Typical symptoms of hearing loss may include one or more of the following:

• People sound like they are mumbling.
  
• You have to strain to hear when someone talks or whispers.
  
• You have difficulty hearing someone call from behind or from another room.
  
• Asking people to repeat themselves.
  
• You have to turn up the TV or radio which then becomes uncomfortable for others.
  
• Misunderstanding conversation and saying yes when you should have said no etc.
  
• Following conversation is difficult when you are in a group of people, for example at a meeting, or church etc.
  
• You need to watch the lips of the person talking to you more closely to follow conversation. You may yourself, or have heard people say "I need to put my glasses on to hear better".
  
• You have problems hearing clearly on the telephone.
  
• You find it increasingly difficult to hear in noisy environments such as a restaurant or in the car.
  
• You have begun to limit your social activities due to difficulty hearing and communicating. As a result you become more withdrawn.
  
• You experience a loss of confidence and possibly depression.

If you can relate to any of the above then you may have a hearing loss. It would therefore be recommended that you have a hearing test to determine whether this is the case or not.

Acquired hearing loss:

Traumatic:

• Physical trauma - blow to the head
  
• Noise trauma - exposure to steady rate of noise
  
• Acoustic trauma - exposure to repeated loud sounds such as gun fire
  
• Blast injury - explosions
  
• Barotrauma - pressure changes due to flying or diving
  
• Miscellaneous - radiation exposure, electric shock
  

Iatrogenic:

• Surgical e.g. poor ear syringing techniques, post surgery operations such as a stapedectomy
  
• Pharmacological - certain drugs
  

Infective:

• Viral - measles, mumps, herpes zoster (shingles)
  
• Bacterial - upper respiratory infections e.g. colds & flu which can lead to middle ear infections
  
• Fungus - Otomycosis (fungus in the outer ear)
  
• Parasitic - meningitis
  

Neoplastic:

• Cancer of the middle ear, leukaemia, vestibulocochlea schwannoma (acoustic neuroma)
  

Metabolic:

• Hormonal - Myxodema (hypothyroidism), diabetes, acromegaly - can cause excessive growth in children or soft tissue growth in adults
  
• Others - Dyslipidaemia (too much fat in the blood), hyperuricaemia (gout-excessive uric acid in blood), renal failure where kidneys cannot cleanse body of impurities, causing toxicity

Vascular:

• Arteriosclerosis (hardening of the arteries), hyper-tension (high blood pressure), other circulatory disorders
  

Auto immune disorders:

• Wegenet's granulomatosis (bone lesion), polyarteritis nodosa (disease of artery wall), Bechets Syndrome
  

Miscellaneous disorders:

• Ototoxic substances not iatrogenically introduced such as carbon monoxide, tobacco and alcohol
  
• Meniere's disorder

Congenital hearing loss:

Pre-natal:

• Genetically (some 50-60% of all cases are hereditary) - Osteo genesis imperfecta (brittle bones), ushers syndrome, gargoylism (skull/facial deformities), Waardenburgs syndrome, Treacher Collins syndrome, Allports syndrome, Paget's disease (softening of the bones with age), hereditary presbyacusis. The most common form of hereditary hearing loss is otosclerosis (restriction of middle ear bone movement)
  
• Pre-natal maternal rubella - Mother contracts German Measles during pregnancy
  
• Cyto megalovirus (CMV) - Mother contracts this herpes like virus with flu type symptoms
  
• Ototoxicity
  
• Congenital syphilis
  

Peri-natal:

• Premature birth
  
• Anoxia - oxygen deficiency at birth e.g. umbilical chord twisted around baby's neck
  
• Birth Trauma - damage by forceps during delivery
  
• Rhesus incompatibilities - Rhesus factors in father's & mother's blood can cause jaundice