

An audiologist can:

• Carry out a diagnostic hearing evaluation to determine the type and the degree of your hearing loss.
• Assess any other ear-related issues such as ear/head noises (tinnitus) and balance/dizziness problems.
• Discuss your results with you and recommend a referral an ear specialist (ENT) if the results suggest that this is necessary.
• Discuss how to employ some simple but effective communication strategies.
• Help you to choose appropriate hearing protection devices, including custom made ear plugs.
• Discuss management options with you that suit the type and degree of your hearing loss and your lifestyle. These options may include obtaining an assistive listening device such as a personal or television amplifier, or trialling hearing aids or other hearing devices.
• Arrange regular review appointments with you to check on your progress in using your communication strategies and any listening devices that you have chosen.
• Carry out a review hearing test every 12 months or sooner if you notice any change in your hearing.