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About Hearing Loss

Hearing loss has a lot of different causes and manifestations.

About Hearing Loss

Hearing loss has a lot of different causes and manifestations.

HEARING LOSS

Hearing loss has a lot of different causes and manifestations. It can be sudden or gradual. It can occur in one ear or both ears. It can be temporary or permanent. It happens to people of all ages and is associated with the aging process. Before discussing causes and treatments for hearing loss, it is important to understand how hearing works.

HOW WE HEAR

There are three sections of the ear: the outer ear, middle ear and inner ear. Each section helps move sound through the process of hearing. When a sound occurs, the outer ear feeds it through the ear canal to the eardrum. The noise causes the eardrum to vibrate. This, in turn, causes three little bones inside the middle ear (malleus, incus, stapes) to move. That movement travels into the inner ear (cochlea), where it makes tiny little hairs move in a fluid. These hairs convert the movement to auditory signals, which are then transmitted to the brain to register the sound.

TYPES OF HEARING LOSS:

Hearing loss is measured in four degrees: mild, moderate, severe or profound. The degree of hearing loss drives the selection of the best form of treatment on a case-by-case basis.

sensorineural-hearing-loss

Sensorineural hearing loss (SNHL) 

  • The most common type of permanent hearing loss. 
  • Occurs when there is damage to the inner ear (cochlea), or to the nerve pathways between the inner ear and the brain. 
  • Most of the time, SNHL cannot be medically or surgically corrected, but can usually be rehabilitated through hearing aids. 
  • Speech is usually distorted, quieter and incomplete.

conductive-hearing-loss 

Conductive hearing loss

Occurs when the outer or middle ear structures fail to properly conduct sound  waves to the inner ear.
Conductive hearing loss is often medically or surgically treatable.
Speech is still clear, but is much quieter since sound is being blocked.

Mixed hearing loss: 

Mixed hearing loss refers to people who have both conductive and sensorineural hearing loss. Most people experience more than one type of hearing loss.

Central hearing loss: 

This occurs when the central nervous system fails to send a readable signal to the brain, which is called a central auditory processing disorder. People with central hearing loss generally can hear all sounds, but can’t separate or process them.

COMMON CAUSES OF HEARING LOSS:

Presbycusis – Age-Related

  • Result of the aging process or extended exposure to environmental noise factors throughout a lifetime.
  • Permanent change in inner ear.

Sociocusis – Noise-Induced

  • Damage to hair cells and cochlea
  • Occurs suddenly or gradually
  • Approximately 16 million Americans between the ages of 20 and 69 have high-frequency hearing loss due to exposure to noise at work or in leisure activities. 1

Congenital – Genetic

  • Results from a family history of hearing loss or predisposition.

Ototoxicity – Drug-Related

There are 200+ known ototoxic (toxic to the ears) prescription and over-the-counter medications on the market today.2 This list includes:

  • Aspirin
  • Quinine
  • Certain antibiotics
  • Some cancer treatments
  • Some anesthetics

 

COMMON SIGNS OF HEARING LOSS:

You may...

  • Hear but not understand people
  • Have difficulty understanding radio, television or public address systems
  • Need to watch a person's lips in order to understand
  • Find yourself asking people to repeat what they have said
  • Pretend to understand
  • May avoid people and isolate yourself
  • May find it emotionally and physically exhausting to communicate
  • Think that you are the only one who has these difficulties

 

HOW MUCH HEARING LOSS WARRANTS A CONSULTATION?

Any noticeable change in hearing activities:

  • Should result in a hearing consult
  • May represent a communication problem that interferes with one’s lifestyle
  • May respond well to hearing aids and should be counseled about the benefits of amplification
  • May be medically or surgically treatable


HEARING LOSS TREATMENTS

The location, type and degree of hearing loss impact the choice of treatments for any hearing problem. 
The most common treatment options include:

  • Antibiotics, decongestants and pain medication to overcome ear infections.
  • Myringotomy, a piercing of the eardrum to allow for fluids to drain out of the outer ear.
  • Insertion of a tube into the Eustachian tube (part of the anatomy that connects the middle ear to the back of the throat) to keep it open and allow for normal fluid drainage. This technique may be recommended for people who get frequent ear infections.
  • Hearing aids.
  • Surgery to remove benign or malignant tumors or correct bone- or nerve-related problems.

