What Is Hearing Impairment
Hearing impairment occurs when theres a problem with or damage to one or more parts of the ear.
The degree of hearing impairment can vary widely from person to person. Some people have partial hearing loss, meaning that the ear can pick up some sounds others have complete hearing loss, meaning that the ear cannot hear at all . In some types of hearing loss, a person can have much more trouble when there is background noise. One or both ears may be affected, and the impairment may be worse in one ear than in the other.
The timing of the hearing loss can vary, too. Congenital hearing loss is present at birth. Acquired hearing loss happens later in life during childhood, the teen years, or in adulthood and it can be sudden or progressive .
According to the National Institute on Deafness and Other Communication Disorders, about 37.5 million American people aged 18 and over are deaf or hearing impaired. Thats about 15 out of every 100 people. Another 26 million are exposed to hazardous noise levels on a regular basis. Hearing loss is also the most common birth anomaly.
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What Is Hearing Loss
Hearing loss makes it hard to hear or understand sounds. This happens when there is a problem with one or more parts of the ear, the nerves coming from the ears, or the hearing part of the brain.
Some people are born with hearing loss. But hearing loss may come on slowly over time or show up later in life. Hearing loss runs in some families, or may be caused by a birth defects, infections, or medicines that damage the ear. You cant prevent these kinds of hearing loss.
But you can do something about noise-induced hearing loss. A sudden loud noise or being around loud sounds over time can damage the tiny hair cells of the inner ear, making it hard to hear. If the noise around you is so loud that you must shout to be heard or you cant hear the people around you, there is a chance that youll have some trouble hearing.
How Can I Prevent Noise
The best way to prevent noise-induced hearing loss is to protect your ears from loud noises:
- Move away from loud sounds or speakers.
- Turn down the volume when listening to music or watching TV. When wearing earphones or earbuds, you should be able to hear conversations around you.
- Take breaks after listening to music with headphones or earbuds for more than 1 hour at a time.
- Wear ear plugs at concerts or if you play in a band.
- Wear ear plugs or ear muffs when mowing the lawn, using power tools, or anytime you are around loud machinery.
- Talk to your doctor about getting a hearing test if you have tinnitus that doesnt go away or you are concerned about your hearing.
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Causes Of Progressive Hearing Loss
Why does my hearing get worse? Many types of hearing loss develop and get worse over time. Just as our vision becomes poorer as we age, the same happens with our hearing. Our ability to hear declines when we get older. This is called an age-related hearing loss. In this way, many of us will experience a progressive hearing loss sooner or later.
Also, a hearing loss caused by noise and some types of genetic hearing loss can get worse over time. Some illnesses and certain types of medication can also result in progressive hearing loss.
Most often, it is a sensorineural hearing loss that develops and becomes worse. A sensorineural hearing loss results from damage to the tiny hair cells in the inner ear. This damage in the inner ear can get worse and more widespread over time.
An age-related hearing loss and a noise-induced hearing loss are both forms of sensorineural hearing loss.
A conductive hearing loss is often more stable. A progressive conductive hearing loss is quite rare, but the condition otosclerosis often causes a progressive conductive hearing loss. A conductive hearing loss is when the ability to conduct sound from the external and middle ear into the inner ear is reduced or lost.
Buildup of earwax can also result in a progressive hearing loss. In this case, the earwax must be removed by a professional and the hearing will then typically be restored.
Exposure To Loud Noise
As stated earlier, extended or sudden exposure to loud noise can damage the hair cells in your ear and cause sensorineural hearing loss. Most people think that until they have been exposed to loud noise over an extended time, no damage is done to their hair, but this is not true. Sudden exposure to loud noise, for instance, a bomb blast, can instantly damage your ears. Depending on the amount of damage done to the ear, the hearing loss can be temporary or permanent. Sensorineural hearing loss that is caused by sudden exposure to loud noise often affects only one ear.Occupational noises, noise from recreational activities like snowmobiling, noise in musical activities like concerts and clubs, or constant use of headphones at high volumes for an extended period can all cause sensorineural hearing loss.
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Factors That Can Lead To Sensorineural Hearing Loss
- Aging is one of the most common factor progressive sensorineural hearing loss
- Some Sensorineural hearing loss causes due to advanced age and typically occurs in both ears.
- Ototoxic medications, such as those used to treat heart disease and cancer, can also result in SNHL.
- Genetics diseases infection, trauma, and prolonged noise exposure are other possible causes of SNHL.
- The sensorineural hearing loss may also occur due to some diseases such as mumps, meningitis, multiple sclerosis, ménières disease.
