Hearing Loss

Hearing loss affects millions worldwide, manifesting in various forms and severities, from partial hearing loss in one ear to total deafness. It's a condition that touches all ages and is driven by genetic predispositions, environmental factors, and lifestyle choices. Understanding the initial signs of hearing loss, the underlying causes, and the available treatments can empower individuals to seek timely intervention, enhancing their overall well-being and connectivity with the world around them. 

What is Hearing Loss? 

Hearing loss is a prevalent medical condition that affects people of all ages, from newborns to older adults. Its prevalence and severity tend to increase with age, making it nearly ubiquitous in the 70+ age group. The consequences of untreated hearing problems can significantly impact one's quality of life, influencing communication, social interactions, and even mental health. 

Different types of Hearing Loss 

The following are three main types of hearing loss: 

• Sensorineural Hearing Loss: This hearing loss occurs when some of the hair cells within the cochlear or the auditory nerve become damaged. It is the most common form of hearing loss and can result from ageing, exposure to loud noises, injury, disease, certain medications, or an inherited condition. 
• Conductive Hearing Loss: This hearing loss develops in the outer or middle ear, where sound cannot travel all the way to the inner ear. Sound waves may be blocked by earwax or due to a foreign object in the auditory canal, fluid in the middle ear space, abnormalities in the bones of the middle ear, or a perforated eardrum. 
• Mixed Hearing Loss: Sometimes, people may have sensorineural hearing loss and develop an additional conductive component. 

Symptoms of Hearing Loss 

Some common signs and indicators include: 

• One of the initial hearing loss symptoms is struggling to understand speech, particularly in noisy environments or when multiple people speak simultaneously. 
• High-pitched sounds like children's or women's voices may become muffled or unclear. Frequently ask others to repeat themselves and speak more slowly or clearly. 
• People with hearing loss often experience difficulty distinguishing consonant sounds like "s," "f," "th," and "sh," which can make it challenging to follow conversations. If you need to increase the volume on your television, radio, or other audio devices to a level that others find uncomfortably loud, it may indicate a hearing problem. 
• Individuals with hearing loss may start withdrawing from social situations or avoid crowded environments because they find it challenging to follow conversations. 
• Continuous or intermittent ringing, buzzing, or hissing sounds in the ears, known as tinnitus, can be an indicative symptom of hearing loss. 
• The feeling of fullness or pressure in the ears.

What Causes Hearing Loss 

The causes of hearing loss can be broadly categorised based on different life stages: 

• Prenatal Period: 
  • Genetic components, including hereditary and non-hereditary hearing impairment 
  • Intrauterine infections, like rubella and cytomegalovirus infection 
• Perinatal Period: 
  • Birth asphyxia (lack of oxygen at birth) 
  • Hyperbilirubinemia (severe jaundice in the neonatal period) 
  • Low birth weight 
• Childhood and Adolescence:
  • Chronic ear infections (chronic suppurative otitis media) 
  • Fluid accumulation in the ear (chronic non-suppurative otitis media) 
  • Meningitis and other infections 
• Adulthood and Older Age: 
  • Chronic diseases 
  • Otosclerosis (abnormal bone overgrowth in the middle ear) 
  • Age-related sensorineural degeneration 
  • Sudden sensorineural hearing loss 
• Factors Across the Life Span:
  • Earwax impaction 
  • Trauma to the ear or head 
  • Exposure to loud noise or sounds 
  • Ototoxic medications 
  • Work-related ototoxic chemicals 
  • Nutritional deficiencies 
  • Viral infections and other ear conditions 
  • Delayed onset or progressive genetic hearing loss 

Risk Factors 

• Damage to the inner ear due to ageing or loud noise exposure leads to wear and tear on the hair cells or nerve cells in the cochlea, resulting in hearing loss. 
• Ear infections, unusual bone growths, or tumours in the outer or middle ear Smoking can significantly affect the hair cells or nerve cells in the cochlea. 
• Ruptured eardrum (tympanic membrane perforation) caused by loud blasts of noise, sudden pressure changes, poking with an object, or infection. 

Diagnosis

The diagnostic process involves the following steps: 

• Medical History and Physical Examination: Doctors will gather information about your medical history, including when the symptoms first appeared, whether the hearing loss affects one or both ears or a family history of hearing problems. They may also inquire about ongoing medications and previous ear infections or conditions. 
  • During the physical examination, the otolaryngologist uses an otoscope (a handheld device with a magnifying lens and a light source) to examine the ear canal and eardrum for structural damage, earwax buildup, or other obstructions. They may also use a tuning fork to conduct preliminary hearing tests and narrow down the potential hearing loss causes. 
• Audiometric Hearing Tests: 
  • Audiologists conduct various hearing tests, also known as audiometric tests, to determine the location and nature of the hearing loss, such as: 
  • Pure-Tone Audiometry: It helps identify the specific frequencies and levels at which hearing is impaired. 
  • Speech Audiometry: During this test, the doctor may ask you to repeat words or sentences presented at different volumes to assess your ability to understand speech. 
  • Bone Conduction Testing: This test helps distinguish between conductive and sensorineural hearing loss. 
  • Tympanometry and Acoustic Reflex Testing: These tests assess the middle ear anatomy, functionality and related structures by measuring the eardrum's movement and response to loud sounds. 
  • Otoacoustic Emissions (OAEs): OAEs help evaluate the function of the cochlea (inner ear) by measuring the faint sounds produced by healthy hair cells in response to specific tones. 
• Imaging Tests: 
  • Magnetic Resonance Imaging (MRI): An MRI scan helps examine the inner ear and auditory nerve for abnormalities or tumours. 
  • Computed Tomography (CT) Scan: A CT scan can provide detailed images of the middle ear structures, helping identify any obstructions or abnormalities. 

