Hearing management

Updated 15 August 2018

Causes of hearing loss

The causes of hearing impairment can be divided into two main groups, namely genetic (inherited) causes and acquired causes.


The causes of hearing impairment can be divided into two main groups, namely genetic (inherited) causes and acquired causes.

Inherited causes
Most hearing impairment is inherited. Of all types of inherited deafness only one third is present at birth. Another third starts during childhood and the other third only manifests in adulthood.

Acquired causes
There are many ways in which people acquire hearing loss.

1. Causes before birth
German measles and other infections: During the first 28 days of pregnancy it is of utmost importance that the mother does not get an infection, especially German measles and cytomegalovirus. If the mother gets German measles during the first eight weeks of pregnancy there is an 86% chance that her baby will be hearing impaired. German measles appears to be dangerous throughout pregnancy. Any contact with a person with this illness is therefore potentially dangerous.

Rhesus incompatibility and other factors: Other factors which can play a role in hearing impairment include Rhesus incompatibility as well as metabolic illnesses such as diabetes and thyroid problems.

2. Causes during and just after birth
The most common causes of hearing impairment at this stage are birth injuries, jaundice and a lack of oxygen.

3. Causes after birth
These causes include:

  • viral and bacterial infections such as meningitis
  • drug toxicity
  • excessive noise exposure
  • middle ear infection
  • head trauma

4. Ear infections
Ear infections are painful and should be treated in time. If not, infection can cause lasting damage. Many conductive hearing losses can be eliminated or substantially improved by medical treatment.

Outer ear infection (otitis externa):
Infection can be caused by an object in the external ear canal, for example excessive ear wax. Foreign objects include peas, a piece of prestik and small insects.

Adults should not attempt to remove the object unless it can be done easily. Children should be taught that the only thing they are allowed to put into their ears is their elbow.

Rough cleaning can scratch the delicate skin in the ear canal and it may become infected.

Chlorine in swimming pools (and bacteria in dirty swimming pools) can irritate the ear canal.

If a child has earache or a discharge from his ear, he could have an outer ear infection. Ask the child to open his mouth wide, then gently pull the ear lobe back. If this is very painful, there could be an ear infection.

Middle ear infection (otitis media):
This is the most common source of conductive hearing loss. It is an inflammation and/or infection of the middle ear. Infections can be caused by a build-up of fluid in the middle ear.

Otitis media is common in children under five years, particularly those under two years. This might be because the eustachian tube connecting the throat with the ear is short. This allows bacteria and viruses to move quickly from the nose and throat to the middle ear.

Enlarged adenoids block the entrance to the eustachian tube, preventing mucous from draining into the throat. This could also cause infection. Children prone to hayfever and those with a cleft palate are particularly at risk.

Read more:
Treating hearing loss


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Hearing Expert

Dr Kara Hoffman graduated from UCT in 2004, thereafter she completed her year of community service in Durban. In 2010 she completed her Masters Degree in Paediatric Aural Rehabilitation from UKZN. In 2016, she became a Doctor of Audiology through the University of Arizona (ATSU). Dr Hoffman and her partner Lauren Thompson opened a fully diagnostic audiology practice called Thompson & Hoffman Audiology Inc. In 2011 with world-class technology and equipment to be able to offer the broad public all hearing-related services including hearing testing for adults and babies, vestibular (balance) assessments and rehabilitation, industrial audiology, hearing devices, central auditory processing assessments for school-aged children, school screening, neonatal hearing screening programmes at Alberlito and Parklands Hospital, cochlear implants and other implantable devices, medicolegal assessments and advanced electroacoustic assessments of hearing. Thompson and Hoffman Audiology Inc. are based at Alberlito Hospital in Ballito, St Augustines Hospital in Durban and at 345 Essenwood Road, Musgrave. The practices are all wheelchair friendly. There are three audiologists that practice from Thompson & Hoffman – including Dr Kara Hoffman, Lauren Thompson & Minette Lister. The practice boasts professional, highly qualified, and extensive diagnostic services where all your hearing healthcare needs can be met. The additional licensing in vestibular assessment and rehabilitation, paediatric rehabilitation and cochlear implantation places this practice in one of the top specialist audiological positions in South Africa, with a wealth of experience in all clinical areas of audiology and is a very well respected and sought-after practice.

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