3 Types of Hearing Loss | Which One Do You Have?

Nearly 50 million people in the United States have some form of hearing loss, and by 2060, that number is expected to climb to nearly 75 million. At present, two thirds of people over the age of 70 have hearing loss. The fact of the matter is that at one point or another, hearing loss touches everyone's lives, whether it's your hearing loss or a family member's. That's why today I'll be reviewing the three types of hearing loss, including their main causes, if it can be prevented, and treatment options. But before we do that, we would really appreciate if you could give this video a thumbs up to bring videos like these to a wider audience, and while you're at it, if you haven't yet already, hit that subscribe button with notification bell. Make sure you do that too, so that you never miss any one of our newly released videos.

Now, to understand each type of hearing loss, you first need a foundational understanding of ear anatomy. The human ear is actually composed of three distinct elements, the outer ear, the middle ear, and the inner ear. The outer ear includes your pinna, which is what most people think of when they hear the word ear, as well as your ear canal and eardrum. The purpose of the outer ear is to pick up sound vibrations and funnel them down to your eardrum, where they're then transferred to the middle ear. The middle ear happens to consist of the three smallest bones in your body, known as the ossicles, which include the malleus, incus, and stapes. In both the outer and middle ear, sound vibrations are amplified and turned into mechanical pulses that are then sent to the inner ear. The inner ear is comprised of the cochlea, which is your hearing organ, the semicircular canals, which control balance, and the auditory nerve.

Inside of the cochlea, there's a bunch of fluid and a membrane with three rows of outer hair cells and a single row of inner hair cells. The outer hair cells are responsible for enhancing these vibrations even more, and the inner hair cells are responsible for receiving these vibrations. Once received, the inner hair cells turn these vibrations into neural impulses that travel up the auditory nerve to your brain. As you can tell, this system is very complex and any issues along this pathway can lead to hearing loss, but it is the location of these issues that will determine which type of hearing loss you have. First, let's talk about sensorineural hearing loss, which is the most common type accounting for nearly 90% of all hearing losses. This is when the sensory or nerve portion of your hearing is affected, including the structures within the cochlea or your auditory nerve.

More often than not, this type of hearing loss is caused by damage to the tiny inner and outer hair cells within the cochlea. Although the outer and middle ear may be doing their job just fine, the inner ear is unable to receive or transmit the vibration of sound up to the brain effectively. But what causes these hair cells to become damaged in the first place? The most common causes of sensorineural hearing loss include loud noise, exposure, age and genetics. Noise-induced hearing loss is caused by exposure to loud sounds. This can include high intensity sounds that don't occur for very long, including gunfire, explosions, and even power tools. Noise-induced hearing loss can also occur with more sustained loud noises such as motorcycles, concerts, and heavy equipment. Whether it's caused by a one-time incident or over years of exposure, loud noises can cause serious damage to the cells in the hearing organ resulting in permanent hearing loss.

Fortunately, this is the only cause of hearing loss that is entirely preventable, so long as you know your risk and use proper hearing protection. Another common cause of sensorineural hearing loss is aging. This is a pretty unavoidable source of hearing loss that is growing in prevalence as people are living longer and longer, which leads to the natural inner and outer hair cell deterioration. With age comes the development of other health issues that could accelerate the deterioration of these hair cells, including diabetes, high blood pressure, and kidney disease. While you can't avoid age-related hearing loss entirely, it's important to minimize your risk of developing any of these other health conditions that could impact your hearing. In general, this involves leading a healthy lifestyle, monitoring any current conditions you may already have, and following your doctor's to treatment recommendations. Lastly, genetics play a huge role in whether you will develop hearing loss, including when and how rapidly.

Nearly 60% of cases of children born with hearing loss are due to genetic factors making it impossible to avoid. While noise exposure, aging and genetics are the most common causes of sensorineural hearing loss. There are numerous less common causes. For example, sudden sensorineural hearing loss is the rapid development of significant hearing loss, generally in one ear. This condition often occurs instantaneously, and researchers are still stumped as to why it happens, though there is a strong theory that it is due to a viral attack of the inner ear. Often disguising itself as an ear plugged with earwax, this type of hearing loss should be assessed immediately by a hearing healthcare professional because it often requires medical intervention that is time sensitive in order to recover your hearing. Sensorineural hearing loss is diagnosed through a hearing evaluation with responses plotted on an audiogram. On this graph, the Xs and O's indicate your left and right ear responses to tones when sound passes through all three parts of the ear.

