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Types of Hearing loss

how cholesteatoma forms

Broadly there are two different types of hearing loss. The first type is nerve damage (also known as sensorineural hearing loss), which is due to damage to the hearing nerve (cochlear nerve) or the brain. The most common example of this is old age related hearing loss (presbyacusis). Most forms of sensorineural hearing loss are treated with hearing aids as there is currently very little that other treatments can do.

The second type of hearing loss is when the sound from the outside world is blocked from reaching the nerve. This is also known as conductive hearing loss. This is the type of hearing loss that you can recreate yourself by occluding your ear canals with your own fingers tips. It sounds like you are underwater, or far away from the noise.

Conductive hearing loss is the type of hearing loss that can normally be repaired with help from an ENT consultant surgeon. Below is a list of the common causes of conductive hearing loss:

  • Ear wax
  • Infections blocking the ears with swelling or discharge debris (otitis externa or otitis media)
  • Foreign body in the ear canal (like a cotton bud tip or something similar)
  • Ear drum hole (tympanic perforation)
  • Glue ear
  • Eustachian Tube dysfunction (feeling like you need to pop your ears to hear properly)
  • Cholesteatoma (a disease that causes recurrent infections and hearing loss – should be treated as soon as possible)
  • Damage to one of the bones of hearing (Dislocated ossicle from a head injury, damage from a previous operation, cholesteatoma)
  • Otosclerosis (a bit like arthritis of one of the bones of hearing causing it to seize up and stop moving.)

This is by no means a full list of causes, but it does highlight the more common ones. The good news is that most of these causes are treatable without the use of hearing aids afterwards (assuming that the nerve of hearing is good).

There are less invasive operations that can also be done to improve hearing, most of which may be done under local anaesthetic if you wish. More detail about some of these operations is provided below.


Tympanoplasty (Myringoplasty)

This is an operation to close a hole in the ear drum. There are many different ways of performing this operation, but generally Mr Vik Veer prefers to avoid any scars around the ear, keeping all the incisions within the ear canal. This seems to be less painful for patients and also avoids shaving any hair or leaving any scars.


Cholesteatoma Surgery – Mastoidectomy

Cholesteatoma is a mass which slowly damages the bones of hearing in most cases. Fixing the damage afterwards is difficult as normally reconstruction of these millimetre sized bones is required. Mr Vik Veer prefers to use techniques developed by Mr John Hamilton in Gloucester which aim to avoid removing the bones at all. The cholesteatoma is removed with a laser but the vital hearing structures are kept in place. This procedure is not possible in more advanced disease so a more standard operation is used in these cases.






Read about Eustachian Tube Dysfunction

Read about Hearing Loss

Read about Tinnitus

Read about Vertigo

Read about Ear Wax

Read about Ear Infections

Read about Ear Perforations

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