Treatment 

The hearing loss treatment depends on the underlying cause and severity of the condition, including: 

• Hearing Aids: These devices amplify sounds, making them louder and easier for the inner ear to process. 
• Assistive Listening Devices (ALDs): Assistive listening devices (ALDs) enhance sound accessibility for individuals with varying degrees of hearing impairment. One can use them with or without hearing aids, bone-anchored implants, or cochlear implants. 
• Cochlear Implants: Doctors may suggest a cochlear implant when the inner ear or cochlea is damaged. It directly stimulates the auditory nerve, enabling sound perception. 
• Aural Rehabilitation: It involves various techniques and strategies, such as lip-reading, auditory training, and speech-reading. 

Complications 

Untreated hearing loss can impact various aspects of an individual's life, including cognitive function, physical well-being, and emotional health, such as: 

• Struggling to decipher incomplete or distorted sounds can lead to cognitive overload, known as listening fatigue. Over time, this strain may increase your risk of cognitive decline and dementia. 
• People with untreated hearing loss may experience higher stress levels, leading to increased blood pressure and even heart disease. 
• Furthermore, the balance between our visual and auditory systems helps maintain our physical stability. Distorted auditory signals may disrupt this equilibrium, increasing the risk of falls and injuries. 
• Hearing loss can cause anxiety, depression, and social isolation. 

When to see a doctor 

Seek medical guidance promptly if you experience any concerning symptoms related to your hearing, such as: 

• A sudden loss of hearing, either partial or complete, within a span of three days or less 
• Difficulty understanding conversations, especially in noisy environments 
• Frequently asking others to repeat themselves 
• Struggling to hear high-pitched sounds or consonants 
• Ringing, buzzing, or whooshing sounds in the ears (tinnitus) 

Hearing Loss Prevention 

While some causes of hearing loss may be unavoidable, you can take several proactive steps to protect your ears and minimise the risk of noise-induced or age-related hearing damage, such as: 

• Avoid environments with excessive noise levels, such as construction sites, concerts, or loud machinery, whenever possible. 
• Use hearing protection aids, such as earplugs and earmuffs. 
• If you cannot avoid a noisy environment, limit the amount of time you spend in it. Give your ears a rest from the noise. 
• Be careful of the volume levels when listening through headphones or earbuds. 
• If you smoke, quitting can help protect your hearing health and provide numerous other health benefits. 
• Avoid using cotton swabs, pens, or other sharp items to clean your ears. 
• Have your hearing tested periodically, especially if you have a family history of hearing loss, work in a noisy place, or notice any changes in your hearing 

Conclusion 

Hearing loss is a complex condition with far-reaching effects on cognitive, social, and emotional well-being. Understanding its causes, recognising symptoms early, and embracing available treatments can significantly improve outcomes. The journey to better hearing health doesn't end here-it's an ongoing process of awareness, prevention, and adaptation. 

FAQs

1. Is hearing loss common? 

Hearing loss is a prevalent medical condition affecting individuals of all ages. Its prevalence and severity tend to increase with age. 

2. How do you deal with loss of hearing? 

Taking professional evaluation from an audiologist or ENT doctor is crucial for determining the cause and appropriate treatment options. Assistive listening apparatuses (hearing aids or cochlear implants) help improve communication and quality of life. 

3. Can hearing loss be reversed?

Certain types of hearing loss, like conductive hearing loss caused by earwax buildup or middle ear infections, can be temporary and reversible with appropriate treatment. However, sensorineural hearing loss is permanent and irreversible. 

4. How can I improve my hearing?

There are several steps you can take to improve your hearing health and potentially prevent further hearing loss: 

• Avoid exposure to loud noises and wear proper hearing protection when necessary. 
• Maintain ear hygiene and avoid inserting objects into the ear canal. 
• Quit smoking and avoid secondhand smoke. 
• Consume a healthy meal rich in vitamins and minerals. 
• Undergo regular hearing screenings to detect any changes in your hearing. 

5. What's the difference between hearing loss and deafness? 

Hearing loss indicates a diminished ability to hear sounds, ranging from mild to profound. Deafness, on the other hand, is a profound or complete loss of hearing. Individuals with hearing loss may benefit from assistive devices like hearing aids, while those who are deaf rely on sign language and other visual communication methods. 

6. Is hearing loss a disability? 

Hearing loss can be considered a disability, depending on the severity of hearing loss and its impact on an individual's daily life. 

CARE Medical Team