Hearing loss: when the world gets quieter

The ear is our gateway to the world of sound. Hearing loss therefore not only has psychological but also social consequences. That’s why it’s important to act early.

Text: Nicole Krättli; photo: iStock

The ear is one of nature’s masterpieces, allowing us to experience the variety of sounds around us. But what happens when this finely tuned instrument begins to malfunction? When the birdsong in spring or the cherished voices of your partner or children suddenly sound muffled or distorted? Hearing loss often develops gradually over many years. That’s why many people don’t even notice at first that the clarity and richness of sound they once enjoyed is disappearing.

Hearing loss is not just a matter of losing your ability to hear sounds. It also has an impact on all aspects of human interaction. Sixteen percent of adults in Europe are affected by hearing loss, according to the World Health Organisation. Each case of hearing loss follows its own course. There are different types, degrees and stages of hearing loss, ranging from mild impairment to complete deafness. Some are temporary, others permanent. In each case, however, the loss has far-reaching consequences – not only acoustically, but also psychologically and socially.

What are the different types of hearing loss?

Conductive hearing loss

This type of hearing loss occurs when sound waves do not reach the inner ear properly. This can be due to a blockage or impairment in the outer or middle ear. There are many causes, from earwax and fluids in the ear to infections or tumours.

Sensorineural hearing loss

Sensorineural hearing loss: This condition is characterised by damage to or absence of hair cells in the cochlea, the part of the inner ear responsible for transmitting sounds to the brain. The causes can range from genetic factors to environmental influences.

Mixed hearing loss

In this form of hearing loss, both the inner ear and the middle and/or outer ear are affected. It is a combination of the two types mentioned above.

Damage to the auditory nerve

Damage to the auditory nerve can cause a particularly severe hearing loss because the transmission of sounds from the ear to the brain is impaired.

Symptoms: What are the signs of hearing loss?

Hearing loss is often not apparent from one day to the next. Instead, it reveals itself through a gradual diminution in the ability to hear. Certain sound volumes or frequencies are no longer perceived as clearly, and some may not be perceived at all. The symptoms can vary depending on the type of hearing loss. The consequences of hearing loss range from ringing in the ears, such as tinnitus, to dizzy spells or balance problems.

A noticeable feature is that those affected often get tired quickly. No wonder: constantly striving to interpret sounds and conversations properly can be incredibly draining. The range of symptoms extends from minor impairments to those so serious they can be classified as a severe disability.

Some of the most common signs of incipient hearing loss are:

Difficulty understanding high-pitched voices

Women’s and children’s voices in particular are often only perceived indistinctly.

Frequently asking people to repeat themselves

Repeatedly asking people to repeat what is said during conversations can be an indication that somebody is not understanding everything clearly.

Difficulties in conversation

High-frequency consonants such as C, S, F and Z in particular are often heard less clearly than low-frequency vowels. As a result, comments by others are not heard clearly.

Noise sensitivity

When everyday background sounds such as street or construction noise suddenly seem excessively loud, this could also indicate hearing loss.

Increased volume on TV or radio

Another indication may be the need to turn up the volume on the TV or radio higher than usual in order to hear everything clearly.

If you’re experiencing one or more of these symptoms, it’s worth considering a hearing test with a professional.

Causes: What can cause hearing loss?

Hearing loss, also called hypoacusis, is not always due to old age. In some cases, people are born with a hearing impairment. If both parents have a hearing impairment, the hearing loss can even be inherited.

For many people, however, hearing capacity begins to decline as they get older. The first signs can appear as early as the age of 30. By the age of 80, the majority of people have significant hearing problems. The cause often lies in the permanent overuse of the hearing cells in the inner ear. Fine hair cells gradually die and the remaining ones can no longer process high-pitched sounds correctly. This can make conversations difficult to understand, especially in a noisy environment.

Constant exposure to noise, whether from loud music, machine noise or even a sudden explosion, can also lead to permanent damage. It’s a gradual process – the hair cells in the inner ear, overloaded by the noise, recover worse and worse and may eventually die completely.

Some diseases also affect the ear directly. Infections such as middle ear infection or even mumps and measles can cause serious damage if they aren’t treated in time. Bacteria that penetrate the inner ear can also trigger inflammations that lead to anything from mild hearing loss to complete deafness.

Treatment: What can be done about hearing loss?

Treatment of hearing loss depends on the cause and severity. Some problems, for example the build-up of earwax, can be corrected relatively easily by a specialist. For conductive problems, surgery such as tympanoplasty can be helpful to correct damage in the middle ear. If the inner ear is affected, different approaches are available:

Hearing aids

Modern devices are discreet and customisable. They improve hearing quality and enable social interaction. The set-up and fitting are done by professionals, and special training courses are available for wearers.

Cochlear implants

These are suitable for people for whom conventional hearing aids don’t work. They bridge the damaged inner ear and stimulate the auditory nerve directly.

Communication techniques

Lip-reading or sign language can help those affected to communicate better.

Auditory training

Affected people specifically train their hearing to perceive certain sounds or speech more effectively.

Speech therapy

Helps with speech development and improvement.

Early support

For children with hearing problems, early support can be crucial in promoting speech and auditory training.


Psychotherapeutic treatment can be helpful for accompanying emotional problems such as depression.

Relatives can help people cope with their hearing loss through clear communication and understanding. Early diagnosis and treatment are crucial to maintaining and improving quality of life.

Although there are no specific prevention measures, it definitely helps to avoid too much noise. Wearing earplugs at loud events and not listening to loud music through headphones are first important steps towards ensuring you enjoy a future of stable hearing. Occasional rest periods, a healthy diet and abstaining from nicotine are also beneficial.