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Hearing loss in adults has many causes, such as disease or infection, ototoxic drugs, exposure to noise, tumors, trauma, or the aging process. This may or may not be accompanied by tinnitus, a ringing that occurs in the ears. Tinnitus can occur by itself without any hearing loss. Otosclerosis is a disease involving the small bones of the ossicles of the middle ear. One of the bones, known as the stapes, will fuse to the surrounding bone, making it so it can’t vibrate properly, which will cause a hearing loss. Meniere’s disease is a fluid imbalance in the inner ear. The excess fluid causes the membrane to be unable to vibrate properly. The membrane holds the nerve endings, and therefore you end up with hearing loss, ear pressure, dizziness such as vertigo, and ringing in the ears, such as tinnitus. There are some medications that you use to manage diseases that are damaging to the auditory system.
These are ototoxic medications. These could cause hearing loss. Some of the specific drugs known to be ototoxic are aminoglycocides such as streptomycin, neomycin and gentamycin. Salicylates in large quantities, such as aspirin, loop diuretics such as Lasix and drug therapies used in chemotherapy such as cisplatinum, carboplatinum and nitrogen mustard may all cause hearing loss. Exposure to harmful levels of noise results in noise induced hearing loss. A prolonged exposure causes damage to the hair cells in the cochlear, resulting in permanent hearing loss. Noise-induced hearing loss usually develops gradually and painlessly. Hearing loss can also occur as a result of acoustic trauma or a single exposure or very few exposures to a very high level of sound. An acoustic neuroma is an example of a tumor that causes hearing loss. The acoustic neuroma arises on the eighth cranial nerve, the acoustic nerve. It sits there putting pressure on the nerve and the first symptom can be reduction in hearing and a possible feeling of fullness.
Thankfully, these tumors are benign. Trauma can also result in hearing loss. Examples include fractures of the temporal bone, puncture of the eardrum by foreign objects inside to changes in the air pressure. Loss of hearing as a result of the aging process is called presbycusis. The process involves degeneration of the inner ear, known as a cochlea. Presbycusis can also involve other parts of the auditory system. The hearing loss is progressive in nature, with the high frequencies affected first. While the process begins after the age of 20, it is typically at the ages of 55 to 65 that the high frequencies in the speech range begin to be affected.
