The human ear and auditory system are complex structures that provide us with a tremendous amount of information—so much so that when our hearing is healthy, we can distinguish between a multitude of different sounds across a wide range of frequencies. This sophisticated system, however, also is susceptible to damage from noise and is vulnerable to varied disorders of the inner ear.
Below is discussion of some more-common ear and hearing issues
Noise-induced hearing loss
Noise-induced hearing loss is the most common, and preventable, type of hearing loss. It can affect anyone at any age—in an instant or over time.
Noise-induced hearing loss happens when the hair cells in the inner ear are overloaded and become damaged or die from too much noise. As the number of hair cells in the inner ear decreases, so does the ability to hear.
The longer a person is exposed to noise, the greater the damage to these hair cells. The same goes for the intensity or decibel level. The more intense the sound, the more damage it can inflict. (See our web page “Hearing Loss: An Overview” for information about the role of these hair cells in hearing.)
Typically, sounds at 85 decibels and above can damage hearing. To put that into context, a whisper is 30 decibels, heavy city traffic is 85 decibels, a music concert is 110 decibels, and a firecracker is 140 to 165 decibels.
When noise-induced hearing loss comes on over time, the ability to hear higher-frequency sounds usually is lost first. Gradually, people tend to have difficulty deciphering speech, especially the voices of women and children, which tend to be higher pitched. Certain consonants, which are in a higher frequency range, can be particularly difficult to discern. These include S, F, SH, CH, H, or soft C sounds.
About 40 million adults in the United States (20 to 69 years of age) have noise-induced hearing loss. And often, tinnitus—or ringing in the ears—is associated with it. (Visit our “Tinnitus” page for more information.)
Age-related hearing loss (Presbycusis)
Although many people experience age-related hearing loss—medically known as presbycusis (pronounced prez-bi-ˈkyü-səs)—it’s not inevitable, and it’s not experienced by everyone.
Most often, presbycusis involves degenerative changes to the inner ear. Typically, people who experience presbycusis don’t notice it until significant loss has occurred because it tends to come on gradually and typically involves hearing loss in both ears equally.
Experts believe that genetic and/or environmental factors contribute to presbycusis. Diabetes and cardiovascular issues, the use of certain medications, and other factors common with aging may play a role, they believe. What’s more, because noise-induced hearing loss is so prevalent in modern societies, it’s often difficult to separate out what part of an older person’s hearing loss is age-related and what part is the result of noise exposure over decades.
The most common concern of people with presbycusis is hearing speech in noise—such as at a restaurant. It’s interesting to note, as well, that research suggests that older adults shown to have normal hearing on a hearing test also can have difficulty understanding speech in noise as a result of changes in cognitive function—unrelated to the ears.
As research continues to uncover links between hearing loss and other health and quality of life issues—including cognitive function, dementia, and social isolation—it’s critically important for people to address hearing loss as they age and not put it off.
Sudden hearing loss
Sudden hearing loss—also known as sudden deafness—can be extremely frightening. It’s a sensorineural hearing loss that comes on quickly—that is, all at once, over a few hours, or over a several days. Often, it affects only one ear, but it can involve both.
Anyone experiencing sudden hearing loss should treat it as a medical emergency and seek a doctor’s care right away. Getting treatment quickly increases the odds of recovering at least some of the hearing lost.
Many people who experience sudden hearing loss realize their hearing is gone when they wake up in the morning. Others discover a hearing loss when they go to use the phone with the affected ear. For many people, there are no real warning signs. Others say they experienced a “pop” just before the hearing was lost. And sometimes, people have reported a sense of fullness or ringing in the ear and/or dizziness.
Sudden hearing loss is generally defined as the rapid loss of hearing ability of 30 decibels or more over at least three contiguous frequencies. Although experts know that sudden hearing loss happens when something goes wrong with the sensory organs in the inner ear, for the vast majority of people (90%), the exact cause is never identified. Possible causes overlap with those associated with any sensorineural hearing loss—from infection, to autoimmune disease, to neurological disorders, to Meniere’s disease, among other things.
Each year, an estimated one to six of every 5,000 people experience sudden hearing loss, although experts believe the actual prevalence may be higher because it often goes undiagnosed. Sudden hearing loss occurs most frequently in people in their late 40s and early 50s, according the National Institute on Deafness and Other Communication Disorders (NIDCD).
About 50 percent of people who experience sudden hearing loss recover at least some of their hearing within about two weeks of onset. But it’s critically important to see a doctor immediately. Appropriate diagnosis and treatment of sudden hearing loss increases the likelihood of regaining at least some hearing. It’s also important to identify any potential underlying causes that should be treated.
Earwax
Earwax is like a self-cleaning system for our auditory system and is important for the health of the ear. Created by wax glands in the external ear canal, it protects the skin of the ear from water and infection. But when earwax builds up too much, it can cause a blockage within the ear, leading to a reduction in the ability to hear and possible damage to the eardrum.
Symptoms of an earwax blockage can include:
- A feeling of fullness in the ear
- An earache
- Itchiness
- Ringing in the ear
- Dizziness
How much and the consistency of the wax varies considerably from person to person and is largely determined by genetics, among other things. Certain factors increase the likelihood of an earwax blockage. These factors include:
- Structural issues, such as narrow or irregularly formed ear canals
- Hairy ear canals, which can make it harder for the ear to push the wax outward
- Osteoma (a type of benign bone tumor within the ear)
- Eczema
- Age – As people get older, earwax tends to get drier and harder, increasing the chance that it will become impacted
- Certain health conditions, such as lupus and Sjogren’s syndrome
- Certain intellectual disabilities, such as Down Syndrome
Although many people use cotton swabs to remove earwax, hearing health experts advise against it because of the risk of puncturing the eardrum with the swab; pushing the earwax deeper inside the ear, potentially causing damage; and/or introducing bacteria, which can lead to infection.
People who have concerns about earwax should see a hearing healthcare provider who can examine the ear, remove any wax buildup, and advise on home ear care. Pharmacists can advise on the appropriate use of over-the-counter products.
Other resources
We invite you to learn more about hearing loss by visiting our web pages, “Hearing Loss: An Overview” and “Living with Hearing Loss.”
Additional information on hearing loss can be found on the following websites:
National Institute on Deafness and Other Communication Disorders (NIDCD)
Centers for Disease Control and Prevention (CDC)
Hearing Loss Association of America (HLAA)
Learn about donating to AHRF to fund research specifically on hearing loss.