Acute infections are mainly due to bacteria but persistent ear itching may be related to a fungal infection. This is known as otomycosis and most cases are due to the Aspergillus spp of fungi, with the Candida spp causing a minority of fungal ear infections. Ear discharge (purulent) with pain, swelling and redness tends to occur in bacterial infections along with the itching. With fungal infections, a persistent itch and watery discharge (serous), which is often referred to as ‘water in the ears’, are more frequently present.
A case history (usually a written form, with questionnaire) can provide valuable information about the context of the hearing loss, and indicate what kind of diagnostic procedures to employ. Examinations include otoscopy, tympanometry, and differential testing with the Weber, Rinne, Bing and Schwabach tests. In case of infection or inflammation, blood or other body fluids may be submitted for laboratory analysis. MRI and CT scans can be useful to identify the pathology of many causes of hearing loss.
Try the skull-thumping trick. If you're coming home from a concert or a club, and your ears won't stop ringing, it's because you've damaged some of the little hairs in your cochlea, which causes inflammation and stimulation of nerves. Your brain interprets this inflammation as constant ringing or buzzing, and this trick can help make that annoying sound go away.
Prolonged exposure to loud sound or noise levels can lead to tinnitus. Ear plugs or other measures can help with prevention. Employers may use hearing loss prevention programs to help educate and prevent dangerous levels of exposure to noise. Groups like NIOSH and OSHA help set regulations to ensure employees, if following the protocol, should have minimal risk to permanent damage to their hearing.
Speech perception is another aspect of hearing which involves the perceived clarity of a word rather than the intensity of sound made by the word. In humans, this is usually measured with speech discrimination tests, which measure not only the ability to detect sound, but also the ability to understand speech. There are very rare types of hearing loss that affect speech discrimination alone. One example is auditory neuropathy, a variety of hearing loss in which the outer hair cells of the cochlea are intact and functioning, but sound information is not faithfully transmitted by the auditory nerve to the brain.
^ McCombe A, Baguley D, Coles R, McKenna L, McKinney C, Windle-Taylor P (2001). "Guidelines for the grading of tinnitus severity: the results of a working group commissioned by the British Association of Otolaryngologists, Head and Neck Surgeons, 1999". Clinical Otolaryngology and Allied Sciences. 26 (5): 388–93. doi:10.1046/j.1365-2273.2001.00490.x. PMID 11678946. Archived (PDF) from the original on 2017-09-24.
Most hearing loss, that resulting from age and noise, is progressive and irreversible, and there are currently no approved or recommended treatments. A few specific kinds of hearing loss are amenable to surgical treatment. In other cases, treatment is addressed to underlying pathologies, but any hearing loss incurred may be permanent. Some management options include hearing aids, cochlear implants, assistive technology, and closed captioning. This choice depends on the level of hearing loss, type of hearing loss, and personal preference. Hearing aid applications are one of the options for hearing loss management. For people with bilateral hearing loss, it is not clear if bilateral hearing aids (hearing aids in both ears) are better than a unilateral hearing aid (hearing aid in one ear).
Tinnitus is the perception of sound when no corresponding external sound is present. While often described as a ringing, it may also sound like a clicking, buzzing, hiss, or roaring. The sound may be soft or loud, low or high pitched, and appear to be coming from one or both ears. In some people, the sound may interfere with concentration or increase feelings of anxiety or depression. Tinnitus may be associated with some degree of hearing loss and with decreased understanding in noise.