Causes of Hearing Loss

Causes of Hearing Loss

Sensorineural hearing loss accounts for more than 90% of all hearing loss and in most cases it is permanent and bilateral1.  In the UK, age-related hearing loss is the single biggest cause of sensorineural hearing loss. The second most common form is noise-induced hearing loss. Less common causes include: genetic, side effects to certain medicines, infections (viral), Meniere’s disease, systemic illness and other rare conditions.

Conductive hearing loss might account for as much as 8% of reduced hearing. There is often a mechanical cause – e.g. impacted wax, perforated eardrum6. It is usually temporary, but can be permanent. There are medical and surgical treatments for certain forms of conductive hearing loss.

The table below provides a list of conditions that can result in hearing loss11. It is not an exhaustive list. It does not add up to 100% because prevalence of hearing loss is given for each condition, not the proportion that each condition accounts for.

Cause of Hearing LossSensorineuralConductiveHow common is it?Where can I learn more?
Age-related hearing loss (presbycusis). No medical or surgical treatment. Permanent

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Very common.
Single biggest cause of hearing loss.
>40% of people aged 65+ 12
NHS Choices
Earwax+
Not all earwax will result in an individual seeking help from a health care professional. The actual prevalence of earwax varies with age: 0 to 16 years: 10% to 43%. 16 to 59 years of age: 2% to 5%. ≥60: 16% to 57% [Ref: Cited in: The safety and effectiveness of different methods of ear wax removal: a systematic review and economic evaluation. Clegg et al. Health Technology Assessment]

Temporary

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3.9%13+3% to 6% in adults. 10% in Children. Possibly higher in older adults due to changes in the ceruminous glands with age [Ref: Roeser RJ, Balachanda BB. Physiology, pathophysiology and anthropology/epidemiology of human ear canal secretions. J Am Acad. Audiology. 8:391-400. Cited in BMJ Best Practice. Mar. 10. 2015 version of cerumen impaction]. NICE
NHS Choices
BMJ Best Practice
Noise-induced (occupational) hearing loss. No medical or surgical treatment. Permanent

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1.4% of adults14NHS Choices
HSE
NIH
Permanent childhood hearing loss (prelingual and postlingual)

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0.08% to 0.3%15 in children (age 0-17)NHS Choices
CDC
Middle ear disease (Ear inflammation/infection (e.g. otitis media with effusion, chronic otitis media, acute otitis media, other bacterial, viral etc etc).

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Temporary hearing loss most likely. NICE – chronic otitis media
NICE – acute otitis media
NHS Choices
BMJ Best Practice
Meniere’s disease – most common in the fourth decade of life +Primarily a disease of adulthood occurring in the fourth decade of life. [BMJ Best Practice, Meniere’s disease, 17 December 2014]

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0.1%16 + Primarily a disease of adulthood occurring in the fourth decade of life. [BMJ Best Practice, Meniere’s disease, 17 December 2014]NHS Choices
NICE
BMJ Best Practice
Otosclerosis

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0.06%17NHS Choices
BMJ Best Practice
Sudden idiopathic sensorineural loss

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0.02%17American Hearing Research Foundation
Cholesteatoma

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0.01%17NHS Choices
NICE
BMJ Best Practice
Hearing loss in multiple sclerosis Often temporary

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0.01%17MS – USA
MS - UK
Labyrinthitis0.004%17NHS Choices
BMJ Best Practice
Vestibular schwannoma or other retrocochlear mass (e.g. neural tumour)

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0.002%17 +Alternative source: The Annual incidence of acoustic neuroma has also been reported as being 0.001% to 0.002%, with smaller tumours being detected because of the increased use of MRI. Between 40% and 60% of small tumours might not require treatment, and where managed effectively the prognosis for other people is good [BMJ Best Practice, 5 June 2015, Acoustic neuroma].NHS Choices
BMJ Best Practice
Ototoxic drugs

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Unknown how many cases result in hearing lossNHS Choices
Merk Manual
Perforated eardrum
(can be traumatic, but most cases are due to otitis media)

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UnknownNHS Choices
Eustachian tube dysfunction - common in children under the age of 5

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UnknownNICE
BMJ Best Practice
Other - Foreign body, trauma (e.g. temporal bone fracture, external ear-canal trauma, vertebral artery dissection etc.), benign growths (e.g., exostosis, osteoma, polyps, External ear canal neoplasm)

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UnknownBMJ Best Practice

References