Hearing Loss: Types, Causes, Signs and What to Do Next

What is hearing loss?

Hearing depends on a chain of steps. The outer ear collects sound and channels it down the ear canal. The eardrum and the tiny bones of the middle ear turn that sound into vibrations and pass them inward. The inner ear (the cochlea) converts the vibrations into nerve signals, and the hearing nerve carries those signals to the brain, which makes sense of them as speech, music or warning sounds.

A problem at any point in this chain can reduce hearing. Where the problem sits is what determines the type of hearing loss, and that matters because different types are managed in different ways.

Hearing loss is very common. According to the World Health Organization, over 5% of the world's population, around 430 million people, require rehabilitation to address disabling hearing loss, and by 2050 over 700 million people (about 1 in 10) are projected to have disabling hearing loss.

What are the main types of hearing loss?

Conductive hearing loss

Conductive hearing loss happens when sound cannot travel properly through the outer or middle ear. Common reasons include ear wax blocking the canal, fluid behind the eardrum, ear infections, a perforated eardrum or problems with the middle-ear bones. Sounds tend to seem quieter or muffled. Depending on the cause, this type can often be treated medically, so it is important to have it checked.

Sensorineural hearing loss

Sensorineural hearing loss comes from the inner ear or the hearing nerve. It is the most common type in adults and is often linked to ageing, long-term noise exposure, some illnesses, certain medicines or inherited factors. As well as sounds seeming quieter, speech may sound unclear, especially in background noise. This type is usually permanent, but it can very often be managed well, most commonly with hearing aids.

Mixed hearing loss

Mixed hearing loss is a combination of the two: there is a conductive part and a sensorineural part at the same time.

What causes hearing loss in adults?

Common causes and contributing factors include:

• Ageing. Age-related hearing loss usually develops slowly and affects both ears, and many people first notice difficulty with high-pitched sounds and with speech in noisy places.
• Noise. Repeated exposure to loud sound at work, at events or through headphones can damage the delicate structures of the inner ear. Read more in Headphones and Earbuds: How to Listen Safely.
• Ear wax. A build-up can block the ear canal and muffle sound.
• Ear infections and fluid in the middle ear.
• Certain medicines that can affect the inner ear; never stop a prescribed medicine on your own, but do mention any hearing change to your doctor.
• Head injury or injury to the ear.
• Inherited factors, which can make some people more likely to develop hearing loss.

What are the early signs of hearing loss?

Typical signs include:

• Asking people to repeat themselves
• Feeling that others mumble or speak too softly
• Turning up the TV or phone volume higher than others prefer
• Finding conversations in restaurants or gatherings tiring or hard to follow
• Missing the doorbell, phone or alarms
• Ringing or buzzing in the ears (tinnitus)

Our article Do People Seem to Mumble? Early Signs of Hearing Loss in Adults explains these signs in more detail.

Is hearing loss permanent?

It depends on the type and cause. Conductive hearing loss caused by wax, fluid or infection is often temporary and may improve once the cause is treated. Sensorineural hearing loss is usually permanent, but that does not mean nothing can be done: many people find that hearing aids and good communication strategies make a real difference to daily life.

There is one important exception where time matters. Hearing loss that comes on suddenly, over hours or a few days, should be treated as a medical emergency. See Sudden Hearing Loss in One Ear: Why It Needs Urgent Medical Attention.

How is hearing loss assessed?

A hearing assessment usually starts with questions about your hearing, health and noise exposure, followed by a look inside the ears. Tests then measure the softest sounds you can hear at different pitches, how clearly you understand speech and how well the middle ear is working. Together these show whether there is hearing loss, which type it is and how much it affects you. Hearing Tests Explained: The Main Types and What Each One Shows walks through each test.

At our centre in Bousher, Muscat, assessments are carried out by our audiologist, who will explain your results in plain language.

What are the treatment options for hearing loss?

The right option depends on the type and degree of hearing loss, your lifestyle and your preferences. Options may include:

• Treating the cause when it is medical, for example wax removal or treatment of an infection by a doctor.
• Hearing aids, the most common option for permanent hearing loss. Modern devices come in several styles, including behind-the-ear, receiver-in-canal and small in-the-canal designs. You can browse styles in our hearing-aid catalogue, and Hearing Aids: A Complete Guide to How They Work and Getting Started explains how they work.
• Cochlear implants, which may be considered for some people with severe hearing loss who get limited benefit from hearing aids.
• Assistive devices and communication strategies, such as facing the speaker, reducing background noise and using accessories that stream sound directly to the ears.

Leaving hearing loss unaddressed can make conversation tiring and can affect work, relationships and wellbeing, so it is worth acting early rather than waiting.

When to see a specialist

Book a hearing assessment if:

• You or your family have noticed any of the signs above
• Hearing seems different between your two ears
• You have ongoing ringing or buzzing in one or both ears
• You work in a noisy environment or are regularly exposed to loud sound

Seek medical attention promptly if hearing drops suddenly, if you have ear pain with discharge, or if hearing loss comes with dizziness.

You do not need a referral to book a hearing test with us. You can book online or contact us by phone or WhatsApp.

Frequently asked questions

What are the main types of hearing loss?

The three main types are conductive, sensorineural and mixed. Conductive loss affects the outer or middle ear, sensorineural loss affects the inner ear or hearing nerve, and mixed loss is a combination of both. A hearing assessment shows which type you have.

Can hearing loss be reversed?

Some hearing loss can improve once the cause is treated, such as a wax blockage or middle-ear fluid. Sensorineural hearing loss is usually permanent, but it can often be managed well with hearing aids and other support. Sudden hearing loss needs urgent medical attention because early treatment matters.

Should I get a hearing test if only one ear is affected?

Yes. Hearing loss in one ear is a good reason for an assessment, and if it came on suddenly you should see a doctor straight away. A difference between the ears always deserves a professional check rather than waiting to see if it improves.

Related reading

• Do People Seem to Mumble? Early Signs of Hearing Loss in Adults
• Hearing Tests Explained: The Main Types and What Each One Shows
• Sudden Hearing Loss in One Ear: Why It Needs Urgent Medical Attention
• Hearing Aids: A Complete Guide to How They Work and Getting Started

Sources

• WHO — Deafness and hearing loss (fact sheet)
• ASHA — Types of hearing loss
• NIDCD (NIH) — Age-related hearing loss

This article is general information and does not replace advice from a qualified professional.