Hearing loss and its management in the community

Abstract

The World Health Organization (WHO) estimate that by 2050 approximately 2 billion people worldwide will have a degree of hearing impairment, and more than 700,000,000 will require hearing rehabilitation. The presentation and aetiology of patients with hearing loss changes with age, and this can be a useful starting point for an assessment. Another important discriminator in the approach to patients with hearing loss is the timing of onset, which will differentiate those needing urgent management from the more routine. Hearing loss may be ‘conductive’, due to blockage of sound passage to the inner ear, which is often reversible, or ‘sensorineural’, due to damage to the inner ear or auditory nerve such as seen in age-associated hearing loss (also known as presbycusis), which is usually permanent. This article aims to provide a systematic framework for assessing these patients in primary care and a guide to indicate when referrals to secondary care are necessary.