Most causes of
in older people can be categorized into two main groups:
- Conductive hearing loss
- Sensorineural hearing loss
Conductive hearing loss involves abnormalities of the external or middle ear, such as earwax, ear infection, a ruptured eardrum, fluid in the middle ear, or tumor. Another possibility is
otosclerosis, which are abnormal bone deposits that occur on the bones of the middle ear. Treatment involves wearing a hearing aid or having surgery.
Sensorineural hearing loss involves abnormalities of the inner ear or the nerve pathways to the brain. Hearing loss related to aging, called
presbycusis, is one of the most common causes of hearing loss in the US. It is characterized by trouble hearing high-pitched sounds that develops gradually in both ears. Other causes include exposure to loud noises, drug side effects, and health conditions, like cardiovascular disease. Treatment of sensorineural hearing loss often consists of using some sort of hearing device to amplify sound. In certain cases, a cochlear implant
may be needed to restore hearing. If a tumor is compressing the nerve and causing the hearing loss, surgical removal of the tumor can sometimes improve the hearing.
A number of medical devices and treatments are available to help improve hearing. These include:
- Hearing aids
- Assistive listening devices
- Cochlear implant
Hearing aids are small electronic devices that are worn in or behind your ear. They amplify sound as it enters your ears. There are two main types:
- Analog hearing aids are the most common and least expensive type. These aids amplify speech and background noise alike, converting them into electrical signals. Some programmable models offer settings for different listening environments.
- Digital hearing aids are more costly. These devices transform sound waves into digital signals. The computer chip is usually programmed to selectively amplify speech and suppress background noise. This type of hearing aid offers the greatest flexibility for programming and adaptability to individual needs.
Assistive listening devices consist of a variety of devices that can be used as alternatives or supplements to hearing aids. An inexpensive option is to have the speaker talk into a microphone that is hooked up to the listener’s headphones. Other devices can connect the listener directly to the sound system in a TV, radio, stereo, or public place, such as a theater or church.
Cochlear implants are reserved for people with severe hearing loss. This device is a receiver about the size of a quarter that is surgically implanted just under the skin behind one ear. The receiver sends a sound signal to the brain. The person also wears a small external microphone behind one ear and a speech processor that fits in a pocket or on a belt.
It is essential to tell your friends, family, and colleagues that you have difficulty hearing so they can help you. Ask them to face you when speaking. Also, share these communication tips from the National Institute of Health:
- Speak more clearly and a little louder than normal. Do not shout, since it can distort your speech. Talk at a reasonable speed and do not exaggerate sounds.
- Stand in good lighting. Do not cover your mouth, eat, or chew gum.
- Use facial expressions or gestures to give useful clues.
- Reduce background noise during conversations. In public places, try to talk away from noisy areas.
- Repeat yourself if necessary, using different words or shorter sentences.
- Try to be patient. Stay positive and relaxed and ask how you can help.
Talk to your doctor to find out what you can do to prevent further hearing-related problems. For example, exposure to loud noise can worsen many types of hearing damage. Ask about limiting loud noise and wearing earplugs or protectors when noisy environments are unavoidable. Also inquire about safety precautions you can take in situations that involve auditory cues such as driving or crossing streets. Getting the medical care you need can help you learn better ways to cope with your hearing loss.
Cochlear implants. National Institute on Deafness and Other Communication Disorders (NIDCD) website. Available at: https://www.nidcd.nih.gov/health/hearing/pages/coch.aspx. Updated November 2013. Accessed February 18, 2014.
Conductive hearing loss. American Speech-Language-Hearing Association website. Available at: http://www.asha.org/public/hearing/Conductive-Hearing-Loss/. Accessed February 18, 2014.
Hearing aids. National Institute on Deafness and Other Communication Disorders. Available at:
http://www.nidcd.nih.gov/health/hearing/hearingaid.asp. Updated September 2013. Accessed February 18, 2014.
Hearing loss. National Institute on Aging. Available at:
http://www.nia.nih.gov/health/publication/hearing-loss. Updated February 13, 2014. Accessed February 18, 2014.
Hearing loss and older adults. National Institute on Deafness and Other Communication Disorders. Available at:
http://www.nidcd.nih.gov/health/hearing/older.asp. Updated November 2013. Accessed February 18, 2014.
Isaacson JE, Vora NM. Differential diagnosis and treatment of hearing loss.
American Family Physician.
2003; 68: 1125-1132.
Leung J et al. Predictive models for cochlear implantation in elderly candidates.
Arch Otolaryngol Head Neck Surg. 2005;131:1049-54.
Otosclerosis. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated June 4, 2012. Accessed February 18, 2014.
Otosclerosis. Massachusetts Eye and Ear Infirmary website. Available at:
http://www.masseyeandear.org/for-patients/patient-guide/patient-education/diseases-and-conditions/otosclerosis/. Updated July 3, 2012. Accessed February 18, 2014.
Presbycusis. National Institute on Deafness and Other Communication Disorders. Available at:
http://www.nidcd.nih.gov/health/hearing/presbycusis.asp. Updated February 2002. Accessed February 18, 2014.
Sensorineural hearing loss. American Speech-Language-Hearing Association website. Available at: http://www.asha.org/public/hearing/Sensorineural-Hearing-Loss/. Accessed February 18, 2014.
Stidham KR, Roberson JB Jr. Hearing improvement after middle fossa resection of vestibular schwannoma.
Otol Neurotol. 2001 Nov;22(6):917-21.
Yueh B, Shapiro N, MacLean CH, Shekelle PG. Screening and management of adult hearing loss in primary care: Scientific review. Journal of the American Medical Association. 2003; 289: 1976-1990.
Last reviewed February 2014 by Michael Woods, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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