Hearing loss is when you’re unable to partially or completely hear sound in one or both of your ears. Such loss typically occurs gradually over time. Other names for hearing loss are – decreased hearing, deafness, loss of hearing & conductive hearing loss.
You can have hearing loss in one ear (unilateral) or both (bilateral). The type depends on where damage occurs within the hearing system.
• Conductive: Something blocks sound from passing through the outer ear (ear canal) or middle ear (area containing the three tiny ear bones: malleolus, incus and stapes). The block may be an ear infection, earwax or fluid in the ear. Loud noises may sound muffled, and soft sounds can be hard to hear. Medicine or surgery often helps.
• Sensorineural: It affects the inner ear (cochlea) or auditory nerve. Loud noises, diseases or the aging process often cause it. Children are prone to this type due to congenital conditions (present at birth), trauma during childbirth, head injuries or infections. Sensorineural hearing loss is often permanent. Hearing aids and hearing assistive devices can help.
• Mixed: Some people have both conductive and sensorineural hearing loss. A head injury, infection or inherited condition can cause mixed hearing loss. You may need treatments for both types of hearing loss.
It could happen gradually. You might not even notice you’re losing your hearing.
Most people don’t have any pain with hearing loss. Instead, you might notice you:
• Ask people to repeat themselves often.
• Can’t follow a conversation (especially on the telephone or at a restaurant) or think other people mumble.
• Can’t hear certain high-pitched sounds, like birds singing.
• Need to turn up the volume on the TV or radio.
• Experience ringing in the ears (tinnitus), pain (earache), a fluid sensation or pressure inside the ear.
• Have balance problems or dizziness.
Signs of hearing loss in children include:
• Not startling at loud noises.
• Not turning toward sounds or when you say the child’s name (after a child is 6 months of age).
• Responding to some but not all sounds.
• Saying “huh?” a lot.
• Speech delays, such as not saying “dada” or “mama” by age 1.
To understand how hearing loss occurs, it can be helpful to first understand how you hear.
How you hear?
Your ear consists of three major areas: outer ear, middle ear and inner ear. Sound waves pass through the outer ear and cause vibrations at the eardrum. The eardrum and three small bones of the middle ear amplify the vibrations as they travel to the inner ear. There, the vibrations pass through fluid in a snail-shaped structure in the inner ear (cochlea).
Attached to nerve cells in the cochlea are thousands of tiny hairs that help translate sound vibrations into electrical signals that are transmitted to your brain. Your brain turns these signals into sound.
How hearing loss can occur?
Causes of this loss includes –
• Damage to the inner ear.
Aging and exposure to loud noise may cause wear and tear on the hairs or nerve cells in the cochlea that send sound signals to the brain. When these hairs or nerve cells are damaged or missing, electrical signals aren’t transmitted as efficiently, and hearing loss occurs.
Higher pitched tones may become muffled to you. It may become difficult for you to pick out words against background noise.
• Gradual buildup of earwax.
Earwax can block the ear canal and prevent conduction of sound waves. Earwax removal can help restore your hearing.
• Ear infection and abnormal bone growths or tumors.
In the outer or middle ear, any of these can cause hearing loss.
• Ruptured eardrum (tympanic membrane perforation).
Loud blasts of noise, sudden changes in pressure, poking your eardrum with an object and infection can cause your eardrum to rupture and affect your hearing
Risk factors –
Factors that may damage or lead to loss of the hairs and nerve cells in your inner ear includes –
• Aging. Degeneration of inner ear structures occurs over time.
• Loud noise. Exposure to loud sounds can damage the cells of your inner ear. Damage can occur with long-term exposure to loud noises, or from a short blast of noise, such as from a gunshot.
• Heredity. Your genetic makeup may make you more susceptible to ear damage from sound or deterioration from aging.
• Occupational noises. Jobs where loud noise is a regular part of the working environment, such as farming, construction or factory work, can lead to damage inside your ear.
• Recreational noises. Exposure to explosive noises, such as from firearms and jet engines, can cause immediate, permanent hearing loss. Other recreational activities with dangerously high noise levels include snow mobiling, motorcycling, carpentry or listening to loud music.
• Some medications. Drugs such as the antibiotic gentamicin, sildenafil (Viagra) and certain chemotherapy drugs, can damage the inner ear. Temporary effects on your hearing — ringing in the ear (tinnitus) — can occur if you take very high doses of aspirin, other pain relievers, antimalarial drugs or loop diuretics.
• Some illnesses. Diseases or illnesses that result in high fever, such as meningitis, may damage the cochlea.
Hearing loss vs. deafness
It is important to distinguish between the different levels of hearing loss.
• Hearing loss: This is a reduced ability to hear sounds in the same way as other people.
• Deafness: This occurs when a person cannot understand speech through hearing, even when sound is amplified.
• Profound deafness: This refers to a total lack of hearing. An individual with profound deafness is unable to detect sound at all.
• Having hearing loss can make you feel disconnected from the world around you. You may become frustrated, irritable or angry. People with severe stage of loss can become anxious or depressed.
• Children with this problem may struggle in school and get poor grades.
• Studies also show a link between hearing loss in older adults and dementia.
• Your provider will ask about your symptoms and do a physical exam. They check for signs of infection or other issues that could cause this difficult situation.
To measure hearing loss, a healthcare provider performs an audiogram. This hearing test measures which types of sounds you can hear. The test measures:
• Configuration: How well you hear high-pitched and low-pitched sounds.
• Degree: Measured in terms of normal, slight to severe or profound hearing loss.
• Type: Constructive, sensorineural or mixed.
If you have an injury or a possible tumor, you may get a CT scan or MRI.
It’s treatments often depend on the type and degree of hearing loss. Treatments includes –
• Hearing assist devices
These devices help restore hearing. Hearing aids are devices worn on or inside the ear to amplify sound. Healthcare providers surgically implant cochlear implants into the inner ear to treat inner ear hearing loss.
• Hearing rehabilitation
Also called audiologic rehabilitation, this therapy helps you adjust to hearing loss and hearing aids. A therapist also can help you learn to use visual cues and lip reading to improve communication.
• Listening devices
Devices can make it easier to hear the telephone, television or videos on your computer.
Hearing loss caused by ear infections may improve with antibiotics. Corticosteroids can ease the swelling of cochlear hair cells after exposure to loud noise. If medications are causing your problem, your provider may prescribe a different drug.
Your provider may place ear tubes in the eardrum. Ear tubes treat chronic middle ear infections that contribute to hearing loss. Providers also perform surgeries to remove tumors, repair birth defects and place cochlear implants.
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