Hearing Loss Is More Common Than You Think

When you hear of hearing loss, what comes to mind?

Older people, right? Yes.

Well, it may surprise you to know that hearing loss is actually more common than you think, and it can also affect younger individuals for various reasons.

Hearing loss can significantly impact our ability to communicate, enjoy everyday activities, interact with the world, and be productive at work. It’s not just a health issue but a barrier to fully experiencing life.

Research conducted in 2014 on the experiences of individuals with hearing loss revealed that it significantly affected both their personal and professional lives, often leading to feelings of isolation and frustration.

Seventy-four per cent (74%) of respondents believed their hearing loss limited their job opportunities. Another seventy percent (70%) agreed that their loss of hearing sometimes prevented them from performing optimally at work, and two-fifths (41%) retired early due to the impact of their loss and struggles with communication at work.

Not much is being said about hearing loss, and many seem to attribute it to old age. However, the lack of awareness about the prevalence and impact of hearing loss is a significant issue that needs to be addressed.

Research has shown that in 2024, over 50% of the world’s population, or 430 million people, will require rehabilitation to address their disabling hearing loss, including 34 million children. In addition, it is estimated that by 2050, over 700 million people or 1 in every 10 people will have disabling hearing loss.

These statistics highlight the alarming prevalence of hearing loss and the urgent need for proactive measures to address this issue.

The major causes of hearing loss include extended and constant exposure to loud sounds, direct ear or ear drum trauma, genetics, growing older or other health challenges.

In this article, we will explore the types of hearing loss, causes of hearing loss, the social effects of hearing loss, solutions for hearing loss, and prevention and management of hearing loss.

Brief Physiology Of Hearing

To appreciate the ability to hear, let’s explore briefly the physiology of hearing.

• The Outer Ear

The outer ear consists of the auricle, the visible part of the ear, and the external auditory canal. This canal is a narrow passage, approximately the width of a pencil and about 2.5 cm long. It is lined with skin and ends at the eardrum, the tympanic membrane. The outer ear contains glands that secrete wax and hair follicles that help protect it from dust and debris. When sound waves enter the ear, they cause the eardrum to vibrate. The vibrations cause tiny bones or ossicles in the ear (malleus [hammer], incus [anvil] and stapes [stirrup] ). Vibrations are sent to the cochlea (in the inner ear), where fluid movement stimulates hair cells that convert the vibrations into electrical signals that are sent to the brain as sound waves for interpretation by auditory nerves. Amazing, isn’t it?

• The Middle Ear

The middle ear is a small cavity approximately 1.3cm by 1.3cm, filled with air and includes three tiny bones or ossicles (as mentioned). The eardrum lies between the middle ear and the outer ear. The middle ear connects to the back of the nose and throat by a narrow area called the eustachian tube. Yawning and swallowing opens this tube, equalising the air pressure in the middle ear. The snail-shaped cochlea is part of the inner ear.

• The Inner Ear

The inner ear( snail-shaped labyrinth, literally a structure of winding passages) is embedded with a petrous bone, which is, embryologically, one of the oldest and hardest bony areas of the body. It consists of the cochlea, semi-circular canals, utricle and saccule, which all work together to maintain balance and the orientation and movement of your head and body and monitor your head’s position in relation to gravity and linear motion.

Having had a glimpse into the anatomy (the structure of the ear) and physiology (all that takes place for you to be able to hear) of the ear, you now see that the ear is a vital part of the human body and at this point, you should be able to better appreciate the ability to hear.

The ear has two main physiological functions: hearing, maintaining postural equilibrium, and coordinating head and eye movements.

“About 40 million people live with hearing loss in the African region”

What Is Hearing Loss?

Hearing loss refers to the partial or complete inability to hear sounds. It can happen in one ear (unilateral) or both ears (bilateral). Hearing loss can vary in severity, ranging from mild to profound, and can develop gradually or suddenly.

It can affect people of all ages, though it’s most commonly associated with ageing.

Our ears are divided into three parts: the outer ear, the middle ear, and the inner ear. The outer ear collects sound waves, which travel through the ear canal to the middle ear, vibrating tiny bones called ossicles. These vibrations are then sent to the inner ear, where they are transformed into electrical signals and sent to the brain. Hearing loss can occur at any stage of this process.

Types Of Hearing Loss

Hearing loss is typically classified into three types: conductive, sensorineural, and mixed.

• Conductive Hearing Loss: This type of hearing loss occurs when a problem in the outer or middle ear prevents sound from being properly conducted to the inner ear. Common causes include ear infections, earwax buildup, fluid in the ear, or damage to the bones in the middle ear. Conductive hearing loss is often temporary and can be treated with medications, surgery, or simple procedures like earwax removal.

• Sensorineural Hearing Loss: This type of hearing loss happens when the inner ear or the auditory nerve is damaged. The damage can result from ageing, long-term exposure to loud noise, illness, or genetics. Unlike conductive hearing loss, sensorineural hearing loss is usually permanent. While it can’t be cured, it can be managed with hearing aids or cochlear implants to improve hearing.

