Hearing Loss (cont.)
Hearing Loss Causes
There are 2 basic types of hearing loss, which are called conductive and sensorineural.
- Conductive causes: Conductive hearing losses result from physical problems with the movement of the sound wave through the ear. A simple example is blockage of the ear canal.
- Obstructed external ear canal - Cerumen (wax) build-up, hematoma (blood collection), or foreign body in the ear canal. This is one of the most common causes of hearing loss and the easiest to fix.
- Perforated tympanic membrane - Caused by direct trauma such as a cotton swab, middle-ear infections (otitis media), or explosions (blast injury)
- Dislocated ossicle (malleus, incus, or stapes) - Usually from trauma to the ear
- Otitis media - Middle ear infection (probably the most common cause for conductive loss)
- Otitis externa - Infection of the ear canal that causes it to swell
- Retraction of the tympanic membrane (ear drum) toward the middle ear. This may be associated with a collection of skin called a cholesteatoma
- Sensorineural causes: Sensorineural causes are from damage to the hair cells or nerves that sense sound waves.
- Acoustic trauma - Prolonged exposure to loud noises causes the hair cells on the cochlea to become less sensitive.
- Barotrauma (pressure trauma) or ear squeeze - Usually in divers
- Head trauma - A fracture of the temporal bone can disrupt the nerves of the auditory system or the cochlea directly
- Ototoxic drugs - Certain drugs can affect hearing by damaging the nerves involved in hearing. Usually this occurs when large or toxic doses are used but may also occur with lower doses.
- Antibiotics including aminoglycosides (gentamicin, vancomycin), erythromycins, and minocycline
- Diuretics including furosemide and ethacrynic acid
- Salicylates (aspirin) and nonsteroidal anti-inflammatories (NSAIDs) such as ibuprofen and naproxen
- Antineoplastics (cancer drugs)
- Vascular diseases (problems with blood vessels) include sickle cell disease, diabetes, leukemia, polycythemia, and diseases in which excessive blood clotting occurs.
- Children and adults with kidney problems are more susceptible to sensorineural hearing loss.
- Ménière disease - A disease that affects hearing and balance. It is usually associated with tinnitus (ringing in the ears). It has a gradual onset and may progress to deafness and severe vertigo. The cause is unknown, but thought to be associated with fluid shifts in the inner ear.
- Acoustic neuroma - A tumor in the auditory nerve. Usually associated with ringing in the ears.
- Infections, include some occurring during pregnancy and soon after birth in neonates.
- Aging (presbycusis)
Medically Reviewed by a Doctor on 9/10/2015
Angelique S Kelly Campen, MD
Scott H Plantz, MD, FAAEM
Francisco Talavera, PharmD, PhD
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