Hearing Loss - Diagnosis & Treatment

How is hearing loss diagnosed?

If you are experiencing hearing loss symptoms, your doctor may assess you with the following tests:

• Physical examination. The doctor will inspect your ear for causes of hearing loss, such as earwax build-up, inflammation from an infection and structural ear problems. The doctor may perform a tuning fork test in the clinic. This simple test uses two-pronged tuning forks that make a sound when struck. This evaluation can help the doctor detect hearing loss and help determine the type of hearing loss.
• Pure tone audiometry. In this test conducted by an audiologist, sounds at different speech frequencies will be directed to each ear via earphones. You will be asked to indicate the softest sound that you can hear at each frequency.
• Speech test. Also known as the word recognition test, a speech test assesses your ability to understand speech with and without background noises. Speech may sound unclear if your speech discrimination is poor. Speech test scores can help predict the usefulness of a hearing aid.
• Tympanometry. This test measures middle ear pressures. It can help your doctor determine if you have fluid in your middle ear, middle ear infection, a perforation in the tympanic membrane, or a problem with the Eustachian tube.

Proper diagnosis is crucial to determine the most suitable hearing loss treatment by an ENT specialist.

How is hearing loss treated?

The treatment of hearing loss depends on the root cause:

• Earwax / foreign body. Earwax build-up or a foreign object in the ear canal can be removed by an ear, nose and throat (ENT) surgeon often facilitated by the use of a microscope.
• Ear infections. Ear infections in the ear canal are treated by the cleaning of pus or infected material, and application of topical medications. Middle ear infections are usually treated by appropriate oral medications.
• Conductive hearing loss. Conductive hearing loss can often be restored by surgery to reconstruct the conducting hearing mechanism. For example, a perforated eardrum can be surgically repaired to improve hearing as well as to prevent infections.

Sensorineural hearing loss

If sudden sensorineural hearing loss occurs, it can possibly be restored by medication if treated early. Longer-term sensorineural hearing loss is usually permanent due to irreversible damage to the hearing cells in the inner ear. If the hearing loss is not too severe, there are usually adequate residual hearing cells left for hearing aids to work well.

However, significant loss of inner ear hearing cells results in severe to profound hearing loss where amplification of sounds by hearing aids does not work. Such patients may benefit from cochlear implantation. A cochlear implant is a small electronic device surgically implanted to restore hearing by directly stimulating the hearing nerve. Hence, unlike hearing aids, it does not rely on viable hearing cells in the inner ear to work.