There are three primary types of hearing loss:

•    Conductive-hearing loss caused by the inability of the sound to reach the inner ear. This can result from outer or middle ear problems, such as ear infection, excess wax, or swelling. This type of hearing loss is most likely to respond to medical or surgical treatment.

•    Sensorineural-hearing loss caused by disorders of the inner ear or auditory nerve. This type of loss is usually permanent. It can be caused by heredity or congenital problems, excess noise, old age, medications, infections such as ear infections and meningitis , or from tumors compressing the nerve of hearing such as an acoustic neuroma .

•    Mixed-hearing losses that are a combination of both conductive and sensorineural loss.

Symptoms

Hearing loss usually comes on gradually, but may come on suddenly. Symptoms may include:

•    Difficulty hearing
•    Ringing in the ears ( tinnitus )
•    Dizziness
•    Ear pain in case of an infection
•    Feeling of ear fullness (as in earwax or fluid)

Symptoms of deafness in infants may be noted at these stages:

•    1 to 4 months: lack of response to sounds or voices
•    4 to 8 months:

o    Disinterest in musical toys

o    Lack of verbalization, such as babbling, cooing, making sounds

•    8 to 12 months: lack of recognition of child's own name
•    12 to 16 months: lack of speech

According to the American Academy of Pediatrics, all children (including newborns) should be screened for hearing loss so that hearing loss occurring before birth can be uniformly detected prior to three months of age.

Causes/Diagnosis

Though there are more than 100 possible causes of sudden deafness, it is rare for a specific cause to be precisely identified. Only 10 to 15 percent of patients with SSHL know what caused their loss. Normally, diagnosis is based on the patient's medical history. Possible causes include the following:

•    Infectious diseases.
•    Trauma, such as a head injury.
•    Abnormal tissue growth.
•    Immunologic diseases such as Cogan's syndrome.
•    Toxic causes, such as snake bites.
•    Ototoxic drugs (drugs that harm the ear).
•    Circulatory problems.
•    Neurologic causes such as multiple sclerosis.
•    Relation to disorders such as Ménière's disease.

Treatment

Treatment for deafness depends on the type of hearing loss. Options may include:

•    Medical treatment-for example, removal of earwax or use of antibiotics to treat an ear infection
•    In selected cases of sudden hearing loss, medical treatment with Intratympanic steroids may be effective.
•    Hearing aids-small devices that are worn in or behind the ear to help amplify sounds

•    Surgery-in some cases, surgery may be recommended to help improve hearing; types of surgery include:

o    Stapedectomy-for treatment of otosclerosis
o    Tympanoplasty-for a perforated eardrum
o    Tympanoplasty tubes-for persistent middle ear infections or fluid

•    Cochlear implant-a surgically implanted electronic device that helps provide sound to a person with severe sensorineural hearing loss.

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