Loss of hearing may relate to any impairment of the hearing organ components. The ear technically has three parts, but the nervous system needs to be considered as a factor as well, because it connects the hearing apparatus to the brain where we perceive sound and understand its meaning.

Sound enters the external ear, travels through the ear canal to the middle ear where it encounters the eardrum with its attachments to the hammer, anvil, and stirrup. At the stirrup, sound vibrations are transformed to hydraulic energy at entry to the cochlea where they are converted to neural energy by our hair cell sensors. That nerve energy is then transmitted to the brain.

External Ear. Foreign objects in the ear canal may impair hearing. Peanuts, pencil erasers, chewing gum, tissue, and even bugs can cause hearing problems. People who regularly “clean” their ears with cotton tips may force earwax deeper into their ear canals or against their eardrums, essentially plugging up the ear canal, resulting in loss of hearing. When trauma accompanies foreign objects entering the ear, permanent loss of hearing may result because sound cannot travel its usual route to the organ of hearing. Injury to the outer ear may also cause the ear canal to become plugged by swelling and scar tissue, preventing sound from reaching the eardrum. Prevention of Loss of Hearing: Avoid poking things into your ear canal. Have an audiologist evaluate your ear canal for obstruction.

Middle Ear. Foreign bodies in the ear canal may be forced into the middle ear, dislocating the ossicular chain, puncturing the eardrum, or bringing infection into the middle ear. Eustachian tube problems, often accompanying ongoing infection, may cause build up of fluids behind the eardrum, resulting in hearing loss. Infection has the potential to cross from the middle ear into the cochlear and cause permanent damage to the hair cells. The result is big time hearing loss and sometimes balance problems. Prevention of Loss of Hearing: Seek professional help for earaches. See a health care professional for continuing ear pain, fever, or balance problem

Inner Ear. Head trauma from car accident, sports injury, fall, or workplace hazard may damage that ossicular chain, but traumatic injury may cause membrane rupture at the cochlea’s oval or round windows or in the membranes of the inner ear or at the hair cell structures themselves. Infectious disease or its treatment may cause hair cell disruption or destruction. “Tertiary” health infections may present as inner ear problems (e.g., syphilis). Meniere’s Disease and other inner ear metabolic problems may have similar symptoms. The result is hearing loss and often dizziness or balance problems. Prevention of Loss of Hearing: See a health care professional for ear and head injury complaints.

Nervous System. Nervous system disease may cause hearing loss and balance problems, but the disease process may not be “peripheral,” i.e., in the ear proper. Prevention of Loss of Hearing: See an otolaryngologist or neurologist for unexplained hearing loss or balance problems.