Hearing Loss (Hypoacusis): Interview with Dr. Fiorini
Do you find yourself straining to hear conversations in noisy, crowded places? Or maybe someone next to you points out that the TV volume is too high. Do you often ask people to repeat what they’ve said?
These may be early warning signs of hearing loss (hypoacusis). We discussed this with Dr. Lanfranco Fiorini, otolaryngology specialist at UPMC Salvator Mundi International Hospital.
Dr. Fiorini, Is Hearing Loss Only a Consequence of Aging?
It’s true that aging is one of the most common causes of hearing loss, especially after age 65. As we get older, the nerve cells in the ear deteriorate and transmit signals to the brain less effectively.
Conditions such as hypertension or diabetes can also contribute. But hearing loss is not only age-related. There are other important causes: certain diseases, such as acoustic neuroma or Ménière’s disease, can lead to tinnitus, vertigo, and fluctuating hearing loss.
Otosclerosis and some autoimmune disorders of the inner ear can have similar effects.
Sometimes hearing loss is temporary and due to simple factors, such as earwax excess, which can be easily removed by a doctor.
There are also genetic causes: some children are born with hearing problems or develop them later, and even adults may have a hereditary predisposition.
Finally, head trauma, eardrum perforations, and prolonged exposure to loud noise—from industrial machinery to loud music—can damage hearing either suddenly or progressively.
What Are the Main Symptoms of Hearing Loss?
In most cases, hearing loss symptoms appear gradually, especially with aging. Often the change goes unnoticed at first, showing up as small signs.
Common warning signs include frequently asking others to repeat themselves, difficulty following conversations when multiple people are speaking, or trouble hearing in noisy environments such as restaurants or bars.
Other signs may include difficulty perceiving high-pitched sounds (like children’s voices), trouble understanding speech over the phone, a sensation of blocked ears, or the impression that others are speaking softly or mumbling.
A very frequent sign is the tendency to increase the volume of the television or other devices more than those around you.
What if We Are Faced with Sudden Hearing Loss Instead?
Sudden hearing loss is different from progressive loss and is always a warning sign. It may be related to an infection or trauma, but in some cases, it can indicate more serious conditions, such as a vascular event. It can affect one or both ears.
If hearing decreases abruptly, it is essential to seek medical attention immediately, especially if accompanied by symptoms such as vertigo, ear discharge, sudden pain, acute tinnitus, or neurological signs like severe headache, weakness, or numbness. Timeliness is crucial: early intervention can make a significant difference in hearing recovery.
What Are the Different Degrees of Hearing Loss?
Hearing loss is classified into different stages or degrees based on the minimum sound intensity a person can perceive, measured in decibels (dB) during an audiometric test.
Mild loss (26–40 dB) involves difficulty hearing soft voices or distinguishing certain consonants, such as “S” or “F.”
In moderate loss (41–55 dB), understanding speech becomes more challenging because several sounds—especially consonants—are missed, making speech less clear.
With moderately severe loss (56–70 dB), understanding speech without hearing aids is very difficult, and some people begin relying on lip reading.
In severe loss (71–90 dB), speech is not understandable without devices such as hearing aids or cochlear implants.
Finally, in profound loss (over 91 dB), only very loud sounds are perceived, and sign language or other visual communication aids may be necessary.
What Do You Recommend to Someone Who Shows Symptoms of Hearing Loss?
The first recommendation is not to ignore the signs.
Even initially mild hearing loss can have significant consequences on quality of life, social relationships, and professional activity.
Early intervention makes it possible to identify the cause of the disorder and to set up the most appropriate treatment, which may include medical therapy, auditory rehabilitation, or customized hearing‑aid solutions.
A timely diagnosis not only improves daily communication but also helps prevent social isolation and potential long‑term cognitive impacts.
In Cases of Hypoacusis, Is It Possible to Recover Hearing?
It is not always possible to fully restore hearing, especially when the damage is sensorineural. Fortunately, today we have several solutions that can significantly improve hearing ability and, consequently, the patient’s quality of life.
In mild or moderate cases, hearing aids—including over-the-counter devices—can be used, while moderate-to-severe forms require prescription devices programmed and customized to the specific type of hearing loss.
For severe or profound loss, cochlear implants are available—devices surgically inserted that convert sounds into electrical signals perceived by the brain.
Alongside these solutions, there are also various assistive technologies such as subtitles, speech-to-text apps, and visual or vibrating alert systems that can facilitate communication in daily life.
Taking care of your hearing is essential not only to hear well but also to live well, maintain personal relationships, and preserve autonomy and quality of life.
Don’t wait for the problem to become disabling: prevention is the first step.