ENTcare Clinic hearing specialist Dr Annabelle shares more about common causes of hearing loss in patients in Mt Elizabeth Medical Centre.
In Singapore, it’s not uncommon for people to attribute changes in hearing to something simple, like earwax buildup, recent flights, or a lingering cold. And while these minor causes are real and sometimes harmless, persistent or worsening hearing loss should never be brushed off.
Hearing loss, especially when left untreated, can lead to a cascade of health issues beyond the ear, affecting mental well-being, communication, and even cognitive function. Whether you’re experiencing muffled sounds, ear pressure, or sudden deafness, it’s crucial to know when it’s more than just wax. That’s where timely intervention from an makes all the difference.
This article explores the subtle and not-so-subtle signs that your hearing loss may indicate something more serious, and why consulting an ENT doctor in Singapore should be your first step toward clearer hearing and overall health.
Understanding Common Causes of Hearing Loss
Hearing loss is broadly categorised into conductive, sensorineural, or mixed types. Each presents differently, and the causes can vary widely, from reversible blockages to irreversible nerve damage.
Let’s start with conductive hearing loss, which occurs when sound waves are blocked from reaching the inner ear. Some of the most common causes include:
1. Earwax Impaction
A leading cause of temporary hearing loss, earwax can block the ear canal, resulting in muffled sounds and a sensation of fullness. Many people attempt to clear this at home using cotton buds or over-the-counter remedies, but improper removal can worsen the problem or cause injury.
2. Perforated Eardrum
A hole or tear in the eardrum, caused by infections, trauma, or sudden pressure changes, can result in hearing loss, ear pain, and sometimes discharge. While small perforations may heal on their own, larger ones may require assessment by an ENT doctor and rely on for diagnosis and microsurgical treatment.
3. Otitis Media (Middle Ear Infection)
Acute or chronic ear infections can lead to fluid buildup behind the eardrum, affecting sound conduction. Children are especially prone, but adults can also experience middle ear infections, particularly after upper respiratory illnesses or allergies.
4. Otosclerosis
A lesser-known cause of hearing loss, otosclerosis is a condition in which one of the tiny middle ear bones, the stapes, becomes fixed and unable to vibrate. This inherited condition often causes progressive hearing loss and is typically treated by a doctor patients trust for specialised ear surgery.
5. Cholesteatoma
This abnormal skin growth behind the eardrum may develop after repeated infections or eardrum perforation. Over time, a cholesteatoma can erode bone and lead to chronic infection, discharge, and significant hearing loss. It requires early detection and surgical intervention by a specialist.
Is Sudden Hearing Loss a Medical Emergency?
While conductive causes may develop slowly, sudden sensorineural hearing loss (SSNHL) is a true ENT emergency.
If you or someone you know suddenly loses hearing in one ear over a few hours or days, it’s critical to seek help immediately. Delays in treatment can result in permanent hearing loss.
ENT doctors often prescribe oral steroids or administer intratympanic (eardrum) steroid injections directly into the middle ear. These interventions are most effective when started within 72 hours of symptom onset. Prompt treatment can significantly improve hearing recovery, highlighting the importance of recognising urgency and not mistaking it for wax or congestion.
When Should You See an ENT Doctor?
Not all hearing issues are emergencies, but many deserve medical attention. Here’s when to stop waiting and make an appointment with a trusted doctor:
- Hearing loss in one or both ears that persists longer than a week
- Recurrent ear infections or constant pressure in the ears
- Tinnitus (ringing or buzzing) that interferes with daily life
- Ear discharge, particularly if it’s foul-smelling or bloody
- History of loud noise exposure with gradual hearing deterioration
- Difficulty understanding conversations even in quiet settings
- Family history of early hearing loss or otosclerosis
- Sudden hearing loss, dizziness, or imbalance
Hearing Loss and Its Long-Term Effects
Untreated hearing loss isn’t only about missing out on conversations or increasing the TV volume. Over time, it can lead to social isolation, frustration, and communication difficulties with loved ones. Even more concerning, medical studies have linked untreated hearing loss to an increased risk of depression and cognitive decline, including dementia.
In Singapore’s ageing population, this is especially relevant. Hearing loss is one of the modifiable risk factors for dementia identified by researchers. Early treatment, whether through hearing aids, medical therapy, or surgical intervention, can significantly reduce that risk.
By seeing a specialist in Singapore residents can trust, patients gain access to audiological evaluations, imaging tests, and tailored treatment options that support long-term neurological and psychological well-being.
Treatment Options, From Simple to Surgical
Once your ENT doctor has determined the underlying cause of your hearing issue, they’ll recommend a treatment plan. Options vary depending on the diagnosis:
1. Cerumen (Wax) Removal
Safe removal of impacted earwax is typically performed in a clinical setting using methods such as microsuction, gentle irrigation, or curettage with specialised instruments. These procedures are done under direct visual guidance, ensuring precision and minimizing the risk of injury. It’s important to avoid using cotton buds or home remedies, as these can push the wax deeper, cause irritation, or even lead to eardrum damage.
2. Medication
For infections causing hearing loss or ear discomfort, ENT doctors often prescribe targeted treatments such as oral antibiotics, antifungal ear drops, or anti-inflammatory medications to address the underlying cause. When allergies contribute to ear issues, such as fluid buildup or eustachian tube dysfunction, antihistamines or nasal steroid sprays may be used to reduce inflammation, relieve congestion, and promote proper drainage, ultimately restoring hearing and preventing recurrent ear infections.
3. Surgical Interventions
In more complex cases, surgery may be necessary. Some common procedures include:
- Myringoplasty: Repair of a perforated eardrum
- Tympanoplasty: Reconstructive surgery of the middle ear
- Stapedectomy: Replacement of the fixed stapes bone in otosclerosis
- Cholesteatoma excision: Surgical removal of the abnormal growth behind the eardrum
Can Hearing Aids Help?
When hearing loss is sensorineural or mixed, and not surgically correctable, hearing aids or cochlear implants may be recommended. ENT doctors work closely with audiologists to select the right device based on the patient’s lifestyle, hearing profile, and communication needs.
Today’s hearing aids are discreet, highly functional, and often Bluetooth-enabled. With proper fitting and follow-up, they can greatly enhance quality of life and keep patients socially and cognitively engaged.
Trust Your Ears, And Your ENT
What starts as a subtle change in hearing can be a sign of something far more significant. While earwax is a common and treatable cause of hearing loss, it’s not the only one, and certainly not the most dangerous.
By recognising symptoms early and consulting a trained ENT doctor, patients can access safe, effective treatments that restore hearing and protect long-term health. Whether it’s a perforated eardrum, middle ear disease, or something more urgent like sudden hearing loss, prompt ENT evaluation can make all the difference.
