Ear is one of the well designed sense organs which connect us to the world of communication. Human ear hears sounds in the range of 20Hz to 20,000Hz. Good hearing leads to better quality of life
Approximately, 10% of Indian population is estimated to be suffering from hearing problems, unfortunately, 80% of them are in denial.
You may be suffering from poor hearing if you
- Ask for frequent repetitions.
- Have difficulty hearing sounds of nature ,such as rustling of leaves , birds chirping or rain drops
- Have trouble hearing when you are in a group or there is background noise.
Think others mumble
- Fail to hear someone talking from behind
- Turn up the volume on the TV or Radio
- Have difficulty hearing on phone
- Have trouble hearing alarm clock
Causes of Hearing loss
Hearing loss can occur due to a problem in the external ear, middle ear, and/or the inner ear.
Conditions of the External Ear
Wax: A build up of wax in the external ear canal can sometimes cause hearing loss. This condition would easily resolve when the wax works its way out by itself or when it is removed manually by a professional.
Conditions of the Middle Ear
Glue ear: This condition is most common in children. This refers to a condition where there is fluid collection behind the ear drum. This can be caused by malfunction of the Eustachian tube (the tube that connects the middle ear and the back of the nose and helps in ventilating the middle ear). The fluid in the ear hampers the vibration of the bones and the ear drum causing a hearing loss. This condition resolves by itself in many cases but sometimes requires medical treatment (eg, insertion of grommet). Usually, hearing improves when the fluid clears. Sometimes, hearing aids are provided depending on the impact of hearing loss until the surgery. This condition is more common in the winter months.
Otosclerosis: This is a condition where there is excess bone formation/accumulation around the last of the three tiny bones (Stapes/Stirrup) in the middle ear. Conduction of sounds through the bones is reduced due to limited movement of the bones, leading to hearing loss. Individuals with this condition are given the option of correction by surgery or use of hearing aids. This condition is more common in females specifically getting worse during pregnancy.
In some patients, the development of the ear is either incomplete or is defective. This can also lead to hearing loss.
Conditions of the Inner Ear
Noise-Induced Hearing loss (NIHL): This is the damage caused to hearing due to exposure to loud noise either over a period of time or sudden exposure to very loud noises. The severity of the hearing loss can depend on the amount of exposure. Sometimes, the ear drum perforates causing a conductive loss or it could damage the inner ear’s hair cells. The hearing loss is mainly sensorineural aid is one of the options depending on the hearing loss.
Oto-toxcitity: This refers to hearing loss induced by medication harmful to the ear. Medicines like the ”Mycin” family, aminoglyosides, Aspirin (above 80mg on a daily basis) are a few examples.
Presbyacusis: Hearing loss that develops due aging (50 years +). This is sensorineural in nature and hearing aids are usually the only options.
Meniere’s disease: This is a condition when the fluid balance is disturbed in the inner ear either due to over production or mal- absorption of the fluid. This can cause short spells of severe dizziness, sea-roaring tinnitus and fluctuating hearing loss (mostly in one ear).
Genetic causes/ syndromes: Hearing loss can also occur due to genetic causes. Hearing loss, like many other diseases can be passed on from generation to generation. Recently, many genes responsible for the cause of genetic hearing loss have been identified. Genetic counseling is a major tool in reducing gene related hearing impairment. Hearing loss can also occur with other gene related disorders like cleft palate and blindness.
Auto-immune disease: Auto-immune disease is a condition when one’s body’s own defenses attack the organs of the body. Some of the Auto-immune diseases that can affect hearing include Cogan’s disease, systemic lupus erythematosus, Wegener’s granulomatosis, polyarteritis nodosa, relapsing polychondritis, temporal arteritis, and Takayasu’s disease.
Sudden Sensori-neural hearing loss (SSNHL): A sudden drop in hearing ability of at least 30 dBHL within 3 days period causing a sensori-neural hearing loss is classified as SSNHL. This could be due to several reasons such as viral/bacterial infection, reduced blood supply, oto-toxic drugs, auto-immune disease, metastatic tumours, polycythemia, syphilis, leukemia and sickle cell disease. Studies quote that one third of the population affected by SSNHL recover to complete normalcy.