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Types Of Hearing Loss
There are three main types of hearing loss:
Conductive hearing loss happens because of a problem in the ear canal, eardrum, or the middle ear that prevents sound from carrying well to the inner ear. An ear infection, trauma, a mass , fluid, or an object in the ear can cause it.
Sensorineural hearing loss happens most often from damage to the hair cells in the inner ear. Other causes include damage to the nerve for hearing, called the auditory nerve, or the brain. It usually happens as you get older, but it also can happen because of noise exposure, chemotherapy, radiation, trauma, and your genes. Learn more about what causes sensorineural hearing loss.
Mixed hearing loss is a combination of conductive and sensorineural hearing loss. There may be a problem in the outer or middle ear and in the inner ear or auditory nerve. It can happen after a head injury, long-term infection, or because of a disorder that runs in your family.
Hearing loss can affect one or both ears. It can happen suddenly or gradually get worse over time. If you notice sudden hearing loss, you should see an ear, nose, and throat specialist as soon as possible.
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How Does The Ear Function
The outer ear, middle ear, and inner ear are the three main parts of the ear. Hearing starts when the waves of the sound cross from the outer ear to the thin skin between the middle and outer ear called the eardrum. There is a vibration when the waves of the sound reach the eardrum.
Ossicles present in the middle ear consists of three bones. They are named as hammer, anvil, and stirrup. To increase the vibrations of the eardrum and ossicles have to work together when the waves of the sound travel towards the inner ear.
The waves travel through the fluids of cochlea when the waves of sound reaching the inner ear. The snail-shaped structure in the inner ear is called the cochlea. Thousands of miniature hairs are attached to the nerve cells present in the cochlea.
The function of these hairs is to change the vibrations of sound waves to electrical signals that travel to the brain. The interpretations of these signals by the brain is called sound. Different reactions are created by different sounds in these tiny hairs which inturn signals different sounds to the brain.
How Loud Is Too Loud
Youre probably exposing yourself to dangerous noise levels if:
- if you need to shout to be heard by a person 1 metre away from you
- youre listening to music through headphones and cant hear traffic sounds or people talking near you
If you hear ringing in your ears after an event or a day at work, it was too loud. If you have a lot of days like that, you will almost certainly damage your hearing.
You may have some misconceptions regarding sensorineural hearing loss. Alright not everything is wrong. But theres at least one thing worth clearing up. Typically, we think that sensorineural hearing loss comes on slowly while conductive hearing loss happens quickly. It turns out thats not inevitably true and that rapid onset of sensorineural hearing loss could often be wrongly diagnosed.
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What Causes Age
Most commonly, presbycusis comes from changes in the inner ear that occur as you age. It typically affects both ears equally and has a gradual onset. Many people have a combination of age-related hearing loss and noise-induced hearing loss. Over time, loud noises can damage your sensory hair cells, one of the parts of your ear that allows hearing.
Causes of hearing loss can vary. You are more likely to experience age-related hearing loss if you have:
How Do We Hear
Sound waves are created when air vibrates. To hear, the ear must change sound into electrical signals which the brain can interpret. The outer part of the ear funnels sound waves into the ear canal. When sound waves reach the eardrum they make it vibrate. Vibrations of the eardrum make the tiny bones in the middle ear move too. The last of these bones passes on the vibrations to the fluid-filled chamber called the cochlea. When the vibrations reach the cochlea, the fluid inside it moves. As the fluid moves it vibrates the hairs on the cells that line the cochlea. Each cell is stimulated by a particular note of sound. The vibration of the hair cells is turned into an electrical signal by the organ of Corti, at their base. The organ of Corti then sends signals down the hearing nerve to the brain. Special areas in the brain receive these signals and translate them into what we know as sound.
Your ears create electrical signals that represent an extraordinary variety of sounds. For example, the speed at which the eardrum vibrates varies with different types of sound. With low-pitched sounds the eardrum vibrates slowly. With high-pitched sounds it vibrates faster. This means that the special hair cells in the cochlea also vibrate at varying speeds. This causes different signals to be sent to the brain. This is one of the ways in which we are able to distinguish between a wide range of sounds.
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The sources of loud noise are everywhere from movie theaters to concerts to the earbuds that seem to be permanently lodged in young peoples ears. And just as sun exposure accumulates over time and can eventually lead to skin cancer, noise exposure can lead to hearing loss years or decades later.