• Mixed Hearing Loss: This combines both conductive and sensorineural hearing loss. It means that a person has damage in both the outer/middle ear and the inner ear or auditory nerve. Treatment for mixed hearing loss may involve a combination of methods used for both types of hearing loss.

Other types include:

• Auditory Neuropathy Spectrum Disorder: Auditory Neuropathy Spectrum Disorder (ANSD) is a relatively rare type of sensorineural deafness which occurs in the inner ear. In ANSD, sounds are initially received normally by the cochlea (inner ear), but the transmission of these sounds to the brain becomes disrupted. This disruption makes it challenging to understand speech and distinguish between different sounds, particularly in the presence of background noise.

• Auditory Processing Disorder: Auditory processing disorder (APD), also known as central auditory processing disorder (CAPD), is a type of hearing loss that occurs when something affects the part of the brain responsible for processing sound. Unlike other types of hearing loss caused by damage to the ears, APD involves the brain’s ability to interpret sounds. This condition can affect individuals of all ages, but it is most commonly observed in children and older adults.

“Over 1 billion young adults are at risk of permanent, avoidable hearing loss due to unsafe listening practices.”

Causes Of Hearing Loss

Hearing loss has many causes, and some people may experience a combination of factors. The most common causes include:

• Age (Presbycusis): As people age, the structures in the inner ear can deteriorate, leading to a gradual decline in hearing ability. This type of hearing loss is most common in people over 60.

• Noise Exposure: Prolonged exposure to loud sounds, such as listening to music through headphones at high volume, attending loud concerts, or working in noisy environments, can damage the delicate hair cells in the inner ear. This damage is usually permanent.

• Infections and Illnesses: Ear infections, colds, flu, or even serious conditions like meningitis can cause hearing loss. Some prolonged infections may damage the middle or inner ear, while others may cause temporary hearing loss that improves with treatment.

• Genetics: Some people are born with genetic conditions that cause hearing loss or may inherit a predisposition to it. Genetic factors can lead to hearing loss at birth or later in life.

• Medications And Ototoxic Drugs: Certain medications, including some antibiotics, chemotherapy drugs, and high doses of aspirin, can cause hearing loss by damaging the ear structures or auditory nerve.

• Trauma: Injury to the head or ear or loud explosions (such as gunshots or fireworks) can cause immediate hearing loss, which may improve over time depending on the degree of trauma.

• Health Conditions: Diseases like diabetes, high blood pressure, or cardiovascular issues can lead to hearing loss as well. Conditions that affect the blood flow to the ears can damage hearing over time.

“About 14.4% of adults worldwide have experienced tinnitus. Roughly 2% have experienced severe tinnitus, and almost 10% have experienced chronic tinnitus (lasting more than 3 months).“

Common Symptoms Of Hearing Loss

• Continuously feeling the need to raise your voice in order to ensure that you are heard by others during conversations.

• Experiencing a persistent ringing or buzzing sensation in your ears, commonly known as tinnitus, which can be distracting, irritating and uncomfortable.

• Struggling to hear someone speaking just three feet away, often leading to misunderstandings or missed information.

• Feeling a sense of disconnection or detachment during social gatherings, making it challenging to engage with others fully.

• Consistently finding it necessary to turn up the volume on televisions, radios, or other audio devices to a level that may seem excessive to others.

• Having difficulty distinguishing and hearing consonant sounds in the alphabet, which can make following conversations more challenging, particularly when those sounds are not the prominent vowels.

• Noticing that speech and other auditory sounds often seem muffled, as if there’s a layer of distortion that prevents you from fully understanding what’s being said around you.

“Non-Hispanic White adults are more likely than adults in other racial/ethnic groups to have hearing loss; non-Hispanic Black adults have the lowest prevalence of hearing loss among adults ages 20-69.“

Degrees Of Hearing Loss

There are degrees of hearing loss. The most common are:

• Mild Hearing Loss: Individuals struggle to hear soft sounds and may misunderstand speech, especially in noisy environments.

• Moderate Hearing Loss: People with moderate hearing loss find it hard to hear normal conversations and may rely on lip reading or hearing aids, especially in noisy places.

• Severe Hearing Loss: People with severe hearing loss can only hear loud sounds and often need hearing aids or sign language to communicate effectively.

• Profound Hearing Loss: Individuals cannot hear speech at all and rely on sign language or other visual methods for communication.

Classifying Hearing Loss

• Unilateral Or Bilateral: Unilateral is hearing loss in one ear, while bilateral is in both ears.

• Pre-lingual Or Post-lingual: Pre-lingual hearing loss occurs before a person learns to talk, while post-lingual hearing loss occurs after a person learns to talk.

• Symmetrical Or Asymmetrical: Symmetrical means hearing loss is the same in both ears, while asymmetrical means different in each ear.

