Hearing Loss

What Is Hearing Loss?

Hearing loss refers to a partial or severe decline in hearing or auditory function. Its severity can range from mild to profound and may affect one ear (unilateral) or both ears (bilateral). This condition can be caused by several factors, such as ageing, loud noise exposure (up to 85 decibels), or a structural defect in the ear. In Singapore, hearing loss is a major health concern, affecting around 500,000 individuals.

Types of Hearing Loss

There are three main types of hearing loss, including:

Sensorineural Hearing Loss (SNHL)

This occurs when the tiny hair cells within the inner ear's structures (cochlea) or the nerve pathways that transmit sound to the brain are damaged. The condition is typically associated with age-related hearing loss (presbycusis).

Conductive Hearing Loss (CHL)

This type of hearing loss occurs when a problem in the outer or middle ear hinders sound waves from reaching the inner ear. Potential causes may include ear wax buildup, outer ear blockages, infections, or eardrum perforations.

Mixed Hearing Loss

This is a combination of sensorineural and conductive hearing loss, indicating potential damage in both the inner ear and the middle or outer ear.

At Barrie Tan ENT Head & Neck Surgery, we have subspecialised expertise in the diagnosis and treatment of hearing loss.
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What Are the Symptoms of Hearing Loss?

The symptoms of hearing loss can develop suddenly or gradually worsen over time. Either way, here are some common symptoms of hearing loss to be mindful of:

  • Muffled or distorted speech or other sounds
  • Difficulty discerning words clearly, often requiring conversations to be repeated
  • A constant ringing or hissing sound in the ear (tinnitus)
  • A sensation of spinning or dizziness (vertigo)
  • Ear pain (otalgia), discharge, and blockage from ear infections

If these symptoms occur more frequently or are worsening, consult an ENT doctor immediately for a detailed hearing evaluation.

Possible Causes of Hearing Loss

A number of factors can contribute to hearing loss, including:

Ear Infection

Bacteria may enter the ear and cause infections in the middle ear (otitis media) or the inner ear (labyrinthitis), which can cause temporary or permanent hearing loss.

Ear Blockage

An excessive buildup of earwax (cerumen) or the presence of a foreign object in the ear canal can block sound waves from reaching the eardrum, impairing normal hearing.

Ruptured Eardrums

Also known as tympanic membrane perforation, this condition can result from loud noises, sudden pressure changes, trauma, and chronic infections.

Ménière's Disease

Ménière's disease is an inner ear condition that can affect one’s balance and hearing; and it presents in recurrent episodes. In most cases, only one ear is affected.

Acoustic Neuroma

This refers to a tumour of the vestibular nerve, which lies close to the auditory nerve and can affect its function.

Ototoxic Drugs

Some medications can damage the nerves required for hearing, or the sensory cells in the cochlea.

Structural/Congenital Ear Defects

Individuals born with structural or congenital ear defects, such as microtia and external auditory canal atresia, may experience hearing difficulties.

Autoimmune Inner Ear Disease

This is caused by an uncontrolled immune system response that attacks the inner ear causing progressive sensorineural hearing loss.

How Is Hearing Loss Diagnosed?

When hearing loss is suspected, it is advisable to see an ENT doctor for a diagnosis. Together with an audiologist, they may perform a series of tests and examinations, such as:

  • 1
    Physical Examination

    The doctor or audiologist will begin by inspecting the outer ear and ear canal using an otoscope to check for visible abnormalities like swelling, infections, impacted earwax or blockages, and structural defects.

  • 2
    Hearing Tests

    The doctor or audiologist will then perform several hearing tests to evaluate the patient’s auditory health, as well as the nature and severity of hearing impairment. Some hearing tests include:

This test measures hearing sensitivity across different frequencies using headphones or earplugs. It helps determine the softest sound a patient can perceive at various pitches.

This test is similar to pure tone audiometry, except that it measures hearing performance in the high-frequency range. It is typically recommended for hearing impairments caused by ototoxicity (medication side effect), noise exposure, and acoustic traumas.

This test examines hearing sensitivity to pure tones and speech stimuli within a sound field. Instead of using headphones or ear transducers, sounds are delivered through loudspeakers.

In this test, a small probe is inserted into the ear to measure the pressure in the ear canal and examine eardrum function. This allows the doctor to detect any signs of middle ear problems that may cause hearing loss, such as fluid buildup, infections, eardrum perforations, or Eustachian tube dysfunction.

This test evaluates the reflexive contractions of the stapedius muscle in response to a loud sound. It utilises headphones and a small probe placed in the ear canal to assess the integrity of the middle ear and the auditory nerve pathways.

This test evaluates a patient’s ability to understand and repeat spoken words in low- and high-noise environments. The results can determine how hearing loss affects speech recognition and predict the effectiveness of hearing aids.

Our specialist clinic is well-equipped with advanced audiological technology and experienced staff to provide an accurate, one-stop diagnosis.
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Our Hearing Clinic’s Facilities

Our specialist clinic is equipped with modern audiological evaluation technologies conducted by qualified hearing professionals in a comfortable and professionally sound-treated room. We also perform paediatric audiological evaluations for children (newborns to 16 years old), ensuring an accurate diagnosis of hearing loss patterns and severity for patients of all ages.

Our diagnostic services include:

  • Pure Tone Audiogram (Bone and Air Conduction) 
  • Tympanograms 
  • Stapedial Reflexes 
  • Speech Discrimination Tests 
  • Aided Audiograms and Speech Discrimination Tests 
  • Otoacoustic Emissions (OAEs)
  • Auditory Brainstem Responses (ABR)  
  • Auditory Steady State Responses (ASSR) 
  • Visual Response Audiometry (VRA) 
  • Play Audiometry 
  • Central Auditory Processing Disorder (CAPD) Diagnostics

Hearing Loss Treatments We Provide

Our clinic offers comprehensive and targeted treatments to manage and improve hearing loss. We develop our treatment plans based on the type and severity of hearing loss, as well as the individual needs of each patient. These treatment options include:

A doctor can safely remove earwax or foreign objects obstructing the ear canal using a suction-tipped catheter, forceps, and a handheld otoscope.

Surgery may be considered in some cases of hearing loss arising from perforated eardrums, bony growths in the ear canal, ear bone fixations or deformities.

For patients with severe to profound sensorineural hearing loss, these electronic devices are surgically placed into the cochlea to directly stimulate the hearing or cochlear nerve and bypass the damaged portions of the cochlear hair cells.

These devices capture sound signals from the environment and amplify them in the ear canal to help patients hear better. They are available in different shapes and forms, including behind-the-ear (BTE) and completely-in-the-canal (CIC) hearing aids, which are small enough to fit inside the ear canal.

Your Trusted Partner in Hearing & ENT Care

At Barrie Tan ENT Head & Neck Surgery, we are committed to providing compassionate and comprehensive care to help our patients regain their hearing and restore optimal ENT health.

Contact us

Appointments: +65 6738 1616 Whatsapp: +65 8123 1214
Email: info@drbarrietan.com

Visit us

Gleneagles Hospital, 6A Napier Road #03-32A/B Annexe Block, Singapore 258500

Opening hours

Mon to Fri: 9am - 5pm,
Sat: 9am - 1pm
Sunday: Closed

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