We are now seeing increasing numbers of young adults who are experiencing tinnitus a consistent buzzing or ringing sound in the ears. Tinnitus, which is caused by exposure to loud noise, will sometimes go away on its own. Persistent tinnitus lasting more than a few days, however, is likely permanent. Consistent exposure to loud noise over time is cumulative, and could ultimately cause serious damage to your hearing. But the data is growing that constant use of cellphones and other electronic devices could cause damage in the long term.
Many electronic devices including smartphones can harm your hearing over time due to exposure to high decibels, the unit used to measure sound. A whisper is 30 decibels, a normal conversation 60 decibels. Prolonged exposure to anything above 85 decibels the maximum volume for many phones is considered damaging. As a general rule, try to listen to your device at no more than 60 percent of its maximum volume for no more than 60 minutes a day.
The National Institute on Deafness and Other Communication Disorders for different sounds include:
- 30: Whisper
- 105: MP3 player maximum
- 120: Ambulance siren
According to NIDCD, noise is too loud when:
Conditions Affecting The Air Space
Eustachian tube dysfunctionWhen your Eustachian tube isn’t working properly this can dull your hearing. It is usually a temporary problem that lasts a week or so and most commonly happens during or after a cold. The middle ear can fill with fluid. This is called a middle ear effusion. See the separate leaflet called Eustachian Tube Dysfunction for more details.
Glue earGlue ear happens when the middle ear fills with a glue-like liquid instead of air. Usually it clears without treatment. However, an operation to clear the fluid and put in a tiny tube to allow air to get into the middle ear may be advised if it persists. See the separate leaflet called Glue Ear for more details.
Ear infectionAn ear infection is very common, particularly in children. The main symptoms are earache and feeling unwell but it can cause temporary hearing loss. See the separate leaflet called Ear Infection for more details.
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Some Loss Is Expected As Decades Pass
When hearing decline begins depends partly on genetic factors and partly on long-term noise exposure.
Just as it becomes more difficult to see clearly at a close distance or to have perfect recall of names as you get older, certain hearing changes become noticeable as the decades pass.
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If you live long enough, youre going to suffer some hearing loss its part of the normal aging process, says Sean McMenomey, M.D., a professor of otolaryngology, head and neck surgery and neurological surgery at the New York University Langone Medical Center. One study, published in the March 1, 2017, issue of JAMA Otolaryngology-Head & Neck Surgery, found that while hearing loss is declining slightly among adults between the ages of 20 and 69, age is the biggest risk factor for hearing impairment 39 percent of adults ages 60 to 69 have trouble hearing speech clearly.
Age-related hearing loss, called presbycusis, occurs gradually, usually in both ears. When the decline begins depends partly on genetic factors and partly on long-term noise exposure, McMenomey says. Noise exposure that you had as a kid is the gift that keeps on giving it cannot be reversed.
How Severe Is Your Hearing Loss
This is the simplest and most frequently used way of describing a hearing loss. Audiologists often use the categories mild, moderate, severe, and profound.
By and large, if you have a mild hearing loss you will be able to hear a conversation without much struggle if youre in a quiet room near the person talking, as long as there is little background noise, but you may struggle when louder background noise is present.
If you have a severe to profound hearing loss you will be unable to hear what anyone is saying under almost most circumstances.
However, there is much more you need to know before you can understand your hearing fully, as it is not simply about hearing individual sounds and tones.
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What Is Sudden Sensorineural Hearing Loss
Sudden sensorineural hearing loss, or SSHL, is defined as hearing loss that either occurs suddenly or over a period of 72 hours.
It involves a hearing reduction of 30 decibels or more and affects three contiguous frequencies.
Nine out of 10 people with SSHL in Albany are affected in only one ear.
The condition is rare, affecting only about six in every 5,000 people, according to estimates from the National Institutes of Health.
The actual number might be considerably higher, as SSHL is frequently unreported or misdiagnosed.
It is most common in adults in their 40s and 50s but can strike people of all ages.
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Types Of Sensorineural Hearing Loss
Sensorineural hearing loss may affect one ear or both ears depending on the cause.
- Bilateral sensorineural hearing loss. Genetics, exposure to loud sounds, and diseases like measles can lead to SNHL in both ears.
- Unilateral sensorineural hearing loss. SNHL might only affect one ear if its caused by a tumor, Menieres disease, or a sudden loud noise in one ear.
- Asymmetrical sensorineural hearing loss. Asymmetrical SNHL occurs when theres hearing loss on both sides but one side is worse than the other.
Doctors use several types of tests to properly diagnose sensorineural hearing loss.
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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.