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Hearing Loss

What is Hearing loss

Hearing loss is a partial or total inability to hear. Hearing loss may be present at birth or acquired at any time afterwards. Hearing loss may occur in one or both ears. In children, hearing problems can affect the ability to learn spoken language and in adults it can create difficulties with social interaction and at work.Hearing loss can be temporary or permanent. Hearing loss related to age usually affects both ears and is due to cochlear hair cell loss.  In some people, particularly older people, hearing loss can result in loneliness. Deaf people usually have little to no hearing.

Hearing loss may be caused by a number of factors, including: genetics, ageing, exposure to noise, some infections, birth complications, trauma to the ear, and certain medications or toxins. A common condition that results in hearing loss is chronic ear infections.Certain infections during pregnancy, such as cytomegalovirus, syphilis and rubella, may also cause hearing loss in the child.Hearing loss is diagnosed when hearing testing finds that a person is unable to hear 25 decibels in at least one ear.  Testing for poor hearing is recommended for all newborns.Hearing loss can be categorized as mild (25 to 40 dB), moderate (41 to 55 dB), moderate-severe (56 to 70 dB), severe (71 to 90 dB), or profound (greater than 90 dB). There are three main types of hearing loss: conductive hearing loss, sensorineural hearing loss, and mixed hearing loss.

About half of hearing loss globally is preventable through public health measures. Such practices include immunization, proper care around pregnancy, avoiding loud noise, and avoiding certain medications. The World Health Organization recommends that young people limit exposure to loud sounds and the use of personal audio players to an hour a day in an effort to limit exposure to noise. Early identification and support are particularly important in children.For many hearing aids, sign language, cochlear implants and subtitles are useful. Lip reading is another useful skill some develop.Access to hearing aids, however, is limited in many areas of the world.

As of 2013 hearing loss affects about 1.1 billion people to some degree. It causes disability in about 466 million people (5% of the global population), and moderate to severe disability in 124 million people. Of those with moderate to severe disability 108 million live in low and middle income countries.  Of those with hearing loss, it began during childhood for 65 million. Those who use sign language and are members of Deaf culture see themselves as having a difference rather than an illness. Most members of Deaf culture oppose attempts to cure deafness  and some within this community view cochlear implants with concern as they have the potential to eliminate their culture. The term hearing impairment is often viewed negatively as it emphasizes what people cannot do.

What is Sensorineural Hearing Loss

Your ear is made up of three parts— the outer, the middle, and the inner ear. Sensorineural hearing loss, or SNHL, happens after inner ear damage. Problems with the nerve pathways from your inner ear to your brain can also cause SNHL. Soft sounds may be hard to hear. Even louder sounds may be unclear or may sound muffled.

This is the most common type of permanent hearing loss. Most of the time, medicine or surgery cannot fix SNHL. Hearing aids may help you hear.

Causes of Sensorineural Hearing Loss

This type of hearing loss can be caused by the following things:

  • Illnesses.
  • Drugs that are toxic to hearing.
  • Hearing loss that runs in the family.
  • Aging.
  • A blow to the head.
  • A problem in the way the inner ear is formed.
  • Listening to loud noises or explosions.

What is Conductive Hearing Loss

Your ear is made up of three parts— the outer, the middle, and the inner ear. A conductive hearing loss happens when sounds cannot get through the outer and middle ear. It may be hard to hear soft sounds. Louder sounds may be muffled.

Medicine or surgery can often fix this type of hearing loss.

Causes of Conductive Hearing Loss

This type of hearing loss can be caused by the following:

  • Fluid in your middle ear from colds or allergies.
  • Ear infection, or otitis media. Otitis is a term used to mean ear infection, and media means middle.
  • Poor Eustachian tube function. The Eustachian tube connects your middle ear and your nose. Fluid in the middle ear can drain out through this tube. Fluid can stay in the middle ear if the tube does not work correctly.
  • A hole in your eardrum.
  • Benign tumors. These tumors are not cancer but can block the outer or middle ear.
  • Earwax , or cerumen, stuck in your ear canal.
  • Infection in the ear canal, called external otitis. You may hear this called swimmer’s ear.
  • An object stuck in your outer ear. An example might be if your child put a pebble in his ear when playing outside.
  • A problem with how the outer or middle ear is formed. Some people are born without an outer ear. Some may have a deformed ear canal or have a problem with the bones in their middle ear.

What is Mixed Hearing Loss

Sometimes, a conductive hearing loss happens at the same time as a sensorineural hearing loss, or SNHL. This means that there may be damage in the outer or middle ear and in the inner ear or nerve pathway to the brain. This is a mixed hearing loss.

Causes of Mixed Hearing Loss

Anything that causes a conductive hearing loss or SNHL can lead to a mixed hearing loss. An example would be if you have a hearing loss because you work around loud noises and you have fluid in your middle ear. The two together might make your hearing worse than it would be with only one problem.

How to Prevent Hearing Loss

Many adults eventually realize they’re pressing the “volume up” button on the TV remote more often, or that a lot of people around them need to speak up. There are two common reasons people start to lose their hearing:

Age: As you get older, the tiny hair cells in your inner ears slowly break down and can’t pick up sound vibrations as well as they used to.

Noise: A lot of loud sound over time can damage the hair cells in your ears.

The good news? You can do some things to avoid noise-induced hearing loss and keep age-related hearing loss from getting worse. Here are eight tips to help keep your ears as sharp as possible.

1. Avoid Too Much Noise

How loud is too loud? If you have to shout over the noise around you, it’s loud enough to damage your hearing. Sounds from motorcycles, concert speakers, power tools like saws and drills, earphones, and more are all loud enough to make a difference.

