Can Ear Infections Cause Hearing Loss?

March 13, 2024
Amy Sarow, AuD, CCC-A
Written by
Amy Sarow, AuD, CCC-A
Amy Sarow, AuD, CCC-A

Dr. Amy Sarow is a practicing clinical audiologist and serves as Audiology Lead for Soundly. Her expertise and experience span topics including tinnitus, cochlear implants, hearing aid technology, and hearing testing. She holds a doctoral degree in audiology from the University of Iowa. During her residency at Mayo Clinic, Dr. Sarow was inspired by the three-tiered, patient-centered approach, incorporating clinical work, teaching and research.

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As an audiologist, I've witnessed firsthand how ear infections can impact individuals—from the tiniest toddlers to even grown adults. While it's true that children are more susceptible to ear infections, mainly due to the anatomy of their Eustachian tubes, one thing is for sure: discomfort does not discriminate. Adults can experience ear infections, too, albeit less frequently than children. Understandably, ear infections are a source of significant discomfort and anxiety. If you're wondering whether ear infections lead to hearing loss, we will explain everything you need to know about ear infections and their relationship to hearing loss. 

Understanding the Connection

An ear infection can lead to hearing loss, which can be temporary or permanent in chronic cases. An infection in the middle ear can interfere with sound traveling to the cochlea due to fluid that builds up in the middle ear space. If you've had a nasty ear infection, you might remember feeling pain or pressure in the ear, which can build up and lead to a rupture. While it may relieve some pressure, an eardrum rupture can cause problems, such as bleeding or fluid leaking from the ear post-rupture. Fluid build-up or a ruptured eardrum can cause temporary conductive hearing loss. 

Temporary Versus Permanent Hearing Loss

Temporary hearing loss is often related to fluid build-up that can dampen the ability of sound to travel normally through the auditory pathway, resulting in a temporary reduction in hearing acuity. If you've ever been underwater in a swimming pool, you might notice how voices sound muffled while your head is underwater. That's because sound travels much more easily through air than through water, so it's much easier to hear when the middle ear space is healthy and free of fluid. Most commonly, ear infections cause temporary hearing loss. The good news is that proper medical intervention and healing often reverses conductive hearing loss. 

On the other hand, permanent hearing loss can be caused by more severe, untreated, or chronic infections that lead to damage within the ear. The entrance to the cochlea is connected to the middle ear space. If bacteria pass through the round window membrane and enter the cochlea, they may, unfortunately, cause permanent hearing damage in the inner ear.

Recognizing the Signs

Recognizing the symptoms early can lead to prompt and effective treatment if you are concerned about an ear infection or conductive hearing loss. Here's a list of common symptoms associated with these conditions:

  • Persistent Ear Pain: A continuous, often sharp or throbbing pain within the ear.
  • Hearing Difficulties: Experiencing a noticeable difficulty in hearing, which may include muffled sounds or feeling as though your ear is "plugged."
  • Fluid Discharge: Unusual fluid draining from the ear.
  • Fever: Increased body temperature can often accompany an ear infection, indicating your body is fighting the infection.
  • Tinnitus: Ringing or buzzing noises in the ear that are not caused by external sounds.
  • Irritability in Children: For young children or those who cannot express their symptoms clearly, increased irritability or fussiness can indicate ear discomfort.

Consult with a healthcare provider if you or your child exhibit any of these symptoms. Early diagnosis and treatment are crucial in preventing the progression to more severe conditions, including potential hearing loss.

What To Do If You Have An Ear Infection

If you suspect you have an ear infection, it's essential to seek medical attention promptly. A healthcare provider, audiologist, or ENT specialist can perform a thorough examination to diagnose the issue and recommend appropriate treatment. Common ear infection treatments include using antibiotic ear drops or systemic antibiotics, decongestants to relieve pressure and pain, or, in some cases, an ENT may place pressure equalization (PE) tubes in the ear to aerate the middle ear.

Tests for Hearing Loss

Your audiologist may conduct a series of tests to assess hearing loss. 

Types of Tests to Check for Conductive Hearing Loss

When assessing for conductive hearing loss, healthcare providers will typically conduct the following tests, which are critical for an accurate diagnosis:

  • Pure Tone Audiometry: This test involves wearing headphones and responding to various pitches at soft volumes. It helps to determine the quietest sounds you can hear at different frequencies, providing a detailed profile of your frequency-specific hearing ability.
  • Pure Tone Bone Conduction: This test uses a device placed behind the ear to send sounds directly to the inner ear through the skull bone, bypassing the outer and middle ear. It distinguishes between conductive and sensorineural hearing loss.
  • Speech Testing: To understand how well you can hear and interpret speech, this assessment measures the lowest level at which you can detect words and how clearly you understand words at a comfortable volume.
  • Tympanometry: This test evaluates the condition of the middle ear and the mobility of the eardrum by varying air pressure within the ear canal. It aids in the identification of fluid in the middle ear, eardrum perforations, and Eustachian tube dysfunction.

By combining the results of these tests, an audiologist can ascertain the extent and type of hearing loss and, subsequently, recommend the most effective treatment options. Having these tests conducted by a qualified professional for proper evaluation and management of any hearing impairments is crucial.

What does conductive hearing loss look like on an audiogram?

There are several common features of conductive hearing loss. Typically, you'll see a gap of 15 dB HL or more between your air conduction hearing thresholds and bone conduction thresholds in the low frequencies (250 - 1000 Hz). Air conduction symbols on your audiogram will be either blue X or blue square symbols for the left ear and red circles or red squares for the right ear. Your bone conduction thresholds will look like little brackets. Here's an example:

Treatment Options

The treatment for hearing loss due to ear infections will depend on the severity and underlying cause of the condition. 

Medical Intervention

The primary focus for conductive hearing loss caused by infection will be to clear the infection and alleviate symptoms. This may involve a combination of antibiotics administered systemically or as ear drops, and decongestants or antihistamines to address underlying causes such as sinusitis or allergies.

Audiological Intervention

For those experiencing sensorineural hearing loss due to their multiple chronic ear infections, the treatment will focus on managing the hearing loss itself. Children with chronic ear infections may also wear hearing aids, which aid in speech and language learning. Even mild conductive hearing loss is considered educationally significant. Children under 18 will work with an audiologist to fit and manage their hearing loss with hearing devices, which include hearing aids and remote microphones.

Tips for Prevention

Prevention is always the best medicine. To reduce the risk of ear infections and subsequent hearing loss, it's essential to practice good ear hygiene, avoid exposing your ears to loud noises, and attend to ear infections promptly. 

Caring for Your Hearing Health

Maintain a healthy lifestyle that supports your overall health and immune system. A robust immune system can help fight off infections before they take hold. Additionally, be mindful of your hearing and do not ignore signs of potential hearing loss. Regular screenings and check-ups with your doctor or an audiologist can help detect issues early and ensure prompt intervention.

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Final Thoughts

Dealing with ear infections and their potential impact on hearing can be challenging, both for the individuals experiencing them and their families. It's crucial to remember, though, that many people can effectively manage these conditions with the proper medical and audiological support. Advancements in medical treatment and hearing technology continue to offer hope and improved quality of life for those affected by hearing loss. Remember, you are not alone on this journey. A community of healthcare providers, hearing specialists, and support groups are available to guide you through the diagnosis, treatment, and management of hearing issues.

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