Acoustic trauma: a very loud, brief sound such as an explosion or gunshot can cause hearing lsos.Long term exposure to noise or loud sound can lead to permanent loss
TYPES OF HEARING LOSS
Conductive hearing loss: Conductive hearing loss is caused by problems in the outer and middle ear, which can prevent sounds getting through to the inner ear. Most common causes is blockage in the ear canal, damage to the eardrum, and fluid or an infection in ME .It’s a Temporary Hearing loss can be corrected with medication/ surgery
Sensorineural Hearing Loss: This type of hearing loss happens when the delicate sensory cells or nerve fibers in the inner ear get damaged. This stops them transmitting sound properly. The most common causes of sensorineural hearing loss are the natural process of ageing or excessive exposure to noise. It’s a Permanent Hearing loss .Amplification is essential (Hearing Aids)
Screening for hearing loss is a simple procedure and can be done in all age groups. Some sections of the population are at greater risk and should be screened for hearing loss regularly
– Premature delivery
– Low birth weight
– Infantile Jaundice
– Incubated babies
– Frequent attacks of cold
– Typhoid /malaria(viral fever)
– Adult candidates for hearing screening
– Sedentary lifestyle
– Diabetes, high blood pressure, heart problem, Dementia etc.,
– Occupation at noisy places
– People who are fond of Disco & Rock concerts
– Frequent users of Ear Phones
– People working at call centre
If you’re hearing noises that others don’t, it may mean a problem inside your ear
– 15-20% of general population affected by Tinnitus
– < 70% hearing impaired affected with tinnitus - Only 10-25% seek medical attention - include buzzing, roaring, ringing, whistling or hissing sounds perceived in the ear - Intermittent, continuous or pulsatile type of tinnitus Solution for Hearing loss (SN Hl) and tinnitus
Hearing aid styles:
the behind-the-ear (BTE) hearing aid which sits behind the ear. The case is connected to an ear mold by a piece of clear plastic tubing. The ear mold is specially designed to fit inside of the user’s ear. A BTE hearing aid may be used with any degree of hearing loss and can be very flexible for use with a telephone or assistive listening device
the in-the-ear (ITE) hearing aid is smaller than the BTE hearing aid. All of the components fit inside of the plastic case which is made to fit the user’s ear. The ITE hearing aid is not always the most appropriate choice for children’s amplification because the aid must be replaced as the child grows.
the in-the-canal (ITC) hearing aid is even smaller than the ITE hearing aid, fitting entirely inside of the ear canal. The ITC is used primarily with mild-to-moderate hearing losses. It is not recommended for child’s use because of its size, and because it must also be replaced as the child grows
Receiver –In-the canal aids (RIC): These devices are very much similar to the BTE aid, the crucial difference is the speaker (Receiver) of the hearing aid is placed inside the ear canal of the user and thin electrical wires replace the acoustic tube of the BTE aid. The main benefits of this model besides being highly invisible are low distortion & smoother sound.
FAQs about hearing
What is an audiogram?
An audiogram is test of your hearing sensitivity. It is done by an audiologist. It evaluates your hearing to determine the cause of hearing loss and extent of loss.
Do hearing aids restore normal hearing????
Hearing aids don’t restore normal hearing but they do offer substantial benefit. They make sure that your hearing loss doesn’t restrict normal life activities. Properly fitted hearing aids with appropriate communication strategies can help in many listening situations
How soon should you fit the hearing aid?
It should be fitted as soon as hearing loss is detected/
Is one hearing aid is better or two?
Wearing hearing aid for one ear or both depends on your hearing loss. Hearing is designed to work best with both ears working together. Wearing two hearing aids is known as “BINAURAL FITTING “
1) better understanding in noisy places
2) Better identification of direction of sound
3) Better sound quality
4) Smoother tone quality
5) Wider hearing range
6) Better sound identification
7) Keeps both ears active
8) Listening is more pleasant
9) Feeling of balance
10) Speech understanding in noisy environments
11) Reduced need for volume
Which hearing aid is better – Analog or digital Hearing aid?
Digital hearing aids are most appropriate ones. It is the most advanced technology that allows the most precise prescriptive fitting. The hearing aids tailor the sound level to individual needs without amplifying the unwanted signals
Communication with the hearing impaired
When someone suffers from hearing loss, it is difficult (and frustrating) for them to communicate effectively with others. While there are a variety of assistive devices available to make sound louder, it is most important that proper communication techniques be practiced in order to maximize hearing and listening performance.
Some effective tips you can use when talking with someone who has a hearing problem.
– Get Their Attention
– Get the listener’s attention before speaking. Give them a topic related to the conversation so they have a better understanding of what to expect.
– Reduce Background Noise
– Try to eliminate as much background noise as possible. During conversations, turn off the radio or television. When you are in restaurants and social gatherings, choose seats or conversation areas away from crowded or noisy areas.
– Speak One at a Time
– Try to make sure only one person talks at a time. Include people with hearing loss in the conversation, but don’t talk over other people.
– Speak Clearly
– Face the person and talk clearly. Speak at a reasonable speed. Do not hide your mouth, eat, or chew gum.
– Speak Loudly
– Speak a little more loudly than normal, but don’t shout. Try to annunciate your words clearly and be conscious of the volume of your voice.
– Repeat Yourself
It is not uncommon for a person with hearing loss to shake their head as though they understand what you’ve said. Ask them if they got the information and if necessary, repeat yourself.
Rephrase your statement into shorter, simpler sentences if it appears you are not being understood.
Have Good Lighting
Stand in good lighting, use facial expressions and look at the person’s face while speaking. Even if the individual with hearing loss never studied lip-reading, they can gain a great deal of information looking at the speakers face and body language.
If you feel frustrated trying to speak to someone with a hearing loss, think for a minute how it must be for them. Try to make it easier by changing words or re-phrasing statements.
As much as you want the person with hearing loss to hear what you have to say, they want to be able to listen, understand and participate. Coping with hearing loss requires cooperative efforts.