2. Be a Quiet Enforcer

Think about buying appliances and devices that have low noise ratings. And if it’s too loud in the movie theater, restaurant, or any other place you go often, ask the manager to turn it down.

3. Limit Loud Sounds in Your Life

Sometimes you can’t avoid the blare of an ambulance siren or the jackhammer on your street corner. But it’s best to limit the amount of time you’re around them. Noise-induced hearing loss is a result of the loudness of sounds and how long you hear them.

4. Wear Hearing Protection

If you know you’re going to be around loud sounds for more than a few minutes, think about wearing protection, such as:

  • Earplugs. Usually made of foam or rubber, they go in your ear canal and can reduce noise by 15 to 30 decibels. You can buy them off-the-shelf or have them custom-made to fit you. Some earplugs lower noise levels evenly across all frequencies. They’re useful for people who need to make sound quieter but undistorted, such as musicians.
  • Earmuffs. These fit completely over your ears and reduce sounds by about 15 to 30 decibels. They have to fit tightly over both ears to block sound.

You can also wear earplugs and earmuffs together for even greater protection.

5. Don’t Smoke

Tobacco can make you more likely to lose your hearing, too, research shows. So if you light up, that’s one more good reason to quit. If you aren’t a smoker, avoid breathing secondhand smoke.

6. Remove Earwax Properly

A buildup of wax in your ears can muffle sound. But don’t use a cotton swab to clean them out — they can push wax deeper in. Instead, use an at-home irrigation kit to soften wax and gently wash it out. If it gets compacted in your ear, your doctor may need to remove it.

7. Check Medications for Hearing Risks

About 200 drugs can damage hearing, including some antibiotics and cancer-fighting drugs. Even high doses of aspirin can harm your ears. If you take a prescription medication, check with your doctor to make sure it won’t make an impact. If you must take a medication that may harm your ears, make sure your doctor checks your hearing and balance before and during your treatment.

8. Have Your Hearing Tested

Make an appointment to get a hearing test if you:

  • Have close relatives with hearing loss
  • Have trouble hearing conversations
  • Are around loud noises on a regular basis
  • Often hear ringing in your ears

Hearing Loss Treatment

Help is available for people with all types of hearing loss. Treatment depends on both the cause and severity of the deafness.

Sensorineural hearing loss is incurable. When the hair cells in the cochlea are damaged, they cannot be repaired. However, various treatments and strategies can help improve quality of life.

Hearing aids

Hearing aids Share on Pinterest
Hearing aids can help to improve hearing and quality of life.

These are wearable devices that assist hearing.

There are several types of hearing aid. They come in a range of sizes, circuitries, and levels of power. Hearing aids do not cure deafness but amplify the sound that enters the ear so that the listener can hear more clearly.

Hearing aids consist of a battery, loudspeaker, amplifier, and microphone. Today, they are very small, discreet, and can fit inside the ear. Many modern versions can distinguish background noise from foreground sounds, such as speech.

A hearing aid is not suitable for a person with profound deafness.

The audiologist takes an impression of the ear to make sure the device fits well. It will be adjusted to suit auditory requirements.

Examples of hearing aids include:

Behind-the-ear (BTE) hearing aids: These consist of a dome called an earmold and a case, with a connection linking one to the other. The case sits behind the outer ear, with the connection to the dome coming down the front of the ear. The sound from the device is either electrically or acoustically routed to the ear.

BTE hearing aids tend to last longer than other devices, as the electrical components are located outside the ear, meaning that there is less moisture and earwax damage These devices are more popular with children who need a sturdy and easy-to-use device.

In-the-canal (ITC) hearing aids: These fill the outer part of the ear canal and can be seen. Soft ear inserts, usually made of silicone, are used to position the loudspeaker inside the ear. These devices fit most patients straight away and have better sound quality.

Completely in the canal (CIC) hearing aids: These are tiny, discreet devices but not recommended for people with severe hearing loss.

Bone conduction hearing aids: These assist people with conductive hearing loss, as well as those unable to wear conventional type hearing aids. The vibrating part of the device is held against the mastoid with a headband. The vibrations go through the mastoid bone, to the cochlea. These devices can be painful or uncomfortable if worn for too long.

Cochlear implants

If the eardrum and middle ear are functioning correctly, a person may benefit from a cochlear implant.

This thin electrode is inserted into the cochlea. It stimulates electricity through a tiny microprocessor placed under the skin behind the ear.

A cochlear implant is inserted to help patients whose hearing impairment is caused by hair cell damage in the cochlea. The implants usually improve speech comprehension. The latest cochlear implants have new technology that helps patients enjoy music, understand speech better even with background noise, and use their processors while they are swimming.

According to the National Institutes of Health (NIH), there were about 58,000 adults and 38,000 children with cochlear implants in the U.S. as of 2012. The World Health Organization (WHO) says approximately 219,000 people globally use one, most of them in industrial countries.

On the outside, a cochlear implant consists of:

  • A microphone: This gathers sound from the environment.
  • A speech processor: This prioritizes the sounds that matter more to the patient, such as speech. The electrical sound signals are split into channels and sent through a very thin wire to the transmitter.
  • A transmitter: This is a coil secured with a magnet. It is located behind the outer ear and transmits the processed sound signals to the internally implanted device.

On the inside:

  • A surgeon secures a receiver and stimulator in the bone beneath the skin. The signals are converted into electrical impulses and sent through internal wires to the electrodes.
  • Up to 22 electrodes are wound through the cochlea. The impulses are sent to the nerves in the lower passages of the cochlea and then directly to the brain. The number of electrodes depends on manufacturers of the implant.

Children will usually have cochlear implants in both ears, while adults tend to have just one.

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