Hearing loss

Causes

Hearing loss can be present at birth (congenital) or become evident later in life (acquired deafness). The distinction between acquired and congenital deafness specifies only the time that the deafness appears.

Risk Factors

According to the Journal of Pediatrics, 12.5% of kids between the ages of 6 and 19 suffer from loss of hearing as a result of using ear phones/buds turned to a high volume. Young people are actually vulnerable to hearing loss due to their excessive use of listening to music at overly high/ loud volumes (using personal music systems/ music at discotheques). Exposure to loud noise in certain occupations from sources such as construction machinery, heavy equipment, or amplified music can cause permanent sensorineural hearing loss in people of all ages and is the second most common cause of hearing loss. Other sources of excess noise include attendance at concerts and nightclubs, and use of music headphones, household power tools, or firearms. The louder the noise and the longer a person is exposed to it, the greater their risk of this type of hearing loss. To prevent this type of hearing loss it is important to wear proper hearing protection and avoid exposure to loud noise whenever possible.

Symptoms

The first sign of hearing loss is a difficulty in hearing speech clearly in certain daily life situations. For example, difficulty with cross-conversations, hearing at a distance such as in meetings, listening to the TV or radio, or hearing in large buildings where there may be echoes such as in churches or auditorium. Other signs include difficulty in hearing certain speech sounds or tones clearly. For example, you may be unable to distinguish similar sounding words or hear higher pitched voices, such as those of children. Aging is a very common cause of hearing loss. Usually hearing loss is first noticed by others around you. Detecting and treating hearing loss early is a significant step towards improving the quality of your life. If you feel you have trouble understanding speech in any two different situations of life or more, it is time for you to visit an Audiologist. Experience and the research suggests that untreated hearing loss can lead to a variety of complications, the most common one being the less (treatment) responsive hearing loss, over time. Other immediate complications include getting isolated in the immediate family, workplace and society and less productivity at the work place.

Diagnosis

Audiometry is the testing of hearing capacity that quantifies the total hearing/loss. There are various different ways to test hearing depending on the age of the person involved and the type of hearing loss. In order to test middle ear condition, it is customary to administer Impedance testing in some cases. To determine the degree of hearing loss of an individual, a series of tests needs to be done by certified audiologist.  Based on the degree of loss hearing can be classified as –

• Mild: 25-40 dB HL
• Moderate:  41-55 dB HL
• Moderately Severe:  56-70 dB HL
• Severe: 71-90 dB HL
• Profound> 90 dB HL

Babies and young children are obviously not able to say when they have heard a sound (like adults do), so special methods are used. In children the principles of testing may be the same, but the way in which the tests are carried out may be varied to get the most accurate results. There are also additional tests which help to check how well the middle ear and the brain are working in the hearing pathway. Two common tests are used to screen newborn infants for hearing loss:

• Auditory brain stem response (ABR) test: This test uses patches, called electrodes, to see how the auditory nerve reacts to sound.
• Otoacoustic emissions (OAE) test: Microphones placed into the baby’s ears detect nearby sounds. The sounds should echo in the ear canal. If there is no echo, it is a sign of hearing loss.

Testing in older children and adults Testing in adults mainly uses a technique called pure tone audiometry. This uses a machine called an audiometer to play a series of tones through headphones. The tones vary in pitch (frequency, measured in hertz) and loudness (intensity, measured in decibels). The health professional conducting the test will control the volume of a tone and reduce its loudness until you can no longer hear it. The results of the test are plotted on a special graph called an Audiogram which helps to show the pattern of any hearing loss.

Treatment

The first step is to have a routine hearing check for monitoring the hearing loss and to take appropriate steps to maintain the amount of hearing ability left. It is recommend one get frequent and regular checks, hearing rehabilitation strategies or the use of hearing instruments. Acquiring a hearing aid is not a decision made lightly and you must visit a good audiologist who can help you choose the best way to help you hear better. 

Complications

A gradual hearing loss can often make people feel isolated as they find it difficult to carry on conversations with family or friends. One of the main impacts of hearing loss is on the individual’s ability to communicate with others. Spoken language development is often delayed in children with deafness. Limited access to services and exclusion from communication can have a significant impact on everyday life, causing feelings of loneliness, isolation and frustration, particularly among older people with hearing loss. Importantly, it can also increase risk both at home and in the workplace, for example, not hearing a warning alarm. If a person with congenital deafness has not been given the opportunity to learn sign language as a child, they may feel excluded from social interaction. Hearing care in India is at a nascent stage for various reasons like the discomfort of wearing a hearing aid, the unawareness to problems related to hearing deficiencies. However, with various developments in technology today we are able to provide customized hearing care solutions