Hearing and hearing loss
Why hearing gets worse, types of hearing loss, what an audiogram shows and how to protect your hearing.
Why hearing gets worse
- Age — the most common cause, gradual wear of the hair cells in the inner ear.
- Noise — long-term (work, music in headphones) or one-off (a gunshot, fireworks).
- Genetics — some types of hearing loss are congenital or run in families, and may appear in childhood or only in adulthood.
- Infections and illnesses — repeated middle-ear infections, meningitis, mumps.
- Certain medicines — for example some antibiotics, cancer drugs or high doses of some diuretics. If you take them, please tell us.
- Head or ear injury, otosclerosis.
- Earwax — the simplest and easily solved cause.
- Impaired blood supply to the auditory nerve — a cause of sudden hearing loss.
Sudden hearing loss is an emergency
If you suddenly lose hearing in one ear within hours or days, do not wait and see an ENT doctor as soon as possible — ideally within 24 to 72 hours. Early treatment can save your hearing.
Types of hearing loss
Conductive hearing loss
Sound cannot pass through the outer or middle ear. Typical causes are earwax, inflammation, fluid behind the eardrum, a damaged eardrum or stiffened ossicles (otosclerosis). It can often be treated — by cleaning, medication or surgery.
Sensorineural hearing loss
Damage to the inner ear or the auditory nerve, most often due to age or noise. It is permanent, but a hearing aid compensates for it effectively.
Mixed hearing loss
A combination of both. The conductive part is treated and a hearing aid compensates for the rest.
An ENT doctor determines which type you have from the examination. That is why every hearing aid fitting at our practice starts with a specialist ENT examination.
What an audiogram shows
An audiogram is the result of a hearing test. Together with other instrument-based examinations (such as tympanometry), it can tell the type of hearing loss, determine how severe it is and point you to the right treatment — whether that is medication, surgery or a hearing aid.
With age, high tones usually go first — and that is where consonants such as s, sh, f and t are. That is why people say “I can hear, but I can’t understand”: they hear the voice, but the words blur together.
What about online hearing tests?
The only way to a reliable diagnosis is an ENT examination and a hearing test on certified, calibrated equipment in a soundproof booth. Online hearing tests on the internet are only a very rough and inaccurate guide — the result is affected by your headphones or speakers, background noise and volume settings. They can never make a diagnosis: they cannot tell the type of hearing loss, cannot find the cause (such as simple earwax or an infection), and a hearing aid cannot be set according to them. If you feel your hearing has got worse, book an examination — it does not hurt, it only takes a short while and you get the result straight away.
Can hearing be protected? How?
- In noise (concerts, lawnmowers, drills, shooting) wear earplugs or ear defenders.
- Headphones: no more than 60 % volume and no more than 60 minutes at a time (the 60/60 rule).
- Do not clean your ears with cotton buds — you push the wax deeper and can injure the eardrum. Washing the outer ear is enough; earwax comes out by itself.
- If you have ear pain, discharge, ringing or worse hearing, come for an examination.
If you are exposed to noise more often (at work, as a musician, hunter, motorcyclist…), there are also preventive aids that greatly reduce the risk of hearing damage — universal or custom-made hearing protectors. The safe noise limit is 85 dB; above it, hearing protection is essential.
Custom hearing protectors: at our practice we can take an individual impression (mould) of your ear, from which hearing protection earpieces are made precisely for your ears — comfortable even when worn all day. More about hearing protection on the website of our ENT practice (in Czech).