ENT Nuffield Medical

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Hearing Loss Assessment

1. What is the condition about?

Hearing loss is a broad term encompassing the partial or total inability to hear sounds. It can range from mild to profound and may occur suddenly or gradually. Hearing loss can impact one or both ears and can result from various causes, including aging, exposure to loud noise, medical conditions, and more.

2. What are the causes?

  1. Age-related Hearing Loss (Presbycusis) : Gradual hearing loss is a common part of the aging process.
  2. Noise-induced Hearing Loss : Prolonged exposure to loud noises, either at work or through recreational activities, can damage the inner ear.
  3. Medical Conditions : Conditions like ear infections, otosclerosis, and Meniere’s disease can lead to hearing loss.
  4. Medications : Certain medications (ototoxic drugs) can harm the auditory system.
  5. Genetics : Genetic factors can contribute to hearing loss.
  6. Trauma : Head injuries or trauma to the ear can result in hearing impairment.

3. How common is the condition?

Hearing loss is a prevalent health issue globally, affecting people of all ages. Its prevalence tends to increase with
age, making it a common concern among the elderly population.

Conductive Hearing Loss :
  • Condition : Conductive hearing loss occurs when sound waves are not conducted efficiently through the outer ear canal to the middle ear structures, including the eardrum and the three tiny bones (ossicles).
  • Causes : Common causes include earwax blockage, ear infections, fluid accumulation in the middle ear (effusion), or problems with the ear’s anatomy.
  • Surgical Procedure : Surgical correction may be considered for cases where conductive hearing loss is due to anatomical issues. Procedures include:
    • Tympanoplasty : This surgery repairs a perforated eardrum.
    • Stapedectomy : Used to treat otosclerosis, this procedure replaces the stapes bone with a prosthesis.
    • Ossicular Chain Reconstruction : This surgery aims to repair or replace damaged ossicles.
  • Recovery : Post-surgery, patients typically experience improved hearing. Recovery times vary depending on the specific procedure.
Sensorineural Hearing Loss:
  • Condition : Sensorineural hearing loss results from damage to the inner ear or the auditory nerve.
  • Causes : It can be caused by aging, exposure to loud noise, genetic factors, viral infections, or certain medications.
  • Surgical Procedure : Surgical options for sensorineural hearing loss are limited. Cochlear implantation is a significant surgical intervention that can restore hearing for some individuals with severe or profound sensorineural hearing loss.
    • Cochlear Implant Surgery : This involves implanting an electronic device directly into the inner ear to stimulate the auditory nerve.
  • Recovery : After cochlear implant surgery, patients undergo a rehabilitation process to adapt to the new hearing sensation. This may involve regular adjustments and therapy.
Mixed Hearing Loss:
  • Condition : Mixed hearing loss combines elements of both conductive and sensorineural hearing loss.
  • Causes : It can result from a combination of factors, such as chronic ear infections and preexisting sensorineural hearing loss.
  • Surgical Procedure : Surgical intervention may be required to address the conductive component of mixed hearing loss, similar to procedures mentioned earlier.
  • Recovery : Surgical recovery and outcomes depend on the specific surgical procedure performed.
Meniere's Disease:
  • Condition : Meniere’s disease is characterized by recurrent vertigo, fluctuating hearing loss,tinnitus (ringing in the ears), and a feeling of fullness in the affected ear.
  • Causes : The exact cause is unknown, but it is believed to involve fluid buildup in the inner ear.
  • Surgical Procedure : In cases of severe, unresponsive Meniere’s disease, surgery may be considered as a last resort. Surgical options include:
    • Endolymphatic Sac Decompression : This procedure aims to reduce fluid buildup.
    • Vestibular Nerve Section : It severs the vestibular nerve to control vertigo.
  • Recovery : Recovery and symptom relief vary among individuals and depend on the specific surgical approach.

4. What can an ENT Specialist do for you?

An ENT specialist plays a crucial role in addressing hearing loss:

The specialist will perform a comprehensive evaluation, including audiometry tests, to assess the type and extent of hearing loss.


Depending on the cause, treatment options may include medication, hearing aids, cochlear implants, or surgery.

Hearing Aids

ENT specialists can recommend and fit patients with hearing aids to improve hearing.

Cochlear Implants

 For severe or profound hearing loss, cochlear implantation may be considered.

5. How can the condition be treated?

Treatment for hearing loss depends on the specific cause :

Hearing Aids

These electronic devices amplify sounds and are often used for age-related or sensorineural hearing loss.

Cochlear Implants

These devices can be surgically implanted to stimulate the auditory nerve directly for
individuals with severe or profound hearing loss.


If hearing loss is due to a medical condition or infection, medication may be prescribed.


Surgical procedures, such as stapedectomy for otosclerosis, can sometimes restore hearing.

6. Guidelines for Surgery

When surgery is recommended to treat hearing loss, it typically involves : 

  • Preparation : Patients will receive pre-operative instructions, including fasting if necessary.
  • Anesthesia :Most hearing-related surgeries are performed under local or general anesthesia.
  • Procedure : The specific surgical procedure depends on the underlying cause of hearing loss. For example, stapedectomy is performed to treat otosclerosis, while cochlear implant surgery involves implanting a device in the inner ear.
  • Recovery : Post-surgery, patients will have a recovery period and may require follow-up appointments to assess their progress.

7. Evaluation & Follow Up for Treatment

Regular follow-up appointments are essential to monitor the patient’s progress, ensure the effectiveness of
treatment, and make any necessary adjustments to hearing aids or implants.

8. Risks of Surgery

While surgical interventions for hearing loss are generally safe, they may carry some risks, including infection, changes in taste or balance, and in rare cases, worsening of hearing.

9. Alternatives to Surgery

Depending on the type and severity of hearing loss, alternatives to surgery may include hearing aids, assistive listening devices, or communication strategies and therapies to help individuals manage their hearing impairment effectively.