HEARING LOSS RISK FACTORS:

SMOKING Current smokers have a 70% higher risk, of having hearing loss than nonsmokers.3

HEART HEALTH the inner ear is extremely sensitive to blood flow. Studies have shown that a healthy cardiovascular system — a person’s heart, arteries and veins— has a positive effect on hearing. Conversely, inadequate blood flow and trauma to the blood vessels of the inner ear can contribute to hearing loss.4

HYPERTENSION there is a significant association between high blood pressure and hearing loss. Hypertension is an accelerating factor of degeneration in hearing ability due to aging. 5

DIABETES hearing loss is about twice as common in people with diabetes compared to those without the disease. 6. Adults with pre-diabetes, whose blood glucose is higher than normal but not at diabetes levels, have a 30 percent higher rate of hearing loss compared to those with normal blood sugar.7

RESOURCES

AMERICAN ACADEMY OF AUDIOLOGY (AAA)
American Academy of Audiology
AAA is a professional organization of individuals dedicated to providing quality hearing care to the public.  The organization works to enhance the ability of its members to achieve career and practice objectives through professional development, education, and research, and increase public awareness of hearing disorders and audiologic services.

AMERICAN SPEECH-LANGUAGE-HEARING ASSOCIATION (ASHA)
American Speech-Language-Hearing Association
ASHA is the professional association for more than 91,000 audiologists, speech-language pathologists, and speech, language, and hearing scientists.  This site is a resource for ASHA members, persons interested in information about communication disorders, and for those who want career and membership information. 

BETTER HEARING INSTITUTE (BHI)
Better Hearing Institute
The Better Hearing Institute provides comprehensive information on hearing loss, tinnitus, and hearing aids.  Within this site are also pages on assistive listening technology, famous people with hearing loss, a physician's guide to hearing loss, and BHI's newsletter. 

AMERICAN TINNITUS ASSOCIATION
American Tinnitus Association
The American Tinnitus Association promotes the relief, prevention, and the eventual cure of tinnitus.  Tinnitus is a subjective experience where one hears a sound when no external physical sound is present.  Often described as a ringing or roaring sound, these "head noises" vary in intensity from barley audible to extremely loud.  This site answers frequently asked questions about tinnitus, highlights the latest new, offers resources, and more. 

 

SOURCES

1     National  Institute on Deafness and Other Communication Disorders. (2014, March). Noise-Induced Hearing  Loss.
Retrieved  from: http://www.nidcd.nih.gov/health/hearing/pages/noise.aspx
2    Cone, B., Dorn, P., Konrad-Martin, D., Lister, J., Ortiz, C., & Schairer, K. (n.d.). Ototoxic Medications (Medication Effects).
Retrieved  from: http://www.asha.org/public/hearing/Ototoxic-Medications/
3     Cruickshanks, K., Klien, R., Wiley, T., Nondahl,  D. M., & Tweed T. S. (1998). Cigarette smoking and hearing loss:  the epidemiology  of hearing loss study. Retrieved  from: http://www.ncbi.nlm.nih.gov/pubmed/9624024
4     Hull, R. H. & Kerschen, S. R. (2010). The Influence  of Cardiovascular health on Peripheral and Central Auditory
Function  in Adults: A Research Review. American  Journal of Audiology, 19. 9-16. Doi:10.1044/1059-0889(2010/08-0040)
5   Agarwal, S., Mishra, A., Jagade, M., Kasbekar, V. & Nagle, S. K. (2013). Effects of Hypertension on Hearing.  Indian J Otolaryngol Head Neck Surg. 2013 December; 65(Suppl 3): 614–618. Published online 2013 February 17. Retrieved from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3889339/
6   Diabetes and Hearing  Loss (2013). Retrieved  from: http://www.diabetes.org/living-with-diabetes/treatment-and-care/seniors/diabetes-and-hearing-loss.html
7  Hearing  Loss Is Common  in People with Diabetes (2008). Retrieved  from:   http://www.nih.gov/news/health/jun2008/niddk-16.htm