How To Cope With Hearing Loss
If you notice signs of hearing loss, talk to your doctor. If you have trouble hearing, you should:
- Let people know you have a hearing problem.
- Ask people to face you and to speak more slowly and clearly. Also, ask them to speak louder without shouting.
- Pay attention to what is being said and to facial expressions or gestures.
- Let the person talking know if you do not understand what he or she said.
- Ask the person speaking to reword a sentence and try again.
- Find a good location to listen. Place yourself between the speaker and sources of noise and look for quieter places to talk.
The most important thing you can do if you think you have a hearing problem is to seek professional advice. Your family doctor may be able to diagnose and treat your hearing problem. Or, your doctor may refer you to other experts, like an otolaryngologist or an audiologist .
How Bad Is My Hearing Loss
The only way to answer this question is to have it measured by a hearing professional and charted on anaudiogram. We will document your hearing thresholds using various tests, charting the softest sounds you can hear at different frequencies or pitches. The result will be an audiogram, which visually shows what sounds you have the most trouble hearing and how severe your hearing loss is.
How Does The Ear Work
It is easier to understand sensorineural ;hearing loss if you know more about how the ear works. The ear is made up of 3 main parts: 1) the outer ear, 2) the middle ear, and 3) the inner ear. The outer ear extends from the part of the ear you can touch to the ear drum. The outer ear acts like a funnel to direct sound to the ear drum.
The ear drum separates the outer ear and the middle ear. Behind the ear drum is the middle ear, which is normally filled with air. Three tiny bones inside the middle ear are named for their shapes: the malleus , the incus , and the stapes . The 3 bones connect to form a chain. The first bone, the malleus, is connected to the ear drum. The last bone, the stapes, is connected to another tiny membrane called the oval window.
The oval window is the beginning of the inner ear, or cochlea. When sound hits the ear drum, the tiny bones are set in motion, and the last one pushes on the oval window. Inside the cochlea are more than 15,000 tiny nerve endings, called hair cells. These hair cells are surrounded by fluid. The hair cells change the sound waves into electrical impulses that travel along the auditory nerve to the brain. The brain processes these impulses and changes the sounds into something meaningful to you.
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Symptoms Of A Sensorineural Hearing Loss
Typically, a sensorineural hearing loss develops gradually and slowly becomes worse and worse. It does not happen from day to another unless it is a sudden sensorineural hearing loss . In this way, we often do not notice that our hearing has becomes worse.
But if it has become more difficult to hear voices in places with background noise, e.g. at parties, restaurants or family gatherings, or it has become more difficult to hear or understand females or childrens voices, you might have a sensorineural hearing loss. Problems hearing soft or high sounds such as the clock ticking, the refrigerator humming or the birds singing may also be an indication of a sensorineural hearing loss.
If you are not sure whether you are suffering from SNHL, you can find more information about the general signs of hearing loss.
If you think that you might have a sensorineural hearing loss, we recommend that you get your hearing checked by a hearing professional.
How Is It Treated
Treatment for hearing loss varies depending upon the cause of the hearing impairment. Treatment may involve removing wax or dirt from the ear or treating an underlying infection. If there is damage or a structural problem with the eardrum or ossicles, surgery may help to repair it. If the problem is with the cochlea or hearing nerve, a hearing aid or cochlear implant may be recommended.
Hearing aids come in various forms that fit inside or behind the ear and make sounds louder. They are adjusted by the audiologist so that the sound coming in is amplified enough to allow the person with a hearing impairment to hear it clearly.
Sometimes, the hearing loss is so severe that the most powerful hearing aids can’t amplify the sound enough. In those cases, a cochlear implant may be recommended.
Cochlear implants are surgically implanted devices that bypass the damaged inner ear and send signals directly to the auditory nerve. A small microphone behind the ear picks up sound waves and sends them to a receiver that has been placed under the scalp. This receiver then transmits impulses directly to the auditory nerve. These signals are perceived as sound and allow the person to hear.
Depending upon whether someone is born without hearing or loses hearing later in life , medical professionals will determine how much therapy the person needs to learn to use an implant effectively. Many people with implants learn to hear sounds effectively and even use the telephone.
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The Symptoms Of Sudden Hearing Loss
Ear pressure and/or tinnitus are the first signs of a sudden sensorineural hearing loss. Symptoms usually occur at once or after a few days, usually in one ear. The severity of the symptoms may vary significantly. In worst case scenarios, permanent deafness may be possible.
The symptoms for sudden hearing loss include: Occurrence of hearing loss without a recognizable cause The absence of earache Hearing loss in one ear only
The accompanying symptoms include: Loss of sensation in the outer ear Ear pressure
Canadian Academy Of Audiology
Presbycusis is the loss of hearing that gradually occurs in most individuals as they growolder. Hearing loss is a common disorder associated with aging. About 30-35 percentof adults between the ages of 65 and 75 years have a hearing loss. It is estimated that40-50 percent of people 75 and older have a hearing loss. The loss associated withpresbycusis is usually greater for high-pitched sounds. For example, it may be difficultfor someone to hear the nearby chirping of a bird or the ringing of a telephone. However,the same person may be able to clearly hear the low-pitched sound of a truck rumblingdown the street.
