Deafness (Hearing Loss)

Medically Reviewed on 11/20/2023

What is hearing loss?

Anatomy of the ear
Anatomy of the ear

Hearing loss, or deafness, can be present at birth (congenital), or become evident later in life (acquired). The distinction between acquired and congenital deafness specifies only the time that the deafness appears. It does not specify whether the cause of the deafness is genetic (inherited).

Acquired deafness may or may not be genetic. For example, it may be a manifestation of a delayed-onset form of genetic deafness. Alternatively, acquired deafness may be due to damage to the ear due to noise or other conditions.

Congenital deafness may or may not be genetic. In non-genetic causes, congenital deafness may be due to a condition or infection to which the mother was exposed during pregnancy, such as the rubella virus. Alternatively, congenital hearing loss may be associated with certain other characteristic findings. For example, a white forelock may be a sign of a genetic disease called Waardenburg syndrome that includes congenital deafness in the spectrum of disease. Overall, more than half of congenital hearing loss is inherited.

What are the types of hearing loss and what causes it?

Hearing loss can also be classified based on which portions of the hearing system (auditory system) are affected. When the nervous system is affected, it is referred to as sensorineural hearing loss. When the portions of the ear that are responsible for transmitting the sound to the nerves are affected, it is referred to as conductive hearing loss.

Conditions affecting the cochlea, eighth cranial nerve, spinal cord, or brain cause sensorineural hearing loss, such as:

  • Meniere's disease
  • Noise-induced hearing loss (such as prolonged or excessive exposure to loud music or machinery)
  • Hearing loss of aging (presbycusis)
  • Nerve injury from syphilis
  • Hearing loss of unknown cause (idiopathic hearing loss)
  • Nerve tumors
  • Drug toxicity (such as aspirin and aminoglycosides)

Conditions that affect the ear canal, eardrum (tympanic membrane), and middle ear lead to conductive hearing loss. Examples of conductive hearing loss include:

Other potential causes of hearing loss include:

  • Fluid buildup in the middle of the ear
  • Head injury
  • Autoimmune disorder


Ear Infection Symptoms, Causes, and Treatment See Slideshow

What are the symptoms of hearing loss?

Symptoms of hearing loss include mild loss of high-frequency hearing, hearing loss associated with ringing or noises (tinnitus), and complete deafness. Symptoms may develop gradually over time with many causes of hearing loss.

People who are experiencing hearing loss may refrain from taking part in conversations, may turn the volume up high on the radio or TV, and may frequently ask others to repeat what they have said.

What is the treatment for hearing loss?

The treatment of hearing loss depends on its cause, such as:

  • Ear wax can be removed
  • Ear infections can be treated with medications
  • Diseases that cause inflammation of the ear can be treated with medication
  • Medications that are toxic to the ear can be avoided
  • Occasionally surgical procedures are necessary

What is an assisted hearing device?

Hearing aids and cochlear or brainstem implants are examples of assisted hearing devices. These would enable any person, including those who are born deaf, to be able to hear and develop speech and language.

A hearing aid is a small removable electronic device that is worn in or behind the ear to improve hearing. Hearing aids can benefit those with moderate hearing to learn. Those with severe to profound deafness would need other options, such as a bone-anchored hearing aid, cochlear implant, or auditory brainstem implant.

A bone-anchored hearing aid is a type of hearing aid used in people who have conductive hearing loss and cannot benefit from a hearing aid. It is a surgically implanted device behind the ear. It allows the bone to transfer sound to a functioning cochlea (the inner ear) rather than via the middle ear, which happens in normal hearing. Hence, this process is called direct bone conduction.

What features should you look for in a pair of hearing aids?

Choosing the best hearing aid for you will depend on your individual listening needs, budget, and lifestyle. The right hearing aid can improve your hearing and dramatically improve your quality of life, so investing in the right product is important.

