Adult Hearing Loss


A hearing loss is the partial or total inability to hear sounds in one (unilateral) or both (bilateral) ears.  Hearing loss occurs when any part of the ear (outer ear, middle ear, inner ear, hearing (acoustic) nerve, and auditory system) is not functioning properly.  Hearing loss can be described in 3 categories:  type of hearing loss (conductive, sensorineural and mixed), severity of hearing loss (mild, moderate, severe, profound), and configuration (shape) of hearing loss – this refers to the pattern and degree of hearing loss depicted on an audiogram (a graph that shows results of a pure-tone hearing test).  Hearing loss can occur suddenly or gradually over time and can be due to any number of causes (see below).

Conductive hearing loss occurs when sound is not being conducted properly anywhere from the outer ear – ear canal – tympanic membrane (ear drum) – ossicles (3 tiny bones: malleus, incus, stapes) of the middle ear.  The possible causes for a conductive hearing loss can be: impacted earwax (cerumen), fluid in the middle ear, ear infection (otitis media), allergies (serous otitis media), perforated tympanic membrane (whole in ear drum), presence of a foreign body, malformation or absence of the outer ear, ear canal or middle ear, and benign tumors.  A conductive hearing loss can often be corrected medically or surgically.

Sensorineural hearing loss (SNHL) occurs when there is damage to the inner ear, the acoustic nerve to the brain.  The possible causes of a SNHL can be:  excessive noise exposure (most common), aging (presbycusis), ototoxic drugs (ie: cisplatin), genetic or hereditary, illnesses and malformation of the inner ear.  This type of hearing loss is often not correctable with medicine or surgery – it is typically a permanent hearing loss. A sensorineural hearing loss is often best managed with amplification (hearing aids).

Mixed hearing loss is a result of both a conductive and sensorineural hearing loss.  Simply put, damage may have occurred in the outer or middle ear and in the inner ear (cochlea) or auditory nerve.

**Please Note** 

Should you experience a SUDDEN HEARING LOSS (less than 3 days) – you should contact your physician immediately as this is a medical emergency and could suggest a viral infection. This usually occurs only in one ear.


Teenangers

A new national study found that one in five teens has “lost a little bit of hearing” and the problem appears to be increasing substantially in recent years.


Here are some examples of noise that may affect a teen (all over 60 decibels):


By: BkCreative

The hair dryer – (77 to 92 decibels) – many teens use a hair dryer daily.

The rock concert – (89 to 120 decibels) – it’s been years since I have been to an indoor rock concert. I was thrilled to get nearly front row seats – but when I left I could not hear for the rest of the evening. Our teens, of course, love a good indoor loud concert.

The lawn mower – (86 to 99 decibels) – if you’ve tried to sleep late on the weekend, only to hear your neighbor cutting grass at 7am, you know how loud these monster machines can be. If you send your teen out to cut the grass, be aware if the teen takes an MP3 player. Chances are the MP3 player will be turned to maximum volume to compensate for the noise of the mower, or other lawn equipment. A double whammy!

The movie theater – (72 to 104 decibels) – I suspect a love story may be a bit quieter, but if you sit through one of those car chase, bomb everything, shoot ’em ups, I am sure they reach the top of this decibel range. Teens tend to like action flicks.

The NYC subway – (83 to 112 decibels) – I am a native NYer and I can attest to the noise underground. Do this five days a week and I am sure this is one of the leading causes of stress in NYers. Many teenagers here in the city travel to school by subway.

Sporting Events – (89 to 115 decibels) – I remember going to Shea Stadium to a baseball game and I did it just one time because the screaming and yelling was overwhelming (not to mention the beer swilling, toilet paper throwing, etc.) Teenagers love sporting events and many are held indoors.

You can also add to the list, a fun-filled night at a dance club or house party, where the music is turned up so loud that it aids in energizing the crowd and is considered “fun”. Technology (like IPods, car stereos, sound systems) is ever changing and advancing in its sound sophistication and volume, so go ahead and enjoy being a teenager, just do it in a smart and responsible manner. Teenagers have many wonderful experiences and opportunities ahead of them in life; so take care of your ears by using proper ear protection when engaging in life’s (noisy) adventures.