The brackets indicate when sound is picked up by the cochlea directly. If the X's and O's line up with the brackets and they fall into the mild hearing loss range or worse, this is characterized as sensorineural hearing loss. Although the exact pattern of hearing loss is different from person to person, there are some clues in an audiogram that can point to specific causes. For example, noise-induced hearing loss generally has some form of a noise notch near 3000 hertz. Age-related hearing loss first develops in the high pitches resulting in a characteristic downward slope through the high frequencies. Genetic hearing loss patterns depend on the genetic mutation itself, but a common pattern is a cookie bite hearing loss, with hearing loss mostly in the mid pitches. With all the different causes and presentations, you may be wondering if anything can be done to treat this hearing loss.

Luckily, the majority of sensorineural hearing losses can be successfully treated through the use of properly programmed hearing aids. In some cases of severe to profound hearing loss, cochlear implants may be required for successful treatment. Now let's move on to the second type of hearing loss: Conductive hearing loss. Conductive hearing loss accounts for somewhere between five to 15% of hearing losses, and it occurs when the vibration of sound cannot make it from your outer ear to your inner ear. As you'll recall, sound vibrations must travel through the outer ear and the middle ear before they can make it to the cochlea. If there is a blockage or physical issue impacting the function of this pathway, sound vibrations cannot turn into electrical impulses that travel up to the brain in the outer ear. Sound vibrations can be blocked by earwax buildup or outer ear infections. Many conductive hearing losses are also caused by issues with the eardrum, including perforations or buildup of scar tissue from chronic outer ear infections. In the middle ear space, infections, disconnected or fused ossicles, and even issues

equalizing middle ear pressure can lead to conductive hearing loss. Certain conductive hearing losses are preventable. For example, if excessive earwax is causing hearing loss, you can schedule regular professional earwax removal appointments or attempt at home earwax removal. Additionally, you don't have to worry about poking a hole through your eardrum causing a conductive hearing loss if you're not sticking anything in your ear canal like car keys, bobby pins, or cotton swabs. During the hearing test, a hearing healthcare professional will be able to easily identify a conductive hearing loss by spotting something called an air-bone gap. This is when there is a gap between the X's and O's and the brackets on your audiogram, but the brackets still remain in the normal hearing range. These gaps demonstrate the difference in responses when the whole auditory system is being tested with the X's and the O's versus the responses when just the hearing organ is being tested with the brackets.

Fortunately, conductive hearing loss can be treated through the use of medication in-office procedures or surgery. Once the cause of the conductive hearing loss has been identified, oftentimes this gap can be eliminated returning the X's and O's back to the level of the brackets that are in the normal range, but depending on the person and the problem. Treatment may include the use of hearing technology, including hearing aids, bone anchored hearing aids, and even middle ear implants, such as Sound Bridge. The third and least common type of hearing loss is mixed hearing loss. That includes components of both sensorineural and conductive hearing loss. For example, someone with mixed hearing loss may have sensorineural hearing loss from years of unprotected target shooting, and they may have conductive hearing loss from accidentally sending a cotton swab

through their eardrum. You can see from this example audiogram that there are noticeable air-bone gaps, which indicates some level of conductive hearing loss, but neither the Xs and Os nor the brackets fall within the normal range, indicating that this hearing loss is caused by both the conductive pathway of the outer and middle ear and the sensorineural portion of the inner ear. Mixed hearing loss generally requires a care team that includes an ear, nose, and throat physician for the medical management of the conductive component of the mixed hearing loss, and an audiologist to treat any remaining sensorineural portion of the mixed hearing loss. Research has now consistently identified that untreated hearing loss is the single largest potentially modifiable risk factor for developing dementia, not to mention the negative impacts that hearing loss can have on communication, work relationships, depression and social isolation. For this reason, it's important that you have your hearing tested if you, any of your family members or your medical providers express any concerns or once you're over the age of 50.