Features to look for include the following:

  • Telecoil: Boosts sound signals through a magnet
  • Digital feedback suppression: Suppresses any secondary interfering sounds
  • Digital noise reduction: Cuts down on unwanted background noise
  • Directional mic: Receives sound from the required direction
  • Low battery indicator: Indicates when to change the battery
  • Volume control: Allows you to adjust the volume according to your hearing ability
  • Wax guard: Protects the device from accumulated ear wax
  • Data logging: Keeps track of usage statistics such as time
  • Memory: Remembers ideal configurations set by the user
  • Audio input: Receives sound from surroundings
  • Wireless connectivity: Facilitates maximum freedom of movement
  • Frequency shifting: Adjusts to varying wavelengths of sounds
  • Remote control: Allows you to control the device with ease and accuracy

What is the difference between analog and digital hearing aids?

Analog hearing aids

  • Make continuous sound waves louder.
  • Amplify all sounds in the same way (some analog hearing aids are programmable)
  • Have a microchip that allows the aid to have settings programmed for different listening environments.
  • It can store multiple programs for various environments.
  • Allows you to change settings as the listening environment changes.

Digital hearing aids

  • It has all the features of analog programmable aids but converts sound waves into digital signals and produces an exact duplication of sound.
  • Analyze speech and other environmental sounds through computer chips.
  • Allow for more complex sound processing during the amplification process that may improve performance in certain situations (background noise and whistle reduction).
  • Have greater flexibility in hearing aid programming so that the sound transmitted can be matched to the needs of a specific pattern of hearing loss.
  • Provide multiple program memories.

Does health insurance cover the cost of hearing aids?

Medicare does not cover the cost of a hearing test, hearing aid evaluation, or hearing aids.

When it comes to private insurance, coverage for hearing aids varies. Although most private insurers do not cover the full cost of hearing aids, some may cover hearing tests and evaluations. It's best to contact your insurance company directly to determine whether your policy includes hearing aids as a covered benefit.

How do deaf people learn to speak?

Deaf people need to learn the ways to communicate. Several ways are there that may be learned to communicate.

Normally, young children pick up and respond to auditory cues from their surroundings, including different sounds and tones of voice. By the age of one year, they may begin to imitate the sounds that parents make if their hearing is normal. Learning to speak is typically difficult for a person born deaf or became deaf at a young age. Learning to talk can be a long and difficult process. They may often never be able to speak because they have never heard normal sounds and speech. The process is usually easier for people who have become deaf later during childhood or life after acquiring some speech skills. This is because they are familiar with sounds and speech. Hence, with appropriate training, such people would be able to regain their speech and language skills.

Strategies for deaf people to learn speech

A trained speech and language therapist works with people with hearing loss and helps them learn speech. Even with training, it may still be difficult for people to understand the speech of a deaf person. For example, they may have difficulty using sounds that are softer or more difficult for them to hear. They may speak either too softly or too loudly. They may talk at a different pitch and sound different compared to a person with normal hearing. It is also important that parents and caregivers take an active role in the process. Several strategies may be used to help learn speech. They include:

  • Speech training. This is oral training that focuses on teaching how to produce various sounds, pronunciations, words, and speech.
  • Assistive hearing devices. Hearing aids and cochlear or brainstem implants can help deaf people hear. Being able to hear, would help develop speech and language.
  • Auditory training. The individual is trained to recognize and distinguish different sounds, words, and phrases from one another.
  • Lip reading. Someone with hearing loss can watch the movements of a person's lips as they speak to understand what they are saying.

What happens if hearing issues are left untreated?

Untreated hearing loss can lead to other problems:

  • Anger and irritability
  • Depression
  • Fatigue
  • Dementia or acute memory loss
  • Loss of concentration
  • Self-seclusion
  • Constant loneliness
  • Increased risk of personal safety
  • Inability to learn new concepts or perform tasks
  • Reduced job performance
  • Reduced mental and physical health

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Medically Reviewed on 11/20/2023
Shah, Rahul. "Hearing Impairment." Sept. 24, 2019. <>.

Why Do Hearing Aids Cost So Much?

Hearing Aids:

Hearing Aids:

Centers for Disease Control and Prevention. How People with Hearing Loss Learn Language.

Deaf Education. Learning to Talk.

Hearing Loss Association of America. Assistive Listening Systems.