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Age-Related Hearing Loss

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Written by
David Lee, MD.
Clinical Fellow, Pediatric Otolaryngology, Children's Hospital of Philadelphia
Last updated October 17, 2022

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Care Plan

1

First steps to consider

  • Very minimal hearing loss can be managed at home.
  • Try to avoid loud noise exposure and conversations in settings with a lot of background noise (like a busy restaurant).
2

When you may need a provider

  • Anyone who has noticeable hearing loss should consider seeing a hearing specialist for a baseline hearing test and to confirm that hearing loss is from age-related changes.
  • Testing requires an in-person visit.

Emergency Care

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Go to the ER if you have any of the following symptoms:

  • The degree of your hearing loss suddenly changes.
  • There is a change in your hearing along with neurologic symptoms (mental status changes, confusion, delirium, muscle weakness).

What is hearing loss?

Hearing loss is when you are having trouble with sound or can’t hear it at regular loudness levels. You can be born with it or it can develop from an injury or over time.

There are many parts of the ear that help you hear, including the eardrum, ear canal, middle ear bones, and nerves. Damage to any of these structures—from exposure to loud noise, infections, or even certain medications—can cause hearing loss.

One of the most common types of hearing loss is caused by noise exposure over time and aging (also known as presbycusis). This hearing loss can be very subtle and slowly get worse over many years. Many people are not aware of just how bad their hearing loss actually is.

Symptoms

Age-related hearing loss develops over a long period of time. You may find it hard to follow conversations in a loud environment, like a busy restaurant. Then you may notice that you are having trouble understanding conversation in less loud environments, or problems hearing the television. You may start asking family members to repeat themselves or or they say you are turning up the television too loud.

You may also develop tinnitus, which is ringing in your ears that can also cause dizziness.

Age-related hearing loss tends to be the same on both sides. If one side has a significant difference in hearing compared to the other side, you may want to get a formal hearing test (audiogram) by an otolaryngologist.

  • Difficulty hearing in noisy environments
  • Eventually may have a harder time hearing in quieter environments
  • Having to ask people to repeat themselves

What are warning signs of sudden hearing loss?

  • If you have a sudden decrease in hearing, especially with a change in mental state (confusion, delirium) or dizziness, go to the ER.
  • If there is a significant difference between hearing in one ear, you should be evaluated by an otolaryngologist.
  • You have hearing loss along with tinnitus on one side. If only one ear has ringing, it may be a sign of an underlying condition like infection, a tumor, or trauma. It should be evaluated by an otolaryngologist.

Causes

Age-related hearing loss is caused by long-term and ongoing damage to the delicate structures in the inner ear (cochlea). Some people may be more susceptible to age-related hearing loss.

Prolonged exposure to loud noises, like at work, can also cause permanent damage to the inner ear.

Some diseases, like diabetes and high blood pressure, can increase the risk of damage to the inner ear.

Treatment

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Preventative tips

The best way to prevent or reduce age-related hearing loss is with good hearing hygiene. This includes:

  • Avoid very loud environments, like concerts, work environments like factories or machinery, or even repeatedly shooting firearms. If you have to be in a loud environment, using ear protection is important.
  • Keep headphone volume low.
  • A good rule of thumb: If after a noise exposure your ears are ringing or your hearing is temporarily decreased, then the exposure was too loud and likely caused some damage to your inner ear.
Share your story
Clinical Fellow, Pediatric Otolaryngology, Children's Hospital of Philadelphia
Dr. Lee is a board-certified otolaryngologist and medical consultant for Buoy Health. He completed his undergraduate degree in Biochemistry and Spanish at the University of Arkansas (2011) and went on to complete medical school from the University of Arkansas for Medical Sciences (2015). He completed his residency training in Otolaryngology - Head and Neck Surgery at the University of Cincinnati (...
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