Hearing loss is very common, affecting approximately 40 million American adults. If you or a loved one is experiencing hearing loss, it’s helpful to learn as much as you can about the condition and how to treat it.

What is hearing loss?

Hearing loss is the  inability to hear sounds in one or both ears, and it can occur at a wide range of frequencies and at various volumes. Hearing levels are determined by decibels, which measure the intensity or loudness of sounds a person can hear. For humans to hear sounds, they need to be above a certain decibel level. Normal hearing is between 0 – 20 decibels. For example, the sound of breathing is approximately 10 decibels. Those who have difficulty picking up sounds in this decibel range have some sort of hearing loss.

Hearing loss symptoms 

The main symptoms experienced by patients that may indicate hearing loss are: 

  • They need to turn up the TV volume louder than normal

  • They can’t follow conversations in noisy places like restaurants

  • They have to ask people to repeat themselves more than usual

Other symptoms may include:

  • Sudden hearing loss in one ear

  • A feeling of ear fullness or tinnitus, a constant ringing or buzzing sound in the head or ears, sometimes combined with dizziness

  • When sounds are muffled, as if you are underwater

Causes of hearing loss

There are two types of hearing loss: sensorineural and conductive.

Sensorineural hearing loss typically occurs when the hair cells in the cochlea, the fluid-filled cavity in the inner ear, become damaged and are unable to send sound signals to the brain. This is the most common cause of hearing loss for older adults and can be a result of:

  • The natural aging process. Up to 30% of adults over 65 and 50% of adults over 75 experience some hearing loss

  • Repeated exposure to loud noises

  • Certain drugs, such as types of chemotherapy

  • Congenital diseases that cause deafness or hearing loss at birth

Conductive hearing loss occurs in the outer or middle ear when sound waves are not able to reach the inner ear and therefore the brain. This may be caused by:

  • Buildup of earwax that can block the ear canal 

  • Eardrum injury

  • Fluid, infection or bone abnormality in the middle ear

  • Head trauma

Levels of hearing loss 

There are five different levels of hearing loss, depending on what types of sounds people are able to pick up.

  • Mild: Hearing of between 20 and <35 decibels, meaning a person has a hard time hearing whispering.

  • Moderate: Hearing of between 35 and <50 decibels, meaning a person may miss soft sounds and sometimes normal conversations. 

  • Moderately severe: Hearing of between 50 and <65 decibels, meaning a person may not hear people talking at a normal level.

  • Severe: Hearing of between 65 and <80 decibels, meaning a person may not pick up doorbells or cellphones ringing or the sounds of traffic.

  • Profound: Hearing loss of more than 81 decibels, meaning that people can hear only very loud sounds, such as someone shouting. 

A hearing loss of more than 40 decibels is considered to interfere in daily communication.

Hearing loss treatment 

When you begin to sense a change in your hearing, see a doctor right away. For sensorineural hearing loss, hearing aids are often the best option. Today, there is a wide variety of hearing aids to choose from, and your doctor, usually an otolaryngologist (or ear, nose and throat specialist), will help you find the management options for your situation. 

If you experience sudden hearing loss in one ear, this is usually caused by a viral infection and needs quick treatment. Steroids can usually restore some or partial hearing if treated within a few weeks. 

For hearing loss due to earwax, injury or structural abnormalities, treatments run from the simple (removal of the earwax by a physician) to surgery to fix the ear bones. Consult your physician for the most appropriate option.

For those with moderate to profound hearing loss with poor benefits from hearing aids, a cochlear implant, a small electronic device surgically implanted in the inner ear, is another option to discuss with your doctor.

Hearing loss prevention 

The best way to protect your hearing is to avoid noisy environments. If you are exposed to loud noise, let’s say at a concert, wear ear plugs. Hearing loss can occur from a one-time event, such as experiencing an explosion, but more often it is from repeated noise exposure.

Living with hearing loss

My main advice as an otolaryngologist with Keck Medicine of USC: Try hearing aids if recommended by your health professional. Not only do hearing aids improve your ability to hear, but they improve your daily communication, quality of life and guard against withdrawal from others. Isolating oneself puts people at greater risk of depression, dementia and even death.

Hearing loss affects so many people, and wearing hearing aids should not be a source of shame or a stigma. As someone who was born with hearing loss, I wear them myself, proudly and happily.

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