Infants/Children


The human ear begins development around the 22nd week of gestation and fully functional at birth.  Babies are able to hear the sounds around them as soon as they are born.  Within a few weeks of life, a baby’s ears collects information, which in turn, fosters brain development.  A baby’s hearing is vitally important because it will allow them to process information, and understand and learn to effectively communicate in the world around them.

Research suggests that approximately 3 in every 1,000 newborns can have hearing loss at birth, which is why newborns should have their hearing screened before being discharged from the hospital.  If an infant fails a hearing screening, they are at risk for hearing loss and should be referred for a comprehensive audiologic (hearing) evaluation by visiting their audiologist.  It is recommended that once hearing loss is identified in infants, that it be treated (if possible) or receive early intervention (before 6 months of age) so the infant has a better chance of reaching their full potential and start school at equivalent skill levels as their peers.  Otherwise, late diagnosis of a child’s hearing loss may cause them to experience irreversible and permanent impairments in their speech, language, cognitive abilities and social skills.

Preschoolers and school-age children are periodically screened at their doctor’s office (usually pediatrician and audiologist) or their schools.



The audiogram above shows where the speech and different environmental sounds fall on the graph. Please note the frequency (pitch) and decibel (dB – volume) levels of the speech sounds we make – it is referred to as a Speech Banana (for obvious reasons).

The Better Hearing Institute (BHI) recently released a study entitled, “Are 1 Million Dependents in America with Hearing Loss Being Left Behind?

They report the following findings:

* Historically 50 percent of infants who failed an initial hearing screening were not brought in for their follow-up evaluation with a detailed hearing test.

* Only 12 percent of children under the age of 18 with hearing loss use hearing aids, yet an estimated 1.5 million youths (including adult dependents) under the age of 21 have hearing loss that may be improved with amplification.

* Three in ten parents (32%) cite embarrassment or other social stigma issues as a reason their children do not use hearing aids.

* Many parents were advised inappropriately that their children could not be helped because they had sensorineural hearing loss.

* One in five parents cannot afford hearing aids for their children.

* There is a tendency to minimize the impact of “mild” or even “moderate” hearing loss, as well as unilateral hearing loss (hearing loss in one ear) among children despite the well known (negative) impact it has on their language, academic, and emotional development.


FACT CHECK:

Decibels (dB) is used to measure sound level.  On the audiogram (above), you can see that 0dB is the quietest sound a person hears, 60dB is the average level for normal conversation and a gunshot at close range can reach 140dB.  According to National Institute for Occupational Safety and Health (NIOSH), sounds levels less than 80dB is considered safe to listen to (see graph below) – however, any sounds above 85dB can hurt your ears and even damage sensitive hair cells in the cochlea.  It cannot be said enough that exposure to loud sounds can result in hearing loss, tinnitus and hyperacusis – more poignant is the fact that these issues can be prevented in approximately 30% of the population.

According to a recent survey, there are more than 30 million adults in the United States with hearing loss. As discussed above, there are many causes for hearing loss.  Some people have age-related hearing loss (also known as presbycusis).  Many of these people (usually after age 60) are not aware they have hearing loss, nor its severity, because their hearing decreases so slowly over time.  People with presbycusis are usually made aware of their hearing loss because family members, friends and/or co-workers bring it to their attention.   They typically have more difficulty hearing high-pitched tones (children/women voices, and speech sounds like f, s, th, sh) as opposed to low-pitched tones (men’s voices).  Other causes may include: otosclerosis, Meniere’s disease, trauma to any part of the ear, acoustic neuroma, drugs (anticancer chemotherapy drugs, antibiotics, antimalaria drugs).

**Please note**  Individuals taking any of the three erectile dysfunction drugs – Cialis, Viagra, Levitra – may be at high risk for sudden hearing loss.  A blood pressure medication called Revatio may also cause sudden hearing loss because it contains the same active ingredient as the other drugs mentioned.  Please consult your physician immediately.

Each person is unique and so are their hearing healthcare needs.  Communication skills are central for all individuals maintaining a productive life.  Hearing loss can negatively impact one’s overall well-being on a personal, social and professional level if not addressed.  Although in many cases, hearing loss cannot be corrected with medications or surgery, hearing aids can significantly improve your hearing and quality of life.  Other viable options available are assistive listening devices (ALD) and cochlear implants.

Consult your physician and/or audiologist regarding any ear/hearing problems you are experiencing so that the best hearing healthcare plan can be tailored and implemented to resolve your issue(s).