Hearing Loss

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What Is Hearing Loss and How Is It Caused?​

Hearing loss or hearing impairment is the inability to hear, and it can be total or partial and present in one ear (unilateral) or both ears (bilateral).

Hearing loss may be present at birth, gradually acquired over your lifetime, or it may even happen suddenly. Hearing impairment is therefore often described as either congenital or acquired.

One thing is for sure you are not alone if you suffer from hearing impairment. In 2016 there was estimated to be 880,350 people in New Zealand with hearing loss or almost 19 per cent of all people. Men are more likely to have hearing loss, with 472,961 sufferers, and there were 407,388 females.

The economic and loss of wellbeing cost of hearing impairment in NZ was estimated to be $4.9 billion in 2016.

Congenital Hearing Loss

Congenital causes of hearing loss are present at birth or soon after. Hearing impairment may be caused by hereditary and non-hereditary genetic determinants or by specific complications throughout pregnancy and childbirth, including:

  • infections during pregnancy like maternal rubella or syphilis
  • low birth weight
  • a deficiency of oxygen during birth (birth asphyxia)
  • inappropriate use of particular drugs during pregnancy, such as cytotoxic drugs, antimalarial drugs, aminoglycosides, and diuretics
  • severe jaundice in the neonatal stage, which can harm the hearing nerve in a newborn baby.

Acquired Hearing Loss

Acquired causes of hearing impairment may happen at any age and can include:

  • infectious diseases including measles, meningitis, and mumps
  • chronic ear infections
  • specific drugs used in the treatment of neonatal conditions, malaria, drug-resistant tuberculosis, and cancers
  • injury to the ear or head
  • excessive industrial noise from farm machinery, building sites and explosions
  • repeated and prolonged exposure to personal audio devices at high volumes

Temporary Hearing Loss

Hearing loss can be temporary or permanent, depending on the cause. Temporary hearing impairment is more likely to be associated with conductive causes or obstruction, or damage to the outer or middle ear that inhibits sound from being carried to the inner ear.

Causes of temporary hearing loss include:

  • impacted earwax
  • surfer’s ear
  • swimmer’s ear
  • glue ear
  • ear canal stenosis or a narrowing of the ear canal
  • ruptured eardrum
  • ear infection
  • Eustachian tube dysfunction
  • thickening of the tympanic membrane called tympanosclerosis.

Managing Hearing Loss

There is no cure for permanent hearing loss, but there are many effective ways to manage it.

Management options include hearing aids, cochlear implants, brain stem implants, assistive technology, and closed captioning and subtitles. The degree and type of your hearing loss and your personal preference will help to determine the management option most suitable for you.

Hearing Loss Types

Hearing loss type is categorised according to the site of the lesion.

Sensorineural hearing loss, affecting the inner ear, auditory nerve or central auditory pathway.

Conductive hearing loss, affecting the outer or middle ear.

Mixed hearing loss, which is a combination of conductive and sensorineural hearing loss.

Accompanying and Secondary Symptoms of Hearing Loss

Of course, the main symptom of hearing is that you have trouble hearing. However, there are some other signs and symptoms that indicate a hearing impairment might be present.

Most people have experienced a blocked feeling inside their ears which is called occlusion. Usually, this feeling is temporary, but it may be an accompanying symptom of hearing loss if it persists. Pain or pressure in your ear is also an accompanying symptom.

Secondary symptoms include:

  • tinnitus, ringing, buzzing, or other sounds in the ear when no outside noise is present
  • hyperacusis, a rare hearing disorder of reduced tolerance to sound with accompanying auditory pain to specific intensities and frequencies of sound
  • vertigo, the feeling that you or your surroundings are moving, but they’re not
  • disequilibrium or a dizziness feeling of an impending fall or of the need to obtain external assistance to be able to move properly
  • increased hearing of one’s own voice and respiratory sounds, usually due to a constantly open eustachian tube or the tremor of the soft palate or muscles of auditory ossicles.

How Is Hearing Loss Measured?

Hearing loss is measured in decibels (dB). When your audiologist talks about your degree of hearing loss, they will describe it as a range from mild to profound. The degrees include:

  • Mild (26 – 40 dB) – quiet speech, such as a child’s voice, may be difficult for you to detect or interpret accurately.
  • Moderate (41 – 55 dB) – having a one-to-one conversation is challenging and tiring, especially in background noise as you might experience in a crowded room or busy cafe.
  • Moderately severe (56 – 70 dB) – it’s hard to understand conversations in most scenarios, particularly if you don’t have direct eye contact with the speaker.
  • Severe (71 – 90 dB) – conversational speech is inaudible.
  • Profound (91+ dB) – most sounds, including speech, are unable to be heard.

After you have a diagnostic hearing test, your audiologist will be able to inform you of the level of your hearing impairment. They will also advise you on the cause of your hearing loss, if it requires further investigation, and any possible treatment options, including hearing aids if appropriate.

Have You Been Ignoring Your Hearing Loss?

There’s nothing quite like hearing loss. It happens gradually. So slowly, in fact, most people don’t take much notice until it starts to have a profoundly negative impact on our lives. Life’s just too short to ignore and evade your hearing health.

Did you know most people wait an average of 10 years after being diagnosed with hearing loss before they decide to do something about it?

Many people find it hard to come to terms with the idea of wearing hearing aids. They put off the decision and only do something about it when the problems associated with poor hearing become too much for them.

A bit of uncertainty about the actual condition of one’s hearing is pretty standard. You can follow a conversation easily while facing someone, but if there are lots of people talking, and you can’t see someone’s face as they speak, it’s hard to follow the conversation.

Often it’s the people we talk to regularly that take note and might politely point out perhaps our hearing is not quite as good as we think it is.

All the people in your life telling you to turn down the TV really do mean well. Because the earlier you do something about your hearing loss, the better. Even when hearing is just starting to deteriorate, hearing aids help to maintain the neural pathways in your brain responsible for decoding all of the sounds you hear.

Simply put, hearing keeps your brain active, which in turn keeps your brain healthy.

An indifferent man with hearing loss ignores the pleas of his wife
Most people wait an average of 10 years after being diagnosed with hearing loss before they decide to do something about it.

5 Sensory Signs You Need a Hearing Check

If you experience any or all of these sensory symptoms, it’s a good indication you need to take action about your hearing.

  1. Phone calls are hard work! Do you find it difficult to understand phone conversations clearly?
  2. Your TV volume is turned up to 11. Do family or friends complain about the volume when you are listening to the radio or television?
  3. It’s difficult to hear in noisy places. Is it a struggle for you to follow a conversation in a restaurant or when there is a lot of noise around you?
  4. Eye contact is essential. Do you hear much better when you can look at the person talking to you?
  5. Being social is exhausting! Are you often exhausted after social outings because listening is such an effort?

Be Proactive About Your Hearing Health

As your age increases, your quality and enjoyment of life need not decrease. All you need is a little luck and to establish some preventative measures. Sure, it takes a bit of effort, and that’s partly because living to an advanced age is a relatively recent achievement.

The average human life span gained more years during the 20th century than in all prior millennia combined. In many ways, we’re still becoming used to getting “old”.

There are many ways to lose touch with our youth, both physically and philosophically. The good news is with your hearing it doesn’t have to be that way. That is if you decide to do something about it.

Author Bio

Ron Trounson
Ron Trounson
Ron Trounson holds a Master of Audiology (with Distinction) from the University of Canterbury. He has been in the hearing industry since 2010 and has a broad knowledge of ear disorders, hearing loss, hearing aids and specialised hearing devices.

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