Hearing Loss: Symptoms, Causes, and When to Seek Help

Hearing impairment issues

This afternoon, I felt a bit dizzy, but since I have a history of heart disease, I often experience dizziness, so I didn't pay much attention to it.
I also occasionally have tinnitus (sometimes it coincidentally occurs before a major earthquake).
Today, it suddenly flared up again, but I didn't think much of it.
Later tonight, I suddenly experienced a loud ringing in my right ear, which then diminished but continued to ring.
While listening to music (without headphones, as I have a habit of using speakers, so I notice even slight differences in sound quality), I couldn't tell if it was just my perception or if my hearing had declined.
It felt like the bass sounded quieter, particularly the timbre of low notes (similar to piano sounds).
After about 30 minutes, it seemed to return to normal.
Doctor, is this a sign of hearing loss? If treatment is necessary, should I go to a major hospital for an examination, or is it better to just observe for now? Thank you.

Niming, 30~39 year old female. Ask Date: 2017/09/30

Dr. Zheng Jueyi reply Otolaryngology

Hello, if there are changes in hearing or persistent tinnitus that does not improve, it is recommended to visit a hospital for a hearing examination and differential diagnosis.
Wishing you safety and health.
Director of the Department of Otolaryngology, Taoyuan Hospital, Ministry of Health and Welfare, Zheng Jue-Yi.

Reply Date: 2017/09/30

More Info

Hearing loss can be a complex issue, and your symptoms warrant careful consideration. Based on your description, it seems you are experiencing a combination of tinnitus (the ringing in your ears) and a perceived change in your hearing, particularly with low-frequency sounds. These symptoms can be concerning, especially when they occur suddenly or fluctuate.

Understanding Hearing Loss
Hearing loss can be classified into two main categories: conductive hearing loss and sensorineural hearing loss. Conductive hearing loss occurs when sound waves cannot efficiently travel through the outer ear canal to the eardrum and the tiny bones of the middle ear. This can be due to blockages, infections, or structural issues. Sensorineural hearing loss, on the other hand, involves damage to the inner ear (cochlea) or the auditory nerve pathways to the brain. This type of hearing loss is often permanent and can be caused by aging, exposure to loud noises, or medical conditions.

Symptoms of Hearing Loss
Common symptoms of hearing loss include:
1. Difficulty understanding speech, especially in noisy environments.

2. Muffled sounds or a sensation that sounds are not as clear as they used to be.

3. Tinnitus, which can manifest as ringing, buzzing, or hissing in the ears.

4. Feeling of fullness in the ear.

5. Difficulty hearing certain frequencies, which may explain your experience with low-frequency sounds.

Causes of Hearing Loss
Hearing loss can be caused by various factors, including:
- Aging: Presbycusis is age-related hearing loss that typically affects high frequencies first.

- Noise exposure: Prolonged exposure to loud sounds can damage the hair cells in the cochlea.

- Ear infections: These can lead to temporary conductive hearing loss.

- Medical conditions: Conditions such as Meniere's disease, otosclerosis, or acoustic neuroma can affect hearing.

- Trauma: Physical injury to the ear can lead to hearing loss.

When to Seek Help
Given your symptoms of dizziness, tinnitus, and perceived changes in hearing, it is advisable to seek medical attention. Here are some guidelines for when to see a healthcare professional:
1. Sudden hearing loss: If you experience a rapid change in hearing, especially if it occurs in one ear, you should seek immediate medical evaluation.

2. Persistent tinnitus: If the ringing in your ears continues or worsens, it is important to consult a doctor.

3. Associated symptoms: Dizziness or balance issues, especially if they are new or worsening, should be evaluated by a healthcare provider.

4. Difficulty understanding speech: If you find it increasingly hard to follow conversations, this could indicate a significant hearing issue.

Next Steps
1. Consult an Ear, Nose, and Throat (ENT) Specialist: An ENT can perform a thorough examination, including hearing tests, to determine the cause of your symptoms.

2. Hearing Tests: Audiometric testing can help assess the degree and type of hearing loss. This may include pure-tone audiometry and speech discrimination tests.

3. Imaging Studies: If there is suspicion of an underlying condition, imaging studies like an MRI or CT scan may be necessary.

Conclusion
In summary, while your symptoms may fluctuate and sometimes resolve, it is crucial to take them seriously, especially with the combination of tinnitus and changes in hearing. Early intervention can lead to better outcomes, whether through medical treatment, hearing aids, or other therapies. Do not hesitate to seek help from a qualified healthcare professional to ensure your hearing health is properly assessed and managed.

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