There are many causes of presbycusis. Most commonly, it arises from changes in theinner ear of a person as he or she ages, but presbycusis can also result from complexchanges along the nerve pathways leading to the brain. Presbycusis most often occursin both ears, affecting them equally. Because the process of loss is gradual, people whohave presbycusis may not realize that their hearing is diminishing.
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Causes Of Sensorineural Hearing Loss
There are several causes of sensorineural hearing loss. One frequent cause is age-associated hearing loss, which can begin at the age of 50 or 60. This type of hearing loss is usually accompanied by a reduced perception of high tones.
The second most common cause is noise. Noise related hearing loss is one of the most frequently recognized occupational illnesses in the United States. Six to eight hours of noise above 85dB on a daily basis is able to cause this type of hearing loss.
Additional reasons for sensorineural hearing loss include circulatory problems, as they may occur in diabetes mellitus, arteriosclerosis, or sudden hearing loss, as well as metabolic illnesses, such as thyroid malfunction.
Surgery For Conductive Hearing Loss
Conductive hearing loss occurs when there is an;obstruction or damage to the outer or middle ear that prevents sound from being conducted to;the inner ear. Conductive hearing loss may be temporary or permanent, depending on the cause and sometimes, medical or surgical intervention can restore hearing.
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The Distortional Component Of Sensorineural Hearing Loss
Lets talk about the distortional component of hearing loss.; As I said, we have studied a lot about threshold and loudness changes in sensorineural hearing loss, or at least dynamic range size changes in sensorineural hearing loss and how you would change the prescribed compression in a hearing aid based on loudness changes.; Of course, there are many more elements of the processing disruptions in sensorineural hearing loss.
Autoimmune Inner Ear Disease
As explained above, autoimmune inner ear disease is a specific kind of autoimmune disease that targets certain inner ear cells and causes your immune system to view them as foreign. This disease can occur on its own or be part of a wider spread autoimmune disorder.;
AIED is also extremely rare. While hearing loss is one of the most common disabilities, less than one percent of people with hearing loss will experience AIED. Despite it being so rare, it has had very definable presentations in the people who have developed it.;
Typically a person who has AIED will experience this disease with a sudden onset of hearing loss. This is called sensorineural hearing loss, or SNHL.
Not only does it develop quickly, but it typically develops unilaterally before eventually becoming bilateral. This means that the most common presentation of AIED will be sudden, unexplained loss of hearing in one ear over a short period of time, eventually followed by loss of hearing in the second ear as well.
This disease has proven hard to diagnose because it is similar in presentation to many others. The ability to recognize that the immune system is attacking healthy cells in the ear is difficult. One symptom that has been reported commonly with AIED is the presence of tinnitus.;
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Hearing Aids Turn An Invisible Disability Into A Visible One
One of the biggest problems for someone with a hearing loss is that it is invisible. Meaning that someone looking at you cannot tell if you have a problem hearing or not. Now, you may like this fact but in reality, it does you a disservice.;
When someone knows that you have a hearing loss they will naturally try to speak slower and more clear. People articulate their words more and face you when speaking to you. If they are not aware of your hearing loss, they likely speak while not looking at you and talk to you when there is background noise present.
Think of it this way with this analogy. Imagine that you were in a wheelchair. No one in their right mind would ever take you to a set of stairs and ask you to walk down it. However, if you have a hearing loss, anyone wouldnt think twice about taking you into a very noisy restaurant and say lets have a conversation.;
This is because hearing loss is an invisible disability, people do not realize that you may struggle to hear in a complexed noisy environment. When you wear a visible hearing aid. Meaning one that isnt hidden down deep in your ear canal, co-workers, strangers and anyone else will be able to see that you have a hearing loss and naturally use better communication strategies.;
What Causes Sudden Sensorineural Hearing Loss
A cause for SSHL can be identified in only 10 to 15 percent of diagnosed cases. Some possible known causes include:
Tumors , ;Neurologic diseases or disorders , Bacterial infections, Head injury or trauma, Inner ear disorders , Autoimmune diseases , Ototoxic medications, Circulation issues plus other inner ear problems like Menieres disease. But in most cases, the cause of sudden hearing loss remains idiopathic
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Can Conductive Hearing Loss Be Treated With Surgery
If you do have conductive hearing loss, the odds are good that it can be reversed through a surgical procedure.
Common surgeries for correcting conductive hearing loss include:
- PE tubes. Patients with chronic ear infectionsusually childrenmay be treated with pressure equalization tubes. These provide ventilation and allow fluid that has built up in the inner ear to drain. PE tubes are inserted surgically and should fall out on their own after 6-18 months.
- Stapedectomy. Patients whose hearing loss is caused by a hardening of bone tissue in the middle ear known as osteosclerosis often undergo a surgical procedure called a stapedectomy. This involves either partial or total removal of the stapes bone, letting sound waves pass through to the inner ear unimpeded. 90 percent of patients who have this procedure report a significant improvement in their hearing afterward.
