Cause of hearing loss

Is it possible to know the cause of hearing loss from an audiogram? I’ve never had that discussion with an audiologist and I’m curious as to what may have caused it.

I’m aware that certain childhood diseases as well as some antibiotics in 50’s and 60’s could cause hearing problems. I’ll give a little background here. I’m currently 72 and doing well with Phonak Audeo P90L’s. When I entered the military in 1967 my hearing was nearly poor enough to prevent me from serving. I spent time in a combat zone in close proximity to artillery and frequent firing of small weapons. In those years there was little(no) hearing protection provided to service members. I have no record of a hearing test at discharge. Later in life I worked in a factory setting for 10 years or so with constant machine noise. In the 90’s I was denied acceptance for a specific training course in the Army Reserves due to hearing loss.

I would imagine that the combination of my life circumstances lead to where my hearing profile is at present but I’m curious why the poor hearing when I entered the military at a young age. Could there be clues in my present audiogram?

I don’t think it can from the audiogram. My hearing loss is a combination of genetic and loud jet engine noise. Going in the Navy my hearing was said to be normal even though I wasn’t able to understand the dots and dashes of Morse Code. But I look back over my life and I believe I have had hearing loss most of my life. I wasn’t able to do spelling by sounding out words. I have always mispronounced words. But I could hear a pin drop or an animal moving very quietly in the forest. My hearing loss started out as a cookie bite loss which is a genetic condition. But loud jet engine noise made it much worse.

1 Like

My VA audiologist has asserted that my cookie-bite loss is genetic. Even though I passed comp&pen for hearing loss & tinnitus being service-connected (by my audiologist’s boss) they turn around and say it is genetic. I think they feel it started showing up while I was in the service and thus it becomes service connected. Somehow.

I dunno about anyone else. I have heard others assert cookie bite is genetic, though.



Yes a cookie bite hearing loss is genetic, I have been told that by 5 different audiologists and a couple of ENT doctors. My present audiologist managed to get a copy of my hearing exam results from my medical records and noted that the presents of my cookies bite was noted in my boot camp that time he saids I have better than normal low and high frequency hearing and my midrange the cookie bite was at the normal range of hearing. But jet engine noise destroyed the rest of my hearing.

1 Like

Some etiologies are pretty obvious from the audiometric configuration (cookie-bite, reverse slope, otosclerosis) but many are not. You could have a genetic panel done, I suppose? I hear that in the states you can just pay for whatever medical procedures you want.

Congential hearing loss is hugely genetic. I believe, when not assossicated with other syndromes, it often comes down to one of two recessive genes that you can be heterozygous or homozygous for. In well-babies without a genetic component, I believe the next most common cause is congenital cytomegalovirus, which I believe is also the most common infectious cause of birth defects generally but which is weirdly unknown. [The typical route of infection is that an older toddler picks it up and passes it to the pregnant mother through saliva and then it passes through the placental barrier to the fetus. Infection can be reduced by not sharing food with your toddlers, avoiding saliva transfer generally, hand washing. So, if you know anyone who is pregnant or planning to get pregnant let them know; I don’t know why doctors don’t talk about this.] After genetics and cCMV, in well-babies I believe next up is idiopathic hypoplastic auditory nerve. Lots of possible risk factors in NICU babies (e.g. forced oxygen, chemotheraputrics, glucocorticoids).

There are some other rare genes that cause progressive loss later in life (cookie-bite confuguration being one). A child with a strong history of ear infection, tubes, eardrum perforation may also present with minor conductive hearing losses later in life. And then childhood illnesses that were once common and now less so can be associated with hearing loss (e.g. measles, rubella, scarlet fever).

Non-genetic and non-noise causes in adults include autoimmune and cardio issues. However, there is noise and then there is NOISE. Long-term exposure to, say, factory noise will cause what we generally think of when we think of “noise-related” hearing loss and tends to be sloping high frequency or notched high frequency, but artillary fire can cause actual mechanical sheering damage within the cochlea and may look quite different in terms of audiometric configuration.

PSA: Smoking also increases your risk for noise-related hearing loss and hearing loss generally. I mean, it’s 2023, who smokes anymore? But boy it was cool when I was younger and what a beast of a habit for some people to kick.


Neville, thank you for such an indepth and knowledgeable reply. You have made me aware of myriad potential causes for my loss. So in the end, I may never know the exact reason or reasons but can see several factors that may have played a part. Thank you

I have no idea what caused mine, neither does my audiologist or doctor. I was diagnosed with speech and language delay when I was about 4, then doctors found out I had conductive hearing loss due to glue ear, had surgery to insert grommets, my audiogram went back to normal and my family thought that was the end of it. I was cured. Then when I was around 10, my family took me back to the doctors as they noticed I had a bad speech impediment and was not picking up what people were saying, and there I was diagnosed with sensorineural hearing loss in both ears, gradually declining as time goes on. I am 30 years old now.

1 Like