• Progressive Or Sudden: Progressive hearing loss occurs when hearing worsens over time, while sudden hearing loss happens suddenly.

• Fluctuating Or Stable: Fluctuating hearing loss occurs when hearing loss seizes and continues, while stable hearing loss stays the same over time.

• Congenital Or Delayed Onset: Hearing loss is present at birth (congenital) or appears sometime later in life (delayed).

Effects Of Hearing Loss

Hearing loss can significantly impact daily life. It can affect communication, leading to misunderstandings and frustration.

People with hearing loss may find it hard to follow conversations, especially in noisy environments. They may also struggle with phone calls or watching TV without subtitles.

For those with severe hearing loss, social isolation can become a concern. Communication with family, friends, and colleagues may become challenging, leading to feelings of loneliness or depression.

Untreated hearing loss can delay language development in children, affecting their education and social skills.

Additionally, hearing loss can affect safety. Not being able to hear alarms, sirens, or people calling for help can be dangerous.

Solutions And Treatment For Hearing Loss

The good news is that, depending on its type and severity, there are many ways to manage and treat hearing loss.

For mild to moderate hearing loss, hearing aids are often an effective solution.

These devices amplify sounds and make hearing speech and other noises easier.

Hearing aids come in different styles, such as behind-the-ear or in-ear models, and they can be customised to the user’s specific needs.

A cochlear implant may be an option for those with more severe hearing loss.

This device is surgically implanted into the inner ear and helps bypass damaged hair cells to send sound signals directly to the auditory nerve.

Cochlear implants (surgical intervention) are often recommended when hearing aids are not sufficient.

Assistive Listening Devices (ALDs), like FM systems, can help in specific situations, such as classrooms or theatres. These devices work by picking up sound from a microphone and sending it directly to a receiver, making it easier for the listener to hear.

Improving or enhancing communication strategies can also make a big difference. Using visual cues, lip reading, and ensuring good lighting during conversations can help those with hearing loss understand better. Many people with hearing loss also find that speech therapy or auditory training can improve their communication skills.

Sometimes, earwax removal can help restore normal hearing in mild cases. Treating underlying conditions like an ear infection can also aid in improving hearing.

Preventing Hearing Loss

While some causes of hearing loss are beyond our control, there are steps we can take to protect our hearing.

Avoiding loud noises is one of the best ways to prevent hearing damage.

If you must be in a noisy environment, use ear protection, such as earplugs or earmuffs.

Turning down the volume on music players and wearing noise-cancelling headphones can help protect your hearing.

Regular hearing checks are also important, especially as you age or if you work in noisy environments.

Early detection can help address hearing issues before they become more severe.

A Baseline Hearing Test

Visits to the audiology should be as important as visits to the dentist. Most adults don’t usually do hearing tests.

It’s vital to check your hearing at least once a year. It makes it easier to detect any hearing issues early and quickly intervene appropriately.

Once you check your baseline hearing, if you suffer hearing loss in the future, the audiologist can compare the hearing loss to your baseline. This will help you understand the severity of your loss and map out an effective treatment plan.

The Burden Of Hearing Loss In Africa

A recent WHO report reveals that hearing loss is a rising issue in Africa, affecting 40 million people and is projected to reach 54 million by 2030 if no action is taken.

Hearing loss costs Africa about $27 billion each year and mainly impacts vulnerable populations, worsening health inequalities.

Children with hearing loss risk delays in language development, which harms their education. For adults, untreated hearing loss can lead to isolation, depression, and dementia.

A significant cause of this rise is the shortage of ear and hearing care specialists; over half of African countries have fewer than one ENT specialist per million people, and many lack sufficient audiologists and speech therapists. Although 33 million need hearing aids, only 10% have access due to high costs (In comparison, the  European region has about 50 for every million people).

Most African countries do not provide ear and hearing care at the primary level, and hearing loss screening for newborns is rare. Preventable causes like infections account for 75% of hearing loss in children, especially in low-and middle-income countries.

The report urges governments to prioritise ear and hearing care by developing stronger policies, integrating services into health programs, and seeking public-private partnerships. It also recommends increasing funding to improve care infrastructure and workforce capacity.

Conclusion

Hearing loss is a common condition that affects millions of people worldwide.

Whether caused by ageing, noise exposure, genetics, or health conditions, it can impact communication and quality of life.

However, with the right treatment, including hearing aids, cochlear implants, and communication strategies, people with hearing loss can continue to live full and active lives.

Protecting your hearing early on and seeking professional help when necessary can make all the difference in preserving your ability to hear.

Resources

• The lived experience of hearing loss – an individualised responsibility. International Journal Of Audiology.

• Burden of hearing loss in Africa could rise to 54 million by 2030: WHO Report.

• Hearing Loss and Cognitive Decline in Older Adults. Research.

• Experiences of young people with mild to moderate hearing loss: Views of parents and teachers. The Ear Foundation.