While its great that surgery can, in some cases, reverse hearing loss, its important to note that the vast majority of patients have damage to the inner ear, which cannot be corrected.
Can Sshl Be Treated With Surgery
Most patients are prescribed hearing aids to help them hear better and communicate more effectively. Those with severe hearing loss or deafness may be candidates for cochlear implants.
This surgical procedure bypasses damaged portions of the inner ear to directly stimulate the auditory nerve.
How do cochlear implants work?
Cochlear implants contain an electronic device that is surgically implanted beneath the ear; it is connected to electrodes that are placed in the cochlea. An external portion includes a microphone that captures sound and a processor that converts the sound to electrical signals that are transmitted to the internal component and converted to sound. This isnt true hearing, however; cochlear implant patients must learn how to decode signals in order to understand speech and other sounds.
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The Role Of Hair Cells
The human ear is divided into three sections; the outer ear, the middle ear, and the inner ear. There is an organ known as the cochlea in the inner ear, which contains microscopic hair cells known as stereocilia. The stereocilia are responsible for the conversion of vibrations in sound waves into neural signals that are transported to the brain through the auditory nerve. The brain interprets this signal as a sound and relays it back to the ear. These inner ear hair cells that play a vital role in your hearing can get damaged by exposure to loud noise. Exposure to sounds or noise louder than 85 decibels can permanently damage the hair cells. This type of damage often results in severe hearing loss. In most cases, you will not experience sensorineural hearing loss until about thirty to fifty percent of the hair cells in your inner ear have been damaged. Once they are damaged, hair cells cannot be repaired or replaced. This means that your hearing loss will be permanent. Sensorineural hearing loss often starts with difficulty understanding high frequency or high pitched sounds, but as more damage occurs, hearing in the lower frequency may become worse.
In Search Of Better Faster And Safer
So things seemed to stand, until recently. Then several studies were published that challenged these long-held assumptions, suggesting that steroids given by injection into the ear, called intratympanic steroid injection, could achieve a higher concentration of the drug in the inner ear than could oral administration and that this might salvage more hearing than oral steroid therapy. The use of the injection was rst studied in guinea pigs by Lorne Parnes, M.D., and his colleagues, who later showed the efcacy of this approach in some cases of SSNHL in humans.7 The steroid, injected into the middle ear in a simple ofce procedure, will partially diffuse into the inner ear uids. Parnes reported some hearing improvement in 6 of 12 patients with SSNHL treated this way. Since then, a handful of other uncontrolled studies on intratympanic steroid injection for SSNHL has suggested that treatment is benecial in one-half to three-fourths of cases, similar to the results of using oral steroids.
For all its apparent promise, however, the actual success rate is not known for intratympanic steroid injections as compared with oral treatment, because no studies have been published with control populations treated with conventional oral dosing. To produce the evidence and answers needed, a national multicenter clinical trial sponsored by the National Institutes of Health is now underway.
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The Importance Of Getting A Hearing Evaluation
About one in four U.S. adults who report excellent to good hearing already has hearing losswhich means, getting a professional hearing exam not only helps identify existing hearing loss, but also provides a baseline for measuring any future loss.
Its important for anyone who believes they may have a hearing loss to see an otolaryngologist or an audiologist to get a proper diagnosis and appropriate treatment. Hearing aid specialists also can provide basic hearing tests.
Although procedures may vary somewhat from state to state and among practices, a basic hearing evaluation is likely to involve three steps:
- A review of the individuals hearing and general health, including family history
- A visual examination of the ear canal with an otoscopea special magnifying light used for this purpose
- Hearing testing, which may include:
- A tone test during which the individual wears headphones and listens for short tones of different volumes and pitch that are played into the right and left ears separately
- A pressure test, which uses air pressure to determine the flexibility of the eardrum and tiny bones in the middle ear
- A speech test, which involves listening to spoken words at different volumes, and repeating them
Why Has Sudden Sensorineural Hearing Loss Not Been Addressed Sooner
Most of us have become educated about the warning signs of stroke, heart attack, and other illnesses. And in order to hold off or treat those conditions, weve been advised to watch our diet, exercise more, control our cholesterol and blood pressure, perhaps take baby aspirin, or other medications. But what about SSHL? Are there warning signs? Which protocols should you follow if you should experience SSHL? What are the treatments to resolve SSHL? And is there agreement about these questions in the medical community?
Every year, about 8,000 people in the US experience sudden onset hearing loss, according to Healthy Hearing and the American Hearing Research Foundation. That number, of course, does not include those cases that go unreported and undiagnosed. Nine out of 10 occurrences of SSHL is in one ear only, but sudden bilateral hearing loss also happens. Men and women are affected equally. The average age of first occurrence is mid-40s to mid-50s, with an increasing incidence with age. Tinnitus is reported in roughly 40% of cases. SSHL accounts for 1% of all sensorineural hearing loss cases.
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