January 03, 2024

Hearing loss is a pervasive and global problem; the World Health Organization (WHO) estimates that almost 500 million people throughout the world have some form of hearing loss. By the year 2050, over 900 million are expected to suffer from hearing loss. Let’s discuss common ear traumas that people experience. 

Conductive Hearing Loss

The three parts of your ear, the outer, middle, and inner ear, all work together to funnel sound waves to your auditory nerve and brain for processing as sound. Conductive hearing loss is an ear trauma that occurs when sound cannot pass through the outer or middle ear. Some of the causes of conductive hearing loss include:

• Fluid buildup in the middle ear, resulting from common colds or allergies
• Perforated eardrum
• Tumors, which may partially or completely block the ear canal
• Earwax blockage in the ear canal
• Foreign object in the ear (more common in children that may place an object in their ear)
• Outer or middle ear malformations

Treatments for conductive hearing loss may include surgery, in the case of congenital ear malformations or the development of tumors. If surgery is not an option, then some conductive hearing loss can be treated with hearing aids. Another treatment option for conductive hearing loss is the implantation of bone-conduction hearing aid, which bypasses the ear canal and transmits sound via bone to the auditory nerve.

Sensorineural Hearing Loss

Sensorineural hearing loss is by far the most common type of hearing loss ear trauma, affecting approximately nine out of 10 people that suffer from hearing loss. While conductive hearing loss affects the outer and middle ear, sensorineural hearing loss occurs when the when the small hair cells in our inner ear are damaged. These hair cells are responsible for converting vibrations from sound waves into neural signals. The auditory nerve then carries these signals to your brain. 

Sensorineural hearing loss affects both the volume of sounds you hear, and the clarity of those sounds. Most people lose the ability to hear sounds in higher frequencies, such as birds chirping, or the voices of women and children. Sensorineural hearing loss has many causes, including:

• Noise-induced hearing loss
• Age-related hearing loss, or presbycusis
• Ototoxic medications, or medications that harm normal ear function
• Diseases or infections, such as meningitis, measles, and mumps
• Head trauma

Unfortunately, once hair cells in the inner ear are damaged, they never grow back. As a result, this common hearing condition is permanent. Depending on the severity of hearing loss, hearing aids can greatly help some gain back some hearing. In cases of profound hearing loss, a cochlear implant, a device implanted in a person’s skull and bypasses the inner ear altogether, may be an option.

Ménière’s Disease

Ménière’s disease is a disorder of the inner ear. While not the most common ear trauma, it still affects approximately one in every 1000 people and can lead to dizziness (such as vertigo) and hearing loss. Meniere’s disease affects over 600,000 people in the United States specifically. Currently, there are no definite answers as to why people develop Ménière’s disease.

Unfortunately, there is also currently no cure for Ménière’s disease. There are several treatments that doctors recommend to alleviate some of the symptoms associated with Ménière’s disease:

• Medications such as meclizine, diazepam, or lorazepam can help relieve some of the dizziness and vertigo and decrease the length of an attack
• Dietary modifications, such as limiting salt intake and taking diuretics, can help reduce body fluids, which can help lessen fluid pressure in the inner ear. Avoiding caffeine, chocolate, alcohol, and smoking may also lessen symptoms.
• Injections into the inner ear, either the antibiotic gentamicin or corticosteroids, can be used to control dizziness and vertigo.
• A device that fits into the outer ear and periodically delivers a pulse of air pressure to the middle ear has recently been approved by the FDA; these air pressure pulses reduce or prevent dizziness.
• In extreme cases, doctors may perform surgery to relieve the symptoms of Ménière’s disease; the surgery consists of decompressing the endolymphatic sac or cutting the vestibular nerve.

Tinnitus

If you hear a constant ringing or buzzing in your ears, then you may suffer from tinnitus, as do an estimated 32% of Americans. Another common ear trauma, tinnitus is the sensation of sound (often ringing, buzzing, roaring, hissing, or humming) when no sound is present. It’s actually not a condition by itself; it’s a symptom of some other condition, such as:

• Age-related hearing loss: inner ear hair cells become damaged with age, and this damage may trigger tinnitus in some people
• Noise exposure: short-term tinnitus can occur from attending a noisy concert or party, but permanent tinnitus can result from noise-induced hearing loss after repeated exposure to dangerously loud sounds.
• Earwax: a blockage or accumulation of earwax can interfere with normal sound transmission and cause tinnitus
• Abnormal bone growth: otosclerosis is the hardening of middle ear bones; this condition can cause hearing loss and the development of tinnitus

Treatment of tinnitus involves treatment of the underlying condition, if possible. This may include removing earwax, surgical intervention, or hearing aids. If the tinnitus cannot be treated, then ways of coping with the sound are used, such as white noise machines and tinnitus retraining.

Ear Infections

Most ear infections affect the middle ear, where the usually air-filled space behind the eardrum fills with fluid and causes pain and sometimes hearing loss. An ear infection is usually caused by a bacterium or virus; a common cold, the flu, or an allergy all could be triggers for an ear infection. This is the most common trauma people will face.

Children are much more prone to ear infections than adults.

Ear infections often resolve themselves without any treatment, so doctors may start by managing the associated pain and discomfort with acetaminophen or ibuprofen. If, after a few days or weeks, the infection has not resolved, the doctor may prescribe antibiotics to treat the ear infection.

More serious or chronic ear infections may require a surgical procedure to install tubes that allow excess fluid to drain from the middle ear.

The information in this guide has been written using the following reliable sources:

https://www.asha.org, https://www.hearingloss.org, https://www.marshfieldclinic.org, https://www.mayoclinic.org, https://www.who.int, https://www.healthyhearing.com